WASHINGTON (AP) — The U.S. effort in World War II was off the charts. Battles spread over three continents and four years, 16 million served in uniform and the government shoved levers of the economy full force into defeating Nazi Germany and imperial Japan.

All of that was cheaper for American taxpayers than this pandemic.

The $1,400 federal payments going into millions of people’s bank accounts are but one slice of a&nbsp;<a href="https://apnews.com/article/what-is-inside-covid-19-bill-relief-package-52fa93ac75d38eae4cd3dbb6402e7eba">nearly $2 trillion relief package made law</a>&nbsp;this past week. With that, the United States has spent or committed to spend nearly $6 trillion to crush the coronavirus, recover economically and&nbsp;<a href="https://apnews.com/article/covid-19-relief-bill-social-safety-net-3bff45f1be9d5f7eb8cd7c14a51c6732">take a bite out of child poverty.</a>

Set in motion over one year, that’s warp-speed spending in a capital known for gridlock, ugly argument and now an episode of violent insurrection.

For a year now, Americans have grappled with numbers beyond ordinary comprehension: some 30 million infected, more than half a million dead, millions of jobs lost, vast sums of money sloshing through government pipelines to try to set things right.

How high can you count? At one turn after another, that may be the rhetorical question of these COVID-19 times.

Once, the attack on Pearl Harbor was the modern marker for national trauma. About 2,400 Americans died in the assault on the naval base in Hawaii that drew the United States into the Pacific war. The nearly 3,000 dead from the terrorist attacks Sept. 11, 2001, became the new point of comparison as the ravages of COVID-19 grew.

The U.S. reached a total of 3,000 COVID-19 deaths even before March 2020 was out. By December, the country was experiencing the toll of 9/11 day after day after day. In that time, COVID-19 was killing more Americans than any other disease, any other single cause.

“COVID-19 now is the leading cause of death, surpassing heart disease,” Dr. Robert Redfield, then leading the Centers for Disease and Prevention,&nbsp;<a href="https://www.cfr.org/event/conversation-robert-redfield" target="_blank">said Dec. 10</a>. Looking to the weeks ahead, he said “it’s going to be the most difficult time in the public health history of this nation.”

So it was, even with the vaccine rollout five days later.

With deaths now moderating — so that a 9/11 toll comes cumulatively every few days — the U.S. death toll now has surpassed 530,000,&nbsp;<a href="https://www.va.gov/opa/publications/factsheets/fs_americas_wars.pdf" target="_blank">exceeding U.S. combat deaths</a>&nbsp;of all of the last century’s wars.

A new marker looms: the estimated&nbsp;<a href="https://www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html" target="_blank">675,000 Americans who died in the 1918-19 pandemic</a>&nbsp;misnamed the Spanish flu.

That milestone may not be reached, if worst-case scenarios are avoided. Yet this much is clear — the United States has taken a proportionally worse hit in this pandemic.

The U.S. has experienced 1 in 5 deaths worldwide, compared with 1 in 75 deaths globally by the rough estimates of the pandemic a century ago.

The blame game is on, exacerbated by the record of a president, Donald Trump, who rarely acknowledged the gravity of the crisis and routinely distorted it. He told Americans in March 2020 the country would be “just raring to go by Easter” and declared on the cusp of soaring infections that the U.S. was “rounding the final turn” on the virus.

“We were hit with a virus that was met with silence and spread unchecked,” President Joe Biden said&nbsp;<a href="https://apnews.com/article/joe-biden-religion-pandemics-coronavirus-pandemic-holidays-e01c6d13db6a28a06fe770e1c6d46122">in his prime-time address</a>&nbsp;Thursday. “Denials for days, weeks, then months.”

But while Trump persisted in sunny side up, he also opened the coffers on vaccine development and pandemic relief, backing $4 trillion in aid, equal to 20% of the U.S. economy.

And he pulled together a Star Wars-sounding effort that pretty much lived up to the hyperbole of its name. By the usual yearslong lag in coming up with a vaccine, the authorization to release two vaccines — now three — proved something of an Operation Warp Speed.

The Trump administration’s striking success in backing the invention of coronavirus vaccines through direct spending or advance purchase commitments has been followed by the Biden administration’s nascent success in spurring the production and delivery of those shots.

On this Trump-Biden continuum, shots have risen from 48,757 the first day, Dec. 15, to an average of 1.5 million to 2 million per day the first week of March, raising hope that a persistent bottleneck and vaccine shortages can be overcome. More than 100 million doses have been administered; 35 million people have been fully vaccinated.

Back in February 2020, when the financial markets showed strain from the pandemic and oil prices started to plunge, many economists began to predict that the U.S. government would need to borrow sums unimaginable to older generations.

Biden’s $1.9 trillion package follows five others in the past year, altogether worth almost $6 trillion. That’s about $1 trillion more than U.S military expenditures in World War II, all in today’s dollars. It’s more than the government’s entire budget just two years ago, $4.4 trillion.

About two-thirds of the money in Biden’s plan is to be spent in one year, a hefty infusion that has some economists worried about inflation.

The cost of servicing the debt last year was only&nbsp;<a href="https://www.cbo.gov/system/files/2020-12/56780-Net-Interest-Primer.pdf" target="_blank">1.6% of the gross domestic product</a>&nbsp;— a bargain compared with the 1990s, when the total debt was much lower. Back then, the federal government spent about 3% of GDP on net interest costs.

Bargain, of course, is relative. Debt is historically high, up 130% over 10 years even before the latest relief package, a burden made manageable by historically low interest rates.&nbsp;<a href="https://apnews.com/article/biden-politics-coronavirus-relief-infrastructure-66f5f5a3de700941aa41f675157f8748">Big-ticket plans on infrastructure&nbsp;</a>and more are still to come.

And they are bound to come with 12 zeroes. It’s a world of trillions now.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/12/1608071469793.jpg" alt="" />
 <figcaption></figcaption>
 </figure>WASHINGTON (AP) — The U.S. effort in World War II was off the charts. Battles spread over three continents and four years, 16 million served in uniform and the government shoved levers of the economy full force into defeating Nazi Germany and imperial Japan.All of that was cheaper for American taxpayers than this pandemic.The $1,400 federal payments going into millions of people’s bank accounts are but one slice of a&nbsp;<a href="https://apnews.com/article/what-is-inside-covid-19-bill-relief-package-52fa93ac75d38eae4cd3dbb6402e7eba">nearly $2 trillion relief package made law</a>&nbsp;this past week. With that, the United States has spent or committed to spend nearly $6 trillion to crush the coronavirus, recover economically and&nbsp;<a href="https://apnews.com/article/covid-19-relief-bill-social-safety-net-3bff45f1be9d5f7eb8cd7c14a51c6732">take a bite out of child poverty.</a>Set in motion over one year, that’s warp-speed spending in a capital known for gridlock, ugly argument and now an episode of violent insurrection.For a year now, Americans have grappled with numbers beyond ordinary comprehension: some 30 million infected, more than half a million dead, millions of jobs lost, vast sums of money sloshing through government pipelines to try to set things right.How high can you count? At one turn after another, that may be the rhetorical question of these COVID-19 times.THE TOLLOnce, the attack on Pearl Harbor was the modern marker for national trauma. About 2,400 Americans died in the assault on the naval base in Hawaii that drew the United States into the Pacific war. The nearly 3,000 dead from the terrorist attacks Sept. 11, 2001, became the new point of comparison as the ravages of COVID-19 grew.The U.S. reached a total of 3,000 COVID-19 deaths even before March 2020 was out. By December, the country was experiencing the toll of 9/11 day after day after day. In that time, COVID-19 was killing more Americans than any other disease, any other single cause.“COVID-19 now is the leading cause of death, surpassing heart disease,” Dr. Robert Redfield, then leading the Centers for Disease and Prevention,&nbsp;<a href="https://www.cfr.org/event/conversation-robert-redfield" target="_blank">said Dec. 10</a>. Looking to the weeks ahead, he said “it’s going to be the most difficult time in the public health history of this nation.”So it was, even with the vaccine rollout five days later.With deaths now moderating — so that a 9/11 toll comes cumulatively every few days — the U.S. death toll now has surpassed 530,000,&nbsp;<a href="https://www.va.gov/opa/publications/factsheets/fs_americas_wars.pdf" target="_blank">exceeding U.S. combat deaths</a>&nbsp;of all of the last century’s wars.A new marker looms: the estimated&nbsp;<a href="https://www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html" target="_blank">675,000 Americans who died in the 1918-19 pandemic</a>&nbsp;misnamed the Spanish flu.That milestone may not be reached, if worst-case scenarios are avoided. Yet this much is clear — the United States has taken a proportionally worse hit in this pandemic.The U.S. has experienced 1 in 5 deaths worldwide, compared with 1 in 75 deaths globally by the rough estimates of the pandemic a century ago.___THE RESPONSEThe blame game is on, exacerbated by the record of a president, Donald Trump, who rarely acknowledged the gravity of the crisis and routinely distorted it. He told Americans in March 2020 the country would be “just raring to go by Easter” and declared on the cusp of soaring infections that the U.S. was “rounding the final turn” on the virus.“We were hit with a virus that was met with silence and spread unchecked,” President Joe Biden said&nbsp;<a href="https://apnews.com/article/joe-biden-religion-pandemics-coronavirus-pandemic-holidays-e01c6d13db6a28a06fe770e1c6d46122">in his prime-time address</a>&nbsp;Thursday. “Denials for days, weeks, then months.”But while Trump persisted in sunny side up, he also opened the coffers on vaccine development and pandemic relief, backing $4 trillion in aid, equal to 20% of the U.S. economy.And he pulled together a Star Wars-sounding effort that pretty much lived up to the hyperbole of its name. By the usual yearslong lag in coming up with a vaccine, the authorization to release two vaccines — now three — proved something of an Operation Warp Speed.The Trump administration’s striking success in backing the invention of coronavirus vaccines through direct spending or advance purchase commitments has been followed by the Biden administration’s nascent success in spurring the production and delivery of those shots.On this Trump-Biden continuum, shots have risen from 48,757 the first day, Dec. 15, to an average of 1.5 million to 2 million per day the first week of March, raising hope that a persistent bottleneck and vaccine shortages can be overcome. More than 100 million doses have been administered; 35 million people have been fully vaccinated.The bill for it all is stratospheric.Back in February 2020, when the financial markets showed strain from the pandemic and oil prices started to plunge, many economists began to predict that the U.S. government would need to borrow sums unimaginable to older generations.Now that’s reality.Biden’s $1.9 trillion package follows five others in the past year, altogether worth almost $6 trillion. That’s about $1 trillion more than U.S military expenditures in World War II, all in today’s dollars. It’s more than the government’s entire budget just two years ago, $4.4 trillion.About two-thirds of the money in Biden’s plan is to be spent in one year, a hefty infusion that has some economists worried about inflation.How can the U.S. possibly afford this?At least for now, debt is cheap.The cost of servicing the debt last year was only&nbsp;<a href="https://www.cbo.gov/system/files/2020-12/56780-Net-Interest-Primer.pdf" target="_blank">1.6% of the gross domestic product</a>&nbsp;— a bargain compared with the 1990s, when the total debt was much lower. Back then, the federal government spent about 3% of GDP on net interest costs.Bargain, of course, is relative. Debt is historically high, up 130% over 10 years even before the latest relief package, a burden made manageable by historically low interest rates.&nbsp;<a href="https://apnews.com/article/biden-politics-coronavirus-relief-infrastructure-66f5f5a3de700941aa41f675157f8748">Big-ticket plans on infrastructure&nbsp;</a>and more are still to come.And they are bound to come with 12 zeroes. It’s a world of trillions now.___

How high can you count? Surreal stats of COVID times

NORTH PLATTE — Visitors to Victoria Springs, Nebraska’s first state recreation area, will enjoy upgrades at this oasis in the Sandhills just in time for the Nebraska Game and Parks Commission parks system centennial celebration.

Recent improvements mean campers will have 50-amp electrical service at 21 new camping sites. Additional basic camping sites are available on the south end of the campground. Later this spring, two new concrete latrines also will be installed to enhance the shower house and restroom.

The two, two-bedroom rental cabins will undergo renovations as well this spring to make them accessible, increase living space and create new decks with views of the lake.

When complete, about $374,000 of Capitol Maintenance Funds will have been put into Victoria Springs for improvements. Victoria Springs is located 6 miles east of Anselmo and 9 miles north of Merna.

The park, which features mineral springs, historic buildings and plenty of outdoor opportunity, will be featured in a Game and Parks signature centennial event July 10 for its role in Nebraska parks’ history. Explore more at&nbsp;<a href="https://lnks.gd/l/eyJhbGciOiJIUzI1NiJ9.eyJidWxsZXRpbl9saW5rX2lkIjoxMDEsInVyaSI6ImJwMjpjbGljayIsImJ1bGxldGluX2lkIjoiMjAyMTAzMTIuMzY4OTE4OTEiLCJ1cmwiOiJodHRwczovL3BhcmtzMTAwLm91dGRvb3JuZWJyYXNrYS5nb3YvIn0.A_eVznLlK0PET0bAMxMqhmzzrVu2Mp1jDtlQzJIUe_c/s/497221906/br/99839251677-l" target="_blank">YourNebraskaParks100.org</a>.

To learn more about improvements made at Nebraska state parks, visit&nbsp;<a href="https://lnks.gd/l/eyJhbGciOiJIUzI1NiJ9.eyJidWxsZXRpbl9saW5rX2lkIjoxMDIsInVyaSI6ImJwMjpjbGljayIsImJ1bGxldGluX2lkIjoiMjAyMTAzMTIuMzY4OTE4OTEiLCJ1cmwiOiJodHRwOi8vb3V0ZG9vcm5lYnJhc2thLmdvdi9wYXJrc3Byb2plY3RzLyJ9.ERi9Cz8dBhKnePPgjh4-8nv3TCjkJEwiq8DZ41Jq8U0/s/497221906/br/99839251677-l" target="_blank">OutdoorNebraska.org/parksprojects</a>.

NORTH PLATTE — Visitors to Victoria Springs, Nebraska’s first state recreation area, will enjoy upgrades at this oasis in the Sandhills just in time for the Nebraska Game and Parks Commission parks system centennial celebration.Recent improvements mean campers will have 50-amp electrical service at 21 new camping sites. Additional basic camping sites are available on the south end of the campground. Later this spring, two new concrete latrines also will be installed to enhance the shower house and restroom.The two, two-bedroom rental cabins will undergo renovations as well this spring to make them accessible, increase living space and create new decks with views of the lake.When complete, about $374,000 of Capitol Maintenance Funds will have been put into Victoria Springs for improvements. Victoria Springs is located 6 miles east of Anselmo and 9 miles north of Merna.The park, which features mineral springs, historic buildings and plenty of outdoor opportunity, will be featured in a Game and Parks signature centennial event July 10 for its role in Nebraska parks’ history. Explore more at&nbsp;<a href="https://lnks.gd/l/eyJhbGciOiJIUzI1NiJ9.eyJidWxsZXRpbl9saW5rX2lkIjoxMDEsInVyaSI6ImJwMjpjbGljayIsImJ1bGxldGluX2lkIjoiMjAyMTAzMTIuMzY4OTE4OTEiLCJ1cmwiOiJodHRwczovL3BhcmtzMTAwLm91dGRvb3JuZWJyYXNrYS5nb3YvIn0.A_eVznLlK0PET0bAMxMqhmzzrVu2Mp1jDtlQzJIUe_c/s/497221906/br/99839251677-l" target="_blank">YourNebraskaParks100.org</a>.To learn more about improvements made at Nebraska state parks, visit&nbsp;<a href="https://lnks.gd/l/eyJhbGciOiJIUzI1NiJ9.eyJidWxsZXRpbl9saW5rX2lkIjoxMDIsInVyaSI6ImJwMjpjbGljayIsImJ1bGxldGluX2lkIjoiMjAyMTAzMTIuMzY4OTE4OTEiLCJ1cmwiOiJodHRwOi8vb3V0ZG9vcm5lYnJhc2thLmdvdi9wYXJrc3Byb2plY3RzLyJ9.ERi9Cz8dBhKnePPgjh4-8nv3TCjkJEwiq8DZ41Jq8U0/s/497221906/br/99839251677-l" target="_blank">OutdoorNebraska.org/parksprojects</a>.

Victoria Springs gets spruced up in time for centennial celebration

OMAHA, Neb. (AP) — Police in Omaha are looking for suspects in the shooting death of a man early in the weekend. 

Police say in a news release that officers were called to a north Omaha neighborhood around 8 p.m. Friday, where they found  59-year-old Larry Thompson suffering from gunshot wounds.

 Thompson was taken to an area hospital, where he later died. 

Police have not released other details about the shooting, and had not announced any arrests or named any suspects in the shooting by Monday morning.

OMAHA, Neb. (AP) — Police in Omaha are looking for suspects in the shooting death of a man early in the weekend. Police say in a news release that officers were called to a north Omaha neighborhood around 8 p.m. Friday, where they found 59-year-old Larry Thompson suffering from gunshot wounds. Thompson was taken to an area hospital, where he later died. Police have not released other details about the shooting, and had not announced any arrests or named any suspects in the shooting by Monday morning.

Omaha police seeking suspects in weekend shooting death

OMAHA, Neb. (AP) — Authorities say an Omaha police officer was shot and wounded during a confrontation with a man who was suspected of shoplifting T-shirts. 

The Omaha World-Herald reports that 21-year-old Kenya Lamont Jenkins Jr. was booked into the Douglas County Jail early Saturday on suspicion of attempted first-degree murder and use of a gun to commit a felony.

 Officials said Officer Jeffrey Wittstruck was “stable and recovering" after being shot around 4 p.m. Friday in the JC Penney department store security office.

OMAHA, Neb. (AP) — Authorities say an Omaha police officer was shot and wounded during a confrontation with a man who was suspected of shoplifting T-shirts. The Omaha World-Herald reports that 21-year-old Kenya Lamont Jenkins Jr. was booked into the Douglas County Jail early Saturday on suspicion of attempted first-degree murder and use of a gun to commit a felony. Officials said Officer Jeffrey Wittstruck was “stable and recovering" after being shot around 4 p.m. Friday in the JC Penney department store security office.

T-shirt shoplifting suspect arrested in shooting of officer

OMAHA, Neb. (AP) — Omaha Police Chief Todd Schmaderer says a police officer was shot and critically injured at the Westroads Mall.

 The chief said two officers responded to a call at the shopping center Friday afternoon and one was shot. 

Police Lt. Sherie Thomas said the suspect was later arrested after a chase along Interstate 80 that reached high speeds. 

She said the gun used in the shooting was found when the suspect was arrested.

 The officer was alert Friday evening and will have to undergo surgery.

OMAHA, Neb. (AP) — Omaha Police Chief Todd Schmaderer says a police officer was shot and critically injured at the Westroads Mall. The chief said two officers responded to a call at the shopping center Friday afternoon and one was shot. Police Lt. Sherie Thomas said the suspect was later arrested after a chase along Interstate 80 that reached high speeds. She said the gun used in the shooting was found when the suspect was arrested. The officer was alert Friday evening and will have to undergo surgery.

Omaha officer shot, critically injured at shopping mall

ROME (AP) — The Vatican decreed Monday that the Catholic Church cannot bless same-sex unions since God “cannot bless sin.”

The Vatican’s orthodoxy office, the Congregation for the Doctrine of the Faith, issued a formal response Monday to a question about whether Catholic clergy can bless gay unions.

The answer, contained in a two-page explanation published in seven languages and approved by Pope Francis, was “negative.”

The decree distinguished between the church’s welcoming and blessing of gay people, which it upheld, but not their unions.

The Vatican holds that gays much be treated with dignity and respect, but that gay sex is “intrinsically disordered.” Catholic teaching holds that marriage between a man and woman is part of God’s plan and is intended for the sake of creating new life.

Since gay unions are not intended to be part of that plan, they cannot be blessed by the church, the document said.

“The presence in such relationships of positive elements, which are in themselves to be valued and appreciated, cannot justify these relationships and render them legitimate objects of an ecclesial blessing, since the positive elements exist within the context of a union not ordered to the Creator’s plan,” the response said.

God “does not and cannot bless sin: He blesses sinful man, so that he may recognize that he is part of his plan of love and allow himself to be changed by him,” it said.

Francis has endorsed providing gay couples with legal protections in same-sex unions, but that is in reference to the civil sphere, not within the church. His comments were made during an interview with a Mexican television station, Televisa, in 2019, but were cut by the Vatican until they appeared in a documentary last year.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/10/1603292366279.png" alt="Pope Francis enters the House chamber ahead of an address to a joint session of Congress in 2015- image courtesy CSPAN" />
 <figcaption>Pope Francis enters the House chamber ahead of an address to a joint session of Congress in 2015- image courtesy CSPAN</figcaption>
 </figure>ROME (AP) — The Vatican decreed Monday that the Catholic Church cannot bless same-sex unions since God “cannot bless sin.”The Vatican’s orthodoxy office, the Congregation for the Doctrine of the Faith, issued a formal response Monday to a question about whether Catholic clergy can bless gay unions.The answer, contained in a two-page explanation published in seven languages and approved by Pope Francis, was “negative.”The decree distinguished between the church’s welcoming and blessing of gay people, which it upheld, but not their unions.The Vatican holds that gays much be treated with dignity and respect, but that gay sex is “intrinsically disordered.” Catholic teaching holds that marriage between a man and woman is part of God’s plan and is intended for the sake of creating new life.Since gay unions are not intended to be part of that plan, they cannot be blessed by the church, the document said.“The presence in such relationships of positive elements, which are in themselves to be valued and appreciated, cannot justify these relationships and render them legitimate objects of an ecclesial blessing, since the positive elements exist within the context of a union not ordered to the Creator’s plan,” the response said.God “does not and cannot bless sin: He blesses sinful man, so that he may recognize that he is part of his plan of love and allow himself to be changed by him,” it said.Francis has endorsed providing gay couples with legal protections in same-sex unions, but that is in reference to the civil sphere, not within the church. His comments were made during an interview with a Mexican television station, Televisa, in 2019, but were cut by the Vatican until they appeared in a documentary last year.

Vatican issues new statement on Catholic church, same-sex unions

WASHINGTON (AP) — Let the sales push begin.

President Joe Biden, Vice President Kamala Harris and their spouses are opening an ambitious, cross-country tour this week to highlight&nbsp;<a href="https://apnews.com/article/joe-biden-first-prime-time-speech-next-phase-pandemic-85d1ae52bc61abffd3ae91c324e58308">the benefits of his $1.9 trillion plan</a>&nbsp;to defeat the coronavirus and boost the economy.

The road show — dubbed the “Help is Here” tour by the White House — begins Monday with Harris heading to a COVID-19 vaccination site and a culinary academy in Las Vegas and first lady Jill Biden touring a New Jersey elementary school.

The president will have more to say about the plan Monday at the White House, and he plans to visit a small business in Delaware County, Pennsylvania, on Tuesday. He and Harris are slated to appear together in Atlanta on Friday.

Harris will meet with small-business owners in Denver on Tuesday. Wednesday sees Jill Biden in Concord, New Hampshire, and Harris’ husband, Doug Emhoff, in Albuquerque, New Mexico.

The stops at vaccination sites, businesses, schools and more are meant to educate the public about different aspects of&nbsp;<a href="https://apnews.com/article/joe-biden-personal-taxes-legislation-coronavirus-pandemic-local-governments-e828c92fbdd7f4fa1e35d9ab95fe705e">the giant American Rescue Plan</a>&nbsp;and how it will help people get to the other side of&nbsp;<a href="https://apnews.com/hub/coronavirus-pandemic">the coronavirus pandemic</a>.

Biden has said President Barack Obama’s administration, in which Biden was vice president, failed to adequately educate the public about the benefits of its economic recovery plan. He said he wants to do a better sales job this time around on the details of his first big legislative victory.

One of the plan’s key features is&nbsp;<a href="https://apnews.com/article/white-house-virus-relief-checks-3eed6a4659f1fb7d36b4ced0eba58f86">direct payments of $1,400 for a single taxpayer</a>, or $2,800 for a married couple filing their taxes jointly, plus $1,400 per dependent — for a total of $5,600 for a married couple with two children. The payments phase out for those with higher incomes.

An extension of federal unemployment benefits will continue through Sept. 6 at $300 a week. There’s $350 billion for state, local and tribal governments, $130 billion for K-12 schools and about $50 billion to expand COVID-19 testing, among other measures.

Restaurants and bars that were forced to close or limit service will take advantage of a new multibillion-dollar grant program, and the plan also has tens of billions of dollars to help people who have fallen behind on their rent and mortgage payments.

The bill cleared Congress without any backing from Republicans, despite polling that found broad public support for the plan. Republicans argued the bill was too expensive. Democrats provided the votes and Biden signed it into law last week.

The “Help is Here” tour is taking Harris on her first domestic trip as vice president. She’ll be accompanied by her husband, the nation’s first “second gentleman,” who plans to break off for separate events in Las Vegas on Monday and New Mexico on Wednesday.

Since taking office, Harris has presided over swearing-in ceremonies for members of Biden’s Cabinet. She has stood with the president at his speeches, delivered remarks of her own, spoken by telephone with assorted world leaders and made appearances in the Washington area, including at funeral services for Washington power broker Vernon Jordan.

Harris also cast three tie-breaking votes in the 50-50 Senate in her role as president of the Senate.

Jill Biden will be joined by New Jersey Gov. Phil Murphy on a tour Monday of Samuel Smith Elementary School in Burlington, where she is expected to talk about how the plan will help families and communities, and highlight steps the school took to reopen.

The first lady has kept a robust schedule focused on education, military families and cancer research since stepping into her new role. Earlier this month, she and Education Secretary Miguel Cardona visited Connecticut and Pennsylvania public schools that reopened during the pandemic.

Emhoff, an entertainment lawyer, also has made a few appearances in the Washington area in between his stint teaching at Georgetown Law. He plans to visit a food relief organization Monday in Las Vegas and participate in a listening session with the organization’s partners.

In addition to the president, vice president and their spouses, Cabinet secretaries will also be out on the tour. Hundreds of mayors and governors, including Republicans, are being lined up to give interviews to discuss what the plan means for their communities.

Transportation Secretary Pete Buttigieg was set Monday to tour a UPS distribution center in Landover, Maryland, that also delivers vaccines in the Washington area.

<figure>
 <img src="https://media.eaglewebservices.com/public/2021/3/1615804276114.png" alt="Vice President Kamala Harris and President Joe Biden during a Rose Garden event to discuss the $1.9T America Rescue Plan Act.-image courtesy White House" />
 <figcaption>Vice President Kamala Harris and President Joe Biden during a Rose Garden event to discuss the $1.9T America Rescue Plan Act.-image courtesy White House</figcaption>
 </figure>WASHINGTON (AP) — Let the sales push begin.President Joe Biden, Vice President Kamala Harris and their spouses are opening an ambitious, cross-country tour this week to highlight&nbsp;<a href="https://apnews.com/article/joe-biden-first-prime-time-speech-next-phase-pandemic-85d1ae52bc61abffd3ae91c324e58308">the benefits of his $1.9 trillion plan</a>&nbsp;to defeat the coronavirus and boost the economy.The road show — dubbed the “Help is Here” tour by the White House — begins Monday with Harris heading to a COVID-19 vaccination site and a culinary academy in Las Vegas and first lady Jill Biden touring a New Jersey elementary school.The president will have more to say about the plan Monday at the White House, and he plans to visit a small business in Delaware County, Pennsylvania, on Tuesday. He and Harris are slated to appear together in Atlanta on Friday.Harris will meet with small-business owners in Denver on Tuesday. Wednesday sees Jill Biden in Concord, New Hampshire, and Harris’ husband, Doug Emhoff, in Albuquerque, New Mexico.The stops at vaccination sites, businesses, schools and more are meant to educate the public about different aspects of&nbsp;<a href="https://apnews.com/article/joe-biden-personal-taxes-legislation-coronavirus-pandemic-local-governments-e828c92fbdd7f4fa1e35d9ab95fe705e">the giant American Rescue Plan</a>&nbsp;and how it will help people get to the other side of&nbsp;<a href="https://apnews.com/hub/coronavirus-pandemic">the coronavirus pandemic</a>.Biden has said President Barack Obama’s administration, in which Biden was vice president, failed to adequately educate the public about the benefits of its economic recovery plan. He said he wants to do a better sales job this time around on the details of his first big legislative victory.One of the plan’s key features is&nbsp;<a href="https://apnews.com/article/white-house-virus-relief-checks-3eed6a4659f1fb7d36b4ced0eba58f86">direct payments of $1,400 for a single taxpayer</a>, or $2,800 for a married couple filing their taxes jointly, plus $1,400 per dependent — for a total of $5,600 for a married couple with two children. The payments phase out for those with higher incomes.An extension of federal unemployment benefits will continue through Sept. 6 at $300 a week. There’s $350 billion for state, local and tribal governments, $130 billion for K-12 schools and about $50 billion to expand COVID-19 testing, among other measures.Restaurants and bars that were forced to close or limit service will take advantage of a new multibillion-dollar grant program, and the plan also has tens of billions of dollars to help people who have fallen behind on their rent and mortgage payments.The bill cleared Congress without any backing from Republicans, despite polling that found broad public support for the plan. Republicans argued the bill was too expensive. Democrats provided the votes and Biden signed it into law last week.The “Help is Here” tour is taking Harris on her first domestic trip as vice president. She’ll be accompanied by her husband, the nation’s first “second gentleman,” who plans to break off for separate events in Las Vegas on Monday and New Mexico on Wednesday.Since taking office, Harris has presided over swearing-in ceremonies for members of Biden’s Cabinet. She has stood with the president at his speeches, delivered remarks of her own, spoken by telephone with assorted world leaders and made appearances in the Washington area, including at funeral services for Washington power broker Vernon Jordan.Harris also cast three tie-breaking votes in the 50-50 Senate in her role as president of the Senate.Jill Biden will be joined by New Jersey Gov. Phil Murphy on a tour Monday of Samuel Smith Elementary School in Burlington, where she is expected to talk about how the plan will help families and communities, and highlight steps the school took to reopen.The first lady has kept a robust schedule focused on education, military families and cancer research since stepping into her new role. Earlier this month, she and Education Secretary Miguel Cardona visited Connecticut and Pennsylvania public schools that reopened during the pandemic.Emhoff, an entertainment lawyer, also has made a few appearances in the Washington area in between his stint teaching at Georgetown Law. He plans to visit a food relief organization Monday in Las Vegas and participate in a listening session with the organization’s partners.In addition to the president, vice president and their spouses, Cabinet secretaries will also be out on the tour. Hundreds of mayors and governors, including Republicans, are being lined up to give interviews to discuss what the plan means for their communities.Transportation Secretary Pete Buttigieg was set Monday to tour a UPS distribution center in Landover, Maryland, that also delivers vaccines in the Washington area.

Road show: Biden, Harris to promote relief plan's benefits

By ANNE M. PETERSON, Associated Press

More than 500 college athletes have signed a letter to the NCAA Board of Governors asking the organization to refuse to schedule championships in states that have banned transgender participation in sports.

The move follows a wave of legislative efforts across the country aimed at transgender athletes. Idaho banned transgender women from taking part in women’s and girls’ sports last year, although that law has been challenged in court. State legislatures in North Dakota and Mississippi have recently passed similar measures.

The letter to the NCAA asks the board to uphold the organization’s nondiscrimination policy, citing the decision to move championships out of North Carolina in 2016 in response to House Bill 2, which legislated transgender use of public restrooms.

“We call upon you to ensure that the NCAA lives up to the guidelines and standards that they claim to uphold by making a firm statement that you will uphold the NCAA Anti-Discrimination Policy and only operate championships and events in states that promote an inclusive atmosphere,” the letter says.

The NCAA has had policies in place since 2011 that allow for transgender participation in sports.

The letter was the idea of track and field athletes Aliya Schenck and Alana Bojar of Washington University in St. Louis, who work with Athlete Ally. Athletes from across the different college sports signed on to the effort.

“All student-athletes should be safe and protected when competing in NCAA championships,” the two said in a statement. “Your silence on this issue is only allowing more states to pass these bills. We urge you to act now and make a strong statement against these bills, saying that the NCAA will not host championships in states that openly discriminate against LGBTQI+ athletes.”

Athlete Ally is a nonprofit group that advocates for LGBTQI+ athletes. Last year it was part of an effort on behalf of 200 current and former athletes —— including Megan Rapinoe, Billie Jean King and Candace Parker — who filed an amicus brief with the 9th U.S. Circuit Court of Appeals in opposition to the Idaho law.

“Though the NCAA has continued to monitor the bills and has spoken out in support of trans athletes, the time is now for the NCAA to listen to hundreds of student athletes calling on them to clearly and unequivocally put the health and safety of all student-athletes first and condemn these horrific bills,” said Anne Lieberman, Athlete Ally’s director of policy and programs.

The NCAA issued a statement to The Associated Press saying it continues to monitor legislation that affects transgender athletes.

“The NCAA believes in fair and respectful student-athlete participation at all levels of sport. The Association’s transgender student-athlete participation policy and other diversity policies are designed to facilitate and support inclusion,” the statement said. “The NCAA believes diversity and inclusion improve the learning environment and it encourages its member colleges and universities to support the well-being of all student-athletes.”

By ANNE M. PETERSON, Associated PressMore than 500 college athletes have signed a letter to the NCAA Board of Governors asking the organization to refuse to schedule championships in states that have banned transgender participation in sports.The move follows a wave of legislative efforts across the country aimed at transgender athletes. Idaho banned transgender women from taking part in women’s and girls’ sports last year, although that law has been challenged in court. State legislatures in North Dakota and Mississippi have recently passed similar measures.The letter to the NCAA asks the board to uphold the organization’s nondiscrimination policy, citing the decision to move championships out of North Carolina in 2016 in response to House Bill 2, which legislated transgender use of public restrooms.“We call upon you to ensure that the NCAA lives up to the guidelines and standards that they claim to uphold by making a firm statement that you will uphold the NCAA Anti-Discrimination Policy and only operate championships and events in states that promote an inclusive atmosphere,” the letter says.The NCAA has had policies in place since 2011 that allow for transgender participation in sports.The letter was the idea of track and field athletes Aliya Schenck and Alana Bojar of Washington University in St. Louis, who work with Athlete Ally. Athletes from across the different college sports signed on to the effort.“All student-athletes should be safe and protected when competing in NCAA championships,” the two said in a statement. “Your silence on this issue is only allowing more states to pass these bills. We urge you to act now and make a strong statement against these bills, saying that the NCAA will not host championships in states that openly discriminate against LGBTQI+ athletes.”Athlete Ally is a nonprofit group that advocates for LGBTQI+ athletes. Last year it was part of an effort on behalf of 200 current and former athletes —— including Megan Rapinoe, Billie Jean King and Candace Parker — who filed an amicus brief with the 9th U.S. Circuit Court of Appeals in opposition to the Idaho law.“Though the NCAA has continued to monitor the bills and has spoken out in support of trans athletes, the time is now for the NCAA to listen to hundreds of student athletes calling on them to clearly and unequivocally put the health and safety of all student-athletes first and condemn these horrific bills,” said Anne Lieberman, Athlete Ally’s director of policy and programs.The NCAA issued a statement to The Associated Press saying it continues to monitor legislation that affects transgender athletes.“The NCAA believes in fair and respectful student-athlete participation at all levels of sport. The Association’s transgender student-athlete participation policy and other diversity policies are designed to facilitate and support inclusion,” the statement said. “The NCAA believes diversity and inclusion improve the learning environment and it encourages its member colleges and universities to support the well-being of all student-athletes.”

Athletes appeal to NCAA in protest of anti-transgender laws

HUTCHINSON, Kan. — One year after the COVID-19 pandemic upended plans for travelers in Kansas and throughout the world, there are new signs that travel dreams won’t be deferred.

"In a recent survey by Destination Analysts, well over half of Americans, 60% surveyed said that they are going to be traveling for leisure in the next three months," said Shawn Steward with AAA Kansas.

Even though they are planning later trips, spring break still feels like too soon to most Americans, based on the March 8 survey.

"Only 14% of Americans said that they plan to travel for Spring Break," Steward said. "It's looking more like late spring, early summer is going to be that peak time where people's comfort level seems to be for getting back out on the road."

A total of 36% in a late February survey believe travel activities will return to normal in the June-August time frame, while an even greater percentage, 42%, see fall as the travel sweet spot.

By NICK GOSNELLHutch PostHUTCHINSON, Kan. — One year after the COVID-19 pandemic upended plans for travelers in Kansas and throughout the world, there are new signs that travel dreams won’t be deferred."In a recent survey by Destination Analysts, well over half of Americans, 60% surveyed said that they are going to be traveling for leisure in the next three months," said Shawn Steward with AAA Kansas.Even though they are planning later trips, spring break still feels like too soon to most Americans, based on the March 8 survey."Only 14% of Americans said that they plan to travel for Spring Break," Steward said. "It's looking more like late spring, early summer is going to be that peak time where people's comfort level seems to be for getting back out on the road."A total of 36% in a late February survey believe travel activities will return to normal in the June-August time frame, while an even greater percentage, 42%, see fall as the travel sweet spot.

Survey: Travelers will get moving later in the year

WASHINGTON (AP) — President Joe Biden’s administration is stockpiling tens of millions of doses of a COVID-19 vaccine whose authorization in the U.S. remains uncertain, frustrating U.S. allies who say those doses should be used now to save lives overseas.

The standoff is part of a growing global debate over who should have access to hundreds of millions of doses of vaccine that pharmaceutical companies are churning out in the U.S. Besides generating ill will, Biden’s insistence on an excess supply for America is potentially creating new openings for geopolitical rivals Russia and China.

A two-dose vaccine from AstraZeneca has received&nbsp;<a href="https://apnews.com/article/eu-authorizes-astrazeneca-vaccine-adults-18b545dd51ea56f422ff28cdeb2dd08b">emergency clearance&nbsp;</a>from the European Union and World Health Organization but not from the U.S. Now America’s partners are prodding Biden to release his supply, noting that the administration has lined up enough doses of three already-authorized vaccines&nbsp;<a href="https://apnews.com/article/joe-biden-ap-top-news-coronavirus-pandemic-4de42d355f18b8a1352f1206b5253814">to cover every American adult by the end of May&nbsp;</a>and the entire U.S. population by the end of July.

AstraZeneca says that the U.S.-produced vaccines are “owned” by the U.S. government and that sending them overseas would require White House approval.

“We understand other governments may have reached out to the U.S. government about donation of AstraZeneca doses, and we’ve asked the U.S. government to give thoughtful consideration to these requests,” Gonzalo Viña, a spokesman for AstraZeneca, said in a statement.

Even though the 27-nation European Union is eager to relaunch a more fruitful trans-Atlantic relationship after the bruising Trump presidency, the vaccine issue is proving to be a thorny topic, with some in Europe seeing it as a continuation of former President Donald Trump’s “America First” focus.

EU member states’ ambassadors discussed the challenge this week. The German government said on Friday it was in contact with U.S. officials about vaccine supplies but stressed that the European Commission has the lead when it comes to procuring shots for member states.

Biden and European Commission President Ursula von der Leyen have directed representatives to discuss supply chains in the vaccine production.

“Hopefully, we will be in a position on both sides of the Atlantic to ensure that sufficient quantities of vaccine doses are distributed out in line with the schedule so as to complete the vaccination campaigns,” EU commission chief spokesman Eric Mamer said.

Well over 10 million doses of AstraZeneca’s vaccine are stockpiled in the U.S. for use here.

“We want to be oversupplied and overprepared,” White House press secretary Jen Psaki said Friday, so Americans can still be swiftly vaccinated in the event of unforeseen issues with the existing production timeline.

“We have not provided doses from the U.S. government to anyone,” she said.

Asked about the stockpiled vaccine, White House COVID-19 coordinator Jeff Zients said, “We have a small inventory of AstraZeneca so, if approved, we can g&nbsp;<a href="https://apnews.com/article/pandemics-new-york-rochelle-walensky-coronavirus-pandemic-fcec736ac8474e121bfc3b2fd41718b2">et that inventory out to the American people&nbsp;</a>as quickly as possible.” He said the U.S. was following the same procedure it used for the already-authorized vaccines.

Drug manufacturers that received federal assistance in developing or expanding vaccine manufacturing were required to sell their first doses to the U.S. In the case of AstraZeneca, whose vaccine was initially expected to be the first to receive federal emergency authorization, the government ordered 300 million doses — enough for 150 million Americans — before issues with the vaccine’s clinical trial held up clearance..

The company said this month it believes it will have roughly 30 million doses available to the U.S. government by the end of March, and an additional 20 million by the end of April.

As foreign regulators have moved ahead with the shot, the U.S. has not dropped its contractual claim on the initial doses produced in America.

That policy has also come under criticism from U.S. neighbors Canada and Mexico, which have been forced to seek vaccine manufactured on a different continent, rather than across the border. Meanwhile, the Biden administration has purchased enough doses of Moderna, Pfizer and Johnson &amp; Johnson to inoculate 150 million more people than the U.S. population by the end of the year.

The U.S. has also ordered 110 million doses of vaccine from Novavax, which is expected to file for emergency authorization as soon as next month.

AstraZeneca’s 30,000-person U.S. trial didn’t complete enrollment until January. The company hasn’t given any hints of when initial results might be ready beyond an executive telling Congress last month he expected it would be “soon.”

The European Union, amid its own stumbling vaccine rollout, appears increasingly resigned to the Biden administration retaining control of the U.S. doses.

The EU is at odds with AstraZeneca, too, because the company is delivering far fewer doses to the bloc than it had promised. Of the initial order for 80 million in the first quarter this year, the company will be struggling to deliver half.

Despite shortages at home and often being accused of vaccine protectionism itself, the 27-nation bloc has allowed the export of well over 34 million doses of COVID-19 vaccines in past weeks, including 953,723 to the United States.

Meanwhile, Russia and China have used their domestically produced vaccines for strategic leverage.

China has pledged roughly half a billion doses to more than 45 countries, according to a country-by-country tally by The Associated Press. Four of China’s many vaccine makers are claiming they will be able to produce at least 2.6 billion doses this year.

Russia has sent millions of doses of its&nbsp;<a href="https://apnews.com/article/europe-italy-coronavirus-pandemic-russia-1c9bac0105f04e297e51f04859f304a9">Sputnik V vaccine</a>&nbsp;to countries around the world, even as it vaccinates its own population. Analysts say a goal of this vaccine diplomacy is to bolster Russia’s image as a scientific, technological and benevolent power, especially as other countries encounter shortages of COVID-19 vaccines because richer nations are scooping up the Western-made versions.

Israel, which has vaccinated more than half of its population with Pfizer vaccines produced in Europe, has also attempted to use vaccine diplomacy to reward allies.

Biden did move to have the U.S. contribute financially to the United Nations- and World Health Organization-backed COVAX alliance, which will help share vaccine with more than 90 lower and middle-income nations, but the U.S. has yet to commit to sharing any doses.

WASHINGTON (AP) — President Joe Biden’s administration is stockpiling tens of millions of doses of a COVID-19 vaccine whose authorization in the U.S. remains uncertain, frustrating U.S. allies who say those doses should be used now to save lives overseas.The standoff is part of a growing global debate over who should have access to hundreds of millions of doses of vaccine that pharmaceutical companies are churning out in the U.S. Besides generating ill will, Biden’s insistence on an excess supply for America is potentially creating new openings for geopolitical rivals Russia and China.A two-dose vaccine from AstraZeneca has received&nbsp;<a href="https://apnews.com/article/eu-authorizes-astrazeneca-vaccine-adults-18b545dd51ea56f422ff28cdeb2dd08b">emergency clearance&nbsp;</a>from the European Union and World Health Organization but not from the U.S. Now America’s partners are prodding Biden to release his supply, noting that the administration has lined up enough doses of three already-authorized vaccines&nbsp;<a href="https://apnews.com/article/joe-biden-ap-top-news-coronavirus-pandemic-4de42d355f18b8a1352f1206b5253814">to cover every American adult by the end of May&nbsp;</a>and the entire U.S. population by the end of July.AstraZeneca says that the U.S.-produced vaccines are “owned” by the U.S. government and that sending them overseas would require White House approval.“We understand other governments may have reached out to the U.S. government about donation of AstraZeneca doses, and we’ve asked the U.S. government to give thoughtful consideration to these requests,” Gonzalo Viña, a spokesman for AstraZeneca, said in a statement.Even though the 27-nation European Union is eager to relaunch a more fruitful trans-Atlantic relationship after the bruising Trump presidency, the vaccine issue is proving to be a thorny topic, with some in Europe seeing it as a continuation of former President Donald Trump’s “America First” focus.EU member states’ ambassadors discussed the challenge this week. The German government said on Friday it was in contact with U.S. officials about vaccine supplies but stressed that the European Commission has the lead when it comes to procuring shots for member states.Biden and European Commission President Ursula von der Leyen have directed representatives to discuss supply chains in the vaccine production.“Hopefully, we will be in a position on both sides of the Atlantic to ensure that sufficient quantities of vaccine doses are distributed out in line with the schedule so as to complete the vaccination campaigns,” EU commission chief spokesman Eric Mamer said.Well over 10 million doses of AstraZeneca’s vaccine are stockpiled in the U.S. for use here.“We want to be oversupplied and overprepared,” White House press secretary Jen Psaki said Friday, so Americans can still be swiftly vaccinated in the event of unforeseen issues with the existing production timeline.“We have not provided doses from the U.S. government to anyone,” she said.Asked about the stockpiled vaccine, White House COVID-19 coordinator Jeff Zients said, “We have a small inventory of AstraZeneca so, if approved, we can g&nbsp;<a href="https://apnews.com/article/pandemics-new-york-rochelle-walensky-coronavirus-pandemic-fcec736ac8474e121bfc3b2fd41718b2">et that inventory out to the American people&nbsp;</a>as quickly as possible.” He said the U.S. was following the same procedure it used for the already-authorized vaccines.Drug manufacturers that received federal assistance in developing or expanding vaccine manufacturing were required to sell their first doses to the U.S. In the case of AstraZeneca, whose vaccine was initially expected to be the first to receive federal emergency authorization, the government ordered 300 million doses — enough for 150 million Americans — before issues with the vaccine’s clinical trial held up clearance..The company said this month it believes it will have roughly 30 million doses available to the U.S. government by the end of March, and an additional 20 million by the end of April.As foreign regulators have moved ahead with the shot, the U.S. has not dropped its contractual claim on the initial doses produced in America.That policy has also come under criticism from U.S. neighbors Canada and Mexico, which have been forced to seek vaccine manufactured on a different continent, rather than across the border. Meanwhile, the Biden administration has purchased enough doses of Moderna, Pfizer and Johnson &amp; Johnson to inoculate 150 million more people than the U.S. population by the end of the year.The U.S. has also ordered 110 million doses of vaccine from Novavax, which is expected to file for emergency authorization as soon as next month.AstraZeneca’s 30,000-person U.S. trial didn’t complete enrollment until January. The company hasn’t given any hints of when initial results might be ready beyond an executive telling Congress last month he expected it would be “soon.”The European Union, amid its own stumbling vaccine rollout, appears increasingly resigned to the Biden administration retaining control of the U.S. doses.The EU is at odds with AstraZeneca, too, because the company is delivering far fewer doses to the bloc than it had promised. Of the initial order for 80 million in the first quarter this year, the company will be struggling to deliver half.Despite shortages at home and often being accused of vaccine protectionism itself, the 27-nation bloc has allowed the export of well over 34 million doses of COVID-19 vaccines in past weeks, including 953,723 to the United States.Meanwhile, Russia and China have used their domestically produced vaccines for strategic leverage.China has pledged roughly half a billion doses to more than 45 countries, according to a country-by-country tally by The Associated Press. Four of China’s many vaccine makers are claiming they will be able to produce at least 2.6 billion doses this year.Russia has sent millions of doses of its&nbsp;<a href="https://apnews.com/article/europe-italy-coronavirus-pandemic-russia-1c9bac0105f04e297e51f04859f304a9">Sputnik V vaccine</a>&nbsp;to countries around the world, even as it vaccinates its own population. Analysts say a goal of this vaccine diplomacy is to bolster Russia’s image as a scientific, technological and benevolent power, especially as other countries encounter shortages of COVID-19 vaccines because richer nations are scooping up the Western-made versions.Israel, which has vaccinated more than half of its population with Pfizer vaccines produced in Europe, has also attempted to use vaccine diplomacy to reward allies.Biden did move to have the U.S. contribute financially to the United Nations- and World Health Organization-backed COVAX alliance, which will help share vaccine with more than 90 lower and middle-income nations, but the U.S. has yet to commit to sharing any doses.

Tussle between US, allies over vaccine supply escalates

LINCOLN, Neb. (AP) — The U.S. military's four “doomsday” planes have been moved to their new temporary home in Lincoln from Offutt Air Force Base south of Omaha as the base undergoes a $144 million runway replacement. 

The E-4B Nightwatch aircraft serve as aerial command centers for top military officials in case of a catastrophic national emergency, such as a nuclear attack. 

Air Force Lt. Col. Derek Ligon is deputy commander of the 595th Command and Control Group. 

He said the move to Lincoln’s airport was the logical choice, as it has a nearly 13,000-foot runway that can handle the big planes. 

And it's only about an hour's drive from the base.

LINCOLN, Neb. (AP) — The U.S. military's four “doomsday” planes have been moved to their new temporary home in Lincoln from Offutt Air Force Base south of Omaha as the base undergoes a $144 million runway replacement. The E-4B Nightwatch aircraft serve as aerial command centers for top military officials in case of a catastrophic national emergency, such as a nuclear attack. Air Force Lt. Col. Derek Ligon is deputy commander of the 595th Command and Control Group. He said the move to Lincoln’s airport was the logical choice, as it has a nearly 13,000-foot runway that can handle the big planes. And it's only about an hour's drive from the base.

Offutt E-4B Nightwatch planes moved to Lincoln airport

WILMINGTON, Del. (AP) — The Biden administration is turning to the Federal Emergency Management Agency for help managing and caring for record numbers of unaccompanied immigrant children who are streaming into the United States by illegally crossing the border with Mexico.

FEMA will support a governmentwide effort over the next three months to safely receive, shelter and transfer minor children who arrive alone at the U.S. southwest border, without a parent or other adult, Homeland Security Secretary Alejandro Mayorkas said Saturday.

Government figures show a growing crisis at the border as hundreds of children illegally enter the U.S. from Mexico daily and are taken into custody.

The Homeland Security Department is supposed to process and transfer unaccompanied minor children to the Department of Health and Human Services within three days so that they can be placed with a parent already living in the United States, or other suitable sponsor, until their immigration cases can be resolved.

But more children are being held longer at Border Patrol facilities that weren’t designed with their care in mind because long-term shelters run by the Department of Health and Human Services have next to no capacity to accommodate them. Children are being apprehended daily at far higher rates than HHS can release them to parents or sponsors.

Mayorkas said FEMA is working with the Health and Human Services Department to “look at every available option to quickly expand physical capacity for appropriate lodging.”

“Our goal is to ensure that unaccompanied children are transferred to HHS as quickly as possible, consistent with legal requirements and in the best interest of the children,” Mayorkas said.

During an record influx of unaccompanied minors in 2014, the Obama administration also turned to FEMA for help coordinating the governmentwide response. During that crisis, FEMA helped stand up temporary shelters and processing stations on military bases.

President Joe Biden has ended the Trump-era practice of expelling immigrant children who cross the border alone, but maintained expulsions of immigrant families and single adults.

While his administration has tried to deter immigrants from entering the U.S., many believe they have a better chance now that Biden is president.

There have also been growing reports of parents sending their children across the border alone while they remain in Mexico or Central America.

<figure>
 <img src="https://media.eaglewebservices.com/public/2019/6/1560133940225.png" alt="" />
 <figcaption></figcaption>
 </figure>WILMINGTON, Del. (AP) — The Biden administration is turning to the Federal Emergency Management Agency for help managing and caring for record numbers of unaccompanied immigrant children who are streaming into the United States by illegally crossing the border with Mexico.FEMA will support a governmentwide effort over the next three months to safely receive, shelter and transfer minor children who arrive alone at the U.S. southwest border, without a parent or other adult, Homeland Security Secretary Alejandro Mayorkas said Saturday.Government figures show a growing crisis at the border as hundreds of children illegally enter the U.S. from Mexico daily and are taken into custody.The Homeland Security Department is supposed to process and transfer unaccompanied minor children to the Department of Health and Human Services within three days so that they can be placed with a parent already living in the United States, or other suitable sponsor, until their immigration cases can be resolved.But more children are being held longer at Border Patrol facilities that weren’t designed with their care in mind because long-term shelters run by the Department of Health and Human Services have next to no capacity to accommodate them. Children are being apprehended daily at far higher rates than HHS can release them to parents or sponsors.Mayorkas said FEMA is working with the Health and Human Services Department to “look at every available option to quickly expand physical capacity for appropriate lodging.”“Our goal is to ensure that unaccompanied children are transferred to HHS as quickly as possible, consistent with legal requirements and in the best interest of the children,” Mayorkas said.During an record influx of unaccompanied minors in 2014, the Obama administration also turned to FEMA for help coordinating the governmentwide response. During that crisis, FEMA helped stand up temporary shelters and processing stations on military bases.President Joe Biden has ended the Trump-era practice of expelling immigrant children who cross the border alone, but maintained expulsions of immigrant families and single adults.While his administration has tried to deter immigrants from entering the U.S., many believe they have a better chance now that Biden is president.There have also been growing reports of parents sending their children across the border alone while they remain in Mexico or Central America.

FEMA to help manage unaccompanied minors at US-Mexico border

By ALI SWENSON and DAVID KLEPPER-Associated Press

(AP)-Los Angeles emergency room nurse Sandra Younan spent the last year juggling long hours as she watched many patients struggle with the coronavirus and some die.

Then there were the patients who claimed the virus was fake or coughed in her face, ignoring mask rules. One man stormed out of the hospital after a positive COVID-19 test, refusing to believe it was accurate.

“You have patients that are literally dying, and then you have patients that are denying the disease,” she said. “You try to educate and you try to educate, but then you just hit a wall.”

Bogus claims about the virus, masks and vaccines have exploded since COVID-19 was declared a global pandemic a year ago. Journalists, public health officials and tech companies have tried to push back against the falsehoods, but much of the job of correcting misinformation has fallen to the world’s front-line medical workers.

In&nbsp;<a href="https://apnews.com/article/fact-checking-afs:Content:9845984765">Germany</a>, a video clip showing a nurse using an empty syringe while practicing vaccinations traveled widely online as purported evidence that COVID-19 is fake. Doctors in&nbsp;<a href="https://apnews.com/article/7aaf0329a6a5785844483f36d8e5eddd">Afghanistan&nbsp;</a>reported patients telling them COVID-19 was created by the U.S. and China to reduce the world population. In&nbsp;<a href="https://apnews.com/article/97afc6e9f07751ba14493a4587ff26dc">Bolivia</a>, medical workers had to care for five people who ingested a toxic bleaching agent falsely touted as a COVID-19 cure.

Younan, 27, says her friends used to describe her as the “chillest person ever,” but now she deals with crushing anxiety.

“My life is being a nurse, so I don’t care if you’re really sick, you throw up on me, whatever,” Younan said. “But when you know what you’re doing is wrong, and I’m asking you repeatedly to please wear your mask to protect me, and you’re still not doing it, it’s like you have no regard for anybody but yourself. And that’s why this virus is spreading. It just makes you lose hope.”

Emily Scott, 36, who is based at a Seattle hospital, has worked around the world on medical missions and helped care for the first U.S. COVID-19 patient last year. She was selected because of her experience working in Sierra Leone during the 2014-2016 Ebola outbreak.

While many Americans were terrified of Ebola — a disease that isn’t nearly as contagious as the coronavirus and poses little threat in the U.S. — they aren’t nearly afraid enough of COVID-19, she said.

Scott blames a few factors: Ebola’s frightening symptoms, racism against Africans and the politicization of COVID-19 by American elected officials.

“I felt so much safer in Sierra Leone during Ebola than I did at the beginning of this outbreak in the U.S.,” Scott said, because of how many people failed to heed social distancing and mask directives. “Things that are facts, and science, have become politicized.”

ER nurse L’Erin Ogle has heard a litany of false claims about the virus while working at a hospital in the suburbs of Kansas City, Missouri. They include: The virus&nbsp;<a href="https://apnews.com/article/fact-checking-afs:Content:9573357676">isn’t any worse than the flu</a>. It’s caused by&nbsp;<a href="https://apnews.com/article/4ac3679b6f39e8bd2561c1c8eeafd855">5G wireless towers</a>.&nbsp;<a href="https://apnews.com/article/280e3742a4d27b9a550ad1c03fba2d6d">Masks won’t help and may hurt</a>. Or, the most painful to her: The virus isn’t real, and doctors and nurses are engaged in a vast global conspiracy to hide the truth.

“It just feels so defeating, and it makes you question: Why am I doing this?” said Ogle, 40.

Nurses are often the health care providers with the most patient contact, and patients frequently view nurses as more approachable, according to professor Maria Brann, an expert on health communication at Indiana University-Purdue University Indianapolis. That means nurses are more likely to encounter patients spreading misinformation, which gives them a special opportunity to intervene.

“Nurses have always been patient advocates, but this pandemic has thrown so much more at them,” Brann said. “It can definitely take a toll. This isn’t necessarily what they signed up for.”

In some cases, it’s nurses and other health care workers themselves spreading misinformation. And many nurses say they encounter falsehoods about the coronavirus vaccine in their own families.

For Brenda Olmos, 31, a nurse practitioner in Austin, Texas, who focuses on a geriatric and Hispanic patient population, it was a no-brainer to get the vaccine. But first she had to debate her parents, who had heard unsubstantiated claims that the shot would cause&nbsp;<a href="https://apnews.com/article/fact-checking-afs:Content:9856420671">infertility</a>&nbsp;and&nbsp;<a href="https://apnews.com/article/fact-checking-afs:Content:9817754888">Bell’s palsy</a>&nbsp;on Spanish-language TV shows.

Olmos eventually convinced her parents to get the vaccine, too, but she worries about vaccine hesitancy in her community.

When she recently encountered an elderly patient with cancerous tumors, Olmos knew the growths had taken years to develop. But the man’s adult children who had recently gotten him the vaccine insisted that the two were connected.

“To them, it just seemed too coincidental,” Olmos said. “I just wanted them to not have that guilt.”

Olmos said the real problem with misinformation is not just bad actors spreading lies — it’s people believing false claims because they aren’t as comfortable navigating often complex medical findings.

“Low health literacy is the real pandemic,” she said. “As health care providers, we have a duty to serve the information in a way that’s palatable, and that’s easy to understand, so that people don’t consume misinformation because they can’t digest the real data.”

When Texas Gov. Greg Abbott&nbsp;<a href="https://apnews.com/article/texas-lifts-covid-19-mask-mandate-ed7cd1b065a1afd71175f255fb5148aa">lifted the state’s mask mandate&nbsp;</a>this month against the guidance of many scientists, nurse practitioner Guillermo Carnegie called the decision a “spit in the face.”

“I was disgusted,” said Carnegie, 34, of Temple, Texas. “This governor, and different people, they act like, ‘Oh, we’re proud of our front-line workers, we support them.’ But then they do something like that, and it taxes the medical field tremendously.”

Brian Southwell, who started a program at Duke University School of Medicine to train medical professionals how to talk to misinformed patients, said providers should view the patient confiding in them as an opportunity.

“That patient trusts you enough to raise that information with you,” Southwell said. “And so that’s a good thing, even if you disagree with it.”

He said medical workers should resist going into “academic argumentation mode” and instead find out why patients hold certain beliefs — and whether they might be open to other ideas.

That act of listening is imperative to building trust, according to Dr. Seema Yasmin, a physician, journalist and Stanford University professor who studies medical misinformation.

“Put down your pen, put down your notebook and listen,” Yasmin said.

<figure>
 <img src="https://media.eaglewebservices.com/public/2021/3/1615724588028.jpg" alt="Image courtesy of Pixabay" />
 <figcaption>Image courtesy of Pixabay</figcaption>
 </figure>By ALI SWENSON and DAVID KLEPPER-Associated Press(AP)-Los Angeles emergency room nurse Sandra Younan spent the last year juggling long hours as she watched many patients struggle with the coronavirus and some die.Then there were the patients who claimed the virus was fake or coughed in her face, ignoring mask rules. One man stormed out of the hospital after a positive COVID-19 test, refusing to believe it was accurate.“You have patients that are literally dying, and then you have patients that are denying the disease,” she said. “You try to educate and you try to educate, but then you just hit a wall.”Bogus claims about the virus, masks and vaccines have exploded since COVID-19 was declared a global pandemic a year ago. Journalists, public health officials and tech companies have tried to push back against the falsehoods, but much of the job of correcting misinformation has fallen to the world’s front-line medical workers.In&nbsp;<a href="https://apnews.com/article/fact-checking-afs:Content:9845984765">Germany</a>, a video clip showing a nurse using an empty syringe while practicing vaccinations traveled widely online as purported evidence that COVID-19 is fake. Doctors in&nbsp;<a href="https://apnews.com/article/7aaf0329a6a5785844483f36d8e5eddd">Afghanistan&nbsp;</a>reported patients telling them COVID-19 was created by the U.S. and China to reduce the world population. In&nbsp;<a href="https://apnews.com/article/97afc6e9f07751ba14493a4587ff26dc">Bolivia</a>, medical workers had to care for five people who ingested a toxic bleaching agent falsely touted as a COVID-19 cure.Younan, 27, says her friends used to describe her as the “chillest person ever,” but now she deals with crushing anxiety.“My life is being a nurse, so I don’t care if you’re really sick, you throw up on me, whatever,” Younan said. “But when you know what you’re doing is wrong, and I’m asking you repeatedly to please wear your mask to protect me, and you’re still not doing it, it’s like you have no regard for anybody but yourself. And that’s why this virus is spreading. It just makes you lose hope.”Emily Scott, 36, who is based at a Seattle hospital, has worked around the world on medical missions and helped care for the first U.S. COVID-19 patient last year. She was selected because of her experience working in Sierra Leone during the 2014-2016 Ebola outbreak.While many Americans were terrified of Ebola — a disease that isn’t nearly as contagious as the coronavirus and poses little threat in the U.S. — they aren’t nearly afraid enough of COVID-19, she said.Scott blames a few factors: Ebola’s frightening symptoms, racism against Africans and the politicization of COVID-19 by American elected officials.“I felt so much safer in Sierra Leone during Ebola than I did at the beginning of this outbreak in the U.S.,” Scott said, because of how many people failed to heed social distancing and mask directives. “Things that are facts, and science, have become politicized.”ER nurse L’Erin Ogle has heard a litany of false claims about the virus while working at a hospital in the suburbs of Kansas City, Missouri. They include: The virus&nbsp;<a href="https://apnews.com/article/fact-checking-afs:Content:9573357676">isn’t any worse than the flu</a>. It’s caused by&nbsp;<a href="https://apnews.com/article/4ac3679b6f39e8bd2561c1c8eeafd855">5G wireless towers</a>.&nbsp;<a href="https://apnews.com/article/280e3742a4d27b9a550ad1c03fba2d6d">Masks won’t help and may hurt</a>. Or, the most painful to her: The virus isn’t real, and doctors and nurses are engaged in a vast global conspiracy to hide the truth.“It just feels so defeating, and it makes you question: Why am I doing this?” said Ogle, 40.Nurses are often the health care providers with the most patient contact, and patients frequently view nurses as more approachable, according to professor Maria Brann, an expert on health communication at Indiana University-Purdue University Indianapolis. That means nurses are more likely to encounter patients spreading misinformation, which gives them a special opportunity to intervene.“Nurses have always been patient advocates, but this pandemic has thrown so much more at them,” Brann said. “It can definitely take a toll. This isn’t necessarily what they signed up for.”In some cases, it’s nurses and other health care workers themselves spreading misinformation. And many nurses say they encounter falsehoods about the coronavirus vaccine in their own families.For Brenda Olmos, 31, a nurse practitioner in Austin, Texas, who focuses on a geriatric and Hispanic patient population, it was a no-brainer to get the vaccine. But first she had to debate her parents, who had heard unsubstantiated claims that the shot would cause&nbsp;<a href="https://apnews.com/article/fact-checking-afs:Content:9856420671">infertility</a>&nbsp;and&nbsp;<a href="https://apnews.com/article/fact-checking-afs:Content:9817754888">Bell’s palsy</a>&nbsp;on Spanish-language TV shows.Olmos eventually convinced her parents to get the vaccine, too, but she worries about vaccine hesitancy in her community.When she recently encountered an elderly patient with cancerous tumors, Olmos knew the growths had taken years to develop. But the man’s adult children who had recently gotten him the vaccine insisted that the two were connected.“To them, it just seemed too coincidental,” Olmos said. “I just wanted them to not have that guilt.”Olmos said the real problem with misinformation is not just bad actors spreading lies — it’s people believing false claims because they aren’t as comfortable navigating often complex medical findings.“Low health literacy is the real pandemic,” she said. “As health care providers, we have a duty to serve the information in a way that’s palatable, and that’s easy to understand, so that people don’t consume misinformation because they can’t digest the real data.”When Texas Gov. Greg Abbott&nbsp;<a href="https://apnews.com/article/texas-lifts-covid-19-mask-mandate-ed7cd1b065a1afd71175f255fb5148aa">lifted the state’s mask mandate&nbsp;</a>this month against the guidance of many scientists, nurse practitioner Guillermo Carnegie called the decision a “spit in the face.”“I was disgusted,” said Carnegie, 34, of Temple, Texas. “This governor, and different people, they act like, ‘Oh, we’re proud of our front-line workers, we support them.’ But then they do something like that, and it taxes the medical field tremendously.”Brian Southwell, who started a program at Duke University School of Medicine to train medical professionals how to talk to misinformed patients, said providers should view the patient confiding in them as an opportunity.“That patient trusts you enough to raise that information with you,” Southwell said. “And so that’s a good thing, even if you disagree with it.”He said medical workers should resist going into “academic argumentation mode” and instead find out why patients hold certain beliefs — and whether they might be open to other ideas.That act of listening is imperative to building trust, according to Dr. Seema Yasmin, a physician, journalist and Stanford University professor who studies medical misinformation.“Put down your pen, put down your notebook and listen,” Yasmin said.

Nurses fight conspiracy theories along with coronavirus

By MARKIAN HAWRYLUK <a href="https://www.kcur.org/news/2021-03-12/rural-americans-in-pharmacy-deserts-hurting-for-covid-19-vaccines">Kaiser Health News</a>

As the Biden administration accelerates a plan to use pharmacies to 
distribute COVID-19 vaccines, significant areas of the country lack 
brick-and-mortar pharmacies capable of administering the protective 
shots.

A <a href="https://rupri.public-health.uiowa.edu/publications/policybriefs/2020/COVID%20Pharmacy%20Brief.pdf" target="_blank">recent analysis</a>
 by the Rural Policy Research Institute found that 111 rural counties, 
mostly between the Mississippi River and the Rocky Mountains, have no 
pharmacy that can give the vaccines. That could leave thousands of 
vulnerable Americans struggling to find vaccines, which in turn 
threatens to prolong the pandemic in many hard-hit rural regions.

And
 in those areas without pharmacies, rural residents may have to drive 
long distances to get shots, and do so twice for two-dose vaccines. <a href="https://s8637.pcdn.co/wp-content/uploads/2021/02/Access-to-Potential-COVID-19-Vaccine-Administration-Facilities-2-2-2021.pdf" target="_blank">An analysis</a>
 by the University of Pittsburgh School of Pharmacy and the West Health 
Policy Center found that 89% of Americans live within five miles of a 
pharmacy. But more than 1.6 million people must travel more than 20 
miles to the nearest pharmacy, which can mean facing difficult weather 
and road conditions in remote areas.

“If pharmacies are closed, 
especially in places where there’s no other health care provider, then 
you’ve got essentially a health care desert,” said Michael Hogue, 
president of the <a href="https://www.pharmacist.com/" target="_blank">American Pharmacists Association</a>.
 “You have to be dependent on either a mobile clinic coming in from 
another area to provide vaccines, or the citizens are going to have to 
drive farther to get a vaccine.”

So far, with a limited quantity of doses and strict limitations on 
who is eligible, that hasn’t been a problem. But as vaccination opens up
 to the general public and supplies of the vaccines increase, local 
health departments may be overwhelmed with demand and may need to 
offload the task of vaccinating local residents to other health care 
providers.

“It’s probably not playing out yet because we’re not 
getting enough supply,” said Keith Mueller, director of the Rural Policy
 Research Institute’s Center for Rural Health Policy Analysis. “That 
means we have some time for those local health departments to figure 
this out: Who in my radius, if you will, has the capacity to administer 
vaccines?”

From 2003 to 2018, 1,231 independent rural pharmacies 
closed, Mueller’s team found, leaving some 630 rural communities with no
 retail drugstore. The changing economics in the pharmacy industry did 
them in, a combination of national pharmacy chains expanding and 
consolidating, big-box stores and supermarkets opening their own 
competing pharmacies and pharmacy benefit managers eating into 
small-pharmacy profits. Mail-order options siphoned off business.

And you can’t get vaccines in the mail.

In
 many towns, those pharmacies represented the last bastion of health 
care in their communities. Now more than ever, residents are feeling the
 void.

“We have no medical infrastructure,” said DeAnne Gallegos, a
 spokesperson for the San Juan County health department in southwestern 
Colorado. “We don’t even have a doctor.”

With the closest pharmacy
 located in a neighboring county an hour away in Durango, vaccinations 
in San Juan County have been handled by the public health director and 
two nurses. They hold weekly vaccination clinics if they get any doses. 
As of Feb. 18, the health department had fully vaccinated 298 of its 700
 residents.

Counties are allocated doses based on their year-round
 populations, but the health department hopes to vaccinate 
out-of-staters who visit as well. San Juan County deals with an influx 
of tourists and second-home owners coming from states such as Texas, 
Arizona and Florida, where the pandemic has hit harder and vaccination 
rates are lagging. So the health department could end up vaccinating 
more than 200% of San Juan County’s official population to keep covid 
out.

<figure>
 <img src="https://media.eaglewebservices.com/public/2021/3/1615579215378.png" alt="David Condos / Kansas News Service" />
 <figcaption>David Condos / Kansas News Service</figcaption>
 </figure>By MARKIAN HAWRYLUK <a href="https://www.kcur.org/news/2021-03-12/rural-americans-in-pharmacy-deserts-hurting-for-covid-19-vaccines">Kaiser Health News</a>As the Biden administration accelerates a plan to use pharmacies to 
distribute COVID-19 vaccines, significant areas of the country lack 
brick-and-mortar pharmacies capable of administering the protective 
shots.A <a href="https://rupri.public-health.uiowa.edu/publications/policybriefs/2020/COVID%20Pharmacy%20Brief.pdf" target="_blank">recent analysis</a>
 by the Rural Policy Research Institute found that 111 rural counties, 
mostly between the Mississippi River and the Rocky Mountains, have no 
pharmacy that can give the vaccines. That could leave thousands of 
vulnerable Americans struggling to find vaccines, which in turn 
threatens to prolong the pandemic in many hard-hit rural regions.And
 in those areas without pharmacies, rural residents may have to drive 
long distances to get shots, and do so twice for two-dose vaccines. <a href="https://s8637.pcdn.co/wp-content/uploads/2021/02/Access-to-Potential-COVID-19-Vaccine-Administration-Facilities-2-2-2021.pdf" target="_blank">An analysis</a>
 by the University of Pittsburgh School of Pharmacy and the West Health 
Policy Center found that 89% of Americans live within five miles of a 
pharmacy. But more than 1.6 million people must travel more than 20 
miles to the nearest pharmacy, which can mean facing difficult weather 
and road conditions in remote areas.“If pharmacies are closed, 
especially in places where there’s no other health care provider, then 
you’ve got essentially a health care desert,” said Michael Hogue, 
president of the <a href="https://www.pharmacist.com/" target="_blank">American Pharmacists Association</a>.
 “You have to be dependent on either a mobile clinic coming in from 
another area to provide vaccines, or the citizens are going to have to 
drive farther to get a vaccine.”<div><iframe title="Where Pharmacies — And Options for Vaccines — Are in Short Supply" aria-label="Map" id="datawrapper-chart-pprZa" src="https://datawrapper.dwcdn.net/pprZa/2/" scrolling="no" frameborder="0" style="border: none;" width="800" height="687"></iframe></div>So far, with a limited quantity of doses and strict limitations on 
who is eligible, that hasn’t been a problem. But as vaccination opens up
 to the general public and supplies of the vaccines increase, local 
health departments may be overwhelmed with demand and may need to 
offload the task of vaccinating local residents to other health care 
providers.“It’s probably not playing out yet because we’re not 
getting enough supply,” said Keith Mueller, director of the Rural Policy
 Research Institute’s Center for Rural Health Policy Analysis. “That 
means we have some time for those local health departments to figure 
this out: Who in my radius, if you will, has the capacity to administer 
vaccines?”From 2003 to 2018, 1,231 independent rural pharmacies 
closed, Mueller’s team found, leaving some 630 rural communities with no
 retail drugstore. The changing economics in the pharmacy industry did 
them in, a combination of national pharmacy chains expanding and 
consolidating, big-box stores and supermarkets opening their own 
competing pharmacies and pharmacy benefit managers eating into 
small-pharmacy profits. Mail-order options siphoned off business.And you can’t get vaccines in the mail.In
 many towns, those pharmacies represented the last bastion of health 
care in their communities. Now more than ever, residents are feeling the
 void.“We have no medical infrastructure,” said DeAnne Gallegos, a
 spokesperson for the San Juan County health department in southwestern 
Colorado. “We don’t even have a doctor.”With the closest pharmacy
 located in a neighboring county an hour away in Durango, vaccinations 
in San Juan County have been handled by the public health director and 
two nurses. They hold weekly vaccination clinics if they get any doses. 
As of Feb. 18, the health department had fully vaccinated 298 of its 700
 residents.Counties are allocated doses based on their year-round
 populations, but the health department hopes to vaccinate 
out-of-staters who visit as well. San Juan County deals with an influx 
of tourists and second-home owners coming from states such as Texas, 
Arizona and Florida, where the pandemic has hit harder and vaccination 
rates are lagging. So the health department could end up vaccinating 
more than 200% of San Juan County’s official population to keep covid 
out.“Our attitude is, no matter what your driver’s license or 
your ZIP code says, if you are living within our tight-knit community, 
that is someone we hope the state would allow us to bring into the 
fold,” Gallegos said.But that stresses what she called the <a href="https://khn.org/news/us-public-health-system-underfunded-under-threat-faces-more-cuts-amid-covid-pandemic/" target="_blank">frail structure</a> the department had in the first place.“It’s
 our responsibility to make appointments, manage the data, make contact,
 receive phone calls,” Gallegos said. “When you don’t have the staff or 
the budget to hire additional staff, that also makes it very difficult.”Farther
 east, Custer County hasn’t had a pharmacy for years. Only recently, a 
pharmacist who lives in the county but works in an adjacent county an 
hour away has started delivering prescriptions to Custer residents when 
she returns home after each shift.But she can’t bring vaccines home from work.Instead,
 a public health nurse who was due to retire at the end of 2020 decided 
to stay on to vaccinate residents with the help of another nurse and 
retired health care workers who maintained their licenses. According to 
Custer County Public Health Agency Director Dr. Clifford Brown, they 
have vaccinated more than 630 of the county’s 5,200 residents.In an ideal world, they could have handed off the task to a pharmacy.“We
 do feel the pinch,” Brown said. “I wake up about 3 o’clock in the 
morning thinking about, how in the world are we going to stretch things 
to cover for this day?”Pharmacies offer distinct advantages as 
vaccine providers. Hospitals, which didn’t traditionally vaccinate the 
general public, have had to create programs to distribute their 
allocated doses.In Colorado, pharmacies give over a million flu shots a year, said Emily Zadvorny, executive director of the <a href="https://www.copharm.org/" target="_blank">Colorado Pharmacists Society</a>,
 and, particularly in smaller towns, have a much closer relationship 
with their customers than larger health care providers do. She pointed 
to a pharmacist in Kiowa County, Colorado, who pulled a list of all his 
customers age 70 and up and called each of them to schedule their covid 
vaccinations.“They have so much more capacity than they have supplies,” Zadvorny said. “It’s just a slow process of ramping up.”Even
 where pharmacies exist, it’s been a challenge for independent 
drugstores to participate in the covid vaccine rollout. For influenza, 
pneumonia or shingles vaccines, stores typically order as many doses as 
they think they can sell, which get delivered alongside the pills they 
distribute.The covid vaccines, on the other hand, are being 
distributed through a national program that comes with a significant 
learning curve for pharmacies. The federal Centers for Disease Control 
and Prevention partnered with 21 pharmacy chains, including four 
networks of independent community pharmacies that give smaller 
drugstores more purchasing power. According to the National Community 
Pharmacists Association, those four networks include about 8,000 of the 
21,000 community pharmacies nationwide. Pharmacies that are not part of 
those networks can apply to be vaccine providers in their states.“The
 biggest hurdle for most pharmacies is just getting approved,” said Kyle
 Lancaster, pharmacy director for Our Valley Pharmacy, a three-pharmacy 
chain in rural Lincoln County, Wyoming.Our Valley applied to 
federal and state health agencies and had to upgrade its freezers with 
digital data loggers, which upload the pharmacies’ refrigerator and 
freezer temperatures and report them directly to the CDC.Most 
small pharmacies like his, he said, had been limited to the Moderna 
vaccine, which has less stringent temperature requirements than Pfizer’s
 version. The Johnson &amp; Johnson vaccine, <a href="https://www.cnn.com/2021/02/28/health/johnson-and-johnson-acip-meeting/index.html" target="_blank">which was recently approved</a>, would be even easier for rural pharmacies to handle.Lancaster said he’s unsure how many doses of the vaccine his chain will get or when.Those
 uncertainties leave residents such as Nan Burton, 63, worried about how
 to get vaccinated. Last year, she and her husband decided to ride out 
the pandemic in their vacation home in Lincoln County, trading apartment
 living in Seattle for the wide-open, physically distanced spaces of 
Star Valley Ranch, about 8 miles from the nearest Our Valley branch. 
With plans to retire fully next year, now they’re staying for good.So
 far, Lincoln County — more than three times the size of Rhode Island — 
has vaccinated about 2,500 of its nearly 20,000 residents, mainly 
through the local hospital. But with no major chain pharmacies in the 
region, the county must wait for independent community pharmacies, such 
as Our Valley, to get up to speed.Burton said she and her husband
 have little choice but to wait and hope that the vaccine distribution 
logistics are sorted out. They’d be willing to drive hours to get a 
vaccine if they knew they weren’t taking it away from someone else in 
need.“Until there’s some kind of a national push to do outreach 
to rural communities, I think we’re going to be in trouble,” Burton 
said.