csmonitor--2020-09-14--Japan's ruling party elects Yoshihide Suga to replace Shinzo Abe

Yoshihide Suga was elected as the new head of Japan ’ s ruling party on Monday , all but assuring that he will become the country ’ s new prime minister when a parliamentary election is held later in the week .
Despite his low-key image , Mr. Suga has been an important figure in outgoing Prime Minister Shinzo Abe ’ s administration , serving as the government ’ s top spokesperson in his role as chief Cabinet secretary .
Mr. Abe announced last month that he would resign due to health problems .
Mr. Suga ’ s victory in @ @ @ @ @ @ @ guarantees his election in a parliamentary vote Wednesday because of the majority held by the LDP ’ s ruling coalition .
Mr. Suga , the son of a strawberry grower in northern Japan ’ s Akita prefecture , said he had come a long way .
“ I will devote all of myself to work for the nation and the people , ” he said in his victory speech .
He has said that his top priorities will be fighting the coronavirus and turning around a Japanese economy battered by the pandemic .
@ @ @ @ @ @ @ and their wing members early in the campaign on expectations that he would continue Mr. Abe ’ s policies .
Mr. Suga received 377 votes in Monday ’ s vote to pick a successor to Mr. Abe .
Former Foreign Minister Fumio Kishida , one of the other two contenders , received 89 votes , while former Defense Minister Shigeru Ishiba got 68 .
“ Now I ’ m handing the baton to new LDP President Suga , ” Mr. Abe said after the vote .
“ We can count on him.
” @ @ @ @ @ @ @ of Mr. Abe since Mr. Abe ’ s first stint as prime minister from 2006 to 2007 .
Mr. Abe ’ s tenure ended abruptly because of chronic illness , and Mr. Suga helped him return as prime minister in 2012 .
Mr. Suga repeatedly has praised Mr. Abe ’ s diplomacy and economic policies when asked about what he would like to accomplish as prime minister .
He also has defended scores of favoritism and cronyism scandals , saying that investigations into the cases were properly handled .
On the surface , @ @ @ @ @ @ @ offering bland comments at twice-daily televised news briefings .
But behind the scenes , he ’ s known for his iron-fist approach to getting jobs done as a policy coordinator and influencing bureaucrats by using the centralized power of the prime minister ’ s office , leading political watchers to call him the “ shadow prime minister.
” Some bureaucrats who have opposed his policies have reportedly been removed from projects or transferred elsewhere .
Mr. Suga , whose portfolio also included a ministerial role as head of Okinawa issues in the Abe-led @ @ @ @ @ @ @ his high-handed approach to a disputed relocation of a United States Marine air station on the southern island .
He also sparked criticism last year over his hostile responses to a female reporter asking tough questions about Mr. Abe ’ s policies and scandals .
As his parents ’ eldest son , Mr. Suga defied tradition by deciding not to take over the family farm .
Instead , he headed to Tokyo , where he became a self-made politician , a rarity in Japan ’ s largely hereditary business of politics – and @ @ @ @ @ @ @ scion of a political dynasty .
“ Where there is a will , there is a way , ” is Mr. Suga ’ s motto .
He also says he seeks to build a nation of “ self-support , mutual support , then public support , ” raising concerns of having a vision of a government that is cold to the weak and the needy .
Mr. Suga says that he is a reformist and that he has worked to achieve policies by breaking territorial barriers of bureaucracy .
He has credited himself @ @ @ @ @ @ @ foreign tourism industry in Japan , lowering cellphone bills , and bolstering agricultural exports .
On Monday , he pledged to crack into vested interests and rules hampering reforms .
While there is speculation that he may form a caretaker Cabinet that mainly keeps key members from the Abe government , Mr. Suga said he might as well pick reform-minded people willing to carry out his policies .
Despite speculation that Mr. Suga may be a caretaker for the remainder of Mr. Abe ’ s scheduled term , which was to end in @ @ @ @ @ @ @ longer , according to analysts .
Mr. Suga , who grew up in rural Japan and does not belong to a faction within the ruling party , may be a political realist with a broad national perspective , more so than Mr. Abe , said Tobias Harris , a political analyst .
“ I think he has a more holistic view of politics and the government than maybe a lot of people who have occupied the post of prime minister , ” Mr. Harris said .
Compared to his political prowess at home @ @ @ @ @ @ @ , and his diplomatic skills are unknown , though he is largely expected to pursue Mr. Abe ’ s priorities .
In addition to the coronavirus and the economic fallout , Mr. Suga stands to inherit several other challenges , including China , which continues its assertive actions in the East China Sea .
He also will have to decide what to do with the Tokyo Olympics , which were pushed back to next summer due to the coronavirus .
And he will have to establish a good relationship with whoever wins the @ @ @ @ @ @ @ said he wants to maintain communication and develop strategic ties with China and South Korea despite rocky relations with them .
Chinese foreign ministry spokesperson Wang Wenbin congratulated Mr. Suga and expressed willingness “ to deepen cooperation in the fight against the epidemic and economic and social development , and continuously promote improvement and development of China-Japan relations.
” Mr. Suga is known to have helped smooth out differences by keeping close ties with a centrist coalition partner , Komeito .
His ties to the more dovish partner could make his administration less @ @ @ @ @ @ @ say .
A man of self-discipline , his daily routine includes sit-ups and walking – in his business suits in the neighborhood of the parliament so he can immediately head to work in an emergency .
But he says he has a weakness : He loves sweets , namely pancakes , and Japanese mochi with sweet bean paste inside .
This story was reported by The Associated Press .
AP researcher Liu Zheng in Beijing contributed to this report .

Yoshihide Suga was elected as the new head of Japan’s ruling party on Monday, all but assuring that he will become the country’s new prime minister when a parliamentary election is held later in the week.
Despite his low-key image, Mr. Suga has been an important figure in outgoing Prime Minister Shinzo Abe’s administration, serving as the government’s top spokesperson in his role as chief Cabinet secretary. Mr. Abe announced last month that he would resign due to health problems.
Mr. Suga’s victory in the ruling Liberal Democratic Party vote virtually guarantees his election in a parliamentary vote Wednesday because of the majority held by the LDP’s ruling coalition.
Mr. Suga, the son of a strawberry grower in northern Japan’s Akita prefecture, said he had come a long way. “I will devote all of myself to work for the nation and the people,” he said in his victory speech.
He has said that his top priorities will be fighting the coronavirus and turning around a Japanese economy battered by the pandemic. He gained the support of party heavyweights and their wing members early in the campaign on expectations that he would continue Mr. Abe’s policies.
Mr. Suga received 377 votes in Monday’s vote to pick a successor to Mr. Abe. Former Foreign Minister Fumio Kishida, one of the other two contenders, received 89 votes, while former Defense Minister Shigeru Ishiba got 68.
“Now I’m handing the baton to new LDP President Suga,” Mr. Abe said after the vote. “We can count on him.”
Mr. Suga has been a loyal supporter of Mr. Abe since Mr. Abe’s first stint as prime minister from 2006 to 2007. Mr. Abe’s tenure ended abruptly because of chronic illness, and Mr. Suga helped him return as prime minister in 2012.
Mr. Suga repeatedly has praised Mr. Abe’s diplomacy and economic policies when asked about what he would like to accomplish as prime minister. He also has defended scores of favoritism and cronyism scandals, saying that investigations into the cases were properly handled.
On the surface, the straight-faced Mr. Suga is known for offering bland comments at twice-daily televised news briefings.
But behind the scenes, he’s known for his iron-fist approach to getting jobs done as a policy coordinator and influencing bureaucrats by using the centralized power of the prime minister’s office, leading political watchers to call him the “shadow prime minister.” Some bureaucrats who have opposed his policies have reportedly been removed from projects or transferred elsewhere.
Mr. Suga, whose portfolio also included a ministerial role as head of Okinawa issues in the Abe-led government, has offended local leaders with his high-handed approach to a disputed relocation of a United States Marine air station on the southern island. He also sparked criticism last year over his hostile responses to a female reporter asking tough questions about Mr. Abe’s policies and scandals.
As his parents’ eldest son, Mr. Suga defied tradition by deciding not to take over the family farm. Instead, he headed to Tokyo, where he became a self-made politician, a rarity in Japan’s largely hereditary business of politics – and a change from Mr. Abe, the scion of a political dynasty.
“Where there is a will, there is a way,” is Mr. Suga’s motto. He also says he seeks to build a nation of “self-support, mutual support, then public support,” raising concerns of having a vision of a government that is cold to the weak and the needy.
Mr. Suga says that he is a reformist and that he has worked to achieve policies by breaking territorial barriers of bureaucracy. He has credited himself for those efforts in achieving a booming foreign tourism industry in Japan, lowering cellphone bills, and bolstering agricultural exports. On Monday, he pledged to crack into vested interests and rules hampering reforms.
While there is speculation that he may form a caretaker Cabinet that mainly keeps key members from the Abe government, Mr. Suga said he might as well pick reform-minded people willing to carry out his policies.
Despite speculation that Mr. Suga may be a caretaker for the remainder of Mr. Abe’s scheduled term, which was to end in September 2021, he may actually last longer, according to analysts.
Mr. Suga, who grew up in rural Japan and does not belong to a faction within the ruling party, may be a political realist with a broad national perspective, more so than Mr. Abe, said Tobias Harris, a political analyst. “I think he has a more holistic view of politics and the government than maybe a lot of people who have occupied the post of prime minister,” Mr. Harris said.
Compared to his political prowess at home, Mr. Suga has hardly traveled overseas, and his diplomatic skills are unknown, though he is largely expected to pursue Mr. Abe’s priorities.
In addition to the coronavirus and the economic fallout, Mr. Suga stands to inherit several other challenges, including China, which continues its assertive actions in the East China Sea. He also will have to decide what to do with the Tokyo Olympics, which were pushed back to next summer due to the coronavirus. And he will have to establish a good relationship with whoever wins the U.S. presidential race.
Mr. Suga has said he wants to maintain communication and develop strategic ties with China and South Korea despite rocky relations with them.
Chinese foreign ministry spokesperson Wang Wenbin congratulated Mr. Suga and expressed willingness “to deepen cooperation in the fight against the epidemic and economic and social development, and continuously promote improvement and development of China-Japan relations.”
Mr. Suga is known to have helped smooth out differences by keeping close ties with a centrist coalition partner, Komeito. His ties to the more dovish partner could make his administration less hawkish on national security issues, analysts say.
A man of self-discipline, his daily routine includes sit-ups and walking – in his business suits in the neighborhood of the parliament so he can immediately head to work in an emergency.
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But he says he has a weakness: He loves sweets, namely pancakes, and Japanese mochi with sweet bean paste inside.
This story was reported by The Associated Press. AP researcher Liu Zheng in Beijing contributed to this report.


csmonitor--2020-09-14--How could nursing homes have done better?

Nurses are grateful for food donations , she said .
But “ my co-workers and I don ’ t need a pizza party .
We need PPE , ” she told the committee .
Melinda Haschak was one of them .
A licensed practical nurse , she testified before a House Ways and Means Committee hearing last month about RegalCare ’ s lack of staffing , shortage of personal protective equipment such as masks , and her perception that management didn ’ t support front-line employees .
For instance , at RegalCare at Southport , a for-profit 120-bed facility in @ @ @ @ @ @ @ nurses provide less than half the state average of resident coverage .
It ’ s been on a federal watch list for two years for a list of deficiencies , including poor infection control .
Nursing home residents have accounted for some 40 % of all COVID-19 deaths in the United States .
To some experts , this tragic toll was simply the result of location : in hotspots such as New York City .
Even well-run , highly rated , long-term care facilities were hit hard .
But other analyses point to @ @ @ @ @ @ @ run for profit did worse at keeping their residents safe from the coronavirus .
Two peer-reviewed studies of nursing homes in Connecticut and California separately found that low nurse-to-patient ratios , particularly of registered nurses , were associated with larger and deadlier COVID-19 outbreaks .
As Melinda Haschak responded to the Code Blue that blared through the intercom , she was missing a crucial piece of information .
The resident she was rushing to save had tested positive for the coronavirus .
Ms. Haschak knew that some of the residents in the Connecticut @ @ @ @ @ @ @ licensed nurse had tested positive .
But the fellow nurse who could have helped her most – who had begun to piece together the larger picture , who knew the resident in distress had tested positive , and whose concerns had been dismissed by management – was at home , recovering from the coronavirus herself .
Before falling ill , Kennethe Polissaint had noticed that the first resident who tested positive and died in the hospital had never left the facility – meaning the nursing home staff itself was unwittingly spreading the virus @ @ @ @ @ @ @ she told the assistant director of nursing , a registered nurse , “ they didn ’ t do anything about it , ” Ms. Polissaint says .
Ms. Haschak was not able to save the Code Blue resident , who never regained consciousness .
And afterward , the senior nurses who oversee infection control didn ’ t send her home to isolate .
Instead , she went back to her wing , which was supposed to be COVID-19-free .
Two weeks later , Ms. Haschak fell ill with COVID-19 .
The pattern that @ @ @ @ @ @ @ been mirrored at thousands of nursing facilities across the United States .
More than 41 % of the 186,000 Americans who have died of COVID-19 in the 47 states that reported data have been in nursing homes and assisted living centers , according to Kaiser Health News .
The question is whether nursing homes could have done better – and can do better going forward .
To some experts , there was probably little care facilities could have done .
“ This pandemic hit all nursing homes .
It ’ s a lot @ @ @ @ @ @ @ and how much traffic they had and the neighborhoods that got hit , ” says Tamara Konetzka , a professor of public health at the University of Chicago .
Gaps and inconsistencies in reporting standards across states have also made it hard to reach clear conclusions .
“ There ’ s a lot of uncertainty around the data , ” says Michael Barnett , an assistant professor at Harvard T.H .
Chan School of Public Health in Boston .
Yet two state-level studies in Connecticut and California separately found that facilities employing more @ @ @ @ @ @ @ residents safe .
The findings are consistent with other cross-state studies , which have also found that inadequate nursing staffing , including RNs , was a factor in COVID-19 outbreaks .
The staffing factor in COVID-19 outbreaks is persuasive , says Dr. Barnett .
“ I think the bottom line is that it seems like nursing homes that have worse staffing have more extensive outbreaks.
” It ’ s not the only relevant factor .
In hotspots , even highly regarded homes weren ’ t spared .
But it offers a potentially valuable @ @ @ @ @ @ @ senior nursing expertise , along with personal protective equipment ( PPE ) and testing capacity , could save lives .
Overall nurse staffing at RegalCare at Southport , a for-profit facility , is in line with the industry average in Connecticut .
But it employs relatively few registered nurses .
Payroll data for the first three months of 2020 show that its RNs averaged 20 minutes a day per resident , compared with the state average of 42 minutes .
That RN ratio seemed to be a factor in the disease ’ s @ @ @ @ @ @ @ says Yue Li , a professor of public health sciences at the University of Rochester .
He led a study of state data published in the Journal of the American Geriatrics Society .
“ A higher ratio is really helpful to identify and prevent disease , ” he says .
Professor Li ’ s study modeled the impact of having fewer RNs .
At homes in Connecticut with confirmed cases , a 20-minute increase in RN staffing was associated with 22 % fewer cases .
In homes with at least one death , @ @ @ @ @ @ @ % fewer deaths .
RNs are vital because they are the “ top dogs ” in facilities who oversee direct carers like Ms. Haschak and Ms. Polissaint and manage routine and emergency medical care .
Particularly crucial during this pandemic , they are also typically in charge of infection control and for assessing residents .
“ The reason why [ registered ] nurses are important is that they set a standard , ” says Nicole Howell , executive director of Ombudsman Services of Contra Costa , Solano and Alameda in Northern California , @ @ @ @ @ @ @ residents .
“ It ’ s about leadership.
” RegalCare at Southport has been on a federal watch list since 2018 for a string of deficiencies , including citations for infection control .
Homes on the list that fail to improve care standards can be barred from federal funding .
As of July , RegalCare Southport still hadn ’ t improved , one of 27 such homes nationwide in that category .
( The U.S. has around 15,400 federally regulated nursing homes . )
Ms. Polissaint has worked at the facility for 11 @ @ @ @ @ @ @ she was frustrated at a lack of support for front-line carers from management .
“ We don ’ t have any support .
Communication is very poor , ” she says .
When Ms. Haschak was off sick for a month with COVID-19 , she says her supervisors never called to check on her .
Only Ms. Polissaint called and texted her .
By May , Ms. Polissaint was back on her wing , the designated COVID-19 section of the facility .
She says the emotional strain of losing residents to the disease @ @ @ @ @ @ @ end , as visitors weren ’ t allowed inside nursing homes .
“ The worst part is the families weren ’ t able to come in and see them , ” she says .
They never saw how Ms. Polissaint and her aides cared for them , despite the shortages of masks and gowns and other equipment in the facility .
“ It was a hustle to get a mask , ” she says .
In May this year , RegalCare at Southport was cited by state inspectors twice for COVID-19-related violations : @ @ @ @ @ @ @ protective suits being reused .
On another , staff told inspectors that they couldn ’ t obtain masks , face shields , and other PPE , and a worker said she was given a brown paper bag to use as protection .
In response , Christopher Massaro , the facility ’ s executive administrator , said in a statement : “ Regalcare at Southport has followed and continues to follow all CDC and State of Connecticut Department of Health guidelines for Covid 19 including the myriad of changes and updates they have made @ @ @ @ @ @ @ , Gov .
Ned Lamont ordered an independent inquiry into what had happened in nursing homes and assisted care facilities and whether more could have been done to protect residents from the coronavirus .
By late July , RegalCare had lost 19 residents , out of more than 2,500 deaths in Connecticut nursing homes .
That put it in the middle of the pack on a per-bed basis .
River Glen Health Center in Southbury , Connecticut , is a 45-minute drive from Southport .
It has the same number of beds – @ @ @ @ @ @ @ for-profit regional chain , CareOne .
But it has significantly more RNs per resident , averaging 48 minutes in the first quarter .
When COVID-19 hit Connecticut in March , River Glen supervisors zeroed in on the risk of transmission both from staff and patients discharged from hospitals , says administrator Mary Noonan .
They insisted that residents wear masks while receiving care .
Nurses who worked in other health facilities were assessed for risk ; others who had been on vacation were also monitored .
“ We were trying not to have @ @ @ @ @ @ @ What helped , she says , was low staff turnover and having supervisors who knew them well and could be proactive at a time when testing and PPE were in short supply .
The RNs “ were invaluable .
They knew how to be vigilant .
They knew the procedures , ” says Ms. Noonan .
So far , only three residents and two employees at River Glen have tested positive for COVID-19 .
None have died .
To members of the industry , singling out nurse staffing misses the larger picture .
@ @ @ @ @ @ @ and were blindsided by asymptomatic spread of an unknown virus and then left to fend for themselves as hospitals , not long-term care homes , got priority for PPE and testing .
For example , the Centers for Disease Control and Prevention initially required only nursing home staff who served residents who had tested positive for COVID-19 to wear masks .
It to include all staff .
“ Even the highest quality organizations could not handle this [ pandemic ] because of where they were located and who the populations were in their @ @ @ @ @ @ @ senior vice president at LeadingAge , which represents nonprofit homes .
“ We have fabulous providers in New York that were filled with COVID.
” Some research supports this view .
One study looked at more than 9,000 facilities and found that most outbreaks happened inside homes where the virus was prevalent in the outside community .
The study , published in the Journal of the American Geriatrics Society , found no association with quality ratings or past infection problems .
“ This suggests that COVID-19 is not a ‘ bad apples ’ @ @ @ @ @ @ @ can impact any nursing home in any state , ” the study ’ s leader , David Grabowski of Harvard Medical School , told a U.S. House Ways and Means subcommittee hearing on June 25 .
Yet many carers and experts say that nursing levels – and particularly RN levels – can have an important effect .
While some key variables , like location , were out of nursing homes ’ control , having a “ strong RN , trained in up-to-date protocols ” meant a facility was better prepared to respond , @ @ @ @ @ @ @ Northern California .
“ It matters what you do from there.
” Federal law requires one registered nurse to be present at nursing facilities eight consecutive hours per day , but there are no federal minimum levels for the ratio of RNs per resident .
At least one licensed nurse – Ms. Haschak ’ s position – must be present at all times .
In 2018 , Office of Inspector General for Health and Human Services found that nearly 1,000 nursing homes , or 7 % of those surveyed , had failed to @ @ @ @ @ @ @ than 30 days , mostly on weekends .
“ This raises concerns that some nursing homes may not have fully met their residents ’ needs , ” it wrote .
Decades of research shows that higher nursing staffing improves quality of care and that higher RN staffing in particular is associated with decreased infections and other positive indicators .
Most states mandate a minimum overall staffing ratio .
California sets a minimum of 3.5 hours of nursing care per resident , a standard that 1 in 4 homes failed to meet in 2017 @ @ @ @ @ @ @ found that those where RNs averaged less than 45 minutes a day per resident were twice as likely to have resident COVID-19 infections .
Homes that had no infections had both higher RN and total staffing ratios compared with those that did , according to the study .
Charlene Harrington , who led the study , has spent decades studying how nursing homes are run and staffed , both in the U.S. and other wealthy countries .
Now a professor emeritus at the University of California , San Francisco , she says that @ @ @ @ @ @ @ to the severity of the outbreak in California ’ s nursing homes .
Her study found that some nursing home operators substitute for RNs with nurses with less training as a way to keep down costs .
After recovering , Ms. Haschak went back to work in May .
The nursing home had fewer residents , but her wing was still short-staffed and there wasn ’ t enough PPE .
Her facility wasn ’ t alone : Around 1 in 5 nursing homes nationally reported being short of staff and lacking protective gear @ @ @ @ @ @ @ to federal data .
In June , she was asked by her union to speak at a House Ways and Means hearing on the nursing home crisis .
Ms. Haschak spent days practicing her speech , trying not to break down as she recounted her experience .
Her teenage daughter encouraged her to keep going .
“ You can do it , ” she told her .
On June 25 , she sat on her sofa and spoke via video link to the committee .
“ Thank you for allowing me to share @ @ @ @ @ @ @ , her voice wavering .
“ My name is Melinda Haschak .
I ’ m a nursing home worker from Stamford , Connecticut .
I ’ ve worked in the health care industry for over 20 years.
” She went on to describe the conditions at her facility and what she felt was the lack of support from managers , and how she had to scrounge money to buy thousands of surgical masks for the staff , before she got sick with COVID-19 .
Then she calmly spoke of the continued strain caused @ @ @ @ @ @ @ and not knowing which residents had tested positive .
Nurses have received food donations , she added .
Staff also received extra hazard pay in May and June .
But that ’ s no substitute for decent wages and conditions , she told the committee .
“ My co-workers and I do not need a pizza party , ” she said .
“ We need PPE.
” Staff writers Sarah Matusek and Kelsey Olya Evans contributed to this report .
Editor ’ s note : As a public service , we have removed @ @ @ @ @ @ @

Nurses are grateful for food donations, she said. But “my co-workers and I don’t need a pizza party. We need PPE,” she told the committee.
Melinda Haschak was one of them. A licensed practical nurse, she testified before a House Ways and Means Committee hearing last month about RegalCare’s lack of staffing, shortage of personal protective equipment such as masks, and her perception that management didn’t support front-line employees.
By late July, RegalCare had lost 19 residents. A number of staff members caught the virus themselves.
Nursing home residents constitute a disproportionately large percentage of pandemic deaths. Here we take a look inside to see what might be improved.
For instance, at RegalCare at Southport, a for-profit 120-bed facility in Connecticut, payroll data indicates that registered nurses provide less than half the state average of resident coverage. It’s been on a federal watch list for two years for a list of deficiencies, including poor infection control.
Nursing home residents have accounted for some 40% of all COVID-19 deaths in the United States. To some experts, this tragic toll was simply the result of location: in hotspots such as New York City. Even well-run, highly rated, long-term care facilities were hit hard. But other analyses point to a particular problem area: understaffed homes run for profit did worse at keeping their residents safe from the coronavirus. Two peer-reviewed studies of nursing homes in Connecticut and California separately found that low nurse-to-patient ratios, particularly of registered nurses, were associated with larger and deadlier COVID-19 outbreaks.
As Melinda Haschak responded to the Code Blue that blared through the intercom, she was missing a crucial piece of information.
The resident she was rushing to save had tested positive for the coronavirus.
Ms. Haschak knew that some of the residents in the Connecticut nursing home where she works as a licensed nurse had tested positive. But the fellow nurse who could have helped her most – who had begun to piece together the larger picture, who knew the resident in distress had tested positive, and whose concerns had been dismissed by management – was at home, recovering from the coronavirus herself.
Why We Wrote This Nursing home residents constitute a disproportionately large percentage of pandemic deaths. Here we take a look inside to see what might be improved.
Before falling ill, Kennethe Polissaint had noticed that the first resident who tested positive and died in the hospital had never left the facility – meaning the nursing home staff itself was unwittingly spreading the virus and should be tested. Yet when she told the assistant director of nursing, a registered nurse, “they didn’t do anything about it,” Ms. Polissaint says.
Ms. Haschak was not able to save the Code Blue resident, who never regained consciousness.
And afterward, the senior nurses who oversee infection control didn’t send her home to isolate. Instead, she went back to her wing, which was supposed to be COVID-19-free.
Two weeks later, Ms. Haschak fell ill with COVID-19.
The pattern that played out in RegalCare at Southport has been mirrored at thousands of nursing facilities across the United States. More than 41% of the 186,000 Americans who have died of COVID-19 in the 47 states that reported data have been in nursing homes and assisted living centers, according to Kaiser Health News.
SOURCE: Kaiser Family Foundation | Karen Norris/Staff
The question is whether nursing homes could have done better – and can do better going forward.
To some experts, there was probably little care facilities could have done. “This pandemic hit all nursing homes. It’s a lot more about where they’re located and how much traffic they had and the neighborhoods that got hit,” says Tamara Konetzka, a professor of public health at the University of Chicago.
Gaps and inconsistencies in reporting standards across states have also made it hard to reach clear conclusions. “There’s a lot of uncertainty around the data,” says Michael Barnett, an assistant professor at Harvard T.H. Chan School of Public Health in Boston.
Yet two state-level studies in Connecticut and California separately found that facilities employing more registered nurses did better at keeping their residents safe. The findings are consistent with other cross-state studies, which have also found that inadequate nursing staffing, including RNs, was a factor in COVID-19 outbreaks.
The staffing factor in COVID-19 outbreaks is persuasive, says Dr. Barnett. “I think the bottom line is that it seems like nursing homes that have worse staffing have more extensive outbreaks.”
It’s not the only relevant factor. In hotspots, even highly regarded homes weren’t spared. But it offers a potentially valuable confirmation of the idea that investing in senior nursing expertise, along with personal protective equipment (PPE) and testing capacity, could save lives.
Importance of registered nurses
Overall nurse staffing at RegalCare at Southport, a for-profit facility, is in line with the industry average in Connecticut. But it employs relatively few registered nurses. Payroll data for the first three months of 2020 show that its RNs averaged 20 minutes a day per resident, compared with the state average of 42 minutes.
That RN ratio seemed to be a factor in the disease’s spread in nursing homes in Connecticut, says Yue Li, a professor of public health sciences at the University of Rochester. He led a study of state data published in the Journal of the American Geriatrics Society. “A higher ratio is really helpful to identify and prevent disease,” he says.
Ann Hermes/Staff View caption Hide caption Melinda Haschak, a licensed practical nurse, shows off her stethoscope "charms" including one from a current patient, near her home on July 20, 2020, in Stamford, Connecticut.
Professor Li’s study modeled the impact of having fewer RNs. At homes in Connecticut with confirmed cases, a 20-minute increase in RN staffing was associated with 22% fewer cases. In homes with at least one death, a 20-minute increase was associated with 26% fewer deaths.
RNs are vital because they are the “top dogs” in facilities who oversee direct carers like Ms. Haschak and Ms. Polissaint and manage routine and emergency medical care. Particularly crucial during this pandemic, they are also typically in charge of infection control and for assessing residents.
“The reason why [registered] nurses are important is that they set a standard,” says Nicole Howell, executive director of Ombudsman Services of Contra Costa, Solano and Alameda in Northern California, which represents the interests of care home residents. “It’s about leadership.”
Inside one nursing home
RegalCare at Southport has been on a federal watch list since 2018 for a string of deficiencies, including citations for infection control. Homes on the list that fail to improve care standards can be barred from federal funding. As of July, RegalCare Southport still hadn’t improved, one of 27 such homes nationwide in that category. (The U.S. has around 15,400 federally regulated nursing homes.)
Ms. Polissaint has worked at the facility for 11 years. Even before the pandemic, she was frustrated at a lack of support for front-line carers from management. “We don’t have any support. Communication is very poor,” she says.
When Ms. Haschak was off sick for a month with COVID-19, she says her supervisors never called to check on her. Only Ms. Polissaint called and texted her.
By May, Ms. Polissaint was back on her wing, the designated COVID-19 section of the facility. She says the emotional strain of losing residents to the disease was compounded by their near-isolation at the end, as visitors weren’t allowed inside nursing homes.
“The worst part is the families weren’t able to come in and see them,” she says. They never saw how Ms. Polissaint and her aides cared for them, despite the shortages of masks and gowns and other equipment in the facility. “It was a hustle to get a mask,” she says.
Ann Hermes/Staff View caption Hide caption A sign supporting essential workers sits near the entrance of RegalCare, a nursing home that has been dealing with COVID-19 cases, on July 21, 2020 in Southport, Connecticut.
In May this year, RegalCare at Southport was cited by state inspectors twice for COVID-19-related violations: On one visit, they found single-use protective suits being reused. On another, staff told inspectors that they couldn’t obtain masks, face shields, and other PPE, and a worker said she was given a brown paper bag to use as protection.
In response, Christopher Massaro, the facility’s executive administrator, said in a statement: “Regalcare at Southport has followed and continues to follow all CDC and State of Connecticut Department of Health guidelines for Covid 19 including the myriad of changes and updates they have made throughout this pandemic.”
On June 8, Gov. Ned Lamont ordered an independent inquiry into what had happened in nursing homes and assisted care facilities and whether more could have been done to protect residents from the coronavirus.
By late July, RegalCare had lost 19 residents, out of more than 2,500 deaths in Connecticut nursing homes. That put it in the middle of the pack on a per-bed basis.
A different experience
River Glen Health Center in Southbury, Connecticut, is a 45-minute drive from Southport. It has the same number of beds – 120 – and is part of a for-profit regional chain, CareOne. But it has significantly more RNs per resident, averaging 48 minutes in the first quarter.
When COVID-19 hit Connecticut in March, River Glen supervisors zeroed in on the risk of transmission both from staff and patients discharged from hospitals, says administrator Mary Noonan. They insisted that residents wear masks while receiving care. Nurses who worked in other health facilities were assessed for risk; others who had been on vacation were also monitored.
“We were trying not to have any contamination,” she says.
What helped, she says, was low staff turnover and having supervisors who knew them well and could be proactive at a time when testing and PPE were in short supply. The RNs “were invaluable. They knew how to be vigilant. They knew the procedures,” says Ms. Noonan.
So far, only three residents and two employees at River Glen have tested positive for COVID-19. None have died.
Not just a “bad apples” problem
To members of the industry, singling out nurse staffing misses the larger picture. They argue that operators followed federal guidelines and were blindsided by asymptomatic spread of an unknown virus and then left to fend for themselves as hospitals, not long-term care homes, got priority for PPE and testing.
For example, the Centers for Disease Control and Prevention initially required only nursing home staff who served residents who had tested positive for COVID-19 to wear masks. It changed its guidance on April 2 to include all staff.
“Even the highest quality organizations could not handle this [pandemic] because of where they were located and who the populations were in their building,” says Robyn Stone, senior vice president at LeadingAge, which represents nonprofit homes. “We have fabulous providers in New York that were filled with COVID.”
Some research supports this view. One study looked at more than 9,000 facilities and found that most outbreaks happened inside homes where the virus was prevalent in the outside community. The study, published in the Journal of the American Geriatrics Society, found no association with quality ratings or past infection problems.
“This suggests that COVID-19 is not a ‘bad apples’ problem, but a system-wide problem that can impact any nursing home in any state,” the study’s leader, David Grabowski of Harvard Medical School, told a U.S. House Ways and Means subcommittee hearing on June 25.
The effects of nursing levels
Yet many carers and experts say that nursing levels – and particularly RN levels – can have an important effect. While some key variables, like location, were out of nursing homes’ control, having a “strong RN, trained in up-to-date protocols” meant a facility was better prepared to respond, says Ms. Howell, the ombudsman in Northern California. “It matters what you do from there.”
Federal law requires one registered nurse to be present at nursing facilities eight consecutive hours per day, but there are no federal minimum levels for the ratio of RNs per resident. At least one licensed nurse – Ms. Haschak’s position – must be present at all times.
In 2018, Office of Inspector General for Health and Human Services found that nearly 1,000 nursing homes, or 7% of those surveyed, had failed to meet federal minimum staffing requirements for more than 30 days, mostly on weekends. “This raises concerns that some nursing homes may not have fully met their residents’ needs,” it wrote.
Ann Hermes/Staff View caption Hide caption Melinda Haschak, a licensed practical nurse, demonstrates the use of a set of 60 headbands, made and donated by a friend of her family to protect the ears of essential workers wearing masks, near her home on July 20, 2020, in Stamford, Connecticut. Ms. Haschak contracted COVID-19 while working her job at RegalCare, a nursing home in Southport, Connecticut.
Decades of research shows that higher nursing staffing improves quality of care and that higher RN staffing in particular is associated with decreased infections and other positive indicators. Most states mandate a minimum overall staffing ratio. California sets a minimum of 3.5 hours of nursing care per resident, a standard that 1 in 4 homes failed to meet in 2017.
A recent study of California facilities found that those where RNs averaged less than 45 minutes a day per resident were twice as likely to have resident COVID-19 infections. Homes that had no infections had both higher RN and total staffing ratios compared with those that did, according to the study.
Charlene Harrington, who led the study, has spent decades studying how nursing homes are run and staffed, both in the U.S. and other wealthy countries. Now a professor emeritus at the University of California, San Francisco, she says that quality of care and inadequate staffing contributed to the severity of the outbreak in California’s nursing homes. Her study found that some nursing home operators substitute for RNs with nurses with less training as a way to keep down costs.
More than a pizza party
After recovering, Ms. Haschak went back to work in May. The nursing home had fewer residents, but her wing was still short-staffed and there wasn’t enough PPE.
Her facility wasn’t alone: Around 1 in 5 nursing homes nationally reported being short of staff and lacking protective gear like N95 masks in May, according to federal data.
In June, she was asked by her union to speak at a House Ways and Means hearing on the nursing home crisis. Ms. Haschak spent days practicing her speech, trying not to break down as she recounted her experience. Her teenage daughter encouraged her to keep going. “You can do it,” she told her.
On June 25, she sat on her sofa and spoke via video link to the committee.
“Thank you for allowing me to share my story today,” she began, her voice wavering. “My name is Melinda Haschak. I’m a nursing home worker from Stamford, Connecticut. I’ve worked in the health care industry for over 20 years.”
She went on to describe the conditions at her facility and what she felt was the lack of support from managers, and how she had to scrounge money to buy thousands of surgical masks for the staff, before she got sick with COVID-19. Then she calmly spoke of the continued strain caused by understaffing and shortages of PPE, and not knowing which residents had tested positive.
Nurses have received food donations, she added. Staff also received extra hazard pay in May and June. But that’s no substitute for decent wages and conditions, she told the committee.
“My co-workers and I do not need a pizza party,” she said. “We need PPE.”
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Staff writers Sarah Matusek and Kelsey Olya Evans contributed to this report.
Editor’s note: As a public service, we have removed our paywall for all pandemic-related stories.


csmonitor--2020-09-17--Bolivia cancels school year. Parents ask: What now?

“ The pandemic lifted a veil on the historic disparities that still exist in Bolivia , ” says Lina Beltrán , chief of education for UNICEF Bolivia .
She notes that the longer students are out of school , the more likely they are to drop out entirely .
“ The learning losses also threaten to extend beyond this generation and erase decades of progress , ” she adds .
Only about 25 % of the country ’ s households have broadband internet , and continuing digital classes was unrealistic , the government argued .
The rest of the school @ @ @ @ @ @ @ , was canceled , though public school teachers still receive their salary , and many continue trying to reach out to students .
There are targeted efforts to reach children in secluded Indigenous communities , and nonprofit groups are attempting to bridge the education gap with lessons , too .
But many parents and observers are concerned about long-term effects .
Bolivia has been through the wringer over the past year , from contested elections and the flight of its ex-president to the arrival of COVID-19 and the challenges of online learning .
@ @ @ @ @ @ @ are facing a new dilemma : no school , at all .
Full stop .
Four kids .
One cellphone .
No internet .
That was the distance-learning setup for José Luis Torrez ’ s family in Tilata , Bolivia , a town on the outskirts of La Paz , at the start of the pandemic .
“ We were blowing through our savings ” to buy phone credit , says Mr. Torrez , who runs a mechanic ’ s garage .
But in early August , not long after a neighbor helped @ @ @ @ @ @ @ , Bolivia ’ s department of education canceled the rest of the school year .
Ever since schooling moved online last spring , just a month after classes started in the Southern Hemisphere , millions of Bolivians without access to the internet or electronic devices struggled to keep their children learning and engaged .
The government argued that continuing digital classes through November , typically the end of the school year , was simply unrealistic – pointing to disagreements with the teachers union , its inability to provide universal education online , and @ @ @ @ @ @ @ “ Just like any parent , our dream is for the kids to achieve more and go further than their parents , ” says Mr. Torrez , whose children range from 4 to 12 years old .
“ I always hoped they ’ d become professionals.
” “ After this , ” he says with a sad laugh , “ Bolivia ’ s best hope may be for a generation of mediocre professionals.
” Bolivia has been through the wringer over the past year : From a contested presidential election , nationwide political @ @ @ @ @ @ @ leftist ex-president , to a right-wing caretaker government that has postponed new elections , and the arrival of COVID-19 .
The political unrest and presidential elections promised for next month have created an additional layer of uncertainty .
Although nongovernmental organizations , individual teachers , international organizations , and even the Ministry of Education are trying to bridge the schooling gap , many observers and parents are concerned about the well-being of Bolivia ’ s children – and the future of the nation .
“ Imagine the implications of having six months without @ @ @ @ @ @ @ Gustavo Sever , the director of a private school in Cochabamba .
“ Not having the continuity of formal education – whether virtual or not – is huge .
You create a discrepancy and create gaps between the world and the students in this country , ” he says .
As a private school , Mr.
Sever ’ s institution is still offering online courses , though nearly 60 % of parents withdrew their children , in many cases due to economic hardship , once the academic year became optional .
The government @ @ @ @ @ @ @ the next academic year , regardless of grades or attendance .
“ It ’ s a child ’ s right to access education and it ’ s the responsibility of the state to provide that , ” Mr .
Sever says .
Only about 25 % of Bolivian households had broadband internet in 2016 , well below the Latin American average of 45 % , according to the Economic Commission for Latin America and the Caribbean .
A 2018 report by Bolivia ’ s Agency for Electronic Government and Information and Communication Technologies @ @ @ @ @ @ @ access to a computer and 10 % have fixed internet .
In rural areas the numbers are ever more extreme : 19 % and 3 % , respectively .
“ The vast majority of rural areas don ’ t have internet , ” Yerko Núñez , a government minister , said in August when clarifying the decision to end the school year early .
“ There ’ s no other option than to close out the year.
” The Ministry of Education did not respond to written request for comment .
“ The @ @ @ @ @ @ @ disparities that still exist in Bolivia , ” says Lina Beltrán , chief of education for UNICEF Bolivia .
“ When education systems collapse , [ peaceful ] , prosperous and productive societies are undermined , ” Ms. Beltrán writes in an email .
“ The learning losses also threaten to extend beyond this generation and erase decades of progress , not least in support of girls and young women ’ s educational access and retention.
” She notes that the longer students are out of school , the more likely they are @ @ @ @ @ @ @ the closures could decrease affected students ’ future earnings by 8 % to 10 % .
Plenty of Latin American countries struggle with internet access .
But Bolivia is the only one to use it as a reason to halt education entirely .
Mexico deployed pre-recorded , televised classes featuring trained actors and teachers to reach its estimated 30 million public school students .
It ’ s not a perfect model for learning , says Gabriel Sánchez Zinny , an expert on Latin American education .
But it ’ s a success in @ @ @ @ @ @ @ the most vulnerable .
“ TV may not be the best , but it ’ s certainly better than nothing , ” says Mr. Zinny , the former education minister for the province of Buenos Aires .
“ Governments aren ’ t making enough of an effort to create opportunities and share knowledge ” during the pandemic .
Peru , Chile , Colombia , and Brazil have incorporated some televised education into their distance learning approaches , as well .
The Dominican Republic has expanded free access to internet hotspots across the country @ @ @ @ @ @ @ to offer internet plans at special prices .
In Buenos Aires , government institutions already delivering meals to vulnerable children are also printing out school materials for students without access to computers or printers .
“ Kids are desperate to do work ” In Bolivia , public school teachers are still receiving their salaries , and many are still making an effort to send students materials , parents say .
Some educators put on superhero costumes to try and keep their students motivated online , while others travel house to house to try @ @ @ @ @ @ @ in .
There are targeted efforts to reach children in secluded Indigenous communities , like radio education programs that UNICEF estimates reach more than 6,000 children .
The United Nations organization also teamed up with cellphone provider Tigo Bolivia to provide teacher trainings for online instruction , counseling for students , and other resources for not just learning but staying healthy during the pandemic .
For Alicia Layme , the pandemic has been a blur of stress .
Her husband , a construction worker , lost his job .
Her family , complete @ @ @ @ @ @ @ and 10-year-old , have been forced to move twice due to evictions over late rent payments .
“ We don ’ t know what to do .
We can ’ t cry anymore , ” Ms. Layme says .
“ These schools don ’ t recognize the realities for so many of us.
” Many students didn ’ t have a chance to buy their books for the academic year before Bolivia mandated a quarantine .
She doesn ’ t have a smartphone , and before classes were called off , her kids @ @ @ @ @ @ @ ’ t receive photos of assignments and print them out .
Her kids told her she ’ s not their teacher when she tried to help them through tough homework .
But Ms. Layme says her family is fortunate in some respects .
A local initiative run by the international NGO Bolivia Kids and the local Sariry Foundation delivers food and psychological support to communities surrounding La Paz .
Roughly 30 families , or 70 kids , have weekly visits from three foundation staff who give informal lessons on the street in front @ @ @ @ @ @ @ are desperate to do work , ” says Elisa Aguilar , director of programs and community development for Bolivia Kids .
On top of connectivity challenges , many parents don ’ t have enough education themselves to help their children with schoolwork .
Staff members walk from house to house – there ’ s no public transportation running in the area – delivering printouts or giving lessons .
“ I think we ’ re going to see a lot of kids dropping out of school next year – nationwide , ” Ms. Aguilar @ @ @ @ @ @ @ to help in the ways we can , but at a certain point , we all feel powerless.
” “ Parents are told we have to make sacrifices for our kids , ” she says .
“ What does that even mean at this point ?
Am I supposed to steal phone credit so that my child can keep learning ?
” Ms. Layme says the distance education situation was bad , `` but there are alternatives to closing schools or doing it online .
”

Remote learning has proved patchy at best for many families around the world. But what happens when you simply cancel the school year altogether? Bolivia’s about to find out.
“The pandemic lifted a veil on the historic disparities that still exist in Bolivia,” says Lina Beltrán, chief of education for UNICEF Bolivia. She notes that the longer students are out of school, the more likely they are to drop out entirely. “The learning losses also threaten to extend beyond this generation and erase decades of progress,” she adds.
Only about 25% of the country’s households have broadband internet, and continuing digital classes was unrealistic, the government argued. The rest of the school year, which typically ends in November, was canceled, though public school teachers still receive their salary, and many continue trying to reach out to students. There are targeted efforts to reach children in secluded Indigenous communities, and nonprofit groups are attempting to bridge the education gap with lessons, too. But many parents and observers are concerned about long-term effects.
Bolivia has been through the wringer over the past year, from contested elections and the flight of its ex-president to the arrival of COVID-19 and the challenges of online learning. But since early August, Bolivian parents are facing a new dilemma: no school, at all. Full stop.
Four kids. One cellphone. No internet.
That was the distance-learning setup for José Luis Torrez’s family in Tilata, Bolivia, a town on the outskirts of La Paz, at the start of the pandemic. “We were blowing through our savings” to buy phone credit, says Mr. Torrez, who runs a mechanic’s garage. But in early August, not long after a neighbor helped Mr. Torrez set up a Wi-Fi connection, Bolivia’s department of education canceled the rest of the school year.
Ever since schooling moved online last spring, just a month after classes started in the Southern Hemisphere, millions of Bolivians without access to the internet or electronic devices struggled to keep their children learning and engaged. The government argued that continuing digital classes through November, typically the end of the school year, was simply unrealistic – pointing to disagreements with the teachers union, its inability to provide universal education online, and the public-health danger of in-person classes.
Why We Wrote This Remote learning has proved patchy at best for many families around the world. But what happens when you simply cancel the school year altogether? Bolivia’s about to find out.
“Just like any parent, our dream is for the kids to achieve more and go further than their parents,” says Mr. Torrez, whose children range from 4 to 12 years old. “I always hoped they’d become professionals.”
“After this,” he says with a sad laugh, “Bolivia’s best hope may be for a generation of mediocre professionals.”
Bolivia has been through the wringer over the past year: From a contested presidential election, nationwide political protests, and the flight of its leftist ex-president, to a right-wing caretaker government that has postponed new elections, and the arrival of COVID-19. The political unrest and presidential elections promised for next month have created an additional layer of uncertainty. Although nongovernmental organizations, individual teachers, international organizations, and even the Ministry of Education are trying to bridge the schooling gap, many observers and parents are concerned about the well-being of Bolivia’s children – and the future of the nation.
“Imagine the implications of having six months without any type of instruction,” says Gustavo Sever, the director of a private school in Cochabamba. “Not having the continuity of formal education – whether virtual or not – is huge. You create a discrepancy and create gaps between the world and the students in this country,” he says. As a private school, Mr. Sever’s institution is still offering online courses, though nearly 60% of parents withdrew their children, in many cases due to economic hardship, once the academic year became optional.
The government says all students will be promoted to the next academic year, regardless of grades or attendance.
“It’s a child’s right to access education and it’s the responsibility of the state to provide that,” Mr. Sever says.
Continental challenge
Only about 25% of Bolivian households had broadband internet in 2016, well below the Latin American average of 45%, according to the Economic Commission for Latin America and the Caribbean. A 2018 report by Bolivia’s Agency for Electronic Government and Information and Communication Technologies found only 42% of Bolivians have access to a computer and 10% have fixed internet. In rural areas the numbers are ever more extreme: 19% and 3%, respectively.
“The vast majority of rural areas don’t have internet,” Yerko Núñez, a government minister, said in August when clarifying the decision to end the school year early. “There’s no other option than to close out the year.”
The Ministry of Education did not respond to written request for comment.
“The pandemic lifted a veil on the historic disparities that still exist in Bolivia,” says Lina Beltrán, chief of education for UNICEF Bolivia.
“When education systems collapse, [peaceful], prosperous and productive societies are undermined,” Ms. Beltrán writes in an email. “The learning losses also threaten to extend beyond this generation and erase decades of progress, not least in support of girls and young women’s educational access and retention.” She notes that the longer students are out of school, the more likely they are to drop out entirely, and estimates the closures could decrease affected students’ future earnings by 8% to 10%.
Plenty of Latin American countries struggle with internet access. But Bolivia is the only one to use it as a reason to halt education entirely.
Mexico deployed pre-recorded, televised classes featuring trained actors and teachers to reach its estimated 30 million public school students. It’s not a perfect model for learning, says Gabriel Sánchez Zinny, an expert on Latin American education. But it’s a success in terms of the government trying to reach the most vulnerable.
“TV may not be the best, but it’s certainly better than nothing,” says Mr. Zinny, the former education minister for the province of Buenos Aires. “Governments aren’t making enough of an effort to create opportunities and share knowledge” during the pandemic.
Peru, Chile, Colombia, and Brazil have incorporated some televised education into their distance learning approaches, as well. The Dominican Republic has expanded free access to internet hotspots across the country and teamed up with a cellphone company to offer internet plans at special prices. In Buenos Aires, government institutions already delivering meals to vulnerable children are also printing out school materials for students without access to computers or printers.
“Kids are desperate to do work”
In Bolivia, public school teachers are still receiving their salaries, and many are still making an effort to send students materials, parents say. Some educators put on superhero costumes to try and keep their students motivated online, while others travel house to house to try to keep their most isolated students looped in. There are targeted efforts to reach children in secluded Indigenous communities, like radio education programs that UNICEF estimates reach more than 6,000 children. The United Nations organization also teamed up with cellphone provider Tigo Bolivia to provide teacher trainings for online instruction, counseling for students, and other resources for not just learning but staying healthy during the pandemic.
For Alicia Layme, the pandemic has been a blur of stress. Her husband, a construction worker, lost his job. Her family, complete with an 8-month-old baby, 8-year-old, and 10-year-old, have been forced to move twice due to evictions over late rent payments.
“We don’t know what to do. We can’t cry anymore,” Ms. Layme says. “These schools don’t recognize the realities for so many of us.” Many students didn’t have a chance to buy their books for the academic year before Bolivia mandated a quarantine. She doesn’t have a smartphone, and before classes were called off, her kids’ teachers were frustrated that she couldn’t receive photos of assignments and print them out. Her kids told her she’s not their teacher when she tried to help them through tough homework.
But Ms. Layme says her family is fortunate in some respects. A local initiative run by the international NGO Bolivia Kids and the local Sariry Foundation delivers food and psychological support to communities surrounding La Paz. Roughly 30 families, or 70 kids, have weekly visits from three foundation staff who give informal lessons on the street in front of participants’ homes.
“Kids are desperate to do work,” says Elisa Aguilar, director of programs and community development for Bolivia Kids. On top of connectivity challenges, many parents don’t have enough education themselves to help their children with schoolwork. Staff members walk from house to house – there’s no public transportation running in the area – delivering printouts or giving lessons.
“I think we’re going to see a lot of kids dropping out of school next year – nationwide,” Ms. Aguilar says. “We’re trying to help in the ways we can, but at a certain point, we all feel powerless.”
Ms. Layme can relate.
“Parents are told we have to make sacrifices for our kids,” she says. “What does that even mean at this point? Am I supposed to steal phone credit so that my child can keep learning?”
Get stories that
empower and uplift daily. By signing up, you agree to our Privacy Policy Already a subscriber? Log in to hide ads.
Ms. Layme says the distance education situation was bad, "but there are alternatives to closing schools or doing it online.”
“The government just needed to try.”


csmonitor--2020-09-17--‘Living with fire’: Can West learn to coexist with longtime adversary?

As Ms. Quinn-Davidson told me , “ If we ’ re not protecting the resources we care about and we ’ re not taking action , then we will continue to lose them to big fires.
” A few weeks ago , I spoke with Lenya Quinn-Davidson , director of the Northern California Prescribed Fire Council , who suggested that federal and state officials steer more resources to land management and fire prevention .
The fallout illustrates the urgency for states to rethink approaches to fire suppression and prevention .
Reaching a detente with wildfire will depend on various parties @ @ @ @ @ @ @ loggers and foresters , elected officials and community residents – leaving their ideological bunkers to embrace collective strategies for managing fires and forests .
The West ’ s forever war has wrought a summer of catastrophe .
Thick layers of smoke and ash have coated the region ’ s skies for weeks as tens of thousands of firefighters battle hundreds of wildfires from California ’ s border with Mexico to Washington ’ s border with Canada .
The infernos have scorched more than 5 million acres and killed at least 36 people .
@ @ @ @ @ @ @ starting in 2011 , when U.S. troop levels had peaked at 100,000 .
Since 2018 , I ’ ve covered wildfires in the West , where each summer the ranks of firefighters swell as volunteers from other states and countries rush to aid their brothers and sisters on the fiery front lines .
Throwing more bodies at the adversary has yielded as little progress here as there .
American military leaders in Afghanistan first conceded a decade ago that the United States couldn ’ t kill its way out of an insurgency .
@ @ @ @ @ @ @ that next month will pass the 19-year mark , the Taliban ’ s strength and stubbornness had forced the generals to accept that ending the bloodshed would require compromise .
Earlier this year , American and Taliban officials signed a conditional peace accord , the first phase in a two-stage process to broker a permanent cease-fire .
The second began last weekend as Afghan government and Taliban leaders convened in Qatar for negotiations that for years the Taliban vowed they would never consider .
The war has fractured the country ’ s public @ @ @ @ @ @ @ tens of thousands of lives , including Afghan civilians and military personnel , Taliban fighters , and more than 2,400 U.S. troops .
Given the toll , any agreement that emerges from the ongoing talks will be imperfect , neither redressing all grievances nor fulfilling every demand of the parties involved .
For conciliation to succeed , both sides must offer concessions and search for mutual understanding , realizing that a refusal to give ground will ensure a future as violent and tragic as the recent past .
They will need to cultivate @ @ @ @ @ @ @ .
Several thousand miles away , the same painful lessons and the same hard truths apply to another long , costly , and intractable conflict : the war on wildfire in the American West .
The region has sought to kill its way out of fire for more than a century , attempting to extinguish flames as soon as they ignite to protect communities , homeowners , and natural lands .
The policy of suppression , if well-intentioned , has led to overgrown forests and grasslands that , combined with climate change , @ @ @ @ @ @ @ , and hotter , inflicting ever more destruction and despair .
The West ’ s own forever war has wrought a summer of catastrophe .
Thick layers of smoke and ash have coated the region ’ s skies for weeks as tens of thousands of firefighters battle hundreds of wildfires from California ’ s border with Mexico to Washington ’ s border with Canada .
The infernos have scorched more than 5 million acres and killed at least 36 people since early August , ravaging entire towns and displacing hundreds of thousands of @ @ @ @ @ @ @ for states to rethink approaches to fire suppression and prevention .
Reaching a detente with wildfire will depend on various parties – firefighting agencies and environmental groups , loggers and foresters , elected officials and community residents – leaving their ideological bunkers to embrace collective strategies for managing fires and forests .
As with the Afghanistan peace talks , any potential resolution will fail to satisfy everyone .
But resisting compromise in the war on wildfire will bring only more devastation , more summers of catastrophe .
Adapting to the era of megafires @ @ @ @ @ @ @ starting in 2011 , when U.S. troop levels had peaked at 100,000 .
Since 2018 , I ’ ve covered wildfires in the West , where each summer the ranks of firefighters swell as volunteers from other states and countries rush to aid their brothers and sisters on the fiery front lines .
Throwing more bodies at the adversary has yielded as little progress here as there .
The era of megafires has dawned in the West during the past decade as temperatures rise .
In California , an extended drought and a @ @ @ @ @ @ @ , providing a vast stockpile of wildfire fuel .
Some 3.3 million acres have burned already this year , and the state appears certain to double its record of 1.85 million acres set in 2018 .
The state ’ s primary firefighting agency , known as Cal Fire , employs 9,700 full-time and seasonal firefighters and operates a fleet of 52 aircraft .
In fiscal year 2018-19 , the agency spent $ 635 million on extinguishing wildfires – another figure that could double in this ruinous fire season .
The state ’ s @ @ @ @ @ @ @ part , from a reluctance to manage land through prescribed burns , tree thinning , brush clearing , and other “ treatments ” that reduce wildfire fuels and fire risk .
Cal Fire treats 20,000 to 50,000 acres a year and dedicates 150 personnel to the task .
A few weeks ago , I spoke with Lenya Quinn-Davidson , director of the Northern California Prescribed Fire Council , who suggested that federal and state officials steer more resources to land management and fire prevention .
The move would push firefighting agencies in the @ @ @ @ @ @ @ devoted to fuel-reduction operations , a shift that could ease dependency on fire suppression over time .
A new initiative in California holds promise in that regard .
Democratic Gov .
Gavin Newsom last month announced an agreement between the state and the U.S. Forest Service to treat 1 million acres of wildlands a year by 2025 .
At the same time , the pact reveals the long road ahead to reduce overgrowth in California ’ s forests and grasslands .
One recent analysis by Stanford researchers estimated that the state would need @ @ @ @ @ @ @ one-fifth of California ’ s land area – to restore balance to its forests and lower the risk of cataclysmic wildfires .
The sobering numbers offer ample reason to nurture fire prevention efforts beyond those of state and federal land managers .
The futility of fire suppression has renewed interest in the cultural burning practices of Native American tribes in Northern California and elsewhere .
A similar reawakening has occurred in Australia , as I learned earlier this year while reporting on bushfires that destroyed a staggering 46 million acres .
Ms. Quinn-Davidson @ @ @ @ @ @ @ and farmers to conduct prescribed burns that can forestall wildfires from exploding into developed areas .
“ We need public agencies , communities , Native American tribes , private landowners – everybody has to be involved , ” she told me .
“ We really need to aspire to get to that place where there isn ’ t this division between experts and the public , where we ’ re all kind of one fire-adapted culture.
” California could further pursue more state-federal alliances for sustainable forestry in the mold of the Tahoe-Central @ @ @ @ @ @ @ and timber industry groups , formed in 2017 , has set out to restore 2.4 million acres of federal forestland in the Sierra Nevada through prescribed burns , thinning , and limited logging .
As one scientist involved with the project explained to me last year , “ We have to make a cultural shift away from both the Smokey Bear days of putting every fire out and from the anti-logging days of saying the removal of any tree is bad .
That ’ s giving us bigger and bigger fires.
” Wildfires @ @ @ @ @ @ @ and puncture the West ’ s mythos of rugged individualism .
The infernos roaring through communities in California , Oregon , and Washington expose our shared vulnerability as we turn to emergency officials , aid workers , and public agencies for relief .
The communal hardship , in turn , reveals the cost of our aversion to fire prevention methods – more prescribed burning , restricted wildland development , stronger building codes – that can reduce our wildfire risk .
“ Our ” is the key word .
Nobody living in the West @ @ @ @ @ @ @ direct or indirect impact of megafires .
In that light , each of us owns a stake in improving fire prevention because “ we all end up paying for the destruction , ” Max Moritz told me in 2018 , the previous “ worst-ever ” year for fires in the Golden State .
A wildfire expert with the University of California , Santa Barbara , Mr. Moritz added , “ We also publicly fund all the fire suppression , the fire agencies , the disaster support systems .
So there ’ s a @ @ @ @ @ @ @ more science-based approach to land management that could reduce the amount of damage.
” Fire researchers estimate that at least 4.4 million acres burned each year in California before 1800 .
Between 1950 and 1999 , as a result of the state ’ s unrelenting fire suppression , the annual average plummeted to 250,000 acres .
The collision of dense forests with climate change has ignited a crisis two decades later that requires us to accept the responsibility we bear for our universal plight .
The Stanford study found that opposition from local @ @ @ @ @ @ @ along with liability concerns if a fire escapes its handlers – deters public and private land managers from the practice .
But as a Cal Fire official pointed out to me last year , if we allow more prescribed burning , fire crews can create more fuel breaks – areas cleared of most smaller trees and shrubs – that slow or stop a wildfire ’ s advance .
The tactic can prevent wildfires from erupting into megafires and , over time , resuscitate forest health as mature trees regain the space they need @ @ @ @ @ @ @ when we weigh the destruction of this year ’ s infernos against the strictly monitored loss of habitat that occurs with prescribed fire , we might want to reconsider complaining about , say , smoke from a controlled burn .
Or as Ms. Quinn-Davidson told me , “ If we ’ re not protecting the resources we care about and we ’ re not taking action , then we will continue to lose them to big fires.
” Our fondness for building homes in wildlands deserves similar reevaluation .
Eleven million people live @ @ @ @ @ @ @ , and from 2000 to 2013 , three-quarters of the homes destroyed by wildfire fell within those zones .
The state could take a cue from Washington , where five years ago , two communities 40 miles apart pooled resources to forge a joint land-use plan that restricts growth in wildlands to reduce the threat from wildfires .
Another example of enlightened planning has taken root in Paradise , a Northern California town of 27,000 people nestled among towering pines in the Sierra Nevada foothills .
Two years after the deadliest and most @ @ @ @ @ @ @ history leveled the city , local officials are creating a buffer zone on its outskirts , acquiring vacant property that will remain undeveloped to serve as a massive fuel break .
The strategies illuminate what wildfire researchers describe as “ living with fire , ” an ethos that parallels the realization of U.S. military leaders in Afghanistan a decade ago .
Here as there , brute force has shown its limits , and after long years of war , the time has come for compromise .
For peace .

As Ms. Quinn-Davidson told me, “If we’re not protecting the resources we care about and we’re not taking action, then we will continue to lose them to big fires.”
A few weeks ago, I spoke with Lenya Quinn-Davidson, director of the Northern California Prescribed Fire Council, who suggested that federal and state officials steer more resources to land management and fire prevention.
The fallout illustrates the urgency for states to rethink approaches to fire suppression and prevention. Reaching a detente with wildfire will depend on various parties – firefighting agencies and environmental groups, loggers and foresters, elected officials and community residents – leaving their ideological bunkers to embrace collective strategies for managing fires and forests.
The region has fought a war against wildfire for more than a century. Reaching a detente with wildfire will depend on various parties embracing collective strategies for managing fires and forests.
The West’s forever war has wrought a summer of catastrophe. Thick layers of smoke and ash have coated the region’s skies for weeks as tens of thousands of firefighters battle hundreds of wildfires from California’s border with Mexico to Washington’s border with Canada. The infernos have scorched more than 5 million acres and killed at least 36 people.
I reported from Afghanistan for three years starting in 2011, when U.S. troop levels had peaked at 100,000. Since 2018, I’ve covered wildfires in the West, where each summer the ranks of firefighters swell as volunteers from other states and countries rush to aid their brothers and sisters on the fiery front lines. Throwing more bodies at the adversary has yielded as little progress here as there.
American military leaders in Afghanistan first conceded a decade ago that the United States couldn’t kill its way out of an insurgency. By then, halfway through a war that next month will pass the 19-year mark, the Taliban’s strength and stubbornness had forced the generals to accept that ending the bloodshed would require compromise.
Earlier this year, American and Taliban officials signed a conditional peace accord, the first phase in a two-stage process to broker a permanent cease-fire. The second began last weekend as Afghan government and Taliban leaders convened in Qatar for negotiations that for years the Taliban vowed they would never consider.
The war has fractured the country’s public institutions and decimated the economy while claiming tens of thousands of lives, including Afghan civilians and military personnel, Taliban fighters, and more than 2,400 U.S. troops. Given the toll, any agreement that emerges from the ongoing talks will be imperfect, neither redressing all grievances nor fulfilling every demand of the parties involved.
Why We Wrote This The region has fought a war against wildfire for more than a century. Reaching a detente with wildfire will depend on various parties embracing collective strategies for managing fires and forests.
For conciliation to succeed, both sides must offer concessions and search for mutual understanding, realizing that a refusal to give ground will ensure a future as violent and tragic as the recent past. They will need to cultivate peace in the mixed soil of cooperation.
Several thousand miles away, the same painful lessons and the same hard truths apply to another long, costly, and intractable conflict: the war on wildfire in the American West.
The region has sought to kill its way out of fire for more than a century, attempting to extinguish flames as soon as they ignite to protect communities, homeowners, and natural lands. The policy of suppression, if well-intentioned, has led to overgrown forests and grasslands that, combined with climate change, feed fires that burn bigger, faster, and hotter, inflicting ever more destruction and despair.
The West’s own forever war has wrought a summer of catastrophe. Thick layers of smoke and ash have coated the region’s skies for weeks as tens of thousands of firefighters battle hundreds of wildfires from California’s border with Mexico to Washington’s border with Canada. The infernos have scorched more than 5 million acres and killed at least 36 people since early August, ravaging entire towns and displacing hundreds of thousands of people.
The fallout illustrates the urgency for states to rethink approaches to fire suppression and prevention. Reaching a detente with wildfire will depend on various parties – firefighting agencies and environmental groups, loggers and foresters, elected officials and community residents – leaving their ideological bunkers to embrace collective strategies for managing fires and forests.
As with the Afghanistan peace talks, any potential resolution will fail to satisfy everyone. But resisting compromise in the war on wildfire will bring only more devastation, more summers of catastrophe.
Adapting to the era of megafires
I reported from Afghanistan for three years starting in 2011, when U.S. troop levels had peaked at 100,000. Since 2018, I’ve covered wildfires in the West, where each summer the ranks of firefighters swell as volunteers from other states and countries rush to aid their brothers and sisters on the fiery front lines. Throwing more bodies at the adversary has yielded as little progress here as there.
Patrick T. Fallon/Reuters View caption Hide caption Elizabeth Wright of the U.S. Forest Service watches a helicopter as it makes a water drop in the Angeles National Forest during the Bobcat Fire in Los Angeles Sept. 16, 2020.
The era of megafires has dawned in the West during the past decade as temperatures rise. In California, an extended drought and a beetle infestation have killed 150 million trees, providing a vast stockpile of wildfire fuel. Some 3.3 million acres have burned already this year, and the state appears certain to double its record of 1.85 million acres set in 2018.
The state’s primary firefighting agency, known as Cal Fire, employs 9,700 full-time and seasonal firefighters and operates a fleet of 52 aircraft. In fiscal year 2018-19, the agency spent $635 million on extinguishing wildfires – another figure that could double in this ruinous fire season.
The state’s heavy reliance on suppression arises, in part, from a reluctance to manage land through prescribed burns, tree thinning, brush clearing, and other “treatments” that reduce wildfire fuels and fire risk. Cal Fire treats 20,000 to 50,000 acres a year and dedicates 150 personnel to the task.
A few weeks ago, I spoke with Lenya Quinn-Davidson, director of the Northern California Prescribed Fire Council, who suggested that federal and state officials steer more resources to land management and fire prevention. The move would push firefighting agencies in the West to increase the attention and manpower devoted to fuel-reduction operations, a shift that could ease dependency on fire suppression over time.
A new initiative in California holds promise in that regard. Democratic Gov. Gavin Newsom last month announced an agreement between the state and the U.S. Forest Service to treat 1 million acres of wildlands a year by 2025.
At the same time, the pact reveals the long road ahead to reduce overgrowth in California’s forests and grasslands. One recent analysis by Stanford researchers estimated that the state would need to treat 20 million acres – almost one-fifth of California’s land area – to restore balance to its forests and lower the risk of cataclysmic wildfires.
The sobering numbers offer ample reason to nurture fire prevention efforts beyond those of state and federal land managers. The futility of fire suppression has renewed interest in the cultural burning practices of Native American tribes in Northern California and elsewhere. A similar reawakening has occurred in Australia, as I learned earlier this year while reporting on bushfires that destroyed a staggering 46 million acres.
Ms. Quinn-Davidson works with communities, ranch owners, and farmers to conduct prescribed burns that can forestall wildfires from exploding into developed areas. “We need public agencies, communities, Native American tribes, private landowners – everybody has to be involved,” she told me. “We really need to aspire to get to that place where there isn’t this division between experts and the public, where we’re all kind of one fire-adapted culture.”
California could further pursue more state-federal alliances for sustainable forestry in the mold of the Tahoe-Central Sierra Initiative. The coalition of environmental and timber industry groups, formed in 2017, has set out to restore 2.4 million acres of federal forestland in the Sierra Nevada through prescribed burns, thinning, and limited logging.
As one scientist involved with the project explained to me last year, “We have to make a cultural shift away from both the Smokey Bear days of putting every fire out and from the anti-logging days of saying the removal of any tree is bad. That’s giving us bigger and bigger fires.”
“Our” is the key word
Wildfires at once incinerate the order of life and puncture the West’s mythos of rugged individualism. The infernos roaring through communities in California, Oregon, and Washington expose our shared vulnerability as we turn to emergency officials, aid workers, and public agencies for relief.
The communal hardship, in turn, reveals the cost of our aversion to fire prevention methods – more prescribed burning, restricted wildland development, stronger building codes – that can reduce our wildfire risk.
“Our” is the key word. Nobody living in the West can claim full immunity from either the direct or indirect impact of megafires. In that light, each of us owns a stake in improving fire prevention because “we all end up paying for the destruction,” Max Moritz told me in 2018, the previous “worst-ever” year for fires in the Golden State.
A wildfire expert with the University of California, Santa Barbara, Mr. Moritz added, “We also publicly fund all the fire suppression, the fire agencies, the disaster support systems. So there’s a place for saying that we need a more science-based approach to land management that could reduce the amount of damage.”
Fire researchers estimate that at least 4.4 million acres burned each year in California before 1800. Between 1950 and 1999, as a result of the state’s unrelenting fire suppression, the annual average plummeted to 250,000 acres. The collision of dense forests with climate change has ignited a crisis two decades later that requires us to accept the responsibility we bear for our universal plight.
The Stanford study found that opposition from local residents and officials to prescribed burning – along with liability concerns if a fire escapes its handlers – deters public and private land managers from the practice.
But as a Cal Fire official pointed out to me last year, if we allow more prescribed burning, fire crews can create more fuel breaks – areas cleared of most smaller trees and shrubs – that slow or stop a wildfire’s advance. The tactic can prevent wildfires from erupting into megafires and, over time, resuscitate forest health as mature trees regain the space they need to survive.
In other words, when we weigh the destruction of this year’s infernos against the strictly monitored loss of habitat that occurs with prescribed fire, we might want to reconsider complaining about, say, smoke from a controlled burn. Or as Ms. Quinn-Davidson told me, “If we’re not protecting the resources we care about and we’re not taking action, then we will continue to lose them to big fires.”
Our fondness for building homes in wildlands deserves similar reevaluation. Eleven million people live in areas designated as fire-prone in California, and from 2000 to 2013, three-quarters of the homes destroyed by wildfire fell within those zones.
The state could take a cue from Washington, where five years ago, two communities 40 miles apart pooled resources to forge a joint land-use plan that restricts growth in wildlands to reduce the threat from wildfires. Another example of enlightened planning has taken root in Paradise, a Northern California town of 27,000 people nestled among towering pines in the Sierra Nevada foothills.
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Two years after the deadliest and most destructive fire in the state’s history leveled the city, local officials are creating a buffer zone on its outskirts, acquiring vacant property that will remain undeveloped to serve as a massive fuel break.
The strategies illuminate what wildfire researchers describe as “living with fire,” an ethos that parallels the realization of U.S. military leaders in Afghanistan a decade ago. Here as there, brute force has shown its limits, and after long years of war, the time has come for compromise. For peace.