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Religiosos enferman de covid mientras confortan a enfermos y moribundos

El sacerdote José Luis Garayoa sobrevivió a la fiebre tifoidea, a la malaria, a un secuestro y a la crisis del ébola como misionero en Sierra Leona, pero murió a causa de covid-19 después de atender a los enfermos de su iglesia en Texas y a los afligidos familiares de los fallecidos.

Garayoa, de 68 años, servía en la iglesia católica Little Flower de El Paso, y fue uno de los tres sacerdotes que vivía en la casa local de la Orden Católica de los Agustinos Recoletos que contrajo la enfermedad. Garayoa murió dos días antes del Día de Acción de Gracias.

Era consciente de los peligros de covid, pero no podía rechazar a un feligrés que buscaba consuelo y oraciones cuando esa persona o un ser querido luchaba contra la enfermedad, según contó la peluquera jubilada María Luisa Placencia, una de sus feligresas.

“Siempre que veía a alguien sufriendo o preocupado por un hijo o un padre, rezaba con ellos y mostraba compasión”, dijo Placencia.

La muerte de Garayoa subraya los riesgos personales que corren los líderes espirituales que confortan a los enfermos y a sus familias, dan la extremaunción o dirigen los funerales de las personas que han muerto de covid. Muchos de ellos también se enfrentan al reto de liderar a congregaciones divididas sobre la gravedad de la pandemia.

Atender a los enfermos o a los moribundos es una de las principales funciones de los líderes espirituales de todas las religiones. Susan Dunlap, teóloga en la Universidad de Duke, dijo que covid crea un sentimiento de obligación aún mayor para el clero, porque muchos pacientes están aislados de los miembros de la familia.

Las personas terminales suelen querer interactuar con Dios o arreglar las cosas, señaló Dunlap, y un miembro del clero “puede ayudar a facilitar eso”.

Esta labor espiritual es la clave del trabajo de los capellanes de los hospitales, pero puede exponerlos a la propagación de virus en el aire o, a veces, a través del tacto.

Jayne Barnes, capellán de la Clínica Billings de Montana, dijo que trata de evitar el contacto físico con los pacientes de coronavirus, pero puede ser difícil resistirse a un breve contacto, que a menudo es la mejor forma de transmitir compasión.

“Es casi un momento incómodo cuando ves a un paciente angustiado, y sabes que no debes cogerle la mano o darle un abrazo”, apuntó Barnes. “Pero eso no significa que no podamos estar ahí para ellos. Son personas que no pueden recibir visitas, y tienen muchas cosas que decir. A veces están enfadados con Dios, y me lo hacen saber. Estoy allí para escuchar”.

Sin embargo, hay veces, dijo Barnes, que la desesperación es tan profunda que no puede evitar “ponerte un guante y tomar la mano de un paciente”.

A Barnes le diagnosticaron covid cerca del Día de Acción de Gracias. Se ha recuperado y tiene una “mejor comprensión” de lo que los pacientes están soportando.

Tratar con tanto sufrimiento afecta incluso a los médicos y enfermeras más curtidos, comentó. El personal de la Clínica Billings quedó devastado cuando un médico muy querido murió de covid, y se unió en apoyo a una enfermera que estuvo gravemente enferma, pero se recuperó.

“No sólo cuidamos de los pacientes, también estamos ahí para el personal, y creo que hemos sido un activo importante”, dijo refiriéndose a los capellanes del hospital.

En Abington, Pennsylvania, el pastor Marshall Mitchell, de la Iglesia Bautista de Salem, explicó que parte de su deber espiritual es persuadir a su congregación y a la comunidad afroamericana, en general, de que tomen precauciones para evitar la enfermedad.

Por eso Mitchell permitió que los fotógrafos captaran el momento en que, en diciembre, recibió su primera dosis de la vacuna.

“Como pastor de una de las mayores iglesias de la región de Philadelphia, me corresponde demostrar los poderes tanto de la ciencia como de la fe”, dijo.

Mitchell aseguró que podría utilizar su credibilidad para convencer a otros afroamericanos, que se han visto desproporcionadamente afectados por covid, de que una vacuna puede salvar vidas. Muchos son escépticos.

La politización de las precauciones para evitar contagiarse el coronavirus, como las máscaras y el distanciamiento social, ha puesto a muchos pastores en una posición difícil.

Mitchell dijo que no tiene paciencia con las personas que se niegan a usar máscaras.

“Los mantengo muy lejos de mí”, añadió.

Jayne Barnes, capellana en la Billings Clinic, en Montana, dice que es raro no poder tocar o abrazar a un paciente con covid en crisis. Dijo que algunas veces no puede contenerse y “me pongo un guante y sostengo su mano”. (Zach Benoit)

Jeff Wheeler, pastor principal de la Iglesia Central de Sioux Falls, en Dakota del Sur, dijo que su iglesia anima a llevar máscaras y que la mayoría de los feligreses lo hacen. Sin embargo, la tensión subyacente se refleja en su mensaje a los miembros en el sitio web de la iglesia:

“A medida que avanzamos, simplemente les pedimos que eviten avergonzar, juzgar o hacer comentarios críticos a quienes llevan o no llevan máscaras”.

El jeque Tarik Ata, que dirige la Fundación Islámica del Condado de Orange, en California, explica que el Corán pide a los musulmanes que tomen medidas para cuidar de su salud y que los congregantes cumplen, en gran medida, las directrices de covid.

“Por lo tanto, nuestros miembros no tienen ningún problema con el mandato de llevar máscara”, dijo.

Covid ha golpeado duramente a la población musulmana del condado de Orange, indicó Ata. La religión se ha convertido en una importante fuente de consuelo para los miembros que han perdido sus trabajos o se han enfermado.

“Nuestra fe dice que, por muy difícil que sea la situación, siempre tenemos acceso a Dios y así el futuro será mejor”, dijo Ata.

Adam Morris, rabino del Templo Micah de Denver, Colorado, contó que se reúne con enfermos de covid a través de internet. En los servicios funerarios, le preocupa que con la máscara puesta las personas no aprecien la preocupación y la compasión que siente por su situación.

Oficia los funerales junto a la tumba para un pequeño número de dolientes, pero exige que todos los participantes lleven máscara.

Musulmanes y judíos practicantes creen que es importante enterrar a las personas rápidamente después de su muerte, dijo Morris.

“Algunas tradiciones y rituales deben seguir adelante”, concluyó Morris, “con o sin covid”.

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Global Health Watch Noticias En Español

Feds OK’d Export of Millions of N95 Masks as U.S. Workers Cried for More

In the midst of a national shortage of N95 masks, the U.S. government quietly granted an exception to its export ban on protective gear, allowing as many as 5 million of the masks per month to be shipped overseas.

The Federal Emergency Management Agency issued the waiver in the final moments of Donald Trump’s presidency last month, allowing a Texas company to export its products after it failed to secure U.S. customers, according to the FEMA letter obtained by KHN.

National Nurses United president Zenei Triunfo-Cortez called the export waiver “unconscionable” and said N95s remain under lock and key in many hospitals. She said she still has to “beg” for a new N95 if hers gets soiled during a shift caring for covid-19 patients.

Health care employers “and a federal agency that is supposed to be protecting the people of America are not doing their jobs,” she said. “They have no regard for our safety.”

The disconnect between front-line workers going without better protection and federal officials suddenly exporting masks boils down to one thing, workplace-safety experts say: The government has not pivoted quickly enough to lift supply chain crisis-mode guidelines and force employers to take costly and sometimes cumbersome steps to better protect workers with top-quality gear.

The FEMA letter references the challenge that Fort Worth-based Prestige Ameritech faced in finding customers for its government-approved, high-end respirators: Hospitals did not want to “fit test” employees to its N95s, a 15-minute process per employee to ensure that a new N95 model seals to the face, according to company president Mike Bowen.

Prestige Ameritech’s Mike Bowen testifies before the House Energy and Commerce Subcommittee on Health hearing to discuss protecting scientific integrity in response to the covid pandemic on May 14, 2020. (Shaw Thew/AFP / Getty Images)

Bowen said he ramped up N95 production during the pandemic from 75,000 to 9.6 million per month. Lately, he said, he can’t sell them to major buyers, does not have the infrastructure to sell them to small buyers and has so many in storage that he may need to lay off workers and wind down production.

The FEMA letter references those challenges and says the waiver was granted in the “national defense interest” to ensure he keeps production running at pace. The letter was transmitted to Border Patrol officials who oversee exports 103 minutes before Joe Biden was sworn into office.

Yet even with the waiver, Bowen said, he hasn’t been able to find an overseas buyer. He said he can’t understand the contradictory information he’s getting: Front-line workers say they need more N95s, but hospitals say they don’t.

“There is a disconnect someplace, and I don’t know where it is,” Bowen said. “Why aren’t my phones ringing off the hook if there’s a shortage?”

A FEMA official said by email that the waiver could be revoked at any time if U.S. demand increases and that the agency could require the company to “satisfy domestic demand” before exporting N95s.

Although prices fall considerably for those buying in bulk, prices for smaller lots of N95s have reached $4 to $7 each, according to Get Us PPE, a nonprofit meant to match front-line workers with needed gear.

The requirement for employers to perform fit tests annually was set aside amid the public health emergency, giving employers little incentive to veer from the industry-standard models like 3M that were used for years. And the Centers for Disease Control and Prevention has left guidelines in place that say a limited cadre of health care workers should get N95s, which can be reused and rationed.

That adds up to an unusual situation in which U.S. mask supplies have surged, but employers’ motivation to buy the best protective gear has not, said Peg Seminario, a former union health and safety official who recently signed a letter urging the CDC to update its guidelines to reflect the risk of inhaling the virus.

“This is crazy,” she said. “We could … crush this pandemic where the biggest risks of infection are and we’re not doing it.”

Started by a group of emergency room doctors in March, Get Us PPE said it gets 89% of requests for gear — often N95s — from health workers outside of hospitals, like community clinics, covid testing sites and psychiatric care facilities. Demand rose throughout January, with 28% of front-line workers seeking N95s reporting that their site had none.

Yet the volunteer-run group has been able to fulfill only about 15% of the requests it receives. Dr. Ali Raja, a founder of the group and executive vice chair of the emergency department at Massachusetts General Hospital, said the need is vast outside of hospitals, but small facilities scrambling for gear are not connecting to bulk sellers like Bowen’s firm.

“There was nothing out there — no centralized place for all facilities to report PPE needs,” Raja said. “We don’t want to be the website with the best data on this. We want that to be the federal government.”

On the last day of 2020, FEMA extended its rule prohibiting anyone from exporting PPE, including N95s, without first getting express approval from the agency. The rule says the fall and winter surge in covid cases meant “domestic supply of the allocated PPE has not kept pace with demand and is not anticipated to do so.”

The U.S. Strategic National Stockpile has not yet met its goal for N95 respirators, according to a U.S. Government Accountability Office report. The report said that as of Dec. 18, there were 190 million N95 respirators in storage — well short of its goal of 300 million.

“GAO remains deeply troubled that agencies have not acted on recommendations to more fully address critical gaps in the medical supply chain,” the government watchdog report says.

Another twist to the saga is that millions of counterfeit N95s stamped “3M,” an industry standard that has long been used in previously required annual fit tests, have flooded hospital shelves even as federal agents rush to seize them at U.S. ports.

A prominent group of scientists wrote to the CDC on Monday to point out guidelines that urgently need to be changed to protect workers from inhaling tiny airborne virus particles. Their letter noted that the “CDC does not recommend the use of N95 respirators” outside health care settings, even though outsize risks are documented for bus drivers, prison guards and meatpacking staffers.

CDC guidelines also allow hospitals to limit which workers get the N95s, leaving out those in community settings and lower-level workers who typically spend the most time next to patients.

In the Lost on the Frontline project, KHN and The Guardian have documented the deaths of hundreds of more than 3,440 front-line health workers, of whom 2 in 3 were workers of color and 56% worked outside of hospitals. For more than 120 who died, family members had concerns about PPE, including the extensive reuse of N95s or the use of surgical masks for direct care of covid patients.

KHN senior correspondent JoNel Aleccia contributed to this report.

What Families Can Learn From the Texas Storm

What Families Can Learn From the Texas Storm

Take these steps when critical services are affected by freezing temperatures.

From left, Charles Flynn, 9, Lucille Flynn, 12, and their mother, Erica Flynn, at their home in Austin, Texas, before fleeing to a hotel. The frigid temperatures caused electrical grids to fail, sending indoor temperatures plummeting. 
From left, Charles Flynn, 9, Lucille Flynn, 12, and their mother, Erica Flynn, at their home in Austin, Texas, before fleeing to a hotel. The frigid temperatures caused electrical grids to fail, sending indoor temperatures plummeting. Credit…Andrew Flynn
Christina Caron

  • Feb. 19, 2021, 1:18 p.m. ET

After days of record-breaking cold and winter storms in Texas that disrupted the electrical grid and froze water lines, millions of people are now being told to boil their water for safety.

Other families have no tap water at all. Valerie Contreras, 20, who lives in Austin, Texas, had to take shelter with her infant son at her parents’ home nearby during the storm. She said her family is melting snow in buckets to flush the toilets, and boiling snow water to wash the dishes.

She uses bottled purified water for her son’s baby formula, but is down to her last two gallons.

With critical services disrupted by severe weather, families are scrambling to navigate dangerous conditions. So we asked experts for tips on how to stay safe. Even if you haven’t yet lost drinking water or power, some of this advice might help you plan ahead in the event of a similar emergency. As climate change accelerates, more electric grids may be crippled by unexpected weather events, putting people at risk of losing power.

A weather crisis combined with the pandemic can “feel pretty hopeless and endless,” said Dr. David J. Schonfeld, the director of the National Center for School Crisis and Bereavement at Children’s Hospital Los Angeles. “Your goal is to be able to identify what the current situation is, figure out what’s most important for you to do at this point and be able to deal with that one issue.”

Conserve warmth and make an exit plan

When the power goes out, there are certain precautions you can take to avoid heat loss, like placing rolled-up towels at the base of exterior doors or stuffing rags in cracks under the doors. Closing curtains and blinds can also keep heat inside, according to the National Weather Service.

The service also advised that residents “move all activities to a main room and close the remaining interior doors to retain heat,” adding that people should wear layers of loosefitting and lightweight warm clothing, and have extra clothing layers handy.

Christina DiVirgilio, 36, who lives in Spring, Texas, a suburb of Houston, bundled her sons, 5 and 11 months, in undershirts and fleece pajamas along with gloves, hats and robes.

“They kept pretty warm for the most part,” she said.

Her youngest slept in a portable crib in Ms. Divirgilio’s walk-in closet, which turned out to be the warmest spot in the house. And because they had stocked up on batteries ahead of the storm, they were able to keep their electric fireplace going throughout the week, ensuring that temperatures in their apartment didn’t dip below 48 degrees Fahrenheit.

If you have a wood-burning fireplace, you can start a fire, provided that you have been cleaning and inspecting your chimney annually. The American Academy of Pediatrics recommends that you take a flashlight and check that the damper or flue is open, which will draw smoke out of the house.

But if it’s very cold, sometimes it might not be safe to stay at home, especially if you have small children, who are more prone to heat loss than adults. The most fortunate will be able to flee to a home with heat by sheltering with family or friends, staying at a hotel or renting a home in a nearby area.

Ms. Contreras and her 13-month-old son quickly drove to her parents’ home because her apartment was so cold the liquid dish soap froze into a solid block, snow blew under her doorway and ice crystallized on the floor. Eventually the thermostat in her living room stopped working, displaying only the letters “Lo.”

“We just could not take the cold anymore. It was horrible,” she said. “You could literally see your breath inside my apartment.”

If you’re staying with people you don’t normally live with, ideally, everyone age 2 and older should wear a mask and try to eat in separate rooms, if possible, said Dr. Carl Baum, a professor of pediatrics and emergency medicine at the Yale School of Medicine and a member of the executive committee for the A.P.A.’s Council on Children and Disasters.

“You don’t want to be the next superspreader event,” he said.

Those who cannot find a place to stay can check their state’s list of warming shelters, if they are in need of power and able to travel.

Beware of carbon monoxide poisoning

When the frigid weather hit Texas this week, hundreds of people in Houston used barbecue pits or portable generators indoors, resulting in carbon monoxide poisoning, the Houston Chronicle reported on Tuesday. Many of the cases were in children.

Portable generators that run on fuel are often used to provide homes with electricity or heat during a power outage, but they can be dangerous when used improperly.

The Federal Emergency Management Agency says to place these generators outdoors and away from windows, keep them dry and properly grounded and never plug them into a wall outlet or main electrical panel.

Other outdoor appliances that are powered by fossil fuels, like camping stoves, can also release carbon monoxide, and should not be used indoors.

Cars left running in a garage and malfunctioning gas stoves, gas dryers and fuel-fired furnaces can all release dangerous levels of carbon monoxide.

According to the Centers for Disease Control and Prevention, the most common symptoms of carbon monoxide poisoning include headache, dizziness, weakness, upset stomach, vomiting, chest pain and confusion.

You cannot smell or see carbon monoxide gas, not even when it builds to deadly levels. According to the Texas Poison Center Network, it is considered the leading cause of death from poisoning in the United States, which is why it’s important to also install a carbon monoxide detector in your home.

Avoid contaminated water and protect your pipes

As of Friday morning, more than 14 million people in 160 counties in Texas are facing disruptions in their water service, according to a spokeswoman for the Texas Commission on Environmental Quality.

If your community is under a boil water advisory, the C.D.C. says you should either use bottled water or boiled tap water for your family and your pets because your community’s water could be contaminated.

It’s not enough to pour your water through a filtered pitcher or faucet attachment. Tap water should be brought to a full rolling boil for at least 1 minute. If you live at an elevation above 6,500 feet, you should boil the water for 3 minutes before allowing it to cool, the C.D.C. says.

And if you have appliances connected to a water line, like a refrigerator, do not use the water or ice that it produces while the boil water advisory is in effect.

Rather than washing dishes, you might consider using disposable plates, cups and utensils. According to the C.D.C., household dishwashers are safe to use if the water reaches a final rinse temperature of at least 150 degrees, or if the dishwasher has a sanitizing cycle.

If you don’t have a dishwasher, you can wash and rinse the dishes like you normally would. The C.D.C. then recommends soaking the rinsed dishes in a separate basin with 1 teaspoon of unscented household liquid bleach for each gallon of warm water. Let the dishes air dry completely before using again.

Babies who drink formula should be fed ready-to-use formula if possible. If you don’t have any available, try to find bottled water labeled de-ionized, purified, demineralized or distilled.

When the boil water order is lifted, residents will be asked to flush their water lines to clear plumbing of potentially contaminated water.

If you are a homeowner, you can take steps to protect your pipes from freezing. The American Red Cross recommends keeping garage doors closed if there are water supply lines in the garage, opening kitchen and bathroom cabinets to allow warmer air to circulate around plumbing and letting cold water drip from the faucet. You can also consider installing insulating materials like a “pipe sleeve” on exposed water pipes.

If you only see a trickle of water coming out of your faucet, or none at all, your pipes may be frozen or damaged. In that case, experts recommend turning off the main water supply to the house to prevent water damage when the temperatures rise or the power comes back on.

Prepare for potential difficulties in getting food

Ideally, if you know winter weather is on the way, you’ll stock up at the grocery store ahead of time. But what if the weather takes you by surprise? Or you haven’t been venturing outside as regularly because of the pandemic?

When the power went out earlier this week, Andrew Flynn, 45, immediately booked a hotel for his wife and two kids in Austin, Texas, but then the hotel ran out of food.

On Tuesday, he said, “I spent three hours driving around central Austin yesterday and all of the grocery stores had long lines.”

He finally visited a gas station and bought non-perishables like ramen and rice so his family could make meals in their slow cooker.

His kids, 9 and 12, “haven’t loved it,” he said. But allowing them to have some candy or potato chips after their “Crock-Pot mixture” provided some incentive, he added.

If your kids are cold and cranky and you cannot give them comfort food, at some point you need to level with them in a gentle but direct way.

You can try saying: “I’m sorry, we don’t have your favorite food or even food you like at this point, but you’re going to have to eat this,” Dr. Schonfeld suggested. “Or, let’s figure out something you can eat even if it’s not particularly healthy.”

But not everyone has a car or the ability to drive around in search of food. Check to see if hunger relief organizations or food banks are providing food to people in the community and how it is being distributed. Friends might also have extra to spare.

Rawlins Gilliland, 75, who lives in Dallas, lost power for three days but his gas stove was still working so he kept himself busy making vegetable soup for his neighbors, including the large family that lives next door.

“My survival mechanism during this was that we do what we can,” he said.

His neighbors helped him out, too. When the power came back, he discovered that his heater had given out, so one of his neighbors drove more than 50 miles to get a replacement part and help him install it. The heater is working again and he’s no longer wearing his lined boots and layers of polar fleece indoors. “Right now, I feel extremely excited because things are under control here,” he said on Friday. “I wish people really did realize that collectively that we’re all in these things together.”