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Trump’s Justice Department Proposes Indefinite Detention in Emergencies—Like the Coronavirus Outbreak

Mother Jones Magazine -

As part of proposed legislation being pushed in response to the coronavirus, Trump’s Justice Department has asked Congress to allow the indefinite detention of people during emergencies, according to a Politico report published Saturday. 

It’s not likely the House’s Democratic majority will support this proposal, which would give federal judges the authority to pause court proceedings at virtually any stage of a civil or criminal proceeding—even preceding a trial. 

“That means you could be arrested and never brought before a judge until they decide that the emergency or the civil disobedience is over,” warns Normal Reimer, the director of the National Association of Criminal Defense Lawyers. “I find it absolutely terrifying. Especially in a time of emergency, we should be very careful about granting new powers to the government.”

As the coronavirus crisis has spread across the United States, President Trump has repeatedly vowed to use “the full power of the Federal Government” to respond, leading some critics to fear overreach by an executive branch already prone to ignoring congressional subpoenas and other checks and balances. Renato Mariotti, a former federal prosecutor and CNN legal analyst, blasted the proposal.

“Can you imagine being arrested and not brought before a judge indefinitely?” he wrote. “This isn’t how America is supposed to work.”

In Coronavirus Crackdown, Ohio Orders Clinics to Stop Abortions

Mother Jones Magazine -

In the face the worsening coronavirus outbreak, Ohio ordered abortion clinics to stop operating as part of a state clampdown on medical procedures it has deemed “non-essential” or “elective.” 

“You and your facility are ordered to immediately stop performing non-essential and elective surgical abortions,” wrote Jonathan Fulkerson, an Ohio deputy attorney general, in a letter sent on Friday to abortion clinics in Dayton, Cleveland, and Cincinnati. The letters, which a spokesperson for Attorney General Dave Yost provided to Mother Jones, warned that “the Department of Health will take all appropriate measures” if the clinics did not immediately comply.

On Tuesday, the Ohio Department of Health ordered the statewide cancellation of non-essential or elective medical procedures in an effort to preserve medical workers’ personal protective equipment. Bethany McCorkle, Yost’s communications director, said in an email that the letters to the abortion providers were written in accordance with the department’s order and did not constitute a shutdown of the clinics. In addition to the three clinics, a urology group was also ordered to stop providing non-essential work. 

The news of Yost’s order quickly spread online Saturday, where pro-choice advocates blasted it as a politicized stunt. “Let me clarify this misinformation: abortion is not an elective procedure, it is an essential component of comprehensive health care,” wrote Heidi Sieck, co-founder and chief executive of #VoteProChoice, said in a statement. “It’s insidious for anti-choice lawmakers to use a time of crisis to restrict abortion and reproductive care when every moment matters greatly to the patient’s ability to access the service.”

Connie Schultz, wife of Sen. Sherrod Brown (D-Ohio), called it an abuse of power.

This attempt to imperil the health of women in Ohio is an abuse of power by @OhioAG David Yost. https://t.co/JrEAX1qI5z

— Connie Schultz (@ConnieSchultz) March 21, 2020

Last year, Ohio passed one of the most restrictive abortion laws in the United States, banning the procedure around when a fetal heartbeat can be detected, or roughly six weeks in to pregnancy—a time by which most women do not know they are pregnant. Ohio has been at the vanguard of anti-abortion politics for decades, becoming the first state in 1995 to ban so-called “partial-birth abortion,” and requiring patients to have two in-person doctor’s visits before scheduling an abortion. 

Yost, a Republican elected as Ohio’s top prosecutor in 2018, said last year that he would “vigorously” defend the state’s restrictive heartbeat bill from a legal challenge. In July, a federal judge in Cincinnati issued an injunction preventing the ban from taking immediate effect. 

A Report From the Coronavirus Frontline: “They Are Essentially Drowning in Their Own Blood.”

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This story was published in partnership with ProPublica, a nonprofit newsroom that investigates abuses of power. Sign up for ProPublica’s Big Story newsletter to receive stories like this one in your inbox as soon as they are published.

As of Friday, Louisiana was reporting 479 confirmed cases of COVID-19, one of the highest numbers in the country. Ten people had died. The majority of cases are in New Orleans, which now has one confirmed case for every 1,000 residents. New Orleans had held Mardi Gras celebrations just two weeks before its first patient, with more than a million revelers on its streets.

“It’s a lot more frightening.”

I spoke to a respiratory therapist there, whose job is to ensure that patients are breathing well. He works in a medium-sized city hospital’s intensive care unit. (We are withholding his name and employer, as he fears retaliation.) Before the virus came to New Orleans, his days were pretty relaxed, nebulizing patients with asthma, adjusting oxygen tubes that run through the nose or, in the most severe cases, setting up and managing ventilators. His patients were usually older, with chronic health conditions and bad lungs.

Since last week, he’s been running ventilators for the sickest COVID-19 patients. Many are relatively young, in their 40s and 50s, and have minimal, if any, preexisting conditions in their charts. He is overwhelmed, stunned by the manifestation of the infection, both its speed and intensity. The ICU where he works has essentially become a coronavirus unit. He estimates that his hospital has admitted dozens of confirmed or presumptive coronavirus patients. About a third have ended up on ventilators.

His hospital had not prepared for this volume before the virus first appeared. One physician had tried to raise alarms, asking about negative pressure rooms and ventilators. Most staff concluded that he was overreacting. “They thought the media was overhyping it,” the respiratory therapist told me. “In retrospect, he was right to be concerned.”

He spoke to me by phone on Thursday about why, exactly, he has been so alarmed. His account has been condensed and edited for clarity.

“Reading about it in the news, I knew it was going to be bad, but we deal with the flu every year so I was thinking: Well, it’s probably not that much worse than the flu. But seeing patients with COVID-19 completely changed my perspective, and it’s a lot more frightening.”

“I have patients in their early 40s and, yeah, I was kind of shocked. I’m seeing people who look relatively healthy with a minimal health history, and they are completely wiped out, like they’ve been hit by a truck. This is knocking out what should be perfectly fit, healthy people. Patients will be on minimal support, on a little bit of oxygen, and then all of a sudden, they go into complete respiratory arrest, shut down and can’t breathe at all.”

“We have an observation unit in the hospital, and we have been admitting patients that had tested positive or are presumptive positive — these are patients that had been in contact with people who were positive. We go and check vitals on patients every four hours, and some are on a continuous cardiac monitor, so we see that their heart rate has a sudden increase or decrease, or someone goes in and sees that the patient is struggling to breathe or is unresponsive. That seems to be what happens to a lot of these patients: They suddenly become unresponsive or go into respiratory failure.”

“It’s called acute respiratory distress syndrome, ARDS. That means the lungs are filled with fluid. And it’s notable for the way the X-ray looks: The entire lung is basically whited out from fluid. Patients with ARDS are extremely difficult to oxygenate. It has a really high mortality rate, about 40%. The way to manage it is to put a patient on a ventilator. The additional pressure helps the oxygen go into the bloodstream.

“With this virus, it seems like it happens overnight.”

“Normally, ARDS is something that happens over time as the lungs get more and more inflamed. But with this virus, it seems like it happens overnight. When you’re healthy, your lung is made up of little balloons. Like a tree is made out of a bunch of little leaves, the lung is made of little air sacs that are called the alveoli. When you breathe in, all of those little air sacs inflate, and they have capillaries in the walls, little blood vessels. The oxygen gets from the air in the lung into the blood so it can be carried around the body.

“Typically with ARDS, the lungs become inflamed. It’s like inflammation anywhere: If you have a burn on your arm, the skin around it turns red from additional blood flow. The body is sending it additional nutrients to heal. The problem is, when that happens in your lungs, fluid and extra blood starts going to the lungs. Viruses can injure cells in the walls of the alveoli, so the fluid leaks into the alveoli. A telltale sign of ARDS in an X-ray is what’s called ‘ground glass opacity,’ like an old-fashioned ground glass privacy window in a shower. And lungs look that way because fluid is white on an X-ray, so the lung looks like white ground glass, or sometimes pure white, because the lung is filled with so much fluid, displacing where the air would normally be.”

“With our coronavirus patients, once they’re on ventilators, most need about the highest settings that we can do. About 90% oxygen, and 16 of PEEP, positive end-expiratory pressure, which keeps the lung inflated. This is nearly as high as I’ve ever seen. The level we’re at means we are running out of options.

“In my experience, this severity of ARDS is usually more typical of someone who has a near drowning experience—they have a bunch of dirty water in their lungs—or people who inhale caustic gas. Especially for it to have such an acute onset like that. I’ve never seen a microorganism or an infectious process cause such acute damage to the lungs so rapidly. That was what really shocked me.”

“It first struck me how different it was when I saw my first coronavirus patient go bad. I was like, ‘Holy shit, this is not the flu.’ Watching this relatively young guy, gasping for air, pink frothy secretions coming out of his tube and out of his mouth. The ventilator should have been doing the work of breathing but he was still gasping for air, moving his mouth, moving his body, struggling. We had to restrain him. With all the coronavirus patients, we’ve had to restrain them. They really hyperventilate, really struggle to breathe. When you’re in that mindstate of struggling to breathe and delirious with fever, you don’t know when someone is trying to help you, so you’ll try to rip the breathing tube out because you feel it is choking you, but you are drowning.

“Holy shit, this is not the flu.”

“When someone has an infection, I’m used to seeing the normal colors you’d associate with it: greens and yellows. The coronavirus patients with ARDS have been having a lot of secretions that are actually pink because they’re filled with blood cells that are leaking into their airways. They are essentially drowning in their own blood and fluids because their lungs are so full. So we’re constantly having to suction out the secretions every time we go into their rooms.”

“Before this, we were all joking. It’s grim humor. If you are exposed to the virus and test positive and go on quarantine, you get paid. We were all joking: I want to get the coronavirus because then I get a paid vacation from work. And once I saw these patients with it, I was like, ‘Holy shit, I do not want to catch this and I don’t want anyone I know to catch this.’

“I worked a long stretch of days last week, and I watched it go from this novelty to a serious issue. We had one or two patients at our hospital, and then five to 10 patients, and then 20 patients. Every day, the intensity kept ratcheting up. More patients, and the patients themselves are starting to get sicker and sicker. When it first started, we all had tons of equipment, tons of supplies, and as we started getting more patients, we started to run out. They had to ration supplies. At first we were trying to use one mask per patient. Then it was just: You get one mask for positive patients, another mask for everyone else. And now it’s just: You get one mask.

“I work 12-hour shifts. Right now, we are running about four times the number of ventilators than we normally have going. We have such a large volume of patients, but it’s really hard to find enough people to fill all the shifts. The caregiver-to-patient ratio has gone down, and you can’t spend as much time with each patient, you can’t adjust the vent settings as aggressively because you’re not going into the room as often. And we’re also trying to avoid going into the room as much as possible to reduce infection risk of staff and to conserve personal protective equipment.”

“But we are trying to wean down the settings on the ventilator as much as possible, because you don’t want someone to be on the ventilator longer than they need to be. Your risk of mortality increases every day that you spend on a ventilator. The high pressures from high vent settings is pushing air into the lung and can overinflate those little balloons. They can pop. It can destroy the alveoli. Even if you survive ARDS, although some damage can heal, it can also do long-lasting damage to the lungs. They can get filled up with scar tissue. ARDS can lead to cognitive decline. Some people’s muscles waste away, and it takes them a long time to recover once they come off the ventilator.

“There is a very real possibility that we might run out of ICU beds and at that point I don’t know what happens if patients get sick and need to be intubated and put on a ventilator. Is that person going to die because we don’t have the equipment to keep them alive? What if it goes on for months and dozens of people die because we don’t have the ventilators?

“Hopefully we don’t get there, but if you only have one ventilator, and you have two patients, you’re going to have to go with the one who has a higher likelihood of surviving. And I’m afraid we’ll get to that point. I’ve heard that’s happening in Italy.”

One Man’s Struggle to Get a Veterans Administration Coronavirus Test

Mother Jones Magazine -

The symptoms started after Jim White arrived at his friend’s house near Corpus Christi, Texas. First came the chills, followed by diarrhea and aches. White, a Coast Guard veteran and former state biologist, had been following the news and knew enough about his health to expect the worst.

“I’m almost 65 years old. I’m a disabled veteran. I have diabetes and high blood pressure,” he told me. “I’m an easy target for something like that—coronavirus.”

“I’m in a high risk group.”

White had recently spent nearly two weeks working the Houston Livestock Show and Rodeo, which shut down on March 11 after an attendee tested positive for COVID-19. When White began feeling his flu-like symptoms the following week, he decided to visit the Veterans Administration’s Corpus Christi clinic. Just inside the building, he was screened by staff who asked about his symptoms and learned that he had been at the rodeo with a confirmed patient. After a brief chat, he was instructed to put on a mask, take some hand sanitizer, and self-quarantine for 14 days. No one took his temperature, and White was never tested for the virus. “It doesn’t surprise me a bit,” he said. “It’s just been my experience with the VA.”

Like nearly every other health care system in the United States, the Veterans Administration has had to reorient itself to battle coronavirus. The VA’s aging patient population—more than 45 percent of veterans are over 65 years old—infections at VA clinics and nursing homes carry a high risk, prompting severe restrictions on who can enter certain VA facilities and screenings like the one White encountered.

But such screenings are not the same as a formal COVID-19 test, and despite having access to 3,000 tests as of Tuesday, the VA has been slow to use them. By Wednesday, the VA had only tested 322 patients. When asked that day how many veterans “of those who need to be tested” had gotten one, Secretary of Veterans Affairs Robert Wilkie sounded an optimistic tune. “We believe we’ve caught most of them,” he said. In the days since that remark, the pace of testing has increased. By Friday, 1,192 veterans had been tested, according to the VA. Meanwhile, the rate of infections has shot up: 137 veterans have now tested positive, only days after the VA acknowledged just five infected patients.

Despite the considerable increase in testing, veterans like White still face obstacles to acquiring a test, primarily because of the VA’s stringent criteria for administering them, based on early Centers for Disease Control and Prevention guidelines. While the CDC recently relaxed these guidelines and now allows doctors to “use their judgment” to determine if a patient should be tested, White still didn’t receive one. A spokesperson for the South Texas Veterans Health Care System directed me to a different VA spokesperson for comment about the availability of COVID-19 test in the region. That second official did not respond.  

Barriers to tests could be a growing problem for veterans, especially as local and regional governments have been slow to adopt the kind of widespread testing seen in other countries where the coronavirus has spread. Corpus Christi, known to tourists as the “shining city by the sea,” has the current distinction of being the largest municipality in the United States without a confirmed COVID-19 test. But that, rather than indicating an absence of the virus, may have more to do with a lack of tests. A drive-thru site only launched this week and it’s not clear how many residents have been tested. “Ten people gave samples for testing at the drive-thru center Sunday, and another 16 were scheduled to be tested there Thursday,” local officials told the Corpus Christi Caller Times. On Friday, a spokesperson for the Nueces County Public Health District would not confirm how many people had been tested. Only five days ago, the city’s Twitter account seemed to downplay the threat of the outbreak, by emphasizing, despite the slow pace of testing, that “there are no confirmed Coronavirus cases” in the surrounding county. 

White says he called the county to inquire about getting tested, and was instead told to self-isolate for 10 days. When he asked about acquiring a thermometer, which local stores had run out of, he says he was instructed to drive to a nearby town for one. “I’m in a high risk group,” he said, explaining why he didn’t want to make the trip: “If I don’t currently have this, I don’t want to take that chance.”

On Friday, I texted White to see if he was any closer to obtaining a test, or if he’d gotten more information from the clinic. “No. No contact from the VA,” he wrote back. “The VA gives the Veteran another chance to die for his country you know. Lol.”

“We’re Going to Pray From God That This Does Work”: Trump Keeps Promoting Unproven Drugs

Mother Jones Magazine -

On Saturday afternoon, President Trump again used the platform of a White House coronavirus briefing to push two unproven drugs as a treatment, feeding into a swirl of medical misinformation and increasing the distance between his ad-hoc views and those of his scientist advisers.

When asked about the anti-malaria drug chloroquine as a possible coronavirus cure, Trump said it, along with the antibiotic azithromycin, could work and suggested they would be shared widely with patients.

“It’s going to be distributed. I think New York is getting 10,000 units,” he said. “We’re going to find out. As the expression goes, ‘What do we have to lose?'”

Trump promoted the drugs at Friday’s briefing and earlier on Saturday morning on Twitter, despite the fact that the Food and Drug Administration has not approved either drug to treat COVID-19, the disease caused by coronavirus. There’s good reason for that. Despite some positive reports stemming from studies with small samples, the untested drug cocktail carries significant risks. As I reported this morning:

When used in conjunction with other medication or in the wrong dosage, taking them can be devastating. In China, officials recommended the use of chloroquine in February after some promising trials, but after a researchers in Wuhan discovered that doubling a daily dose of the drug could lead to death, China quickly “cautioned doctors and health officials about the drug’s lethal side effects and rolled back its usage,” Bloomberg reported. The AFP wire service has reported that social media messages pushing chloroquine have circulated widely in Nigeria, and that health officials there have seen cases of poisoning from the drug. 

Trump seemed unconcerned with these inconvenient details. “This would be a gift from heaven, this would be a gift from God if it works,” he said. “So we’re going to pray from God that it does work.”

When pressed by a reporter about the wisdom of Trump pushing an unverified solution, Vice President Mike Pence said, “There is some anecdotal evidence that several existing medicines may have brought relief to patients struggling in China and Europe.” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, used that same word—”anecdotal”—to describe the case for a prescription that Trump, only hours prior to briefing, insisted should be “put in use IMMEDIATELY.” 

“The president is talking about hope for people and it’s not an unreasonable thing to hope for people,” Fauci said. “My job as a scientist is to ultimately prove without a doubt that a drug is not only safe but works.”

Is Anthony Fauci Really Our Truthteller-in-Chief?

Mother Jones Magazine -

The Washington Post informs us today that Anthony Fauci is everyone’s favorite doctor, the “grandfatherly captain of the corona­virus crisis” who not only has limitless energy to appear everywhere at once but has even performed the miracle of ending political polarization:

Now a public-health catastrophe has remade our reality and pushed Fauci into the spotlight as a figure that might have seemed impossible less than a month ago: a government expert with an unwelcome message who is nonetheless regarded as a truth-teller, if not a godsend, by the president, Democratic leaders and media figures alike. Surviving may require a single set of facts; and Fauci — a slight, bespectacled man with a Brooklyn accent and sympathetic eyebrows — has them.

Hmmm. On Friday Fauci appeared with President Trump and was asked about Trump’s latest infatuation:

Q And to Dr. Fauci, if I could. Dr. Fauci — this was explained yesterday — there has been some promise with hydroxychloroquine as potential therapy for people who are infected with coronavirus. Is there any evidence to suggest that, as with malaria, it might be used as a prophylaxis against COVID-19?

DR. FAUCI: No. The answer is no.

Trump then spent the next ten minutes in a back-and-forth with reporters extolling the virtues of hydroxychloroquine and arguing that he felt really, really good about its potential. And people should listen, because he’s a smart guy. It ended with this final follow-up to Fauci:

Q I would like Dr. Fauci, if you don’t mind, to follow up on what the President is saying. Should Americans have hope in this drug right now? . . .

DR. FAUCI: No, there really isn’t that much of a difference in many respects with what we’re saying. The President feels optimistic about something — his feeling about it. What I’m saying is that it might — it might be effective. I’m not saying that it isn’t. It might be effective. But as a scientist, as we’re getting it out there, we need to do it in a way as — while we are making it available for people who might want the hope that it might work, you’re also collecting data that will ultimately show that it is truly effective and safe under the conditions of COVID-19. So there really isn’t difference. It’s just a question of how one feels about it.

Am I the only one who’s noticed that Fauci does this a lot? Obviously he has a tightrope to walk with Trump, and I shudder to think what he has to do to stay in Trump’s good graces. But that doesn’t make him a truthteller. It just makes him a fairly ordinary politician. It’s obvious what he really thinks, after all: hydroxychloroquine is nonsense, period. But by the time the press conference had moved on, he was basically saying that Trump was right, the stuff might work, and it’s all a matter of how one “feels” about it. Trump could say today that Fauci agrees with him about hydroxychloroquine and he wouldn’t really be stretching things much.

So is this truthtelling? Not so much. Here’s another excerpt from the Post story. It’s from the mid-80s, when Fauci was focused on finding cures for AIDS and hosted regular dinner parties for activists:

As the activists drove down from New York, they would remind one another to be firm and focused with their demands and to be careful not to fall fully into the Tony Fauci charm vortex, according to Peter Staley, an activist with a New York-based group named ACT UP.

….The activists were aware that the dinner parties were as strategic as they were friendly, he says, and afterward they would try to sort out when Fauci had been handling them and what details he’d been carefully hedging on. “We knew he was playing a game of ingratiating, which he has done with every president that he has worked under. He’s incredibly skillful at it.

All fine and good! But is it truthtelling? Several weeks ago I found myself wondering just how much I could trust Fauci, and today I find myself wondering even more.

Please Take Medical Advice From Your Doctor, Not the President

Mother Jones Magazine -

President Trump is many things—businessman, reality TV host, expert on Robert Pattinson’s relationship choices—but one thing he most certainly is not is a medical authority. Remember: This is the same person who refuses to exercise because he thinks it exhausts the body’s finite amount of energy. 

With that context, let’s examine the latest piece of dangerous misinformation to emerge from Trump’s Twitter feed:

….be put in use IMMEDIATELY. PEOPLE ARE DYING, MOVE FAST, and GOD BLESS EVERYONE! @US_FDA @SteveFDA @CDCgov @DHSgov

— Donald J. Trump (@realDonaldTrump) March 21, 2020

The two drugs Trump is referring to here—chloroquine, which has been used to treat malaria, and an antibiotic known as azithromycin—have been floated as possible ways to fight COVID-19, but not without significant reservations. Despite the president’s tagging of the Food and Drug Administration and its commissioner, neither drug has been approved by the federal government to treat the virus. When used in conjunction with other medication or in the wrong dosage, taking them can be devastating. In China, officials recommended the use of chloroquine in February after some promising trials, but after a researchers in Wuhan discovered that doubling a daily dose of the drug could lead to death, China quickly “cautioned doctors and health officials about the drug’s lethal side effects and rolled back its usage,” Bloomberg reported. The AFP wire service has reported that social media messages pushing chloroquine have circulated widely in Nigeria, and that health officials there have seen cases of poisoning from the drug. 

Those notes of caution have not prevented Trump and some of Twitter’s loudest voices from pushing the untested drugs. Tesla’s chief executive, Elon Musk, drew widespread attention to one of the drugs on Monday when he tweeted, “Maybe worth considering chloroquine for C19.” But Trump has quickly became the drug’s most prominent booster, after falsely saying at a Friday White House press briefing that it had been approved. That mention prompted considerable angst from Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, who cautioned that Trump while “feels optimistic about something,” he, as a doctor, was only saying “it may be effective.”

All the talk about chloroquine has led to shortages, the New York Times reported, leading to problems for patients who were already taking it for other conditions like lupus and rheumatoid arthritis. “There is a run on it and we’re getting calls every few minutes, literally, from patients who are trying to stay on the drug and finding it in short supply,” Dr. Michael Lockshin, of Manhattan’s Hospital for Special Surgery, told the newspaper.

Even the evidence Trump cited on Twitter is far from definitive. On Twitter, Trump referred to a study released by French researchers earlier this week that suggested that the drug combination could be effective at treating COVID-19. But the study only looked at 20 patients. As several experts have noted on Twitter. Without more verified information, it’s irresponsible for patients to view these drugs as a fail-safe solution to the virus.

Please don't take hydroxychloroquine (Plaquenil) plus Azithromycin for #COVID19 UNLESS your doctor prescribes it. Both drugs affect the QT interval of your heart and can lead to arrhythmias and sudden death, especially if you are taking other meds or have a heart condition.

— Dr. Edsel Salvana (@EdselSalvana) March 21, 2020

To let Trump, who once promoted a fraudulent university and spent weeks downplaying and ignoring the threat of coronavirus, suddenly become a reliable source of consumers’ medical information is irresponsible. Listen to the experts. Ignore the bloviating tweets. And, for gosh sakes, practice social distancing!

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