npr--2020-12-14--For Hungry Americans Across The Country, Food Insecurity Crisis Deepens

For Hungry Americans Across The Country , Food Insecurity Crisis Deepens Nine months into the pandemic , and lines outside food pantries are still a common sight around the country : families waiting in row after row of cars , snaking as far as the eye can see .
Last year , more than 35 million people experienced food insecurity .
But because of the pandemic , that number could be as high as 50 million for this year , according to the hunger relief organization Feeding America .
And with multiple federal aid programs set to run out soon @ @ @ @ @ @ @ out of food , too .
The crisis is acute , and it 's nationwide , says Kate Leone , Feeding America 's chief government relations officer .
Since the pandemic started , an average of 60 % more people have been seeking help from the organization 's network of 200 food banks , Leone says , with one in two children facing hunger in some counties .
Among their clients , Leone says , are former volunteers and even donors .
`` We think that about four in 10 of the people @ @ @ @ @ @ @ needing charitable assistance , '' Leone says .
That 's been the case in New Orleans , where the tourism based-economy has been hard hit , says Emily Slazer , food sourcing manager of the city 's Second Harvest Food Bank .
`` We 're seeing clients who are sleeping in their cars , arriving on site at 2 , 3 in the morning , sometimes even the night before , '' she says .
`` It 's just a stunning and heartbreaking visual to see so many members of our community who @ @ @ @ @ @ @ their interview with All Things Considered , Leone and Slazer discuss the challenges food banks currently face , the reluctance people may feel in seeking assistance and what the government should do to address the crisis .
What are some of the specific challenges Second Harvest Food Bank is struggling with now ?
Slazer : Food drives are definitely down because people are not gathering in offices and schools and other places where community food drives would be organized .
We also have a lot of restaurant supply donors that have had to @ @ @ @ @ @ @ also have a few government programs that are going to be ending in the next few weeks that are going to leave a really big hole that we do n't have an easy way to fill .
... Also , getting the types of pantry staples donated that our clients need is really hard right now because at times during this pandemic , it 's been hard to buy a can of green beans at your local grocery store , much less get those green beans donated to the food bank .
So @ @ @ @ @ @ @ challenges start to pile up and the food supply is impacted .
What does the government need to do to address this crisis right now ?
Leone : The No .
1 thing they can do is pass a new economic relief package .
The first two packages that passed were very helpful in terms of providing flexibilities in order to be able to continue to deliver meals to schoolchildren who are missing that critical source of nutrition .
But right now , the most efficient and effective way the federal government can @ @ @ @ @ @ @ to increase SNAP benefits .
So SNAP , the program formerly known as food stamps , allows people to use an electronic benefit card right in their grocery stores .
So it has that extra impact of having people spending money locally , which is going to create jobs .
...
It really is the most efficient way to deliver benefits .
Feeding America ... is the largest response to hunger in the charitable sector .
But for every one meal our network provides , SNAP provides nine .
So there really is @ @ @ @ @ @ @ of assistance that we can provide to people than the SNAP program .
So really increasing those benefits just a little bit during this time when grocery prices are spiking — and benefits are n't going as far — would go a long way to helping people everywhere right now .
There are so many people who are right now experiencing food insecurity , homelessness for the first time in their lives .
Is there anything that you would like to say to those people ?
Slazer : Food is a basic human @ @ @ @ @ @ @ .
It makes it impossible to participate in classes , impossible to participate in work tasks .
Being hungry is an emergency and everyone deserves to have that need met .
And it is difficult to be accessing a service for the first time , but also right now so many people from so many backgrounds are facing the same problems .
So I would hope that , particularly the new clients that we 're seeing or people who are needing the help now but just not sure if they 're ready to @ @ @ @ @ @ @ they would understand and hope that they would hear that no one needs to justify getting help or explain why they 're hungry , because what 's much more important than that is how can we offer them help .
Jonaki Mehta and Jolie Myers produced and edited the audio interview .
Maureen Pao adapted it for the Web .

For Hungry Americans Across The Country, Food Insecurity Crisis Deepens
Enlarge this image toggle caption Frederic J. Brown/AFP via Getty Images Frederic J. Brown/AFP via Getty Images
Nine months into the pandemic, and lines outside food pantries are still a common sight around the country: families waiting in row after row of cars, snaking as far as the eye can see.
Last year, more than 35 million people experienced food insecurity. But because of the pandemic, that number could be as high as 50 million for this year, according to the hunger relief organization Feeding America.
And with multiple federal aid programs set to run out soon, many pantries fear they will run out of food, too.
The crisis is acute, and it's nationwide, says Kate Leone, Feeding America's chief government relations officer.
Since the pandemic started, an average of 60% more people have been seeking help from the organization's network of 200 food banks, Leone says, with one in two children facing hunger in some counties.
Among their clients, Leone says, are former volunteers and even donors.
"We think that about four in 10 of the people we're serving now are new to needing charitable assistance," Leone says.
That's been the case in New Orleans, where the tourism based-economy has been hard hit, says Emily Slazer, food sourcing manager of the city's Second Harvest Food Bank.
"We're seeing clients who are sleeping in their cars, arriving on site at 2, 3 in the morning, sometimes even the night before," she says. "It's just a stunning and heartbreaking visual to see so many members of our community who are hungry."
In excerpts from their interview with All Things Considered, Leone and Slazer discuss the challenges food banks currently face, the reluctance people may feel in seeking assistance and what the government should do to address the crisis.
What are some of the specific challenges Second Harvest Food Bank is struggling with now?
Slazer: Food drives are definitely down because people are not gathering in offices and schools and other places where community food drives would be organized. We also have a lot of restaurant supply donors that have had to really reduce their business. ... We also have a few government programs that are going to be ending in the next few weeks that are going to leave a really big hole that we don't have an easy way to fill. ...
Also, getting the types of pantry staples donated that our clients need is really hard right now because at times during this pandemic, it's been hard to buy a can of green beans at your local grocery store, much less get those green beans donated to the food bank. So it has a domino effect of how challenges start to pile up and the food supply is impacted.
What does the government need to do to address this crisis right now?
Leone: The No. 1 thing they can do is pass a new economic relief package. The first two packages that passed were very helpful in terms of providing flexibilities in order to be able to continue to deliver meals to schoolchildren who are missing that critical source of nutrition.
But right now, the most efficient and effective way the federal government can respond to the food insecurity crisis is to increase SNAP benefits. So SNAP, the program formerly known as food stamps, allows people to use an electronic benefit card right in their grocery stores. So it has that extra impact of having people spending money locally, which is going to create jobs. ... It really is the most efficient way to deliver benefits.
Feeding America ... is the largest response to hunger in the charitable sector. But for every one meal our network provides, SNAP provides nine. So there really is nothing that can compare to the scope of assistance that we can provide to people than the SNAP program. So really increasing those benefits just a little bit during this time when grocery prices are spiking — and benefits aren't going as far — would go a long way to helping people everywhere right now.
There are so many people who are right now experiencing food insecurity, homelessness for the first time in their lives. Is there anything that you would like to say to those people?
Slazer: Food is a basic human right and hunger supersedes so many things. It makes it impossible to participate in classes, impossible to participate in work tasks. Being hungry is an emergency and everyone deserves to have that need met. And it is difficult to be accessing a service for the first time, but also right now so many people from so many backgrounds are facing the same problems. So I would hope that, particularly the new clients that we're seeing or people who are needing the help now but just not sure if they're ready to access services, I just hope that they would understand and hope that they would hear that no one needs to justify getting help or explain why they're hungry, because what's much more important than that is how can we offer them help.
Jonaki Mehta and Jolie Myers produced and edited the audio interview. Maureen Pao adapted it for the Web.


npr--2020-12-14--NCAA Plans To Hold All Of Women's Basketball Tournament In San Antonio This Spring

NCAA Plans To Hold All Of Women 's Basketball Tournament In San Antonio This Spring With nation 's confirmed coronavirus infections surging , the NCAA announced Monday it plans to stage the entire Division I women 's basketball tournament in one geographic area when it tips off in March .
Talks are already underway with officials in San Antonio to host the 64 teams that will compete in the single-elimination tournament .
NCAA officials said it aims to limit the spread of the virus by cutting down on the amount of travel required by teams .
It also said having @ @ @ @ @ @ @ allows for NCAA officials to better focus on `` potential benefits '' of hosting the tournament in a controlled setting for games , practice venues and lodging for both teams and game officials .
`` By making this difficult decision now , it allows for an earlier opportunity to work proactively with local public health officials within the host communities and ensures that the identified guidelines and protocols are considered for a more controlled environment , '' Nina King , chair of the NCAA Division I Women 's Basketball Committee said in a @ @ @ @ @ @ @ departure for the NCAA as San Antonio was already slated to host the Women 's Final Four .
However , early rounds of the tournament were scheduled to be played in other parts of the country , including Albany , N.Y. , Austin , Texas , Cincinnati , and Spokane , Wash. , which have all been nixed .
To accommodate the number of games , particularly early on in the tournament , the NCAA said the University of the Incarnate World and the University of Texas at San Antonio will be among @ @ @ @ @ @ @ tournament will feature a total of 63 games and typically gets underway in late March and goes through early April .
NCAA expects the tournament to be played on time , however it 's possible the time frame for the tournament could be shortened , according to the Associated Press .
`` We look forward to working with Bexar County , San Antonio and the state of Texas to further determine a path for creating a special championship experience for all [ of the ] participating school ( s ) while ensuring the @ @ @ @ @ @ @ officials , '' said Lynn Holzman , vice president of women 's basketball at the NCAA .
NCAA officials last month announced a similar plan to hold the Men 's Division I tournament , sometimes referred to as March Madness , in a single location , Indianapolis .
Both the women 's and men 's basketball tournaments were canceled earlier this year as the widespread devastation the coronavirus pandemic was just becoming clear .
The decision to cancel the 2020 tournaments came as the virus shuttered virtually all aspects of the sports world @ @ @ @ @ @ @ Ron Nirenberg , said he was honored his city was selected to host the women 's tournament .
He also said safety precautions were a priority .
`` It is also a tremendous responsibility , and I know our local organizing committee and our hospitality industry will make the safety and wellbeing of the athletes , coaches and fans its highest priority , '' Nirenberg added .

NCAA Plans To Hold All Of Women's Basketball Tournament In San Antonio This Spring
Enlarge this image toggle caption John Raoux/AP John Raoux/AP
With nation's confirmed coronavirus infections surging, the NCAA announced Monday it plans to stage the entire Division I women's basketball tournament in one geographic area when it tips off in March.
Talks are already underway with officials in San Antonio to host the 64 teams that will compete in the single-elimination tournament.
NCAA officials said it aims to limit the spread of the virus by cutting down on the amount of travel required by teams.
It also said having all the teams in a single location allows for NCAA officials to better focus on "potential benefits" of hosting the tournament in a controlled setting for games, practice venues and lodging for both teams and game officials.
"By making this difficult decision now, it allows for an earlier opportunity to work proactively with local public health officials within the host communities and ensures that the identified guidelines and protocols are considered for a more controlled environment," Nina King, chair of the NCAA Division I Women's Basketball Committee said in a statement.
This was not a drastic departure for the NCAA as San Antonio was already slated to host the Women's Final Four. However, early rounds of the tournament were scheduled to be played in other parts of the country, including Albany, N.Y., Austin, Texas, Cincinnati, and Spokane, Wash., which have all been nixed.
To accommodate the number of games, particularly early on in the tournament, the NCAA said the University of the Incarnate World and the University of Texas at San Antonio will be among the venues to host games.
The tournament will feature a total of 63 games and typically gets underway in late March and goes through early April.
NCAA expects the tournament to be played on time, however it's possible the time frame for the tournament could be shortened, according to the Associated Press.
"We look forward to working with Bexar County, San Antonio and the state of Texas to further determine a path for creating a special championship experience for all [of the] participating school(s) while ensuring the safest possible environment for college athletes and officials," said Lynn Holzman, vice president of women's basketball at the NCAA.
NCAA officials last month announced a similar plan to hold the Men's Division I tournament, sometimes referred to as March Madness, in a single location, Indianapolis.
Both the women's and men's basketball tournaments were canceled earlier this year as the widespread devastation the coronavirus pandemic was just becoming clear. The decision to cancel the 2020 tournaments came as the virus shuttered virtually all aspects of the sports world.
The mayor of San Antonio, Ron Nirenberg, said he was honored his city was selected to host the women's tournament. He also said safety precautions were a priority.
"It is also a tremendous responsibility, and I know our local organizing committee and our hospitality industry will make the safety and wellbeing of the athletes, coaches and fans its highest priority," Nirenberg added.


npr--2020-12-14--Millions More COVID-19 Vaccine Doses Are On The Way, U.S. Officials Say

Millions More COVID-19 Vaccine Doses Are On The Way , U.S. Officials Say At least 55 immunization sites across the U.S. received doses of Pfizer and BioNTech 's long-awaited vaccine Monday morning , says Army Gen. Gustave Perna , chief operating officer of Operation Warp Speed .
The effort to get the vaccine into medical professionals ' hands , he said , has gone `` incredibly well . ''
Perna credited a number of people for the success , from volunteers who helped to test the vaccine to those who worked over the weekend to prepare , ship and deliver @ @ @ @ @ @ @ at very cold temperatures to remain viable .
The U.S. vaccine distribution network kicked into high gear over the weekend after the Food and Drug Administration granted an emergency use authorization late Friday .
Vaccinations have now been reported in a number of states , including New York , Florida and Kentucky .
Officials said it 's just the start as they ramp up deliveries of the vaccine and await authorization for a second vaccine .
Health and Human Services Secretary Alex Azar said that by Wednesday , `` the vaccine will be @ @ @ @ @ @ @ to the shores of Guam , to the northeastern corner of Maine . ''
Distribution is being broadened in other ways as well .
`` On Monday , a week from today , over 1,100 long-term health care facilities and nursing homes will also begin vaccination , '' Perna said .
He said that four states are now ready to work with the drugstore chains CVS and Walgreens `` to start scaling the vaccine into those facilities . ''
Operation Warp Speed officials said 145 sites are receiving a vaccine shipment Monday , @ @ @ @ @ @ @ 66 on Wednesday – reflecting 636 shipments in all .
Perna said an additional 581 shipments will take place through the weekend , establishing what he called a `` drumbeat of continuous execution of vaccine as it is available . ''
Shipments that began over the weekend are enough to vaccinate 2.9 million people , Azar said .
Officials are withholding an additional 2.9 million doses , which will be administered in 21 days as a required second dose of the vaccine .
Adding to the optimism , Azar said it 's likely @ @ @ @ @ @ @ could get FDA authorization this week .
Discussing how the plan would adapt to include the Moderna vaccine , Perna said it would mirror this week 's rollout of the Pfizer medicine .
`` We 're going to ship just a little bit short of 6 million doses to the American people , and we 're shipping it to 3,285 locations across the country , '' he said .
Pending the Moderna vaccine 's successful authorization , Azar said , `` we have enough vaccines already purchased to ensure we can meet our @ @ @ @ @ @ @ it by the end of the second quarter of 2021 . ''
The first doses of the vaccine are being administered as many states are reporting record high hospitalizations and deaths from COVID-19 .
`` But today , we have hope on the way , '' Azar said .
While saying the vaccine is `` extraordinarily effective '' at protecting people from the virus , Azar added that Americans must continue to follow safety measures , from washing their hands and maintaining physical distance to wearing a face covering .
`` Our war @ @ @ @ @ @ @ , but this week we 're taking a major step toward our eventual victory , '' Azar said .
In response to a question about possible hiccups in the delivery system , Perna said potential hurdles range from the technical – such as the chance for errors in entering destination data into the system – to the meteorological .
Stormy winter weather is predicted to hit parts of the U.S. later this week , he noted .
Despite requiring subzero temperatures during storage , Azar said , the Pfizer vaccine is stable enough @ @ @ @ @ @ @ being compromised .
He noted that it comes packed in dry ice and is `` five days stable '' before the dry ice needs to be refreshed .
Things could become much easier if the Moderna vaccine wins regulators ' authorization .
It needs only a regular freezer to be stored , for instance , and it 's available in smaller package sizes than Pfizer 's standard of nearly 1,000 doses , making it more flexible for transport and delivery .
On another logistical question , Azar said that people who want to @ @ @ @ @ @ @ pay for it .
`` Operation Warp Speed is taking care of the cost of the vaccines themselves , the ancillary supplies like needles and syringes , and the cost of distributing the vaccines to jurisdictions , '' he said , `` while health care payers are handling administration costs .
So , no American faces an out-of-pocket expense for this vaccine . ''

Millions More COVID-19 Vaccine Doses Are On The Way, U.S. Officials Say
Enlarge this image toggle caption Suzanne Kreiter/The Boston Globe via Getty Images Suzanne Kreiter/The Boston Globe via Getty Images
At least 55 immunization sites across the U.S. received doses of Pfizer and BioNTech's long-awaited vaccine Monday morning, says Army Gen. Gustave Perna, chief operating officer of Operation Warp Speed. The effort to get the vaccine into medical professionals' hands, he said, has gone "incredibly well."
Perna credited a number of people for the success, from volunteers who helped to test the vaccine to those who worked over the weekend to prepare, ship and deliver the doses, which must be stored at very cold temperatures to remain viable.
The U.S. vaccine distribution network kicked into high gear over the weekend after the Food and Drug Administration granted an emergency use authorization late Friday. Vaccinations have now been reported in a number of states, including New York, Florida and Kentucky. Officials said it's just the start as they ramp up deliveries of the vaccine and await authorization for a second vaccine.
Health and Human Services Secretary Alex Azar said that by Wednesday, "the vaccine will be delivered everywhere from sites here in Washington to the shores of Guam, to the northeastern corner of Maine."
Distribution is being broadened in other ways as well.
"On Monday, a week from today, over 1,100 long-term health care facilities and nursing homes will also begin vaccination," Perna said. He said that four states are now ready to work with the drugstore chains CVS and Walgreens "to start scaling the vaccine into those facilities."
Operation Warp Speed officials said 145 sites are receiving a vaccine shipment Monday, with another 425 locations on Tuesday and 66 on Wednesday – reflecting 636 shipments in all. Perna said an additional 581 shipments will take place through the weekend, establishing what he called a "drumbeat of continuous execution of vaccine as it is available."
Shipments that began over the weekend are enough to vaccinate 2.9 million people, Azar said. Officials are withholding an additional 2.9 million doses, which will be administered in 21 days as a required second dose of the vaccine.
Adding to the optimism, Azar said it's likely another vaccine, made by Moderna, could get FDA authorization this week.
Discussing how the plan would adapt to include the Moderna vaccine, Perna said it would mirror this week's rollout of the Pfizer medicine.
"We're going to ship just a little bit short of 6 million doses to the American people, and we're shipping it to 3,285 locations across the country," he said.
Pending the Moderna vaccine's successful authorization, Azar said, "we have enough vaccines already purchased to ensure we can meet our goal of vaccinating every American who wants it by the end of the second quarter of 2021."
The first doses of the vaccine are being administered as many states are reporting record high hospitalizations and deaths from COVID-19. "But today, we have hope on the way," Azar said.
While saying the vaccine is "extraordinarily effective" at protecting people from the virus, Azar added that Americans must continue to follow safety measures, from washing their hands and maintaining physical distance to wearing a face covering.
"Our war against the virus is not over yet, but this week we're taking a major step toward our eventual victory," Azar said.
In response to a question about possible hiccups in the delivery system, Perna said potential hurdles range from the technical – such as the chance for errors in entering destination data into the system – to the meteorological. Stormy winter weather is predicted to hit parts of the U.S. later this week, he noted.
Despite requiring subzero temperatures during storage, Azar said, the Pfizer vaccine is stable enough to reach rural areas without its efficacy being compromised. He noted that it comes packed in dry ice and is "five days stable" before the dry ice needs to be refreshed.
Things could become much easier if the Moderna vaccine wins regulators' authorization. It needs only a regular freezer to be stored, for instance, and it's available in smaller package sizes than Pfizer's standard of nearly 1,000 doses, making it more flexible for transport and delivery.
On another logistical question, Azar said that people who want to get the vaccine will not have to pay for it.
"Operation Warp Speed is taking care of the cost of the vaccines themselves, the ancillary supplies like needles and syringes, and the cost of distributing the vaccines to jurisdictions," he said, "while health care payers are handling administration costs. So, no American faces an out-of-pocket expense for this vaccine."


npr--2020-12-14--Federal Data Reveal Which Hospitals Are Dangerously Full This Week. Is Yours?

Federal Data Reveal Which Hospitals Are Dangerously Full This Week .
Is Yours ?
The federal government on Monday released an updated set of detailed hospital-level data showing the toll COVID-19 is taking on health care facilities , including how many inpatient and ICU beds are available on a weekly basis .
Using an analysis from the University of Minnesota 's COVID-19 Hospitalization Tracking Project , NPR has created a tool that allows you to see how your local hospital and your county overall are faring .
( Jump to look-up tool . )
It focuses on one important metric @ @ @ @ @ @ @ COVID-19 patients — and shows this for each hospital and on average for each county .
The ratio of COVID-19 hospitalizations to total beds gives a picture of how much strain a hospital is under .
Though there 's not a clear threshold , it 's concerning when that rate rises above 10 % , hospital capacity experts told NPR .
Anything above 20 % represents `` extreme stress '' for the hospital , according to a framework developed by the Institute for Health Metrics and Evaluation at the University of Washington .
@ @ @ @ @ @ @ % or above , the stress on staff is immense .
`` It means the hospital is overloaded .
It means other services in that hospital are being delayed .
The hospital becomes a nightmare , '' IHME 's Ali Mokdad told NPR .
Use the look-up tool below the map to find details about hospitals in your county .
Thomas Wilburn contributed to this report .
This story was originally published on Dec. 9 , 2020 .

Are COVID hospitalizations high where you live? Look up your hospital
Editor's note: The final update to this page was on August 22, 2022.
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With COVID cases still high in the U.S., many hospitals across the country remain under strain. The federal government regularly releases detailed hospital-level data which show how many inpatient and ICU beds are in use on a weekly basis — and what portion of them are occupied by COVID-19 patients.
Using an analysis from the University of Minnesota's COVID-19 Hospitalization Tracking Project, NPR has created a tool that allows you to see how your local hospital and your county overall are faring.
Look up the hospitals where you live to find out how many beds are filled with COVID-19 patients, and the average for hospitals in your county.
Loading...
The ratio of COVID-19 hospitalizations to total beds gives a picture of how much strain a hospital is under.
That ratio is concerning when it rises above 10%, hospital capacity experts told NPR. Anything above 20% represents "extreme stress" for the hospital, according to a framework developed by the Institute for Health Metrics and Evaluation at the University of Washington.
ICU capacity is another important indicator of hospital strain. Those thresholds are higher: When 30% or more of ICU beds are filled by COVID-19 patients, it suggests a hospital is operating under "high stress." When 60% or more are full, it's considered at "extreme stress," according to IHME.
This federal hospitalization data, which is available going back to August 2020, also provides a historical perspective on the stress level over time in each state. See how your state is faring now:
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All of these indicators vary depending on the size of a given hospital and its resources. The number of hospitals reporting their data also varies each week, though more have started reporting since the federal government started collecting this data.
Methodology
Data used for this story come from the Department of Health and Human Services and University of Minnesota COVID-19 Hospitalization Tracking Project.
Hospital stress levels reflect the percent of inpatient beds occupied by COVID-19 patients at reporting hospitals. Stress levels are based on a framework developed by the Institute for Health Metrics and Evaluation at the University of Washington.
Averages calculated by summing the seven-day average for each individual hospital, then dividing by the number of hospitals reporting data in a county. "No data" may indicate a sample size of fewer than four patients or hospitals that did not report statistics to the Department of Health and Human Services.
Hospitals in Louisiana are not included in the data for the week of Aug. 27-Sept. 2, 2021 due to possible reporting anomalies related to Hurricane Ida.


npr--2020-12-14--Cleveland Baseball Team Will Drop Controversial Name To 'Unify Our Community'

Cleveland Baseball Team Will Drop Controversial Name To 'Unify Our Community' Cleveland 's Major League Baseball team is the latest professional sports franchise to announce it will abandon its longtime name , which is widely seen as racist or culturally offensive .
The baseball club , known since 1915 as the Cleveland Indians , announced in a statement Monday that it will `` begin the process of changing the name , '' according to a letter to fans from owner Paul Dolan .
Dolan said the team would continue to use its current name until a new name and brand @ @ @ @ @ @ @ unify our community and build our legacy for a new generation . ''
Dolan said the decisions `` are complex and would take time . ''
In an interview with The Associated Press , Dolan said the team would use the current name during the 2021 season .
The new name will be `` non-Native American based , '' the organization said in a statement .
The team is the second franchise to shed a team name referring to Native Americans .
In July , the Washington Football Team of the NFL dropped @ @ @ @ @ @ @ by protests against racism and police brutality .
Cleveland is following Washington 's lead by delaying its selection of a new team name .
The team cited several logistical considerations for a go-slow approach to choosing a new name , including the need to redesign uniforms , team equipment and fan merchandise .
Both Cleveland and Washington long faced criticism for their teams ' names , but the owners of the clubs had pushed back against demands to change .
Ahead of the 2019 season , Cleveland 's baseball team phased out Native @ @ @ @ @ @ @ mascot , a Native American caricature .
Even so , in July , the Cleveland team appeared to reject demands for it to drop its name .
At the time , management released a statement on Twitter saying it was `` committed to making a positive impact in the community '' but said the team 's name is one of the most visible ways it forms fan connections .
Dolan followed up last summer by saying he would welcome communication with Native American leaders at the start of the regular season .
`` @ @ @ @ @ @ @ to discuss these perspectives with key stakeholders while also taking the time needed to ensure those conversations are inclusive and meaningful , '' Dolan 's statement at the time read .
At least one early , high-profile detractor criticized the team 's decision to rebrand .
President Trump tweeted Sunday ahead of the official news of the name change that the move was an example of `` cancel culture at work ! ''
According to the team history , before its present name Cleveland 's baseball team was known as the Naps , @ @ @ @ @ @ @ team 's star players at the time .
The team was a founding member of the American League in 1901 .

Cleveland Baseball Team Will Drop Controversial Name To 'Unify Our Community'
Enlarge this image toggle caption Jason Miller/Getty Images Jason Miller/Getty Images
Cleveland's Major League Baseball team is the latest professional sports franchise to announce it will abandon its longtime name, which is widely seen as racist or culturally offensive.
The baseball club, known since 1915 as the Cleveland Indians, announced in a statement Monday that it will "begin the process of changing the name," according to a letter to fans from owner Paul Dolan.
Dolan said the team would continue to use its current name until a new name and brand are settled on that will "better unify our community and build our legacy for a new generation."
Dolan said the decisions "are complex and would take time." In an interview with The Associated Press, Dolan said the team would use the current name during the 2021 season.
The new name will be "non-Native American based," the organization said in a statement.
The team is the second franchise to shed a team name referring to Native Americans. In July, the Washington Football Team of the NFL dropped its former name during a summer rattled by protests against racism and police brutality.
Cleveland is following Washington's lead by delaying its selection of a new team name. The team cited several logistical considerations for a go-slow approach to choosing a new name, including the need to redesign uniforms, team equipment and fan merchandise.
Both Cleveland and Washington long faced criticism for their teams' names, but the owners of the clubs had pushed back against demands to change.
Ahead of the 2019 season, Cleveland's baseball team phased out Native American imagery and logos and retired its mascot, a Native American caricature.
Even so, in July, the Cleveland team appeared to reject demands for it to drop its name. At the time, management released a statement on Twitter saying it was "committed to making a positive impact in the community" but said the team's name is one of the most visible ways it forms fan connections.
Dolan followed up last summer by saying he would welcome communication with Native American leaders at the start of the regular season.
"We feel a real sense of urgency to discuss these perspectives with key stakeholders while also taking the time needed to ensure those conversations are inclusive and meaningful," Dolan's statement at the time read.
At least one early, high-profile detractor criticized the team's decision to rebrand.
President Trump tweeted Sunday ahead of the official news of the name change that the move was an example of "cancel culture at work!"
According to the team history, before its present name Cleveland's baseball team was known as the Naps, after Nap Lajoie, one of the team's star players at the time. The team was a founding member of the American League in 1901.
NPR's Merrit Kennedy contributed to this report.


npr--2020-12-15--FDA Analysis Of Moderna COVID-19 Vaccine Finds It Effective And Safe

FDA Analysis Of Moderna COVID-19 Vaccine Finds It Effective And Safe The Food and Drug Administration released a detailed analysis Tuesday morning of the COVID-19 vaccine from drugmaker Moderna that supports the authorization of the company 's vaccine for emergency use .
The FDA 's briefing document along with one from Moderna were posted two days before a group of experts will convene to advise the agency on whether to grant the vaccine emergency authorization for use , or EUA , during the pandemic .
The agency 's analysis finds the vaccine has a `` favorable safety profile '' and @ @ @ @ @ @ @ concerns identified that would preclude issuance of an EUA . ''
Serious reactions were rare .
Side effects are common , however , with a majority of study volunteers experiencing pain at the site of injection , fatigue and headaches .
The analysis also affirms the effectiveness of the vaccine .
It is 95 % overall , assessed at least two weeks after the second dose of vaccine .
The vaccine shots are given 28 days apart .
The vaccine is less effective in older people , the FDA analysis finds .
For @ @ @ @ @ @ @ , the effectiveness is 96 % , compared with 86 % for people 65 and older .
On Thursday , the Vaccines and Related Biological Products Advisory Committee , an advisory group , will discuss the vaccine in an open public meeting .
Last Thursday , Dec. 10 , the same committee voted 17-4 , with one abstention , in favor of emergency authorization of the Pfizer vaccine for use during the pandemic .
The Pfizer vaccine , developed in partnership with German drugmaker BioNTech , was given the OK for use for @ @ @ @ @ @ @ will ask the experts to assess whether the available scientific evidence supports the proposed emergency use of the Moderna vaccine .
The FDA will also ask the experts to weigh in on what studies should be done by the companies to further characterize the safety and effectiveness of the vaccine after it is available under an EUA .
Immunizations with the Pfizer vaccine began Monday .
Distribution of the vaccine is complicated by its need to be kept extremely cold : minus 76 degrees Fahrenheit or colder .
For shipping and storage , @ @ @ @ @ @ @ , too , but at minus 4 degrees Fahrenheit — more like a regular home freezer .
Once the vaccine is thawed for use , it can be kept at 36 to 46 degrees Fahrenheit , the temperature of a typical home fridge , for up to 30 days .

FDA Analysis Of Moderna COVID-19 Vaccine Finds It Effective And Safe
Enlarge this image toggle caption Joseph Prezioso/AFP via Getty Images Joseph Prezioso/AFP via Getty Images
The Food and Drug Administration released a detailed analysis Tuesday morning of the COVID-19 vaccine from drugmaker Moderna that supports the authorization of the company's vaccine for emergency use.
The FDA's briefing document along with one from Moderna were posted two days before a group of experts will convene to advise the agency on whether to grant the vaccine emergency authorization for use, or EUA, during the pandemic.
The agency's analysis finds the vaccine has a "favorable safety profile" and that there are "no specific safety concerns identified that would preclude issuance of an EUA." Serious reactions were rare. Side effects are common, however, with a majority of study volunteers experiencing pain at the site of injection, fatigue and headaches.
The agency's analysis also affirms the effectiveness of the vaccine. It is 94% overall, assessed at least two weeks after the second dose of vaccine, in the final analysis. An interim analysis put it at 95%. The vaccine shots are given 28 days apart.
The vaccine is less effective in older people, the FDA analysis finds. For people ages 18 to less than 65, the effectiveness is 96%, compared with 86% for people 65 and older.
On Thursday, the Vaccines and Related Biological Products Advisory Committee, an advisory group, will discuss the vaccine in an open public meeting.
Last Thursday, Dec. 10, the same committee voted 17-4, with one abstention, in favor of emergency authorization of the Pfizer vaccine for use during the pandemic. The Pfizer vaccine, developed in partnership with German drugmaker BioNTech, was given the OK for use for people 16 and older.
The FDA will ask the experts to assess whether the available scientific evidence supports the proposed emergency use of the Moderna vaccine. The FDA will also ask the experts to weigh in on what studies should be done by the companies to further characterize the safety and effectiveness of the vaccine after it is available under an EUA.
Immunizations with the Pfizer vaccine began Monday. Distribution of the vaccine is complicated by its need to be kept extremely cold: minus 76 degrees Fahrenheit or colder.
For shipping and storage, Moderna's vaccine needs to be frozen, too, but at minus 4 degrees Fahrenheit — more like a regular home freezer. Once the vaccine is thawed for use, it can be kept at 36 to 46 degrees Fahrenheit, the temperature of a typical home fridge, for up to 30 days.


npr--2020-12-15--How To Help Someone At Risk Of Suicide

How To Help Someone At Risk Of Suicide

How To Help Someone At Risk Of Suicide If you or someone you know may be considering suicide , contact the National Suicide Prevention Lifeline at 1-800-273-8255 ( En Español : 1-888-628-9454 ; Deaf and Hard of Hearing : 1-800-799-4889 ) or the Crisis Text Line by texting HOME to 741741 .
The pandemic has taken a heavy emotional toll on many people , and if you know someone struggling with despair , depression or thoughts of suicide , you may be wondering how to help .
A recent survey by the U.S. Centers for Disease Control and Prevention showed @ @ @ @ @ @ @ this year , 40.9 % of adults in the United States had experienced at least one mental health problem , including symptoms of anxiety or depression .
And about 11 % of all adults , and 25 % of 18-24 year-olds said they had seriously considered suicide during the previous month .
Most Americans recently surveyed say that they understand that suicide is preventable and that they would act to help someone they know who is at risk .
Yet many of us are afraid to do the wrong thing .
In fact @ @ @ @ @ @ @ a trained professional to help , says Doreen Marshall , a psychologist and vice president of programs at the AFSP .
`` Everyone has a role to play in suicide prevention , '' she says .
But `` most people hold back .
We often say , 'Trust your gut .
If you 're worried about someone , take that step . '
`` And that first step starts with simply reaching out , says Marshall .
It may seem like a small thing , but survivors of suicide attempts and suicide experts @ @ @ @ @ @ @ .
Simple acts of connection are powerful , says Ursula Whiteside , a psychologist and a faculty member at the University of Washington School of Medicine .
`` Looking out for each other in general reduces [ suicide ] risk , '' says Whiteside .
`` Because people who feel connected are less likely to kill themselves . ''
And `` the earlier you catch someone , '' she adds , `` the less they have to suffer . ''
Here are nine things you can do that can make a difference .
@ @ @ @ @ @ @ include changes in mood and behavior , Marshall says .
`` For example , someone who is usually part of a group or activity and you notice that they stop showing up , '' explains Marshall .
`` Someone who is usually pretty even-tempered , and you see they are easily frustrated or angry . ''
If you 're only seeing your loved ones virtually because of the pandemic , pay attention if they start withdrawing from virtual spaces , too , says Whiteside .
Maybe `` they 're not responding to phone @ @ @ @ @ @ @ on a call with family or they 're not on social media , '' she says .
`` That 's one time that it makes sense to get curious about what 's going on with your friend — when people start to disappear . ''
Other signs include feeling depressed , anxious , irritable or losing interest in things .
`` They may talk about wanting to end their lives or seeing no purpose or wanting to go to sleep and never wake up , '' says Marshall .
`` Those are signs @ @ @ @ @ @ @ suicide ] .
It may be couched as a need to get away from , or escape the pain . ''
According to the AFSP , people who take their own lives often show a combination of these warning signs .
And the signs can be different for different individuals , says Madelyn Gould , a professor of epidemiology in psychiatry at Columbia University who studies suicide and suicide prevention .
`` For some people , it might be starting to have difficulty sleeping , '' she says .
Someone else might easily @ @ @ @ @ @ @ one of these things can put [ someone ] more at risk , '' explains Gould , `` Until at some point , [ they 're ] not in control anymore . ''
2 .
Reach out and ask , `` Are you OK ? ''
So , what do you do when you notice someone is struggling and you fear they may be considering suicide ?
Reach out , check in and show you care , say suicide prevention experts .
`` The very nature of someone struggling with suicide and depression @ @ @ @ @ @ @ not likely to reach out , '' says Marshall .
`` They feel like a burden to others . ''
People who are having thoughts of suicide often feel trapped and alone , explains DeQuincy Lezine , a psychologist and a member of the board of directors of the American Association of Suicidology .
He is also a survivor of suicide attempts .
When someone reaches out and offers support , it reduces a person 's sense of isolation , he explains .
`` Even if you ca n't find the exact words @ @ @ @ @ @ @ that somebody cares makes a big difference , '' says Lezine .
Questions like `` Are you doing OK ? ''
and statements like `` If you need anything , let me know '' are simple supportive gestures that can have a big impact on someone who 's in emotional pain , explains Julie DeGolier , a medical assistant in Seattle and a survivor of suicide attempts .
It can interrupt the negative spiral that can lead to crisis .
The website for the National Suicide Prevention Lifeline has a list of do @ @ @ @ @ @ @ someone at risk .
3 .
Be direct : Ask about suicide '' Most people are afraid to ask about suicide , because they [ think they ] do n't want to put the thought in their head , '' says Marshall .
`` But there 's no research to support that . ''
Instead , she and other suicide prevention experts say discussing suicide directly and compassionately with a person at risk is key to preventing it .
One can ask a direct question like , `` Have you ever had thoughts @ @ @ @ @ @ @ More general questions like , `` What do you think of people who kill themselves ? ''
can also open up a conversation about suicide , says Gould .
`` Now they are talking about it , when you might not have had the conversation before . ''
4 .
Assess risk and do n't panic : Suicidal feelings are n't always an emergency Say a loved one confides in you that they have been thinking about suicide .
What do you do then ?
`` Do n't let yourself panic , '' @ @ @ @ @ @ @ a person considering suicide needs to be rushed to the hospital .
But `` not everyone who expressed these thoughts needs to be hospitalized immediately , '' says Marshall .
Research shows that most people who 've had suicidal thoughts have n't had the kind of overpowering thoughts that might push them to make an attempt , explains Whiteside .
In other words , many more people experience suicidal thoughts than take action on them .
But how do you know whether your loved one 's situation is an immediate crisis ?
Whiteside @ @ @ @ @ @ @ Are you thinking of killing yourself in the next day or so ? ''
and `` How strong are those urges ? ''
For help with this conversation , psychiatrists at Columbia University have developed the Columbia Protocol , which is a risk-assessment tool drawn from their research-based suicide severity rating scale .
It walks you through six questions to ask your loved one about whether they 've had thoughts about suicide and about the means of suicide and whether they have worked out the details of how they would carry out their @ @ @ @ @ @ @ at hand is at a high risk of acting on it — according to the Suicide Prevention Resource Center , about 38 percent of people who have made a plan go on to make an attempt .
5 .
If it 's a crisis , stick around So what if you 've assessed risk and you fear your loved one is in immediate crisis ?
First , request them to hold off for a day or so , says Whiteside , at the same time being `` validating and gentle . ''
The @ @ @ @ @ @ @ someone act on an impulse , `` usually resolve or become manageable in less than 24 or 48 hours , '' she says .
If you can , offer to stay with them during that time period , she adds .
Otherwise , help them find other immediate social support or medical help .
They should n't be alone at these times of crisis .
Ask whether they have any means of harming themselves at hand and work with them to remove those things from their environment .
Research shows that removing or @ @ @ @ @ @ @ .
The National Suicide Prevention Lifeline offers this guide to the five action steps to take if someone you know is imminent danger .
If you do n't feel confident about helping someone through a crisis period , call the National Suicide Prevention Lifeline , says Gould .
If the person is not in immediate risk , it is still important to listen to them , say survivors of suicide attempts like Lezine and DeGolier .
`` The biggest thing is listening in an open-minded way , to not be judgmental , '' @ @ @ @ @ @ @ a person what to do .
They 're looking to be heard , to have their feelings acknowledged . ''
The next step is to offer hope , says Whiteside .
It helps to say things like , `` I know how strong you are .
I 've seen you get through hard things .
I think we can get through this together , '' she explains .
One of Lezine 's closest friends in college did just that during his suicidal phases , he says .
`` For one thing , she @ @ @ @ @ @ @ says Lezine .
`` She always believed I have a positive life possible and I would achieve good things . ''
He says her faith in him kept him from giving in to his despair completely .
`` Having somebody , a confidante who absolutely believed as a person in [ my ] ability to do something meaningful in life '' was instrumental in his recovery , he says .
7 .
Help your loved one make a safety plan When a person is not in immediate risk of attempting suicide , it @ @ @ @ @ @ @ preventing a future crisis .
`` That 's where we want to make help-seeking and adaptive coping strategies a practice , '' says Gould .
Suicide prevention experts advise people develop what 's known as a safety plan , which research has shown can help reduce suicide risk .
It 's a simple plan for how to cope and get help when a crisis hits , and typically , an at-risk person and their mental health provider create it together , but a family member or friend can also help .
The American @ @ @ @ @ @ @ for creating a safety plan .
It includes making a list of the person 's triggers and warning signs of a coming crisis , people they feel comfortable reaching out to for help and activities they can do to distract themselves during those times — it can be something simple as watching a funny movie .
Safety planning includes helping your loved one make their environment safer .
This is one of the most important steps to preventing suicide , says Marshall .
That involves a conversation about lethal means .
`` If @ @ @ @ @ @ @ 're having , they may tell you the means , '' she says .
If they do n't volunteer that information , it 's worth asking them directly , she adds .
Once they say what means they have thought of using , one can discuss with them how to limit their access to it .
`` The more time and space you can put between the person and harming themselves , the better , '' says Marshall .
`` If this is someone who is a firearm owner , you may talk @ @ @ @ @ @ @ n't have ready access to firearm in moments of crisis . ''
8 .
Help them tackle the mental health care system When someone is in urgent crisis mode , it 's often not the best time to try to navigate the mental health care system , says DeGolier .
But to prevent a future crisis , offer to help your loved one connect with a mental health professional to find out whether medications can help them and to learn ways to manage their mood and suicidal thinking .
A kind of talk @ @ @ @ @ @ @ DBT , has been shown to be effective in reducing risk of suicide .
It teaches people strategies to calm their minds and distract themselves when the suicidal thoughts surface .
It can be hard for someone who 's struggling with negative emotions to get and keep a mental health appointment .
Family members and friends can help , notes Whiteside .
`` Know that it takes persistence , '' she says .
`` You do n't stop until you have an appointment for them .
That may mean you call 30 people @ @ @ @ @ @ @ availability .
You take the day off from work , go with them . ''
Lezine says he was fortunate to have had that kind of help and support from his college friend when he was struggling .
`` One of the things that was helpful ... was she went with me [ to my appointment ] , '' he says .
`` When you 're feeling really down and feeling like you do n't matter as much , you might not want to take time , or think that it 's worth @ @ @ @ @ @ @ do n't want to go through this . ''
Many people do n't make it to their first appointment , or do n't follow up , he says .
Having a person hold your hand through the process , accompany you to your appointments can prevent that .
`` If somebody is sitting there with you , you can have eye contact , touch contact , '' says Lezine .
`` It does make a difference , making you feel like you have another person who cares . ''
For those struggling to @ @ @ @ @ @ @ evidence-based digital tools that can also help .
For example , there 's a smartphone app called Virtual Hope Box , which is modeled on cognitive behavioral therapy techniques .
Research shows that veterans who were feeling suicidal and used the app were able to cope better with negative emotions .
Whiteside and her colleagues started a website called Now Matters Now , which offers videos with personal stories of suicide survivors talking about their own struggles and how they have overcome their suicidal thoughts .
Stories of survival and coping with suicidal @ @ @ @ @ @ @ positive effect on people at risk of suicide .
The website also has videos that teach some simple skills that are otherwise taught by a therapist trained to offer DBT .
Those skills include mindfulness and paced breathing , which involves breathing with exhales that last longer than the inhales .
Whiteside explains that this can calm the nervous system .
Similarly , a cold shower or splashing ice water on one 's face or making eye contact with someone can distract and/or calm the person who is at immediate risk of taking @ @ @ @ @ @ @ people who visit the website and watch the videos have a short-term reduction in their suicidal thoughts , she says .
This page was originally published in SHOTS on April 20 , 2019 .
It has been updated and republished .
Meghan Keane produced the Life Kit podcast version of this story .
We 'd love to hear from you .
Leave the Life Kit team a voicemail at 202-216-9823 , or email us at LifeKit @ npr.org .
For more Life Kit , subscribe to the newsletter .

Reach out and listen: How to help someone at risk of suicide
Enlarge this image Maria Fabrizio for NPR Maria Fabrizio for NPR
If you or someone you know may be considering suicide, contact the 988 Suicide & Crisis Lifeline by dialing 9-8-8, or the Crisis Text Line by texting HOME to 741741.
If you know someone struggling with despair, depression or thoughts of suicide, you may be wondering how to help.
Most Americans recently surveyed say that they understand that suicide is preventable and that they would act to help someone they know who is at risk.
Yet many of us are afraid to do the wrong thing. In fact, you don't have to be a trained professional to help, says Doreen Marshall, a psychologist and vice president of programs at the American Foundation for Suicide Prevention.
"Everyone has a role to play in suicide prevention," she says. But "most people hold back. We often say, 'Trust your gut. If you're worried about someone, take that step.' "
And that first step starts with simply reaching out, says Marshall. It may seem like a small thing, but survivors of suicide attempts and suicide experts say, it can go long way.
Simple acts of connection are powerful, says Ursula Whiteside, a psychologist and a faculty member at the University of Washington School of Medicine.
"Looking out for each other in general reduces [suicide] risk," says Whiteside. "Because people who feel connected are less likely to kill themselves."
And "the earlier you catch someone," she adds, "the less they have to suffer."
Here are nine things you can do that can make a difference.
1. Recognize the warning signs
Signs of suicide risk to watch for include changes in mood and behavior, Marshall says.
"For example, someone who is usually part of a group or activity and you notice that they stop showing up," explains Marshall. "Someone who is usually pretty even-tempered and you see they are easily frustrated or angry."
If you're only seeing your loved ones virtually because of the pandemic, pay attention if they start withdrawing from virtual spaces, too, says Whiteside.
Maybe "they're not responding to phone calls or they're not joining in on a call with family or they're not on social media," she says. "That's one time that it makes sense to get curious about what's going on with your friend — when people start to disappear."
Other signs include feeling depressed, anxious, irritable or losing interest in things.
Pay attention to a person's words, too.
"They may talk about wanting to end their lives or seeing no purpose or wanting to go to sleep and never wake up," says Marshall. "Those are signs that they may be thinking about [suicide]. It may be couched as a need to get away from, or escape the pain."
According to the AFSP, people who take their own lives often show a combination of these warning signs.
And the signs can be different for different people, says Madelyn Gould, a professor of epidemiology in psychiatry at Columbia University who studies suicide and suicide prevention.
"For some people, it might be starting to have difficulty sleeping," she says. Someone else might easily feel humiliated or rejected.
"Each one of these things can put [someone] more at risk," explains Gould, "Until at some point, [they're] not in control anymore."
2. Reach out and ask, "Are you OK?"
So, what do you do when you notice someone is struggling and you fear they may be considering suicide?
Reach out, check in and show you care, say suicide prevention experts.
"The very nature of someone struggling with suicide and depression, [is that] they're not likely to reach out," says Marshall. "They feel like a burden to others."
Opposite Action — Tips from Survivors From the suicide prevention site, Now Matters Now, this video offers examples of "opposite action," a suicide prevention technique derived from dialectical behavior therapy. The technique guides people to choose actions that help them embrace life instead of withdrawing when they're struggling with suicidal feelings.
People who are having thoughts of suicide often feel trapped and alone, explains DeQuincy Lezine, a psychologist and a member of the board of directors of the American Association of Suicidology. He is also a survivor of suicide attempts.
When someone reaches out and offers support, it reduces a person's sense of isolation, he explains.
"Even if you can't find the exact words [to say], the aspect that somebody cares makes a big difference," says Lezine.
Questions like "Are you doing OK?" and statements like "If you need anything, let me know" are simple supportive gestures that can have a big impact on someone who's in emotional pain, explains Julie DeGolier, a medical assistant in Seattle and a survivor of suicide attempts. It can interrupt the negative spiral that can lead to crisis.
The website for the National Suicide Prevention Lifeline has a list of do's and don'ts when trying to help someone at risk.
3. Be direct: Ask about suicide
"Most people are afraid to ask about suicide, because they [think they] don't want to put the thought in their head," says Marshall. "But there's no research to support that."
Instead, she and other suicide prevention experts say discussing suicide directly and compassionately with a person at risk is key to preventing it.
One can ask a direct question like, "Have you ever had thoughts of suicide?" says Marshall.
More general questions like, "What do you think of people who kill themselves?" can also open up a conversation about suicide, says Gould. "Now they are talking about it, when you might not have had the conversation before."
4. Assess risk and don't panic: Suicidal feelings aren't always an emergency
Say a loved one confides in you that they have been thinking about suicide, what do you do then?
"Don't let yourself panic," says Whiteside.
People often believe that a person considering suicide needs to be rushed to the hospital. But "not everyone who expressed these thoughts needs to be hospitalized immediately," says Marshall.
Research shows that most people who've had suicidal thoughts haven't had the kind of overpowering thoughts that might push them to make an attempt, explains Whiteside. In other words, many more people experience suicidal thoughts than take action on them.
But how do you know whether your loved one's situation is an immediate crisis?
Whiteside suggests asking direct questions like: "Are you thinking of killing yourself in the next day or so?" and "How strong are those urges?"
For help with this conversation, psychiatrists at Columbia University have developed the Columbia Protocol, which is a risk-assessment tool drawn from their research-based suicide severity rating scale. It walks you through six questions to ask your loved one about whether they've had thoughts about suicide and about the means of suicide and whether they have worked out the details of how they would carry out their plan.
Someone who has a plan at hand is at a high risk of acting on it — according to the Suicide Prevention Resource Center, about 38 percent of people who have made a plan go on to make an attempt.
5. If it's a crisis, stick around
So what if you've assessed risk and you fear your loved one is in immediate crisis? First, request them to hold off for a day or so, says Whiteside, at the same time being "validating and gentle."
The kind of intense emotions that might make someone act on an impulse, "usually resolve or become manageable in less than 24 or 48 hours," she says. If you can, offer to stay with them during that time period, she adds. Or, if that's hard because of the pandemic, offer to be present virtually via video call. Otherwise, help them find other immediate social support or medical help. They shouldn't be alone at these times of crisis.
Ask whether they have any means of harming themselves at hand and work with them to remove those things from their environment. Research shows that removing or limiting access to means reduces suicide deaths.
The National Suicide Prevention Lifeline offers this guide to the five action steps to take if someone you know is imminent danger.
If you don't feel confident about helping someone through a crisis period, call the National Suicide Prevention Lifeline, says Gould.
6. Listen and offer hope
If the person is not in immediate risk, it is still important to listen to them, say survivors of suicide attempts like Lezine and DeGolier.
"The biggest thing is listening in an open-minded way, to not be judgmental," says DeGolier.
"Don't tell a person what to do. They're looking to be heard, to have their feelings acknowledged."
The next step is to offer hope, says Whiteside. It helps to say things like, "I know how strong you are. I've seen you get through hard things. I think we can get through this together," she explains.
One of Lezine's closest friends in college did just that during his suicidal phases, he says.
"For one thing, she never lost faith in me," says Lezine. "She always believed I have a positive life possible and I would achieve good things."
He says her faith in him kept him from giving in to his despair completely.
"Having somebody, a confidante who absolutely believed as a person in [my] ability to do something meaningful in life" was instrumental in his recovery, he says.
7. Help your loved one make a safety plan
When a person is not in immediate risk of attempting suicide, it's a good time to think about preventing a future crisis.
"That's where we want to make help-seeking and adaptive coping strategies a practice," says Gould.
Suicide prevention experts advise people develop what's known as a safety plan, which research has shown can help reduce suicide risk. It's a simple plan for how to cope and get help when a crisis hits, and typically, an at-risk person and their mental health provider create it together, but a family member or friend can also help.
The American Foundation for Suicide Prevention has a template for creating a safety plan. It includes making a list of the person's triggers and warning signs of a coming crisis, people they feel comfortable reaching out to for help and activities they can do to distract themselves during those times — it can be something simple as watching a funny movie.
Safety planning includes helping your loved one make their environment safer. This includes a conversation about the means they would use when considering suicide, and is one of the most important steps to preventing suicide, says Marshall.
"If you ask what kinds of thoughts you're having, they may tell you the means," she says.
If they don't volunteer that information, it's worth asking them directly, she adds. Once they say what means they have thought of using, one can discuss with them how to limit their access to it.
"The more time and space you can put between the person and harming themselves, the better," says Marshall. "If this is someone who is a firearm owner, you may talk with them to make sure they don't have ready access to firearm in moments of crisis."
8. Help them tackle the mental health care system
When someone is in urgent crisis mode, it's often not the best time to try to navigate the mental health care system, says DeGolier. But to prevent a future crisis, offer to help your loved one connect with a mental health professional to find out whether medications can help them and to learn ways to manage their mood and suicidal thinking.
A kind of talk therapy called dialectical behavior therapy, or DBT, has been shown to be effective in reducing risk of suicide. It teaches people strategies to calm their minds and distract themselves when the suicidal thoughts surface.
One bright side of the pandemic is that mental health providers are doing most appointments virtually, so it has expanded access to care for many.
Still, it can be hard for someone who's struggling with negative emotions to get and keep a mental health appointment. Family members and friends can help, notes Whiteside.
"Know that it takes persistence," she says. "You don't stop until you have an appointment for them. That may mean you call 30 people until you find someone who has an availability. You take the day off from work, go with them."
Lezine says he was fortunate to have had that kind of help and support from his college friend when he was struggling.
"One of the things that was helpful ... was she went with me [to my appointment]," he says. "When you're feeling really down and feeling like you don't matter as much, you might not want to take time, or think that it's worth the time, or feel like 'I don't want to go through this.' "
Many people don't make it to their first appointment, or don't follow up, he says. Having a person hold your hand through the process, accompany you to your appointments can prevent that. This can be hard during the pandemic but get creative: Offer to drive there separately and wait nearby for them, or accompany them by video call while they wait.
"It does make a difference, making you feel like you have another person who cares," says Lezine.
9. Explore tools and support online
For those struggling to access mental health care, there are some evidence-based digital tools that can also help.
For example, there's a smartphone app called Virtual Hope Box, which is modeled on cognitive behavioral therapy techniques. Research shows that veterans who were feeling suicidal and used the app were able to cope better with negative emotions.
Whiteside and her colleagues started a website called Now Matters Now, which offers videos with personal stories of suicide survivors talking about their own struggles and how they have overcome their suicidal thoughts. Stories of survival and coping with suicidal thoughts have been shown to have a positive effect on people at risk of suicide.
The website also has videos that teach some simple skills that are otherwise taught by a therapist trained to offer DBT.
Those skills include mindfulness and paced breathing, which involves breathing with exhales that last longer than the inhales. Whiteside explains that this can calm the nervous system. Similarly, a cold shower or splashing ice water on one's face or making eye contact with someone can distract and/or calm the person who is at immediate risk of taking their own life.
Surveys show that people who visit the website and watch the videos have a short-term reduction in their suicidal thoughts, she says.
This page was originally published in Shots on April 20, 2019. It has been updated and republished.
Meghan Keane produced the Life Kit podcast version of this story.
We'd love to hear from you. Leave the Life Kit team a voicemail at 202-216-9823, or email us at LifeKit@npr.org. For more Life Kit, subscribe to the newsletter.


npr--2020-12-15--Democracy Held With Biden's Win, But Trump Is Keeping America Divided As Ever

Democracy Held With Biden 's Win , But Trump Is Keeping America Divided As Ever The Electoral College affirmed what was already known — that Democrat Joe Biden won the 2020 presidential election .
Biden officially got the votes of 306 electors , exactly what he was supposed to get , based on the popular vote from each state .
It was 36 more than the 270 needed to become president .
So , it 's yet another step showing Biden is president-elect and that he will be sworn in as president on Jan. 20 , 2021 .
And yet @ @ @ @ @ @ @ when or if President Trump will ever accept the results .
Like in any good reality show , there was the kind of drama Monday that everyone has become accustomed to in the Trump presidency .
Minutes after enough electors voted to put Biden over the top ( again ) — remember , states already certified results , and Monday , was a mere formality — Trump announced via Twitter that Attorney General William Barr was stepping down .
In any other administration , people might say it was stunning , if not @ @ @ @ @ @ @ 's closest allies was leaving just weeks before his term would be up .
In the Trump era , though , it 's just another day .
In the last four years , America has become inured to things that would otherwise be surprising .
Taking Russian President Vladimir Putin at his word over U.S. intelligence agencies ' regarding election interference .
Firing an FBI director .
Children separated from their parents , many of whom still ca n't be found .
Declaring there were good people on both sides of a white @ @ @ @ @ @ @ Being impeached .
Tear gassing peaceful protesters for a photo op .
300,000 Americans dead from the worst pandemic in a century .
All this might affect that president 's base of supporters .
It 's not clear he really meant it when he said during the 2016 campaign that he could shoot someone on Fifth Avenue and not lose any of his supporters .
After four years of this presidency , it 's uncertain he would lose anyone if he actually did .
Conservative media would likely amplify Trump 's reasoning and @ @ @ @ @ @ @ rationalize it .
After all , two people died at a protest in Wisconsin when a minor with a right-wing ideology , with a gun he should n't have had and in a state he was n't from , showed up .
And then he was turned into a hero by conservative media .
Given the intense feelings Trump inspired , he won even more votes this year than in 2016 , but not more than Biden .
Biden won the most votes ever , in part , because of the strong opposition @ @ @ @ @ @ @ his supporters ca n't see how that 's possible .
On Monday , Trump did n't so much as publicly acknowledge the step the electors took .
Instead , he was again baselessly tweeting about nonexistent fraud .
Voting machines are a `` disaster , '' swing states — `` all of them '' — have found `` massive voter fraud '' ( they have n't ) , states `` can not legally certify '' ( they already have ) .
Trump also tweeted about the first vaccine being administered in the U.S. @ @ @ @ @ @ @ .
Never mind that the U.K. administered vaccines earlier than the U.S. — or the celebratory tone of the tweet on a day the U.S. crossed 300,000 deaths from the coronavirus , something seen as unfathomable months ago .
For his part , the man who beat Trump seemed to have had enough .
`` Our democracy — pushed , tested , threatened — proved to be resilient , true , and strong , '' President-elect Biden said .
He defended election workers , calling pressure put on them , abuse they faced @ @ @ @ @ @ @ . ''
`` We owe these public servants a debt of gratitude , '' Biden said .
`` They did n't seek the spotlight , and our democracy survived because of them . ''
Biden noted that Trump had every opportunity to have his allegations heard in courts of law .
`` They were heard , '' he said .
`` And they were found to be without merit . ''
He added , `` Every avenue was made available to President Trump to contest the results .
He took full advantage of @ @ @ @ @ @ @ .
President Trump was denied no course of action he wanted to take . ''
And Trump lost , fair and square .
Time to move on , `` turn the page , '' as Biden said .
In addition to lauding democratic institutions held up in the face of political pressure , another message Biden seemed to want to get across was one for his former Senate colleagues — it 's over , you know it , say it .
`` I am pleased — but not surprised — that a number @ @ @ @ @ @ @ Senate have acknowledged the results of the Electoral College , '' Biden said .
`` I thank them .
I am convinced we can work together for the good of the nation . ''
And several Republicans acknowledged — some grudgingly — that Biden will be president .
`` It does n't matter what Chuck Grassley thinks , the Constitution has answered that question for you , '' said Republican Sen. Chuck Grassley of Iowa after being asked if he considered Biden president-elect .
`` That 's all I can say on it @ @ @ @ @ @ @ , '' North Carolina Sen. Tom Tillis said , `` but I do n't want to discount valid , legal disputes that 'll be settled over the next couple weeks . ''
`` I guess if that 's what you officially call somebody after the Electoral College , I 'm fine with that , '' said North Dakota Sen. Kevin Cramer , who could n't seem to say the words `` president-elect . ''
`` I 'd call him Joe until he gets sworn in , '' said South Carolina Sen. Lindsey Graham @ @ @ @ @ @ @ to respond to repeated questions from reporters .
`` Not yet , '' said Oklahoma Sen. Jim Inhofe , asked if he recognized Biden as president-elect .
That came despite Inhofe 's sparring with Trump over the defense authorization act .
Others , though , did seem to have broken the spell .
Sens .
Rob Portman of Ohio , Shelly Moore-Capito of West Virginia , Lamar Alexander of Tennessee and John Thune of South Dakota were clear in stating that they recognized Biden had won the election .
`` At some point @ @ @ @ @ @ @ , '' Thune told reporters Monday before it became official .
`` And I think once the Electoral College settles the issue today , it 's time for everybody to move on . ''
But tens and tens of millions of Trump supporters and rank-and-file Republicans these legislators represent are juiced up by President Trump and conservative media , and are n't ready to move on .
They 're locked in for partisan warfare , standing at the ready for the next fight , the next legislation to knock down , the next @ @ @ @ @ @ @ next presidential primary when they can `` take the country back . ''
And in the meantime , there 's a vaccine to distribute , a pandemic to recover from , regular people and businesses that need help from a cratered economy — and that 's to say nothing of societal inequities that remain unaddressed .
Asked on Fox News this past weekend whether he is concerned that his actions and rhetoric after the election has done more to divide the country , Trump said , `` No . ''
And then he @ @ @ @ @ @ @ I worry about the country having an illegitimate president , '' he said .
`` That 's what I worry about .
A president that lost and lost badly .
This was n't , like , a close election .
...
I did n't lose .
The election was rigged . ''
Democracy may have tenuously held , but almost half the country will continue believe Trump 's debunked claims — and , Trump hopes , keep adding to the more than $ 200 million that he has raised from his supporters since @ @ @

As Democracy Holds, Trump Finds Himself Increasingly Isolated
Enlarge this image toggle caption Patrick Semansky/AP Patrick Semansky/AP
Updated 10:41 a.m. ET
What a day Monday was.
The Electoral College affirmed what was already known — that Democrat Joe Biden won the 2020 presidential election.
Biden officially got the votes of 306 electors, exactly what he was supposed to get based on the popular vote from each state. It was 36 electoral votes more than the 270 needed to become president.
So, it's yet another step showing that Biden is president-elect and that he will be sworn in as president on Jan. 20, 2021.
And yet there's still the lingering question of when or if President Trump will ever accept the results.
Like in any good reality show, there was the kind of drama Monday that everyone has become accustomed to in the Trump presidency. Minutes after enough electors voted to put Biden over the top (again) — remember, states already certified results, and Monday was a mere formality — Trump announced via Twitter that Attorney General William Barr was stepping down.
In any other administration, people might say it was stunning, if not shocking, that one of the president's closest allies was leaving just weeks before his term would be up.
In the Trump era, though, it's just another day.
In the last four years, America has become inured to things that would otherwise be surprising.
Taking Russian President Vladimir Putin at his word over U.S. intelligence agencies' regarding election interference. Firing an FBI director. Children separated from their parents, many of whom still can't be found. Declaring there were good people on both sides of a white supremacist march and protests against them. Being impeached. Tear-gassing peaceful protesters for a photo op. Three hundred thousand Americans dead from the worst pandemic in a century.
All this might affect that president's base of supporters.
But not Trump.
It's not clear he really meant it when he said during the 2016 campaign that he could shoot someone on Fifth Avenue and not lose any of his supporters.
After four years of this presidency, it's uncertain he would lose anyone if he actually did.
Conservative media would likely amplify Trump's reasoning and make it acceptable for his base to rationalize it.
After all, two people died at a protest in Wisconsin when a minor with a right-wing ideology, with a gun he shouldn't have had and in a state he wasn't from showed up.
And then he was turned into a hero by conservative media.
Given the intense feelings Trump inspired, he won even more votes this year than in 2016, but not more than Biden. Biden won the most votes ever, in part, because of the strong opposition to the sitting president.
Trump and his supporters can't see how that's possible. On Monday, Trump didn't so much as publicly acknowledge the step the electors took. Instead, he was again baselessly tweeting about nonexistent fraud.
Voting machines are a "disaster," swing states — "all of them" — have found "massive voter fraud" (they haven't), states "cannot legally certify" (they already have).
Trump also tweeted about the first vaccine being administered in the U.S. on Monday, undoubtedly a significant scientific achievement.
"Congratulations USA! Congratulations WORLD!" he tweeted.
Never mind that the U.K. administered vaccines earlier than the U.S. — or the celebratory tone of the tweet on a day the U.S. crossed 300,000 deaths from the coronavirus, something seen as unfathomable months ago.
For his part, the man who beat Trump seemed to have had enough.
"Our democracy — pushed, tested, threatened — proved to be resilient, true and strong," President-elect Biden said.
He defended election workers, calling pressure put on them, abuse they faced and threats on their lives "unconscionable."
"We owe these public servants a debt of gratitude," Biden said. "They didn't seek the spotlight, and our democracy survived because of them."
Biden noted that Trump had every opportunity to have his allegations heard in courts of law.
"They were heard," he said. "And they were found to be without merit."
He added, "Every avenue was made available to President Trump to contest the results. He took full advantage of each and every one of these avenues. President Trump was denied no course of action he wanted to take."
And Trump lost, fair and square. Time to move on, "turn the page," as Biden said.
In addition to lauding democratic institutions held up in the face of political pressure, Biden seemed to want to get another message across to his former Senate colleagues — it's over, you know it, say it.
"I am pleased — but not surprised — that a number of my former Republican colleagues in the Senate have acknowledged the results of the Electoral College," Biden said. "I thank them. I am convinced we can work together for the good of the nation."
And several Republicans acknowledged — some grudgingly — that Biden will be president.
"It doesn't matter what Chuck Grassley thinks, the Constitution has answered that question for you," said Republican Sen. Chuck Grassley of Iowa after being asked whether he considered Biden president-elect. "That's all I can say on it."
"He's presumptive president," North Carolina Sen. Thom Tillis said, "but I don't want to discount valid, legal disputes that'll be settled over the next couple weeks."
"I guess if that's what you officially call somebody after the Electoral College, I'm fine with that," said North Dakota Sen. Kevin Cramer, who couldn't seem to say the words "president-elect."
"I'd call him Joe until he gets sworn in," said South Carolina Sen. Lindsey Graham.
"Not yet," said Oklahoma Sen. Jim Inhofe, asked whether he recognized Biden as president-elect. That came despite Inhofe's sparring with Trump over the defense authorization act.
Senate Majority Leader Mitch McConnell declined to respond Monday to repeated questions from reporters. McConnell, however, recognized Biden's win on the Senate floor Tuesday morning.
"The Electoral College has spoken," McConnell said. "So today I want to congratulate President-elect Joe Biden."
The spell was been broken for others, as well.
Sens. Rob Portman of Ohio, Shelley Moore Capito of West Virginia, Lamar Alexander of Tennessee and John Thune of South Dakota were clear in stating that they recognized Biden had won the election.
"At some point, you have to face the music," Thune told reporters Monday before it became official. "And I think once the Electoral College settles the issue today, it's time for everybody to move on."
But tens and tens of millions of Trump supporters and rank-and-file Republicans these legislators represent are juiced up by Trump and conservative media and aren't ready to move on.
They're locked in for partisan warfare, standing at the ready for the next fight, the next legislation to knock down, the next regulation to be outraged by, the next presidential primary when they can "take the country back."
And in the meantime, there's a vaccine to distribute, a pandemic to recover from, regular people and businesses that need help from a cratered economy — and that's to say nothing of societal inequities that remain unaddressed.
Asked on Fox News this past weekend whether he is concerned that his actions and rhetoric after the election has done more to divide the country, Trump said, "No."
And then he went on to sow doubt. "I worry about the country having an illegitimate president," he said. "That's what I worry about. A president that lost and lost badly. This wasn't, like, a close election. ... I didn't lose. The election was rigged."
Democracy may have tenuously held, but almost half the country will continue to believe Trump's debunked claims — and, Trump hopes, keep adding to the more than $200 million that he has raised from his supporters since Election Day.


npr--2020-12-15--Japan's 'Twitter Killer' Sentenced To Death In Killing Of 9

Japan 's 'Twitter Killer ' Sentenced To Death In Killing Of 9 Takahiro Shiraishi , 30 , was found guilty by the Tokyo District Court for the murder of eight women and one man , according to reports .
Shiraishi also robbed and sexually assaulted the eight women he murdered , some of whom were underage .
Shiraishi used Twitter to lure the women , who shared on the website they wanted to commit suicide .
He told them he could help them kill themselves .
But once in his apartment , Shiraishi strangled them to death .
Afterward , @ @ @ @ @ @ @ body parts throughout his apartment .
The man he killed was murdered to conceal the death of his first victim .
News of the shocking crime pushed Twitter to roll out new rules against promoting or encouraging suicide and social harm on the site .
It also led Japan 's government to expand telephone and online suicide support channels .
Shiraishi was arrested in 2017 for the killings , after police searched his apartment following complaints made by a victim 's brother .
The brother had discovered Twitter messages between Shiraishi and his @ @ @ @ @ @ @ .
When police arrived they found bodies stored in Shiraishi 's freezer and other containers .
During his trial , Shiraishi 's defense team claimed he deserved a lesser sentence because he helped the victims , who had wanted to die , commit suicide .
But Shiraishi himself tanked this defense during his trial and said while on the stand that the women had n't consented to being killed , according to The Asahi Shimbun , a Japanese newspaper .
He specifically targeted most of his victims .
He said during the trial @ @ @ @ @ @ @ to convince people with worries and other issues and manipulate them to my way of thinking . ''
Japan regularly executes prisoners , though at a slower rate than the U.S .
Prisoners there are executed by hanging , according to the Death Penalty Database .
The date of the execution is kept a secret , to both the prisoner and their family .
The offender is only notified on the morning of his execution .
There were three executions in the country in 2019 , according to Amnesty International .
If you @ @ @ @ @ @ @ thoughts , reach out for help .
The National Suicide Prevention Lifeline is open 24 hours a day at 800-273-8255 .

Japan's 'Twitter Killer' Sentenced To Death In Killing Of 9
Enlarge this image toggle caption Masato Yamashita/Jiji Press/AFP via Getty Images Masato Yamashita/Jiji Press/AFP via Getty Images
A Japanese court sentenced a convicted murderer dubbed the "Twitter Killer" to death early Tuesday.
Takahiro Shiraishi, 30, was found guilty by the Tokyo District Court for the murder of eight women and one man, according to reports. Shiraishi also robbed and sexually assaulted the eight women he murdered, some of whom were minors.
Shiraishi used Twitter to lure the women, who shared on the website that they wanted to kill themselves. He told them he could help them do so. But once in his apartment, Shiraishi strangled them. Afterward, Shiraishi dismembered their bodies and stored the body parts throughout his apartment. The man he killed was murdered to conceal the death of his first victim.
News of the shocking crime pushed Twitter to roll out new rules against promoting or encouraging suicide and social harm on the site. It also led Japan's government to expand telephone and online suicide support channels.
Shiraishi was arrested in 2017 for the killings after police searched his apartment following complaints made by a victim's brother. The brother had discovered Twitter messages between Shiraishi and his sister, according to The Washington Post. When police arrived, they found body parts stored in Shiraishi's freezer and other containers.
During his trial, Shiraishi's defense team said he deserved a lesser sentence because he helped the victims, who had said they wanted to die. But Shiraishi himself tanked this defense during his trial; while on the stand, he said the women hadn't consented to being killed, according to The Asahi Shimbun, a Japanese newspaper.
During the trial, he said, "It was easier for me to convince people with worries and other issues and manipulate them to my way of thinking."
Death penalty in Japan
Japan regularly executes prisoners, though at a slower rate than the U.S. Prisoners there are executed by hanging, according to the Death Penalty Database.
The date of the execution is kept a secret from both the prisoner and their family. The offender is only notified on the morning of his execution.
There were three executions in the country in 2019, according to Amnesty International.
If you or someone you know is having suicidal thoughts, reach out for help. The National Suicide Prevention Lifeline is open 24 hours a day at 800-273-8255.