Despite the pandemic, North Carolina has seen a record number of new businesses created in the past year.

A report from the Secretary of State's office says new business filings for 2021 grew 40% over 2020, for a total of more than 178,000 new businesses in the state. The previous record had been set in 2020, and new business growth overall has more than doubled since 2017.

Secretary of State Elaine Marshall said the state is seeing a lot of homegrown activity, with residents inspired to start their own small businesses in an effort to find more flexibility during the pandemic.

"And I know a lot of folks that took their hobby and they decided to up their game," said Marshall. "They started working on it, perfecting it, maybe mass-producing it in some effects. Or they took an online course, to learn how to do something totally brand new for relaxation and said, 'I can make a business out of this.'"

The trend can be seen across the country, too, with Montana and Ohio also reporting record levels of new business creation in 2021.

Last year, the Secretary of State's office surveyed new businesses created in the last three years and found 90% still in operation.

Looking ahead, Marshall said it's smart to keep an eye on news headlines in the state when looking for potential new business ideas - such as the new Plant Sciences Initiative at North Carolina State University for research on sustainable agriculture.

"Those kinds of things will provide niches for folks in rural areas," said Marshall. "If we can get more productivity out of our land, if we can get diversity in productivity out of our land, all of those will create opportunities for folks in the rural areas."

Marshall said her department's new "Web Wizards," an interactive tool, has helped speed up the application process to incorporate a business in the state.

The cost of heading out of town this Memorial Day weekend will be higher than past years, with higher gas prices and inflation hitting travelers. However, many Montanans still will be getting out of town.

The average price of gas per gallon in Montana is $4.38, slightly below the national average of $4.60 but still a record high for the state.

Aldo Vazquez, spokesperson for AAA Montana, said people want to get away from home this weekend.

"It really isn't impacting their desire to travel much," Vazquez reported. "We are seeing an increase in travel across the board - 39 million people are going to be traveling across the country for the Memorial Day holiday. That's three million more folks than traveled last year."

Although numbers are up from last year, Vazquez noted they are not to the levels from just before the pandemic, and are more in line with 2017 numbers.

Vazquez pointed out there are some ways to save money, such as making sure your tires are fully inflated, and dodging stop-and-go traffic, which burns gas faster.

"If you can avoid those hours between 1 to about 8 p.m. and leave maybe earlier in the morning or later on at night," Vazquez advised. "Not only are you going to save a little bit more on gasoline, but you can also save a lot of that headache and stress about being stuck in traffic and get to your destination smoother."

For people traveling by air, Vazquez suggested passengers arrive at the airport early. He noted staff shortages have led to more flight cancellations than usual, a pattern ongoing since last year.

During the first year of the global pandemic, medical consumers in Colorado received more than one million low-value healthcare services - diagnostic tests, screenings and treatments where the risk of harm outweighs any likely benefit to the patient.

Cari Frank, vice president for communications with the Center for Improving Value in HealthCare - the group behind a new report, said consumers and insurers paid $134 million for these services in 2020.

"Even in spite of COVID, when people weren't accessing health-care services the same way," said Frank, "we still saw high numbers of these low-value care services. And they cost a lot of money, both to the health plans and to the patient, and actually can cause harm to patients."

The most obvious example of low-value care is when providers prescribe opioids for acute back pain without first trying alternative medication - a remedy that comes with significant risk of addiction and even death.

Health providers across the nation, working with medical boards and other professional associations, have created a list and guidelines for low-value services through an initiative called Choosing Wisely.

Frank said getting the word out can help bring down overall health costs. She said many services now considered low-value care were considered best practices at one time.

"A lot of things are just, historically, the way the provider has treated patients," said Frank. "And it takes a while when the guidelines change, for there to be an actual adoption of the guidelines."

The average cost for low-value services is $130 - but some, including peripheral catheters for patients with late-stage kidney disease, cost more than $14,000 per incidence.

Frank noted that every patient is different, and some procedures flagged as low-value may actually be the right course for patients.

"There might be family history, or there might be medical history where they have tried some other alternative," said Frank. "So there still needs to be that kind of communication between the provider and the patient."

The baby-formula shortage is hitting Michigan families hard, especially those who live in rural areas, are low-income or have kids with digestive or other health issues.

Because of supply problems and a massive safety recall by the Michigan Abbott factory in February, the Food and Drug Administration says it is working with manufacturers to increase their output and trying to import more formula.

Data released this week revealed out-of-stock rates jumped to 40% at the end of April. Elyssa Schmier, vice president for government relations with Moms Rising, said she has been dealing with the shortage herself in Michigan.

"Anyone who has a child with medical issues or digestive issues, a lot of them use a particular type of formula that they've found works along with their doctors," said Schmier. "And switching formula is not only incredibly hard, but could be detrimental to their child's health."

She said some moms are driving hours and even crossing state lines to find specialized formula, or buying online for prices far higher than normal. She added that for folks living in rural areas, if their regular store is out of formula, they might not have another nearby option.

Schmier said folks who are struggling to afford formula should reach out to WIC - the Women, Infants and Children special supplemental nutrition program. But she added that the shortage is hitting WIC recipients particularly hard, because they are limited to purchasing certain brands.

"They've been able to get waivers and work in some flexibility for WIC recipients," said Schmier. "But these are people who are low-income. They don't have the ability to stockpile."

Schmier said while it may be tempting to water down formula to conserve it, try to make homemade formula or use cow's milk, it's really important to consult your pediatrician.

"I know from personal experience," said Schmier. "My son didn't switch very easily. He had some digestive issues when we originally switched him. And so your health-care provider can provide you with a lot of good advice of how to slowly do that, how to safely do that."

Moms Rising is circulating a petition calling on President Joe Biden to use the Defense Production Act to get formula on the shelves as soon as possible.