npr--2020-12-28--Federal Data Reveal Which Hospitals Are Dangerously Full This Week. Is Yours?

Federal Data Reveal Which Hospitals Are Dangerously Full This Week .
Is Yours ?
Note : This story was updated at 11.30 a.m .
ET Monday , Dec. 28 , and will be updated periodically , as new data are released .
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 @ @ @ @ @ @ @ hospital and your county overall are faring .
( Jump to look-up tool . )
It focuses on one important metric — how many beds are filled with 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 % @ @ @ @ @ @ @ hospital , according to a framework developed by the Institute for Health Metrics and Evaluation at the University of Washington .
If that figure gets to near 50 % 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 @ @ @ @ @ @ @ 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.
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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--2020-12-28--Saudi Activist Who Urged Women's Driving Rights Gets Nearly 6-Year Prison Term

Saudi Activist Who Urged Women 's Driving Rights Gets Nearly 6-Year Prison Term Saudi Arabia 's terrorism court has sentenced Loujain al-Hathloul , the activist who led the push to allow Saudi women to drive , to nearly six years in prison .
Hathloul 's case has drawn widespread scrutiny since her arrest in the spring of 2018 .
As it punished Hathloul , the Specialized Criminal Court suspended nearly three years of her sentence — and because Hathloul has already spent well over two years in prison , she could be released in less than three months , according @ @ @ @ @ @ @ Discussing the verdict on Twitter , she adds that both sides of the case could appeal Monday 's ruling .
In addition to the prison term , the court imposed a five-year travel ban on Hathloul , her sister said .
The suspended portion of the prison term could also be reimposed if the activist is found to have committed any crime over the next three years , according to the Saudi state-linked news outlet Sabq .
Hathloul , 31 , was the most high-profile of a group of female activists who were @ @ @ @ @ @ @ its long-standing ban on women driving .
Her family says she has been tortured and not allowed to have phone calls or visits from her family .
Sabq reports that the Specialized Criminal Court found that Hathloul agitated for changing the kingdom 's laws and used the Internet to push a foreign agenda .
A judge stated that Hathloul confessed to the charges , saying that the activist , who has gone on at least two hunger strikes during her lengthy detention , was not coerced .
The punishment is `` deeply troubling @ @ @ @ @ @ @ tweeted .
Noting that Hathloul has been `` arbitrarily detained '' since 2018 , the office added , `` We understand early release is possible , and strongly encourage it as matter of urgency . ''
In a signal that President-elect Joe Biden is likely to be more willing to criticize Saudi Arabia than the outgoing Trump administration , national security adviser-designate Jake Sullivan in a tweet described the sentence as `` unjust and troubling .
As we have said , the Biden-Harris administration will stand up against human rights violations wherever they @ @ @ @ @ @ @ 's case to the court that normally deals with national security crimes and terrorism cases in late November .
As NPR 's Jackie Northam reported , Hathloul had gone more than a year without a court appearance .
Al-Hathloul 's sister Lina told NPR that her parents , who attended the November court session , saw `` a very weak , tired , exhausted Loujain . ''
Human rights groups and foreign governments have criticized Hathloul 's treatment and the handling of her case .
Amnesty International calls the Specialized Criminal Court a @ @ @ @ @ @ @ stating that its use in Hathloul 's case `` is yet another sign that Saudi Arabia 's claims of reform on human rights are a farce . ''
Including Hathloul , more than a dozen women 's rights activists have been detained , according to Amnesty International .

Saudi Activist Who Urged Women's Driving Rights Gets Nearly 6-Year Prison Term
Enlarge this image toggle caption Loujain al-Hathloul/AP Loujain al-Hathloul/AP
Updated 3:15 p.m. ET
Saudi Arabia's terrorism court has sentenced Loujain al-Hathloul, the activist who led the push to allow Saudi women to drive, to nearly six years in prison. Hathloul's case has drawn widespread scrutiny since her arrest in the spring of 2018.
As it punished Hathloul, the Specialized Criminal Court suspended nearly three years of her sentence — and because Hathloul has already spent well over two years in prison, she could be released in less than three months, according to her sister, Lina al-Hathloul. Discussing the verdict on Twitter, she adds that both sides of the case could appeal Monday's ruling.
In addition to the prison term, the court imposed a five-year travel ban on Hathloul, her sister said. The suspended portion of the prison term could also be reimposed if the activist is found to have committed any crime over the next three years, according to the Saudi state-linked news outlet Sabq.
Hathloul, 31, was the most high-profile of a group of female activists who were arrested shortly before the Saudi kingdom lifted its long-standing ban on women driving. Her family says she has been tortured and not allowed to have phone calls or visits from her family.
Sabq reports that the Specialized Criminal Court found that Hathloul agitated for changing the kingdom's laws and used the Internet to push a foreign agenda. A judge stated that Hathloul confessed to the charges, saying that the activist, who has gone on at least two hunger strikes during her lengthy detention, was not coerced.
The punishment is "deeply troubling," the U.N. human rights office tweeted. Noting that Hathloul has been "arbitrarily detained" since 2018, the office added, "We understand early release is possible, and strongly encourage it as matter of urgency."
In a signal that President-elect Joe Biden is likely to be more willing to criticize Saudi Arabia than the outgoing Trump administration, national security adviser-designate Jake Sullivan in a tweet described the sentence as "unjust and troubling. As we have said, the Biden-Harris administration will stand up against human rights violations wherever they occur."
Saudi officials transferred Hathloul's case to the court that normally deals with national security crimes and terrorism cases in late November. As NPR's Jackie Northam reported, Hathloul had gone more than a year without a court appearance. Al-Hathloul's sister Lina told NPR that her parents, who attended the November court session, saw "a very weak, tired, exhausted Loujain."
Human rights groups and foreign governments have criticized Hathloul's treatment and the handling of her case. Amnesty International calls the Specialized Criminal Court a tool to "silence dissent," stating that its use in Hathloul's case "is yet another sign that Saudi Arabia's claims of reform on human rights are a farce."
Including Hathloul, more than a dozen women's rights activists have been detained, according to Amnesty International.


npr--2020-12-28--Is It Time For A Race Reckoning In Kidney Medicine?

Is It Time For A Race Reckoning In Kidney Medicine ?
As the U.S. grapples with the effects of systemic racism , some in the medical community are questioning whether the tools they use to assess patient health may be contributing to racial health disparities .
That debate is playing out most prominently in the world of kidney medicine .
Black people are almost four times more likely to suffer from kidney failure than non-Hispanic whites .
And once they get to that stage , Black patients spend months longer waiting for a kidney transplant than white patients .
Now @ @ @ @ @ @ @ diagnostic formula most commonly used to assess the health of patients with chronic kidney disease may be unintentionally contributing to those poor outcomes — and reinforcing racist thinking .
The tool in question is a formula used to estimate GFR , or glomerular filtration rate .
It 's a measure of how fast a person 's kidneys filter blood .
Lower kidney filtration rates suggest worse kidney function .
The gold standard for measuring GFR is a burdensome process that involves urine collection over a 24-hour period as well as a blood sample @ @ @ @ @ @ @ routinely estimate kidney function by measuring blood levels of creatinine , a waste product filtered by the kidneys , and then doing a calculation that also factors in the patient 's age and sex .
But if a patient is African American , the person 's race also plays into this calculation .
Doctors and labs will routinely apply what 's called a `` race correction '' or `` race adjustment '' to their estimated GFR number so that Black patients with chronic kidney disease end up with higher values .
Critics say @ @ @ @ @ @ @ assumptions tinged with racism .
And because higher filtration rates suggest better kidney function , critics argue that correcting for race may delay critical referrals to specialists , potentially leading to worse outcomes .
`` Why are we on the side of overestimating [ filtration rates ] if it could result in Black patients getting less care , to put it bluntly ? ''
says Dr. Mallika Mendu , a kidney specialist and executive director for critical care at Brigham and Women 's Hospital in Boston .
In fact , this June , @ @ @ @ @ @ @ Brigham , became one of a growing number of medical institutions in the U.S. to abandon the use of race in estimating GFR , amid a movement driven by medical students .
But other kidney specialists argue that while the use of race in kidney medicine is flawed , the rush to abandon it might cause more harm than it cures .
Is the use of race exacerbating disparities ?
Mendu co-authored a study published this fall that found that if the race correction were removed , up to 1 out of every @ @ @ @ @ @ @ having a more severe stage of chronic kidney disease .
And up to one-quarter of Black patients would have been reclassified from stage 3 to stage 4 of the disease — the final stage before kidney failure , which can trigger more advanced care .
The findings suggest `` there is real potential for exacerbating disparities '' when a race correction is applied , Mendu says .
To conduct the study , the researchers turned to a registry of more than 56,000 patients with chronic kidney disease created by the Mass General Brigham @ @ @ @ @ @ @ self-identified as African American .
The researchers then recalibrated the Black patients ' estimated GFR values to see what they would be without the race correction .
Mendu says perhaps the most striking finding was that when the race correction was removed , 64 Black patients had a kidney filtration rate lower than 20 — the threshold at which patients are referred for a kidney transplant .
But Mendu says records showed that none of those 64 patients had actually been referred or evaluated for a transplant , because with the race correction @ @ @ @ @ @ @ above that threshold .
That 's a really big deal , she says , because that means those patients lost critical time on the waiting list for a new kidney .
`` The more time you spend on a waitlist , if you 're waiting for a kidney , the more likely you are to get a kidney , '' Mendu says .
Given these existing disparities , Mendu says , kidney specialists should rethink the use of the race correction .
Dr. Neil Powe , a kidney specialist at the University of @ @ @ @ @ @ @ those who caution against abandoning race in estimating GFR too quickly .
He points out that racial disparities in outcomes for patients with chronic kidney disease existed long before the use of race to calculate kidney function became widespread two decades ago .
And in the study from Mendu and her colleagues , he notes that 80 % of the Black patients who did have an estimated GFR of 20 or lower with the race correction were not referred for a kidney transplant , either .
Powe says that this suggests the race-based @ @ @ @ @ @ @ what 's causing disparities in African Americans getting waitlisted [ for a kidney transplant ] .
And those other things that cause disparities could be racism as well . ''
First , do no harm The use of race-adjusted algorithms to estimate kidney filtration rates dates back to 1999 .
It was based on a study that included 1,304 white people and 197 Black people .
The researchers found that , on average , Black people in the study had higher kidney filtration rates than white people at the same blood creatinine concentrations @ @ @ @ @ @ @ to estimate GFR was underestimating kidney function in Black people .
So the authors introduced a race correction to the formula that better fit the data .
Another much larger study , published in 2009 , revised the equation used to estimate GFR but also found that it more accurately reflected measured GFR when it adjusted values for Black patients .
Dr. Vanessa Grubbs , a kidney specialist at the University of California , San Francisco and a longtime critic of using a race-adjusted GFR , says the originators of race adjustments in @ @ @ @ @ @ @ Black people might produce and clear creatinine from their bodies differently than white people do .
`` The suggestion that Black people and only Black people are different than every other human on the planet is just ludicrous , '' she says .
One explanation that is often cited is muscle mass , since creatinine is a breakdown product of muscles .
In the 1999 study , the authors observed that three previous studies had found Black people on average have greater muscle mass than white people .
But as Grubbs noted in @ @ @ @ @ @ @ now decades old , were small and did not measure muscle mass directly .
Yet the use of race as a proxy for muscle mass reinforces the notion that `` black bodies are biologically different than white ones , '' she wrote .
Mendu notes that in the 2009 study , the majority of all patients — not just Black ones — had a sizable difference between their measured and estimated GFRs , suggesting that GFR is an imprecise variable .
And she says that race itself is a poor marker of biological @ @ @ @ @ @ @ is more diversity within Black patients than there is genetic diversity between a Black person and a white person , '' she says .
`` To say that somebody being Black is somehow a monolithic thing when it comes to genetics , when it comes to ancestry , I think is challenging . ''
How , she asks , would you apply the race adjustment to someone biracial , like former President Barack Obama ?
The debate in kidney medicine comes amid a broader examination of the use of race in clinical diagnostics @ @ @ @ @ @ @ has been brought about in large part by medical students at institutions across the country who have questioned the scientific evidence justifying the use of race in diagnostic formulas and whether that might be perpetuating inequalities .
`` From our social science and genetics faculty , we were getting a message loud and clear : Race is a social construct , and it 's not a reliable proxy for genetic difference .
And then , on the other hand , our clinical faculty were turning around and teaching us that race is being @ @ @ @ @ @ @ every day in clinical medicine , '' says Dr. Leo Eisenstein , a second-year medical resident at New York University and Bellevue hospitals .
As a medical student at Harvard University , Eisenstein was part of a coalition of students whose research and lobbying efforts convinced Beth Israel Deaconess Medical Center in Boston to abandon the use of race in GFR in 2017 .
The students zeroed in on race-adjusted estimated GFR , he says , in part because it seemed to be systematically correcting Black patients to a healthier level in a @ @ @ @ @ @ @ Since then , Eisenstein and some of his former classmates have advised medical students at other universities who are seeking to convince their institutions to abandon race-based GFR as well .
This summer , the University of Washington health system and Vanderbilt University Medical Center also dropped race from their estimated GFR equations after students teamed up with faculty to examine the strength of the evidence behind the use of race adjustments .
Eisenstein says for younger generations of medical students who see the world with a racial justice lens , the issue @ @ @ @ @ @ @ to go .
`` We 're possibly perpetuating or worsening racial health disparities without anyone intending to do so , '' says Eisenstein .
In August , the National Kidney Foundation and the American Society of Nephrology formed a task force to debate the pros and cons of using race in estimated GFR .
The group is expected to issue its interim recommendations in January 2021 .
Powe is co-chair of the panel ; Mendu is on it as well .
Both agree that if doctors do continue to use race-adjusted GFR , @ @ @ @ @ @ @ patients about it and they should not rely on GFR alone to make decisions about patient care .
Another member of the panel , Dr. Lesley Inker , is a kidney specialist at Tufts University who helped develop the revised 2009 GFR algorithm that includes a race correction .
She too thinks that the reasons behind the observed differences in GFR values for Black and white patients are not well understood and that the use of race in such calculations has limitations .
`` I think it 's appropriate these questions keep getting @ @ @ @ @ @ @ Inker warns that moving to abandon the use of race in GFR too quickly could have widespread unintended consequences and could potentially lead to less care for Black patients .
Without the race correction , Inker says , Black patients ' kidney function might look worse than it actually is .
For patients with other medical conditions , she says that could mean less access to treatments , clinical trials and medications that they would otherwise have qualified for .
For example , metformin is the first drug of choice to treat diabetes @ @ @ @ @ @ @ but those with a GFR of 30 or below can not use the drug , which means they might have to turn to other medications with more side effects .
Powe notes that it could even affect Black patients ' ability to secure life insurance .
Powe says he sees why the use of race to estimate GFR is problematic , but when the data show actual racial and ethnic differences in kidney function , he asks , `` Do we just ignore them ? ''
`` There 's benefits and disadvantages on @ @ @ @ @ @ @ Her research group is working on a more precise formula to calculate GFR without the use of demographics , and it 's analyzing how eliminating the race correction could affect patients .
Ultimately , Inker says , doctors should be asking , `` What 's the best outcome for each individual patient ? ''
Everyone interviewed for this story agrees that an ideal solution would be to use another biomarker to measure kidney function that does not rely on race .
But Powe worries that doctors will start dropping race-corrected estimated GFR before @ @ @ @ @ @ @ what that biomarker should be .
`` We want to have a standardized approach so that we do n't have chaos in the medical community , '' Powe says .
Meanwhile , the use of race in other clinical diagnostic tools has come to the attention of lawmakers .
In September , the House Ways and Means Committee asked medical professional associations to reexamine the use — and misuse — of race in clinical care .
Their inquiry was prompted in part by an article published this summer in the New England Journal @ @ @ @ @ @ @ that analyzed 13 clinical algorithms that incorporate a patient 's race in various specialties , from kidney medicine to pulmonology , obstetrics , urology and cardiology .
All of the examples cited had the potential to affect the quality of care that people of color receive — for example , by underestimating the risks of heart failure in hospitalized Black patients or by steering more pregnant women of color toward cesarean sections if they 'd had one in the past .
`` That 's perverse .
The minorities are the ones who have @ @ @ @ @ @ @ Dr. David Jones , a physician and medical historian at Harvard and a co-author of the NEJM article .
Jones stresses that he and others are n't calling for medicine to abandon the collection of race data altogether , because it 's necessary in order to understand the racial health disparities that exist in the United States .
Instead he says : `` We 're calling to take a really close look at predictive uses of race , especially ones that exaggerate or accentuate health disparities . ''

Is It Time For A Race Reckoning In Kidney Medicine?
Enlarge this image toggle caption FG Trade/Getty Images FG Trade/Getty Images
As the U.S. grapples with the effects of systemic racism, some in the medical community are questioning whether the tools they use to assess patient health may be contributing to racial health disparities.
That debate is playing out most prominently in the world of kidney medicine. Black people are almost four times more likely to suffer from kidney failure than non-Hispanic whites. And once they get to that stage, Black patients spend months longer waiting for a kidney transplant than white patients.
Now, some doctors are asking whether a diagnostic formula most commonly used to assess the health of patients with chronic kidney disease may be unintentionally contributing to those poor outcomes — and reinforcing racist thinking.
The tool in question is a formula used to estimate GFR, or glomerular filtration rate. It's a measure of how fast a person's kidneys filter blood. Lower kidney filtration rates suggest worse kidney function.
The gold standard for measuring GFR is a burdensome process that involves urine collection over a 24-hour period as well as a blood sample. So instead, doctors and labs routinely estimate kidney function by measuring blood levels of creatinine, a waste product filtered by the kidneys, and then doing a calculation that also factors in the patient's age and sex.
But if a patient is African American, the person's race also plays into this calculation. Doctors and labs will routinely apply what's called a "race correction" or "race adjustment" to their estimated GFR number so that Black patients with chronic kidney disease end up with higher values.
Critics say the practice is based on flawed scientific assumptions tinged with racism. And because higher filtration rates suggest better kidney function, critics argue that correcting for race may delay critical referrals to specialists, potentially leading to worse outcomes.
"Why are we on the side of overestimating [filtration rates] if it could result in Black patients getting less care, to put it bluntly?" says Dr. Mallika Mendu, a kidney specialist and executive medical director of clinical operations for Brigham Health.
In fact, this June, Mendu's hospital system, Mass General Brigham, became one of a growing number of medical institutions in the U.S. to abandon the use of race in estimating GFR, amid a movement driven by medical students.
But other kidney specialists argue that while the use of race in kidney medicine is flawed, the rush to abandon it might cause more harm than it cures.
Is the use of race exacerbating disparities?
Mendu co-authored a study published this fall that found that if the race correction were removed, up to 1 out of every 3 Black patients would be reclassified as having a more severe stage of chronic kidney disease. And up to one-quarter of Black patients would have been reclassified from stage 3 to stage 4 of the disease — the final stage before kidney failure, which can trigger more advanced care.
The findings suggest "there is real potential for exacerbating disparities" when a race correction is applied, Mendu says.
To conduct the study, the researchers turned to a registry of more than 56,000 patients with chronic kidney disease created by the Mass General Brigham hospital network. Of those, 2,225 self-identified as African American. The researchers then recalibrated the Black patients' estimated GFR values to see what they would be without the race correction.
Mendu says perhaps the most striking finding was that when the race correction was removed, 64 Black patients had a kidney filtration rate lower than 20 — the threshold at which patients are referred for a kidney transplant. But Mendu says records showed that none of those 64 patients had actually been referred or evaluated for a transplant, because with the race correction applied, their GFR values were hovering above that threshold.
That's a really big deal, she says, because that means those patients lost critical time on the waiting list for a new kidney.
"The more time you spend on a waitlist, if you're waiting for a kidney, the more likely you are to get a kidney," Mendu says.
Given these existing disparities, Mendu says, kidney specialists should rethink the use of the race correction.
Dr. Neil Powe, a kidney specialist at the University of California, San Francisco, is among those who caution against abandoning race in estimating GFR too quickly. He points out that racial disparities in outcomes for patients with chronic kidney disease existed long before the use of race to calculate kidney function became widespread two decades ago. And in the study from Mendu and her colleagues, he notes that 80% of the Black patients who did have an estimated GFR of 20 or lower with the race correction were not referred for a kidney transplant, either.
Powe says that this suggests the race-based equations "are a smaller part of what's causing disparities in African Americans getting waitlisted [for a kidney transplant]. And those other things that cause disparities could be racism as well."
First, do no harm
The use of race-adjusted algorithms to estimate kidney filtration rates dates back to 1999. It was based on a study that included 1,304 white people and 197 Black people. The researchers found that, on average, Black people in the study had higher kidney filtration rates than white people at the same blood creatinine concentrations, suggesting that the formula then used to estimate GFR was underestimating kidney function in Black people. So the authors introduced a race correction to the formula that better fit the data.
Another much larger study, published in 2009, revised the equation used to estimate GFR but also found that it more accurately reflected measured GFR when it adjusted values for Black patients.
Dr. Vanessa Grubbs, a kidney specialist at the University of California, San Francisco and a longtime critic of using a race-adjusted GFR, says the originators of race adjustments in GFR algorithms were unable to explain why Black people might produce and clear creatinine from their bodies differently than white people do.
"The suggestion that Black people and only Black people are different than every other human on the planet is just ludicrous," she says.
One explanation that is often cited is muscle mass, since creatinine is a breakdown product of muscles. In the 1999 study, the authors observed that three previous studies had found Black people on average have greater muscle mass than white people. But as Grubbs noted in a recent paper, those studies, now decades old, were small and did not measure muscle mass directly. Yet the use of race as a proxy for muscle mass reinforces the notion that "black bodies are biologically different than white ones," she wrote.
Mendu notes that in the 2009 study, the majority of all patients — not just Black ones — had a sizable difference between their measured and estimated GFRs, suggesting that GFR is an imprecise variable.
And she says that race itself is a poor marker of biological difference. "We know that there is more diversity within Black patients than there is genetic diversity between a Black person and a white person," she says. "To say that somebody being Black is somehow a monolithic thing when it comes to genetics, when it comes to ancestry, I think is challenging."
How, she asks, would you apply the race adjustment to someone biracial, like former President Barack Obama?
A movement for change
The debate in kidney medicine comes amid a broader examination of the use of race in clinical diagnostics in the medical community. That reckoning has been brought about in large part by medical students at institutions across the country who have questioned the scientific evidence justifying the use of race in diagnostic formulas and whether that might be perpetuating inequalities.
"From our social science and genetics faculty, we were getting a message loud and clear: Race is a social construct, and it's not a reliable proxy for genetic difference. And then, on the other hand, our clinical faculty were turning around and teaching us that race is being used as a proxy for genetic difference every day in clinical medicine," says Dr. Leo Eisenstein, a second-year medical resident at New York University and Bellevue hospitals.
As a medical student at Harvard University, Eisenstein was part of a coalition of students whose research and lobbying efforts convinced Beth Israel Deaconess Medical Center in Boston to abandon the use of race in GFR in 2017. The students zeroed in on race-adjusted estimated GFR, he says, in part because it seemed to be systematically correcting Black patients to a healthier level in a way that might be less protective.
Since then, Eisenstein and some of his former classmates have advised medical students at other universities who are seeking to convince their institutions to abandon race-based GFR as well. This summer, the University of Washington health system and Vanderbilt University Medical Center also dropped race from their estimated GFR equations after students teamed up with faculty to examine the strength of the evidence behind the use of race adjustments.
Eisenstein says for younger generations of medical students who see the world with a racial justice lens, the issue was clear — the race correction had to go.
"We're possibly perpetuating or worsening racial health disparities without anyone intending to do so," says Eisenstein.
Seeking a new standard
In August, the National Kidney Foundation and the American Society of Nephrology formed a task force to debate the pros and cons of using race in estimated GFR. The group is expected to issue its interim recommendations in January 2021. Powe is co-chair of the panel; Mendu is on it as well. Both agree that if doctors do continue to use race-adjusted GFR, they need to be transparent with Black patients about it and they should not rely on GFR alone to make decisions about patient care.
Another member of the panel, Dr. Lesley Inker, is a kidney specialist at Tufts University who helped develop the revised 2009 GFR algorithm that includes a race correction. She too thinks that the reasons behind the observed differences in GFR values for Black and white patients are not well understood and that the use of race in such calculations has limitations.
"I think it's appropriate these questions keep getting asked," she says.
But Inker warns that moving to abandon the use of race in GFR too quickly could have widespread unintended consequences and could potentially lead to less care for Black patients.
Without the race correction, Inker says, Black patients' kidney function might look worse than it actually is. For patients with other medical conditions, she says that could mean less access to treatments, clinical trials and medications that they would otherwise have qualified for. For example, metformin is the first drug of choice to treat diabetes in patients with chronic kidney disease, but those with a GFR of 30 or below cannot use the drug, which means they might have to turn to other medications with more side effects.
Powe notes that it could even affect Black patients' ability to secure life insurance.
Powe says he sees why the use of race to estimate GFR is problematic, but when the data show actual racial and ethnic differences in kidney function, he asks, "Do we just ignore them?"
"There's benefits and disadvantages on both sides," Inker says. Her research group is working on a more precise formula to calculate GFR without the use of demographics, and it's analyzing how eliminating the race correction could affect patients.
Ultimately, Inker says, doctors should be asking, "What's the best outcome for each individual patient?"
Everyone interviewed for this story agrees that an ideal solution would be to use another biomarker to measure kidney function that does not rely on race. But Powe worries that doctors will start dropping race-corrected estimated GFR before the broader kidney specialist community agrees on what that biomarker should be. "We want to have a standardized approach so that we don't have chaos in the medical community," Powe says.
Meanwhile, the use of race in other clinical diagnostic tools has come to the attention of lawmakers. In September, the House Ways and Means Committee asked medical professional associations to reexamine the use — and misuse — of race in clinical care.
Their inquiry was prompted in part by an article published this summer in the New England Journal of Medicine — co-authored by Eisenstein — that analyzed 13 clinical algorithms that incorporate a patient's race in various specialties, from kidney medicine to pulmonology, obstetrics, urology and cardiology.
All of the examples cited had the potential to affect the quality of care that people of color receive — for example, by underestimating the risks of heart failure in hospitalized Black patients or by steering more pregnant women of color toward cesarean sections if they'd had one in the past.
"That's perverse. The minorities are the ones who have the worst health outcomes," says Dr. David Jones, a physician and medical historian at Harvard and a co-author of the NEJM article.
Jones stresses that he and others aren't calling for medicine to abandon the collection of race data altogether, because it's necessary in order to understand the racial health disparities that exist in the United States. Instead he says: "We're calling to take a really close look at predictive uses of race, especially ones that exaggerate or accentuate health disparities."


npr--2020-12-29--Coronavirus World Map: Tracking The Spread Of The Outbreak

Coronavirus World Map : Tracking The Spread Of The Outbreak Explore the chart below to find a country-by-country breakdown of new and total cases since January .
In late spring and early summer , new COVID-19 cases were largely driven by cases in the Americas .
While the U.S. has consistently had the most new daily cases of coronavirus in the region , Brazil 's new daily cases increased rapidly between May and August .
However , in September , several countries that had previously flattened their curve saw a resurgence in cases , including Spain and France .
In @ @ @ @ @ @ @ swiftly since June .
Explore how the number of coronavirus cases have shifted in different parts of the world over time .
The first chart compares each continent to each other , while the next charts highlight the number of cases in select countries by region .
To compare country outbreaks , the chart below graphs trend lines for average new daily cases and deaths against each country 's totals to date .
This type of visualization highlights a state 's daily growth or decline relative to the overall size of its outbreak @ @ @ @ @ @ @ and death counts grow quickly , the curves bend upward .
As new cases and deaths slow , the curves level or bend down .
In countries like Israel , which is seeing a second wave of case growth after an initial wave in April , the line forms a V-shape , as the initially bent curve spikes upwards again .
Click here to see the state-by-state breakdown of cases in the United States .
This story was originally published on March 30 , 2020 .

Coronavirus world map: We've now passed the 600 million mark for infections
Editor's note: This page is no longer being updated. The last update was Sept. 5, 2022. For current data about COVID-19 cases and deaths around the world, Johns Hopkins University and Our World in Data are useful resources.
In late January 2020 only a few dozen COVID-19 infections had been identified outside of China. A year later, the world tallied its first 100 million cases. It took the globe just 7 more months to pass the 200 million mark— then another 5 months to hit 300 million, according to researchers at Johns Hopkins University. Now the virus has spread to every corner of the globe and has been blamed for more than 6 million deaths.
The United States, India and Brazil in that order have had the most COVID cases and the three nations collectively account for almost half of all recorded infections so far in the pandemic.
Explore the chart below to find a country-by-country breakdown of new and total cases since January 2020.
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Explore how the number of coronavirus cases have shifted in different parts of the world over time. The first chart compares each continent to each other, while the next charts highlight the number of cases in select countries by region.
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This story was originally published on March 30, 2020.


npr--2020-12-29--Coronavirus Is Surging: How Severe Is Your State's Outbreak?

Coronavirus Is Surging : How Severe Is Your State 's Outbreak ?
More than 19 million people in the U.S. have had confirmed coronavirus infections and more than 330,000 have died of COVID-19 .
Tens of thousands of new cases are reported daily nationwide .
In the graphics below , explore the trends in your state .
View the data via a heat map ( immediately below ) , curve charts , a table of state-by-state trends over four weeks , or a map of total cases and deaths .
The map above shows the risk of infection in each @ @ @ @ @ @ @ capita .
The consortium of researchers and public health experts who developed these risk levels advises states in the red category to issue stay-home orders .
They advise orange states to consider stay-home orders , along with increased testing and contact tracing .
Yellow states need to keep up social distancing and mask usage , and all states should continue testing and contact tracing .
To compare state outbreaks , the chart above graphs trend lines for average new daily cases and deaths against each state 's totals to date .
This type @ @ @ @ @ @ @ growth or decline relative to the overall size of its outbreak .
When both new and total case and death counts grow quickly , the curves bend upward .
As new cases and deaths slow , the curves level or bend down .
In New York , the curve rose sharply before reaching over 170,000 total cases in April .
New cases fell from about 10,000 per day in mid-April to under 900 a day most of the summer , before starting to rise in the fall .
Explore the map above to @ @ @ @ @ @ @ the country for both new confirmed cases and reported deaths from COVID-19 .
New York was the original epicenter of the pandemic in the U.S. As of mid October , California , Florida and Texas surpass New York for total cases to date , though New York still has the highest death total .
Click here to see a global map of confirmed cases and deaths .
To show trends , the table below shows the change in average new cases per day in each state , week over week for the last @ @ @ @ @ @ @ of red have growing outbreaks ; those in shades of green , are declining .
The graphics on this page pull from data compiled by the Center for Systems Science and Engineering at Johns Hopkins University from several sources , including the Centers for Disease Control and Prevention ; the World Health Organization ; national , state and local government health departments ; 1point3acres ; and local media reports .
The JHU team automates its data uploads and regularly checks them for anomalies .
This may result in occasional data discrepancies on this @ @ @ @ @ @ @ and updates its feeds .
State-by-state recovery data are unavailable at this time .
There may be discrepancies between what you see here and what you see on your local health department 's website .
Figures shown do not include cases on cruise ships .
Fluctuations in the numbers may happen as health authorities review old cases and or update their methodologies .
For example , in early June , Michigan health authorities started including probable cases in its totals .
This resulted in a brief spike in the state 's daily numbers @ @ @ @ @ @ @ reconcile the historical data .
On June 25 , New Jersey included 1,854 previously-unreported probable deaths in its totals , resulting in a spike in the state 's daily death numbers .
On Sept. 2 , Massachusetts changed its methodology for counting probable cases , which lowered its overall case and death numbers .
The JHU team maintains a list of such changes .
This story was originally published on March 16 , 2020 .
Elena Renken was a co-author on that version .
Sean McMinn and Audrey Carlsen contributed to this story @ @ @ @ @ @ @

Tracking the coronavirus around the U.S.: See how your state is doing
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Note: This page was last updated on Feb. 1, 2023. It will no longer be updated. For current data on COVID cases and deaths, demographics, and hospitalizations, consult the Centers for Disease Control and Prevention.
As of Feb. 1, there have been more than 101 million confirmed coronavirus infections in the U.S. and more than 1 million people have died of COVID-19. In the graphics below, explore the trends in your state.
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The above charts show average new cases per 100,000 people for each state over the last 12 months.
Note: Actual cases may be substantially higher, since many who test positive with at-home tests don't report their cases.
For additional data about COVID-19 in the U.S, including cases and deaths, demographics, and hospitalizations, consult the Centers for Disease Control and Prevention website.
To show trends, the table below shows the change in average new cases per day in each state, week over week for the last 28 days. States marked in shades of red have growing outbreaks; those in shades of green, are declining.
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Methodology
The graphics on this page pull from data compiled by the Center for Systems Science and Engineering at Johns Hopkins University from several sources, including the Centers for Disease Control and Prevention; the World Health Organization; national, state and local government health departments; 1point3acres; and local media reports.
The JHU team automates its data uploads and regularly checks them for anomalies. This may result in occasional data discrepancies on this page as the JHU team resolves anomalies and updates its feeds. There may be discrepancies between what you see here and what you see on your local health department's website. Figures shown do not include cases on cruise ships.
Fluctuations in the numbers may happen as health authorities review old cases, process testing backlogs or update their methodologies. The JHU team maintains a list of such changes.
This story was originally published on March 16, 2020. Elena Renken was a co-author on that version. Sean McMinn and Audrey Carlsen contributed to this story. Carmel Wroth edited this story.


npr--2020-12-29--Pierre Cardin: French Fashion Designer Dies At 98

French designer Pierre Cardin , who extended his brand far beyond the fashion world , has died at age 98 @ @ @ @ @ immigrants worked with luminaries such as Jean Cocteau and Christian Dior before launching his own @ @ @ @ @ his love for futuristic design .
Cardin 's family announced his death to Agence France-Presse @ @ @ @ @ des Beaux-Arts also issued several statements mourning his passing .
`` Immense sadness , '' @ @ @ @ @ Cyril Barthalois said via Twitter , adding , `` Equally great joy of having known @ @ @ @ @ .
In the 1960s , Cardin 's simple , high-collared suits were a hit with @ @ @ @ @ one of many ways his work extended past fashion-show runways — he also designed uniforms @ @ @ @ @ International Airlines .
In the business world , Cardin is known for his eager embrace @ @ @ @ @ his name on products that had nothing to do with high fashion – including frying @ @ @ @ @ reported .

Pierre Cardin, French Fashion Designer, Dies At 98
Enlarge this image toggle caption Chesnot/Getty Images Chesnot/Getty Images
French designer Pierre Cardin, who extended his brand far beyond the fashion world, has died at age 98. The son of Italian immigrants worked with luminaries such as filmmaker Jean Cocteau and designer Christian Dior before launching his own fashion house, drawing on his love for futuristic design.
Cardin's family announced his death to Agence France-Presse on Tuesday. The French Académie des Beaux-Arts also issued several statements mourning his passing.
"Immense sadness," the academy's secretary general Cyril Barthalois said via Twitter, adding, "Equally great joy of having known him" through the academy.
Cardin was known for his forward-thinking designs, helping shape what we now see as space-age aesthetics: Clean, curved lines. Bold, beautiful colors contrasted with black tights and leggings. Helmets, visors and experimental materials that exuded both a sense of adventure and a knowing playfulness.
Enlarge this image toggle caption Jacques Brinon/AP Jacques Brinon/AP
In the 1960s, Cardin's simple, high-collared suits were a hit with the Beatles. It was one of many ways his work extended past fashion-show runways — he also designed uniforms for nurses and for Pakistan International Airlines.
Outer space was always a main inspiration for Cardin, says Matthew Yokobosky, senior curator of fashion and material culture at the Brooklyn Museum.
"He said to me at one point that when he was a child, he looked up at the sky and he imagined all the stars were women in evening dresses," said Yokobosky, who curated a 2019 retrospective of Cardin's work.
"And so when he went to make evening gowns for women, he imagined that they were stars in the galaxy."
Enlarge this image toggle caption Christophe Ena/AP Christophe Ena/AP
Pietro Costante Cardini was born July 2, 1922, in Venice, Italy, according to the Académie des Beaux-Arts, of which he was a member. His parents moved to France between the two world wars, and the young Cardin worked designing costumes and masks for Cocteau's 1946 film Beauty and the Beast. Then he started tailoring for Dior. By 1950, Cardin was out on his own, making a name for himself in the world of haute couture.
In 1959, Cardin released a mass-produced ready-to-wear collection with the French department store Printemps. While common today, it was a bold move back then — one that got Cardin kicked out of the small syndicate of haute couture designers. But Cardin had his eye toward getting the world to know his name.
Through licensing and branding deals, the words "Pierre Cardin" have appeared on clothes, furniture, perfume, accessories, cars — even frying pans, as NPR has reported.
While these licensing deals drew criticism that the great designer was diluting his brand, the tactic also gave Cardin's name and influence a far-reaching legacy.


npr--2020-12-29--A Quiet And 'Unsettling' Pandemic Toll: Students Who've Fallen Off The Grid

A Quiet And 'Unsettling ' Pandemic Toll : Students Who 've Fallen Off The Grid For American families and their children , school is more than just a building .
It 's a social life and a community , an athletic center and a place to get meals that are n't available at home .
The pandemic has disrupted — and continues to disrupt — the lives of U.S. students in profound ways .
Many kids have n't set foot in their schools since March , when most in-person schooling shut down across the country .
Teachers are working tirelessly @ @ @ @ @ @ @ they are growing increasingly anxious about the kids who are n't showing up at all .
An estimated 3 million students may have dropped out of school learning since March , according to Bellwether Education Partners , a national nonprofit that focuses on underserved youth .
The group 's study cited a lack of Internet access , housing insecurity , disabilities and language barriers as major obstacles to attending virtual classes during the pandemic .
`` It is really , really unsettling , '' says Alex , a teacher in western Virginia , @ @ @ @ @ @ @ be used for fear of repercussions for speaking out .
`` I think people do n't realize how much we need to see these kids .
A lot of times in schools , we are the first line for seeing signs of child abuse , for seeing signs of food insecurity .
And you do n't have that with virtual students .
Especially when they ghost . ''
That `` ghosting '' is a constant problem for school employees who track attendance in both urban and rural districts .
Staying connected to students @ @ @ @ @ @ @ become impossible in many cases .
`` They find ways to disappear when they do n't want to be found , '' says Karen Smith , who has been an educator for more than three decades and teaches high school English in a rural area on Maryland 's Eastern Shore .
`` Many of our students and even our faculty and staff do n't have reliable Internet , '' she says .
`` We experimented with portable Wi-Fi , and in our neck of the woods , that 's not really a feasible @ @ @ @ @ @ @ signal to bounce off of .
And in some cases , they 're rural enough that they do n't have that option . ''
Located about 150 miles northwest of Smith 's school district , Baltimore might seem like a different world .
But families in Evan Murray 's urban school district face many of the same challenges .
`` The Wi-Fi has been problematic for everybody , '' says Murray , who has worked in education for 13 years .
He 's now employed by Baltimore City Public Schools as a community @ @ @ @ @ @ @ and their families about what they need for both their academic and nonacademic life .
Smith and Murray 's two Maryland communities have nearly identical poverty levels , hovering just above 20 % .
So when a student is absent , missed lessons are n't the only concern .
`` Our kids already rely on the teachers and the staff for a lot of different levels of support , '' such as food and health care resources , Murray says .
`` We have a bunch of kids who rely on the morning @ @ @ @ @ @ @ the day , '' he continues .
`` We need to communicate and check on our babies , our scholars .
And make sure they 're fine . ''
Smith , in rural Maryland , is worried about that , too .
`` It 's really created a hardship for those families , and I think that is one of the reasons that there 's been such a push to go back to school in person , '' she says , also noting that schools act as child care for many working parents @ @ @ @ @ @ @ and teachers see that reflected in class participation .
`` Some of the students are in and out of touch , '' says Smith .
`` There 's one student that I have n't heard from her in , I do n't know how long . ''
Smith says she 's been trying to reach the student by phone , but senses that she might be dealing with a precarious family situation .
`` I think they 're hesitant to be upfront about what 's going on at home sometimes , '' she @ @ @ @ @ @ @ her own Internet access at home about 10 minutes before class was supposed to start .
After that , she decided to start working out of the empty school building .
The loud , buzzing hallways she remembers , filled with young voices and bodies , are now silent .
After a few minutes , the motion-sensitive lights go off .
One thing she and her colleagues often think about is how they do n't necessarily even know what their students look like .
`` They could walk in my room , face @ @ @ @ @ @ @ absolutely no idea , '' she says .
`` I do n't even know if I 've heard their voices . ''
Before the pandemic , Murray of the Baltimore schools says he spent a lot of time doing things like getting uniforms for kids and making parents feel involved .
Now , his job deals largely with technology issues — getting tablets and other equipment out to students ' homes , assuming he has the correct address .
Otherwise , he spends much of his workday on the phone , trying to @ @ @ @ @ @ @ the grid .
On a recent day , he says he spent two hours — from 1:30 to 3:30 p.m. — trying to contact 13 kids .
`` We have to , because there are still a number of students we have n't gotten , we have n't made contact with . ''
There are wrong numbers , kids who are tracked down to a different state , and home visits — when they were happening — where no one comes to the door .
Echoing Smith 's experience in rural Maryland , @ @ @ @ @ @ @ or embarrassment , from students or their families , behind those unanswered messages and knocks on the doors .
And amid worries that some of the temporary student absences could become permanent , Murray says schools need to be relentless in their outreach efforts .
`` You ca n't go in this like you 're waiting and wishing for students to come back , '' he says .
`` It 's not going to happen . ''

A Quiet And 'Unsettling' Pandemic Toll: Students Who've Fallen Off The Grid
Enlarge this image toggle caption Sarah Gonzales for NPR Sarah Gonzales for NPR
For American families and their children, school is more than just a building. It's a social life and a community, an athletic center and a place to get meals that aren't available at home. The coronavirus pandemic has disrupted — and continues to disrupt — the lives of U.S. students in profound ways.
Many kids haven't set foot in their schools since March, when most in-person schooling shut down across the United States. Teachers are working tirelessly to educate their students online, but they are growing increasingly anxious about the kids who aren't showing up at all.
An estimated 3 million students may have dropped out of school learning since March, according to Bellwether Education Partners, a national nonprofit that focuses on underserved youth. The group's study cited a lack of Internet access, housing insecurity, disabilities and language barriers as major obstacles to attending virtual classes during the pandemic.
"It is really, really unsettling," says Alex, a teacher in western Virginia, who asked that her last name not be used for fear of repercussions for speaking out. "I think people don't realize how much we need to see these kids. A lot of times in schools, we are the first line for seeing signs of child abuse, for seeing signs of food insecurity. And you don't have that with virtual students. Especially when they ghost."
That "ghosting" is a constant problem for school employees who track attendance in both urban and rural districts. Staying connected to students with little to no Internet access has become impossible in many cases.
"They find ways to disappear when they don't want to be found," says Karen Smith, who has been an educator for more than three decades and teaches high school English in a rural area on Maryland's Eastern Shore.
"Many of our students and even our faculty and staff don't have reliable Internet," she says. "We experimented with portable Wi-Fi, and in our neck of the woods, that's not really a feasible thing because you have to have a signal to bounce off of. And in some cases, they're rural enough that they don't have that option."
Located about 150 miles northwest of Smith's school district, Baltimore might seem like a different world. But families in Evan Murray's urban school district face many of the same challenges.
"The Wi-Fi has been problematic for everybody," says Murray, who has worked in education for 13 years. He's now employed by Baltimore City Public Schools as a community school site specialist, communicating with students and their families about what they need for both their academic and nonacademic lives.
Smith's and Murray's two Maryland communities have nearly identical poverty levels, hovering just above 20%. So when a student is absent, missed lessons aren't the only concern.
"Our kids already rely on the teachers and the staff for a lot of different levels of support," such as food and health care resources, Murray says.
"We have a bunch of kids who rely on the morning breakfast and lunch programs to eat throughout the day," he continues. "We need to communicate and check on our babies, our scholars, and make sure they're fine."
Smith, in rural Maryland, is worried about that too.
"It's really created a hardship for those families, and I think that is one of the reasons that there's been such a push to go back to school in person," she says, also noting that schools act as child care for many working parents.
The pandemic has made life unpredictable, and teachers see that reflected in class participation.
"Some of the students are in and out of touch," says Smith. "There's one student that I haven't heard from her in, I don't know how long."
Smith says she has been trying to reach the student by phone but senses that she might be dealing with a precarious family situation.
"I think they're hesitant to be upfront about what's going on at home sometimes," she says.
Last week, Smith lost her own Internet access at home about 10 minutes before class was supposed to start. After that, she decided to start working out of the empty school building. The loud, buzzing hallways she remembers, filled with young voices and bodies, are now silent. After a few minutes, the motion-sensitive lights go off.
One thing she and her colleagues often think about is how they don't necessarily even know what their students look like.
"They could walk in my room, face-to-face, and I would have absolutely no idea," she says. "I don't even know if I've heard their voices."
Before the pandemic, Murray of the Baltimore schools says he spent a lot of time doing things like getting uniforms for kids and making parents feel involved. Now, his job deals largely with technology issues — getting tablets and other equipment out to students' homes, assuming he has the correct address.
Otherwise, he spends much of his workday on the phone, trying to track down students who have fallen off the grid.
On a recent day, he says he spent two hours — from 1:30 to 3:30 p.m. — trying to contact 13 kids. "We have to, because there are still a number of students we haven't gotten, we haven't made contact with."
There are wrong numbers, kids who are tracked down to a different state, and home visits — when they were happening — where no one comes to the door.
Echoing Smith's experience in rural Maryland, Murray says he thinks there is shame or embarrassment, from students or their families, behind those unanswered messages and knocks on the doors.
And amid worries that some of the temporary student absences could become permanent, Murray says schools need to be relentless in their outreach efforts.
"You can't go in this like you're waiting and wishing for students to come back," he says. "It's not going to happen."
Jolie Myers edited the audio story. Maureen Pao edited the Web version.


npr--2020-12-29--Our Top Global Stories Of 2020 Not About The Pandemic

Our Top Global Stories Of 2020 Not About The Pandemic It seemed like there was only one global health story this year : the pandemic .
But that was n't the only topic that grabbed our audience 's attention .
According to NPR 's data on pageviews , readers were attracted to all kinds of Goats and Soda stories in 2020 .
The mix of content might surprise you .
A 2019 story about how to teach kids to control their anger made a huge comeback .
Readers loved our commentary on the Netflix reality show Indian Matchmaking -- and @ @ @ @ @ @ @ of our beautiful planet made a big impression .
Here 's a list of the most popular stories on our blog in 2020 , based on pageviews , that were not about the pandemic .
How Inuit Parents Teach Kids To Control Their Anger The Inuit culture has developed a sophisticated way to sculpt kids ' behavior without yelling or scolding .
Could discipline actually be playful ?
Read the story here .
Locusts Are A Plague Of Biblical Scope In 2020 .
Why ?
And ... What Are They Exactly ?
They @ @ @ @ @ @ @ of Africa and South Asia — and posing a major threat to the food supply .
If you have questions about these insects , we have answers .
Read the story here .
Opinion : We Are Africans .
Here 's Our View Of Beyoncé 's 'Black Is King' Esther Ngumbi , a professor from Kenya , and Ifeanyi Nsofor , a doctor in Nigeria , react to the megastar 's movie-length music video — and to criticism of Beyoncé creation from other Africans .
Read the story here .
Netflix 's 'Indian @ @ @ @ @ @ @ — And Not In A Good Way The TV series , which debuted on the streaming service , has sparked debates about colorism , classism and casteism .
Read the story here .
A Flying Photographer Looks Down On Earth In Awe And Sorrow In his new book , The Human Planet : Earth at the Dawn of the Anthropocene , George Steinmetz offers a bird's-eye view of the mark humans have made on the global landscape .
Read the story here .
If You Should n't Call It The Third World , @ @ @ @ @ @ @ are many ways to refer to the parts of our planet where people lack decent health care , education and services like electricity and clean water .
And just about every label has its problems .
This story was first posted in 2015 but is still timely in 2020 .
Read the story here .
They faced bias against women in science .
They faced racism because their families come from Africa .
And they triumphed in a competition to develop a problem-solving app !
Read the story here .
The Secret To @ @ @ @ @ @ @ new study from Kenya compared young children who have an older sister as compared to an older brother .
Big sisters the world over wo n't be surprised at the findings .
Read the story here .
Need A Reminder Of How Gorgeous Earth Is ?
Peep These Photo Award Winners Awash in color , texture and movement , the winners of the Siena International Photo Awards showcase images of beauty , culture and nature across the globe .
Read the story here .

Our Top Global Stories Of 2020 Not About The Pandemic
It seemed like there was only one global health story this year: the pandemic.
But that wasn't the only topic that grabbed our audience's attention. According to NPR's data on page views, readers were attracted to all kinds of Goats and Soda stories in 2020.
The mix of content might surprise you. A 2019 story about how to teach kids to control their anger made a huge comeback. Readers loved our commentary on the Netflix reality show Indian Matchmaking — and an explainer on locusts. And photos of our beautiful planet made a big impression.
Here's a list of the most popular stories on our blog in 2020, based on page views, that were not about the pandemic.
The Inuit culture has developed a sophisticated way to sculpt kids' behavior without yelling or scolding. Could discipline actually be playful? Read the story here.
toggle caption Johan Hallberg-Campbell for NPR
They're swarming in gargantuan numbers in parts of Africa and South Asia — and posing a major threat to the food supply. If you have questions about these insects, we have answers. Read the story here.
Enlarge this image toggle caption Ben Curtis/AP Ben Curtis/AP
Esther Ngumbi, a professor from Kenya, and Ifeanyi Nsofor, a doctor in Nigeria, react to the megastar's movie-length music video — and to criticism of Beyoncé creation from other Africans. Read the story here.
Enlarge this image toggle caption Parkwood Entertainment/Disney + via AP Parkwood Entertainment/Disney + via AP
The TV series, which debuted on the streaming service, has sparked debates about colorism, classism and casteism. Read the story here.
Enlarge this image toggle caption Netflix Netflix
In his new book, The Human Planet: Earth at the Dawn of the Anthropocene, George Steinmetz offers a bird's-eye view of the mark humans have made on the global landscape. Read the story here.
Enlarge this image toggle caption George Steinmetz George Steinmetz
There are many ways to refer to the parts of our planet where people lack decent health care, education, and services like electricity and clean water. And just about every label has its problems. This story was first posted in 2015 but is still timely in 2020. Read the story here.
Enlarge this image toggle caption Jing Wei for NPR Jing Wei for NPR
They faced bias against women in science. They faced racism because their families come from Africa. And they triumphed in a competition to develop a problem-solving app! Read the story here.
toggle caption Memory Haven For NPR
A new study from Kenya compared young children who have an older sister as compared to an older brother. Big sisters the world over won't be surprised at the findings. Read the story here.
Enlarge this image toggle caption Wendy Stone/Corbis via Getty Images Wendy Stone/Corbis via Getty Images
Awash in color, texture and movement, the winners of the Siena International Photo Awards showcase images of beauty, culture and nature across the globe. Read the story here.


npr--2020-12-29--Door To Door In Miami's 'Little Havana' To Build Trust For Testing And Vaccination

Door To Door In Miami 's 'Little Havana ' To Build Trust For Testing And Vaccination Little Havana is a neighborhood in Miami that , until the pandemic , was known for its active street life along Calle Ocho , including live music venues .
There you can find examples of the quintessential ventanita serving Cuban coffee and a historic park where men gather to play dominoes .
But during the pandemic , a local group called Healthy Little Havana is zeroing in on this area with a very specific assignment : convincing residents to get a coronavirus test .
@ @ @ @ @ @ @ .
It helped with the local count for the 2020 Census , for example , and because of the pandemic did most of that work by phone .
But this new challenge , community leaders say , needs a face-to-face approach .
The group 's outreach workers have been heading out almost daily to walk the quiet residential streets , to convince as many people as possible to get tested for the coronavirus .
On a recent afternoon , a group of three — Elvis Mendes , María Elena González and Alejandro Díaz @ @ @ @ @ @ @ a two-story apartment building .
Many people here have jobs in the service industry , retail or construction ; most of them are n't home when visitors come calling .
Lisette Mejía did answer her door , holding a baby in her arms , and flanked by two small children .
`` Not everyone has easy access to the internet or the ability to look for appointments , '' Mejía replied , after being asked why she had n't gotten a test .
She added that she has n't had any symptoms , @ @ @ @ @ @ @ gave her some cotton masks and told her about pop-up testing planned for that weekend at an elementary school just a short walk away .
They explained that people might lack symptoms , but still have the virus .
For many low-income Miamians , getting a coronavirus test is still too difficult The nonprofit organization is one of several receiving funding from the Health Foundation of South Florida .
The foundation is spending $ 1.5 million on these outreach efforts , in part to help make coronavirus testing as accessible and convenient as @ @ @ @ @ @ @ social and economic reasons that make it difficult for some Miamians to get tested , treated , or isolate themselves if they are sick with COVID-19 .
One big problem is that many people say they ca n't afford to stay home when they 're sick .
`` People usually rather go to work than actually treat themselves — because they have to pay rent , they have to pay school expenses , food , '' says Elvis Mendes .
This part of Miami is home to many Cuban exiles , as well @ @ @ @ @ @ @ .
Some of them do n't have health insurance , while others are undocumented immigrants .
So Mendes and his team try to spread the word among residents here about programs like Ready Responders , a group of paramedics that now has foundation funding to give free coronavirus tests at home in areas like this one , regardless of immigration status .
`` Our mission is for all these people to get tested — regardless if they have a symptom or not — so we can diminish the level of people getting COVID-19 @ @ @ @ @ @ @ the Centers for Disease Control and Protection , people who are infected but presymptomatic or asymptomatic account for more than 50 % of transmissions .
The Health Foundation of South Florida 's coronavirus-related grants have ranged from $ 35,000 to $ 160,000 ; other recipients include the South Florida chapter of the National Medical Association , Centro Campesino and the YMCA of South Florida .
The foundation is focusing on low-income neighborhoods where some residents might not have access to a car , or be able to afford to pay for a coronavirus @ @ @ @ @ @ @ includes residential areas near agriculture work sites .
In Miami-Dade County , the foundation is working with county officials directly to increase testing .
In nearby Broward County , the foundation is collaborating with public housing authorities to bring more testing into people 's homes .
In Spanish , soothing fears about testing and offering free options It 's time-consuming to go door-to-door , but worthwhile : Residents respond when outreach teams speak their language and make a personal connection .
In Little Havana , resident Gloria Carvajal told the outreach group that @ @ @ @ @ @ @ test is painful .
`` What about that stick they put all the way up ? ''
Carvajal asked , laughing nervously .
María Elena González jumped in to reassure her that it 's not so bad : `` I 've done it many times , because obviously we 're out and about in public and so we have to get the test done . ''
Another outreach effort is happening at the Faith Community Baptist Church in Miami .
The church hosted a day of free testing back in October , with @ @ @ @ @ @ @ know us .
You know who we are , '' said the church 's pastor , Richard Dunn II .
`` You know we would n't allow anybody to do anything to hurt you . ''
Dunn spoke recently in nearby Liberty City , a historically Black neighborhood , at an outdoor memorial service for Black residents who have died from COVID-19 .
To convey the magnitude of the community 's losses , hundreds of white plastic tombstones were set up behind the podium .
They filled an entire field in the park @ @ @ @ @ @ @ , and so we 're saying to the Lord here today , we 're not going to let their deaths be in vain , '' Dunn said .
Dunn is also helping with a newly-launched effort to build trust in the COVID-19 vaccines among Black residents , by participating in online meetings during which Black church members can hear directly from Black medical experts .
The message of the meetings is that the vaccines are safe and vital .
`` It 's taken over 300,000 lives in the United States of America , @ @ @ @ @ @ @ the meeting .
`` And I believe to do nothing would be more of a tragedy than to at least try to do something to prevent it and to stop the spreading of the coronavirus . ''
Churches will play a big role in the ongoing outreach efforts , and Dunn is committed to doing his part .
He knows it 's an extremely contagious and serious disease — this past summer he caught the illness himself .
This story comes from NPR 's health reporting partnership with WLRN and Kaiser Health News @

Door To Door In Miami's 'Little Havana' To Build Trust For Testing And Vaccination
Enlarge this image toggle caption Verónica Zaragovia/WLRN Verónica Zaragovia/WLRN
Little Havana is a neighborhood in Miami that, until the pandemic, was known for its active street life along Calle Ocho, including live music venues. There you can find examples of the quintessential ventanita serving Cuban coffee and a historic park where men gather to play dominoes.
But during the pandemic, a local group called Healthy Little Havana is zeroing in on this area with a very specific assignment: convincing residents to get a coronavirus test.
The nonprofit has lots of outreach experience. It helped with the local count for the 2020 Census, for example, and because of the pandemic did most of that work by phone. But this new challenge, community leaders say, needs a face-to-face approach.
The group's outreach workers have been heading out almost daily to walk the quiet residential streets, to convince as many people as possible to get tested for the coronavirus. On a recent afternoon, a group of three — Elvis Mendes, María Elena González and Alejandro Díaz — knocked on door after door at a two-story apartment building. Many people here have jobs in the service industry, retail or construction; most of them aren't home when visitors come calling.
Lisette Mejía did answer her door, holding a baby in her arms, and flanked by two small children.
"Not everyone has easy access to the internet or the ability to look for appointments," Mejía replied, after being asked why she hadn't gotten a test. She added that she hasn't had any symptoms, either.
The Healthy Little Havana team gave her some cotton masks and told her about pop-up testing planned for that weekend at an elementary school just a short walk away. They explained that people might lack symptoms, but still have the virus.
For many low-income Miamians, getting a coronavirus test is still too difficult
The nonprofit organization is one of several receiving funding from the Health Foundation of South Florida. The foundation is spending $1.5 million on these outreach efforts, in part to help make coronavirus testing as accessible and convenient as possible.
There are a number of social and economic reasons that make it difficult for some Miamians to get tested, treated, or isolate themselves if they are sick with COVID-19. One big problem is that many people say they can't afford to stay home when they're sick.
"People usually rather go to work than actually treat themselves — because they have to pay rent, they have to pay school expenses, food," says Elvis Mendes.
This part of Miami is home to many Cuban exiles, as well as people from all over Latin America. Some of them don't have health insurance, while others are undocumented immigrants.
Enlarge this image toggle caption Verónica Zaragovia/WLRN Verónica Zaragovia/WLRN
So Mendes and his team try to spread the word among residents here about programs like Ready Responders, a group of paramedics that now has foundation funding to give free coronavirus tests at home in areas like this one, regardless of immigration status.
"Our mission is for all these people to get tested — regardless if they have a symptom or not — so we can diminish the level of people getting COVID-19," Mendes explains. According to the Centers for Disease Control and Protection, people who are infected but presymptomatic or asymptomatic account for more than 50% of transmissions.
The Health Foundation of South Florida's coronavirus-related grants have ranged from $35,000 to $160,000; other recipients include the South Florida chapter of the National Medical Association, Centro Campesino and the YMCA of South Florida.
The foundation is focusing on low-income neighborhoods where some residents might not have access to a car, or be able to afford to pay for a coronavirus test at a pharmacy. Their focus includes residential areas near agriculture work sites. In Miami-Dade County, the foundation is working with county officials directly to increase testing. In nearby Broward County, the foundation is collaborating with public housing authorities to bring more testing into people's homes.
In Spanish, soothing fears about testing and offering free options
It's time-consuming to go door-to-door, but worthwhile: Residents respond when outreach teams speak their language and make a personal connection.
In Little Havana, resident Gloria Carvajal told the outreach group that she felt anxious about whether the PCR test is painful.
"What about that stick they put all the way up?" Carvajal asked, laughing nervously.
María Elena González jumped in to reassure her that it's not so bad: "I've done it many times, because obviously we're out and about in public and so we have to get the test done."
Enlarge this image toggle caption Lynne Sladky/AP Photo/Lynne Sladky Lynne Sladky/AP Photo/Lynne Sladky
Another outreach effort is happening at the Faith Community Baptist Church in Miami. The church hosted a day of free testing back in October, with help from the foundation.
"You know us. You know who we are," said the church's pastor, Richard Dunn II. "You know we wouldn't allow anybody to do anything to hurt you."
Dunn spoke recently in nearby Liberty City, a historically Black neighborhood, at an outdoor memorial service for Black residents who have died from COVID-19. To convey the magnitude of the community's losses, hundreds of white plastic tombstones were set up behind the podium. They filled an entire field in the park.
"Thousands upon thousands have died, and so we're saying to the Lord here today, we're not going to let their deaths be in vain," Dunn said.
Enlarge this image toggle caption Verónica Zaragovia/WLRN Verónica Zaragovia/WLRN
Dunn is also helping with a newly-launched effort to build trust in the COVID-19 vaccines among Black residents, by participating in online meetings during which Black church members can hear directly from Black medical experts. The message of the meetings is that the vaccines are safe and vital.
"It's taken over 300,000 lives in the United States of America," Dunn said at the end of the meeting. "And I believe to do nothing would be more of a tragedy than to at least try to do something to prevent it and to stop the spreading of the coronavirus."
Churches will play a big role in the ongoing outreach efforts, and Dunn is committed to doing his part. He knows it's an extremely contagious and serious disease — this past summer he caught the illness himself.
This story comes from NPR's health reporting partnership with WLRN and Kaiser Health News.


npr--2020-12-29--New York Approves Eviction Moratorium Until May

New York Approves Eviction Moratorium Until May The New York Legislature approved a sweeping eviction ban for tenants living in the state , giving residents fearful of losing their homes during the pandemic some relief at least until May .
The law , which Gov .
Andrew Cuomo signed late Monday , places a moratorium on residential evictions until May 1 for tenants who endured a `` COVID-related hardship . ''
Tenants must show documentation explaining their situation to prevent evictions .
Landlords can still evict people who do n't show that documentation .
The law also stops residential foreclosure @ @ @ @ @ @ @ landlords who own 10 or fewer residences can also file hardship declarations with their mortgage lender or a court to prevent a foreclosure .
`` When the COVID-19 pandemic began , we asked New Yorkers to protect each other by staying at home .
As we fight our way through the marathon this pandemic has become , we need to make sure New Yorkers still have homes to provide that protection , '' Cuomo said after signing the bill .
The Centers for Disease Control and Prevention 's nationwide temporary ban on residential @ @ @ @ @ @ @ was set to expire Dec. 31 , but Congress extended that moratorium for another month in the latest COVID-19 relief bill just signed by President Trump .
Federal lawmakers also put $ 25 billion into rental assistance programs .
New York , like many states in the country , is facing high rates of unemployment caused by the coronavirus pandemic .
Tenant advocacy groups have protested for months , urging lawmakers to do more to prevent people from losing their homes .
A report by the National Council of State Housing Agencies earlier @ @ @ @ @ @ @ up to $ 34 billion in past-due rent by January .
This is set to increase eviction filings and impose financial hardship on millions in just a few months , the organization said .
Many of those tenants struggling to pay rent in New York are in communities of color , according to Stanley Fritz , political director of Citizen Action of New York .
He said in a statement Monday that Black and brown tenants are `` three to four times as likely to be facing eviction as their white counterparts .
@ @ @ @ @ @ @ is an `` important first step '' to helping the 1.4 million tenant households behind on rent .
The long-term economic impact of unpaid rent for landlords has organizations representing building owners criticizing the new law .
Jay Martin , executive director of the landlord group Community Housing Improvement Program , accused tenant advocates of having a broader political agenda by pushing the bill .
Days before the bill was signed Martin tweeted that an eviction moratorium is just `` kicking the can down the road . ''
He tweeted , `` Eviction @ @ @ @ @ @ @ of the costs of housing .
A problem for owners and renters . ''

New York Approves Eviction Moratorium Until May
Enlarge this image toggle caption Angela Weiss/AFP via Getty Images Angela Weiss/AFP via Getty Images
The New York Legislature approved a sweeping eviction ban for tenants living in the state, giving residents fearful of losing their homes during the pandemic some relief at least until May.
The law, which Gov. Andrew Cuomo signed late Monday, places a moratorium on residential evictions until May 1 for tenants who endured a "COVID-related hardship." Tenants must show documentation explaining their situation to prevent evictions. Landlords can still evict people who don't show that documentation.
The law also stops residential foreclosure proceedings until May 1. Homeowners and landlords who own 10 or fewer residences can also file hardship declarations with their mortgage lender or a court to prevent a foreclosure.
"When the COVID-19 pandemic began, we asked New Yorkers to protect each other by staying at home. As we fight our way through the marathon this pandemic has become, we need to make sure New Yorkers still have homes to provide that protection," Cuomo said after signing the bill.
The Centers for Disease Control and Prevention's nationwide temporary ban on residential evictions expires early next year. It was set to expire Dec. 31, but Congress extended that moratorium for another month in the latest coronavirus relief bill just signed by President Trump. Federal lawmakers also put $25 billion into rental assistance programs.
New York, like many states in the country, is facing high rates of unemployment caused by the coronavirus pandemic. Tenant advocacy groups have protested for months, urging lawmakers to do more to prevent people from losing their homes.
A report by the National Council of State Housing Agencies earlier this year estimated U.S. renters will owe up to $34 billion in past-due rent by January. This is set to increase eviction filings and impose financial hardship on millions in just a few months, the organization said.
Many of those tenants struggling to pay rent in New York are in communities of color, according to Stanley Fritz, political director of Citizen Action of New York. He said in a statement Monday that Black and brown tenants are "three to four times as likely to be facing eviction as their white counterparts."
He said passing the eviction ban is an "important first step" to helping the 1.4 million tenant households behind on rent.
Landlord critics
The long-term economic impact of unpaid rent for landlords has organizations representing building owners criticizing the new law.
Jay Martin, executive director of the landlord group Community Housing Improvement Program, accused tenant advocates of having a broader political agenda by pushing the bill.
Days before the bill was signed, Martin tweeted that an eviction moratorium is just "kicking the can down the road."
He tweeted, "Eviction moratoriums do not address the fundamental problem of the costs of housing. A problem for owners and renters."


npr--2020-12-29--Omni Hotels Accepted Millions In PPP Funds But Didn't Pay Workers

Omni Hotels & Resorts , the international luxury hotel chain owned by billionaire Robert B. Rowling , is being accused of misusing millions of dollars in federal pandemic relief funds meant to keep workers on payroll .
Unite Here , a service workers union with more than 300,000 members in North America , said several Omni hotels where it represents workers took Paycheck Protection Program loans but never paid hundreds of workers .
Unite Here said 32 Omni hotels received about $ 76 million in loans from the program , known as PPP .
About $ 23 million of that @ @ @ @ @ @ @ including Chicago , Boston , Washington , D.C. , and San Francisco , where the union represents more than 1,000 housekeepers , servers and other service workers .
In its application to the Small Business Administration , the Omni Providence Hotel in Rhode Island asked for a $ 2.6 million PPP loan , promising to retain 246 jobs .
Quilcia Moronta , a health club attendant , was laid off after working at the hotel for 21 years .
She applied for unemployment benefits and food stamps and was hopeful when the hotel @ @ @ @ @ @ @ .
`` As I was struggling to provide for my family , I learned that the Omni had received some PPP money , '' said Moronta , a single mother with two children .
`` I said , 'Great , at least they 're gon na help us get by when it comes to basic needs . '
`` Eight months later , unemployment benefits for Moronta and other workers have expired , and health coverage is long gone .
And they are still waiting for PPP benefits .
`` Right now , @ @ @ @ @ @ @ we have n't heard anything about Omni using that money to help their employees , '' she said .
`` Here in Boston , I 've spoken to hundreds of workers who work at the Omni Parker House , and I know none of them have received a single dime of this money , '' said Carlos Aramayo , Unite Here 's executive vice president .
`` Looking at this winter , a lot of them could really use it . ''
Zebedee Williams was laid off in March from his job as @ @ @ @ @ @ @ William Penn in Pittsburgh .
He said that since unemployment and weekly supplemental assistance from the federal government ran out , he has struggled to feed his household , which includes a partner on disability and three daughters .
To stretch the budget , he said , he has skipped meals .
`` It 's not right for the kids not to eat , '' Williams said .
`` I would do it 10 times again if the situation happened .
I would make sure my children eat .
I would make do @ @ @ @ @ @ @ a spokesperson for the Dallas-based chain said workers at the hotels had not been retained because the facilities were either closed or operating at greatly reduced capacity .
The PPP was part of the CARES Act , the huge pandemic-relief package President Trump signed in March .
Some 5.2 million businesses have secured $ 523 billion in PPP loans .
Though the Small Business Administration program was meant to help small businesses keep workers paid — as an alternative to unemployment — it has been widely criticized for favoring large businesses , and @ @ @ @ @ @ @ rules do permit a business to use funds for payroll even if it is closed .
But the Omni elected not to do that .
Instead , the chain said in its statement , `` any amount of the PPP loans that are not forgiven will be returned or repaid with interest per program terms . ''
Critics say whether the hotels pay back the loans is beside the point .
They note , for instance , that the interest rate on PPP loans is just 1 % — well below market rate @ @ @ @ @ @ @ want to use this as a way to get a low-interest loan from the federal government , '' says Unite Here 's Aramayo .
`` It 's really not fair for a company to take money that was intended to help out their own workforce and use it for some other purpose . ''
Omni 's use of the funds is `` obviously really contravening the spirit of what this [ program ] was about , '' said Harry J .
Van Buren , a professor of business ethics at the University of @ @ @ @ @ @ @ if they do repay the loan , the fact that they got awfully close to free money for some period of time , is really an advantage to them as well . ''
`` I do think about other businesses that maybe did n't get money because Omni did , either truly small businesses that were struggling , or another company that might have used it to actually pay their workers , '' said Lisa Gilbert , executive vice president of the consumer advocacy group Public Citizen .
`` It does n't seem @ @ @ @ @ @ @ , even if they pay back the money at the end of the day . ''
On Dec. 8 , Aramayo wrote to the Small Business Administration and the U.S. Department of the Treasury , to scrutinize PPP loans to Omni hotels , `` especially if [ the borrowers ] apply for forgiveness . ''
It was just weeks before President Trump signed into law a new pandemic-relief package with its own version of the Paycheck Protection Program — one with new rules to help address some of the problems critics found with @ @ @ @

Omni Hotels Accepted Millions In PPP Funds But Didn't Pay Workers
Updated at 8:27 p.m. ET
Omni Hotels & Resorts, the international luxury hotel chain owned by billionaire Robert B. Rowling, is being accused of misusing millions of dollars in federal pandemic relief funds meant to keep workers on payroll.
Enlarge this image toggle caption Bill O'Driscoll/WESA Bill O'Driscoll/WESA
Unite Here, a service workers union with more than 300,000 members in North America, said several Omni hotels where it represents workers took Paycheck Protection Program loans but never paid hundreds of workers.
Unite Here said 32 Omni hotels received about $76 million in loans from the program, known as PPP. About $23 million of that went to seven hotels, in cities including Chicago, Boston, Washington, D.C., and San Francisco, where the union represents more than 1,000 housekeepers, servers and other service workers.
In its application to the Small Business Administration, the Omni Providence Hotel in Rhode Island asked for a $2.6 million PPP loan, promising to retain 246 jobs.
Quilcia Moronta, a health club attendant, was laid off after working at the hotel for 21 years. She applied for unemployment benefits and food stamps and was hopeful when the hotel's loan was approved on April 13.
"As I was struggling to provide for my family, I learned that the Omni had received some PPP money," said Moronta, a single mother with two children. "I said, 'Great, at least they're gonna help us get by when it comes to basic needs.' "
Eight months later, unemployment benefits for Moronta and other workers have expired, and health coverage is long gone. And they are still waiting for PPP benefits.
"Right now, here we are in December, and we haven't heard anything about Omni using that money to help their employees," she said.
"Here in Boston, I've spoken to hundreds of workers who work at the Omni Parker House, and I know none of them have received a single dime of this money," said Carlos Aramayo, Unite Here's executive vice president. "Looking at this winter, a lot of them could really use it."
Zebedee Williams was laid off in March from his job as an overnight banquet houseman at the Omni William Penn Hotel in Pittsburgh. He said that since unemployment benefits and weekly supplemental assistance from the federal government ran out, he has struggled to feed his household, which includes a partner on disability and three daughters. To stretch the budget, he said, he has skipped meals.
"It's not right for the kids not to eat," Williams said. "I would do it 10 times again if the situation happened. I would make sure my children eat. I would make do."
In a written statement, a spokesperson for the Dallas-based chain said workers at the hotels had not been retained because the facilities were either closed or operating at greatly reduced capacity.
PPP was part of the CARES Act, the huge pandemic-relief package President Trump signed in March. Some 5.2 million businesses have secured $523 billion in PPP loans. Though the Small Business Administration program was meant to help small businesses keep workers paid — as an alternative to unemployment — it has been widely criticized for favoring large businesses and been stung with allegations of fraud.
PPP rules do permit a business to use funds for payroll even if it is closed. But the Omni elected not to do that. Instead, the chain said in its statement, "any amount of the PPP loans that are not forgiven will be returned or repaid with interest per program terms."
Enlarge this image toggle caption Quilcia Moronta Quilcia Moronta
Critics say whether the hotels pay back the loans is beside the point. They note, for instance, that the interest rate on PPP loans is just 1% — well below market rate.
"It's disgusting if companies want to use this as a way to get a low-interest loan from the federal government," says Unite Here's Aramayo. "It's really not fair for a company to take money that was intended to help out their own workforce and use it for some other purpose."
Omni's use of the funds is "obviously really contravening the spirit of what this [program] was about," said Harry J. Van Buren, a professor of business ethics at the University of St. Thomas in St. Paul, Minn. "Even if they do repay the loan, the fact that they got awfully close to free money for some period of time is really an advantage to them as well."
"I do think about other businesses that maybe didn't get money because Omni did, either truly small businesses that were struggling or another company that might have used it to actually pay their workers," said Lisa Gilbert, executive vice president of the consumer advocacy group Public Citizen. "It doesn't seem like a great investment of taxpayer dollars, even if they pay back the money at the end of the day."
On Dec. 8, Aramayo wrote to the Small Business Administration and the Treasury Department, urging them to scrutinize PPP loans to Omni hotels, "especially if [the borrowers] apply for forgiveness." It was just weeks before Trump signed into law a new pandemic-relief package with its own version of the Paycheck Protection Program — one with new rules to help address some of the problems critics found with the first iteration.