Are More Women Physicians Leaving Medicine as Pandemic Surges?

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

For mid-career oncologist Tanya Wildes, MD, the pandemic was the last straw. In late September, she tweeted: “I have done the academically unfathomable: I am resigning my faculty position without another job lined up.”

She wasn’t burned out, she insisted. She loved her patients and her research. But she was also “100% confident” in her decision and “also 100% sad. This did not have to happen,” she lamented, asking not to disclose her workplace for fear of retribution.



Dr Tanya Wildes and family

Being a woman in medicine “is a hard life to start with,” Wildes told Medscape Medical News. “We all have that tenuous balance going on and the pandemic made everything just a little bit harder.”

She describes her pre-pandemic work-life balance as a “Jenga tower, with everything only just in place.” But she realized that the balance had tipped, when after a difficult clinic she felt emotionally wrung-out. Her 11-year-old son had asked her to help him fly his model airplane. “I told him, ‘Honey, I can’t do it because if it crashes or gets stuck in a tree…you’re going to be devastated and I have nothing left for you.’ “

This was a eureka moment, as “I realized, this is not who I want to be,” she says, holding back tears. “Seventy years from now my son is going to tell his grandchildren about the pandemic and I don’t want his memory of his mom to be that she couldn’t be there for him because she was too spent.”

When Wildes shared her story on Twitter, other women oncologists and physicians responded that they too have felt they’re under increased pressure this year, with the extra stress of the pandemic leading others to quit as well.

The trend of doctors leaving medicine has been noticeable. A July survey from the Physicians Foundation found that roughly 16,000 medical practices had already closed during the pandemic, with another 8000 predicted to close within the next year.

“Similar patterns” were evident in another analysis by the Larry A. Green Center and the Primary Care Collaborative, as reported by The New York Times. In that survey, nearly one fifth of primary care clinicians said “someone in their practice plans to retire early or has already retired because of COVID-19,” and 15% say “someone has left or plans to leave the practice.” About half said their mental exhaustion was at an all-time high, the survey found.



Dr Monica Bertagnolli

“COVID-19 is a burden, and that added burden has tipped people over the edge of many things,” acknowledges Monica Bertagnolli, MD, chief of the Division of Surgical Oncology at Brigham and Women’s Hospital in Boston and former president of the American Society of Clinical Oncology (ASCO).

“It has illustrated that we do have a lot of people who are working kind of on the edge of not being able to handle everything,” she says.

While many

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U.S. reports nearly 90,000 new coronavirus cases amid surges in every swing state

Nearly 90,000 new coronavirus infections were reported in the United States on Thursday, a record, as cases surge in every swing state that will be crucial to next week’s presidential election.



a group of people wearing costumes: Voters wearing face masks wait in a nearly four-hour line to cast their ballots during early voting at a polling site in Edmond, Okla., on Thursday.


© Nick Oxford/Reuters
Voters wearing face masks wait in a nearly four-hour line to cast their ballots during early voting at a polling site in Edmond, Okla., on Thursday.

The total number of infections reported nationwide since February is virtually guaranteed to reach 9 million on Friday, just 15 days after the tally hit 8 million. At least 228,000 deaths have been linked to the coronavirus.

Here are some significant developments:

Sign up for our coronavirus newsletter | Mapping the spread of the coronavirus: Across the U.S. | Worldwide | Vaccine tracker | Where states reopened and cases spiked | Has someone close to you died of covid-19? Share your story with The Washington Post.

1:03 AM: Options dwindle for voters diagnosed with covid-19 as Election Day draws near



a man holding a laptop: Linda Harrison of Austin was tested positive for the coronavirus on July 2, the deadline to apply for mail-in ballots in Texas’s primary runoff. She asked a judge to waive the requirement for a doctor’s signature but was denied.


© Ilana Panich-Linsman for The Washington Post
Linda Harrison of Austin was tested positive for the coronavirus on July 2, the deadline to apply for mail-in ballots in Texas’s primary runoff. She asked a judge to waive the requirement for a doctor’s signature but was denied.

Hundreds of thousands of Americans will test positive for the novel coronavirus between now and Election Day, leaving many scrambling for alternatives to in-person voting and injecting another dimension of uncertainty into an election already shadowed by the pandemic.

Those voters will need to navigate an unfamiliar and varied landscape to cast their ballots. Some will be required to get doctor’s notes or enlist family members to help. Others, in isolation, will need to have a witness present while they vote. Planned accommodations — such as officials hand-delivering ballots — may prove inadequate or could be strained beyond limits.

Sudden illness is an impediment to voting every election year, typically for a small number of Americans. Many provisions to help those voters apply exclusively to people who are hospitalized.

But with around 70,000 new cases of the coronavirus being recorded each day, a swath of Americans larger than the population of Wyoming or Vermont will probably contract the disease in the 10 days leading up to Nov. 3.

Read the full story

By: Neena Satija

12:23 AM: Coronavirus cases are on the rise in every swing state

Coronavirus cases are surging in every competitive state before Election Day, offering irrefutable evidence against President Trump’s closing argument that the pandemic is nearly over and restrictions are no longer necessary.

In the 13 states deemed competitive by the Cook Political Report, the weekly average of new cases reported daily has jumped 45 percent over the past two weeks, from fewer than 21,000 on Oct. 14 to more than 30,000 on Oct. 28.

Iowa, Michigan, Minnesota and Pennsylvania have all hit new weekly average highs in recent days, and in Florida and Georgia, case counts are growing again after having fallen from summer highs.

Read the

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As virus surges, Trump rallies keep packing in thousands



President Donald Trump gestures as he is introduced by first lady Melania Trump during a campaign rally Thursday, Oct. 29, 2020, in Tampa, Fla. (AP Photo/Chris O'Meara)


© Provided by Associated Press
President Donald Trump gestures as he is introduced by first lady Melania Trump during a campaign rally Thursday, Oct. 29, 2020, in Tampa, Fla. (AP Photo/Chris O’Meara)

WASHINGTON (AP) — There are no crowds at Disneyland, still shut down by the coronavirus. Fewer fans attended the World Series this year than at any time in the past century. Big concerts are canceled.

But it’s a different story in Trumpland. Thousands of President Donald Trump’s supporters regularly cram together at campaign rallies around the country — masks optional and social distancing frowned upon.

Trump rallies are among the nation’s biggest events being held in defiance of crowd restrictions designed to stop the virus from spreading. This at a time when public health experts are advising people to think twice even about inviting many guests for Thanksgiving dinner.

“It doesn’t matter who you are or where you are, when you have congregate settings where people are crowded together and virtually no one is wearing a mask, that’s a perfect setup to have an outbreak of acquisition and transmissibility,” Dr. Anthony Fauci, the nation’s top infectious disease expert, recently told Yahoo News. “It’s a public health and scientific fact.”

The Trump campaign, which distributes masks and hand sanitizer at its rallies, says those who attend are peaceful protesters who, just like Black Lives Matter demonstrators, have a right to assemble. The president says he wants to get the country back to normal.



Vice President Mike Pence speaks during an airport rally, Thursday, Oct. 29, 2020, in Des Moines, Iowa. (AP Photo/Charlie Neibergall)


© Provided by Associated Press
Vice President Mike Pence speaks during an airport rally, Thursday, Oct. 29, 2020, in Des Moines, Iowa. (AP Photo/Charlie Neibergall)

Some states have fined venues that host Trump rallies for violating caps on crowd size. But the rallies continue — even as the U.S. sees cases spike, especially in the Midwest and the Plains. The nation posted a record high number of new infections last week — nearly 500,000.



President Donald Trump and first lady Melania Trump arrive for a campaign rally Thursday, Oct. 29, 2020, in Tampa, Fla. (AP Photo/Chris O'Meara)


© Provided by Associated Press
President Donald Trump and first lady Melania Trump arrive for a campaign rally Thursday, Oct. 29, 2020, in Tampa, Fla. (AP Photo/Chris O’Meara)

And the crowds keep turning out for Trump.

Ysabel Benejam, 69, of West Bloomfield, Michigan, drove about 90 minutes to Lansing and waited more than four hours in rainy, near-freezing temperatures to see Trump on Tuesday.

“I’m not afraid at all,” said Benejam, wearing a “Make America Great Again” hat and a mask emblazoned with “Trump 2020.” “We need to step back into normality.”

Democrat Joe Biden, in contrast, has shunned rallies and instead holds online and drive-in events where people honk their horns to show support. He calls the Trump rallies “super-spreader events” and says he’s listening to the warnings of public health experts.

Since Feb. 7, when Trump told author Bob Woodward that he knew the coronavirus was airborne and deadlier than than the flu, the president has hosted more than 50 rallies in more than two dozen states. They were halted during most of March, April and May because of the

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Central Europe sounds alarm facing a shortages of medics as virus surges

KYJOV, Czech Republic (AP) — Soldiers in Poland are giving coronavirus tests. American National Guard troops with medical training are headed to the Czech Republic to work alongside doctors there. A Czech university student is running blood samples to labs, and the mayor of the capital is taking shifts at a hospital.

With cases surging in many central European countries, firefighters, students and retired doctors are being asked to help shore up buckling health care systems.

“This is actually terrifying,” Dr. Piotr Suwalski, the head of the cardiac surgery ward at a Polish hospital said on a day when daily COVID-19 cases rose 20% nationwide. “I think if we continue to gain 20% a day, no system can withstand it.”

Even before the pandemic, many countries in the region faced a tragic shortage of medical personnel due to years of underfunding in their public health sectors and an exodus of doctors and nurses to better paying jobs in Western Europe after the nations joined the European Union in 2004. Now, with the virus ripping through their hospitals, many health workers have been sickened, compounding the shortfall.

Over 13,200 medical personnel across the Czech Republic have been infected, including 6,000 nurses and 2,600 doctors, according to the doctors’ union.

It’s not just clinicians these countries need. Both Poland and the Czech Republic are building field hospitals as beds fill up on wards, and authorities say there are only 12 ventilators left in all hospitals taking COVID-19 patients in the region around Warsaw, the Polish capital.

This may sound familiar, but not for these countries. Many in the region imposed tough restrictions in the spring — including sealing borders and closing schools, stores and restaurants — and saw very low infection rates even as the virus killed tens of thousands in Western Europe.

READ MORE: France, Germany impose new lockdowns to curb virus spread

But now many central European countries are seeing an onslaught similar to the one their western neighbors experienced — and the same dire warnings.

As he announced new restrictions last week, Czech Prime Minister Andrej Babis put a date on when his country’s health system would collapse, if the new regulations were not imposed to slow the virus’s spread: between Nov. 7 and 11.

With one of the highest infection rates in Europe, the Czech Republic’s hospitals are desperately looking for volunteers. The government is deploying thousands of medical students to hospitals and other students to testing sites.

In the capital of Prague, Mayor Zdenek Hrib, who has a degree in medicine, volunteered to help do initial exams of possible coronavirus patients at a university hospital. Soon, 28 medical personnel from the Nebraska and Texas national guards are expected to arrive to help treat patients at Prague’s military hospital and a new field hospital at the city’s exhibition ground.

Croatia has asked former doctors to come out of retirement to help in hospitals, while Slovenia has put retired physicians and current medical students on standby in case its

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Short of medics as virus surges, central Europe sounds alarm

KYJOV, Czech Republic (AP) — Soldiers in Poland are giving coronavirus tests. American National Guard troops with medical training are headed to the Czech Republic to work alongside doctors there. A Czech university student is running blood samples to labs, and the mayor of the capital is taking shifts at a hospital.

With cases surging in many central European countries, firefighters, students and retired doctors are being asked to help shore up buckling health care systems.

“This is actually terrifying,” Dr. Piotr Suwalski, the head of the cardiac surgery ward at a Polish hospital said on a day when daily COVID-19 cases rose 20% nationwide. “I think if we continue to gain 20% a day, no system can withstand it.”


Even before the pandemic, many countries in the region faced a tragic shortage of medical personnel due to years of underfunding in their public health sectors and an exodus of doctors and nurses to better paying jobs in Western Europe after the nations joined the European Union in 2004. Now, with the virus ripping through their hospitals, many health workers have been sickened, compounding the shortfall.

Over 13,200 medical personnel across the Czech Republic have been infected, including 6,000 nurses and 2,600 doctors, according to the doctors’ union.

It’s not just clinicians these countries need. Both Poland and the Czech Republic are building field hospitals as beds fill up on wards, and authorities say there are only 12 ventilators left in all hospitals taking COVID-19 patients in the region around Warsaw, the Polish capital.

This may sound familiar, but not for these countries. Many in the region imposed tough restrictions in the spring — including sealing borders and closing schools, stores and restaurants — and saw very low infection rates even as the virus killed tens of thousands in Western Europe.

But now many central European countries are seeing an onslaught similar to the one their western neighbors experienced — and the same dire warnings.

As he announced new restrictions last week, Czech Prime Minister Andrej Babis put a date on when his country’s health system would collapse, if the new regulations were not imposed to slow the virus’s spread: between Nov. 7 and 11.

With one of the highest infection rates in Europe, the Czech Republic’s hospitals are desperately looking for volunteers. The government is deploying thousands of medical students to hospitals and other students to testing sites.

In the capital of Prague, Mayor Zdenek Hrib, who has a degree in medicine, volunteered to help do initial exams of possible coronavirus patients at a university hospital. Soon, 28 medical personnel from the Nebraska and Texas national guards are expected to arrive to help treat patients at Prague’s military hospital and a new field hospital at the city’s exhibition ground.

Croatia has asked former doctors to come out of retirement to help in hospitals, while Slovenia has put retired physicians and current medical students on standby in case its situation deteriorates.

Poland, meanwhile, is mobilizing soldiers to conduct COVID-19 testing,

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U.S. pharmacies attract new flu shot customers as coronavirus surges

By Caroline Humer

NEW YORK (Reuters) – Walmart Inc, Walgreens Boots Alliance Inc, CVS Health Corp and Rite Aid Corp have told Reuters demand for flu shots at their U.S. pharmacies is up sharply – in some cases double from last year – as people try to protect themselves from influenza in the midst of a worsening COVID-19 pandemic.The pharmacies are giving millions more flu shots than they have in past years, filling a gap from COVID-19 wary consumers who are avoiding the doctor’s office. The gains represent millions of dollars in potential profit.

U.S. public health officials have been urging Americans for months to inoculate themselves against the flu, which kills about 60,000 people a year, warning of a potential “twindemic” of influenza and the novel coronavirus that could overwhelm hospitals this winter.

More Americans are choosing to get vaccinated at local pharmacies than in the past, partly due to cancellation of annual “flu shot clinics” in workplaces that remain shut by the pandemic. Walmart <WMT.N> reported increased demand from entire families seeking shots.

“Right out of the gate, we saw much more volume than last August,” Rite Aid Chief Pharmacy Officer Jocelyn Konrad said.

She said the company has been able to keep up with the high demand and has not seen any vaccine shortages.

The shift to pharmacies is a potential boost to the country’s biggest chains that may not yet be factored into many Wall Street earnings estimates.

Cowen & Co said in a research note that the flu demand will increase profit at CVS <CVS.N>, forecasting that it would beat Wall Street estimates when the company reports quarterly earnings on Nov. 6.

Rite Aid <RAD.N> flagged a 40% jump in demand and said last month that increased immunizations will help third-quarter retail profit. Fears of coronavirus infection has led to a decrease in U.S. doctor visits, a decline in new prescriptions and a drop in pharmacy retail sales.

Flu shots are typically covered by commercial insurance and government health plans, or can cost about $40 out of pocket at a pharmacy.

Pharmacies make a gross profit of about $15 per shot, according to healthcare services analyst Brian Tanquilut at Jefferies LLC. In addition, the extra trip to the store may entice customers to purchase other items.

Pharmacies began laying the groundwork for increased flu shot demand early this year, anticipating that a potential second wave of coronavirus cases would push more customers their way. An early Reuters poll showed that 60% of Americans planned to get the flu shot in the fall, up from a more typical 50%. A CVS survey found more people saying they would get the shot at a pharmacy.

GlaxoSmithKline Plc <GSK.L>, Sanofi SA <SASY.PA>, and CSL Ltd’s <CSL.AX> Seqirus, which manufacture flu shots used in the United States, increased production by between 10% and 20% this year for a total of about 190 million shots.

DOUBLING OF DEMAND

The rise in flu shots at pharmacies coincides with an increase in

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As the coronavirus surges, it is reaching into the nation’s last untouched areas

Then came October. Three residents tested positive, knocking Petroleum off zero-case lists, forcing the county’s lone school to close for a week and proving, as Sheriff Bill Cassell put it, that “eventually we were going to get it,” and that the virus “ain’t gone yet.”

That is a lesson people in many other wide-open places have been learning as the coronavirus surges anew. Months after it raced in successive waves along the nation’s coasts and through the Sun Belt, it is reaching deep into its final frontier — the most sparsely populated states and counties, where distance from others has long been part of the appeal and this year had appeared to be a buffer against a deadly communicable disease.

In Montana, which boasts just seven people per square mile, active cases have more than doubled since the start of the month, and officials are warning of crisis-level hospitalization rates and strains on rural health care. In Wyoming, which ranks 49th in population density, the National Guard has been deployed to help with contact tracing. Those two states, along with the low-density states of Idaho, North Dakota and South Dakota, now have some of the nation’s highest per capita caseloads. Even Alaska, the least-crowded state, is logging unprecedented increases, including in rural villages.

“People here make the joke that we’ve been socially isolating since before the state was founded,” said Christine M. Porter, an associate professor of public health at the University of Wyoming. “In terms of the reason this happened now and it didn’t happen before, it was essentially luck-slash-geography. It’s a disease that spreads exponentially once it’s taken root, unless you take severe measures to stop it.”

The bulk of these states’ cases are clustered in their relatively small cities, but infections are fanning out. In Montana, about 55 percent of cases were in population centers by mid-month, down from nearly 80 percent over the summer. And although the caseloads may look low, they loom large for local public health officials and facilities.

Sue Woods directs the Central Montana Health District, a Massachusetts-sized area that includes Petroleum and five other rural counties. The district has about 120 active cases, and Woods is working 10- to 12-hour days, mostly on contact tracing.

“The numbers of cases that we see are so small compared to large population centers, but when you take our population into account, we’re right in the same percentages,” Woods said. “Two of us are doing the bulk of the patient contacts. It is overwhelming.”

Some officials point to the positive side of being hit by the coronavirus later in the pandemic. It gave jurisdictions and health-care facilities the opportunity, they say, to collect personal protective equipment, ramp up testing and learn more about the virus and how to treat covid-19, the disease it causes.

“Up until a few weeks ago, we had been very successful in limiting transmission,” said Alexia Harrist, Wyoming’s state health officer and state epidemiologist. “It did buy us very important time to

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Fauci says it might be time to mandate masks as Covid-19 surges across US

Dr. Anthony Fauci has been reluctant to support a federal mask mandate.



Anthony S. Fauci wearing a suit and tie standing in front of a sign


© Provided by CNN


“A national mandate probably would not work,” he said on Sept 15 during a news conference with Vermont Gov. Phil Scott.

Fauci, the director of the National Institute of Allergy and Infectious Diseases, has been urging Americans to use masks for months. “I have trust in the American people that if we put a strong emphasis on the importance of wearing masks, that we will come around and do that and get that percentage up above the relatively low percentage of people that are using masks,” Fauci said on July 21 on NPR’s Morning Edition.

But he has said before that he doesn’t think a federal law would be the way to go.

“I don’t like to be authoritarian from the federal government, but at the local level, if governors and others essentially mandate the use of masks when you have an outbreak, I think that would be very important,” Fauci told Alabama Sen. Doug Jones during a Facebook live event in July.

Until now.

“Well, if people are not wearing masks, then maybe we should be mandating it,” Fauci told CNN’s Erin Burnett Friday.

Covid-19 has been worsening across the United States, with cases rising in 32 states Friday and holding steady in 17 more. The University of Washington’s Institute for Health Metrics and Evaluation said the country was entering a winter surge as new infections passed 75,000 in a single day on Friday and more than 800 deaths were reported.

Mask mandates may be tricky to enforce, but it might be time to call for them, Fauci said.

“There’s going to be a difficulty enforcing it, but if everyone agrees that this is something that’s important and they mandate it and everybody pulls together and says, you know, we’re going to mandate it but let’s just do it, I think that would be a great idea to have everybody do it uniformly,” he said.

As cooler weather comes, people need to “double down” on measures that work, Fauci said. “Universal mask wearing” is one, he said, as is keeping a distance from others and frequent hand washing. “They sound very simple. But we’re not uniformly doing that and that’s one of the reasons we’re seeing these surges,” Fauci said.

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COVID-19 Surges Across U.S. as Some Hospitals Stretched | Top News

By Maria Caspani and Shaina Ahluwalia

NEW YORK (Reuters) – Several U.S. states, many of them in the Midwest, reported record single-day increases in COVID-19 infections on Thursday, further evidence that the pandemic is accelerating anew as cooler weather takes hold in many parts of the country.

Indiana, North Dakota, Illinois, Montana, Oklahoma, Utah and Ohio posted daily records on Thursday, according to a Reuters analysis, while Florida reported more than 5,500 new cases, its highest single-day increase since Aug. 15.

Twenty-eight states have reported their daily record high of COVID-19 cases in the month of October alone.

On Wednesday, the number of coronavirus deaths reported across the country reached its highest in two months. Increases in deaths tend to trail spikes new infections by several weeks.

The U.S. Food and Drug Administration on Thursday formally approved Gilead Sciences Inc’s antiviral drug remdesivir, which has been in wide use under an emergency authorization, for treating patients hospitalized with COVID-19. It is the first drug officially approved for the disease in the United States.

Since the pandemic reached the United States earlier this year, the nation has lost more than 222,000 lives, the world’s highest total as well as one of the highest per capita death rates, especially among developed nations. (Graphic: https://tmsnrt.rs/35hBCSa)

The autumn resurgence and dire predictions that the spread would further accelerate in the cold winter months have once again cast a harsh spotlight on President Donald Trump’s handling of the pandemic.

The Republican incumbent will debate Democratic challenger Joe Biden on Thursday evening for the last time before the Nov. 3 election. But with less than two weeks before the election, Trump’s seemingly dismissive approach to the coronavirus has clouded his re-election prospects, with polls showing Americans losing confidence in his ability to handle the pandemic.

A report released on Wednesday by Columbia University estimated that between 130,000 and 210,000 COVID-19 deaths could have been avoided in the United States, calling the federal government’s response to the pandemic an “enormous failure”.

“The weight of this enormous failure ultimately falls to the leadership at the White House – and among a number of state governments – which consistently undercut the efforts of top officials at the CDC and HHS,” the report said, referring to the U.S. Centers for Disease Control and Prevention and the Department of Health and Human Services.

White House spokesman Judd Deere blamed the pandemic’s toll on China, where the virus originated, and the World Health Organization – two favorite Trump targets – and said Trump’s actions saved American lives. Last month on the Fox & Friends show, Trump said he would give himself an “A+” for his coronavirus response.

Along with spikes in cases and deaths, the number of COVID-19 patients in U.S. hospitals climbed to a two-month high. There are now over 40,000 hospitalized coronavirus patients across the country, up 33% from Oct. 1, according to a Reuters analysis.

In Wisconsin, a COVID-19 hotspot and a pivotal battleground state that could help decide

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Noem says South Dakota is doing ‘good’ as virus surges

SIOUX FALLS, S.D. (AP) — Gov. Kristi Noem has insisted South Dakota is excelling in its handling of the pandemic, even though the state surpassed 9,000 active coronavirus cases on Thursday and matched an all-time high for deaths reported in a day.

The state ranks second in the country in new infections per capita over the last two weeks, according to Johns Hopkins University data. There were about 1,036 new cases per 100,000 people in South Dakota, meaning that about one in every 97 people in the state has tested positive for the virus in the last two weeks. Health officials on Thursday also reported an all-time high of 973 new cases.

But the Republican governor has used her refusal to issue mandates to vault to nationwide relevance among conservatives. She told Fox News on Wednesday night: “We’re doing really good in South Dakota. We’re managing COVID-19, but also our economy is thriving.”

Health officials reported Thursday that the number of people hospitalized with COVID-19 reached a record high with 355 in hospitals, including 75 in Intensive Care Units. The state matched its record of 14 deaths in a day.

Noem has said COVID-19 hospitalizations account for a relatively small percentage of total hospital capacity and that hospitals are still handling an influx of patients for other health issues. Currently, 35% of general-care hospital beds and 36% of Intensive Care Units remain open, according to the Department of Health.


However, both of the state’s largest hospital systems have altered the logistics of some elective procedures to free up space and staff to handle the virus surge. Without a statewide mask mandate in place, the hospital systems have also urged people to wear masks when they are around people outside of their households.

The hospital systems got support on that message from Sioux Falls Mayor Paul TenHaken, who earlier this week put it bluntly: “Wear a dang mask.”

But Noem has made it clear she will not institute a mask requirement and doubts the usefulness of the recommendation from the nation’s top health experts that widespread masking helps prevent infections from spreading.

In an opinion article published Wednesday, the governor pointed to doctors who say it is not clear how effective masks are in preventing infections. She said places with mask mandates have still seen case growth, but conceded that masks are “appropriate” in hospitals or when caring for someone with COVID-19 symptoms.

Noem’s opinion piece also included a link to an article on masks from a conservative medical group called Association of American Physicians and Surgeons. The group has a history of staking out unorthodox positions on medical issues, including calling mass vaccinations “equivalent to human experimentation” and opposing Medicare, the government-funded health insurance for older people.

More recently, the group has s poken out against lockdowns to prevent the spread of the virus and encouraged treating COVID-19 with hydroxychloroquine, a malaria drug that President Donald Trump pushed before the Food and Drug Administration revoked its emergency-use authorization. Noem also

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