A former Girard medical doctor and his wife shared some of their experiences as medical missionaries to Haiti on Dec. 18 at Girard’s Public Library.
Dr. Jim and Sandy Wilkins have served in Haiti since 1999 and currently have approximately 35,000 patients in the area they serve west of the capital city, Port Au Prince. They are home visiting family for two weeks.
Haiti Health Ministries is located in Gressier.
Haiti is the poorest country in the Western Hemisphere and conditions have deteriorated even further since the assassination of the country’s president this year, Sandy said.
Haiti, taken from BIng.
The COVID Pandemic has curtailed the normal amount of volunteers that the ministry has seen in the past.
The current need is a maintenance person and other Christian mission-minded volunteers, Jim said.
TOPEKA – The Kansas Department of Health and Environment (KDHE) has amended its travel quarantine list to remove the countries of Austria, Belgium, Cayman Islands, Czechia, Gibraltar, Jersey, Liechtenstein, Netherlands, Slovakia and Slovenia. The country of Andorra has been added to the travel quarantine list. An unvaccinated individual should quarantine if they meet the following criteria:
Traveled between Nov. 4 and Dec. 17 to Slovenia.
Traveled between Nov. 18 and Dec. 17 to Austria, Cayman Islands and Gibraltar.
Traveled between Dec. 2 and Dec. 17 to Belgium, Czechia, Jersey, Liechtenstein, Netherlands and Slovakia.
Traveled on or after Dec. 17 to Andorra.
Attendance at any out-of-state or in-state mass gatherings of 500 or more where individuals do not socially distance (6 feet) and wear a mask.
Been on a cruise ship or river cruise on or after March 15, 2020.
The next travel quarantine list update will be sent out during the first week of January.
The travel and mass gathering quarantine period is seven days with a negative test result or 10 days without testing, with release from quarantine on Day 8 and Day 11, respectively. Further information on quarantine periods can be found on KDHE’s website.
For those traveling internationally, the Centers for Disease Control and Prevention (CDC) is requiring testing within three days of flights into the U.S. For further information on this and other requirements, visit their website.
For those who are fully vaccinated (meaning it has been greater than two weeks since they completed their vaccinations) they are not required to quarantine regarding travel or mass gatherings if they meet all of the following criteria:
Are fully vaccinated (i.e., ≥2 weeks following receipt of the second dose in a 2- dose series, or ≥2 weeks following receipt of one dose of a single-dose vaccine).
Have remained asymptomatic since the travel.
Persons who do not meet the above criteria should continue to follow current quarantine guidance for travel or mass gatherings.
Additionally, people with previous COVID-19 disease are not required to quarantine following travel if they meet all of the following criteria:
Have evidence of a previous infection supported by a positive PCR or antigen test
Are within 6 months following infection. If an investigation was done documenting the date that symptoms resolved, or the date isolation measures were discontinued for asymptomatic patients, then the 6-month period can start from that end date. If those dates are not available, then the period will start from the date of the positive laboratory test. A serology or antibody test may not be substituted for a laboratory report of a viral diagnostic test.
Have remained asymptomatic since the travel
Persons who do not meet all three of the above criteria should continue to follow current quarantine guidance for travel.
The travel quarantine list is determined using a formula to evaluate new cases over a two-week period, then adjusted for population size to provide a case rate per 100,000 population. This provides a number that can then be compared to the rate in Kansas. Locations with significantly higher rates — approximately 3x higher — are added to the list.
TOPEKA – The Kansas Department of Health and Environment (KDHE) today announced that the state Health and Environmental Laboratories has found the Omicron variant of the SARS-CoV-2 virus in one Kansas resident.
The Kansas Health and Environmental Laboratories are screening all current positive PCR COVID-19 samples received at the lab to look for a specific genetic characteristic that would indicate the Omicron variant. Any samples that screen positive will be sequenced for confirmation of the Omicron variant. Additionally, the lab sequences a random sample of PCR positive COVID-19 samples regardless of whether they pass this screening process. This multi-pronged approach led to the detection of the variant.
“Since the Omicron variant was classified as a Variant of Concern, KDHE’s Kansas Health and Environmental Laboratories has been working to identify the variant in the state. Through genomic sequencing, they were able to confirm the first case of the Omicron variant in Kansas,” Janet Stanek, Acting Secretary, said. “The detection of the variant does not come as a surprise. This virus is highly infectious and transmittable. We must do our part to protect ourselves and those around us by using the tools available to us.”
The individual with the Omicron variant is a vaccinated adult in Franklin County. This individual has not received a booster dose. No additional details will be released to protect the privacy of the individual.
Health officials urge Kansans to use the following tools to protect against COVID-19 and the Omicron variant.
Get vaccinated and boosted. Vaccines remain the best tool to protect people from COVID-19, slow transmission and reduce the likelihood of new variants emerging. The three authorized COVID-19 vaccines are highly effective in preventing serious illness, hospitalizations, and death. Scientists expect the vaccines to prevent serious illness, hospitalizations, and death in people infected with the Omicron variant. COVID-19 vaccines are now authorized for people ages 5 and over. The COVID-19 booster shots are authorized for all individuals ages 16 and over. To find a vaccine near you, visit Vaccines.gov.
Wear a mask. Masks offer protection against all variants. It is recommended that people wear a well-fitting mask in public indoor settings in Kansas, where COVID-19 transmission remains high, regardless of vaccination status.
Get tested. If you are sick or have been in close contact with someone diagnosed with COVID-19, it is recommended that you get tested for COVID-19. COVID-19 tests are available across Kansas. Go to KnowBeforeYouGoKS.com to find a free testing location near you.
At-home tests are available for purchase at grocery stores and pharmacies. These can be used at home, work or anywhere and can provide rapid results. If a positive result is received through an at-home test, individuals should follow up with a health care provider about a confirmation test.
Social distance. When in public settings, stay at least 6 feet from other people, especially if you are at higher risk of getting sick.
TOPEKA – The Kansas Department of Health and Environment (KDHE) has been selected by the U.S. Department of Health and Human Services (HHS) Office on Women’s Health to receive funding as part of the State, Local, Territorial, and TribalPartnership Programs to Reduce Maternal Deaths due to Violence. Additionally, KDHE, in partnership with Kansas Perinatal Quality Collaborative (KPQC), has been accepted to enroll into the Alliance for Innovation on Maternal Health (AIM) for the October 2021 cohort. The Kansas maternal mortality rate of 14.8 (2014-2018) is 29.8% higher than the Healthy People 2020 goal of 11.4 maternal deaths per 100,0000 live births. These initiatives will help address the urgent matter of maternal mortality in Kansas.
“These initiatives will provide vital education and training to patients and providers across the state of Kansas,” said Janet Stanek Acting Secretary. “We are thankful for the ongoing collaboration with our partners across the state to implement these key initiatives to help in reducing the maternal mortality rate.”
Maternal Anti-Violence Innovation and Sharing Project
Through Kansas Maternal Mortality Review Committee (KMMRC) case reviews of maternal deaths in Kansas between 2016-2018, homicide was the second leading cause of maternal deaths with substance use disorder and/or mental health contributing to more than half of all pregnancy-associated deaths.
The MAVIS Project will continue to build and expand on the success of the KMMRC to gather additional data related to violent maternal deaths. Additionally, the MAVIS Project will provide cross-training to perinatal care providers and domestic violence service providers related to perinatal mood and anxiety disorders, perinatal substance use and intimate partner violence.
Alliance for Innovation on Maternal Health
KMMRC has determined that approximately one in four deaths of women during or within one year of pregnancy were pregnancy-related, and over 90% of these deaths were preventable.
The Alliance for Innovation on Maternal Health will implement a maternal quality initiative project based on their Postpartum Discharge Transition Patient Safety Bundle. It offers a national forum to exchange innovative ideas and a resource for continuous improvement in maternal safety and quality.
Additional Maternal Health Initiatives
KDHE has partnered with KPQC to launch the Fourth Trimester Initiative (FTI), a statewide effort focused on improving maternal health and decreasing maternal morbidity and mortality for all Kansas mothers. FTI uses a three-pronged collaborative approach to address maternal health by including the patient, private and public sectors in education and awareness efforts, including over 25 birthing facilities across the state.
KDHE’s Maternal Warning Signs Initiative (MWS), a component of the FTI project, provides patient, partner and community education throughout pregnancy and the postpartum period on key topics such as the signs of preterm birth and stillbirth, perinatal mood and anxiety disorders, and warning signs of life-threatening pregnancy-related complications.
More information on maternal and child health is available on our website, kdheks.gov/c-f/mch.htm.
Community Health Center of Southeast Kansas has been busy, among other things, with hiring, getting their new building secured and equipment purchased, and of course giving COVID-19 Vaccines and tests.
They will be announcing a new pediatrician coming to Fort Scott soon, according to Krista Postai, CEO, once she has secured her Kansas license.
“She is a very skilled and personable young woman who we interviewed three years ago, just out of residency, and now has decided this would be a much better option than practicing in Missouri where she is now,” Postai said.
New Building Site Is Secured
CHC secured the parking lot by blocking off entrances at their new building as 2322 S. Main.
“We secured the parking lot of the Price Chopper building to reduce the wear and tear on the parking lot and reduce our liability,” Postai said. “Work on the interior will begin in earnest in early 2022 for completion by December 2022, so we can get moved before our lease expires.”
The Price Chopper building, 2322 S. Main.
New Equipment
“A new CT Scanner and X-ray equipment has been ordered for our new building and will be delivered once the space is ready,” she said. “We are now installing a CT Scanner at our Pittsburg clinic which will be ready to use in January.”
COVID-19 Self Test Kits Available To Employers, Organizations
“We have received thousands of Quidel brand home self-testing kits from the Health and Resource Administration Services Administration(HRSA) for COVID, that we will be distributing, free, through our clinics,” she said.
The mission of HRSA is to improve health outcomes and achieve health equity through access to quality services, a skilled health workforce, and innovative, high-value programs, according to https://www.hrsa.gov/about/strategic-plan/index.html
CHC sent 200 kits to Fort Scott Community College last week and will send a supply to local employers or organizations with a need to test to protect others, she said.
“Organizations needing kits, there are two tests to each kit, can request them by emailing [email protected] she said. “There are no tracking or reporting requirements although anyone testing positive is urged to get a confirmatory test through our clinics. The tests in the kits take about 15 minutes for results.”
Sliding fee discounts and financial assistance is available to eligible patients, as stated on the front door of the CHC/SEK Clinic in Fort Scott.
COVID Vaccine
“COVID is still very much with us, we have patients in the hospital in Pittsburg and had a COVID-related death (last) weekend,” Robert Poole, CHC Communications and Marketing Director said. “I know we are all COVID-19 information-fatigued, however as we go into the holidays and begin travels and visit family it’s important to be cautious and be safely vaccinated.”
“CHC/SEK just hit 58,000 vaccines delivered so far last Monday morning,” he said. “Our vaccine teams have been working tirelessly to protect our communities.”
“We have plenty of vaccines available today,” he said. “You can receive a shot in our walk-in clinics and we encourage our patients to schedule their COVID-19 vaccinations and boosters through our website. (chcsek.org) Scheduling your shots through the website helps us to allocate vaccines to the clinics that need them and group vaccinations together to minimize vaccine waste.”
CHC has Pfizer vaccines for children ages 5 through 17 years old.
“Children need protection from COVID-19 for their health and the health of their friends, siblings, parents, and grandparents,” he said. “The contagious Delta variant, emerging Omicron variant, and more in-person indoor activities means that COVID is still spreading and there is a risk for getting sick.”
For boosters, anyone 18 years or older can choose either a Pfizer or Moderna booster six months after their last dose. The wait is two months for anyone who received the single-dose Johnson & Johnson vaccine to receive a booster.
For more information: 620.223.8040.
The front door of the Community Health Center of Southeast Kansas at Fort Scott.
The Southeast Kansas Multi-County Health Department has all 3 COVID-19 vaccines available at their offices.
To get vaccinated, call for an appointment.
“Things are seeming to pick up with children getting vaccinated, but there are still more adults getting vaccinated than children,” Rebecca Johnson, administrator, said. “I’m glad for the increase in children’s vaccinations but wish we’d see more getting the shot. This will decrease quarantines and time missed from school and work, that is something encouraging for parents!”
“There’s quite a bit of information for parents online about safety of the vaccine for children. I recommend reviewing information from the CDC.”
“With any variant, there is always fear of the unknown, but we are monitoring this new variant (Omicron) and staying up to date with what information KDHE has to provide, the CDC, the other Health Departments in the state as well as information we get from our bordering states. I would recommend our residents stay vigilant in their mitigation against COVID-19, stay home if they’re aware they have been exposed to the virus and stay home if sick! ”
The department is located at 524 S. Lowman, Ft. Scott, KS 66701
Phone (620)223-4464, Fax (620)223-1686
From the Kansas Department of Health and Environment:
“No confirmed cases have been identified in Kansas or the United States to date. This variant is new, and it is still unknown how transmissible or contagious this variant is. It is unclear how quickly it will spread, but it has been found in 17 countries already and we should assume that it is only a matter of time before it will be found in the United States. KDHE will continue to sequence positive COVID-19 samples to look for the Omicron variant.
With over 64% of the eligible population fully vaccinated, Kansas is more prepared for Omicron than previous variants. Experts continue to believe that the COVID-19 vaccine will continue to protect those who are vaccinated against severe disease and death. The COVID-19 vaccine is available for all individuals aged five years and over. The vaccine booster dose is available for all adults aged 18 and over. Boosters increase the strength of your antibody response, so even if the virus mutates, a boost makes it more likely that your antibodies can prevent you from getting sick or seriously ill, even with the new variant. If you are six months past your second dose of the Pfizer or Moderna vaccine or two months past your J&J vaccine, get boosted now.
As we continue to learn more about the Omicron variant, taking steps to prevent the spread of the COVID-19 virus remains the same. Kansans should receive the COVID-19 vaccine or booster shot, wear a mask in public indoor settings, wash their hands frequently, physically distance from others as much as possible, stay home if they feel sick, and get tested if they have been exposed to COVID-19 disease or have symptoms.”
~As KDHE shifts to a sustainable, long-term plan to support COVID-19 monitoring,testing will remain free and available to the general public ~
TOPEKA – Following the recent release of the Kansas Department of Health and Environment’s (KDHE) updated Employer Testing Playbook, KDHE is announcing upcoming changes to its COVID-19 testing strategy that ensure testing remains accessible to all Kansans across the State.
As widespread COVID-19 vaccination continues to prevent serious illness and death, the virus is expected to continue to circulate in the near future, not unlike the flu. Testing remains an important tool to identify the virus and protect Kansan communities against its spread.
“Testing has become an increasingly important way in which those who choose to be unvaccinated may still be able to work, attend events, and travel,” said Ashley Goss, Acting Secretary of the Kansas Department of Health and Environment. “This is especially critical as more businesses and employers have begun requiring either proof of vaccination or demonstration of a negative COVID-19 test with greater frequency.”
However, as COVID-19 continues to be present in our communities, it is no longer sustainable for public health to fund testing alone. KDHE initially allocated $141M of federal grant funding to make COVID-19 testing accessible for all Kansans, including support for commercial and university labs to help expand processing and sampling capacity. The surge of infections due to the Delta variant significantly depleted this budget in a shorter timeframe than expected.
As a result, and to ensure Kansans have uninterrupted access to crucial COVID-19 testing, KDHE is implementing the next phase of its COVID-19 testing strategy, which is intended to reduce the State’s costs for its testing program while ensuring it can continue into 2022.
These changes will also mean employers, health insurers, and individuals are going to be increasingly asked to pay for COVID-19 testing, as they would with testing for most other communicable diseases. Moving forward, access to COVID-19 testing will be a shared responsibility of both the public and private sector. To ensure adequate time for testing partners to transition, KDHE has approached state and federal bodies to secure additional funding for continuity of testing operations through March 2022.
Free COVID-19 testing will continue to be available across Kansas for those who are experiencing symptoms or have potential exposures to COVID-19 in their communities. To get a COVID-19 test through KDHE’s mass testing sites, the network of Community and Volunteer Testing Partners, and Local Health Departments, Kansans can access a full list of sites offering free testing at KnowBeforeYouGoKS.com. The following options remain available for free testing across the State, with availability dependent on need as well as state and federal funding:
Mass testing sites: KDHE will continue to offer free COVID-19 PCR tests at 9 mass testing sites in Johnson, Wyandotte, Douglas, Sedgwick, Shawnee and Riley counties
Employer testing: KDHE will continue employer testing for those previously enrolled in the COVID-19 employer testing program, supporting biweekly testing for 10% of employees. KDHE is working with state and federal bodies to secure funding to support this program through March 2022, at which point it will be phased out. Any changes to this timeline will be communicated as clearly and early as possible.
Community Testing Partner Program and Volunteer Testing Partner Program: Free rapid antigen tests will continue to be offered as long as supplies are available by over 100 partner organizations enrolled in the program in more than 80 counties across Kansas. KDHE is working with state and federal bodies to secure funding to support this program through at least March 2022. Any changes to availability of testing supplies or the program will be communicated as clearly and early as possible.
Local Health Departments: KDHE will continue to support Local Health Departments that offer free COVID-19 PCR tests to Kansans in their communities
K-12 schools: KDHE will continue to fund free testing for students and staff at schools that are participating in the school testing program. Schools not currently enrolled in the school testing program can contact Sarah Allin at [email protected].
Long Term Care Facilities: Facilities have the option of receiving free surveillance testing through a national vendor and / or to modify existing contracts with lab vendors to include billing insurance for diagnostic testing
Outbreaks: KDHE will continue to offer free testing in response to outbreaks in a facility or organization
In addition to KDHE free testing sites, Kansans can receive free testing at pharmacies and retailers that are part of the federal Increasing Community Access to Testing (ICATT) program. Other options for testing that may require insurance include pharmacies, primary care provider clinics, and FQHCs. Individuals can also purchase over the counter antigen tests at many retail grocery stores and pharmacies across Kansas.
For additional information on updates to Kansas’ testing strategy or to find a free testing site, visit KnowBeforeYouGoKS.com.
Governor Kelly and KDHE Ask Kansans to Use Antibiotics Wisely
TOPEKA – Governor Laura Kelly proclaimed Nov. 18–24 as Use Antibiotics Wisely Week in Kansas. The Kansas Department of Health and Environment (KDHE) is asking health care providers and Kansans to use antibiotics wisely to help protect from the threat of growing resistance. This one-week observance led by the Centers for Disease Control and Prevention (CDC) promotes awareness of antibiotic resistance (AR) and the importance of appropriate antibiotic prescribing and use across the United States.
“It will take everyone to do their part in ensuring the proper use of antibiotics,” said Secretary Lee Norman, M.D., Kansas Department of Health and Environment. “Utilizing antibiotics only when appropriate will help decrease the amount of antibiotic resistance infections across the state, further protecting all Kansans.”
Antibiotic awareness does not mean stopping the use of antibiotics; it means improving the way antibiotics are prescribed and used – when necessary and appropriate.
Since the 1940s, antibiotics have been used to treat patients with bacterial infections, significantly reducing the number of related illnesses and deaths. But now, more than 75 years later, antibiotics have been overused and misused to the point that the bacteria the antibiotics are designed to kill have adapted to them, making the drugs less effective, according to the CDC. In fact, some organisms have become so resistant that there are almost no medications that can successfully treat the infections.
The CDC finds that more than one-third of all antibiotics prescribed or otherwise used in the U. S. are either not needed or the antibiotic does not match the germ. Antibiotics are not effective for viruses, such as colds, most sore throats and many sinus infections.
Antibiotic resistance is an ongoing major threat to public health, creating limitations on available treatments for bacterial infections and jeopardizing the ability of healthcare professionals to fight infectious diseases. Additionally, AR increases 4-fold or more when antibiotics are misused for viral infections such as COVID-19 giving this pandemic the potential to kill many more Kansans indirectly by driving antibiotic resistant infections.
Each year, more than 2.8 million people in the United States contract AR infections and more than 35,000 of those people die. Kansas is the 8th highest antibiotic prescribing state with 904 antibiotic prescriptions per 1,000 population, and in the bottom three states in the nation for implementing antibiotic stewardship programs in our healthcare facilities. Antibiotic stewardship (AS) is the effort to improve prescription and use of antibiotics. It is critical that not only health care providers include AS in their practice, but also that all of become stewards of appropriate use.
Here are ways Kansans can help:
Do not request that your doctor prescribe antibiotics.
Antibiotics may have side effects. When your doctor says you do not need an antibiotic, taking one may do more harm than good.
Only take antibiotics that are prescribed for you and take the whole course as described. Do not share or use leftover antibiotics. Antibiotics treat specific types of infections. Taking the wrong medicine may delay correct treatment and allow bacteria to multiply.
Noble Health Corporation announced yesterday that in the near future they will be deciding whether it is feasible to reopen a hospital at the former Mercy Hospital facility, according to Rob Harrington, Director of Bourbon County Regional Economic Development Inc.
“There will be two more meetings with the (Bourbon County) Commission and then they will begin talking with the public about the outcome of the feasibility study,” Harrington said.
“Today was a good day for Bourbon County and we are excited to see the process continue,” he said.
“The next phases will be dedicated to renovation costs and I believe labor,” he said.
“The study has been completed, however, it contains information that at this time needs to remain confidential until after the property is transferred to Noble by the county,” Harrington said. “We are hopeful that this will happen in January and February when they begin doing their town hall meetings.”
Noble Health Corp. announced in June 2021 that it would explore the possibility of reopening the acute care hospital facility in Fort Scott, according to a previous press release from the corporation.
The corporation, a Kansas City company, engaged in a cooperative agreement with Bourbon County to conduct a feasibility study that could lead to the reopening of the former Mercy Hospital building, located at 401 Woodland Hills Blvd., according to the press release.
The building is located just off Hwy. 69 on Fort Scott’s south side.
Mercy Hospital Fort Scott closed in December of 2018.
Mercy Hospital before it closed in December 2018.
Since that time Community Health Center of Southeast Kansas has leased a portion of the building, and Ascension Via Christi Hospital, Pittsburg, has leased the emergency department. Those leases end in December 2022. Fort Scott Community College has leased the western part of the building for student housing.
To view the prior features on Nobel Health in Fort Scott:
The Southeast Kansas Multi-County Health Department is now able to offer Pfizer COVID-19 Vaccine for 5-11 year-olds.
If a parent is interested, they would need to call the local health department to make an appointment. This is a 2-dose series and the 2nd dose is to be given at least 21 days after the first.
Only Pfizer has been approved for 5-17 year-olds.
There is no recommendation at this time for a booster for this age group.
Vaccination promises to help kids more safely resume school and social activities
Community Health Center of Southeast Kansas is now offering Pfizer COVID-19 vaccine for children ages 5-11 by appointment in its Baxter Springs, Coffeeville, Iola, Fort Scott, Pittsburg and Pleasanton locations. The initial number of Pfizer for children’s vaccinations is limited, however, CHC/SEK expects the vaccine supply to become more readily available and will have children’s Pfizer vaccine ages 5-11 at more clinics in the coming weeks.
To speed the process for parents and to prevent vaccine waste (open vials have a short shelf life), CHC/SEK is requesting that children’s COVID-19 vaccinations be administered by appointment when possible.
Parents wishing to have their children vaccinated can schedule an appointment through the CHC/SEK website, www.chcsek.org. After submitting the request, a vaccine scheduler will call to confirm an appointment. Those without web access can call their local clinic or 620-231-9873 to schedule.
The Federal Drug Administration (FDA) recently authorized the Pfizer COVID-19 vaccine for administration to children under emergency use authorization. On Tuesday, Nov. 2, the Centers for Disease Control and Prevention’s (CDC) Advisory Committee for Immunization Practice (ACIP) voted unanimously to recommend the Pfizer vaccination, with Kansas officials adopting the authorization on Wednesday.
This latest vaccination authorization includes children 5-11 and those with underlying conditions and previous COVID infection. Vaccinating ages 5-11 allow children the protection to resume normal childhood activities without risking their own health and reduces the risk of bringing the virus home to a more vulnerable family member.
Pfizer’s child shots contain just a third of the vaccine dose that is already been used to vaccinate millions of people 12 and older. The 5- to 11-year-olds will receive two shots, three weeks apart, the same schedule as everyone else but with a smaller amount in each shot, using a smaller needle.
According to U.S. health authorities and leading doctors’ groups, COVID-19 is causing much preventable suffering among youngsters. About 1.9 million kids ages 5 to 11 have been sickened with COVID-19. Some 8,300 were hospitalized, about one-third needed intensive care, and at least 94 deaths have been verified.
There is never any out-of-pocket expense for any COVID-19 vaccine recipient at CHC/SEK. Vaccination remains the best way to protect yourself, reduce the spread of the virus and help prevent new variants from emerging.
While the U.S. has seen a recent downturn in COVID-19 cases, experts worry about virus variants and another uptick in infections with holiday travel and as winter sends more activity indoors where it is easier for the coronavirus to spread.
