"Connecting Communities for COVID19 News" 29th Mar 2021
Isolation Tips
Covid-19: Importance of touch and other lockdown lessons
As society begins to gradually emerge from this latest lockdown, what have people learned in the past year? BBC News NI put that question to three people who had vastly different experiences of lockdown. Maria, who is originally from County Cork and now lives in Belfast, also started online cafes for adults with learning difficulties. While technology provided a lifeline, it was denial of touch which proved the hardest part for Maria. "Just not being able to reach out and touch another human being."
Self-isolation after Covid contact will be necessary for ‘years’, government adviser warns
People will have to self-isolate after coming into contact with Covid-19 for many years as the UK learns how to “live with this virus”, a government adviser has warned. Mark Woolhouse, a professor of epidemiology, said the test-and-trace system is here to stay – as are some social distancing measures. He also admitted to being “nervous about a full relaxation in June”, calling the idea of emerging from the lockdown “in one great bound” wide of the mark. “I still suspect that looking forward – and I am talking now right through 2021 and into the years ahead – that we are still going to have to be alert to coronavirus,” Prof Woolhouse said.
Spaniards cut back on drink, took more sedatives during pandemic - study
Spaniards cut back on alcohol and almost halved their binge-drinking during the pandemic as the lockdown shuttered bars and nightclubs, a survey by Spain’s Observatory for Drugs and Addiction found on Friday. At the same time, the consumption of unprescribed sedatives increased and internet use jumped, as people spent more of their leisure time browsing, and more youngsters turned to online gambling, the survey showed.
France's lockdown vice? Cheese
French households feasted on cheese last year as they turned to home cooking and sought gastronomic comfort during coronavirus lockdowns that shuttered the restaurant trade. The amount of cheese purchased by French shoppers for at-home consumption increased by more than 8% in 2020, compared with just 2% the previous year, according to figures from farming agency FranceAgriMer and market data firm Kantar. That was part of a shift in food consumption in many countries last year as the COVID-19 pandemic unfolded, with households initially bulk buying staples like pasta and flour, and later settling into home-eating habits with extra purchases of products like butter. In France, mozzarella saw the steepest rise in demand among major cheese categories, with a 21% volume jump, followed by a 12% increase for raclette - a winter favourite eaten melted with potatoes and cured meats.
Hygiene Helpers
Covid-19: Pfizer director says science 'winning the race' against virus
Science is winning the race between coronavirus and the vaccine, Pfizer's UK medical director has said. Dr Berkeley Phillips told BBC News NI it was important people were "allowed to start living again". While the main threat continues to come from new variants, Pfizer is already designing an updated vaccine that will work, he said. Dr Phillips said "incredible progress" had been made in the past year and "we're winning that race". "If you look at what's happening in the UK there are dramatic reductions in the death rate, dramatic reductions in hospitalisations and in the number of cases," he said.
Hauliers face new COVID rules in England as Heathrow seeks holiday easing
Certain lorry drivers arriving in England will need to take COVID-19 tests in a bid to tackle the spread of any future variants, the government said on Sunday as Heathrow Airport lobbied for the easing of an overseas holiday ban from mid-May. From April 6, Hauliers arriving from outside Britain and Ireland for more than two days will need to take a test within 48 hours and one every 72 hours thereafter as part of the new rules. “This is to ensure we keep track of any future coronavirus variants of concern,” transport minister Grant Shapps said. Prime Minister Boris Johnson suggested earlier this week that Britain might need to tighten restrictions on arrivals from France
Keep Your Covid-19 Vaccination Card Safe — You’re Going To Need It
Your most precious travel accessory this summer is going to be a small white piece of paper. Some destinations, cruise lines and major sports venues are already requiring travelers to provide proof that they have been fully vaccinated against Covid-19. Other businesses, like Krispy Kreme, are offering freebies and other perks to people who can prove they’ve been inoculated. If you are among the 48 million Americans who have been fully vaccinated against Covid-19, the only proof that you have received your Covid shots is typically your paper vaccination record card with the CDC logo in the upper corner. The vaccination card tells you what Covid-19 vaccine you received, the date you received it, and where you received it — but that information is not being stored in any centralized, easily searchable database.
COVID-19: Vaccinated people should be able to meet up and go on holidays, says scientist
A scientist has called for vaccinated people to be allowed to meet up with each other and to travel freely, saying there is no scientific reason why this should be forbidden. Professor Tim Spector, who leads the COVID Symptom Tracker app study run by King's College London, said the vaccination programme was successful and now people's mental health needs to be considered. He told the PA news agency: "I think we're actually in a much better place than many people are telling us, and I, for one, I'm not worried too much about what's happening abroad.
Small rise in Covid-19 infections among secondary school children in England, figures show
Covid-19 coronavirus infection levels among children of secondary school age in England have increased slightly, new figures suggest. The percentage of children in school years 7 to 11 likely to have tested positive for Covid-19 in the week to March 20 is 0.43%, up from 0.32% the previous week. The estimates, from the Office for National Statistics (ONS), coincide with the return from March 8 of pupils to secondary schools across England – a move that is likely to have affected the spread of coronavirus, thanks to the mixing of staff, parents and students. Testing has also been scaled up, with all students in secondary schools expected to complete three rapid Covid-19 tests on their return, spaced three to five days apart, then further tests twice a week.
Community Activities
Covid: Boris Johnson urged to share vaccines with poorer nations
A group of charities is urging Boris Johnson to "swiftly clarify" how many Covid vaccine doses the UK is prepared to donate to poorer countries. Save the Children and the Wellcome Trust are among those calling on the PM to start donating jabs through Covax. This scheme aims to provide jabs for low and middle-income countries. Culture Secretary Oliver Dowden said the UK does not currently have a surplus of vaccines, but when it does that surplus will be shared. The UK, which has ordered 400 million vaccine doses and will have many left over, has said it will donate most of its surplus vaccine supply to poorer countries.
Exclusive: Facebook freezes Venezuela president Maduro's page over COVID-19 misinformation
Facebook has frozen Venezuelan President Nicolas Maduro’s page for violating policies against spreading misinformation about COVID-19 by promoting a remedy he claims, without evidence, can cure the disease, a company spokesman said on Saturday. Maduro in January described Carvativir, an oral solution derived from thyme, as a “miracle” medication that neutralizes the coronavirus with no side effects, a claim doctors say is not backed by science. Facebook has taken down a video in which Maduro promotes the medication because it violates a policy against false claims “that something can guarantee prevention from getting COVID-19 or can guarantee recovery from COVID-19.”
Covid vaccine: Social media urged to remove 'disinfo dozen'
Facebook, Twitter and Google have been urged by a US lawmaker to ban a dozen people who it is claimed are spreading the vast majority of disinformation about Covid vaccinations. Representative Mike Doyle made the call to remove their accounts during a US congressional session on how the three firms were dealing with fake news. He challenged Mark Zuckerberg, Jack Dorsey and Sundar Pinchai to deplatform the dozen people immediately. None have responded to the call so far. Facebook said that it was looking into the matter to see if the accounts violated its community standards.
How we can show hesitant Black D.C. residents that coronavirus vaccines are safe and effective
Black Americans are dying at nearly twice the rate of White Americans from the coronavirus. In the nation’s capital, about 75 percent of coronavirus deaths are among Black Americans — despite making up less than half of the population. So, it’s particularly troubling that 44 percent of Black D.C. residents say they won’t get vaccinated. As Black doctors and voices within the health-care community, we have a responsibility to address these views about vaccines. Among Black people who are unsure, the most common two reasons given are worries about side effects and a desire to see how other people respond to the vaccine. These are perfectly reasonable concerns; no one wants to be a guinea pig.
Volatility of vaccine confidence
How can vaccine hesitancy be addressed? Communication about vaccines must be delivered in an empathic manner to avoid stigmatizing those who question inoculation. This requires leveraging established relationships to address concerns of the vaccine hesitant. Examples include the Engaging in Medical Education with Sensitivity initiative during the 2019 measles outbreaks, in which Orthodox Jewish nurses empowered parents in that community to reach their own conclusions about vaccines while listening to their concerns and helping them contextualize information. Also, the University of Maryland's Health Advocates In-Reach and Research network of Black barbershops and salons trains personnel as health educators to encourage customers to pursue healthy behaviors.
Working Remotely
What the great work from home experiment has taught us about the way we work
This is a transcript of episode 8 of The Conversation Weekly podcast, The great remote work experiment – what happens next? In this episode, four experts dissect the impact a year of working from home has had on employees and the companies they work for – and what a more hybrid future might look like.
Government unveils plans to develop new rural remote working hubs around Ireland
In Ireland, the government will unveil plans to convert closing Bank of Ireland branches and other vacant buildings in town centres into new rural remote working hubs. This will be one of the features of the Our Rural Future action plan set to be unveiled by Minister for Rural and Community Development, Heather Humphreys, in Croke Park today. It will also include the pledge to introduce what a source called “sweeteners” in this year’s Budget to drive relocation to rural areas and enhanced home-working.
A Year Into Remote Work, No One Knows When to Stop Working Anymore
A year into the Covid-19 era, employees say work-life boundaries blurred, then vanished, as waking life came to mean “always on” at work. Experts warn that working around the clock—while slipping in meals, helping with homework and grabbing a few moments with a partner—isn’t sustainable, and employers from banking giant Citigroup Inc. to the software company Pegasystems Inc., are trying ways to get staff to dial back. At Accenture PLC, Jimmy Etheredge, the company’s chief executive officer of North America, is embracing the notion of “taking back lunch,” eating in peace away from screens and recharging in the middle of every workday. The company is encouraging employees not to schedule internal meetings unrelated to client business on Fridays, and Mr. Etheredge has repeatedly told employees to be candid with managers, saying, “It’s OK to not be OK.”
Remote Work: The Blurring Of Business And Personal Life
The seeping of work into our personal lives has caused people to seek some form of late-night unwinding and personal time. However, using your devices as a form of relaxation can cause inhibition of sleep. It is a slippery slope from working remotely and being a de facto teacher for your kids to complete burnout. During the Covid-19 pandemic, outlets for stress have been limited, and there can be a lack of distinction between work and personal life when working from home. It’s important to practice self-care, including saying no to videoconferencing. Have designated times where you disconnect, including shutting off your phone. Set strict work hours. If you would usually work until 5 pm at the office, make 5 pm the time you sign off at home. If your employer wants you to work later than your usual hours, speak with them. If the issue is not resolved to your satisfaction, consider consulting with an attorney.
Virtual Classrooms
Non-White Students Twice As Likely To Desire Virtual Internships, Jobs Upon Graduation
The global pandemic continues to reveal important new insights and amplify pre-existing challenges and inequities in education. And few statistics are more revealing on this point than these: non-white college students are more than twice as likely to desire a virtual internship (27% are ‘extremely interested’) compared to white students (12% ‘extremely interested), and they are also more than twice as likely to say they are extremely interested in taking a fully remote job upon graduation (22% non-white vs. 10% white). These findings from the latest college student survey as part of Inside Higher Ed’s Student Voice initiative provide us all with an awful lot to unpack here. There could be any number of drivers behind these astounding differences by race on student interest in virtual internships and fully remote jobs. These findings beg for more research and understanding.
CDC Study: Virtual School Can Be Damaging To Children’s Mental Health
Virtual instruction may pose more risks to the mental health and wellness of children and parents than in-person learning, according to a study published by the US Centers for Disease Control and Prevention. More support may be needed to deal with the effects of the pandemic. Parents whose children received virtual instruction or a combination of virtual and in-person instruction were more likely to report increased risk on 11 of 17 indicators of child and parental well-being, according to the new CDC study.
Public Policies
Covid-19: Several Vaccine Production Sites Approved in E.U.
The European Union’s stumbling Covid-19 vaccination drive, badly shaken by the recent AstraZeneca safety scare, got a boost Friday from the European Medicines Agency, which approved new AstraZeneca, Pfizer-BioNTech and Moderna vaccine production sites. The agency, an arm of the European Union and Europe’s top drug regulator, approved sites in the Netherlands, Germany and Switzerland. It also loosened regulations for how long the Pfizer vaccine must be stored at ultralow temperatures. The moves could speed up the Continent’s lagging vaccine production and distribution, which have been plagued by delays and setbacks.
Coronavirus: UK ‘set to offer 3.7m vaccines to Ireland’ amid EU exports row
The UK is planning to offer 3.7 million Covid-19 vaccines to the Republic of Ireland in a move that could exacerbate its rift with the EU, it has been reported. Foreign secretary Dominic Raab, chancellor of the duchy of Lancaster Michael Gove, and Northern Ireland secretary Brandon Lewis are said to have met privately to discuss the plan, which they see as integral to ensuring lockdown restrictions can be lifted in neighbouring Northern Ireland with the reduced risk of border crossings triggering a third wave of infections, according to The Sunday Times.
Hong Kong and Macao suspend BioNTech coronavirus vaccine rollout due to packaging defect
Authorities in Hong Kong and Macao have suspended the rollout of BioNTech's Covid-19 vaccine citing a packaging defect found in their first batch of doses. Both governments said in statements Wednesday they had received a letter from BioNTech and its Chinese partner, Fosun Pharma, indicating an issue with the seal on individual vials in batch number 210102. According to government figures, as of Tuesday, 150,200 people in Hong Kong had received their first dose of the BioNTech vaccine, which outside of China is partnered with US pharmaceutical giant Pfizer.
India bans Covid-19 vaccine exports to put itself first
India has imposed a de facto ban on vaccine exports as it puts its own needs first. The country is in the grip of a second wave of Covid-19, which is worsening rapidly.
The Serum Institute of India (SII), the largest maker of vaccines in the world, has been told to halt exports until it can cover what India needs, according to sources in the Indian health ministry and Unicef.
Kenya’s president Uhuru Kenyatta orders new lockdown to battle COVID-19 infections wave
Kenya’s President Uhuru Kenyatta on Friday announced a halt to all movement in the capital Nairobi and four other counties on Friday as the COVID-19 outbreak reached its worst ever stage in East Africa’s richest economy.
Macron backs EU vaccine export controls, sees more French restrictions
French President Emmanuel Macron said on Thursday he supported stricter EU export controls on vaccines for drug companies that do not meet their contractual commitments with the European Union. “It’s the end of naivety,” Macron told reporters after a virtual EU summit. “I support export control mechanisms put in place by the European Commission. I support the fact that we must block all exports for as long as some drug companies don’t respect their commitments with Europeans,” he added. Macron said the EU had been late in ramping up vaccine production and inoculations, but was catching up and would become the world’s biggest producer of vaccines this summer.
BioNTech nabs EU approval for former Novartis plant tapped in COVID-19 vaccine production push
On a quest to turn out 2 billion doses of their COVID-19 vaccine Comirnaty this year, Pfizer and BioNTech just scored a major boost thanks to the European approval of a linchpin manufacturing plant in Germany. BioNTech won a thumbs up from the European Medicines Agency (EMA) to start making and supplying partners with vaccine drug product from the Marburg, Germany facility it picked up from Novartis last fall. The regulator this week cleared BioNTech to manufacture messenger RNA—the vaccine's active ingredient—there, making it one of the largest mRNA production sites globally, BioNTech said in a release. Once fully operational, the site is expected to hit annual capacity of up to 1 billion vaccine doses per year, the company said. That's 250 million doses more than BioNTech said the site would be able to turn out last month. The company hopes to produce 250 million doses there in the first half of the year, and the first Marburg-made shots are expected to roll out in the second half of April.
France puts region around Lyon in lockdown
The COVID-19 pandemic is accelerating almost everywhere in France, French health minister Olivier Veran said on Thursday. He added that three additional regions will be put under lockdown, including the area around the city of Lyon. The Paris region and a large part of northern France is already in a third lockdown.
Maintaining Services
COVID-19: Second doses are 'protected' for when UK's vaccine supply falls in April, NHS England says
The UK has enough vaccine supplies to ensure that Britons can receive their second doses without disruption, NHS England's medical director for primary care has said. Weeks after the health service warned that the country will face a "significant reduction" in the availability of coronavirus jabs next month, Dr Nikki Kanani said: "The supply over April is slower, but we know that we will keep going. "We've got enough vaccine to give people the second doses, those second doses are protected, and we've got enough vaccine to protect those in the priority cohorts."
Foreigners flock to Serbia to get coronavirus vaccine shots
Thousands of vaccine-seekers from countries neighboring Serbia have flocked to Belgrade after Serbian authorities offered free coronavirus jabs to foreigners who showed up over the weekend
France sees further rise in coronavirus patients in intensive care
The number of patients with coronavirus in French intensive care units rose on Saturday to a new high for this year, increasing the pressure to impose new restrictions that President Emmanuel Macron says will probably be needed. France had 4,791 ICU patients being treated for COVID-19, up from 4,766 on Friday, health ministry data showed. The numbers are approaching a peak recorded in mid-November during the second wave of the virus, although last spring, when France imposed its first lockdown, saw a peak of more than 7,000. Doctors say intensive care units in the worst-hit regions could become overwhelmed.
Over-70s likely to get coronavirus vaccine booster shots from September to protect against variants
The Government has confirmed i‘s report that over-70s are set to receive booster shots from September, in a bid to protect them against new variants of Covid-19.
Vaccines minister Nadhim Zahawi said confirmed plans for the future of the vaccine rollout, the first booster doses would go to the top four priority groups, including care home staff, NHS workers and the clinically extremely vulnerable. Speaking to The Telegraph, he suggested booster shots would likely begin in September, adding that the Government is expecting up to eight different jabs to be available by the autumn, including one protecting against three different variants in a single dose.
De Croo counting on share of Pfizer's early delivery coronavirus vaccines
Belgium should receive a share of the ten million coronavirus vaccines which Pfizer has promised to deliver to the European Union by this summer, Prime Minister Alexander De Croo said Thursday evening after a European Council meeting. Last week, the European Commission agreed that the company will deliver 10 million doses, which were originally expected to be given to EU member states in November, by the summer. “The consensus is that these doses will be distributed in solidarity, to find a solution to the difference in delivery speed, which means Belgium will also be able to benefit from this,” De Croo said after the video conference.
Frustrated EU leaders pass vaccine fight to ambassadors
Suddenly, the EU’s top diplomats — the Committee of Permanent Representatives — look more like the Committee of Pro-Rata Referees. After EU heads of state and government spent hours arguing during a video summit on Thursday about how to divvy up an extra load of 10 million coronavirus vaccine doses, they gave up and asked diplomats to settle the matter. The decision to seek arbitration among the ambassadors came after Austrian Chancellor Sebastian Kurz virtually sabotaged the meeting by insisting that his country receive extra doses, even though European Commission data shows Austria faring relatively well among EU nations in terms of vaccine supplies. There's also the issue that all EU countries, Austria included, had previously agreed to a pro-rata formula that gives each member state an equal chance to purchase their fair share of shots.
COVID-19 prevalence in England no longer falling, UK's ONS says
The prevalence of COVID-19 infections in England is no longer falling and has levelled off at an estimated 1 in 340 people, Britain's Office for National Statistics (ONS) said on Friday, a possible side-effect of England's emergence from full lockdown. "In England, the percentage of people testing positive for the coronavirus (COVID-19) is likely to have levelled off in the week ending 20 March 2021," the ONS said. The estimate of prevalence at 1 in 340 people was unchanged on the previous week. It is the first time prevalence has not fallen in the closely watched estimate of community infections since late January. England's third national lockdown was introduced on January 5.
More than 30 states expanding COVID-19 vaccine eligibility
With national vaccinations ramping up to more than 2.5 million people per day, at least 34 states have made all adults eligible to receive one of three approved COVID-19 vaccines—or plan to by mid-April— as the United States continues to race to vaccinate as many people as possible while variant cases continue to rise. "It's clear, there is a case for optimism; but there is not a case for relaxation," said Jeff Zients, coordinator of the White House's COVID-19 response, today during a White House press briefing. California is the largest state to announce a change in eligibility: On Apr 1 all residents 50 and older will be eligible, and all residents 16 and older will be able to get a vaccine on Apr 15. On Mar 29, Texas will open up its vaccination to all residents.
Healthcare Innovations
Pregnant women 'didn't have the data' – until now: COVID-19 vaccines are safe and effective, even for babies, study shows
COVID-19 vaccines are extremely effective at protecting pregnant women and likely provide protection for their babies as well, according to a new study. The research, published Thursday in the American Journal of Obstetrics and Gynecology, examined 131 vaccine recipients, including 84 who were pregnant, 31 who were breastfeeding and 16 who weren't pregnant as a control group. Earlier studies suggested the COVID-19 vaccines from Pfizer-BioNTech and Moderna would be safe and effective. But this is the largest study to date looking at the immune responses of pregnant and lactating women to vaccination
Covid: How this Indian firm is vaccinating the world
As pharmaceutical giants ramp up production in the race to vaccinate the world, one firm has shot into the lead. The Serum Institute of India (SII) isn't a household name, but it's the world's largest vaccine maker. The firm churns out 1.5 billion doses every year from the company's vast manufacturing plant in Pune, Western India. It is currently making Covid vaccines under license for pharmaceutical firms such as AstraZeneca. "We took a huge calculated risk", by betting on several vaccines in 2020 before regulators had even approved of them, SII's chief executive Adar Poonawalla told the BBC. "It wasn't a blind risk, because we knew the Oxford scientists from our earlier collaboration with the malaria vaccine."
Joint jab for Covid-19 and flu could be ready next year, says top vaccine developer
Scientists at Imperial College London have demonstrated ‘proof of principle’ and hope to begin developing the joint vaccine later this year. A joint jab for Covid-19 and flu could be ready for use by the end of next year, according to one of Britain’s leading vaccine developers. Professor Robin Shattock, of Imperial College London, said the combination jab “is in our sights” after successfully combining three existing vaccines into one shot using the RNA technology he is developing. Tests of the three-in-one vaccine shot he created for Ebola, Marburg and Lassa fever produced the “same type of immune response” in mice as if they had been administered separately, he said.
Do COVID-19 vaccines stop transmission? Top scientists are now recruiting thousands of college students to find out.
A study began on Thursday to see how well Moderna's COVID-19 vaccine stops the spread of the virus. Scientists plan to recruit 12,000 college students across 21 campuses for the clinical trial. They hope it will tell us how well vaccines prevent asymptomatic infections and stop transmission.
Shots in little arms: COVID-19 vaccine testing turns to kids
The 9-year-old twins didn’t flinch as each received test doses of Pfizer’s COVID-19 vaccine -- and then a sparkly bandage to cover the spot. “Sparkles make everything better,” declared Marisol Gerardo as she hopped off an exam table at Duke University to make way for her sister Alejandra. Researchers in the U.S. and abroad are beginning to test younger and younger kids to make sure COVID-19 vaccines are safe and work for each age. The first shots are going to adults who are most at risk from the coronavirus, but ending the pandemic will require vaccinating children too.
Can one vaccine ward off all coronavirus? Researchers are about to find out
Variants of the virus that causes COVID-19 are emerging and becoming dominant around the world. So some vaccines are being updated to allow our immune system to learn how to deal with them. But this process of identifying and characterising variants that can escape our immune system, then tweaking a vaccine to deal with them, can take time. So researchers are designing a universal coronavirus vaccine. This could mean one vaccine to protect against different variants of SARS-CoV-2, the coronavirus that causes COVID-19. Alternatively, a universal vaccine would target many different coronaviruses, perhaps one waiting in the wings to cause the next pandemic. Here's where the science is up to and the challenges ahead.
Britain gives go-ahead to 20-second COVID-19 test, distributor says
A 20-second COVID-19 test will launch in Britain after regulators accepted its registration, the product’s distributor said on Friday, heralding a testing system it said could be used in airports, sports venues and businesses. Rapid tests are seen as a key plank of Prime Minister Boris Johnson’s roadmap out of lockdown, but concerns have been expressed about the accuracy of existing lateral flow devices.
The Virolens test, which is made by British start-up iAbra and TT Electronics, has been piloted at Heathrow Airport, and uses swabs of saliva. Histate, which is distributing the test, said it would launch with immediate effect after the Medicines and Healthcare products Regulatory Agency (MHRA) accepted the registration of the product, and the company said it was hoping for a wider rollout in coming months.
UK’s HEAL-COVID trial will test existing drugs for the treatment of long Covid
In an effort to reduce the number of deaths and readmissions of patients who have previously been hospitalised with Covid-19, the UK is gearing up to launch national drug trial HEAL-COVID.
Covid: Past infection increases vaccine response six-fold
Health workers with previous Covid-19 infections had six times the immune response to one dose of the Pfizer jab than those who hadn't had the virus. The researchers said this emphasised the importance of people having their second dose to provide the same "booster" effect. Those who have had Covid should still have a second jab, though, to ensure "longer-lasting" protection. Giving the previously-infected one dose would not be efficient, experts say. Having two jabs gives the best chance of activating all parts of the immune system and potentially protecting against new variants. The study, funded by the Department of Health and Social Care, was an extension of Public Health England's Siren study of healthcare workers.
