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Hospices seek to keep families connected
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EAU CLAIRE — From the time his wife moved into a River Falls memory care unit, Bert Russell visited her every day.

The routine was important for both Russell and his wife, Pat, who has been living with Alzheimer’s disease for 19 years and is now in hospice care. But the comforting pattern was broken in March with the arrival of the COVID-19 pandemic and the resulting restrictions on visitors in long-term care facilities.

While Russell has been unable to see his wife in person since March 10 — even though he lives nearby — he is grateful he has had the opportunity to “see” Pat, 77, regularly via video chats arranged and facilitated by the staff at St. Croix Hospice.

“It’s been special,” Russell said of the video chats. “I couldn’t have tolerated this separation without this ability to communicate.”

Maintaining that connection between hospice patients and their loved ones, even when coronavirus safety protocols generally prevent them from being in the same room, is the reason many Wisconsin hospice providers have been coordinating video chats since early in the pandemic.

St. Croix Hospice, based in Oakdale, Minnesota, recently formalized its effort to help patients and families navigate the hospice journey together even when they’re apart by launching its InTouch Family Connection Program. The program’s tools include video chats, phone calls and in-person visits when possible that include personal protective equipment to keep everyone safe.

As regional COVID-19 cases surged in the fall at the same time colder temperatures made window visits less practical, St. Croix Hospice officials decided to launch the program to make it the standard for its offices in six Midwestern states. The hospice’s nurses, aides, social workers and chaplains facilitate the video chats and calls during their scheduled visits with patients.

“It’s devastating when hospice patients haven’t seen their family members for months,” said Sarah Roseth, St. Croix Hospice’s regional clinical director in west-central Wisconsin, including offices in Eau Claire and Hudson. “This allows staff to set aside a certain time to facilitate virtual visits. It certainly doesn’t replace in-person visits, but we’re going to do the best we can to facilitate that connection.”

It’s a trying time for anyone when a patient is going through an end-of-life journey, but pandemic-induced separation makes it even tougher, Roseth said, noting that staff at nursing homes and assisted-living facilities are often too busy to help with frequent video chats.

“We understand the restrictions because facilities are trying to keep everyone safe, but it’s really difficult for families to maintain that connection when they have to be apart,” she said. “We want to bring families and their loved ones together.”

When a patient appears close to death, the hospice sometimes has been able to provide the necessary PPE and work with facilities to allow one or two family members to visit in person, Roseth said, adding that St. Croix also tests its staff for COVID-19 twice a week as a precaution.

Erin Shadbolt, nurse administrator for Mayo Clinic Health System Hospice and a member of the Wisconsin Hospice & Palliative Care Association, said facility lockdowns, visitation limitations and the difficulty of making a connection behind full PPE have made it a particularly difficult year for hospice providers and patients.

In addition, she said, hospice staff have had to wear PPE to visits, screen for potential virus symptoms in patients and family members, educate patients in their homes about how to visit safely and provide frequent phone and video connections and in-person visits when allowed.

“The reality is that this is really challenging. ... There is real grief during this time for patients, loved ones and, ultimately, hospice staff,” Shadbolt said. “Hospice workers are deeply caring individuals and have struggled with their own grief to see people dying without their family at their side. We are hopeful that community vaccination and ongoing prevention methods — masking, hand hygiene and social distancing — will allow facilities to open back up to visitors and that we can return to a ‘new normal.’ “

Russell said his twice-weekly video chats enable him to stay up to speed on his wife’s condition and the care she is receiving.

“I fill her in on what’s going on with the kids and grandkids and great-grandkids,” said Bert, who then is able to keep the couple’s out-of-state children informed. “It’s been a huge help and comfort to actually see her and know how she’s being taken care of.”

That sentiment was echoed by Tarry Schuster, who grew up in Plum City but now lives near Fairbanks, Alaska, and has been unable to visit his mother, who is on hospice in Ellsworth, for nearly a year. Schuster last saw his mom, Dorothy Nooger, when he visited in February just before the pandemic struck Wisconsin.

Schuster was thrilled recently when St. Croix Hospice staff proposed setting up a video chat between mother and son from 2,500 miles apart.

“It was cool to see her,” said Schuster, noting that the virtual visit went smoothly despite nobody in his family being tech-savvy. “If I can do it, anybody can.”

Pauline Beman, a registered nurse case manager in the hospice’s Eau Claire office who facilitated the chat, indicated the joy was obviously mutual.

“My patient recognized her son and daughter-in-law on the video chat,” Beman said. “She had the biggest smile I’d ever seen.”

Roseth said she has been personally moved when conducting video chats between patients and their families.

“It’s emotional. It pulls at the heartstrings,” she said. “It’s an honor to be there for these families.”

While the InTouch program may have been created in response to the pandemic to help families get through a difficult time, it’s really just an extension of the philosophy that drives hospice care, Roseth said.

“We very much focus on the idea that no one dies alone,” Roseth said. “We know our patients are terminal, but we focus on keeping people connected and maintaining quality of life and joy right until their last breath.”

Hundreds of walkers and vehicle passengers enjoy Irvine Park’s Christmas Village on New Year’s Day in Chippewa Falls. The annual display is up from Thanksgiving Day through Jan. 1.

Vaccination campaign picks up speed around the world

The campaign to vanquish the coronavirus is picking up speed in places, with Britain beginning to dispense the second vaccine in its arsenal Monday. But authorities in France and elsewhere in Europe are coming under fire for slow rollouts and delays.

In the U.S., government officials reported that vaccinations have accelerated markedly after a sluggish start. Dr. Anthony Fauci, the nation’s top infectious-disease expert, said over the weekend that 1.5 million shots were administered in 72 hours, bringing the total over the past three weeks to about 4 million.

Britain on Monday became the first nation to start using the COVID-19 vaccine developed by AstraZeneca and Oxford University, ramping up its nationwide inoculation campaign amid soaring infection rates blamed on a new and seemingly more contagious variant of the virus.

Brian Pinker, an 82-year-old dialysis patient, received the first shot at Oxford University Hospital, saying in a statement: “I can now really look forward to celebrating my 48th wedding anniversary.”

Britain’s vaccination program began Dec. 8 with the shot developed by Pfizer and its German partner BioNTech.

The country has recorded more than 50,000 new coronavirus infections a day over the past six days, and deaths have climbed past 75,000, one of the worst tolls in Europe.

Prime Minister Boris Johnson announced a wave of near-lockdowns the weekend before Christmas and warned on Monday that “tough, tough” weeks lie ahead and that tighter restrictions are coming soon: “If you look at the numbers, there’s no question we will have to take tougher measures.”

Israel appears to be among the world leaders in the vaccination campaign, inoculating over 1 million people, or roughly 12% of its population, in just over two weeks. The effort has been boosted by a high-quality, centralized health system and the country’s small size and concentrated population.

Elsewhere, France’s cautious approach appears to have backfired, leaving just a few hundred people vaccinated after the first week and rekindling anger over the government’s handling of the pandemic.

The slow rollout has been blamed on mismanagement, staffing shortages over the holidays and a complex consent policy designed to accommodate vaccine skepticism among the French.

“It’s a state scandal,” Jean Rottner, president of the Grand-Est region of eastern France, said on France-2 television. “Getting vaccinated is becoming more complicated than buying a car.”

Health Minister Olivier Veran promised that by the end of Monday, “several thousand” people will have been vaccinated, with the tempo picking up through the week. But that would still leave France well behind its neighbors.

French media broadcast charts comparing vaccine figures in various countries: In France, a nation of 67 million people, just 516 people were vaccinated in the first six days, according to the French Health Ministry. Germany’s first-week total surpassed 200,000, and Italy’s was over 100,000. Millions have been vaccinated in the U.S. and China.

The European Union likewise faced growing criticism about the slow rollout of COVID-19 shots across the 27-nation bloc of 450 million inhabitants.

EU Commission spokesman Eric Mamer said the main problem “is an issue of production capacity, an issue that everybody is facing.”

The EU has sealed six vaccine contracts with a variety of manufacturers. But only the Pfizer-BioNTech vaccine has been approved for use so far across the EU. The EU’s drug regulators are expected to decide on Wednesday whether to recommend authorizing the Moderna vaccine.

Aspects of Britain’s vaccination plans have also spurred controversy.

British health authorities want to give the first dose to as many people as possible right away, rather than holding vaccine in reserve to ensure recipients get their second shot on time a few weeks later. The plan requires stretching out the time between doses to as much as 12 weeks.

While two doses are required to fully protect against COVID-19, one dose offers a high level of protection.

Stephen Evans, a professor of pharmacoepidemiology at the London School of Hygiene & Tropical Medicine, said policymakers are being forced to balance the potential risks and benefits in the middle of the disaster.

“We have a crisis situation in the U.K. with a new variant spreading rapidly, and as has become clear to everyone during 2020, delays cost lives,” Evans said. “When resources of doses and people to vaccinate are limited, then vaccinating more people with potentially less efficacy is demonstrably better than a fuller efficacy in only half.”

In the U.S., Health and Human Services Secretary Alex Azar dismissed such a strategy, saying on ABC’s “Good Morning America” that the scientific data “just isn’t there” to support that approach.

The rollout in the U.S. has been marked by a multitude of logistical hurdles, a patchwork of approaches by state and local governments, and confusion. Some people are uncertain where or when to get a shot.

Fauci acknowledged over the weekend that “we are not where we want to be,” but he expressed optimism that the momentum will pick up by mid-January. He said President-elect Joe Biden’s goal of vaccinating 100 million people in his first 100 days in office is “realistic.”

On Sunday, India, the world’s second-most populous country, authorized its first two COVID-19 vaccines — the Oxford-AstraZeneca one and another developed by an Indian company. The move paves the way for a huge inoculation program in the desperately poor nation of 1.4 billion people.

India has confirmed more than 10.3 million cases of the virus, second in the world behind the U.S. It also has reported about 150,000 deaths.

Neither of the approved vaccines requires the ultra-cold storage that some others do. Instead, they can be kept in refrigerators, making them easier to handle in less developed parts of the world.

Pandemic grounds bald eagle count for 1st time in almost 50 years

MADISON (AP) — Bald eagles might still be soaring high in Wisconsin, but environmental regulators were grounded after the COVID-19 pandemic prevented an annual aerial survey of bald eagle nests for the first time in almost 50 years.

The Wisconsin Department of Natural Resources has conducted statewide aerial surveys since 1973, according to Jim Woodford, program manager for the DNR’s Bureau of Natural Heritage Conservation. State regulators say it’s one of the longest running surveys of its kind in the country.

“We were all set to go and then the pandemic happened,” said Woodford.

The annual surveys typically take place from February through May, but the pandemic disrupted those plans due to the need for social distancing and new safety protocols to prevent the spread of the virus, Wisconsin Public Radio reported.

“They generally need to be done during that time frame because, for viewing purposes, we want to do it before the deciduous trees leaf out so we have the best visual look at the nests as we are flying by,” said Woodford.

DNR pilots did conduct a few targeted surveys alone later in the spring and summer. But Woodford said the results aren’t as reliable because storms might impact nests or eagles might abandon them.

Bald eagle nests are under federal protection in the U.S. after the species was in danger of extinction decades ago. Nesting pairs of bald eagles dropped to less than 500 by 1963. The species was listed as endangered throughout most of the lower 48 states in 1978 while bald eagles were designated as threatened in Wisconsin.

The species was threatened with extinction due in part to DDT, a pesticide used to control mosquitos. Bald eagles ate fish contaminated with the pesticide, which contained a chemical that affected the viability of eggs. Habitat loss and poisoning from lead ammunition also played a role in the bird’s decline.

Since then, annual surveys have shown the number of occupied bald eagle nests in Wisconsin has grown from 107 in 1974 to 1,684 in 2019. The bird’s nesting range has also expanded from northern Wisconsin to every county in the state except Milwaukee County.

“We also use that information to help us make sure that the activities that we do, whether it be forest management, or lake shore home building, that we’re not impacting the birds,” said Woodford. Woodford said they’re trying to remain flexible and continue to conduct work in the field.

“We are able to get some of these things done,” said Woodford. “I hope we’ll we’ll be able to resume the necessary surveys this coming spring.”