Social distancing as a moral dilemma: Notes from a medical ethicist

by Emily Litvack, University of Arizona  APRIL 1, 2020 

Credit: CC0 Public Domain

Social distancing is a phrase now penetrating the national conversation as well as our collective consciousness. Strongly urged by medical experts during the COVID-19 outbreak, social distancing means deliberately increasing the physical space between people to avoid spreading illness. Staying at least six feet away from other people lessens your chances of catching and spreading the virus.

The body of evidence suggesting that social distancing is a quite effective way to slow the spread of COVID-19 is growing rapidly, and Americans are beginning to treat it less like an optional precaution and more like a moral imperative. Is it? And, if it is, why are many continuing to gather?

Laura Howard is an associate professor of philosophy in University of Arizona's College of Social and Behavioral Sciences. Howard's research focuses on medical ethics and moral distress in health care. She discussed the morality of social distancing and what people's behavior during the pandemic says about the complexity of human nature.

At this point, is social distancing a moral imperative?

This is an interesting philosophical question. A moral imperative is a command to act in a certain way, which everyone should follow, and, in order to invoke one, we need to explain what makes a particular action right or morally good.

In the context of the current health crisis, we can plausibly make the claim that it is a morally good state of affairs if we save the greatest number of lives possible. Not everyone would agree with that claim, but I'll leave that argument aside for now and return to it later. For now, let's assume that promoting health and saving lives is a morally good goal for society. Given that premise—if we also accept the empirical evidence, which suggests that social distancing is a means to halt the spread of the virus—it's easy to see how one would defend their judgment that it is morally wrong not to practice social distancing.

How might someone argue that saving lives isn't a moral imperative?

Some people might argue that there is a naturalistic and evolutionary reason to let the virus take its course. It would reduce human population, which, in the long run, could be a good thing in terms of having more resources for fewer people. Notice one thing this view entails, though: The person who holds it must be willing to accept that they or their loved ones might be among those who contribute to the population reduction.

Likewise, some might argue that certain people have more value than others and therefore deserve to live while others do not. This would require a set of criteria by which to judge the value of a life, and unless someone—or some entity—creates that criteria by fiat, then to define "a valuable life" requires us to circle right back around to our original premise.

So, basically, social distancing as a moral imperative is the most well-reasoned position during a pandemic?

Yes. If we accept that saving the greatest number of lives possible is a self-evident moral premise and if we believe the science, then it logically follows that people who are choosing not to practice social distancing are behaving immorally. Importantly, this leaves out people who don't have a choice.


Then why isn't everyone doing it?

For one thing, humans are notoriously bad at logical reasoning.

For a first example, consider that we are vulnerable to framing problems: A 20-year-old may feel she's not vulnerable if she hears that 70% of the COVID-19 cases are in the elderly population, but it is more likely to get her attention if she hears that 30% of the cases are in people ages 20 to 44. The statistics are the same, but the cognitive process is different. Because the early media reports presented the numbers with a focus on the elderly, a lot of people still think that they are immune if they're not elderly.

Another example of poor reasoning is confirmation bias, meaning people tend to seek out or only listen to information that confirms what they already believe.

Finally, consider the famous Prisoner's Dilemma, in which actors who "rationally" choose to behave in their own self-interest end up worse than if they had simply cooperated.

The one thing all of these examples share in common is that they seem to suggest that people are, at the core, very self-interested, or what we in moral philosophy call "egoistic."

But do we still act out of self-interest even when the consensus is that saving lives is a moral imperative?

Sure. Self-interest seems to stem partially from the thought that, "Well, as long as almost everyone else follows the rule, I can make an exception of myself, and it won't make that much difference." That's actually true—but not when everyone thinks and does the same thing.

Some people think that it won't make that much difference if they socialize with their friends, as long as most everyone else follows the rule, but most philosophers argue that you can't universalize such egoistic thinking, because the maxim would ultimately become self-defeating. If everyone ignores social distancing, there may be no one left to socialize with.

That's a little, well, sad.

Although it may seem that way when we're trying to explain why some people don't follow moral imperatives, remember that there are many people who are truly moral exemplars. Right now, during this public health crisis, there are so many people demonstrating generosity, kindness, compassion and even courage, as they risk their lives for others. Altruistic human goodness seems very real to me, and our greatest hope is that it spreads faster than this virus.

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The Coronavirus Pandemic Has Set Off A Massive Expansion Of Government Surveillance. Civil Libertarians Aren't Sure What To Do.

As nations around the world take on sweeping new powers to fight the disease, critics aren't sure what's necessary and what's too far.
 March 30, 2020, 

The coronavirus pandemic, which has grown to over 740,000 cases and 35,000 deaths around the world, has been so singular an event that even some staunch advocates for civil liberties say they’re willing to accept previously unthinkable surveillance measures.

“I’m very concerned” about civil liberties, writer Glenn Greenwald, cofounder of the Intercept, who built his career as a critic of government surveillance, told BuzzFeed News. “But at the same time, I'm also much more receptive to proposals that in my entire life I never expected I would be, because of the gravity of the threat.”

Greenwald won a Pulitzer Prize in 2014 for his reporting on the disclosures by NSA contractor Edward Snowden, who revealed a vast secret infrastructure of US government surveillance. But like others who have spent years raising concerns about government overreach, he now accepts the idea that surveilling people who have contracted the coronavirus could be better than harsher measures to save lives.

“The kind of digital surveillance that I spent a lot of years — even before Snowden, and then obviously, the two or three years during Snowden — advocating against is now something I think could be warranted principally to stave off the more brute solutions that were used in China,” Greenwald said.

Greenwald said he was still trying to understand how to balance his own views on privacy against the current unprecedented situation. “We have to be very careful not to get into that impulse either where we say, ‘Hey, because your actions affect the society collectively, we have the right now to restrict it in every single way.’ We're in this early stage where our survival instincts are guiding our thinking, and that can be really dangerous. And I’m trying myself to calibrate that.”

“The kind of digital surveillance that I spent a lot of years advocating against is now something I think could be warranted principally to stave off the more brute solutions that were used in China.”

And he is far from the only prominent civil libertarian and opponent of surveillance trying to calibrate their response as governments around the world are planning or have already implemented location-tracking programs to monitor coronavirus transmission, and have ordered wide-scale shutdowns closing businesses and keeping people indoors. Broad expansions of surveillance power that would have been unimaginable in February are being presented as fait accompli in March.

That has split an international community that would have otherwise been staunchly opposed to such measures. Is the coronavirus the kind of emergency that requires setting aside otherwise sacrosanct commitments to privacy and civil liberties? Or like the 9/11 attacks before it, does it mark a moment in which panicked Americans will accept new erosions on their freedoms, only to regret it when the immediate danger recedes?

“Under these circumstances? Yeah, go for it, Facebook. You know, go for it, Google,” Gary Johnson, the former governor of New Mexico and 2016 Libertarian Party presidential candidate, told BuzzFeed News. “But then, when the crisis goes away, how is that going to apply given that it's in place? I mean, these are the obvious questions, and no, that would not be a good thing.”

"My fear is that, historically, in any moment of crisis, people who always want massive surveillance powers will finally have an avenue and an excuse to get them,” Matthew Guariglia, an analyst at the Electronic Frontier Foundation, told BuzzFeed News.

Marc Rotenberg, president and executive director of the Electronic Privacy Information Center (EPIC), told BuzzFeed News that it’s possible to find a solution that protects privacy and prevents the spread of the virus.

“People like to say, 'well, we need to strike a balance between protecting public health and safeguarding privacy' — but that is genuinely the wrong way to think about it,” Rotenberg said. “You really want both. And if you're not getting both, there's a problem with the policy proposal.”


Justin Sullivan / Getty Images
An aerial view from a drone shows an empty Interstate 280 leading into San Francisco, California, March 26.


Beyond the sick and dead, the most immediate effects that the pandemic has visited upon the United States have been broad constraints that state and local governments have imposed on day-to-day movement. Those are in keeping with public health experts’ recommendations to practice social distancing to mitigate the spread of COVID-19, the disease caused by the novel coronavirus.

While the US hasn’t announced a nationwide stay-at-home order like France and Italy have, large parts of the US are under some degree of lockdown, with nonessential businesses shuttered and nonessential activities outside the home either banned or discouraged. And while President Trump and his allies have focused on the economic devastation wrought by this shutdown, some libertarians have raised concerns about the damage those decrees have done to people's freedoms.

Appearing on libertarian former Texas lawmaker and two-time Republican presidential candidate Ron Paul’s YouTube show on March 19, Kentucky Rep. Thomas Massie pointed to a Kentucky man who, after testing positive for the coronavirus, refused to self-isolate, and whom sheriff's deputies forced to stay home. (Massie later came under bipartisan criticism for attempting to hold up the coronavirus stimulus bill in the House.)

“What would they do if that man walked out and got in his car? Would they shoot him? Would they suit up in hazmat uniforms and drag him off?” Massie said. “Those are the images we saw in China two months ago and everybody was appalled at those images. And now we’re literally, we could be five minutes away from that happening in the United States, here in Kentucky.”

“It’s crazy, and what concerns me the most is that once people start accepting that, in our own country, the fact that somebody could immobilize you without due process, that when this virus is over people will have a more paternalistic view of government and more tolerance for ignoring the Constitution,” Massie said.

Last Monday, Paul's son, Kentucky Sen. Rand Paul, announced that he had tested positive for the disease, only a few days after Ron Paul wrote in his online column that the pandemic could be a “big hoax” pushed by “fearmongers” to put more power in government hands.

But the elder Paul's concerns are not shared among some of his fellow former Libertarian Party nominees for president.

Johnson said measures to encourage people to stay in their homes and temporarily shutter businesses taken by states like New York were appropriate. “I really have to believe that they're dealing with [this] in the best way that they possibly can,” he told BuzzFeed News. “And I think it's also telling that most of them are following the same route.”

Johnson added that although it was easy to raise criticisms, as a former governor, he saw few other options.

“You're just not hearing it: What are the alternatives?” Johnson said. “I don't know, not having [currently] sat at the table as governor, what the options were. And given that every state appears to be doing the same thing, I have to believe that everything is based on the best available information.”

A security guard looks at tourists through his augmented reality eyewear equipped with an infrared temperature detector in Xixi Wetland Park in Hangzhou in east China's Zhejiang province Tuesday, March 24. Feature China/Barcroft Media via Getty Images



A map application developed by The Baidu Inc. displays the locations visited by people who have tested positive for the coronavirus in Shanghai, China, on Friday, Feb. 21. Qilai Shen / Bloomberg via Getty Images


Gaming out the role of intense surveillance during a pandemic isn’t just a theoretical political debate on YouTube. Surveillance at previously politically unimaginable scales has reached countries around the world.

Imagine opening an app, scanning a QR code, and creating a profile that’s instantly linked with information about your health and where you've been. The app tells you if you’ve been in close contact with someone sick with the coronavirus.

This software already exists in China. Developed by the Electronics Technology Group Corporation and the Chinese government, it works by tapping into massive troves of data collected by the private sector and the Chinese government. In South Korea, the government is mapping the movements of COVID-19 patients using data from mobile carriers, credit card companies, and the Institute of Public Health and Environment. In Israel, Prime Minister Benjamin Netanyahu ordered the country's internal security agency to tap into a previously undisclosed cache of cellphone data to trace the movements of infected persons in that country and in the West Bank. And in the Indian state of Karnataka, the government is requiring people in lockdown to send it selfies every hour to prove they are staying home.

No such tools currently exist in the United States — but some in the tech community who might have been expected to oppose such capacities have found themselves favoring these previously unthinkable steps.

Maciej Cegłowski, the founder of Pinboard and a frequent critic of tech companies’ intrusions into privacy, wrote a blog post arguing for a “massive surveillance program” to fight the virus.

“My frustration is that we have this giant surveillance network deployed and working," Cegłowski told BuzzFeed News. "We have location tracking. We have people carrying tracking devices on them all the time. But we’re using it to sell skin cream — you know, advertising. And we’re using it to try to persuade investors to put more money into companies. Since that exists and we have this crisis right now, let’s put it to use to save lives.”

“We put up with the fire department breaking down our door if there’s a fire at our neighbor’s house or in our house because we know that in normal times our houses are sacrosanct.”

This position is a major departure for Ceglowski, who has warned of how tech companies have invaded our “ambient privacy” and argued that tech giants’ reach into our lives is as pernicious a force as government surveillance.

“We put up with the fire department breaking down our door if there’s a fire at our neighbor’s house or in our house because we know that in normal times our houses are sacrosanct,” Cegłowski said. “I think similarly if we can have a sense that we’ll have real privacy regulation, then in emergency situations like this we can decide, hey, we’re going to change some things.”

Those doors are already being broken down. The COVID-19 Mobility Data Network — a collaboration between Facebook, Camber Systems, Cuebiq, and health researchers from 13 universities — will use corporate location data from mobile devices to give local officials "consolidated daily situation reports" about "social distancing interventions."

Representatives from the COVID-19 Mobility Data Network did not respond to requests for comment.


Peter Byrne / AP
A person watching live data reporting about the worldwide spread of the coronavirus.

Lots of companies claim that they have the technology to save people’s lives. But critics worry that they are taking advantage of a vulnerable time in American society to sign contracts that won't easily be backed out of when the threat passes.

“Sometimes people have an almost sacrificial sense about their privacy,” Rotenberg told BuzzFeed News. “They say things like, ‘Well, if it'll help save lives for me to disclose my data, of course, I should do that.’ But that's actually not the right way to solve a problem. Particularly if asking people to sacrifice their privacy is not part of an effective plan to save lives.”

In response to the pandemic, some data analytics and facial recognition companies have offered new uses for existing services. Representatives from data analytics company have reportedly been working with the CDC on collecting and integrating data about COVID-19, while Clearview AI has reportedly been in talks with state agencies to track patients infected by the virus.

Neither Palantir nor Clearview AI responded to requests for comment, but the appearance of these controversial companies has raised alarms among those in the privacy community.

“The deployment of face recognition, as a way of preventing the spread of virus, is something that does not pass the sniff test at all,” Guariglia said. “Even the companies themselves, I don't think, can put out a logical explanation as to how face recognition, especially Clearview, would help.”

The leaders of other technology companies that design tools for law enforcement have tried to offer tools to combat COVID-19 as well. Banjo, which combines social media and satellite data with public information, like CCTV camera footage, 911 calls, and vehicle location, to detect criminal or suspicious activity, will be releasing a tool designed to respond to the outbreak.

“We are working with our partners to finalize a new tool that would provide public health agencies and hospitals with HIPAA-compliant information that helps identify potential outbreaks and more efficiently apply resources to prevention and treatment,” a spokesperson told BuzzFeed News.

“We have so much history that shows us that mass surveillance generally isn't very effective, and mission creep is inevitable.”

Those efforts cause concerns for people like Evan Greer, the deputy director of digital rights activist group Fight for the Future, who told BuzzFeed News that such tools, once deployed, would inevitably be used for more purposes than to fight the pandemic.

“We have so much history that shows us that mass surveillance generally isn't very effective, and mission creep is inevitable,” she said. “It's not necessarily a question of if data that was handed over to the government because of this crisis would be repurposed. It's a matter of when.”

In addition to those companies, many camera makers have been making a bold claim: Using just an infrared sensor, they can detect fevers, helping venues filter out the sick from the healthy. These firms include Dahua Technology in Israel, Guide Infrared in China, Diycam in India, Rapid-Tech Equipment in Australia, and Athena Security in the US.

In late February, Guide Infrared announced that it had donated about $144,000 worth of equipment that could “warn users when fever is detected” to Japan. The company said its devices would be used in Japanese “hospitals and epidemic prevention stations.”

Although Guide Infrared claimed that its “temperature measurement solutions” have helped in emergencies including SARS, H1N1, and Ebola, the Chinese army and government authorities are “some of its major customers,” according to the South China Morning Post. It’s been used in railway stations and airports in major Chinese regions. It’s also partnered with Hikvision, a Chinese company blacklisted by the US over its work outfitting Chinese detention centers with surveillance cameras.

Australian company Rapid-Tech Equipment claims that its fever-detection cameras can be used in "minimizing the spread [of] coronavirus infections." Its cameras are being used in Algeria, France, Egypt, Greece, Morocco, Saudi Arabia, Turkey, and “many more” countries, according to its website. UK camera maker Westminster International said that it has a "supply range of Fever Detection Systems for Coronavirus, Ebola & Flu."

US company Testo Thermal Imaging sells two cameras with a “FeverDetection assistant.” A section of its website titled “Why fever detection?” argues that managers of high-traffic venues have a responsibility to filter for fevers: “Whether ebola, SARS or coronavirus: no-one wants to imagine the consequences of an epidemic or even a pandemic.”

A Testo spokesperson told BuzzFeed News that the company has seen a “massive increase in demand” for its products in response to the coronavirus and that its cameras are being used “worldwide.” The spokesperson declined to provide specific examples or name specific countries.

While the appetite for fever-detecting cameras is clearly there, civil liberties advocates have concerns. Guariglia said that, regardless of their thermal imaging capabilities, surveillance cameras are surveillance cameras.

“More surveillance cameras always have dubious implications for civil liberties. Even if their contract with thermal imaging ends at the end of six months,” Guariglia said, “I bet those cameras are gonna stay up.”


Aly Song / Reuters
A man wearing a protective mask walks under surveillance cameras in Shanghai.

Julian Sanchez, an analyst with the Cato Institute and commentator on digital surveillance and privacy issues, told BuzzFeed News he was willing to accept measures he might otherwise have concerns about to limit the spread of the virus.

“I’m about as staunch a privacy guy as it gets,” Sanchez said. “In the middle of an epidemic outbreak, there are a number of things I’m willing to countenance that I would normally object to, on the premise that they are temporary and will save a lot of lives.”

But he still questioned the efficacy of some of the current proposals: There’s “a ton of snake oil being pitched by surveillance vendors,” he said.

More than that, he had concerns about what would happen to civil liberties after the pandemic passed, but the measure put in place to combat it did not.

“I think a lot of civil liberties advocates would say, ‘Well, if this is very tightly restricted, and only for this purpose, and it's temporary, then, you know, maybe that's all right. Maybe we’re able to accept that, if we’re confident it's for this purpose, and then it ends,’” Sanchez said. “The question is whether that's the case.”

Sanchez worried that the coronavirus, like the war on terror, is an open-ended threat with no clear end — inviting opportunities for those surveillance measures to be abused long after the threat has passed.

In the same week that he spoke, the US Senate voted to extend until June the FBI's expanded powers under the Foreign Intelligence Surveillance Act, originally passed in the wake of the 9/11 terrorist attacks 19 years ago. ●

Rosie Gray is a reporter for BuzzFeed News and is based in New York.

Caroline Haskins is a technology reporter for BuzzFeed News and is based in New York.

KAKISTOCRACY

AMERIKA UNDER TRUMP

U.S. OUT OF NORTH AMERICA

• Millions Of People Will Get Sick And The US Is On Track For 100,000 Deaths Because Of The Coronavirus, Fauci Said

The Trump Administration Is Now Deporting Unaccompanied Immigrant Kids Due To The Coronavirus

A refugee advocate said the administration was “using” a public health crisis “to advance their long-standing goal of overturning US laws protecting vulnerable children."

Hamed Aleaziz BuzzFeed News Reporter March 30, 2020

John Moore / Getty Images
Unaccompanied immigrant minors wait to be transported to a US processing center July 2, 2019, in Los Ebanos, Texas.

In a major departure from previous practice mandated by federal law, the Trump administration has begun quickly deporting immigrant children apprehended alone at the southern border.

Administration officials say they are following public health orders designed to prevent the spread of the coronavirus in the US, but opponents say they are using the health orders to skirt federal laws that govern the processing of unaccompanied minors.

The New York Times first reported that the Trump administration would apply to unaccompanied children from Central America a March 20 order issued by the Centers for Disease Control and Prevention (CDC) that bars the entry of those who cross into the country without authorization.

Previously, unaccompanied children from Central America picked up by Border Patrol agents would be sent to the Office of Refugee Resettlement (ORR), where they would be housed in shelters across the country as they began officially applying for asylum and waited to be reunited with family members in the US.

On Monday, a US Customs and Border Protection official confirmed to BuzzFeed News that the agency was now applying the CDC order to children.

“All aliens CBP encounters may be subject to the CDC’s Order Suspending Introduction Of Persons From A Country Where A Communicable Disease Exists (March 20, 2020), including minors,” read a statement from CBP. “When minors are encountered without adult family members, CBP works closely with their home countries to transfer them to the custody of government officials and reunite them with their families quickly and safely, if possible.”

The statement noted that there is discretion for the agency to exclude certain unaccompanied children from the order if, for example, they show signs of illness.


Joe Raedle / Getty Images

Minors are seen as they exercise in a common area at the Homestead shelter for unaccompanied immigrant children April 8, 2019, in Homestead, Florida.

Immigrant advocatEs told BuzzFeed News they were alarmed at the policy shift.

“Children arriving at the border, many of whom have endured unimaginable harm at home and on their journey, are the most vulnerable group encountered by border officials. Unaccompanied children are particularly vulnerable to trafficking,” said Aaron Reichlin-Melnick, a policy analyst at the American Immigration Council. “The answer to coronavirus cannot be to put children in harm’s way."

Eleanor Acer, the refugee protection director at Human Rights First, said the move was proof that the Trump administration was “using” a public health crisis “to advance their long-standing goal of overturning US laws protecting vulnerable children and people seeking asylum.”
If you're someone who is seeing the impact of the coronavirus firsthand, we’d like to hear from you. Reach out to us via one of our tip line channels.

Government data obtained by BuzzFeed News indicates that current referrals of unaccompanied children from the Department of Homeland Security (DHS) to the US refugee agency are especially low. On Sunday, just four unaccompanied minors were referred to ORR shelters. DHS averaged 14 referrals a day over the past week, a drop of 78% from the previous month.

“This is a drastic drop in referrals, especially compared to 2019, when well over a hundred unaccompanied children were referred to ORR each day,” said Sarah Pierce, an analyst with the Migration Policy Institute. “While it likely reflects decreased arrivals at the southern border, it also suggests that many are being refused entry, in direct contravention of federal law.”

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The ORR referral process was created by the Trafficking Victims Protection Reauthorization Act, which was signed by then-president George W. Bush in 2008. Under the law, CBP officials are generally required to refer the children within 72 hours to the US refugee agency.

On Monday, several leading Democrats called on the Trump administration to clarify the new process.

“Reports that DHS is not following the TVPRA are deeply troubling,” wrote Sens. Dianne Feinstein and Dick Durbin, along with Reps. Jerrold Nadler and Zoe Lofgren, in a letter sent to acting DHS Secretary Chad Wolf on Monday. “We have an obligation to ensure the health and safety of these children. Children do not have to be put in harm’s way to protect us from the coronavirus pandemic. DHS has the ability and capacity to protect both these children and the public. We request that DHS stop this practice immediately.”

There are more than 3,500 unaccompanied immigrant children currently in the custody of ORR.

On Wednesday, attorneys filed a legal request in court to force the ORR to release unaccompanied children in government custody due to risks associated with COVID-19, the disease caused by the novel coronavirus.

On Saturday, a federal judge ordered the Trump administration to make every effort to “promptly and safely” release the children to their family members and sponsors.

Silvia Verónica Raquec Cum, migration coordinator for with Asociación Pop No'j, a non-profit that works with deported immigrants in Guatemala and indigenous communities, said the practice of immediately sending unaccompanied minors back to their countries is not only preventing them from accessing the US asylum system, but also endangering their communities.

Recently returned unaccompanied minors who weren't showing symptoms of the virus were monitored for three days at a shelter for children before being released to their family, Raquec said, but people with COVID-19 may not start to show symptoms until much later when they're back in their communities.

"It's especially worrying for those from rural and indigenous communities, which is where most people are migrating from, because there's a lack of access to clean water and food," Raquec told BuzzFeed News. "It's harder for people in poor rural communities to stay home because they have to go out to work to feed their families."

Adolfo Flores contributed reporting.

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After Trump's Tweet, The Government Is Funding A Coronavirus Study Of Hydroxychloroquine

A North Carolina company won a $750,000 deal days after the president’s controversial statements about the antimalarial drugs.
March 28, 2020

The US government awarded a North Carolina pharmaceutical company $750,000 to do research on antimalarial drugs days after President Donald Trump praised the medicines as a possible treatment for COVID-19.

Pharmaceutical Product Development (PPD) is supposed to conduct a one-month study on the use of "hydrochloroquine and chloroquine in patients with coronavirus disease (COVID-19), positive for SARS-COV-2 virus exposure, or pre-exposure and post-exposure prophylaxis,” according to federal contracting records.

Chloroquine and hydroxychloroquine attracted attention earlier this month after a French study involving 42 COVID-19 patients indicated that a small number treated with the drugs — which were developed for use against malaria, but also taken by patients with lupus or rheumatoid arthritis — showed positive results.

At a White House press conference three days after the French study appeared, Trump said “we’re going to be able to make that drug available almost immediately.” Two days later, the president tweeted that a combination of chloroquine and another drug “have a real chance to be one of the biggest game changes in the history of medicine.”



Donald J. Trump@realDonaldTrump
HYDROXYCHLOROQUINE & AZITHROMYCIN, taken together, have a real chance to be one of the biggest game changers in the history of medicine. The FDA has moved mountains - Thank You! Hopefully they will BOTH (H works better with A, International Journal of Antimicrobial Agents).....02:13 PM - 21 Mar 2020

The Food and Drug Administration urged caution, however, and said officials are still trying “to determine whether it can be used to treat patients with mild-to-moderate COVID-19 to potentially reduce the duration of symptoms, as well as viral shedding, which can help prevent the spread of disease.” The World Health Organization agreed that further tests should be conducted, but many scientists criticized Trump’s comments as being overzealous and said the French study was flawed.

Nevertheless, demand for the drugs skyrocketed, leading to a shortage for patients who were taking it for other conditions. The drugs drew widespread exposure from Fox News and Elon Musk.

Do you have questions you want answered? You can always get in touch. And if you're someone who is seeing the impact of this firsthand, we’d also love to hear from you. Reach out to us via one of our tip line channels at tips.buzzfeed.com

The chloroquine study is one of many emergency contracts related to the coronavirus outbreak struck by the US government, which has marshaled some of its enormous purchasing power to enter into similar agreements for hospital beds, protective equipment, and other supplies. Federal contracting data show that 16 agencies have spent more than $250 million on COVID-19 measures since January.

PPD has until April 21 to finish its work, according to the terms of the purchase order. Information about the agreement was posted on a website that lists government contracts. BuzzFeed News has filed a Freedom of Information Act request to obtain a copy of it. The deal was first reported by the Daily Beast.

Within the Department of Health and Human Services, the assistant secretary for preparedness and response has awarded 25 contracts worth more than $210 million since January.

The largest of those went to 3M to produce N95 masks. That $173 million contract runs until October 2021. Rapid Deployment Inc., an Alabama emergency response company, received $28 million for “support services.”

Founded in 1985, PPD is now a global giant with 23,000 employees and offices in 46 countries. The company did not respond to detailed messages seeking comment about its coronavirus research, nor did officials from HHS.

According to the company’s website, it is currently working on about 80 active projects for the Department of Defense, National Institutes of Health, Biomedical Advanced Research and Development Authority (BARDA), and other federal agencies. Under its contract with BARDA, PPD “supports the design and conduct of clinical studies to develop medical countermeasures to protect against bioterrorism, pandemic influenza and other public health emergencies.”

Since 2000, PPD has been awarded more than $700 million in government contracts. The company has also performed work for the Department of Homeland Security, NASA, and the Agency for International Development.

On Jan. 27, PPD announced it was going public. In its first earnings call with investors on March 5, three weeks before its arrangement with HHS, the chair and chief executive, David Simmons, discussed how the pandemic had affected business in China and what PPD was doing to contain the spread of the virus. The outbreak had impacted “the ability of our employees to visit hospitals and other clinical trial sites to conduct monitoring visits,” its earnings report said.


REPORTERS


Jason Leopold is a senior investigative reporter for BuzzFeed News and is based in Los Angeles. He is a 2018 Pulitzer finalist for international reporting, recipient of the IRE 2016 FOI award and a 2016 Newseum Institute National Freedom of Information Hall of Fame inductee.

Anthony Cormier is an investigative reporter for BuzzFeed News and is based in New York. While working for the Tampa Bay Times, Cormier won the 2016 Pulitzer Prize for Investigative Reporting.

John Templon is a data reporter for BuzzFeed News and is based in New York.

Coronavirus Cases Have Surged, But The US Is Refusing To Take The World’s Most Available Masks

The KN95 mask is a Chinese alternative to the scarce N95 mask, but the FDA refuses to allow it into the country.

Ken BensingerBuzzFeed News Reporter  March 29, 2020

Samuel Corum / Getty Images

As hospitals around the country desperately seek N95 respirator masks to protect health care workers treating COVID-19 patients, the federal government has blocked imports of what might be the world’s most abundant alternative.

That mask is designed to filter out at least 95% of particles that are 0.3 microns or larger in size — the same measure used for the scarce N95 mask. Like the N95, it fits closely around the nose and mouth, creating a seal that decreases the risk of infection. And the Centers for Disease Control has said it’s as effective as N95, which is certified under US testing standards. But this second type of mask, called the KN95, complies with slightly different norms and is made in factories that have not been certified by the US government.

By law, masks, along with most medical devices, can’t be imported or sold in the United States without the Food and Drug Administration’s say-so. Last week, to ease the national shortfall of protective gear, the FDA issued an emergency authorization for non-N95 respirators that had been certified by five foreign countries as well as the European Union. It conspicuously left the KN95 masks out of the emergency authorization.

The omission was all the more startling because in late February the Centers for Disease Control and Prevention said that KN95 masks were one of numerous “suitable alternatives” to N95 masks “when supplies are short.”

The FDA did not respond to multiple requests for comment.

A significant majority of all respirator masks, including both the N95 and KN95, are manufactured in China. During the height of that country’s outbreak, China restricted exports of virtually all respirator masks, keeping them for domestic use. As that country’s infection numbers have slowed it has eased those restrictions, but now the US must compete with dozens of other countries desperate to acquire masks.

Allowing the importation and use of KN95 could help to greatly alleviate the scarcity.

“The KN95 masks are far more readily available,” said Bob Tilton, who owns a New Jersey–based cosmetics packaging importer and earlier this month decided to use his familiarity with Chinese supply chains to bring in masks and other personal protective equipment to sell to hospitals. “The N95s are much harder to grab.”

Yet without the FDA’s seal of approval, importers are hesitant to order KN95 masks because they worry they’ll get held up at customs. Many hospitals are refusing to accept them, even as free donations, because they fear legal liability should a health care worker get ill while using a nonpermitted device.

Under ordinary circumstances, N95 masks — which are certified by the National Institute for Occupational Safety and Health — are abundant, available at hardware stores and pharmacies for around $1 apiece and for as little as 35 cents apiece wholesale. But in just two months, the coronavirus pandemic has depleted the world’s supply, creating a gray market that has driven prices for a single mask as high as $12 or more. That, in turn, has opened the door to unscrupulous actors running internet scams that take payment for N95 masks they never deliver, and to others selling counterfeit or mislabeled N95 masks, which could put health care workers at serious risk of infection.

Meanwhile, masks made under the newly permitted US standards — Australia, Brazil, Japan, Korea, Mexico, and the EU — are not made in as great quantities as the N95 or KN95, according to industry experts.

According to 3M, the world’s largest mask manufacturer, the KN95 is “equivalent” and “can be expected to function very similar” to the N95 mask. That opinion was echoed on Feb. 29 by the CDC, which said the KN95 is one of seven foreign-certified respirators “expected to provide protection to workers.”



hakima@hakima70477643
kn95 masks1.05$ available WeChat：15807086825 WhatsApp：+00861841337093207:45 AM - 24 Mar 2020

Tilton is one of a growing number of entrepreneurs and do-gooders who have rushed to find ways to bring respirators into the country to meet the urgent national need. The federal government recently estimated that the US would require 3.5 billion masks over the next year to address COVID-19.

Earlier this month Tilton applied for and received a medical device importer’s license from the FDA and soon thereafter inked a deal to sell 111,000 masks to a large hospital group in New Jersey. Because of the scarcity and high cost of the N95 masks, he split the order between those and KN95 masks and worries that some may get held up.

“You don’t want to risk $500,000 or $1 million on a shipment of masks in hopes the customs people look away,” said Tilton. “I’m not going to take any more orders until I know we can get everything through.”

A spokesperson for Customs and Border Patrol, which oversees all imports, said that the agency had recently intercepted various COVID-19-related products coming into the country because they were either counterfeit or not permitted, but could not elaborate on whether any were KN95 masks. An advisory paper published by law firm Covington and Burling last week predicted “increased screening, examination, and sampling at ports” of medical devices.


Scott Olson / Getty Images

Some believe that the FDA’s omission may be motivated by rising tensions between the US and China during the outbreak. Earlier this month, President Donald Trump made a point of referring to the pathogen as the “Chinese virus,” while last week Secretary of State Mike Pompeo’s insistence on calling it the “Wuhan virus” led to the spiking of a G7 joint communiqué on the pandemic.

“It seems like this is happening for political reasons,” said Byron Walker, who owns SurivalFrog.com, an online store that focuses on survival gear. After noticing a month ago that his own small inventory of N95 masks had sold out overnight, he decided to try to import many more. He reached out to the Colorado Department of Human Services and agreed to sell it 50,000 masks at cost, and plans to donate an additional 10,000 masks to hospitals in Denver, where he lives.

After considerable effort, Walker was able to source the masks at a cost of more than $3 and is awaiting the first shipments early this week. But he says he could have ordered at least twice as many KN95 masks if they were permitted.

Vernessa Pollard, an attorney at McDermott Will & Emery whose practice focuses on FDA law and who formerly worked at the agency, dismisses such concerns. She said she was aware of several health care providers that had been inquiring about authorization from the FDA to import KN95 masks, and understood that the agency was reviewing scientific data to determine that the respirators were truly equivalent.

“My belief is the FDA is looking at the KN95 to be allowed to be imported,” Pollard said. “It’s science-based. I don’t believe there is anything political at all.”

In the meantime, however, prices for the US-approved N95 masks continue to surge. One survey of offers from China on Friday showed KN95 masks averaged significantly less than half the price — roughly $1.44 compared to $3.60 apiece.

Although some hospitals flat-out reject KN95 masks at any price on advice of their lawyers, people rounding up masks to give to hospitals have found that individual doctors or nurses will often accept the donations, given the dire need. On March 17, the CDC issued guidance saying that health care personnel could use bandanas, scarves, or other “homemade masks” as “a last resort.”

Despite the import restrictions, some KN95 masks are trickling through. The FDA has set up several special email addresses for inquiries about shortages, and several importers said that prior to the EUA issued last week, they had received guidance from agency officials that small shipments of KN95 would likely not be stopped at the border.


Courtesy of Jon Passantino

KN95 masks for sale for $8.99 at a market in Santa Monica, California, March 28.

Some of those masks are already working their way into the consumer marketplace. Although N95 masks have been sold out for at least a month, KN95s have begun appearing in retail stores.

The Farms, a neighborhood market in Santa Monica, California, had masks labeled “KN95” for sale at $8.99 for a two-pack, or close to $5 apiece with tax, on Saturday evening. According to an employee who answered the phone, they were sold out by the next morning. “We should have more tomorrow,” the employee said.

Karen Conway, an executive at GHX, which provides technological solutions to supply chain management for the health care industry, said that given the extreme shortages, “the most important thing is to get health care workers what they need.”


Ken Bensinger is an investigative reporter for BuzzFeed News and is based in Los Angeles. He is the author of "Red Card," on the FIFA scandal. His DMs are open.

An American Airlines Flight Attendant Has Died From The Coronavirus As Employees Fight For Safer Working Conditions

Paul Frishkorn is being remembered as a kind, passionate advocate for flight attendants.

Brianna Sacks BuzzFeed News Reporter March 27, 2020, at 5:13 p.m. ET

Association of Flight attendants, Matt York / AP

American Airlines on Friday confirmed that a flight attendant died on Monday after contracting the disease caused by the novel coronavirus.

Paul Frishkorn, who was based in Philadelphia and had been working as a flight attendant since 1997, is the first American Airlines employee to die from COVID-19, his union, the Association of Professional Flight Attendants, said in a statement on Friday.

"Over the years he built a reputation as a consummate professional who was honored as one of American’s Flight Service Champions twice for his excellent service to our customers," American Airlines said.

The company recognized the 65-year-old's tireless dedication to his coworkers, calling him a "servant leader" through his work with the union throughout his career, as well as with the Association of Professional Flight Attendants.

"Our hearts go out to Paul’s loved ones, many of whom work for American," the airline said.

Frishkorn had been spending time in the Philadelphia crew room, helping other flight attendants by answering their questions and providing resources and information about the impacts of the coronavirus, Lori Bassani, president of the Association of Professional Flight Attendants, told BuzzFeed News in a statement.

"Paul’s death sheds a solemn light on our profession as front line workers. It underlines the risk to our members who continue to work as 'essential workers' in the airlines," she said. "Paul is the first of our colleagues to lose his life as a result of this deadly virus. We are deeply saddened and are reminded that no precaution is too much to take during this horrible time."

View this post on FacebookFacebook: afacwa

Friends, coworkers, and fellow flight attendants have been posting tributes to Frishkorn on Facebook, sharing their memories and grief over losing someone who was so dedicated to his job and passionate about helping others. They described him as a helpful and kind person who "helped thousands of flight attendants during his years at [US Airways] and later American."

"We flew together several times. He was a figure skater and was active in the world of figure skating after he stopped competing," Jody Jaeger wrote. "A wonderful person and professional to the core. That moment when somebody you know is taken by this virus changes everything."

Tracey Montanari, who worked with Frishkorn at US Airways, wrote on Monday: "The world lost a beautiful soul today... I have no words to describe this incredible loss."

Kristiano Rowland remembered the times Frishkorn used to come into his New York City bar when he was bartending; Frishkorn "talked [him] into finally applying for a flight attendant position," Rowland said.

"You motivated me to get my wings," he said. "And now you got an eternal set of wings. Fly high. Rest in peace, Paul."

Frishkorn's death comes as airline workers have been sounding the alarm over the dangers of working during the coronavirus pandemic, demanding in petitions that major companies stop nonessential flights and give their workers better compensation and protection for being on the front lines as COVID-19 cases soar.

Several workers from American Airlines have contacted BuzzFeed News over the past week, expressing their fears of working in close quarters without adequate protection or sanitization.

In a statement to BuzzFeed News, American said it has "taken enhanced steps to provide our team members with a safe, healthy and clean working environment" and is encouraging workers to use their vacation or sick time and stay home if they do not feel well.

If an employee does test positive for COVID-19, or is officially put under quarantine, the airline will give them an additional two weeks of paid sick leave.

However, like countless people across the US, if airline workers are feeling symptoms, it has been difficult to get tested and prove you have the virus.

One American Airlines employee told BuzzFeed News his doctor recommended he self-quarantine because he has an immunodeficiency caused by a previous illness. He has 10 days of sick time, he said, and if he tests positive, he'll get those two weeks of paid sick leave. But he hasn't been able to officially confirm he has the virus and will be on "unpaid leave" until he can.

"I expressed to them the lack of testing available," he said. "As my mother use to say, dammed if you do, dammed if you don’t."

In a letter on March 18, Bassani said that while the union had negotiated an extended leave option with some medical benefits, the group was "highly offended" that American Airlines "offered the pilot group financial benefits for two of the pilot options and would not consider the same for our group."

"This is a slap in the face for our members who are keeping this airline in the air — and it severely underestimates our relevance during this or any crisis," she wrote.

Bassani described the difficult working conditions flight attendants face, such as serving and interacting closely with travelers from all over, which makes social distancing nearly impossible.

"To exacerbate that situation, our company designed the interiors of our aircraft by stuffing in as many seats as possible, with passenger seats encroaching on our jump seat areas, airplane aisles more narrow than ever, and severely reducing space in galley areas, bathrooms, and spaces for passengers to wait in line for restrooms," she pointed out.

The president also noted that many flight attendants, like Frishkorn, are in a high-risk position and "flying at an older age than ever before because their pensions were stripped or frozen during the last crisis and they cannot afford to retire."


Sara Nelson@FlyingWithSara
The airline industry is in crisis. A lot of people are asking what to do. We have a plan that starts with workers. A thread: 1/1108:01 PM - 16 Mar 2020

Sara Nelson, president of the Association of Flight Attendants, has been demanding protections for all workers as the aviation industry comes to a grinding, unprecedented halt. The organization represents 50,000 flight attendants across 20 airlines.

On Friday, the House passed a sweeping aid package that specifically addresses the concerns of airline workers and would help prevent employees from mass layoffs.

The Association of Flight Attendants thanked Congress for passing a #WorkersFirst aviation relief package "that includes direct financial assistance for airline workers' wages and benefits."

"The bill is historic. It will save our jobs and our industry. But it’s not perfect. We will continue to work with lawmakers, the administration, and our airlines to ensure the bill is implemented as intended. But also, we need to recognize that this is a baseline for our fight going forward," the group said.

United Airlines executives, for example, told employees that layoffs are still a possibility due to the dramatic drop in business, CNBC reported.


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Brianna Sacks is a reporter for BuzzFeed News and is based in Los Angeles.