AMERICA REOPENED 2021 by STUDIO Gannett

SPECIAL EDITION

AMERICA REOPENED 2021

On the Mend

BUSINESS Corporations help curb virus’ spread

WHAT’S NEXT? Experts say learn to live with COVID-19

EDUCATION Virtual learning tactics transition to classrooms

HEALTH Some parents uneasy about teen vaccines

USA TODAY SPECIAL EDITION

CONTENTS

202 1 S PECI A L E D ITI O N

AMERICA REOPENED

RECOVERING ECONOMY Forecasters predict a post-pandemic rebound GETTY IMAGES

FEATURES

ANSWERING THE CALL These companies stepped up to combat COVID-19

CARING FOR CAREGIVERS Mental health providers struggle to offer comfort during pandemic

AFTER EFFECTS? Experts foresee a long future with COVID-19

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CONTENTS This is a product of

EDITORIAL DIRECTOR Jeanette Barrett-Stokes jbstokes@usatoday.com

CREATIVE DIRECTOR Jerald Council jcouncil@usatoday.com

MANAGING EDITOR Michelle Washington mjwashington@usatoday.com

ISSUE EDITOR Tracy Scott Forson

ISSUE DESIGNER Debra Moore MICHIGAN STATE UNIVERSITY

PRODUCTS

8 12

EDUCATION

CATCH SOME RAYS UV devices sanitize and protect

SEAL OF APPROVAL EPA-certiﬁed disinfectants keep it clean

SURVIVAL STORIES

CARING CURRICULUM

TRIED & TRUE

HEALTH + MEDICINE

Reviewed.com recommends items for fun and ﬁtness

TEEN VACCINES

UNWANTED UPTICK

Parents cautious about shots for minors

Students and teachers recall unprecedented school year

Nursing schools pivot to train students for COVID-19

LESSONS LEARNED Remote-learning techniques enter the classroom

TEACHING TOOLS Innovations enable high-tech instruction

PHOTO FINISH GETTY IMAGES

Reopenings reconsidered amid spread of delta variant

DESIGNERS Hayleigh Corkey David Hyde Gina Toole Saunders Lisa M. Zilka CONTRIBUTING WRITERS Matt Alderton, Deena C. Bouknight, Alia E. Dastagir, Jennifer Bradley Franklin, Pam George, Sheryl Nance Nash, Chris Quintana, Erin Richards, Adrianna Rodriguez, Adam Stone, Meena Thiruvengadam, Elizabeth Weise

ADVERTISING VP, ADVERTISING Patrick Burke | (703) 854-5914 pburke@usatoday.com

ACCOUNT DIRECTOR Vanessa Salvo | (703) 854-6499

PANDEMIC PORTRAITS

vsalvo@usatoday.com

Muralists’ art imitates life

HERE TO STAY

EDITORS Amy Sinatra Ayres Harry Lister Deirdre van Dyk Debbie Williams

FINANCE

Some COVID-19-inspired innovations may stick around

Billing Coordinator Julie Marco

ISSN#0734-7456 A USA TODAY Network publication, Gannett Co. Inc. USA TODAY, its logo and associated graphics are the trademarks of Gannett Co. Inc. or its affiliates. All rights reserved. Copyright 2021, USA TODAY, a division of Gannett Co. Inc. Editorial and publication headquarters are at 7950 Jones Branch Dr., McLean, VA 22108, and at (703) 854-3400.

ON THE COVER Vaccinations spur return to normal.

For accuracy questions, call or send an e-mail to accuracy@usatoday.com.

COVID-19 mural, Las Vegas

PHOTOGRAPHS Getty Images

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PRODUCTS

Groovy UV Clean, disinfect and sanitize By Pam George

OR HOMES, OFFICES AND public places,

experts are touting UV-C light for its potent germicidal properties.

For on-the-go sanitation, sanitation this mini UV-C sanitizer and disinfection stick from BulbAmerica cleans gym equipment, lockers, phones, toilets, shoes and more. $24.99, bulbamerica.com

The CleanScreen, from WatchOut Group, is an antiviral phone case that automatically bathes the device with UV-C light when you close it. $74.95, watchout.group

Ava Robotics recently launched a UV disinfection robot to clean corporate offices, warehouses and other workspaces. It disinfects air and surfaces. Pricing varies depending on application. Find pricing information at avarobotics.com

XtraLight’s UV-C high power ultraviolet disinfection system is designed for commercial spaces, schools and indoor gathering areas. It even tackles black mold. Find pricing information at info.xtralight.com

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PRODUCTS

Casetify’s UV sanitizer is perfectly sized for phones and other small items. $120, casetify.com

UVClean’s Glow Box 2.0 is a portable UV-C sanitizing container with style. It’s lightweight and great for travel. $139.99, uvcleanhouse.com

Bright Clean by Brilli is a recessed lighting fixture with an antimicrobial mode. The LED technology kills viruses, bacteria and fungi. $63.03, amazon.com

HomeSoap by PhoneSoap is a countertop device that delivers a sanitizing blast of UV rays. USB ports allow you to charge tablets and phones during the cleaning. $199.95, phonesoap.com

Einova by Eggtronic offers the Mundus Pro, a UV-C disinfectant tray that doubles as a charging dock. The device eliminates 99.9 percent of viruses and bacteria in an eight-minute cycle. $119.99, einova.com PROVIDED BY THE COMPANIES

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PRODUCTS

Seal of Approval These disinfectants can help protect you from unseen dangers By Pam George

HE PANDEMIC UNDERSCORED THE need

Puracy prides itself on making family-safe products. The disinfecting surface cleaner, for instance, can be used to wash produce. $6.99, puracy.com

to keep disinfectants on hand at work and in the home. You can trust these brands, which have ingredients approved by the Environmental Protection Agency: Microban multipurpose cleaner sanitizes in 10 seconds and kills bacteria for up to 24 hours after application. $6.99, staples.com

By using electricity, Force of Nature capsules turn tap water into a multipurpose cleaner, deodorizer, sanitizer and disinfectant. Just add salt and vinegar. It kills 99.9 percent of germs and is approved for use against SARS-CoV-2, the virus that causes COVID-19. $56 for a starter kit, forceofnatureclean.com

Zep antibacterial disinfectant and cleaner zaps the virus that causes COVID-19 in 60 seconds. $45.99 for a case of four, 1-gallon bottles, buyzep.com GETTY IMAGES; PROVIDED BY THE COMPANIES

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PRODUCTS

For the kitchen, uncap Seventh Generation’s cleaner. There is no rinsing or wiping required. $41.99 for two, 1-gallon bottles, amazon.com

You can’t go wrong with Clorox disinfecting bleach for cleaning household surfaces. $6.19 for 121 ounces, target.com

Honest disinfecting spray is an allpurpose, fragrance-free product with no greasy residue. $6.95, honest.com

CleanWell botanical disinfectant spray is free from alcohol, undesirable chemicals and bleach, and it kills 99.9 percent of household germs and viruses. $8.96, amazon.com

Reduce the spread of germs with SafeHandles antibacterial tape for doorknobs, rails, elevator buttons and toilet handles. The starter kit includes a portable steamer and Pure hard surface disinfectant. $1,097.60, safehandles.com

Lysol disinfectant spray has been trusted for generations. $4.99, walgreens.com PROVIDED BY THE COMPANIES

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Product experts who have all your shopping needs covered

Playtime

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Pleasures The experts at Reviewed.com have curated, tested and deemed these items top-notch for post-quarantine fun and fitness. Whether you enjoy lounging by the pool, grilling on the patio or doing yoga on the lawn, here’s what you need this summer:

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Boredom Busters Keep your kids’ minds and bodies active during summer downtime THE LONG, LAZY DAYS of summer are a great opportunity for kids to relax, but too much unstructured time can lead to boredom. Make sure you have plenty of options on hand to keep everyone engaged and entertained. From online classes to cool subscription kits, here are six of Reviewed’s favorite activities to keep the fun going all summer long:

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w Online learning platform Outschool has a huge selection of classes for kids of all ages. Whether they’re into coding or crafts, science or sports, there are plenty of topics to beat boredom. They’ll love the opportunity to expand their knowledge, and you’ll love not having to entertain them for a few hours. Starting at $5/hour, outschool.com x Anxious to travel, but not ready to get on a plane quite yet? Let Little Global Citizens bring the world to your front door. Every two months, the company sends a new box themed around a different country that includes a colorful informational brochure with age-appropriate facts, suggested activities, arts and crafts supplies and a book. $39.95, little-global-citizens.com

v Few things are as fun as running through the sprinkler on a hot summer day. Funboy’s inflatable rocket ship sprinkler stands nearly 8 feet tall, and it shoots water out of four different sprayers, making this a 360-degree soaker. $69, funboy.com

y Limiting screen time can be a real struggle, especially during the unstructured days of summer. Toniebox, a screen-free digital listening experience, is a great alternative that entertains with stories and songs. It’s safe from questionable content and inspires kids to really listen to whatever they’re hearing. $99, us.tonies.com

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v Motivate your kids to get off the couch with a Think Outside subscription. Each month your child will receive gear and a guide for developing outdoor adventure skills, like tying knots and building fires. Perfect for older kids and tweens, Think Outside provides practical outdoor survival skills, and it may even inspire a family camping trip. Starting at $39.95/ month, thinkoutsideboxes. com

x Bubbles are a summertime must-have, but traditional brands tend to be encased in plastic packaging. This year, opt for BubbleTree, the new eco-conscious brand with refillable metal bottles. Our kid testers loved the fact that the nontoxic solution turns out longer-lasting bubbles. $19.99 for 2-pack with refill spout, bubbletreeusa.com

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ShapeUp These finds can help you drop those pandemic pounds DURING THE LAST YEAR of quarantine and stay-at-home orders, we discovered that you don’t need all that much to get in a good workout — just some space, a few pieces of gear and the willingness to move. These are some of Reviewed’s favorite products for working out at home, from the big investments worth making to the small but effective tools you can stow away when not working up a sweat:

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w Whether you’re doing yoga, abdominal exercises or any other workout that requires being on the floor, you need a good mat. We love the Lululemon reversible 5 millimeter option. Its grippy material keeps fingers and toes in place and provides firm-yetcushy support for joints. $78, shop.lululemon.com

x The TRX Home2 suspension trainer system is the way to go if you’re low on space. The straps hook into a wall or a door jam and leverage your body weight and gravity to train your muscles in new ways. It’s also packable so you can fold up the straps and tuck them away when you’re done. $199.95, store.trxtraining.com

w The NordicTrack Commercial 1750 treadmill breaks the monotony of indoor running with a 10-inch screen that plays workouts filmed all over the world, from the Grand Canyon to Easter Island. $1,799, nordictrack.com x Sometimes a little extra challenge is all you need. The Glute Loop resistance band is made to last longer and perform better than its latex counterparts, providing more intensity to exercises like donkey kicks and lateral band walks the more you stretch it. The loop comes in three strengths. $20, bretcontreras.store

x If you’re looking to go all-in on your home fitness setup, look to Tonal home gym. This machine uses electromagnetic resistance to mimic the feel of using a weighted cable machine, which keeps the device looking sleek and provides smooth pushes and pulls. Its artificial intelligence gauges your strength and designs streaming workouts that are suited to your exact fitness level. $2,995, tonal.com

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Superior E xteriors Create an outdoor oasis in your backyard

WHETHER YOU ARE STILL keeping your social circle small or starting to safely gather with family and friends, the backyard plays a vital role in the summer experience. And spending more time outside means investing in products that make it more pleasurable. Here are a some of Reviewed’s favorites, including a few worthy splurges:

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w An outdoor rug you can toss right into your washing machine? Yes, please — especially this Outdoor Tropical Green pattern of monstera and palm leaves, which aligns with this year’s tropical home décor trend. Starting at $119, ruggable.com

x Reviewed named this Anker Nebula MARS II Pro portable projector its Best Overall in testing, and it is a go-to for a private outdoor movie screening. It works best for nighttime viewings. $549.99, amazon.com

x This Weber Spirit II E-310 gas grill may be the brand’s entry-level model, but it didn’t perform like a lesser product. In fact, Reviewed named it Best Overall for its perfect sear and impressive heat. $519, weber.com

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x The GoSports solid wood premium cornhole set offers a low-key good time. The regulation-size kit comes with two 4-by-2 foot boards, six resin pellet-filled beanbags and a carrying case. $127.67, playgosports.com

x This sleek, stainless steel YETI V Series cooler far outperformed competitors in our lab tests. The price tag is steep, but this product does its job, keeping drinks cold for more than a week. $800, yeti.com

w If you don’t already have a backyard fire pit, here’s one to try, pronto. You can cook over and warm up by this wildly popular, clean burning, stainless steel Yukon Solo Stove. $449.99, solostove.com

v This Shark Tank Spikeball lawn game is as praiseworthy as it is popular. Slamming balls onto a bouncy net and foiling your backyard opponents gets you nice and sweaty whether it’s summer weather or not. $60, rei.com

x The Sonoma Goods For Life antigravity chair takes all the pressure off your back and bum when you want to sit by the fire pit for a few hours with friends. This ultracomfortable, portable chair is easy to get in and out of. $119.99, kolhs.com

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HEALTH + MEDICINE

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Protecting Teens Parents voice concern about vaccinating adolescents By Adrianna Rodriguez and Elizabeth Weise

N MAY, THE CENTERS for Disease Control and Prevention signed off on the recommendations of a federal advisory committee that determined adolescents ages 12 to 15 should get the Pfizer COVID-19 vaccine, and they can get their other routine vaccinations

along with it. “This official CDC action opens vaccination to approximately 17 million adolescents in the United States and strengthens our nation’s efforts to protect even more people from the effects of COVID-19,” says Dr. Rochelle Walensky, director of the CDC. From March 1, 2020, to April 30, 2021, more than 1.5 million adolescents, ages

12 to 17, were diagnosed with COVID-19, according to the CDC. Kim Hagood, 50, was elated when she first heard the Food and Drug Administration was considering authorizing the Pfizer vaccine for youths. Although Hagood’s 10-year-old son, Blake, is still too young to receive the vaccine, she views it as a step in the right direction. “If he can get that shot by the end

of the year, I would be thrilled,” says Hagood, who received the Johnson & Johnson vaccine in April in Birmingham, Ala. “I don’t want to take the chance on my child being the one sick (from COVID-19) and ending up in the hospital.” Not every parent feels that way. In a March survey, 58 percent of CONTINUED

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HEALTH + MEDICINE

“It’s going to take some time for all parents to become comfortable with the vaccine.”

32%

— BETHANY ROBERTSON, co-founder and co-director, ParentsTogether

OF PARENTS SAY THEY’LL WAIT TO SEE HOW THE VACCINE WORKS BEFORE HAVING THEIR CHILD VACCINATED

19% OF PARENTS SAY THEY DEFINITELY WOULDN’T HAVE THEIR CHILD VACCINATED

SOURCE: Kaiser Family Foundation

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parents or caregivers said that they would get their children vaccinated against COVID-19, versus the 70 percent who said they would get vaccinated themselves, according to a report by ParentsTogether, a national organization that provides education and resources for families. A survey published by Kaiser Family Foundation’s COVID-19 Vaccine Monitor in April found 32 percent of parents said they’ll wait to see how the vaccine works before getting their child vaccinated, and 19 percent said they definitely wouldn’t get their child vaccinated. People are naturally more cautious with their children, says Dr. Mary Carol Burkhardt, a pediatrician and associate division director for primary care at Cincinnati Children’s Hospital. “We’re certainly seeing both sides of the coin,” she says. “Some parents want to be first in line and want to get their kids protected ... on the other side, we have a lot of families who are not hesitant but don’t want to be first.” In the ParentsTogether survey from

March, parents said they were concerned about short-term side effects, unknown long-term reactions, the speed of vaccine development and the lack of opportunity for lengthy studies. The study found Black parents were especially hesitant: 26 percent of respondents said they would “probably not” or “definitely not” get their children vaccinated compared with white parents (15 percent) or Hispanic parents (13 percent). Parents’ hesitancy appears to stem from uncertainty rather than outright opposition, health experts say, which is encouraging because it leaves room for pediatricians to engage parents with more information and education. “It’s going to take some time for all parents to become comfortable with the vaccine, but what I’m hoping people understand ... is that this becomes part of a way to protect our children and community,” says Bethany Robertson, co-founder and co-director of ParentsTogether, who wrote the report. One of the ways to encourage vaccinations is to change the conversation

regarding hesitancy, says Dr. Clarissa Dudley, a pediatrician at Children’s National Hospital in Washington, D.C. Instead of categorizing a parent as “vaccine hesitant,” she recommends referring to them as “thoughtful” to avoid feelings of parent-shaming and blame. “There’s a lot of thought that they’re putting into these decisions,” she says. “Some parents feel like they’re being blamed for not jumping into whatever decision somebody tells them to make.” Health experts say targeted education through trusted messengers, such as community leaders or a child’s pediatrician, is key to dispelling misinformation. It’s important to involve children in vaccine conversations, especially those who are between 12 and 17 years old, Dudley says. “You have to involve the child from early on, from the time they’re able to communicate to understand their own bodies,” she advises. “If you understand your body, you’re more capable of making healthy choices.” Many of these kids will turn 18 in the next couple of years, and they’ll be able to decide for themselves whether they want to get vaccinated, she notes. It’s important they have the right tools and education to make that decision when the time comes. Schools may play an important role in distributing COVID-19 vaccine shots the way they do for other childhood immunizations. The American Academy of Pediatrics supports children and adolescents getting the COVID-19 vaccine together with other vaccines “given the importance of routine vaccination and the need for rapid uptake of COVID-19 vaccines,” says Dr. Yvonne Maldonado, a professor of pediatrics at Stanford University School of Medicine. “I’m not sure if the schools know how powerful they are,” Dudley says. “One of the bigger things that helps us pediatricians is the schools ... I hope the schools move very quickly to say a vaccine is required so that we have the support.” So many children have fallen behind on their vaccinations during the pandemic that allowing them to get all the shots they need at once will be helpful, says L.J. Tan, chief strategy officer with the Immunization Action Coalition. “This is necessary to ensure that we can continue to get back to preCOVID-19 coverage levels for routine adolescent vaccines,” he says, “and also for the catch up vaccinations.”

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HEALTH + MEDICINE

‘We’re Still Vulnerable’ Delta variant exploits low vaccine rates, easing of rules

By Lauran Neergaard

HE LATEST CORONAVIRUS VARIANT is emerg-

ing amidst low global vaccination rates and a rush to ease pandemic restrictions, adding new urgency to the drive to get more shots in arms and slow its supercharged spread. The vaccines most used in Western countries still appear to offer strong protection against the highly contagious delta variant, first identified in India and now spreading in more than 90 other countries.

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HEALTH + MEDICINE But the World Health Organization (WHO) recently warned that the trifecta of easier-to-spread strains, insufficiently immunized populations and a drop in mask use and other public health measures before the virus is better contained will “delay the end of the pandemic.” “Any suffering or death from COVID-19 is tragic. With vaccines available across the country, the suffering and loss we are now seeing is nearly entirely avoidable,” says Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention (CDC). She’s urging more Americans to get vaccinated to avoid the variant’s spread.

who never got the vaccine. With just more than half the U.S. population immunized, Walensky says about 1,000 counties, mostly in the Midwest and Southeast, with vaccination rates below 30 percent “are our most vulnerable.” Scientists believe the delta variant is about 50 percent more transmissible than other types. Researchers are just beginning to uncover why. There are early clues that some mutations may ease a key step in how the virus slips inside human cells, says Priyamvada Acharya, a structural biologist at the Duke Human Vaccine Institute in North Carolina. Still, it’s not clear if higher

Dr. Rochelle Walensky SUSAN WALSH/ASSOCIATED PRESS

Parts of Europe have reinstated travel quarantines and several Australian cities are in outbreaksparked lockdowns. The mutation is causing worry even in countries with relatively successful immunization campaigns that nonetheless haven’t reached enough people to snuff out the virus. In the U.S., “We’re still vulnerable for these flare-ups and rebounds,” says Dr. Hilary Babcock, an associate professor of medicine at Washington University in St. Louis. The variants “are able to find any gaps in our protection,” she says, pointing to how hospital beds and intensive care units in Missouri’s least-vaccinated southwestern counties suddenly are filling — mostly with adults younger than 40

70% OF ADULTS AGE 27 AND OLDER HAVE RECEIVED AT LEAST ONE DOSE OF THE VACCINE SOURCE: White House, July 2021 data

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contagion is the only reason the variant is spreading so quickly. In Britain, its rise followed a loosening of restrictions in May, when restaurants, gyms and other businesses reopened, and thousands of fans attended sports events.

IS IT MORE DANGEROUS? It’s difficult to tell if the delta variant makes people sicker than other strains of the virus. British experts say there are some preliminary signs it may increase hospitalization, but there’s no evidence it is more lethal. It fueled a devastating COVID-19 surge in India in February, and “This time around, we had a lot more people who were very sick compared to before,” says Dr. Jacob

John of Christian Medical College at Vellore in India. But he cautioned that the “explosion” of cases didn’t necessarily mean this version was more dangerous, as more cases usually mean more hospitalizations. British researchers found two doses of either the Pfizer or the AstraZeneca vaccine were only slightly less effective at blocking symptomatic illness from the delta variant than from earlier mutations — and importantly, remain protective at preventing hospitalization. But there’s an important catch: Just one dose proved far less effective against the delta variant than against earlier versions of the virus. That has prompted Britain, which originally extended the gap between doses, to shorten the time frame between first and second shots. There’s little information on whether the delta variant can escape other vaccines, such as ones developed in China or Russia. Experts say the Moderna vaccine, the same type as Pfizer’s, should be similarly protective. Johnson & Johnson announced in July that its one-dose shot also protects against the delta variant, citing lab tests of vaccine recipients’ blood. In a news release, the company said the immune response lasts eight months and counting.

WHAT ABOUT WEARING MASKS? WHO has urged governments not to lift pandemic restrictions too quickly and recommends everyone, even the vaccinated, continue to wear masks given that the delta variant spreads more easily and no vaccine is 100 percent effective. In the U.S., the CDC maintains it is still safe for the fully vaccinated to go mask-free, but local governments can set tighter guidelines. In Missouri, fully vaccinated Babcock makes sure to put on a mask if she is in a crowded area: “I feel like my new normal is holding a mask in my hand, ready to put it on if I need it.” Lauran Neergaard writes for The Associated Press. Maria Cheng and Aniruddha Ghosal of The Associated Press contributed to this story.

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Going Forward Some COVID-19 innovations will persist in a post-pandemic world By Adam Stone

hen the COVID-19 virus began to spread in early 2020, Elliott Small realized his product could be repurposed to support pandemic-related needs. As founder and president of the Las Vegasbased Centers for Age Control, Small made a monitoring device designed

to detect the signs of aging. Those same biological markers could serve as COVID-19 indicators. “Every single test that we had for ‘functional age’ was also either a COVID-19 risk factor or a COVID-19 indicator,” he says. “We added a couple of other things like blood pressure and temperature, and we expanded it into a ‘health meter’ concept.” In the future, the company plans to

add new metrics and collect anonymous data from the tool to build an international database of wellness benchmarks. “The bigger the database grows, the more we will know about how each compares us to normal,” Small says. From workplace wellness to online health care, the pandemic saw the rise of a range of tools and technologies. These will likely be around even after the COVID-19 crisis has subsided:

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HEALTH + MEDICINE

RICCARDO URNATO

TOUCHLESS TOOLS In response to heightened concerns about surface contact, Gensler released a hands-free door pull in place of a conventional doorknob. The device “allows people to open doors with their wrists, forearms and elbows instead of their fingers and palms,” says Scott Star, director of product development. “Post-pandemic, people’s focus on hygiene will continue to be elevated,” he says. “Plus, who really wanted to put their hands on a bathroom door pull, even before COVID-19?”

COMFY

AREA MANAGEMENT

HONEYWELL

INDOOR AIR QUALITY In the midst of the pandemic, Honeywell introduced sophisticated indoor air quality sensors. These devices “help building owners and facility managers better determine a building’s environmental state and air quality status, and allow them to take corrective actions through the building management system,” says Manish Sharma, vice president, chief technology officer and chief product officer

of Honeywell Building Technologies. Such sensors can monitor temperature, humidity and various pollutants. “Air quality is not something that will be dismissed once we’re on the other side of this pandemic,” Sharma says. “As mask regulations and occupancy restrictions on indoor spaces are lifted, people will want to understand and feel good about the quality of the air they breathe, whether it’s in their

place of work, a gym, shopping mall or their child’s school.” Along these same lines, Safeology designs and manufactures products that use UVC light to kill pathogens like SARS-CoV-2, the virus that causes COVID-19. These tools will play a role going forward. “Germs will always be around,” says CEO Jim Mischel. “Implementing UVC disinfection now can help minimize the chance that the next outbreak becomes another pandemic.”

Comfy, a Siemens company, recently released an app to help manage office spaces. The technology “lets employees view and reserve office space, control office temperature on-demand for energy savings and receive security, health and safety guidelines and company notifications,” says CEO Stefan Schwab. Such tools will still be needed post-pandemic. Those employees who return to physical workspaces “still rightfully expect a safe, healthy and productive environment when they arrive,” he says. Tools like this will help companies “understand how their space is being used … and how much space they actually need going forward.” Lenovo also has released a number of building-management tools in response to COVID-19 protocols, including touchless access tools, temperature screening devices and contact tracing applications. “These solutions will continue to provide value once we get to the new normal,” says John Gordon, president of industry solutions at Lenovo.

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INDEED

HIRING TOOLS

KINSA

At employment website Indeed, COVID-19 restrictions spurred creativity around the hiring process. “The pandemic upended the way employers and job seekers connect,” says Maggie Hulce, Indeed’s senior vice president and general manager of enterprise. The virtual Indeed

Hiring Platform “allows employers to manage the hiring process, from job postings to interviews all in one place. It automates time-consuming recruiting tasks — sourcing, screening, candidate communications and interview scheduling — shortening the hiring process from weeks to days.” Virtual hiring will remain a post-

pandemic constant. First, it offers “a simpler, faster and more human hiring process for (employers). Recruiters get to focus on the part of their job that matters most, connecting with quality candidates,” Hulce says. For job seekers, such tools offer a faster and simpler process for connecting with hiring managers.

SMART THERMOMETERS Kinsa rolled out smart thermometers as part of its COVID-19 early-warning offerings. In addition to real-time temperature readings, the device “also asks about other symptoms, such as vomiting, stuffy nose, headache — all clues as to what might be causing a mystery outbreak,” says CEO Inder Singh. “Through this aggregated and anonymous data on where and when illness is spiking, health officials can make more informed, early decisions which can literally save lives.” The COVID-19 outbreak demonstrated the importance of early detection. “While we won’t have a pandemic every year, the U.S. still struggles each year to contain the spread of the flu, which kills thousands of people each season,” Singh says. “Kinsa’s mission is to prevent the next pandemic by implementing its early-warning system by tracking the spread of illness in real time and by forecasting future outbreaks.”

TELEHEALTH

GOODRX

When COVID-19 restrictions were implemented, online health care company GoodRX was among the companies looking to support the remote delivery of health care expertise. “We doubled down on our telehealth offering, GoodRx Care, to ensure patients could receive treatment for basic health care needs at a fair price,” says CEO Doug Hirsch. “Within minutes, you can go to our platform, see a doctor, receive a prescription, have a GoodRx coupon applied to it and either pick it up at your local pharmacy or have it delivered to your door free of charge.” “Much of this on-demand care is here to stay,” he says. “There’s no reason why someone should have to take time off work to go to the doctor to get a prescription for birth control or sit in traffic to receive treatment for the flu.”

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Capital Gains Forecasters predict economic recovery, growth By Sheryl Nance-Nash

lthough the U.S. economy wasn’t completely derailed by the COVID-19 pandemic, it did take significant blows, and some things may never be the same. However, with the reopening of America, many businesses are on the road to recovery. What remains to be seen is how long that process will take. “The pandemicinduced recession is over. The economy is back to growth mode and is truly surging. In the first quarter (of 2021), the economy expanded at a 10 percent quarterover- quarter annualized rate,” says Peter Jones, senior vice president of equity research and portfolio management at Ferguson Wellman Capital Management. “We expect around 7 (percent) to 8 percent

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growth for 2021 and another 4 (percent) to 5 percent in 2022. Two-year growth at this level would be the strongest in decades. The economy will recoup all of its losses in output by the end of the year or early in 2022,” Jones says. Confidence is in the air. Seventyfive percent of business executives polled for the second-quarter 2021 AICPA Business and Industry Economic Outlook Survey, a leading indicator of U.S. economic growth, predict the economy will streak back with gusto in the coming year, with revenue and profit growth expectations not seen since 2018. Daniel Bachman, senior manager and U.S. economic forecaster for Deloitte Services, says, “The recovery from the pandemic is quite spectacular at an aggregate level. Second-quarter GDP (gross domestic product) is likely to be higher than the pre-pandemic level, something many forecasters thought would take much longer. And current forecasts project U.S. GDP to be above the level we expected in 2022 before the pandemic. That means that the economy will actually do better than we think it would have done without the pandemic.”

What could cool down the economy?

here is optimism, but there are also concerns. Steve Wyett, chief investment strategist at BOK Financial says, “There are still areas of the economy far from fully recovered. This economic dichotomy presents some unique challenges for the Federal Reserve and Congress as we think about the path forward. Indeed, there are still millions of Americans suffering from the impacts of COVID-19.” Among the chief issues, “the labor market remains compromised as more than 8 million people are still out of work compared to February of 2020, and the economic recovery has been uneven across race, sex and income levels,” says Caleb Silver, editor in chief of Investopedia.

“Much of the goods-producing sector of the economy is doing better than ever. So good, in fact, that raw material shortages are reducing output levels,” says Wyett. On the other hand, the service sector has a lot of room to recover. These businesses, restaurants and hotels, for example, are just now benefitting from reduced restrictions due to COVID-19 and are having trouble finding workers. The industrial sector is also having difficulties finding qualified workers, points out Ted Rossman, a senior CONTINUED

“There’s a 25 percent chance that we could see rising inflation later in the year...” — WILLIAM BRANCH, economics professor, University of California, Irvine

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credit card industry analyst with CreditCards.com. While profits have already rebounded for many companies across most sectors, some may never fully recover, says Bachman. Many small businesses are struggling, particularly those owned by entrepreneurs of color. A recent survey of Small Business Majority’s network found that 15 percent of Latino and 13 percent of Black entrepreneurs say their business is temporarily closed, compared with 6 percent of white business owners. Thirty-five percent of Black entrepreneurs say business conditions are worsening, and 37 percent say they may not survive the next three months. “Addressing the challenges

small-business owners continue to face more than one year into the pandemic requires targeted policy solutions. Unfortunately, we’re not seeing enough of the kind of ideas that they need to survive,” says John Arensmeyer, founder and CEO of Small Business Majority. One thing that could put the brakes on the economy is inflation. William Branch, an economics professor at the University of California, Irvine, says the overall boost in consumer spending seems to be affecting prices, and it is likely that inflation will rise at or above the government’s target, though there’s some debate about whether this is just a temporary blip or the beginning of a sustained inflation cycle. “There’s a 25 percent

“The economy will actually do better than we think it would have done without the pandemic.” — DANIEL BACHMAN, senior manager and U.S. economic forecaster, Deloitte Services

chance that we could see rising inflation later in the year before full economic recovery takes place. That puts a lot of pressure on the Federal Reserve to end their accommodative stance earlier than they’d like,” says Branch.

Aid from the administration

oves already made by President Joe Biden’s administration, such as the $2 trillion American Rescue Plan, were pivotal for the country’s economic recovery. A typical family of four received $11,400 in direct stimulus payments, much of which was used to boost savings and pay down debt, especially for those fortunate enough to retain their jobs, says Rossman. The Paycheck Protection Program encouraged

businesses to keep workers on the payroll, and for those who lost their jobs, further assistance was available, such as expanded unemployment benefits. Rebecca Rockey, head of economic analysis and forecasting and global research at commercial real estate firm Cushman & Wakefield, says the American Rescue Plan was a major factor in upward revisions to the growth outlook among economists earlier this year. “Much of the impact of that law will be seen in the secondquarter economic data, which is expected to be very strong. Stronger growth bodes well for the job market and households.” Up next from the administration is a proposed $6 trillion budget for fiscal year 2022, which calls for a significant expansion in federal spending on education, health care and defense, in addition to infrastructure. “Most of this is paid for via proposed increases in various tax rates. It’s still early in the budget process, but there appears to be bipartisan congressional appetite for infrastructure investment. Conceptually, infrastructure investment is about expanding our productive capacity — the supply side of the economy,” says Rockey. There is debate about how to pay for it (higher taxes versus user fees, for example). “Infrastructure usually pays economic dividends long term, and most economists agree that

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we have been under-investing in it for some time. Negotiations are likely to bring the proposed price tag down, no matter what elements make it into the final budget,” she says. Some fear an uptick in spending will force increased taxation and slow the country’s recovery and overall economic engine. There is concern, too, about rising levels of debt and the borrowing needed to pay for these plans. But others see positive outcomes. Anthony Pellegrino, founder of Goldstone Financial Group, says the infrastructure plan will spur immediate growth in construction and companies that supply those materials, boosting employment in the near future and beyond.

Winners and losers

s the recovery continues, winners and losers emerge. Some significantly increased their savings because they were stuck at home with fewer expenses, but those whose finances were shaky pre-pandemic fell hard with job loss. “To the degree we saw policymakers respond quickly and decisively to the economic impacts of COVID-19, we are all winners,” says Wyett. Everyone will be affected by the administration’s monetary and fiscal strategies, but how

they will be affected differs, he adds. “The winners will be those who will see new and better-paid, skilled green jobs. The losers will be the very rich, who may be asked to pay marginally more to help build the net-zero economy of 2050. This is a reasonable trade-off. Marginally higher taxes for the very rich and (a) redesigned economy for the rest,” says Stuart P.M. Mackintosh, executive director of the Group of Thirty, an international financial think tank.

What to expect

“W

e should expect the red-hot economic rebound to cool throughout the summer as the extended unemployment benefits come to an end in September, and even earlier in most U.S. states. That will impact consumer spending,

which is two-thirds of U.S. GDP. We’re already seeing signs of that cooling following the last round of stimulus payments to U.S. families in March,” says Silver. As Congress debates the Biden administration’s new spending bills, the economic recovery of the country will remain uneven, and the unemployment level, at around 6 percent, will remain high as Americans stay out of the workforce and companies struggle to find qualified workers, he predicts. Investments that are a hedge against inflation could see better returns going forward, says Kelly Crane, president and chief investment officer of Napa Valley Wealth Management. As for the federal government, “They’ve hinted they won’t take steps to slow the

recovery until it gets a firm foothold and unemployment is lower. It’s a delicate balance: Any premature action — before the recovery is firmly rooted — could have a significant slam-on-the-brakes effect.” Pellegrino says there is great hope for the future, with some companies reporting record earnings and reinvesting profits into new endeavors. But he adds, “There should be an expectation that volatility will be a constant in the economy, markets and everyday interactions. We spent 15 months separated, and it’s doubtful that we will feel and act the same way we did before the onset of COVID-19. It will take time to find our footing again in this new world we’re living in.”

“Any premature action — before the recovery is firmly rooted — could have a significant slamon-the-brakes effect.” — KELLY CRANE, president and chief investment officer, Napa Valley Wealth Management

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STARBUCKS

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MICROSOFT

Answering the Call These corporations took on the task of helping prevent the spread of COVID-19

By Meena Thiruvengadam

HEN IT CAME TIME to

distribute the COVID-19 vaccines that researchers around the world worked so hard to quickly develop, insights from a coffee chain turned out to be extremely valuable.

Starbucks is known for getting people in and out of stores efficiently, so in January it joined a Washington state effort to help design a COVID-19 vaccination distribution system. Kevin Johnson, Starbucks’ president and CEO, described it as “an opportunity to serve others and have impact on a significant humanitarian effort.” Starbucks was tapped to provide Washington state officials with advice on operational efficiency and human-

centered design. Microsoft chipped in with technical support. Costco was working on vaccine delivery, and Kaiser Permanente was tasked with helping to get health care workers vaccinated. Throughout the pandemic, companies have found a variety of ways to contribute to COVID-19 relief eﬀorts. This support goes beyond corporate donations, often leveraging a business’ expertise or value proposition to solve

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TRADER JOE’S

ORLY

CVS

one of the many problems presented by a disease that rapidly spread around the world killing millions of people and crippling health care systems. “This wasn’t just write a check to your favorite nonprofit because the companies themselves, they were potential victims too,” says Marc DeCourcey, senior vice president of the U.S. Chamber of Commerce Foundation and head of its Corporate Citizenship Center. “Companies have always been involved in disaster response, but this was different,” says DeCourcey, who spent eight years working for the American Red Cross before joining the foundation. “A lot of these executives had that moment of self-reflection, and they answered the call by stepping out of what they usually do to do so much more.” Those realizations may have come at exactly the right time. Nearly 60 percent of people asked in a recent survey by the Global Strategy Group say they feel “companies have a responsibility to respond to the coronavirus pandemic.” Respondents place an even higher responsibility to help on certain types of businesses

like pharmaceutical companies. “A great many large companies talk about having a social purpose and set of values, or about how much they care for their employees and other stakeholders. Now is the time for them to make good on that commitment,” Harvard University lecturer Mark Kramer wrote in Harvard Business Review in April 2020 — a month during which more Americans died from COVID-19 than were killed in the Vietnam War. Like Starbucks, many companies took the approach of using their business superpower — the thing they do better than their competitors — and applying it to solving a pandemicrelated problem, DeCourcey says. Here are more businesses that went beyond expectations to serve their employees and customers during the COVID-19 pandemic: Early in the pandemic, Albertsons, Kroger, Trader Joe’s and other grocery retailers set aside dedicated shopping hours for high-risk populations. Many also waived prescription delivery fees. Texas grocer H-E-B donated to food banks and made meals for 75,000 health care workers across the state. It also gave out 10,000 self-care gift bags

to hospital workers. CVS not only waived prescription delivery fees, it also waived copays for telemedicine visits for three months. As testing and vaccinations ramped up, the retail pharmacy operator also hired tens of thousands of new staff members, paying them bonuses of up to $500. It wasn’t just pharmacies and supermarkets contributing to the effort. Companies in a broad range of industries around the world found all sorts of ways to chip in, says DeCourcey. Beauty brands Orly, a Los Angelesbased nail polish manufacturer, and IPSY, a cosmetics subscription company, shifted their focus. Orly transitioned to making 75 percent alcohol-based hand sanitizer and donated early batches to local homeless populations. IPSY sent self-care packages to 50,000 U.S. health care workers. Apparel companies continued to churn out their products, but offered them to front-line workers. Trendy sneaker company Allbirds — known for wrapping feet in the comfort of merino CONTINUED

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GM’S PANDEMIC PIVOT

ALLBIRDS

GAP

wool — donated more than 50,000 pairs of its famous shoes to health care workers. Gap pivoted its factories to making masks, gowns and scrubs. With many bartenders across the U.S. out of work, Molson Coors Beverage Company made a $1 million donation to the United States Bartenders Guild charity foundation. Tito’s Handmade Vodka and Anheuser-Busch put liquor and beer production on the back burner, adapting their factories to make hand sanitizer instead. Four Seasons Hotels and Resorts provided rooms to doctors, nurses and other medical personnel — some of whom were forced to quarantine away from family to minimize coronavirus risks. Choice Hotels oﬀered discounts to essential workers. Businesses from just about every

General Motors shifted its focus from manufacturing automobiles to making face masks, latex-free face shields and other PPE that were in short supply for the health care sector early in the pandemic. In spring 2020, GM was “firing on all cylinders to produce PPE for internal use and external,” says Ali Shabbir, an engineering group manager for GM. The automaker began manufacturing ventilators using 3D printing techniques developed while working on features for Chevrolet’s iconic Corvette. “We learned we can move fast when we’re asked to move fast,” Shabbir says, explaining that speed can be a challenge with traditional manufacturing and engineering processes. GM ultimately made more than 250,000 face shields and 30,000 ventilators during the pandemic. It also used 3D printing technology to design ear protectors to make face masks more comfortable, especially for those who have to wear them for long periods of time. GM continues to manufacture face masks in its Rochester, N.Y., facility.

JOHN DEERE

TITO’S HANDMADE VODKA

sector answered the call to help slow the spread of the virus and support front-line workers. MassMutual, a Boston-based insurance company, created a program to provide $25,000 in term life insurance policies to health care workers in Massachusetts and Connecticut. In Moline, Ill., John Deere — best known for its iconic tractors — started making personal protective equipment (PPE) for health care workers. The company ultimately turned out more than 400,000 face shields. Consumer product giant Colgate-Palmolive churned out 25 million bars of soap to donate to global handwashing efforts. Chewy, an online pet supply retailer, donated $1.7 million in pet food and supplies to animal CONTINUED

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KROGER CARES

CHEWY

EXXONMOBIL

welfare organizations across the U.S. Nestlé partnered with Freshly to donate $500,000 to Meals on Wheels. Headspace, a meditation and mindfulness app, provided free subscriptions to health care providers working in the public health sector. Home Depot froze prices on key high-demand items and redirected shipments of N95 masks from its stores to hospitals and ﬁrst responders in need. While many businesses stayed in their proverbial lanes, others pushed themselves outside of their comfort zones to help. ExxonMobil, for example, reconﬁgured its Louisiana manufacturing operations to make medicalgrade hand sanitizer for distribution in Louisiana, New Jersey, New Mexico, New York, Pennsylvania and Texas.

As one of the nation’s largest supermarket chains, Kroger has been on the front lines of the pandemic since COVID-19 began taking hold in the U.S. in early 2020. Kroger stores were among the essential shops that remained open throughout the pandemic, becoming one of a few regular excursions in locked-down Americans’ routines. Kroger leveraged that role to help fight the pandemic. In May 2020, it allocated $130 million to pay bonuses to the workers keeping stores stocked and checkout lines moving. As coronavirus testing was ramping up across the U.S., Kroger joined that effort as well, eventually selling an over-the-counter COVID-19 test in July 2020. By March of this year, Kroger was able to vaccinate more than 1 million customers in a week and had administered more than 4.7 million COVID-19 vaccinations as of June 3.

LEGO

FITBIT

The company produced more than 160,000 gallons — enough to fill almost 5 million, 4-ounce bottles. Fitbit, a company that makes wearable fitness trackers, teamed up with doctors in Massachusetts and Oregon to determine how it could help manufacture emergency-use ventilators. Iconic toy company LEGO modified some of its machines so that it could make face visors for front-line health care workers. It has since manufactured tens of thousands of visors. It’s also donated more than a half-million LEGO sets to children in need. “I’ve never seen corporate America step up the way it has and continues to through COVID,” DeCourcey says. “These examples keep on coming.”

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Mental health professionals are taking care of

us. them? Who’s taking care of

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By Alia E. Dastagir

When

a pandemic

caused

the world to shut down, mental health professionals did not. They kept working, counseling patients on how to survive something few had seen before, something even the counselors feared. They supported others while the virus ravaged their neighborhoods and strained the medical industry for more than a year. CONTINUED

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66%

of psychologists say they have practiced self-care

SOURCE: American Psychological Association

“This has without a doubt been the toughest year really need services, and I simply don’t have the of my life, let alone my career,” says Michael Manroom in my schedule, those moments are really del, a licensed clinical professional counselor who hard.” works with adults and adolescents in Maryland. While Mandel feels capable of helping his clients He and other professionals are helping their cope with a number of stressors, his initial fears patients cope with stress, anxiety and sometimes about COVID-19 sometimes left him at a loss for unimaginable loss, while also managing their own words. “If someone comes to me and says, ‘I had this suffering. Many have taken on heavier caseloads with more patients experiencing trauma and panic attack for the first time,’ I can go, ‘OK, no suicidal ideation. Most have transitioned to problem. I know exactly what to do.’ But when telehealth, which made therapy possible during someone comes in and says, ‘I’m worried about the the pandemic but reduced the intimacy many therapists count on to connect. “In grad school, they don’t teach you how to provide therapy and help during a pandemic,” says Janel Cubbage, chair of Maryland’s Commission on Suicide Prevention. It can be a challenge for people to take their own “This is unprecedented, and at advice, but some mental health care providers times, I feel really helpless. I feel might benefit from ripping a page off their own like I don’t know what to do other precription pad. How can these professionals than be present with my client and practice self-care? Follow these steps to help validate what they’re experiencing.” handle the stress:

Take care of

“IT WAS ALMOST LIKE, I COULDN’T THINK OF WHAT TO SAY OR WHAT TO DO BECAUSE IT WAS SO SCARY FOR ME, TOO.” MICHAEL MANDEL, licensed clinical professional counselor

yourself

Feel your feelings Immense pressure may accompany the increase in care demands. Experiencing stress is not a sign of weakness or a reflection on your ability to do your job. Employ coping strategies Repeat what worked for you in the past during times of stress, whether that’s getting enough rest or engaging in physical activity. Rely on those proven strategies.

experiencing depression go see a movie with friends, for many, that option is off the table. “The main feeling is frustration,” he says. “It definitely does feel very boxed in.”

A shift to telehealth The move to telehealth has been a massive change, lowering one barrier to care but bringing new therapeutic challenges. Cubbage says assessing a suicidal patient, for example, is something she’d prefer to do in person, rather than over Zoom. Cummings says she’s lost valuable connections with colleagues who she would stop in the hall to speak with after a difficult session. Even providers well-versed in telehealth were overwhelmed because they took on the task of training others.

sleeping, intrusive memories or feelings of hopelessness. Turn to a trusted colleague and be open to seeking professional help if symptoms persist or worsen.

Take breaks from the news and social media Step away from your computer and smartphone periodically.

“AS MUCH AS WE SHOW OTHER PEOPLE GRACE, WE ASK THAT PEOPLE PLEASE EXTEND THAT GRACE TO US.” JANEL CUBBAGE, chair, Maryland Commission on Suicide Prevention

Mary Alvord, a psychotherapist in Maryland whose company was providing telehealth the current challenges and frustraservices 10 percent to 15 percent tions, yours is a noble calling — Check in with yourself Monitor “Work is in my personal space,” of the time pre-pandemic, says taking care of those in need. yourself for symptoms of depressays Cubbage. “In terms of like her practice went exclusively sion or stress disorders, such as having boundaries around work remote once COVID-19 shut SOURCE: American Medical Assocation prolonged sadness, difficulty and maintaining my own wellthings down. Staff were able being, which is really important for to adapt relatively quickly, but burnout, that has been so much then she conducted telehealth more challenging now.” trainings for more than 10,000 virus,’ it’s really hard for me to know what to say ... mental health providers. ‘I’m going through the same things that because this is new for me, too,” Mandel says. “No wonder I am so exhausted,” she says. Last spring, a client called to tell him her mother they’re going through’ One of the most unique challenges of the More cases, more guilt, less personal time was in the hospital with COVID-19. Mandel says the People were encouraged during the pandemic to news completely knocked him off his feet. COVID-19 pandemic is the parallel experience for reach out for help when they needed it, and many therapists and their patients, who are experiencing “I just remember repeating ‘I’m so, so sorry. I’m many of the same fears and frustrations brought on more people needed it. so, so sorry,’” he says. “It was almost like, I couldn’t In a survey conducted in June 2020, 40 percent by shared external events. think of what to say or what to do because it was so “I’m going through the same things that they’re of U.S. adults reported struggling with mental scary for me, too.” health or substance abuse, according to the Centers going through,” says psychologist Colleen CumTherapists and their patients have lost many tools mings, whose husband is a hospital physician and for Disease Control and Prevention. More than they would normally use to cope. Cubbage used to 30 percent experienced anxiety or symptoms of who spent months working from home with two decompress on her drive home, but now she works small children. “The moments where someone calls depression; 11 percent seriously considered suicide. from a bedroom she converted to an office. Mandel Mental health professionals have been flooded me or reaches out to me and they sound like they says while he would normally suggest someone

Remember the importance of your work Remind yourself that despite

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30%

of psychologists say they have not met the demand for treatment

with new requests. Patients who stopped therapy asked to begin again. Some who had only been doing one counseling session a month requested to be seen weekly. Sherry Burkhard, who co-founded the Texas nonprofit Mosaics of Mercy, which connects the community with mental health resources, recently surveyed local mental health professionals and found 84 percent had an increase in their caseload since COVID-19 started. Many therapists currently at capacity are taking on new cases. Some are doing it pro-bono. Others are working more hours to accommodate demand, including weekends. “We’re helpers. We want to help everyone. We don’t want to turn people away,” Burkhard says. “So, it’s really hard to say, ‘No, I can’t fit anyone else in.’” Baltimore-area psychologist Riley Benko has tried to keep his caseload manageable, which means he’s watched his wait list grow. Last December, Benko and his wife, also a therapist, contracted COVID-19. Benko has recovered, though his wife has lingering health effects. He says the most difficult part of being sick was worrying about his clients. “There was guilt,” he says. “I thought, ‘Wow, I got sick and now I’m not able to provide therapy or services like I otherwise would,’ which made it challenging to ... take care of myself.”

SOURCE: American Psychological Association

Patients are also coming to therapists with more acute symptoms. Kimberly Griffin, a substance use disorder counselor at Lionrock Recovery, an online drug and alcohol addiction rehab program, says she’s seen an increase in substance use disorders as well as domestic violence. “For the first time I believe in my life, I’ve experienced ... symptoms of burnout,” she says. “The stress comes from trying to figure out how to help people who are experiencing something new at the same time that I’m experiencing something new.”

A mental health crisis with no end

“I BECAME NUMB, AND THEN I BECAME OVERWHELMED, AND THEN I KIND OF WENT BACK TO NUMB.” TIA DOLE, chief clinical operations officer, Trevor Project

‘For the first time in my life, I’ve experienced ... symptoms of burnout’ Experts say burnout occurs when stress is prolonged, and there is no time to recover. Mental health professionals are especially susceptible, and the pandemic has made them more vulnerable. Tia Dole, a clinical psychologist in private practice and chief clinical operations officer at the California-based Trevor Project, which works to prevent suicide in the LGBTQ community, says while mental health providers are used to working in an emergency state, the duration and scale of the COVID-19 emergency has been extraordinary. “Before, when you’d have a patient in crisis, it’s over in a couple of hours. You have a debrief. You huddle up. You go, ‘Whew.’ You go home. In this case, it is going on and on,” she says. “I became numb, and then I became overwhelmed, and then I kind of went back to numb.”

patient having a psychotic episode comes into an emergency room, they are not likely to follow COVID-19 precautions. “You have someone who’s in a psychiatric crisis who is not thinking,” not in their right self, not wearing a mask and getting too close, she says. “I know personally so many people who ended up getting sick because of that.” These professionals go to work each day not knowing whether they will be exposed to the virus, or whether they’ll expose a loved one. Those who work in hospital settings end up providing support to their colleagues who lose patients to COVID-19. “Not only are you treating patients, you’re also helping out your co-workers,” Dole says. “They’re trying to be strong, be present for their peers in the workplace environment. ... Everyone is just really broken down. You’re watching people die who are 30 years old, and it just doesn’t make any sense.”

The pandemic has been a traumatic experience for many people, says Griffin. Before COVID-19, she had a couple of clients coping with trauma. Now she says she’s seeing trauma on “a mass scale.” “I think this past year was the most challenging in my career because it magnified how many people were really suffering mentally and emotionally,” she says. “As a therapist, I wish I could help everyone, but that thought becomes overwhelming and, of course, it’s not realistic.”

For some mental health care workers, COVID-19 is a potent threat Not all mental health professionals are providing care exclusively through telehealth. Some are working in hospital settings and continue to face health risks. Dole, who works in New York City — once the epicenter of the COVID-19 crisis — says when a

The pandemic has been raging for more than a year and has not abated globally. Experts say the negative mental health impacts will outlast the current crises. Research suggests the extreme and prolonged stress of the pandemic may lead to longer-term psychiatric disorders. Many therapists say they are learning — or re-learning — the importance of self-care during a crisis they know will not end for their profession with widespread vaccinations. “Even though we are therapists and mental health professionals and we have training and understanding of things above what the average person does, it doesn’t mean that we aren’t susceptible to dealing with our own mental health challenges,” Cubbage says. “As much as we show other people grace, we ask that people please extend that grace to us.” Mental health professionals say they need organizational support to help ward off burnout. That could look like granting clinicians their day-off requests or respecting when they say they can’t take on another case. They also need better pay, Dole says, so more people can enter the field, stay in the field and serve a greater share of the population. In the immediate future, therapists also need to be able to continue to see patients remotely, Dole says, and they need insurance to continue to cover it. Some insurance companies have already made moves to scale back coverage of telehealth services. Despite the myriad challenges, mental health professionals say people who are suffering should always seek help. “We’re challenged. We’re stretched thin. We’re finding higher acuity in stress levels in our patients, but it’s what we’re here for,” Benko says. “People should still reach out.”

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The

Phase of COVID-19 Like influenza, the virus may linger By Elizabeth Weise

hat does the end of the COVID-19 pandemic in America look like? Perhaps no end at all, but a resigned acceptance of a bearable level of death. “We as a country are willing to tolerate a certain level of risk and still go about a normal level of life,” says Dr. Aaron Carroll, a pediatrician and professor of pediatrics at Indiana University School of Medicine. “It’s becoming clear that that’s likely what we’re going to have to do with COVID. We’re going to have to learn to live with it.” In a “good” flu season, nearly 100 Americans a day might die from influenza, Carroll said at a recent American Public Health Association event. Those 100 deaths a day during flu season is what Americans tolerate, says Dr. Monica Gandhi, an infectious disease expert at the University of California, San Francisco. “So, it’s probably what we’d accept for COVID,” she concludes. As of June 3, COVID-19 was killing an average of 363

Americans a day, according to the Centers for Disease Control and Prevention (CDC). That’s down from more than 3,000 a day at the height of the pandemic in January, and with more people becoming vaccinated, the daily death toll continues to fall. Experts note the SARS-CoV-2 virus that causes COVID-19 could be almost entirely controlled in the U.S. with near-universal vaccination. That’s how smallpox was eradicated in 1980. But the waning of the COVID-19 pandemic will be spotty. For example, earlier this summer (before the delta variant’s dominance in the U.S.), San Francisco County in California went nearly a month with no COVID-19 deaths, according to the local health department. But Davidson County in Tennessee, home to Nashville and 185,000 fewer people, was averaging about one death per day in mid-June. One difference is vaccination rates. In San Francisco, 80 percent of teens and adults have had at least one CONTINUED

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80%

of teens and adults in San Francisco have had at least one shot.

shot. In Davidson County it’s 48 percent.

“This virus,” he told public health officers, “will not eradicate itself.”

PANDEMIC, EPIDEMIC, ENDEMIC To an epidemiologist, a pandemic is the worldwide spread of a new disease. An epidemic is an unexpected increase of a disease in a given geographic area. A disease becomes endemic when it is always present but limited to a particular group or region. Right now, COVID-19 is a pandemic globally, an epidemic in the United States and on the cusp of becoming an endemic in highly vaccinated areas. Worldwide, the pandemic will end when the World Health Organization — which declared a global pandemic on March 11, 2020 — says it is over. That probably won’t come for many months or even years, when enough people are vaccinated or protected from COVID-19 by having antibodies from an infection. The virus is still raging through countries like India, Uganda and Colombia, with thousands dying every day. President Joe Biden’s administration missed its goal of having 70 percent of Americans at least partially vaccinated by July 4, which would have lowered infection rates enough to bring the U.S. outbreak down to endemic levels. At that point, there will effectively be two Americas: one vaccinated, one not. In May, Gov. Jared Polis of Colorado said, “If you have been fully vaccinated, the pandemic is largely over for you.” For the unvaccinated, it won’t be. If they get sick, “There’s just as much chance of them getting severely ill or dying from COVID-19 as there is today,” says Dr. William Schaffner, an infectious disease expert at Vanderbilt University in Nashville. In many regions, COVID-19 will fade into the background. While in others, it will continue to be a significant source of outbreaks, says Dr. Robert Wachter, chairman of the University of California

at San Francisco’s department of medicine. “Assuming there is no variant that comes out that is truly vaccine resistant, I’m going to expect mild surges, probably in the winter, in places with low vaccination rates,” Wachter says. Experts say existing vaccines are effective against the delta variant that’s spreading throughout the U.S. But as with much about the SARS-CoV-2 virus, there’s not enough data to answer many pressing questions, such as how long vaccines’ protection or natural immunity from previous infections lasts, says Ajay Sethi, a professor of population health at the University of Wisconsin-Madison School of Medicine and Public Health. Gandhi doesn’t think variants will be a huge problem. As vaccination rates rise, there will be less circulating COVID-19 and fewer chances for it to evolve. As long as COVID-19 rages in other countries, however, it will have the chance to keep mutating. “COVID is a reminder that we should care about equity, but even if you don’t want to care about it, you need to care because we’re so interconnected globally,” says Anne Rimoin, a professor of epidemiology at the UCLA Fielding School of Public Health. If the vaccines remain effective, boosters may never be required, or perhaps only every two or more years. But that could become a problem because people will forget how bad things could be and won’t be motivated to be protected, Wachter says. “It’s going to recede in people’s memories and then when they’re asked to take a booster, you can’t presume they’ll get the shot,” he says. In the end, only high vaccination rates will truly allow the entire country to return to normal, says Dr. Walter Orenstein, associate director of the Emory Vaccine Center in Atlanta and former director of the immunization program at the CDC.

SOURCE: City Of San Francisco, June 2021 Data

NEXT-GEN EFFORTS TO PROTECT Moderna, the maker of one of the three COVID-19 vaccines authorized for use in the U.S., uses artificial intelligence and machine learning to try to predict mutations that could cause problems and designs vaccines to address them, says Melissa J. Moore, Moderna’s chief scientific officer for platform research. It’s not clear how many variants and viruses the messenger RNA vaccines such as Moderna’s can protect against simultaneously, but Moore says she can make at least six vaccines in one, and maybe 10. Some could cover SARS-CoV-2 variants, along with several flu strains and other respiratory viruses. Any revised Moderna vaccine would include a lower dose than the original, Moore says. The company manufactured a high dose in its initial vaccine to guarantee effectiveness, but she is confident the dose can be lessened, reducing side effects without compromising protection. One of Moderna’s co-founders, MIT professor Robert Langer, is known for his research on microneedles, tiny Band-Aid-like patches that can deliver medications without the pain of a shot. Moderna hasn’t announced delivery plans, but it’s conceivable the company might try to combine the two technologies to provide a booster that doesn’t require an injection. “With so many different approaches to the production of COVID-19 vaccines formulations, only time will tell which of these provides the most effective and long-lasting protection against SARS-CoV-2 virus and the variant strains that are emerging across the globe,” says Dr. Sibtain Ahmed, a member of the business development team at FlowMetric, a research organization.

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Better With a Booster?

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he COVID-19 vaccines have proved to be safe and more than 90 percent effective at preventing many diseases — and even more so at blocking serious illness and death. And drug companies are trying to make them even better. Some shots will be more effective against certain variants of the SARS-CoV-2 virus that causes COVID-19. Others aim to prevent several types of severe respiratory viruses, including the SARS virus, which caused outbreaks from 2002 to 2004, or even all viruses in the larger coronavirus family. Companies are testing vaccines that won’t need to be kept refrigerated, won’t require two shots, will have fewer side effects,

can be produced more efficiently and can be delivered without needles to make them easier to provide in rural areas and the developing world. “There’s a long history within vaccinology of second-generation vaccines being (significantly) improved over first-generation vaccines,” says Scot Roberts, chief scientific officer of Altimmune, a biotech company based in Gaithersburg, Md., that is developing a vaccine that can be inhaled. None of these secondgeneration COVID-19 vaccines will be ready until later this summer at the earliest, and many, including Altimmune’s, will not be available until early next year. No single vaccine will have all the desired

attributes, experts say. Potentially, every one of Earth’s nearly 8 billion inhabitants will need one or two initial doses and possibly boosters, so there’s plenty of room for different approaches, experts say. “Depth and breadth” is what vaccinologist, pharmacist and public health leader John Grabenstein says he wants in a second-generation vaccine. He expects protection against different variants and respiratory diseases and, ideally, a decade or more between shots. The jury is still out on how long the current vaccines will last — or whether we’ll need boosters, says Scott Hensley, a viral immunologist at the University of

Pennsylvania’s Perelman School of Medicine. “Time will tell,” he adds. Most companies investing in COVID-19 vaccines are presuming — even banking on the idea — that regular boosters will be necessary. Stanley Erck, president and CEO of Novavax, which plans to release its vaccine’s effectiveness data soon, says his company’s studies in monkeys show that giving a booster dose a year after initial vaccination yields “spectacular results.” “I think we’re going to want to do that with humans,” he says. “This isn’t going to go away from a commercial point of view anytime in the future.” — Karen Weintraub

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Ending the Long Haul

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accinations could offer a glimmer of hope for people who are still experiencing symptoms weeks or months after contracting COVID-19. Among people who contract the virus, 10 percent to 30 percent end up with long-term symptoms referred to colloquially as long-COVID or long-haul COVID. Although most of those with lingering problems became very ill from the disease, some barely had any symptoms. Could getting a COVID-19 vaccine help some of these long-suffering people? In a Survivor Corps survey of nearly 600 people who selfreported lingering symptoms after having COVID-19, 40 percent improved after getting a vaccine. The group consisted of people with long-term COVID-19. It’s biologically plausible that vaccination could help address persistent symptoms, says Akiko Iwasaki, a professor of epidemiology and immunobiology at Yale University, who developed the theory. It may be that their bodies still harbor particles or pieces of the virus that causes COVID-19.

The vaccine could theoretically stimulate their immune system to hunt those down and clear them away so they can no longer cause inflammation. “We know that the vaccine elicits very robust antibodies that can bind to the virus and viral remnants and clear it,” Iwasaki says. It would be terrific if this works, she says, because that would make vaccination a “cure” for many people with lingering symptoms. “Get rid of the source, and that’s it.” Iwasaki and several colleagues are organizing a large, prospective trial to see whether vaccination resolves some people’s symptoms — either short-term or forever. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and America’s most prominent infectious disease expert, says that the National Institutes of Health considers these lingering symptoms to be a major public health issue, and allocated more than $1 billion to studying longCOVID. He says a large trial is essential to ensure that vaccination should truly get the credit for these

Brent Boschetti

improvements, rather than simply the passage of time, which does make a difference for most people. Fauci described two types of long-suffering patients: Those who had a severe bout with the disease that left them with permanent damage to their heart, lungs or liver, which is unlikely to resolve with vaccination; and those who didn’t suffer as much at first, but have struggled to shake physical symptoms in the months since. Brent Boschetti, 44, of Los Angeles, fits into the second category. A medical sales rep and workout enthusiast, Boschetti contracted COVID-19 in March 2020, before lockdowns or maskwearing were recommended. By March 15, he had lost his sense

of smell and taste, and by April, he was having heart palpitations, severe migraines, breathing difficulty, fatigue and muscle and joint aches. “I was pretty much in bed until May (2020),” Boschetti says. He finally tested negative for the virus and was ready to get back to his six-day-a-week workout routines and daily runs. But his body wasn’t. Every time he pushed himself, he’d retrigger symptoms and land back in bed for several days. He managed to keep up with his work Zoom calls but spent much of last summer shuttling among appointments with specialists: a rheumatologist, cardiologist, immunologist, gastroenterologist. He began weekly acupuncture sessions and joined Survivor Corps for moral support. By November, he was feeling mostly better. “People would say, ‘How do you feel,’ and I’d say, ‘90 percent.’ I just didn’t feel like I was completely myself,” Boschetti says. He got an appointment for a vaccine in early February, though he was nervous that it might retrigger his symptoms. Within a day, he felt like his old self again. His energy was back at 100 percent. “It was like something just cleared, whatever was lingering in me,” Boschetti says. He felt great for three weeks and approached his second shot anxiously, wondering if it would undo all the benefits of the first shot. For the first few days, it looked that way. All the symptoms from his original infection recurred. Then, slowly, they all faded. “I’ve noticed now that that has subsided,” Boschetti says. “I have all my energy back. I ran like 5 miles yesterday, and I’ve been working out like I always used to.” — Karen Weintraub

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EDUCATION What surprised you the most about virtual or hybrid learning?

“What surprised me most about virtual learning is probably how exhausting it is. And I don’t just mean exhausting in the physical sense or your eyestrain sense, which are all very real. I also mean exhausting in the sense that you are reimagining yourself every day, and you are sitting in this place trying to figure out how to really teach this material to students who sometimes don’t have their cameras on.” — Joellen Persad, physics teacher, Madison Park Technical Vocational High School, Roxbury, Mass.

“The mask environment — having to teach through that, having to work with students through that and communicate through this barrier was a struggle.” — JOSH MONTGOMERY, associate professor of computer science, Southern State Community College, Hillsboro, Ohio

Survival Stories Students and teachers share what shook them and strengthened them during the pandemic By Erin Richards and Chris Quintana

ROM GRADE SCHOOL TO

graduate school, in-classroom learning halted abruptly in March 2020. What happened next to schools and families was devastating and electrifying, thought-provoking and quieting, unifying and isolating. Homes became entire worlds. Working parents juggled daytime teaching. College students studied from childhood

bedrooms. Millions of kindergartners started school in a format previously unfathomable: Zoom. Teachers shifted to nurturing and encouraging through screens — with little training on best practices. Many hunted down students in person to ensure they were safe, fed and outfitted with resources to learn. The COVID-19 pandemic has presented a set of real-world lessons. Here, students and educators of all ages and experience share what they learned and how they changed:

“The convenience of being able to wake up and log into class was one of the most surprising things about virtual learning. It allowed me to expand the number of activities I was involved in because it totally removes the travel time. I ended up picking up an extra job, but this also meant I would be online for 12 hours a day. That was really difficult for me.” — Denis Alvarez, student, Arizona State University

What was the most difficult part of the past year?

“Families want a pre-pandemic education, and not being able to give them exactly what they want has been really hard.” — David Miyashiro, superintendent, Cajon Valley Union School District, Calif.

“In my first year of teaching, I taught a group of students on Sept. 11, and I thought for years and years that would be the hardest day. I’m in Littleton, Colorado, so we have experienced a couple of local school shootings since that, and I thought those would be the hardest days. Those days were very hard, but in some ways, they were contained. This has been 12 months of crisis.” — Monica Fuglei, English department chair, Arapahoe Community College, Littleton, Colo. GETTY IMAGES; PROVIDED BY THE SOURCES (4); SOUTHERN STATE COMMUNITY COLLEGE

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EDUCATION What was the most challenging part of your home or social life?

“The most difficult part of my home or social life was having no privacy. Usually during the year, I could go out and find my own space. Being home all day with 10 other family members is stressful. There’s a lot of arguments. You’re together all the time and then you start to feel unappreciated, which is ironic.” — Cristina Alvizo, student, Middle College High School, Santa Ana, Calif.

What did you learn this year that you wouldn’t have learned without living through this pandemic?

“(The pandemic) made that superintendent/ed-leader network stronger. ... I have colleagues that are superintendents out in Washington state, who were a few weeks ahead of me when we were talking about shutting down here in Ohio. I said, ‘What am I not thinking of?’ ‘What don’t I know?’” — Matt Miller, superintendent and CEO, Lakota Local Schools, Liberty Township, Ohio

How did you find strength?

“I got strong when I realized that (home schooling) is learning at your own pace. I think it was the end of the quarter when I got good grades for the entire quarter. I was like, ‘OK, I can do this’ because I was really afraid (that I was) going to have to repeat a grade.” — Victoria Bradley, student, Arts Academy in the Woods, Fraser, Mich.

How did you maintain relationships?

“Initially, it was difficult — I couldn’t find words for it, and I didn’t want to seem like I was complaining. I started seeing a counselor, someone that I could talk to myself, just to kind of release and unload my stress.” — Winnie Williams-Hall, special education teacher, Nicholson STEM Academy, Chicago

“By going on Zoom at my own time, playing Minecraft with my friends. And also, by having discussions with my class, because they usually will put us in breakout rooms, and we’ll be able to talk together.” — GWYNNIE POUTASSE, student, Harvard Public Schools, Harvard, Mass.

“I didn’t really maintain the same relationships. I built new ones. Seeing how everyone responded to the pandemic made me pay attention to who I call my friends.”

“I learned more about American history. These are some of the best times I’ve had, being with my family, learning about myself.” — PATRICK GREEN, student, University Prep Science & Math, Detroit

“I never realized how big of a disparity the digital divide is in certain communities. Things we take for granted, like access to the internet, isn’t there for everyone. Or if there’s an older sibling in the home, they have to watch a younger sibling and at times have to share a device. It was that digital divide that I was not anticipating. It destroyed us last spring.” — Robert Gregory, acting superintendent, Hillside Public Schools, Hillside, N.J.

How do you think the pandemic will permanently change education?

“We’ve learned the power of digital tools is only as good as the buy-in teachers and students develop to include them. With hard-to-reach students, we’ve been gobsmacked with how true that is.” — Orion Smith, computer science teacher, Arlington Heights High School, Fort Worth, Texas

What stories do you think you’ll be retelling 10 or 20 years from now?

“Even though the world (was) at a standstill, I got to keep on moving and progressing and evolving as a human being. Twenty years from now, I hope to tell my children that there can be good things that can come out of times of darkness.” — Alanis Broussard, student, Boston University

— Korea Mi Amour Rankin, student, Juan Rodriguez Cabrillo High School, Long Beach, Calif.

Lindsay Schnell and Alia Wong contributed to this story. PROVIDED BY BOYS & GIRLS CLUBS OF AMERICA (2); PROVIDED BY THE SOURCES (8)

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EDUCATION

Nursing the Future Medical training adapts in the face of a global pandemic

Applications for Michigan State University’s nursing program increased in 2020. MICHIGAN STATE UNIVERSITY

By Matt Alderton

OR MORE THAN A year, nurses have been the face of the COVID-19 pandemic. On news broadcasts and social media, they’ve appeared in face shields, goggles, gowns and gloves as they work on the front lines to care for patients and battle the disease, helping to spread the gospel of hand-washing, mask-wearing and social distancing. It hasn’t been easy. Day after

impossible day, they’ve served in hospitals that are overpopulated and understaffed. They’ve watched patients on respirators die with only health care workers by their side. They’ve engineered elaborate after-work routines to avoid bringing the virus into their homes. They’ve sacrificed sleep, sanity, and in some cases, even their lives. Because of all it entails, it wouldn’t be surprising to learn that many stopped wanting to pursue the career, but that’s not the case.

Instead of dissuading aspiring nurses, COVID-19 has galvanized them. Despite the pandemic, student enrollment in baccalaureate, master’s and doctoral nursing programs increased by 5.6 percent, 4.1 percent and 8.9 percent, respectively, in 2020, according to the American Association of Colleges of Nursing. “Because of the news and the shortage of PPE (personal protective

THE UNITED STATES WILL HAVE A DEFICIT OF

510,394 REGISTERED NURSES BY 2030 SOURCE: American Journal of Medical Quality

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EDUCATION XXXXX equipment), I thought students were going to say, ‘You know what? Never mind. This isn’t what I signed up for.’ But the exact opposite happened,” says Brenda Peterson, associate dean of the school of nursing at the University of Southern Maine in Portland, Maine. “Enrollment in nursing is strong and robust nationwide.” That’s good because the country currently is facing a major nursing shortage: With older nurses retiring and aging baby boomers requiring more care, the United States will have a deficit of 510,394 registered nurses by 2030, according to a 2018 study in the American Journal of Medical Quality. To fill the gap, nursing schools needed to evolve and innovate — which is exactly what they did during the pandemic.

EMBRACING ONLINE OPTIONS One reason nursing enrollment surged during the pandemic might be the economy. “Nursing careers are fairly recession-proof,” says Tom Kannon, assistant dean for graduate online nursing at Regis College in Weston, Mass. “During the pandemic, businesses had to close their doors or shift to operating in a different manner, which caused many people to lose their jobs, whereas there was a dire need for nursing staff in every state.” People want to work, and they also want to serve. “The pandemic has been a call to action,” says Randolph F.R. Rasch, dean of the college of nursing at Michigan State University in East Lansing, Mich., where applications increased 39 percent in 2020 for the university’s traditional baccalaureate nursing program. “People see what they can do to help their neighbors, friends and communities. Part of this is because of media coverage showing the stories of our heroes on the front lines, but it’s also because many individuals had contact with nurses during the pandemic due to an ill family member or friend.” Educating nursing students during the pandemic wasn’t nearly as easy as attracting them. Because students in most states could no longer convene on campus, many schools had to create or expand online learning programs. Doing so had surprising benefits. One, for example, is online literacy. Thanks to the pandemic, telehealth is on the rise, observes Rasch, who says virtual learning helped students develop skills they’ll need to care for patients remotely. Another upside is increased efficiency from “flipped” classrooms, where

Lydia Bukunda, a student at the University of Southern Maine School of Nursing, fills a syringe.

UNIVERSITY OF SOUTHERN MAINE

“For the first time in my career, people truly understand what nurses do and how important a profession nursing is.” — DONNA HAVENS, dean, college of nursing, Villanova University students read or watch instructional content before class, then spend class time engaged in exercises that help them apply their learning. “Teachers are moving from being a ‘sage on the stage’ who lectures for three hours to being a ‘guide on the side,’” explains Rasch, who says flipped classrooms save time and accelerate learning, which in turn allows nursing schools to accommodate more students with fewer instructors. “If we can continue making that switch, it’s one way we can increase capacity.” Because it caters to working adults and students in remote locations, online learning increases not only capacity, but also accessibility. “It allows us to think about graduating more nurses not only in East Lansing, but across the state,” Rasch says. “We can extend our reach.”

VIRTUAL PATIENTS, REAL LEARNING Nursing schools’ biggest challenge during the pandemic has been restricted access to clinical rotations, during which students gain hands-on experience with patients. “A majority of hospitals and clinical sites closed their doors to students in need of clinical hours. This wasn’t done with any malice, it was just a necessary precaution to prevent the spread of COVID-19,” Kannon says. “Nursing

programs responded quickly, making the shift to incorporating more simulation into the clinical experience. This measure allowed students to keep progressing in their clinical skills and knowledge instead of being in limbo hoping for clinical sites to reopen.” Clinical simulators give nurses the opportunity to interact with fictitious patients in realistic albeit virtual environments. Sometimes, simulations take place in sophisticated virtual reality programs utilizing computerized mannequins. Other times, they take the form of role playing with actors via Zoom. “The software we use can be programmed to create thousands of scenarios through which students learn,” says Donna Havens, dean of the M. Louise Fitzpatrick College of Nursing at Pennsylvania’s Villanova University. Nursing regulators in many states relaxed educational requirements during the pandemic to accommodate more simulation — in some cases allowing more than 50 percent of clinical experience to be simulated. “Going virtual to teach a hands-on profession posed questions from staff and students on how that learning would translate upon graduation. What we’ve found is that the virtual experience doesn’t diminish the quality of the education, but in fact can help improve

important skills that don’t always have the chance to be highlighted during in-person clinics,” notes Peterson, who says simulations force students to focus more on listening to patients and less on the manual tasks of a physical exam. “The third-leading cause of death in the United States (before the pandemic) is preventable medical error, with 70 percent of those cases occurring from a breakdown in communication. Having students who are trained to listen and focus on patients is a major step in bringing this shocking statistic down, and the virtual environment is the perfect space to hone these vital listening skills.”

A MORE CARING CURRICULUM COVID-19 didn’t just change how nursing schools teach. It also changed what they teach. Because the pandemic disproportionately affected minorities, for example, Peterson and Rasch foresee an increased focus on health care equity and the social determinants of health. Havens, on the other hand, predicts more courses in public health and disaster preparedness. Self-care also is in the spotlight. In fact, last May Havens launched a 20-year study of the self-reported health of the COVID-19 workforce, including nurses. “In health care in general, burnout has been a huge, huge concern,” reports Havens, who says burnout — which can include sleep disorders, fatigue and depression — surged among nurses during the pandemic. “If we don’t teach our graduating nurses how to do selfcare, they’re going to end up leaving the profession.” Self-care is so important that Michigan State’s College of Nursing now offers dedicated class time for mindfulness and has launched a peer-counseling program modeled after the U.S. Army’s “Battle Buddies” mental health program. “We hear flight attendants say it all the time: Put your own mask on first before you help someone else,” Rasch says. “We have to socialize our students to care for themselves emotionally, physically and mentally.” It’s one of many lessons learned during the pandemic: The next generation of nurses must be more versatile and more resilient. But also, more appreciated. “For the first time in my career, people truly understand what nurses do and how important a profession nursing is,” says Havens. “That’s a wonderful thing to have happened out of a very, very terrible situation.”

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EDUCATION

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Lessons Learned Schools adopt positive pandemic teaching methods By Deena C. Bouknight

HE COVID-19 HEALTH CRISIS resulted in positive

and negative changes to the U.S. educational system. Sara Rimm-Kaufman, commonwealth professor of education at the University of Virginia, is researching

ways to improve elementary and middle school classrooms for teachers and students. She says her book, SEL from the Start: Building Skills in K-5, is a “supportive guide” for instructors managing the transition from full- or part-time digital learning back to in-person instruction. Rimm-Kaufman found that there were so many variables to education in 2020

and early 2021 that teachers will need to plan for “an incredibly wide range of student experiences.” For example, some students considered remote learning a welcome break from being in a classroom, while others found the hybrid model of at-home and in-school learning CONTINUED

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EDUCATION traumatic, unsettling or disruptive. “Fall will present everything in between,” says Rimm-Kaufman. “There will be various challenges for teachers, students and parents (to) contend with. But there will be some new education trends emerging about what education will look like for the present and the future.” She says “pinpointing and filling gaps” is critical. “Formative assessments will be important to find out what kids do and do not know. And then adjustments will need to be made in lesson planning.” Flexibility and patience will be key, she explains, with “teachers learning how to be proactive instead of reactive.” Due to the autonomy that most primary and secondary students experienced during the pandemic, RimmKaufman suggests schools may need to adopt somewhat of a higher education model. “Many kids have really risen to the occasion, organizing their time, managing their attention, etc. We don’t want kids to go back to school and think they had so much autonomy and now they don’t. No one likes privileges taken away from them. The main question is, ‘How do we make learning interesting, relevant?’” She notes that the hybrid model generally strained teachers during the quarantine and beyond, but contends, “Schools should try to avoid just drilling students, and instead introduce service- and project-based learning that gives kids a reason to want to learn, to be excited, to encourage their curiosity, to create positive change in the world.” Ashley Jochim, senior research analyst for the Center on Reinventing Public Education (CRPE) at the University of Washington-Bothell in Seattle, points to a plethora of online aids that can help educators establish a foundation for post-pandemic instruction. The days of one-size-fits-all methods are gone, she suggests. “The pandemic gave families a window into school and learning,” says Jochim. “There is no putting the genie back in the bottle. … Students who thrived in a virtual setting may want to continue that route.” At CRPE, research has been conducted to track responses to remote learning as well as new teaching strategies for better student engagement. “It would be a shame to enter the fall school year with an interest on putting things back the way they were prior to the pandemic,” says Jochim. “Higher education, especially, was already facing tectonic shifts before the pandemic;

Sara RimmKaufman PROVIDED BY SARA RIMM-KAUFMAN

institutions have been shutting down, ways, this was a good thing, but going financial issues occurring … but back is not the answer.” schools have stimulus dollars; there are Bentley would like to see virresources, and this is a moment in time tual schooling as an option for “a small to create new academic opportunities. percentage of students who may need I’m of the mind to really leverage this this way of learning in order to have a moment to do something better opportunity for different.” success.” But he also She warns, however, can envision instructors that thoughtful attention using Zoom to include should be paid to what special guests, such is introduced in the as museum docents or future. “Plans hastily put scientists to make class together don’t often turn time more effective and out so well. We need to interesting. OF TEACHERS build a better education “Teachers have the SURVEYED SAY system, but not do it skills and confidence hastily.” level to utilize digital DIMINISHED Kipp Bentley, senior he says. “But STUDENT LEARNING learning,” fellow with the Folsom, instructors will still have WAS THEIR BIGGEST to do some legwork, Calif.-based Center for CONCERN DURING Digital Education and a establish technologyformer teacher, agrees THE TRANSITION TO involving lessons and that “back to normal” really utilize all the REMOTE LEARNING is not necessarily the benefits of their learning viewpoint educamanagement system. SOURCE: tional institutions should University of Nebraska Medical Center The good that came adopt. out of the pandemic is “Because of necessity, that there are so many teachers had to advance engaging ways to their technology skills tremendously incorporate technology.” in the last year and half,” says Bentley. He also predicts educational institu“They had to embrace educational tions will only increase the use of digital technology tools rapidly due to these textbooks and interactive software. unfortunate circumstances. And in some Thomas Arnett, a senior research

58%

fellow for the Boston-based Clayton Christensen Institute, points to Map Academy, a Plymouth, Mass., single-site, 2-year-old charter school serving grades 9 through 12, which was featured in a recent CRPE report. Map Academy fared well during the pandemic due to its established online system and teaching model that recognizes “each student comes with distinct assets but also unique obstacles to overcome,” according to the report. “Conventional schooling becomes a problem when it marginalizes students whose profiles do not conform to its standard operations. … For many students, conforming to the system just wasn’t compatible with their life circumstances,” the analysis continues. “While many schools were struggling with how to learn during COVID, Map was already set up in a way that it was able to make the transition smoothly,” says Arnett. “The school had already built courses on an online platform, so they could keep doing what they had done in the past. In our broader research, we’ve found that online learning offers key flexibilities in how students are supported in education. Schools like Map are not just about using online learning as a Band-Aid — but for better serving the student’s learning needs and lifestyle.” Arnett says it comes down to asynchronous versus synchronous learning, or learning and meeting deadlines based on one’s individual schedule as opposed to participating in class online or otherwise at set times. The drawback to wholly online learning or in-school, computer-based programs, is that too much screen time is sometimes socially and emotionally detrimental, requiring teachers and parents to identify a balance. A study published last October by the University of Nebraska Medical Center determined that some positive pandemic outcomes to college-level virtual learning included more time to read literature, focus on research and work on manuscripts and the flexibility to learn at the individual’s own pace. Final thoughts from the research: “Students and faculty like the flexibility of attending lectures/seminars remotely and asynchronously.” “Online learning is the background structure at Map, but students are not just staring at a device; they are offline and interacting as well,” says Arnett. “I’m hoping school systems will see, from coming out of COVID, that they don’t have to offer one solution for all students, because all students are different and learn differently.”

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EDUCATION

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Learning Without Limits Ed-tech is booming, spurred by remote learning By Jennifer Bradley Franklin

ECESSITY IS THE MOTHER of invention, or so the saying goes. While technology has long been a part of education, when many schools around the country switched to remote learning during the COVID-19 pandemic, technol-

ogy in education — or ed-tech — became more vital than ever. The resulting ed-tech boom has some feeling optimistic. In a recent report from Cambium Learning Group, a global education technology company, 75 percent of educators believe, as a result of the pandemic, they’re in a better position to solve problems than ever before.

Jaime Favorite, who teaches seventh and eighth grade math at La Mesa Arts Academy in La Mesa, Calif., acknowledges the pandemic highlighted some challenges, namely that not all of her school’s students had their own device or reliable internet access. Pre-pandemic, there was CONTINUED

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EDUCATION XXXXX students more quickly. That shift alone saves her hours of work each week. Parents have also played a big role in helping students stay engaged and plugged in. Dorie Taylor had no idea that remote learning would have such a profound impact on her parenting and her kids’ learning. Thanks to Taylor’s role as producer of an education festival, her 9- and 12-year-old sons had years of experience visiting libraries, science centers, businesses and parks and already knew that learning can happen anywhere. “This year, because we tuned in virtually to organizations across the country, they discovered new tools and methods for learning,” says the Pittsburghbased mom. “I showed my kids what was available, and they followed their curiosity.” That inquisitiveness is likely to serve them well, whether they’re learning remotely or back in a physical classroom. Here are a few of the companies and technologies that helped educate kids when COVID-19 changed the game, and are primed to continue to shape the landscape moving forward:

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“Every kid has a Chromebook or iPad at our schools now. ... I don’t think I’ll ever go back to paper and pencil handouts of tests or quizzes.” — JAIME FAVORITE, teacher, La Mesa Arts Academy

The eGlass writing tool EGLASS BY PATHWAY

approximately one device for every five students. “We are now a 1-to-1 ratio student-to-device district,” she says. “Every kid has a Chromebook or iPad at our schools now.” Favorite utilized Google Classroom, Kami (an app to create interactive assignments) and Pear Deck (to create engaging custom presentations), and she discovered some key elements she plans to use even as things return to pre-pandemic “normal.” “I don’t think I’ll ever go back to doing paper and pencil handouts of tests or quizzes,” she says. Instead, she uses a program called Jupiter Ed that allows her to grade assignments digitally and share feedback with

CLASSTAG CONNECT ClassTag, the parent-teacher communication platform used by 25,000 schools across the country, launched ClassTag Connect in November 2020 to help make it easier for educators to connect with students’ families. The platform enables school leaders to send messages in more than 100 languages via the format selected by the parent (SMS, app, web or voice) and see whether families are engaging with school communication. Educators can learn if a family is likely to fall out of touch, and parents can access all of the vital school documents and assignments via a virtual student backpack, helping streamline communication. HOMER Experts know that brain development starts early, so home learning company Homer focuses on children ages 5 and younger. The subscription-based program creates a journey designed to grow with the child with apps, toys and classes designed by experts. The Learn & Grow app, with subjects presented in fun, age-appropriate ways, is shown CONTINUED

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EDUCATION

Sora SORA

to increase early reading scores by up to 74 percent, according to the company, and the Explore Kits offer hands-on educational game sets that kids receive by mail.

EGLASS The chalkboard or mark-and-wipe whiteboard is so old school. The nextgen way to write and share is eGlass, a transparent writing surface with a builtin camera and software that captures the teacher’s face and writing in the same window. Launched in 2021, the product is useful for in-person, virtual and hybrid classrooms, as it can cast to either an in-room or virtual screen. “When you’re at the whiteboard, you’re constantly turning around, your body is always in

the way, and certain kids can’t see unless you move,” says Favorite, who acquired the tool this spring. “The eGlass has bright colors. It’s really engaging to the kids, and I never have to turn my back. My kids on Zoom and the kids in the classroom can see me the whole time.”

LEARNING A-Z Owned by Cambium Learning Group, this literacy-focused tool is designed to help pre-K through grade six educators create programs that work for their students. Teachers can choose from tools to boost writing, reading comprehension, vocabulary and more, each designed to adapt to individual student needs. The brand recently partnered with UNICEF Kid Power on a program that allowed

students to read books and convert their stars (awards for books read) to donate water and meals to families in need. More than 63,000 meals were donated, and kids read three times the number of books when they were donating.

OUTSCHOOL This online platform offers more than 100,000 live online classes designed for kids ages 3 to 18. With a wide range of subjects like coding, a Harry Potter book club, Minecraft and guitar for beginners, students are connected with a live instructor and a small group of classmates who share their interests to help encourage engagement and learning. Parents who need financial assistance can sign up for free classes via

the company’s nonprofit arm, which has provided more than $1 million in gratis education.

SORA While in-person trips to the library were on hold during the pandemic, the Sora reading app kept students from more than 48,000 schools worldwide supplied with engaging reading material on their digital devices. Owned by parent company OverDrive, the app allows students to check out e-books and audiobooks through their school and local public libraries, sometimes without a library card. Whether the material is assigned by a teacher or just for fun, the app is designed to encourage a love of reading.

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Artist: Samir Arghandwall, Santa Monica, Calif. CHRIS PIZZELLO/ASSOCIATED PRESS

Pandemic Portraits

RTISTS 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 people have felt over the past year.

Artist: Applez, Mexico City PEDRO ARDO

Artist: Miguel Barajas, Dallas LM OTERO/ASSOCIATED PRESS

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