AMERICA RENEWED 2021 by STUDIO Gannett

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AMERICA RENEWED 2021

Determined

PROTECTION Vaccine rollout underway

SUPPORT Products, services assisting recovery

ADAPTATION Remote work, school evolving

TECHNOLOGY Delivery of health care changing

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CONTENTS

202 1 S PECI A L E D ITI O N

AMERICA RENEWED

NEWS

‘WARTIME UNDERTAKING’ New administration pledges aggressive approach to COVID-19 pandemic

SHOT IN THE ARM

VEXING VARIANTS

GOING, GOING …

HELPING THE HELPERS

ALWAYS READY

Despite distribution issues, vaccinations have begun

Scientists keep watchful eyes on coronavirus mutations

Post-pandemic, some jobs may not come back

Organization supports, defends domestic workers

National Guard has multiple roles in pandemic response

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FEATURES

LOVE AND CORONAVIRUS

‘LONG-HAUL’ OR REINFECTION?

REDEFINING CLEAN

How one couple kept faith and hope while battling COVID-19

Scientists studying cases of possible reoccurrence

Coronavirus could have a lasting impact on sanitation

FIGHTING ZOOM FATIGUE Virtual reality could make remote working more engaging

MEETINVR

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PRODUCTS

REOPENING TOOLS

CLEARING THE AIR

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Procedures, devices to help businesses boost safety

Puriﬁers have become a hot consumer commodity

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GOT YOU COVERED Face masks remain an accessory of necessity

CONTRIBUTING WRITERS Matt Alderton, Paul Davidson, Jennifer Bradley Franklin, Joey Garrison, Jefferson Graham, Gina Harkins, Julia MacDougall, Adrianna Rodriguez, Robin Roenker, Sarah Sekula, Sandy Smith, Fiona Soltes, Adam Stone, Jamie Ueda, Karen Weintraub

HEALTH

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TELEHEALTH THRIVES Pandemic highlights advantages of remote patient care

ADVERTISING STRESS AND STRAIN Study indicates link between mental health and COVID-19

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SIGNAL BOOST Solutions for improving your home’s Wi-Fi

TAP AWAY TENSION

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RISE OF THE ZUTOR

The challenges of schooling during the pandemic

Mom creates a studenttutor matchmaking service

MAKING THE GRADE Insights from colleges that successfully reopened

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RANCHING R&R Trade the slopes for stables at these remote winter getaways

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TRAVEL

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Companies provide meditation apps to employees

EDUCATION LESSONS LEARNED

DESIGNERS Hayleigh Corkey David Hyde Debra Moore Gina Toole Saunders

PANDEMIC PORTRAITS Muralists express universal sentiments about the coronavirus

ON THE COVER: Americans continue

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to adjust their lives as the rollout of vaccines promises pandemic relief.

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A worker displays instructions for motorists at a COVID-19 testing site in Los Angeles in early January.

‘Wartime Undertaking’ New administration is taking an aggressive approach to ﬁghting the pandemic

By Joey Garrison

N HIS FIRST FULL day in oﬃce, President Joe Biden formally unveiled his administration’s strategy to defeat the COVID-19 pandemic, and signed a series of executive orders and other directives to jump-start the eﬀort. Declaring “this is a wartime undertaking,” Biden invoked the Defense Production Act to boost coronavirus testing and vaccination supplies, a key plank outlined in the administration’s National Strategy for the COVID-19 Response and Pandemic Preparedness. Jeff Zients, Biden’s White House

coronavirus response coordinator, says the plan will “fundamentally change the course of this pandemic. “This is a national emergency, and we need to treat it accordingly,” Zients says. “Defeating the virus requires a coordinated nationwide eﬀort.” The White House acknowledges several priorities are contingent on passage of Biden’s proposed $1.9 trillion COVID-19 relief package. Biden’s pandemic-related executive orders and directives will do the following: uInstruct federal agencies to exercise all appropriate authorities, including CONTINUED

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White House coronavirus response coordinator Jeff Zients speaks during a Jan. 27 briefing on the Biden administration’s COVID-19 pandemic efforts.

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A presidential executive order makes masks mandatory on airplanes and in airports.

invoking the Defense and higher education instituProduction Act, to accelerate tions. manufacturing and delivery to uRequire masks be worn meet shortfalls in equipment in all federal buildings and in and supplies needed for the airports and certain modes pandemic response. of transportation such as uEstablish the COVID-19 planes, trains, ships and Pandemic Testing Board and intercity buses. Biden has also dedicate $50 billion to bring challenged all Americans to the “full force of the federal wear masks in public settings government’s expertise” to for the first 100 days of his expanding supplies and presidency. uAuthorize new studies — increasing access to testing. including large-scale randomThe order directs federal agencies to facilitate free testized trials — to identify treatments for COVID-19 with a ing for those who lack health insurance and to clarify focus on the needs of diverse insurers’ obligation to cover populations. This includes establishing a COVID-19 the cost. uImprove access to care Health Equity Task Force to and treatment of COVID-19. provide recommendations for allocating resources and That includes outlining steps to bolster clinical care capacfunding to communities with outcome ity; assisting long-term care inequities due to “This is a race, ethnicity, facilities and those for people disability and national emerother considerwith disabilities; increasing health ations. gency, and we uRequire care workforce need to treat all inbound capacity; and supporting acinternational air it accordingly. cess to COVID-19 passengers age 2 and older to therapies for the Defeating the a negauninsured. Biden virus requires a present has also ordered tive COVID-19 test taken no the Department coordinated of Health and more than three nationwide days before their Human Services (HHS) to reopen flight, or proof effort.” that they’ve insurance enrollment on recovered from — JEFF ZIENTS, the coronavirus HealthCare. White House coronavirus gov through within the past response coordinator three months. May 15, giving new coverage Those who don’t will be denied boarding. opportunities to those who lost their jobs and employerThere is no mandabased insurance during the tory quarantine for those pandemic. returning to or arriving in uDirect the Federal Emerthe United States, but the gency Management Agency to Centers for Disease Control support 100 federally funded and Prevention recommends community vaccination that travelers get tested three centers by late February, to five days after travel and and set up mobile units to stay home or in a hotel to administer vaccines in urban self-quarantine for seven days and rural communities. post-travel regardless of test uDirect “a national strategy results. for safely reopening schools,” including requiring the Ken Alltucker, Dawn Gilbertson, Maureen Groppe, Department of Education and Courtney Subramanian and HHS to provide guidance on the reopening and operating Karen Weintraub contributed of schools, child care facilities to this story.

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Shot in the Arm Amid rampedup vaccine production and distribution, initial safety data is encouraging By Karen Weintraub

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Nurse Andre McFarlane administers the Moderna COVID-19 vaccine to Teresa Jimenez at the vaccination facility in the Bathgate Post Office in New York City on Jan. 10.

PPROXIMATELY 1 MILLION AMERICANS daily were

receiving the coronavirus vaccine in early February, and initial data finds the shots are as safe as studies have suggested. Although the rate of severe allergic reactions is higher than for the seasonal flu vaccine, everyone with an allergic response has been treated successfully, and no other serious problems have turned up among the first 22 million people vaccinated, according to the Centers for Disease Control and Prevention (CDC). President Joe Biden said on Jan. 25 that he expects widespread availability of the vaccines by spring, with the U.S. “well on our way to herd immunity” necessary to end the pandemic by summer. Even so, he warned the nation was going to be “in this for a while” and there could be between “600,000 and 660,000 deaths

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Boxes containing the Moderna COVID-19 vaccine are prepared for shipping at the McKesson distribution center in Olive Branch, Miss.

before we begin to turn the corner in a major way.”

PRODUCTION PROCEEDS Makers of COVID-19 vaccines need everything to go smoothly as they scale up production to hundreds of millions of doses — even a minor hiccup could cause a delay. Some of the necessary ingredients have never been produced at the volume needed. The two vaccines authorized in the U.S. so far, from Pfizer-BioNTech and Moderna, are made by inserting a piece of genetic code called mRNA inside a little ball of fat. Making small amounts of

mRNA in a research lab is easy, but “prior to this, nobody made a billion doses or 100 million or even a million doses of mRNA,” says Dr. Drew Weissman of the University of Pennsylvania’s Perelman School of Medicine, who helped pioneer mRNA technology. Scaling up doesn’t just mean multiplying ingredients to fit a bigger vat. Creating mRNA involves a chemical reaction between genetic building blocks and enzymes, and Weissman says the enzymes don’t work as efficiently in larger volumes. Moderna and Pfizer have each pledged to deliver 100 million doses to the U.S.

by the end of March, and another 100 million in the second quarter of the year. Both vaccines require two doses. Biden announced plans to buy more doses over the summer in a push to vaccinate 300 million Americans by early fall. To accelerate the process, other vaccines may soon enter the pipeline. Johnson & Johnson formally requested approval of its one-dose shot on Feb. 4, and Novavax is in final-stage testing of its vaccine.

DISTRIBUTION TRANSPARENCY Even as vaccine production ramps up, however, governors and top health

officials have been increasingly raising the alarm about inadequate supplies and the need for earlier and more reliable estimates of how many doses are on the way so that they can effectively plan for distribution. The lack of transparency around the supply chain has contributed to the lag in vaccine administration. As of Jan. 27, the CDC reports that just over half of the 47 million doses distributed to states have been administered. The Biden administration’s COVID-19 task force has pledged to provide states CONTINUED

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NEWS with firm vaccine allocation figures three weeks ahead of delivery.

in the system have received at least one COVID-19 shot. In that group, there were no signals as of Jan. 16 of increased risk for any MOSTLY MINOR of 20 common conditions, which SIDE EFFECTS included heart attack, appendiCDC data on vaccine reaction citis, embolisms and diseases was collected from several trackcaused by low platelet counts. ing systems, including a voluntary Through mid-January, VAERS process where people who are received reports of 196 deaths folvaccinated report their symptoms lowing COVID-19 vaccination. Of via text. An online system allows those, 66 percent were residents people who believe they have of long-term care facilities. About been harmed by a vaccine to 1.3 million nursing home resicontribute their information, dents were vaccinated between and a third collects reports from Dec. 21, 2020, and Jan. 18, 2021. medical records. In a group that large followed Mild side effects remain a over that length of time, the CDC common result of both the Pfizerindicates 11,440 people would BioNTech and Moderna vaccines, be expected to die of all causes. with 70 percent of people who That led the CDC to conclude the self-reported saymuch lower number of ing they suffered nursing home deaths injection-area pain. was not caused by “The risks More than 2 vaccination. of getting million of the first Both vaccines 22 million people to have been shown to sick from receive at least one trigger a relatively dose of the vaccine COVID-19 are high — though still reported to V-safe, a rare — rate of severe much higher self-reporting system allergic reactions. involving web surveys the first than the risks 10Among and text messages. Of million people these, more than 70 who received the of anaphypercent reported pain, Pfizer-BioNTech laxis (from 33 percent fatigue, 30 vaccine, 50 went into percent headaches, 23 shock, the vaccine).” anaphylactic percent muscle pain a rate of five serious and about 11 percent — DR. ROCHELLE allergic reactions chills, fever, swelling WALENSKY, per 1 million doses. or joint pain. director, Centers for Twenty-one people There was little Disease Control and out of 7.6 million who difference in reported Prevention received the Moderna side effects between vaccine also went into the two rounds of shock, a rate of 2.8 per injections, though people gener1 million doses. Ninety percent of ally had a more difficult time with these incidents occurred within a the second dose than the first. half hour of getting a shot, and all More than 9,000 people recovered. reported post-vaccination side By comparison, the rate of effects to the CDC’s Vaccine anaphylaxis for the seasonal flu Adverse Event Reporting System vaccine is 1.3 per million shots, (VAERS); fewer than 1,000 of roughly one-quarter to one-half those reports were considered the rates of the two authorized serious. The majority of COVID-19 vaccines. Still, complaints involved headaches, “the risks of getting sick from fatigue, dizziness, nausea, chills, COVID-19 are much higher than fever and pain. the risks of anaphylaxis,” CDC The CDC reporting system, the Director Dr. Rochelle Walensky Vaccine Safety Datalink, looks said in late January. at medical records from nine Josh Boak, Jonathan Drew, Zeke participating health care orgaMiller and Lauran Neergaard of nizations, and includes data on The Associated Press contributed to more than 12 million people per this story. year. More than 162,000 people

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President Joe Biden receives the second dose of the Pfizer vaccine on Jan. 11. The administration is hopeful that 300 million Americans will be vaccinated by the fall.

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Vaccine manufacturers Moderna and Pfizer-BioNTech have each committed to delivering 200 million doses in the U.S. by the end of June.

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Vexing Variants Complications posed by COVID-19 mutations remain unknown

Coronavirus SARS-CoV-2 in yellow NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES ROCKY MOUNTAIN LABORATORY VIA ASSOCIATED PRESS

By Karen Weintraub and Adrianna Rodriguez

HE VIRUS THAT CAUSES

COVID-19 is constantly evolving. In most cases, the changes are harmless. But when accumulated, the virus could become more contagious or deadlier, and potentially evade vac-

cines, treatment, diagnostics or natural immunity. A number of these variants are circulating in the U.S. in increasing numbers. But scientiﬁc leaders studying the variants say there’s no reason to panic about them yet, and continue to emphasize the protective measures that have proven to be effective against transmission of the coronavirus, includ-

ing wearing face masks, washing hands, avoiding crowds and getting vaccinated as soon as possible. Here are answers to common questions about these variants: How dangerous are these variants? Several, including ones ﬁrst seen in the U.K., South Africa, Brazil and domestically in California, appear to be more

contagious, but not necessarily deadlier. That is, out of 100 people who contract any variant of the SARS-CoV-2 virus, one to two people are likely to die. Because they’re more contagious, however, these variants could spread more rapidly to a larger population, increasing the overall death rate, according to the data. CONTINUED

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SARS-CoV-2 virus isolated from a U.S. patient NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES ROCKY MOUNTAIN LABORATORY VIA ASSOCIATED PRESS

Do the coronavirus vaccines protect against the variants? So far, both vaccines authorized for use in the United States — one by Pfizer-BioNTech and the other by Moderna — appear to be effective against the known variants. Moderna says its vaccine produced an immune response to “all key emerging variants tested” and no significant reduction in neutralizing antibodies against the variant first identified in the U.K. It is developing a booster dose that could combat the South African variant and future emerging ones. Pfizer-BioNTech says its shot appears to be effective against the variant from Britain, although the company has not yet studied other variants. How can new variants be identified? Standard diagnostic tests cannot differentiate among variants. The only way to identify a variant is by sequencing its genes using samples

from people who are sick. Do any variants originate in the U.S.? The U.S., which has the most cases in the world, is likely a major breeding ground for mutations. In mid-January, officials began raising concerns about a variant ﬁrst seen in California, called B.1.429. It is potentially more infectious but has not been seen to be more dangerous in terms of causing serious illness or death. A mutation in the variant was ﬁrst detected last March, but appears to have been very rare until November. Between Nov. 22 and Dec. 13, 2020, the variant accounted for 3 percent of California cases where the virus had been genetically sequenced. Between Dec. 14, 2020, and Jan. 3, that rose to 25 percent, says Dr. Charles Chiu, a professor of medicine and expert in viral genomics at the University of California, San Francisco. There is concern that the parts of the virus

that are mutating might reduce the eﬀectiveness of vaccines, but the data is very preliminary, Chiu says. The South African variant is raising concerns. Why? The 501Y.V2 variant appears to be about 50 percent more contagious, meaning it does a better job than the original novel coronavirus at invading human cells. This 501Y.V2 variant, which has a mutation called E484K, may be escaping some or all of the antibodies people developed against a natural infection. In looking at blood samples from 44 South Africans who recovered from COVID-19, more than 90 percent showed reduced immunity to the new variant, and almost half had no protection against it, according to a recent study that hasn’t yet been peer-reviewed. Moderna is developing a version of its vaccine to speciﬁcally target the

South African variant, to show that it can quickly tweak its vaccine. This would be delivered as a booster shot, in addition to the two-dose vaccine currently being distributed. What about the Brazilian variant? Scientists are concerned this variant might not be controlled by natural immunity — that is, someone once infected by SARS-CoV-2 might be vulnerable to another infection with the new variant. A 29-year-old Brazilian woman who had COVID-19 in March 2020 contracted a different variant in December. The woman had been healthy prior to the first infection with no immune issues. This raises the possibility that natural infections will not contribute to herd immunity, the level of protection needed to stop the spread of a virus. Kim Hjelmgaard and Elizabeth Weise contributed to this story.

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Going, Going ... Some jobs could decline or disappear because of COVID-19

By Paul Davidson

HE COVID-19 CRISIS UPENDED

the labor market like no other U.S. recession, wiping out roughly 23 million jobs last spring as states ordered business shutdowns. About 12 million jobs had been recouped by last November. While some of the remaining 10-plus million lost jobs are expected to return in coming months, many others are likely to come back only

after COVID-19 vaccines are broadly available and administered. Still others may not return for several years, if ever, as the pandemic reshapes the economy, according to a report by Glassdoor, the job posting and employee review site. “COVID is going to change the way we organize work and the way we spend,” says Glassdoor Chief Economist Andrew Chamberlain. Some positions, like administrative roles, were already in decline because of long-term trends, and the health crisis has accelerated the shift.

Others, like restaurant positions, have been hurt by unprecedented damage to the industry that could take years to reverse. Here’s a look at some jobs that could be in decline for several years, if not longer, according to Glassdoor:

CHEF It’s not that Americans aren’t chomping at the bit to return to dining CONTINUED

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NEWS out in larger numbers. But nearly 1 in 6 restaurants — or a total of about 100,000 — have closed permanently or for the long-term during the health crisis, according to the National Restaurant Association. It will take years for new eateries to launch and replace the chef, server, bartender and other jobs eliminated during the pandemic, Chamberlain says.

EXECUTIVE ASSISTANT The ranks of executive assistants, secretaries and similar office jobs already have been shrinking as voicemail, scheduling software and presentation applications such as PowerPoint supplant their traditional duties. That shift has been accelerated by the pandemic, Chamberlain says. RECEPTIONIST About 40 percent of Americans have been working from home during the outbreak, mostly white-collar employees. Many are expected to continue telecommuting at least a few days a week even after the crisis is over. That lessens the need for receptionists. And if a company reduces its office footprint, it will need fewer receptionists, Chamberlain says. ACCOUNTS PAYABLE SPECIALIST Many staffers who pay invoices and other bills already have been elbowed out by automated software that can perform those functions. The pandemic has accelerated the transition, Chamberlain says, as companies continue to reduce costs amid lower sales.

The coronavirus pandemic is reshaping the economy and “is going to change the way we organize work and the way we spend.” — ANDREW CHAMBERLAIN, chief economist, Glassdoor

HR GENERALIST Employees who email job candidates, schedule interviews and administer skills tests have become scarcer in recent years because of new software, and that trend will pick up steam, Chamberlain says. PRODUCT DEMONSTRATOR/ BRAND AMBASSADOR People who demonstrate housecleaning, personal care or other products in department stores and other locations have fallen in number as Americans increasingly favor online shopping instead of in-store purchases. Like product demonstrators, brand ambassadors tout goods and services, but for a particular company or product. The shift to e-commerce has stepped up dramatically during the pandemic, Chamberlain says, and many compa-

nies now offer online videos that can be viewed by millions.

PROFESSOR Both public and private colleges have seen their finances decimated by the health crisis, squeezing their ability to hire professors. The financial strain isn’t likely to ease even after the outbreak ebbs, Chamberlain says. EVENT COORDINATOR Workers who arrange meetings, conferences, trade shows and other events

have seen job openings disappear as businesses conduct video meetings during the crisis. Many jobs may return after the pandemic is over, Chamberlain says, but it’s unclear to what extent some companies may shift at least some meetings online for the long term.

ARCHITECT This generally stable occupation is likely to face decline as the work-fromhome trend prompts companies to build and lease fewer office buildings, Chamberlain says.

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Helping the Helpers Organization supports often-overlooked domestic workers

By Sarah Sekula

ARAH LUNGU GREW UP in a large family in Zambia, where she spent a lot of time caring for her five siblings. So when she came to the U.S. in 2003, becoming a nanny was a natural fit. As a caregiver, she takes great pride in shaping the lives of children and has sincere passion for what she does on a daily basis, often working long hours. But it wasn’t until she joined the National Domestic Workers Alliance (NDWA) in 2008 that she really began to understand her rights.

“I worked for one family for 13 years, and I left with no severance pay and no recommendation letter,” says Lungu, who lives on Long Island, N.Y. “They paid me so little, and I finally said I can’t live like this and I can’t stand the treatment.” After joining NDWA, which represents approximately 250,000 of the nation’s more than 2.5 million nannies, house cleaners and care workers, Lungu began attending webinars and training sessions. “I took the nanny training again last year, and it’s redefined for me what being CONTINUED

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Sarah Lungu NDWA

Ai-jen Poo OTHELLO BANACI/NDWA

NDWA

fund (assistance) because no one else was looking out for us. The government didn’t help us, NDWA did.” Being part of NDWA, she says, is empowering. “At times you meet some families that take advantage of us, but we know that NDWA is here to guide, support and give us the perspective to know we don’t deserve to be treated this way. I never thought my story mattered until I shared it with a reporter and realized, ‘I do have something to say, and it is important.’ NDWA gives nannies a platform and a voice.” This year, NDWA will continue to lobby for passage of the Domestic Workers Bill of Rights Act, which was sponsored and introduced in 2019 by Vice President

Kamala Harris when she was a member of the U.S. Senate. “One of the biggest reasons we are fighting for the national Domestic Workers Bill of Rights is because of the long history of exclusion of domestic workers from the basic labor laws and rights that most of us take for granted,” says Ai-jen Poo, co-founder and executive director of NDWA. “In the 1930s, members of Congress from the Southern states refused to support labor laws that included equal protections for Black farmworkers and domestic workers. Ninety years later, the history of racial exclusion in our policy and our culture continues to define reality for this workforce of mostly women, and disproportionately women of color.”

NDWA members on a 2019 trip to Washington, D.C., to lobby on behalf of the Domestic Workers Bill of Rights Act.

a nanny is,” she says. “NDWA has helped me to understand my role with more respect because it is a profession that is very important. I now know that I am a very vital part to the community and the workings of the economy. It’s given me a lot of confidence to say that my profession is being a nanny because I help other human beings and shape the lives of the little ones.” Being part of the organization not only means she has a strong support group of like-minded individuals, but at the outset of the pandemic, it also meant she could apply for financial assistance. Last March, Lungu learned about the NDWA Coronavirus Care Fund, an emergency relief fund for domestic workers facing

hardship as a result of the pandemic. Since the fund launched last March, NDWA has approved 50,000 applications and distributed more than $30 million in assistance. NDWA also supports domestic workers by offering COVID-19 resources, organizing activities for more than 60 local chapters and affiliates and providing access to long-term benefits. Many domestic workers have been excluded from federal coronavirus relief packages because of their immigration status or because they work in the informal economy. A number of nannies “were laid off because families went away (and) left their nannies with nothing,” Lungu says. “I’m lucky that I received the NDWA care

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Members of the West Virginia Joint Interagency Task Force for Vaccines rehearse on Dec. 11 to simulate procedures for COVID-19 vaccine receipt, handling and distribution to Phase 1 recipients at the West Virginia National Guard Joint Forces Headquarters in Charleston.

Always Ready, Always There In a time of unprecedented turmoil, the National Guard is true to its motto

By Matt Alderton

HE CORONAVIRUS PANDEMIC HAS been a

maelstrom of historic proportions, but it might have been even more tumultuous were it not for a surprising source of comfort, calm and caretaking: the U.S. National Guard. Through the third quarter of 2020, National Guard members collectively spent a record 8.4 million days conducting homeland

missions, says National Guard Bureau Chief Gen. Daniel Hokanson. Unlike the active-duty military, the National Guard is comprised of citizen-soldiers who have full-time civilian careers. “Ours is a parttime force,” Hokanson says. “These are school teachers. These are folks who work at Home Depot; who run small businesses; who work for state, local and county government ... It’s these men and women — and CONTINUED

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SGT. ANTHONY JONES/U.S. ARMY NATIONAL GUARD

Oklahoma National Guard members transport an ultracold box containing COVID-19 vaccinations.

their families and employers who support them — who have allowed us to do as much as we have done.”

COMBATING COVID-19 The coronavirus isn’t the sort of adversary most service members had in mind when they enlisted. Still, it’s an enemy the National Guard has fought unflinchingly. Guard members nationwide have delivered more than 387 million pieces of personal protective equipment to first responders and health care professionals; provided coronavirus screening for nearly 9.3 million people; and contributed countless manhours to contact tracing, nursing home support and more. As of mid-December, 2020, the National Guard had taken on another critical role — helping to distribute COVID-19 vaccinations in 26 states, according to Military.com. Army Gen. Gustave Perna, chief operating officer of Operation Warp Speed, the Trump administration’s vaccine development program, compared the vaccine distribution effort to D-Day, the U.S.-led military offensive that turned the tide in World War II. “D-Day was the beginning of the end

THOMAS WELLS/THE NORTHEAST MISSISSIPPI DAILY JOURNAL VIA ASSOCIATED PRESS

Mississippi National Guard members deliver an initial shipment of COVID-19 vaccines to the North Mississippi Medical Center in Tupelo.

and that’s where we are today,” Perna said at a Dec. 12 news briefing, though he added that it would take months of work and “diligence, courage and strength to eventually achieve victory.” Although the coronavirus has affected the entire country, no state was more vulnerable in the pandemic’s early days than New York. “When the COVID crisis first hit, our soldiers and airmen ... ran to the sound of the guns,” explains Maj. Gen. Ray Shields, New York’s adjutant general, who says the New York National Guard at its highest point mobilized more than 3,600 members in response to COVID-19. According to Shields, the COVID-19 mission has been longer in duration and larger in scale than any other New York National Guard mission, which has given Gov. Andrew Cuomo scalable resources to help control the virus. Cuomo has deployed those resources in myriad ways. In March 2020, for example, the New York National Guard helped turn Manhattan’s Jacob K. Javits Convention Center into an alternative treatment center where doctors tended to 1,095 COVID-19 patients. New York Guard members also have distributed more than 112,000 gallons

banks and warehouses across the state. of hand sanitizer to local governments, “Many of the volunteers that food answered more than 278,000 calls from concerned New Yorkers dialing state-run banks rely upon are at high risk of COVID either because they’re information lines, older or because they assembled more than 3.6 have underlying health million COVID-19 testing “Ours is a partkits and collected more conditions. So very quickly the volunteer than 616,000 tests at 15 time force. ... It’s drive-thru testing sites. base for food banks these men and dropped to near zero,” “We’re kind of like a handyman; we can do Harris says. “At the same women — and time, because of high almost anything we get asked to do,” explains unemployment and job their families and insecurity, the demand on Shields, who says the employers who mission he’s most proud food banks skyrocketed, which created a perfect of is the one executed support them — by the New York Guard’s storm for food insecurity.” who have allowed In support of the decedent recovery teams, which helped Ohio Department of Job us to do as much and Family Services, overwhelmed medical members of the Guard examiners recover the as we have done.” also packed more than remains of 2,882 de— GEN. DANIEL HOKANSON, 43 million pounds and ceased New Yorkers from National Guard bureau chief homes and hospitals. distributed upward of 50 million pounds of food AID AND COMFORT and helped provide more Pandemic-related demand for food asthan 700,000 meals to families in need in sistance also increased, according to Maj. that state. Gen. John Harris Jr., adjutant general of Ohio, where Gov. Mike DeWine deployed The Associated Press contributed to this story. the National Guard in support of 14 food

USA TODAY SPECIAL EDITION

A tale of love and hope in the time of coronavirus By Tim Sullivan ONNIE BISHOP’S VOICE CRACKED

as she spoke from her hospital bed. “I want to go home,” she pleaded. More than 40 miles away, Mike Bishop sat in the couple’s living room, looking intently at his phone as they spoke on a video call. Bonnie had been in the hospital since early July. She’d been on a ventilator. She’d had surgery to put a tube down her

throat. She’d been in a coma for six weeks. Sometimes, it was just too much, and on this October evening, she started to weep silently. “You are coming home,” Mike Bishop, 63, said firmly. He seemed to be speaking as much to himself as to his wife, who is in her late 60s. “You know you are.” The Bishops live just outside of Jackson, Miss. They met more than 25 years ago when Bonnie was organizing a basketball game to support an

adopt-a-school program run by AT&T. She worked there until retiring a couple years ago. Mike still works for AT&T as a digital technician. Mike is tall and handsome, with a beard going gray and a gentle voice that’s almost musical. He radiates decency. For him, Bonnie is everything. She’s the woman in big sunglasses who hates to have her picture taken. She loves to read and can sometimes be quiet, Mike says, but once she knows you, she’s a talker. In

photos, it’s obvious from how she looks at her husband that she adores him. In early July, Mike began to feel run-down. It was just a minor dry cough, but he took a COVID-19 test, and it came back positive. Soon, Bonnie also tested positive. Several days later, she woke him up at 3 a.m. “I cannot breathe,” she gasped. “911.” Mike, whose own case of the coronavirus meant he CONTINUED

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Mike Bishop WONG MAYE-E/ASSOCIATED PRESS

“It is ... the most alone I’ve felt in all my life.” — MIKE BISHOP couldn’t go with her to the hospital, helped strap her onto a stretcher. He held her hand as they walked out to the ambulance. Then, with lights flashing, the ambulance took her away. He watched it disappear into

the night. “I was empty. Scared. Terrified,” he says. “And I was praying.”

BUILDING A LIFE Bonnie was a manager when they met. Mike is fiercely union. He’s also friendly and

outgoing and has the gargantuan hands of a man who was palming basketballs when he was barely a teenager. So he agreed when she asked if he’d join the AT&T basketball team. At the game, a friend of Mike’s nodded toward Bonnie

and said, “Man, she’s checking you out.” “She hates it when I tell this story,” Mike says. A week or so later, there was an office party at Bonnie’s CONTINUED

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“Had it not been for family, friends and faith, I just don’t think I would have made it.” — MIKE BISHOP

WONG MAYE-E/ASSOCIATED PRESS

The Bishops stayed connected via FaceTime when Bonnie was in the hospital.

house for the people who played in the basketball game. The jury is still out on whether that was a setup to see him again, but “we have been together ever since,” Mike says. “The Sunday (after the party) she invited me over for lunch. I went over for lunch. Monday, on the way to work, (we) had coffee. That weekend we did something. About a month later I moved in. And about eight to 10 months later we were married.” They’ve been married for a quarter century. They bought a house together, which Bonnie decorated with oversized furniture and leopard-print cushions. When they could, they traveled, visiting Caribbean islands and New Orleans.

And now? “I am so empty and lost without her being here,” Mike says. “It is the worst I’ve ever felt. The most alone I’ve felt in all my life.”

DISPARITIES IN DESPAIR But in his own gentle, selfcontrolled way, he’s also angry. “Red-blooded American people say they’re patriotic but don’t care nothing about their fellow man because they don’t want to wear a mask,” he says. Mike says he took every conceivable precaution. “I washed my hands so much I joked to the guys at work, ‘Pretty soon I’m going to be as white as y’all.’” Across the country, racial minorities, especially Black people, have been hit dispro-

portionately hard by COVID-19. They are more likely to live in crowded housing and work essential jobs, and are less likely to have access to first-rate health care. African Americans have also long struggled with chronic conditions that can cause more deaths from COVID-19. The coronavirus ripped through Mississippi’s Black community early in the pandemic, when about 60 percent of infections and deaths were among African Americans, who make up 38 percent of the state’s population. With a late October surge, white people overtook Black Mississippians in both cases and deaths. Mike pauses repeatedly as he contemplates if and how race has played into the response to the coronavirus. “I think that if it had hit the white community (first) like it hit the African American community, it’d be a whole different ballgame,” he says.

REMAINING HOPEFUL For months, Mike had to fight to remain optimistic

about Bonnie’s condition. “Had it not been for family, friends and faith, I just don’t think I would have made it,” he says. “You lose your will to do stuff. It’s almost like it’s a daily struggle: ‘Why am I doing this?’” When Bonnie arrived at the hospital, doctors quickly put her on a ventilator. Shortly thereafter she was placed in a medically induced coma. For weeks, Mike called the hospital routinely: 6 a.m.; midmorning for the hospital shift change; early afternoon; midafternoon; dinnertime; just before he went to bed. Nurses insisted they’d call him if there was news, but he told them that wasn’t enough: “‘I know I might be a pest, but I can’t talk to her. She can’t talk to me. Y’all guys are my eyes and ears,’” he recalls telling them. After about six weeks, doctors brought Bonnie out of the coma. She awoke disoriented and scared, with a breathing tube down her throat that made her feel as if she was CONTINUED

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“This was hers, and it’s empty without her.” — MIKE BISHOP

choking. To make her more comfortable, they cut a hole in her windpipe for the breathing tube. After taking a month off to recover from COVID-19 and to follow Bonnie’s progress, Mike had returned to work. He was living alone, in their big suburban house with pillars out front, a perfectly kept lawn, well-trimmed hedges and magnolia and juniper trees. He’d wake up confused at 2 a.m. when she wasn’t beside him. He was alone when he left for work and when he returned. “All this was for her!” he says, gesturing around at the house. “This was hers, and it’s empty without her.” He avoided things that reminded him too much of Bonnie. Her purse sat untouched in their bedroom, along with her iPad. He wouldn’t sleep on her side of the bed, and he slept with the TV on, otherwise “I hear the clock all night. I hear the ‘tick-tock, tick-tock.’” Mike comes from a large,

The Bishops’ home near Jackson, Miss. WONG MAYE-E/ASSOCIATED PRESS

tight-knit family. He’d felt the pain of losing two brothers and two sisters. He couldn’t imagine losing Bonnie, even if he always believed she’d survive. “But I also had to keep praying that whatever God’s will, I got to be able to accept it.” Complications persisted even after Bonnie was brought out of the coma. She needed regular dialysis. Fevers would spike. She was disoriented and sleepy from all the medication. Mike saw her a couple times when she was in the intensive care unit, though she didn’t know he was there. Very slowly, Bonnie started to get better. She couldn’t feed herself for weeks because she was so weak, and the breathing tube meant she could only speak with the help of a small

electronic voicebox. Day by day, though, they communicated more. FaceTime became a lifeline. By that point, Mike was emotionally spent. His friends could see it. “It’s kind of hard to fake strength when you feel like you’re on the verge of a nervous breakdown,” he admits. There were sparks of hope: when the fevers stopped; when Bonnie could hold a conversation; when she first spoke without the electronic voicebox. But it was not until early October that Mike’s fear began subsiding, as he and Bonnie spoke multiple times a day. After more than three months in a hospital bed, she’d be moved to a rehab facility soon,

to relearn how to walk and care for herself. In late October, the couple received even better news. Bonnie’s recovery was progressing far more quickly than expected. The weeks of rehabilitation could be done at home, doctors said. She was coming home. “She’s not 100 percent, but she’s close enough,” Mike says, almost giddy. He could take care of her, protect her, cook for her. Finally, her voice would fill the quiet of the big house again. “I love that woman,” he says. Tim Sullivan writes for The Associated Press. This story was produced with support from the Pulitzer Center on Crisis Reporting.

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‘Long-Hauling’ – or Reinfected? SCIENTISTS ARE STUDYING CASES OF REOCCURRENCE OF THE CORONAVIRUS

BY KAREN WEINTRAUB

Y MEDICAL STANDARDS, NICOLE Worthley is considered extraordinarily rare. She was diagnosed with COVID-19 last March and tested positive again in September. With the first infection, she had a fever for six weeks and suffered side effects all summer. Then round two kicked in. But she can’t actually prove she’s had COVID-19 twice. That requires genetic testing of both infections, which has only happened a few dozen times

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worldwide, and never in South Dakota where she lives. Many states are keeping track of reinfection claims. South Dakota, for example, is studying at least 28, while Washington state is investigating approximately 100, but they are still considered extremely unusual, according to health experts, including the World Health Organization (WHO). In Colorado, approximately 300 people have had a second positive polymerase chain reaction (PCR) test more than 90 days after the first one. All of these cases are being investigated, according to a statement from the Colorado Department of Health and Environment. The Centers for Disease Control and Prevention (CDC) said in a statement that it is investigating some possible reinfections, but has not yet confirmed any. It considers infections more than 90 days apart to be possible reinfections; otherwise, someone’s illness is likely a lingering infection. Worthley says she’s not sure which is worse: Being able to be reinfected, or having a lingering virus that could flare up anytime. “Whether or not I personally have a proven reinfection isn’t to me as important as it’s possible that you can get it again,” she says. “Or, if you don’t believe that, then it’s possible that for six straight months you can have COVID-19, still test positive for COVID-19 and still be actively ill from it — because I don’t think there’s a lot of understanding of that right now.” It remains unclear how long the immune system can prevent someone from getting reinfected with COVID-19 after recovery. Some diseases, like measles, are one-and-done. Once a person is infected or vaccinated, the immune system typically provides lifetime protection. With other viruses, like the common cold — some of which are closely related to the coronavirus that causes COVID-19 — protection might not last a year, or even a season. This has implications for the longevity and effectiveness of vaccines, the possibility of communities developing herd im-

WORTHLEY FAMILY SABRINA JOHNSON/SEIZE THE DAY PHOTOGRAPHY & VIDEO

NICOLE WORTHLEY PROVIDED BY NICOLE WORTHLEY

“WE ARE STILL LEARNING ABOUT HOW LONG THE ANTIBODIES LAST. SO FAR, WE HAVE DATA THAT SHOWS THAT THE IMMUNE RESPONSE LASTS FOR SEVERAL MONTHS.” — WORLD HEALTH ORGANIZATION SPOKESPERSON

munity (where the virus no longer spreads because so many people have already been infected) and how those infected once should behave. Worthley, 37, could be considered a “long-hauler” — someone whose COVID-19 symptoms lasted for months after infection. She was diagnosed March 31 after suffering sharp chest pains. A few days later, she was so short of breath that she could barely walk across her apartment. A single parent to three young children, she struggled to function. “The room would be spinning and I’d be wheezing and stuff. Sometimes I could feel my teeth tingling,” she says. She had a fever for four straight weeks, then had a break for a day or so — not enough to meet the 72-hour window to be declared JUAN KARITA/ASSOCIATED PRESS

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Worthley tested positive a second time for COVID-19 weeks after donating plasma.

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healthy — and then spiked a fever again for two more weeks. Her children never experienced more than a few tired days and a cough, but Worthley knows her illness affected them. During his bedtime prayers, her oldest son often said he was thankful she was still alive. She and her kids quarantined in their Sioux Falls apartment until early June. At that time, Worthley was told she didn’t need another test and was no longer considered infectious. Worthley returned to work as an assistant teacher at a day care center, but only part time because the pandemic had caused some families to stop sending their children. Still, all summer, Worthley continued to display symptoms. Her doctor prescribed a beta blocker for heart palpitations and an anticonvulsant for nerve pain in her legs. She donated convalescent plasma in September, hoping the antibodies her immune system had developed could

help someone else fight COVID-19. Then, at the end of September, about a month after her kids started in-person school, the oldest came down with strep throat. Worthley was feeling lousy, too, so she got tested for strep. Negative. Still feeling weak a few days later, she called her doctor. “Can you smell anything?” the doctor asked. “I got the Vicks out,” Worthley says. Nothing. Four days later, Worthley received a positive COVID-19 test result. “It was easier this time,” she says. “I was only feverish for 17 days.” She suffered from diarrhea, upset stomach, loss of taste and some respiratory issues, but not as severely as the first infection. More than a month later, though, she still couldn’t smell, and a half-hour phone conversation was punctuated with her coughs. Worthley believes she is among the 28 people that the South Dakota Department of Health has said it’s investigating for reinfection, although

she’s yet to hear from anyone from the department. So far, only about a half-dozen people worldwide have been confirmed to have been infected twice with SARS-CoV-2, the virus that causes COVID-19. One man in Hong Kong didn’t know he’d been infected a second time. He only found out when he was tested on his return home from a trip to Italy. A 25-yearold Nevada man reported being sicker the second time. In both cases, genetic analysis of the infections proved that they were infected twice, with slightly different versions of the virus. “Our current understanding of the immune response is that the majority of people who are infected mount an immune response within a few weeks of infection,” a WHO spokesman said via email. “We are still learning about how long the antibodies last. So far, we have data that shows that the

SOME DISEASES, LIKE MEASLES, ARE ONE-ANDDONE ... WITH OTHER VIRUSES, LIKE THE COMMON COLD — SOME OF WHICH ARE CLOSELY RELATED TO THE CORONAVIRUS THAT CAUSES COVID-19 — PROTECTION MIGHT NOT LAST A YEAR, OR EVEN A SEASON.

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JEFFREY SHAMAN MARY ALTAFFER/ASSOCIATED PRESS

immune response lasts for several months.” In a statement, a CDC representative said the agency is actively investigating a number of suspected cases of reinfection, though none has been confirmed. Jeffrey Shaman, a professor at the Columbia University Mailman School of Public Health, who has been investigating reinfections, says scientists still have a lot of unanswered questions. Among them: How often can reinfection happen? Are people contagious with the second infection — and for how long? Do people who are reinfected have less-severe cases the second

time, or are they worse off? To answer those questions, researchers have to determine what’s behind these reinfections, Shaman says. People might fail to generate immune memory with the first infection and need repeated exposure to build up immunity. If so, a vaccine might have the same problem, and it won’t be very effective. Or people might develop antibodies to the virus and then lose them, Shaman says. In that case, a vaccine’s benefit might not last long. Some diseases can become endemic, returning year after year. If that’s the case with COVID-19, then

a vaccine, even a partially effective one, could have a significant benefit by exposing people to the virus and helping them build up a tolerance, Shaman says. It’s not yet clear how long someone is contagious with COVID-19 if their symptoms linger or recur. A study published in November 2020 in JAMA Internal Medicine found that 18 percent of COVID-19 patients in an Italian hospital tested positive again after recovering from symptoms and having a negative test. Only one of the 32 patients tested showed signs of replicating virus in their bloodstream, suggesting

that they were either still infectious or reinfected — but that couldn’t be confirmed because no genetic testing was done. That patient was still suffering symptoms 39 days after the initial diagnosis, though the others who tested positive again were unlikely to be contagious, the study concluded. Until scientists learn the answers to these questions, people who have been infected once shouldn’t assume they’re protected indefinitely, and should continue to wear masks, wash hands, maintain distance and avoid crowds, Shaman says. “The only way we’re going to get a sense of it is over time,” he says.

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A Cure for VIRTUAL REALITY IS POISED TO MAKE REMOTE WORKING MORE COLLABORATIVE AND ENGAGING By Matt Alderton WHEN SKYPE DEBUTED IN 2003, VIDEOCONFERENCING

was a Jetsons-esque sign that the future had finally arrived. When Apple introduced FaceTime in 2010, video calls still felt fresh and new. Even as recently as last spring, when COVID-19

closed offices everywhere, Zoom and competitors like Microsoft Teams and GoToMeeting were still something of a novelty. A year into the global pandemic, however, what once felt modern suddenly feels mundane — so much so that a new term has been CONTINUED

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coined to describe this distinct type of malaise: Zoom fatigue. “Zoom fatigue is a real phenomenon,” says Tomas Budrys, marketing manager at MeetinVR, a Danish virtual reality (VR) startup that creates videoconferencing alternatives with immersive meeting environments. “While Zoom is a decent option for discussions in small groups, the effectiveness drops as the number of participants increases. There is no sense of presence. Therefore ... focus, engagement and productivity are lower,” he says. Although remote working isn’t going away — a 2020 survey by research firm Gartner found that 82 percent of employers will allow workers to continue working remotely some of the time post-pandemic — VR companies like MeetinVR say they have a better way to do it.

SICK OF SCREENS In her research on remote working, Karen Sobel Lojeski has found significant declines in employee innovation, trust, cooperation, performance and satisfaction. Lojeski, founder and CEO of workplace transformation firm Virtual Distance International, defines this as “a sense of psychological and emotional detachment that begins to grow little by little and unconsciously when most encounters and experiences are mediated by screens.” Zoom perpetuates virtual distance in myriad ways. For one, it’s two-dimensional. Although there are real faces in front of you, they’re relegated to squares on a screen in a room, the contents of which — the dog at your feet, the phone on your desk, the goings-on outside your window — may be a constant distraction. Varjo XR3 headset

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Spatial collaborative room

Sophya virtual office party

Also, there are no social cues to indicate whose turn it is to speak. The result often is either chaos — everyone speaks over everyone else — or resignation — participants put themselves on mute and disengage. Finally, it’s invasive. “Zoom essentially requires you to attend to a bunch of faces, all of which seem to be staring at you. Psychologically, you experience this as a massive amount of attention bearing down on you,” says industrial and organizational psychologist Richard Landers, director of the University of Minnesota’s TNTLAB, which stands for Testing New Technologies in Learning, Assessment and Behavior. “That creates a need for people to engage in selfmonitoring in an attempt to give a certain impression — a need to control how you’re being perceived, which can be overwhelming.”

VIRTUAL REALITY, REAL BENEFITS Proponents believe VR will turn the remote-working revolution into a white-collar renaissance not merely by side-stepping the worst parts of videoconferencing, but also by replicating the best parts of office life. “There are ... dynamic types of meetings that are hard or almost impossible to do over a Zoom call productively. These meetings require additional activities such as sketching, whiteboarding, brainstorming using sticky notes or mindmapping,” Budrys says. “VR enables you to do all this as you would in real life.” A 2020 study by professional services firm PwC compared the performance of employees who completed the same training course in different modalities: VR, classroom and e-learning. VR learners, it found, were

more focused, faster to train, more confident in applying the skills they learned and more emotionally connected to the course content. Its proponents say VR provides several advantages. MeetinVR, for example, offers a variety of virtual meeting spaces, from a classic corporate conference room to meeting rooms that have as their backdrops the desert or outer space. In each 360-degree environment, at-home users wearing VR headsets and holding VR controllers can see and address individual colleagues, interact with whiteboards, share multimedia and even make sketches in midair to illustrate points. What users can’t do — check email on their phones, for example — is just as significant. “You’re more present because you cannot multitask,” says Urho Konttori, co-founder and chief product officer of Varjo, a Finnish maker of industrial-grade VR headsets. “Everybody who is there is 100 percent focused.” Anand Agarawala, co-founder and CEO of VR platform Spatial, puts a finer point on VR’s benefits. “A lot of the things you can get in person you can get in VR,” he says. “Because you’re personified as a 3D avatar, for example, social cues and body language come through. You can even make eye contact, because you can actually look other avatars in the eye.” With spatial audio, you can replicate the auditory experience you’d have in a physical space, which means hearing speakers in different ears and at different volumes as they move around the room, being able to whisper discreetly to your neighbor during a CONTINUED

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MeetinVR avatars

presentation and having the option to pull colleagues aside for spontaneous conversations. And because almost anything is possible in VR — Spatial has toyed with creating a zero-gravity room in which participants float around like astronauts — you can unlock new ways to create and engage. “You can show PowerPoints and access Slack channels, but you can also generate a sword and have a sword fight,” Agarawala says. “It’s quite fun, and we think that’s a key element of working effectively.” Adds Jacob Loewenstein, Spatial’s vice president of business development and strategy: “In theory, you should be able to sit in front of a screen all day and just matrix information into your brain. But human beings aren’t made that way. We crave contact and connection. Feeling like you’re in a room with people allows your brain to behave the way it wants to.”

HEADSET HEADACHES? VR is not a panacea, insists professional meeting facilitator and designer Lee Gimpel, founder and principal of consulting company Better Meetings. “More than anything, bad, unproductive, tiresome

meetings are a function of the format and the content as opposed to the technology,” he says. “The problem with Zoom is not that it cheats us of a third dimension. If you fix the format of a meeting, it goes a long way to alleviating boredom, frustration and fatigue. If your boss runs a bad meeting, holding that remote meeting in a realistic virtual room isn’t much of a fix.” And a virtual room’s bugs can negate its benefits. Technology ultimately delivered an antidote for videoconferencing fatigue — but it was in the form of COVID-19 vaccines, not virtual reality, says longtime VR observer Ben Delaney, CEO of immersive technology consultancy ImmersivEdge Advisors. “In most cases, the technology is not there yet, and the solutions are still looking for the right problems.” To that end, researchers like Landers are studying which use cases are best suited to VR. In the meantime, engineers are making rapid progress on technical warts. Compared with early VR headsets that were difficult to set up and caused side effects like nausea and dizziness, current iterations are easy to use, comfortable and more affordable.

When it was released in 2016, the first headset from Facebook’s Oculus, the Oculus Rift CV1, retailed for $599; the new Oculus Quest 2 retails for $299. Varjo’s industrial-grade headsets, which boast better resolution and a wider field of view than consumer-grade models, have similarly dropped in price; while the company’s first-generation VR-1 cost $7,000 plus a $1,200 annual subscription at launch, its new VR-3 costs about $3,900 with a $970 annual subscription. “The price of these headsets has dropped crazily,” says Loewenstein, adding that the cost of consumer-grade models is now low enough for companies to purchase VR headsets for employees to use at home. In some cases “it’s less than the price of a plane ticket, so it’s pretty easy to justify.”

ENHANCING ENGAGEMENT Still, headsets remain far from ubiquitous, and several companies have developed stopgaps in the form of webbased applications that are a bridge between VR and Zoom. Among them is Spatial, which in May launched support for web browsers so users without headsets could still participate in VR meetings; while users with headsets appear as 3D avatars, users without them appear as floating screens that display video from their webcam. And then there are platforms like Sophya, a browser-based environment that looks like the product of a union between Zoom and social networking game FarmVille. Employees exist as avatars inside a gamelike virtual office that can be subdivided into rooms and floors. Product development can work on one floor, for example, and sales on another. When members of one team need something from members

of another, they can visit that team’s virtual location and approach colleagues’ avatars to initiate private or group video chats. Unlike a scheduled videoconference, the idea is to keep the environment open all day for instant and spontaneous interactions with co-workers as if you were in the office together. There are even public spaces like bars and shops where employees from different companies can congregate to network and socialize. “We built this software not only to facilitate super-fast information flow, but also to create the human connections that we need as a social species,” says Vishal Punwani, Sophya’s CEO and co-founder. “Because if you don’t create a sense of community and belonging for your employees, your company isn’t going to do very well.” That’s exactly the sentiment that persuaded the legal department at Hewlett Packard Enterprise (HPE) to adopt VR, says general counsel Rishi Varma, who in late 2019 began furnishing Oculus headsets to HPE employees around the world with the goal of creating a global team that felt connected instead of disbursed. When COVID-19 hit, his team already was using VR to host interactive war rooms, training and social meetups. They even hosted a ceremony during which Varma virtually shook hands with members of an award-winning team in Geneva. “It all comes down to the employee experience,” Varma says. “It’s not about where you work. It’s about making sure you feel the same level of engagement with the company whether you’re in a physical office or working remotely. We can’t be connected to the business unless we’re connected to each other.”

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COVID-19 will have a lasting impact on sanitation — for consumers and businesses By Matt Alderton

ORTY-EIGHT MILLION AMERICANS GET food poisoning every year. Most ride an uncomfortable but benign rollercoaster of nausea, vomiting and diarrhea. Others aren’t so lucky. According to the Centers for Disease Control and Prevention (CDC), 128,000 people per year are hospitalized due to foodborne illness, and 3,000 actually die from it. When Los Angeles County noticed rates of foodborne illness surging in the 1990s, it introduced the nation’s first letter grading system for restaurants, with ratings of an A, B or C in food safety and sanitation. A study in the Journal of Environmental Health showed that foodborne-illness hospitalizations in Los Angeles County dropped 13 percent in the two years after the grading system was introduced. But grading didn’t just change public health outcomes. It also changed consumer behavior. Suddenly, diners who used to choose restaurants based on price or cachet began choosing them based on cleanliness. In return, establishments that used to sleepwalk through health inspections began taking them seriously, instituting new business practices to improve performance and attract customers. As the nation continues to recover from the coronavirus pandemic, one can’t help but wonder if COVID-19 will have the same effect on America that diseases such as salmonella had on Los Angeles. Now that they’re more aware of public health risks, will Americans place a new premium on cleanliness? Infectious disease epidemiologist and infection preventionist Saskia Popescu thinks they will. “As a society, we’ve seen an increase in cleaning and disinfection both inside and outside the home,” she says. “Part of that is that we’ve become CONTINUED

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Neo floor cleaner at Cincinnati/ Northern Kentucky International Airport AVIDBOTS

acutely aware of the importance of cleaning and disinfection during a novel pandemic. But part of it is also the realization that we should have been doing a better job of cleaning and disinfecting all along. “People are much more cognizant of not only their own cleaning and disinfecting practices, but also those of businesses and people around them,” Popescu says.

CONSUMER CONFIDENCE Restaurant grading established clear benchmarks for businessess while giving consumers an instantaneous means to judge health risks.

In the wake of COVID-19, accreditations offer a similar path forward for businesses and consumers concerned about cleaning, suggests Patty Olinger, executive director of the Global Biorisk Advisory Council (GBAC), a division of the global cleaning industry association ISSA that helps businesses prepare for, respond to and recover from biological threats like the coronavirus. “(Accreditations) provide third-party validation that a company or organization has the proper risk-management procedures in place,” Olinger says. “That gives confidence to employees, employees’ families, customers

and communities that when they go into a facility, it’s doing its best to protect people.” Last May, GBAC launched the GBAC STAR facility accreditation program, which helps commercial facilities establish practices to control risks associated with infectious agents like SARS-CoV-2, the virus that causes COVID-19. To date, more than 3,500 organizations in 81 countries have joined the program, including stadiums and arenas, airports, athletic clubs, convention centers, hotels, museums, health care facilities, schools and CONTINUED

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office buildings. “It’s COVID-19 today, but what if it’s something else next year?” Olinger says. “These facilities will have everything that’s needed to respond quickly and get ahead of it.” The practices required to qualify for GBAC STAR accreditation also earn points with the International WELL Building Institute (IWBI), which grants its WELL Building Standard to facilities that support the health of occupants, communities and the environment. In response to the pandemic, IWBI launched a WELL Health-Safety Rating for Facility Operations and Management that specifically addresses health risks from biohazards. “Our third-party seal goes right on the front door,” explains IWBI President and CEO Rachel Hodgdon, who says more than 7,000 facilities encompassing more than 400 million square feet have achieved the WELL HealthSafety Rating so far. “When they see it, people can feel confident going inside because we’ve vetted and verified that the professionals running that facility are doing everything they’ve said they’re doing to protect human health and well-being.”

BREATHING EASY On a basic level, COVID-19 has changed the very definition of clean. For example, consumers understand better than ever the difference between cleaning and disinfecting. “Cleaning is elbow grease — getting in there with soap and water to wipe away physical dirt, grime and debris,” Popescu says. “Disinfection, on the other hand, is using a chemical to reduce or in many cases eliminate the prevalence of viruses and bacteria ... It’s important to do both.”

3,500 FACILITIES are accredited by the Global Biorisk Advisory Council’s GBAC STAR program.

INTERNATIONAL WELL BUILDING INSTITUTE

Yankee Stadium is one of 7,000 facilities to earn the WELL Health-Safety Rating from the International WELL Building Institute.

Disenfection applies not only to surfaces, but also the air, according to the CDC, which emphasizes the importance of ventilation and air quality. Its recommendations include using HEPA filters that remove viruses from the air and UVGI systems that use ultraviolet light to kill or deactivate them. “For months we’ve been told to keep our distance from people because what we’re breathing and sneezing out might be harmful. Because of that, I believe cleaning the air in indoor spaces that we once frequented without a second thought is going to be top of mind for

a lot of folks going forward,” says mechanical engineer Joe Heaney, president of Lotus Biosecurity, a New York-based consultancy he established during the pandemic to advise businesses on anti-viral mitigation measures. Because occupants can’t inspect a building’s HVAC system for themselves — and are skeptical of what they can’t see — one solution Heaney recommends is portable air cleaners, which provide supplemental and conspicuous air purification. “Portable HEPA units are great, but you have to make sure they’re actively maintained,” he says. “If you never change the filter, it’s going to lose its efficacy. For that reason, we tend to lean toward units that also have (UV) lights in them to destroy whatever the filter captures.” CONTINUED

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IROBOT

Developers at iRobot employ artificial intelligence and machine learning that allows users to program features on products like the Braava jet m6 Wi-Fi-connected robot mop.

DUST-BUSTING BOTS? To ensure their spaces remain dirt- and pathogen-free, Americans increasingly are turning to robot helpers that clean better, deeper and more often than humans. This is evident in sales of the world’s most popular robot vacuum cleaner, iRobot’s Roomba. The company saw year-over-year revenue increase 12 percent in the first nine months of 2020; in the third quarter alone, iRobot’s revenue increased 43 percent from the prior year, driven mostly by an 86 percent increase in sales of its most-expensive robots. Because they have premium features that trap allergens instead of redistributing them, iRobot’s most expensive models also happen to be its most proficient, suggesting an evolution in consumer thinking: Whereas some early adopters may have bought robot cleaners because they were neat as in “cool,” consumers today are buying them because they’re neat as in “tidy.”

“For many years we’ve been talking about how smart homes are going to be the next big thing. The pandemic has helped us decide what we actually mean by that,” says Colin Angle, founder, CEO and chairman of iRobot. The company is investing heavily in artificial intelligence and machine learning in order to give users more control over when and where its robots clean. Future Roombas, for example, will know where to go when you tell them to clean around the kitchen table, and will know when you’ve left the house so they can clean automatically while you’re away. But the primary goal isn’t convenience; it’s cleanliness. “Convenience isn’t what the smart home is going to give us,” Angle continues. “A smart home is a home that maintains itself, operates more efficiently and securely, and most importantly, gives us a healthier environment in which to live.” Businesses also are embracing robot

cleaners as they prepare to welcome employees and customers back to their facilities. Canadian company Avidbots, for example, has sold its industrial robotic floor scrubber solution, Neo, to transit hubs, shopping malls, hospitals, universities, warehouses and nuclear power plants. Japanese company SoftBank Robotics uses its autonomous vacuum sweeper, Whiz, to clean carpets in offices and hotels. And California-based Fetch Robotics partnered with Piedmont National to create SmartGuardUV ultraviolet disinfection robots, as well as with Build With Robots to launch Breezy One fogging robots that disinfect surfaces in airports, factories and meeting facilities. Among these cleaners’ myriad advantages is speed. “Manual disinfection in certain environments can take 12 to 15 hours. ... The Breezy One can disinfect 100,000 square feet in about an hour,” says Fetch Robotics CEO Melonee Wise, who cites reliability as another key benefit. “Robots are very good at being precisely repetitious. If you give them a path to follow, they’ll follow that same path and clean it the exact same way every time.” Avidbots co-founder and CEO Faizan Sheikh agrees. “A robot isn’t going to cut corners or say, ‘That looks clean enough already.’ It’s going to deliver on its mission no matter what.” And if for some reason it doesn’t — if it misses a spot or doesn’t clean it well enough — you can precisely calibrate a robot to use more chemicals, scrub with additional pressure, spend more time on a given spot or travel a different route. What’s more, Sheikh notes that you can validate that cleaning was successfully completed, since robots provide documentary evidence of where they went and what they cleaned. “Cleanliness has moved from a want to a need,” says Brady Watkins, senior vice president and general manager of SoftBank Robotics America. “What technology and robotics can provide is confirmation of the quality and frequency of cleaning.” Even after COVID-19 has been vanquished, the need for confidence in public spaces will likely endure. And so, therefore, will the appetite for cleanliness. “People have started to gain a very intrinsic appreciation for cleaning,” Sheikh says. “After the pandemic is over, I don’t think we’re going to suddenly decide, ‘OK, we can go back to being dirty again.’”

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Tools for Reopening Businesses are adding procedures and devices to boost safety

“It’s very expensive to do that, but I felt that was worth INCE HIS EIGHT it,” Bruell says. “In my mind, RESTAURANTS if you’re committed to moving reopened last May, forward, it was just the cost of Cleveland chef doing business.” The range of busiand restaurateur Zack Bruell has nesses incurring or considering such grown accustomed to doing things additional costs to maintain operations differently. The tables are no longer is broad, from those reopening office set in advance, and staff members wear space to those that heavily rely on foot masks and sanitize every time they traffic. At each turn are a variety of tools serve a table. They that companies can no longer line plates up on their arms, deploy to deliver a instead carrying one safe environment. in each hand. But it can be Those new confusing to know Chef Zack Bruell approaches were where to invest. “A cottage joined by tools like contactless thermometers for industry has grown up around COVID,” says Dr. James reading guests’ temperatures and, in two of the locations, Merlino, chief clinical transforionizers to scrub the air. mation officer at the Cleveland Clinic and lead for the clinic’s AtWork initiative, which helps employers develop and implement plans to reopen safely. Cleveland Clinic also offers nine industry-specific safety guides on its website. Merlino says the “simple tactics” remain the most important: wearing a mask, washing hands, social distancing, educating about symptoms and staying home if you are sick. That aligns with guidance from the American Industrial Hygiene Association (AIHA), which provides similar guidelines on the Back to Work Safely website it sponsors. For companies that want to improve safety for their employees, clients and customers, there are a variety of tools worth considering.

By Sandy Smith

TEMPERATURE CHECKS Merlino recommends the CONTINUED

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SPINTOUCH

SpinTouch’s RapidScreen can detect body temperature using a contactless forehead scan.

use of contactless thermometers by all businesses and workplaces. “It’s controversial whether it’s truly necessary, but it does cause people to pause. I think it provides a certain level of security to stop and think about what’s going on,” he says. Contactless devices start well below $100 and are widely available from manufacturers like Braun and HoMedics. But the Food and Drug Administration cautioned last summer that these devices can miss up to half of those infected with

COVID-19 because not everyone infected has an elevated temperature. Bruell has an employee stationed at the entrance of each restaurant to take diners’ temperatures. “It has slowed the pace of the dining experience because you have to have extra people at the front door to take the temperature and explain what you’re doing,” he admits. Stand-alone kiosks like SpinTouch’s RapidScreen detect body temperature simply by scanning the forehead. Some of these tools, like Zentron from Lama-

saTech, can also print visitor badges, have built-in radio-frequency identiﬁcation (RFID) readers for use with key cards or fobs, and can even determine whether the person entering is wearing a mask.

CONTACT TRACING An app or wearable device can help determine who might have come in contact with an infected employee or guest. SaferMe oﬀers both types of tools to clients that include the government

LAMASATECH

The Zentron kiosk is multifunctional.

of New Zealand, sports organizations, schools and businesses. The devices can be used preemptively and post-exposure, says CEO Clint Van Marrewijk. “Sometimes a symptom is reported, but there is a delay in waiting for test results. During that 24- to 48-hour period, we can take precautions to determine who is most at risk and who needs to get tested.” SaferMe uses Bluetooth technology to determine contact with infected people, CONTINUED

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SAFERME

SaferMe offers Bluetooth-enabled contact tracing in wearable and app forms.

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The Centers for Disease Control and Prevention recommends using tools like HEPA filters to improve indoor air quality.

and the service starts at $60 annually per employee. “A lot of our clients do temperature screenings and a daily health check,” Van Marrewijk says. “It allows someone to assess their own health and make the decision that coming to work is a good idea before they come into the oﬀice and cough.”

AIR CLEANING The Centers for Disease Control and Prevention (CDC) recommends that businesses work with an HVAC professional to increase the percentage of fresh air and total airflow to occupied spaces and improve central air ﬁltration.

The CDC also recommends using tools like HEPA filters and ultraviolet germicidal irradiation. Commercial and industrial air purifiers from companies like Industrial Maid have adapted to include filtration for the coronavirus. These types of systems can neutralize more than 99 percent of virus particles in 30 minutes. They also work on other bacteria and viruses, extending their use well beyond the current pandemic. Fresh-Aire UV makes models specifically for health care, education, office and other settings that it says kill 99.99 percent of coronavirus particles within two seconds of exposure.

FRESH-AIRE UV

Fresh-Aire UV says its products use ultraviolet light to kill up to 99.99 percent of coronavirus particles within two seconds of exposure.

ESSENTIAL — OR OVERKILL? There is a range of opinions as to whether these tools are necessary, particularly for small businesses already struggling ﬁnancially. In fact, Cleveland Clinic advises businesses “to be diligent about the fundamentals” and generally advises against “investing a lot of money in uncertain technologies,” Merlino says. Public-facing establishments have perhaps a higher bar to meet, with the added complication that they have to “work with and rely on the public to follow the recommended guidelines when entering their facility,” says Alan Fleeger, chairman of AIHA’s Re-Open

America Guidelines Task Force. “The more the public-facing establishments can communicate and inform the public of their requirements, the better chance they will have to minimize the spread of the virus.” Fleeger notes that AIHA’s Back to Work Safely guidelines were written primarily for small businesses. “The majority of the recommendations in our guidelines are minimal cost to the employer to implement. For those recommendations which may be more costly, we have tried to include other options for employers to consider which would cost less money,” he says.

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Clearing the Air Puriﬁers have become hot commodities during the pandemic By Julia MacDougall

E’VE ALL HAD TO spend more

time in our homes than usual, so it’s little wonder that indoor air quality has become a higher priority than in years past. Virus particles, smog, wildfire smoke, allergens, mold and exhaust fumes all offer a number of negative health effects, and often come with symptoms CONTINUED

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With consistent use and maintenance, air purifiers have been shown to noticeably mitigate negative side effects related to inhaling airborne pollutants, particularly in vulnerable populations. that may lower your quality of life. More and more people are turning to air purifiers as a way to gain some peace of mind about the airborne particles they are inhaling. These devices cleanse air in the same way filtered water pitchers do drinking water — they use a series of increasingly fine filters, devices and chemicals to remove or reduce pollutants from the air inside a household. With consistent use and proper maintenance, air purifiers have been shown to noticeably mitigate the negative side effects related to inhaling airborne pollutants, especially in vulnerable populations like young children and the elderly. Air purifiers use a variety of mechanical, chemical and electric filtration mechanisms to remove pollutants from the air. They typically operate under the same basic principles as space heaters and air conditioners: A unit draws air in using a series of fans, conditions the air and then uses fans and blowers to recirculate the air. There are several types of filters/air purifiers that trap larger particles. The weaved fibers within filters function like nets. The size of the particulates they can capture is determined by the density of the weave. Electrostatic precipitators (ESPs) and ionizers both involve charged particles. With ESPs, a live wire charges the particles coming in, and an oppositely-charged electric plate collects them

as they pass through the air purifier. Ionizers generate charged particles that are attracted to other charged particulates in the air; once they combine, they sink under their own weight to settle on floors, walls or other surfaces. Ultraviolet germicidal irradiation air purifiers use internal UV lamps to kill biological material like viruses, bacteria and mold. For those also seeking to remove odors, gases and vapors, look for models that contain sorbent media filters. Photocatalytic oxidation (PCO) uses a combination of UV lamps and sorbent media to create ions that oxidize the gas particulates and change their chemical composition until only carbon dioxide and water remain. Plasma air purification is similar to PCO, but it doesn’t utilize sorbent media. Some plasma air purifiers may give off ozone, which is a lung irritant. Not all air cleaners are created equal; they vary in effectiveness, user-friendliness and aesthetics. The Winix 5500-2 is producttesting company Reviewed’s top overall pick because of its strong performance and streamlined interface. For a functional upgrade, Reviewed recommends the Dyson Pure Hot+Cool Cryptomic, which targets formaldehyde. If you’re looking for a smart-homefriendly device, Reviewed recommends the LG PuriCare 360-Degree Air Purifier.

JACKSON RUCKAR

BEST UPGRADE DYSON PURE HOT+COOL CRYPTOMIC $749.99, dyson.com PURIFICATION METHODS: HEPA filter; carbon filter; permanent cryptomic panel PROS: Multipurpose heating/cooling/air purifying appliance; provides a lot of air quality information CONS: Expensive The inclusion of a permanent cryptomic panel helps to remove formaldehyde, a probable human carcinogen that is found in construction materials, paints, cigarette smoke and some beauty products. It’s an extremely small particle that isn’t captured by most filters. The information panel on the machine and in the Dyson Link app (iOS/Android) provides real-time information about the temperature, humidity and air quality of your room. From the app, you can set voice commands (through Amazon Alexa or Siri) and change every setting on the unit, with the exception of the temperature (which can be changed via the remote). This air

purifier can also be used without the app; its unique shape makes it easy to lift and move around. In the at-home smell tests, it easily dispelled the odors of bacon and bleach. During our smell test in the lab, the Dyson did a pretty good job of removing the odor of cigarette smoke; only a hint of a menthol smell remained after it ran for four hours. The Dyson Pure Hot+Cool Cryptomic is expensive. But for gadget fiends, those with serious concerns about formaldehyde or those who don’t have permanent heating or cooling options in particular rooms of their home, it might be worth the investment.

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BEST OVERALL

BEST SMART PURIFIER

WINIX 5500-2 $159.99, amazon.com PURIFICATION METHODS: True HEPA filter; carbon filter; plasma PROS: Easy to move; easy to change filters; affordable CONS: None

LG PURICARE 360-DEGREE AIR PURIFIER $1,332.50, amazon.com PURIFICATION METHODS: Ultrafine prefilter; True HEPA filter; deodorizing filter PROS: Alexa and Google Assistant compatible CONS: Tall and heavy; expensive

While not the most technologically advanced model, the Winix 5500-2 has intuitive controls and thoughtful extras like a sleep mode, a timer and a light sensor that automatically adjusts the back-lighting on the control panel. It also comes with status lights for filter integrity, air quality and odor detection. The Winix 5500-2 employs plasma as one purification method, but it is certified by the California Air Resources Board, meaning that it emits

The LG PuriCare 360-degree air purifier looks like a robot from the future, especially when you turn it on; the booster fan slowly rises, and the display lights up. With the tap of a button, you can bring up the modules that display the concentrations of particulates, make the whole unit rotate, check the filter status and more. You can even track air quality on your phone through SmartThinQ technology, which is compatible with Amazon Alexa and Google Assistant.

minimal, safe levels of ozone. If you have a strong ozone sensitivity, you can turn off the PlasmaWave function. The Winix 5500-2 did well in our smell tests, which were conducted with PlasmaWave off; it was able to noticeably remove odors like cinnamon and cigarette smoke. Our testers also commented favorably on the Winix’s ability to make a basement seem less musty and to noticeably diminish cooking smells as well as the amount of allergens in the air.

During testing, the LG PuriCare excelled at removing fragrance smells, but didn’t do as well with cigarette smoke. The wide range of settings and options allows you to adjust the noise level as needed. But it’s tall (nearly 4 feet) and relatively heavy (more than 40 pounds). If you embrace the Internet of Things and want to know your air’s quality with the touch of a button, the LG PuriCare will fit in perfectly with your tech-focused lifestyle.

Julia MacDougall writes for Reviewed, a USA TODAY content partner offering product testing and recommendations at reviewed.com.

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Accessory of Necessity Need a new face mask? We’ve got you covered By Jamie Ueda

ACE MASKS HAVE BECOME a new normal for society. The Centers for Disease Control and Prevention recommends people wear cloth face masks to help slow the spread of the coronavirus, and in many locales, doing so is required in public spaces. With so many options available, it can be overwhelming to figure out which is the best mask to buy — and which will work best for you. So, product-testing company Reviewed tried dozens of face masks for you. To gauge wearability and comfort, we evaluated how easy it was to put on and take off

each mask. We also noted if adjustments were needed for the nose wire, ear loops or ties to keep the mask in place. Next, we assessed the effectiveness of each mask by evaluating the material and fit. To gauge quality, we washed them according to their care instructions and looked for any post-cleaning damage. We noted if their laundering instructions were inconvenient (i.e. if the mask was hand-wash only). We also examined the fabric to see if it was substantial or flimsy, as well as the overall sewing construction of the mask. After many hours spent researching, testing and wearing multiple brands, Reviewed found its favorite face coverings. Here are some of the best cloth face masks we tested:

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ATHLETA EVERYDAY NON MEDICAL MASKS $20 for a set of five; athleta.com PROS: Three layers of fabric; comfortable; easy to adjust; breathable CONS: Care instructions: lay flat to dry Athleta is known for its functional workout and active lifestyle clothing, so we were curious about how their masks would perform. After hours of wearing them, the face coverings were better than expected. While the material is thinner than other masks, each one is triple-layered. It strikes a nice balance between providing protection and breathability. The masks are comfortable to wear for long periods at a time, as they have adjustable ear loops for a customized fit and an adjustable nose piece. The one drawback is that care instructions advise they not be put in the dryer, which can be an inconvenience.

ATHLETA

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OTHER HIGH-PERFORMING OPTIONS

PLOVER ORGANIC COTTON FACE MASKS $35 for a set of two; ploverorganic.com

TOM BIHN V1 REUSABLE CLOTH FACE MASK $13; tombihn.com PROS: Easy-to-adjust replaceable nose wire; multiple sizes CONS: Fit may be loose on smaller faces This mask, which comes in two sizes, is comfortable to wear due to the soft ear loops, and because of its construction, it did not cling to the face. The material is also densely woven (meaning more protection), but not thick to the point where it becomes hard to breathe.

PROS: Two layers of fabric; comfortable; soft material CONS: Weak elastic ear loops Plover started as an organic cotton bedding company, so it’s no surprise that its face masks are also made of 100 percent organic cotton. This mask was among the softest we tested, and it was comfortable to wear. The ear loops were not extremely tight around the ears, and the bendable nose piece kept glasses from fogging. Although it fit well, it could have been tighter to the face.

OLD NAVY

OLD NAVY TRIPLE-LAYER CLOTH FACE MASK $12.50 for a set of five; oldnavy.com PROS: Three layers of fabric; fits snug to face; breathable CONS: No adjustable nose wire This was one of the most budget-friendly options that Reviewed tested. The face covering is relatively simple and does not have an adjustable nose wire or a pocket for a filter, but it still performed better than other masks that had them. The soft cotton material made it comfortable to wear while out walking, and it was easy to breathe in. It fit well despite not having extra adjustments and has three layers of fabric which offers additional protection. The masks come in two styles – with and without adjustable ear loops. The version we tested had nonadjustable loops, and they struck a good balance between being tight enough to secure the mask, but not so tight as to cause pain around the ears. The only drawback is that without an adjustable nose wire there was a small gap around the nose, which had a tendency to fog glasses.

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SUMMERSALT FACE COVERINGS $32 for a set of three; summersalt.com

UNDER ARMOUR SPORTSMASK $30; underarmour.com

PROS: Three layers of fabric; comfortable CONS: Care instructions: do not tumble dry; nose wire needs re-adjustment

PROS: Five sizes; comfortable ear loops; soft material CONS: Care instructions: lay flat to dry; feels thick

The face coverings come in a three-pack that includes two patterned masks and a solid black one. They all feature the same material as Summersalt’s trendy swimsuits. Each mask is triple-layered, and the inner two layers are thick woven cotton. This mask forms a “cone” shape that gives a snug fit around the border of the mask, providing protection while leaving some space between your face and the material.

Designed for use while exercising, the Sportsmask touts performance fabrics, enhanced airflow, water-resistance, cool-to-touch feel, UPF 50+ sun protection and anti-microbial treatment. The design allows for a snug fit almost everywhere around its edges while leaving room to breathe around the nose and mouth. The “three-layer system” makes it thicker than most masks, however. The sensation is heavy, like wearing a blanket.

Jamie Ueda writes for Reviewed, a USA TODAY content partner offering product testing and recommendations at reviewed.com.

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Signal Boost Working from home with weak internet? There’s a ﬁx for that By Jefferson Graham

F YOU’RE HAVING TROUBLE with your video calls dropping, streaming programs buffering or websites taking too long to load on your computer, faster speeds from your internet service provider (ISP) may not be the solution. That’s the admittedly biased opinion

of Nick Weaver, co-founder and CEO of eero, which produces a line of devices that spread Wi-Fi signals more evenly throughout your home. “You’re welcome to pay Comcast more money monthly if you like, but it won’t solve the problem,” says Weaver, whose company is now a division of CONTINUED

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Nick Weaver JEFFERSON GRAHAM

Amazon. You will get faster internet if using a wired connection, “but not in the places of the home where you need it” or on the devices that depend on Wi-Fi, like laptops, smart TVs, connected speakers and more. ISPs are great at delivering a fast wired signal, but, in terms of distributing Wi-Fi from one end of a large house to another, you’ll likely need additional equipment. And Weaver isn’t the only one saying this. According to Stephen Baker, vice president of industry analysis with research firm NPD Group, sales of routers and mesh units were up 50 percent year-over-year through late 2020. The reason? “Not only are you working from home, and your kids doing their learning online, but you’re not going to the movies, and streaming 4K movies on your new 70-inch TV, and you need the bandwidth,” Baker says. ISPs get the bandwidth to the home, but how far can the router spread the signal? Service will be spottier the farther away you are from the router, according to Google, which competes in this space with its Nest Wi-Fi units. Other players include Netgear and Linksys. Connecting the units is relatively simple: You plug the main device into the back of your current router, and then plug the satellite units into electrical outlets throughout the home. The extender devices have radios which spread the signal. One recent development is the availability of Wi-Fi 6 in many newer models, a standard that increases capacity and speed and makes it easier to connect multiple devices. Here are some devices worth considering to boost your home’s Wi-Fi performance:

The eero 6 Wi-Fi 6 mesh system promises speeds up to 500 Mbps and enough bandwidth to provide high-speed connectivity for up to 75 devices. The units typically sell for $103 each or $223 for a three-pack. Upgrading to eero Pro 6 ($229 each; $599 for a three-pack) boosts the coverage area, allows users with gigabit ISP connections to take greater advantage of the extra speed and includes a Zigbee protocol smart home hub.

Netgear’s Orbi Tri-band Wi-Fi System with DOCSIS 3.1 built-in cable modem can replace your current internet router, which most people rent monthly. The $549.99 package comes with the router and one satellite device and promises to cover up to 5,000 square feet with speeds of up to 4.2 Gbps for more than 40 devices.

The Linksys MX5 Velop AX wholehome Wi-Fi 6 system was named the best overall Wi-Fi 6 home router system by Rolling Stone. Each node ($399.99) provides speeds up to 5.3 Gbps and covers up to 3,000 square feet.

Google rebranded its products as Nest Wi-Fi in 2019. In addition to boosting signal range, Nest Wi-Fi has a built-in speaker and the Google Assistant. A router and one remote point device sell for $269; a router and two points are $349. Nest Wi-Fi isn’t compatible with Wi-Fi 6, however.

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EDUCATION

Lessons Learned The pandemic presents unexpected challenges and beneﬁts for K-12 education By Jennifer Bradley Franklin

AUREN LENEIS’ DAUGHTER, A first-grader in

suburban Orlando, Fla., came home crying last fall after discovering that her beloved teacher was being abruptly transferred to another school. “She was sad. She didn’t want her teacher to leave and didn’t understand why,” Leneis

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EDUCATION still needs a push (to complete says. Because Orange County assignments),” Brown says. Even Public Schools allowed students though his son logs onto class to choose either in-person or diligently, he says, “After a while, virtual learning, teachers had been the kids are just over it. You’ve shuffled to accommodate the new really got to stay on them. For bifurcated reality. parents, helping your kids in “The county did a good job of school is your new job.” letting the teachers decide if they There has been a push-pull efwanted to (work) face to face or fect between parents and students virtual, but every quarter that who would prefer to reinstate has to be rebalanced as more kids in-person classes and teachers decide to come back (in person),” unions, some of which, including Leneis says. It’s just one of the the United Federation of Teachmany scenarios that has affected ers, have demanded all-virtual more than 56 million school-age programs and threatened to strike children in the United States if schools are reopened during the during the COVID-19 pandemic. pandemic. Former science teacher Beyond educating students, Eddie Brown, a Houston-based schools provide a host of comedian known professionally other valuable services. There are as Eddie B., offers daily virtual concerns that cases of abuse or comedy sessions with teachers neglect will from around go unreported the world, because chiladding a bit of dren are cut off humor to what STUDENTS ENROLLING IN from physical can be chalCOLLEGE IMMEDIATELY interactions lenging days. “I with teachers tell them, ‘You AFTER HIGH SCHOOL and professioncan now add DECLINED als who might to your résumé otherwise that you’re a make a report. certified IT According to specialist,’” Childhelp, a he says, nonprofit for highlighting IN 2020 the prevention the extra layer and treatment of technology SOURCE: National Student of child abuse, teachers must Clearinghouse Research Center more than 3.6 contend with million referwhile leading rals involving distance more than 6.6 million children are learning. made each year to child protection When pandemic shutdowns agencies in the United States. started last spring, school systems The Brookings Institute reported scrambled to adjust curriculums, that in March 2020 states such organize videoconferencing tools as Illinois, Oregon, Pennsylvania and make sure students had and Wisconsin saw reports of access to the internet and the child abuse fall by 20 percent to necessary technology. In August, 70 percent, primarily as a result Atlanta public schools approved of reduced contact with teachers, a nearly $25 million contract to doctors, day care providers and lease up to 40,000 iPads and other mandated reporters. Chromebooks to ensure that all students have a device on which UNEXPECTED BENEFITS to learn. Likewise, parents were forced to Nicole Beurkens is a licensed get creative and carve out at-home clinical psychologist with spaces for kids to learn, time to advanced degrees in education, supervise virtual school, and nutrition and psychology; she’s for those whose jobs take them also a mother of four children, two outside the house, to organize of whom are engaged in distance child care during the day. “My learning through their Grand 13-year-old son is doing remote learning. He’s very smart, but he CONTINUED

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EDUCATION terms of learning and education.” She points out that children are also learning practical skills at home — things like personal finance, cooking or doing laundry — that will serve them well in life. The pandemic has created advantages for some students, but for others, it’s been a setback. “I have significant concern for the segment of the population of kids for whom school is their only access point for caring supportive adults and for exposure to reading, writing and math,” Beurkens says. “For those kids, the longer they’re out of school, the more that gap widens, and the more work is going to need to be done to help support them and catch them up.” Lack of parental support, resources such as connectivity or books, and access to proper nutrition can all be detriments to learning, she says.

High school student Nate Beurkens PROVIDED BY NICOLE BEURKENS

ELISE KUTT

“For the majority of kids, I’m not worried about long-term fallout. ... I have significant concern for (those) for whom school is their only access point for caring supportive adults and for exposure to reading, writing and math.” — NICOLE BEURKENS, clinical psychologist

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Rapids, Mich., public schools. She says that while challenges abound, “some kids have done markedly better. Kids who were overwhelmed by the (traditional) school environment or needed, but were not getting, one-on-one or small-group instruction have done much better in this situation.” Beurkens notes that most educators have to teach to the middle of the class. In a virtual environment, students who finish work quickly can pursue their additional academic and extracurricular interests, while students with mild to moderate learning challenges can access smaller group instruction with greater explanation or repetition as needed. “One of the big benefits has been that schools are willing to be more flexible,” Beurkens says. “For the majority of kids, I’m not worried about long-term fallout in

POSTSECONDARY CHANGES Prior to COVID-19, some universities, such as UCLA, were considering abolishing standardized testing as a basis for admission. But the pandemic’s disruption of typical school patterns “is causing standardized tests like the SAT and ACT to become even more necessary,” says Matt Larriva, founder of Powerful Prep, a California-based company offering college admission test preparation services. “Those tests allow college administrators to look at students on an apples-to-apples basis. Opponents will say, ‘Why don’t you just look at GPA?’ But ... with the well-documented grade inflation problems, it’s really hard to pick which student is qualified to attend a certain university (under normal circumstances),” he says, noting that a year of remote education is likely to exacerbate those issues. In many communities across the country, ACT and SAT testing has been canceled or limited. Partially in response to this, more than 400 colleges and universities have made their application processes test-optional for the 2020-2021 admissions cycle. In December, the National Student Clearinghouse Research Center released its annual high CONTINUED

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Temperature screening at a STEM camp in Wylie, Texas LM OTERO/ASSOCIATED PRESS

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“I’m hoping that some students feel it’s destigmatized to not go to college. They might take an opportunity to go to a coding boot camp or look into an advanced trade program. There’s some real potential for some positive shifts to come out of all of this.” — MATT LARRIVA, founder, Powerful Prep

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school benchmarks report showing that, while COVID-19 had little impact on high school graduation rates, the number of students who went to college immediately after high school declined 21.7 percent from the previous year. And, as of Dec. 18, the number of students who had filled out the Free Application for Federal Student Aid was down 12.7 percent, indicating that 2021 college admissions may also be proportionately lower. The long-term economic impact could be significant. A report issued by the United Nations’ Organization for Economic Co-operation and Development estimated that in the United States alone, pandemic-related school closures in 2020 will result in future GDP losses of between $14 trillion and $28 trillion. Larriva is optimistic that the pandemic’s effects on education

will open minds to alternate learning and career paths. “I’m hoping that some students feel it’s destigmatized to not go to college (if it’s not right for them). They might take an opportunity to go to a coding boot camp or look into an advanced trade program,” he says. “There’s some real potential for some positive shifts to come out of all of this.” It’s too early to tell what the long-term effect of the pandemic will be, both on the educational system broadly and on individual students. “We’re looking probably at a year to five years out to really see the impact of this as kids progress,” says Beurkens. For now, Beurkens recommends parents focus on their child’s individual needs, academically and emotionally, as schools and teachers continue to make adjustments.

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Zutor Ashley Bonzell

Zutor Christopher Levenberg

JENNIFER SILVERSTEIN; PROVIDED BY CHRISTOPHER LEVENBERG; GETTY IMAGES

Rise of the Zutor How one mom is making remote learning a whole lot easier By Sarah Sekula

N MANY WAYS, ELYSSA Katz is

a typical working mom in the pandemic era, balancing her professional commitments with the care and remote schooling of three young children. “Like most families, we were

under enormous stress when we had to navigate remote learning and take on the role as teacher,” says Katz, whose kids are 3, 6 and 8 years old. “Don’t get me wrong, the teachers and schools did the best they could with the amount of time they were given, but it was only natural that the pressure was on parents to transition their kids to this new world

of virtual learning.” Each night, she says, she would fall asleep in her Santa Monica, Calif., home brainstorming ways to reduce the mounting household stress. In May, after realizing she was completely burned out on distance learning, she CONTINUED

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had her aha! moment: What if she could find the perfect tutor to step in and handle virtual learning for her children? Katz invested a good deal of time in that search. Along the way, she realized that she could help other families do the same. So she founded The Zutor Concierge, which matches pupils with educators for in-person tutoring. The service is now helping families across the country and abroad and has grown to include 500 Zutors — Zoom tutors — with thousands of client applications by the end of 2020. For now, all Zutors work with students in their homes, but virtual tutoring is a service Katz plans to offer soon. “My boys share a Zutor and he is truly our angel,” Katz says. “He has become such an integral part of the boys’ school year.” Her daughter is in a pod of 3- and 4-year-olds led by a preschool teacher. Katz conducts multiple phone interviews with applicant families. “My conversation includes getting to know more about the child’s needs, struggles and where they shine,” she says. “Some parents do provide a list for me to help me along my matchmaking journey, but I find that I can usually get a very good sense of

Elyssa Katz

what is needed after we have spoken a few times.” Katz similarly interviews each Zutor in person or via Zoom. “They need the opportunity to ask me questions and get to know who I am because, like the family, they are trusting me to make the right match,” she says. “Whether this is a one-hour-per-week job or a 35-hours-a-week job, I want each educator to feel enthusiastic and prepared.” Zutors and families then meet virtually prior to the first session “so that everyone can make sure it’s a good fit,” Katz says.

Christopher Levenberg, a Los Angeles-based Zutor who worked as a preschool teacher for six years, teaches in small groups, which he says creates teamwork and helps ensure each child is thriving and getting what they need despite school being so different this year. “We’re not just going through the motions, but bringing literature to life by reading and talking with them about books they’re really interested in,” Levenberg says. “We’ll practice math by talking about money and the cost of their favorite toys and how long they’d need to work at a certain salary to save up for their toys.” They also squeeze in as much time for art as they can. “One of my students loves modeling clay, so we’ll take breaks from math and reading to mold figures from Mario Kart and other creatures from his imagination,” Levenberg says. “Art is a fantastic way to take a mental break from one subject but still apply critical and spatial/visual thinking skills in whatever project we’re currently working on.” As for her family, “It’s been very eye-opening to watch both our Zutor and preschool teacher work with the kids,” Katz says. “Educators are extraordinary humans.”

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JARED LAZARUS/DUKE UNIVERSITY

A member of Duke University’s Compliance Team distributes COVID-19 information to students.

By Adam Stone

Making the Grade Culture, communication common among colleges that successfully reopened

ENIOR YEAR HAS BEEN anything but typical for Benjy Renton. His study-abroad program in China was cut short in January 2020 by the coronavirus. Back at Middlebury College in Vermont, the student journalist joined a national team of researchers in development of a dashboard to contact-trace Donald Trump, documenting the impact of the former president’s CONTINUED

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Benjy Renton KATHERINE KOEHLER

“I was pleasantly surprised at how much it did feel like being at school. And it’s certainly much better to be on campus than in your parents’ basement.” Duke University testing site

— BENJY RENTON, Middlebury College student

JULIE SCHOONMAKER/DUKE UNIVERSITY

COVID-19 infection. When Middlebury oﬀicials initially announced plans to reopen campus in the fall, Renton had his doubts. “I was skeptical about the plans based on what was happening nationally in July, when there was no testing and the cases were spiking. I thought, ‘This is going to be terrible,’” he says. But the semester exceeded Renton’s expectations. “I was pleasantly surprised at how much it did feel like being at school,” he says. “And it’s certainly much better to be on campus than in your parents’ basement.” Around the nation, many colleges were able to open for on-campus learning in

the fall, even in the face of pandemic concerns. By looking at what went right, experts say, it may be possible to chart a smoother, successful path forward.

STAYING IN-PERSON From the start of the pandemic, the College Crisis Initiative at Davidson College in North Carolina tracked some 1,900 four-year institutions and 1,000 two-year schools. About 55 percent of them opened for on-campus learning in the fall, according to founding director Chris Marsicano, an assistant professor of the practice of higher education at Davidson. Overall, most schools’ efforts were

successful — even if some had to be graded on a curve. “The vast majority of institutions that started in-person or hybrid (classes) stayed in-person or hybrid,” Marsicano says. Not everyone got passing marks, of course. A number of campuses opened in the fall, only to scale back their in-person learning as COVID-19 spread through the student population. The University of Notre Dame in Indiana switched to online learning for two weeks in response to a spike in coronavirus cases; Oklahoma State University quarantined an entire sorority, while Colorado College had to quarantine a dormitory. In the majority of cases where cam-

puses reopening did go well, however, a set of common characteristics emerged, Marsicano says. “First is controlling the mobility of students, not letting students leave campus,” he says. “Second is (coronavirus) testing. Colleges that tested every student (upon arrival) kept their cases down, because they could catch outbreaks before they happened.” And those schools that succeeded with in-person learning focused on creating a campuswide culture in support of safe practices. “Those colleges that did well were able to convince everybody to wear CONTINUED

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Information desk, Rice University student center JEFF FITLOW/RICE UNIVERSITY

masks all the time,” Marsicano says. “They were able push students to be accountable to each other. The schools that sent a message — we are all in this together — they did very well.”

CULTURE OF SAFETY Duke University leaned heavily into testing, delivering close to 200,000 COVID-19 tests from August to November. “Over those four months we had a total of 152 positive tests, and 26 of those were students who tested positive on

arrival,” says Michael Schoenfeld, Duke’s vice president for public affairs and government relations. Widespread testing played a decisive role in the campus’ fall success, Schoenfeld says. “If you have people living and working together, testing and tracing is an essential piece of managing the health of that population,” he says. “If somebody tested positive, they were immediately put in isolation. We had set aside 300 beds on campus for isolation

and quarantine. That absolutely had a significant impact on reducing the overall number of infections.” Duke reduced the resident population from 6,000 to about 3,200. “That allowed every student to have a single room, and it reduced the density in shared bathrooms and dining facilities,” Schoenfeld says. The school also curtailed events and activities. “We had mandatory masking requirements from day one on campus, with a stringent policy for distancing,” Schoenfeld says. “We closed

a number of common facilities — the libraries, the art museum.” At Franklin Pierce University in rural Rindge, N.H., a collaborative approach was key to driving student adherence to COVID-19 guidelines. The school formed working groups comprised of students, faculty and staff to help guide the pandemic response and to garner broad buy-in among campus constituencies. “The working groups originally CONTINUED

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Adelphi University ADELPHI UNIVERSITY

Physics class at Rice University JEFF FITLOW/RICE UNIVERSITY

convened over the summer and continued to meet throughout the fall semester to evaluate the effectiveness of our implementation and to respond to emerging challenges,” says university president Kim Mooney. “Those ongoing conversations have helped ensure that our approach during the pandemic was based on real-life daily experiences of the people who teach and work here and by those who live and learn here.”

OPEN COMMUNICATION At Adelphi University on New York’s Long Island, frequent and open communication proved key in helping to keep all seven residence halls open through the fall semester. In addition to limiting student gatherings and redesigning classroom spaces to allow for social distancing, the admin-

istration adopted a policy of “communicating transparently, consistently and concisely,” says Kristen Capezza, vice president of enrollment management and university communications. “Our students and families — and (the) internal community of staff and faculty — received regular guidance leading up to and throughout the semester,” she says. The school’s website shared detailed information, with supporting videos to communicate key content. “Our ‘Pledge to Protect’ was widely publicized to generate our community’s commitment to measures that intended to protect everyone’s health, safety and well-being,” Capezza says. Of course, students aren’t going to get it right all the time. Having a studentcentric disciplinary response helped

some institutions smooth out the bumps and keep everyone aligned toward the greater community need. At Rice University in Houston, for instance, a student-led COVID-19 Community Court adjudicated infractions and meted out penalties that included writing letters of apology, performing community service projects and meeting with advisers. “There is only so much the administration can do. As an administrator, I don’t socialize with (students), I don’t eat with them, but their peers do,” says Emily Garza, Rice’s director of student judicial programs. “Students need to see that their peers are also modeling this behavior and compelling them to comply,” Garza says. With the student-led court, “the people saying that this is important are the

Duke University JULIE SCHOONMAKER/DUKE UNIVERSITY

people who live with you and socialize with you and eat with you.”

LOOKING AHEAD Schools that struggled can draw lessons from their more-successful counterparts. “It’s a matter of leadership,” Marsicano says. “In the fall, we saw that institutions whose leaders identified problems early, who made data-driven decisions and drew on their institutional ethos, were able to succeed.” Marsicano added that a funding boost could also help. He notes that tests can cost as much as $100 each, and a vigorous program of frequent testing can represent a significant financial hurdle. “States need appropriate funds in support of this,” Marsicano says. “That would make a big difference.”

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Telehealth Thrives in Trying Times Pandemic spotlights the advantages of remote health care By Robin Roenker

F THE COVID-19 PANDEMIC has any sort of silver lining, it may be that it has helped telemedicine go mainstream. When most of the country went into lockdown last March, telehealth became many physicians’ primary means of connecting with patients. The University of Mississippi Medical

Center (UMMC) — one of two federally designated National Telehealth Centers of Excellence — performed 16,938 telehealth visits in 2019. In 2020, UMMC providers conducted more than 165,000 visits via telemedicine, a roughly 874 percent increase. The story is the same throughout the country. Prior to COVID-19, the University of Pittsburgh Medical Center (UPMC) typically conducted 250 telemedicine

visits per day. By the end of 2020, the UPMC health care system was handling 15,000 telehealth visits daily. The telemedicine boom was aided by new, temporary flexibility regarding the types and manner of services that can be provided via telehealth, while still being eligible for coverage by Medicare and Medicaid services. In February 2020, before the federal provisions went into effect, just 0.1

percent of Medicare-covered primary care visits were conducted via telehealth. Two months later, in April, telemedicine represented 43.5 percent of Medicarecovered primary care appointments. By June, the number of patients using telehealth to replace canceled in-person appointments was more than four times the rate of telehealth appointments in CONTINUED

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UNIVERSITY OF PITTSBURGH MEDICAL CENTER

By the end of 2020, the University of Pittsburgh Medical Center system was conducting 15,000 telehealth visits daily.

2019, according to a McKinsey & Co. study. “Prior to the pandemic, the utilization of telemedicine by consumers and physicians was actually quite low,” says Ann Mond Johnson, CEO of ATA (American Telemedicine Association), which is lobbying to make many of the coronavirus-related telehealth provisions permanent. “From our vantage point, the pandemic served to accelerate things. We saw 10 years’ growth in 10 weeks.”

INDIANA UNIVERSITY HEALTH

Dr. Shashank Dave, a physical medicine and rehabilitation physician at Indiana University Health, says patients are often more at ease during telehealth appointments.

CONVENIENT OPTION For patients like Brady Conway, a 27-year-old from St. Clairsville, Ohio, who has autism and epilepsy, telehealth has been a godsend. Prior to the pandemic, Conway’s mother, Jerri McCombs, had to take an entire day off from her job as a nurse to drive him to his behavioral health appointments at UPMC Western Psychiatric Hospital in Pittsburgh, roughly 70 miles away. The trip was agitating for Brady, who is nonverbal, and he was often physically disruptive in the waiting room and during appointments. “It was always stressful, and he was all over the place,” McCombs says. Without the commute, Conway’s doctors were able to see his more typical behavior in his home environment. “Telehealth should, honestly, always be the solution for this population,” McCombs says. Janet Strauch of Greenfield, Ind., found even routine checkups to be more convenient and less stressful using

videoconferencing. “Telehealth saves me at least an hour in commute time, and I actually felt like I got more one-on-one time with the physician to really focus and discuss my personal case,” says Strauch, who used telemedicine for the first time during the pandemic to address orthopedic pain in her spine. Immune suppressed due to medications she is taking, Strauch says telemedicine allowed her to stay on top of her follow-up care without unnecessary risk of exposure to COVID-19. “There are so many advantages to telehealth for appointments that don’t require an in-person procedure,” says Dr. Shashank Dave, a physical medicine and rehabilitation physician at Indiana University Health who is treating Strauch. “There’s ease of use, decrease in travel time. Plus, I’m able to see patients in their normal, natural environments. And I think that helps patients feel more relaxed and at ease during appointments.”

EQUAL ACCESS Beyond its convenience, telemedicine makes health care more equitable by delivering access to primary and specialized care in rural areas that often have few providers. In Mississippi, it allows UMMC specialists — including cardiologists, dermatologists, allergists and psychiatrists — to provide care to patients throughout the state. Telehealth also CONTINUED

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USE THIS

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UNIVERSITY OF MISSISSIPPI MEDICAL CENTER

Dr. Will Campbell, a cardiologist, and Marlene Holloway, a registered nurse care coordinator, meet with a patient via videoconference.

provides physicians with a cutting-edge tool for preventative care. Remote patient monitoring from UMMC Telehealth, for example, connects rural Mississippians with chronic conditions, including diabetes and heart disease, with health care providers who can help monitor and manage their symptoms. Behavioral health is another area in which telehealth usage is growing. While platforms to remotely deliver mental health care existed well before COVID-19, “some providers were a little bit resistant to adopting them. It’s a different way of practicing,” says Dr. John Torous, director of the digital psychiatry division at Beth Israel Deaconess Medical Center in Boston. “COVID has been a catalyst

“Prior to the pandemic, the utilization of telemedicine by consumers and physicians was actually quite low. From our vantage point, the pandemic served to accelerate things. We saw 10 years’ growth in 10 weeks .” — ANN MOND JOHNSON, CEO, American Telemedicine Association (for adoption). I think most patients have been very excited to use telehealth.” JMIR Mental Health, an academic journal for which Torous serves as editorin-chief, recently published research showing that, of surveyed patients who used telepsychiatry during the pandemic,

more than 80 percent had an overall positive experience with remote care — whether via video or telephone — and 63.6 percent said it has been as effective as their in-patient sessions. To achieve telehealth’s full potential, providing reliable, high-speed internet

access to every community must be a priority, advocates say. “We are a rural community, and the (internet) bandwidth in some of these areas is very slim,” says Dr. Danette McAlhaney, a family medicine specialist in Bamberg, S.C., who has been providing telehealth visits for four years. “At times, we’ve had to do audio visits only, because we aren’t able to do video visits for those areas.” And while McAlhaney doesn’t think telemedicine should replace every in-person visit, she knows it serves an important role in bringing high-quality care to her patients. “It’s a good add-on service,” she says. “It has its time and its place.”

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Stress and Strain Study indicates a link between COVID-19 and mental health By Fiona Soltes

S THE COVID-19 PANDEMIC reaches

the one-year milestone, many people have reported experiencing some degree of coronavirus-related stress or anxiety. And those issues may be more acute for those who’ve had the disease. Researchers in the U.K. analyzing electronic health records of nearly 70 million Americans — including more than 62,000 COVID-19 patients — found that 18.1 percent of people infected with the coronavirus were diagnosed with a psychiatric disorder within 90 days of infection. Further, those who had received a mental health diagnosis within the previous year were slightly more likely to contract the coronavirus, and a similar number of coronavirus patients (1.6 percent) received an initial dementia diagnosis within 90 days of contracting COVID-19. The study was published last November in The Lancet Psychiatry journal. James C. Jackson, assistant di-

rector of the ICU Recovery Center at Vanderbilt University Medical Center, ﬁnds the results interesting but “not at all surprising. It’s what we would expect, and what we have seen historically in other contexts.” Mental health concerns such as depression, post-traumatic stress disorder (PTSD) and cognitive impairment are prominent for many non-COVID intensive care survivors, he says. With COVID-19, mental health concerns may be related to the overall experience or the illness itself. “There’s no doubt, for some percentage of individuals with COVID, that their brains are affected in ways that are either fundamental or peripheral,” Jackson says. The common symptom of loss of smell, for example, is neurological. Kristin Addison-Brown, a clinical neuropsychologist in Jonesboro, Ark., says COVID-19 often has pulmonary aspects; prolonged periods of low oxygen can trigger dementia and other mental challenges. There’s also potential overlap between depression and prolonged fatigue commonly associated with COVID-19. As for a prior mental illness diagnosis being a risk factor for COVID-19, Jackson and Addison-Brown say these people may be engaging in unhealthy behaviors — or not engaging in healthy ones — that would affect that risk. Someone with

an anxiety disorder, for example, may feel unable to wear a mask. Another who is depressed may not visit the doctor, exercise or eat healthy foods. Someone with dementia may forget to adhere to pandemic hygiene and safety protocols. Socioeconomic status can also play a role, as financial uncertainty can increase stress and limit access to care. It may not matter whether a mental health diagnosis or illness comes first. Until there’s evidence otherwise, Jackson says, traditional treatments for depression, PTSD and anxiety could still be helpful. There may be nuances, but someone shouldn’t avoid seeking care. With depression and anxiety in general, ruling out underlying causes like thyroid issues or other physical disturbances first is important, Addison-Brown says. After that, it can be “treating the symptom, because that’s what’s causing the distress for the individual.” Patients should start by contacting their primary care physician, she says, and discuss whether a different level of care is needed. It’s time to seek help, Addison-Brown says, when mental health challenges affect day-to-day functioning or cause significant distress. Both Jackson and AddisonBrown found the study’s link between dementia and COVID-19 notable. Here, an underlying cause may be more important in determining the right treatment. The link to dementia, Jackson says, could include those with an underlying but not-yet-expressed condition, or those with diminished cognitive reserve. These patients — especially the elderly, frail and otherwise vulnerable — may have been on the verge of dementia prior to a COVID-19 diagnosis.

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Do You Need Mental Health Help? First, determine how much your symptoms interfere with daily life

IF SO, CONSIDER THESE SELF-CARE ACTIVITIES: uExercising (e.g.; aerobics, yoga)

DO YOU HAVE MILD SYMPTOMS THAT HAVE LASTED FOR LESS THAN TWO WEEKS? uFeeling a little down uFeeling down, but still able to take care of yourself or others, do your job, schoolwork or housework uSome trouble sleeping

uEngaging in social contact (virtual or in person) uGetting adequate sleep on a regular schedule uMaintaining a healthy diet uTalking to a trusted friend or family member uPracticing meditation, realization and mindfulness If symptoms do not improve or seem to be worsening despite self-care efforts, talk to your health care provider.

DO YOU HAVE SEVERE SYMPTOMS THAT HAVE LASTED TWO WEEKS OR MORE? uDifficulty sleeping uAppetite changes that result in unwanted weight shifts uStruggling to get out of bed in the morning because of mood uDifficulty concentrating uLoss of interest in things you usually find enjoyable uUnable to perform your usual daily functions uThoughts of death or self-harm

SEEK PROFESSIONAL HELP: uPsychotherapy (talk therapy) — virtual or in person; individual, group or family uMedication uBrain stimulation therapies

For help finding treatment, visit nimh.nih.gov/health/find-help If you are in crisis, call the National Suicide Prevention Lifeline at 800-273-TALK (8255), or text the Crisis Text Line (text HELLO to 741741).

SOURCE: National Institute of Mental Health

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Tech Takes On Tension More companies turn to meditation apps to help employees relax By Gina Harkins

HERE’S NO DOUBT THE last year has left Americans stressed. Businesses, schools and other institutions shut down as the coronavirus swept across the country and the globe. Tens of millions lost their jobs, and many of those who remained employed have had to juggle working from home with helping their children with remote learning.

At the same time, the country was in the middle of a highly charged presidential election, and racial justice protests and counterprotests sprung up in cities nationwide. When the company I work for announced in October that it would begin oﬀering free access to the Calm app, which provides meditation tools, soothing sleep stories, music and other services, I signed in on day one, starting CONTINUED

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“If there’s one tiny silver lining with this pandemic, it’s that (the stigma surrounding mental health) is starting to fade a bit.” — DARCY GRUTTADARO, director of the Center for Workplace Mental Health with the American Psychiatric Association Foundation

CALM

with a daily meditation designed to reduce anxiety in a week. Turns out I’m not alone in getting a new work benefit to help manage stress. Data shows the rate of people experiencing anxiety and depression has tripled during the pandemic, says Darcy Gruttadaro, director of the Center for Workplace Mental Health with the American Psychiatric Association Foundation. And employers are realizing they need to offer more mental health benefits, she says. “Emotional health, mental health, physical health — there are more and more studies showing that they all have an impact on performance, productivity and retention,” Gruttadaro says. “We also know ... stress impacts physical health. That’s costly for employers.” Calm and Headspace, another popular meditation app, have seen big usage spikes. Daily downloads of Calm have doubled since the pandemic started, according to a company spokesperson. Since March 2020, Headspace has experienced a 500 percent increase in requests from companies looking for ways to support employees’ mental health. “We currently have more than 1,500 companies, such as Starbucks, Adobe, GE, Hyatt and Unilever, who offer Headspace for Work to help employees take care of their minds, build more productive cultures and foster higher-performing organizations,” says

Megan Jones Bell, chief strategy and science officer at Headspace. Some of the app’s most popular features are live group meditations, sleep music and exercises to curb stress and anxiety, she says. On Election Day, Headspace saw a 965 percent increase in unique users from the week before. It even released a special “Politics Without Panic” selection of exercises, which Jones Bell says were “designed to help people handle the mix of emotions they were experiencing.” A 10-minute meditation known as the “Daily Calm” is one of Calm’s most popular features, along with bedtime sleep stories for grown-ups and kids. Gruttadaro, whose center offers resources to employers looking to promote mental health, says she’s also seeing more organizations access its training guides and other tools during the pandemic. “If there’s one tiny silver lining with this pandemic, it’s that (the stigma surrounding mental health) is starting to fade a bit,” she says. “People are starting to recognize that all of us are vulnerable.” Mindfulness and meditation apps can help people relax and focus, Gruttadaro says, which is likely why they’re becoming a popular benefit for employers. Burnout can lead to turnover, which isn’t good for a company’s bottom line. “We want to retain our high performers,” she says. I’ve been using Calm multiple times each

week, mostly tuning in to short, on-demand meditation exercises focused on gratitude or releasing anxiety. If I’m short on time, I take a few moments to view one of the app’s serene scenes, such as snow falling or the northern lights. Even if I don’t have time to access the app, I’m now able to recall the breathing exercises repeated in many of the meditations. One hurdle to employee adoption is the concern that tapping into mental health resources offered at work could harm one’s career. I have wondered if my employer can see how I’m using the Calm app. Do they receive reports showing those of us who might be dealing with anxiety, stress or sleep problems? Calm did not respond to multiple requests for comment about whether they share user data with the companies that pay for subscription plans. Jones Bell says Headspace doesn’t share any personalized data with employers. “The metrics are provided in the aggregate, so they don’t receive details about specific actions any individual employee takes within the Headspace app,” she says. Company leadership can play a big role in helping employees feel comfortable using any new mental health benefits they might be offering, Gruttadaro says. “That opens the door to people thinking, ‘Well, if the leaders are using it and the senior management folks are using it, then it’s OK for me to use it, too.’”

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Goodbye Slopes, Hello Stables For ski-resort fun without the crowds, pony up to a working ranch

C Lazy U Ranch in Granby, Colo. C LAZY U RANCH

By Matt Alderton

IKE TOMATOES AND SWEET

corn, cattle ranching ripens in summer, when cowboys and cowgirls spend long, hot days galloping between pastures on horseback counting and herding cows before shipping them to market. But ranch work doesn’t cease come winter — least of all in the Rocky Mountains, where extreme weather demands constant vigilance from the ranch hands who care for land and livestock. A ranch hand’s winter chore list can include removing snow, repairing fences or conducting animal health checks. And

on some properties, winter is calving season. “Our calving season starts in January,” says Jennifer O’Donohue, brand and communications director at Triple Creek Ranch in Darby, Mont. “We have about 250 cows that will usually drop about 200 or so calves. Taking care of those cows and calves is a full-time job.” Although ranchers don’t get winters off, their burden is a traveler’s benefit, as these lands serve as superb backdrops for seasonal getaways — now, more than ever. With the COVID-19 pandemic still raging, traditional winter retreats like ski resorts might not sound as appealing as they once did. “Ranches are very well positioned

for people who want to escape large mountain towns and crowded ski resorts where you have really big hotels and a lot of commingling,” explains Brady Johnson, director of sales and marketing at C Lazy U Ranch in Granby, Colo. He says ranches are ideal for social distancing because they’re typically small, remote, self-contained and designed around outdoor activities in wide-open spaces. Plus, many guest ranches have made operational changes — reducing capacity limits, for example, and offering private instead of group activities — to mitigate coronavirus risks even further. “Even without COVID, a lot of people just don’t want to deal anymore with the

hustle and bustle of ski resorts,” Johnson continues. “Ranches are easy. You don’t have to make reservations and book activities and rent a bunch of gear. You just show up.” What you find when you show up might surprise you. Instead of manure and manual labor, modern-day guest ranches offer experiences that marry personal service and opulent amenities with rustic recreation and authentic agrarianism. In wintertime, especially, the result is a vacation that feels familiar enough to be comfortable but novel enough to be exciting. The following guest ranches will have you dreaming of stables this winter instead of ski lodges:

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C LAZY U RANCH Granby, Colo. Located 86 miles northwest of Denver is the familyoriented C Lazy U Ranch, an all-inclusive property that dates back to 1919. “I would compare it to an African safari,” Johnson says. “You’re paying one price to have an awesome experience that you’ll never forget, doing things that are unique to the area that you can only do by going to a property like ours.” Chief among those activities in winter is horseback riding through what Johnson calls a “winter wonderland.” There’s also ice skating on a frozen pond, tubing on a natural hillside and snowshoeing, cross-country skiing and snowmobiling on a vast network of groomed trails that traverse the ranch’s 8,500 acres. “There are a lot of nice ranches out there, but when you come to ours, you realize that someone actually chose to homestead this land 100 years ago,” Johnson adds. “It’s truly authentic.” uclazyu.com

C LAZY U RANCH

BRUSH CREEK RANCH Saratoga, Wyo. Wyoming is quintessentially Western, and all-inclusive Brush Creek Ranch is quintessentially Wyoming. Homesteaded since 1884, it encompasses 30,000 acres across three separate properties: The Lodge & Spa at Brush Creek, which occupies the original 6,600-acre ranch; Magee Homestead, which offers private group buyouts; and French Creek Sportsmen’s Club for BRUSH CREEK RANCH

hunting and fishing. In winter, activities include not only outdoor staples like crosscountry skiing, snowshoeing, snowmobiling, ice skating, ice hockey and ice fishing, but also indoor options like shooting at the ranch’s state-of-the-art gun club; culinary classes at The Farm, an epicurean Eden that has its own greenhouse, creamery, brewery, distillery and wine cellar; and horseback riding at its 28,000-square-foot riding arena.

If you ask chief operating officer Mike Williams, however, the ranch’s most exciting winter amenity is Green Mountain. Located 20 minutes away, the private ski mountain opened in 2019 and hosts just 12 skiers a day, who are transported to the mountain’s summit via snowcat. “Until last year, you could do everything here but ski,” Williams says. “Now, there’s really nothing you can’t do here.” ubrushcreekranch.com

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TRAVEL

BLUE SKY RANCH Wanship, Utah Before it was home to an elite luxury resort — The Lodge at Blue Sky, Auberge Resorts Collection — Blue Sky Ranch was the site of a working cattle ranch and a horse rescue organization, Saving Gracie’s Equine Healing Foundation. Now, all three coexist on 3,500 acres near Salt Lake City. For downhill skiers, the property has its own ski lounge at the base of nearby Park City Mountain Resort, which affords Blue Sky guests the chance to carve Park City powder while forgoing Park City crowds. And yet, guests needn’t leave the ranch at all thanks to on-site activities like snowshoeing, cross-country skiing, sporting clays, fly-fishing, snowmobiling and dogsledding. There’s even heli-skiing, where a helicopter transports guests to private ski zones in the Uinta and Wasatch mountain ranges, or natural horsemanship lessons in the style of legendary “horse whisperer” Buck Brannaman. “People naturally go into a more inward, introspective state during the winter season,” explains Henry Hudson, Blue Sky Ranch general manager. “Being outdoors in the elements, working with animals and exploring the peace of our land is a very powerful conduit for putting one back in touch with oneself.” uaubergeresorts.com/ bluesky

MURPHY O’BRIEN/BLUE SKY RANCH

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TRAVEL

TRIPLE CREEK RANCH Darby, Mont. An all-inclusive, adults-only guest ranch that’s surrounded by 4 million acres of national forest, Triple Creek Ranch encompasses 28,000 acres across three noncontiguous parcels, the largest of which is home to the 26,000-acre CB Ranch, Triple Creek’s working cattle operation. In winter, however, most of the action takes place on the other two parcels: the main ranch, where there is year-round horseback riding, and nearby Lavene Creek, where there’s a 15-mile looped trail system for guided snowshoe hiking, snowshoe running, fat biking, cross-country skiing and skate skiing, which combines cross-country skiing with in-line skating. For downhill skiing, staff whisk guests 30 minutes north to Lost Trail Powder Mountain, a family-owned ski hill that’s perched atop the Continental Divide. “It’s not a flashy, Aspen-type experience; it’s where the locals ski, and it very much feels that way,” O’Donohue says. “It’s old and rustic, but the skiing is fabulous, and you never have to wait in line for a lift.” utriplecreekranch. com

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ART FROM XXXXX THE HEART

PANDEMIC PORTRAITS Artists across the country have utilized public spaces to express their sentiments about the coronavirus — encouraging safe behavior, honoring first responders or representing some of the angst many of us have felt over the past year.

ERIC GAY/ASSOCIATED PRESS (2); DAVID ZALUBOWSKI/ASSOCIATED PRESS

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AMERICA RENEWED 2021

Articles inside

TELEHEALTH THRIVES

RANCHING R&R

LESSONS LEARNED

RISE OF THE ZUTOR

MAKING THE GRADE

GOT YOU COVERED

CLEARING THE AIR

SIGNAL BOOST

REOPENING TOOLS