8 million ordered to evacuate as Typhoon Nanmadol slams across Japan: 'Raining like never before'

John Bacon, USA TODAY

Mon, September 19, 2022 

More than 8 million people in southern and western Japan have been ordered to evacuate as Typhoon Nanmadol roars across the island nation with historic wind and waves.

Local government officials across Japan told national broadcaster NHK that a level 5 alert, the highest on Japan's disaster warning scale, was issued to more than 330,000 people in about 160,000 households in Kagoshima, Miyazaki and Oita prefectures.

Nearly 8 million people in about 3.7 million households affected by a level 4 alert were ordered to evacuate in parts of the Kyushu, Shikoku and Chugoku regions, NHK said.

The Japan Meteorological Agency said it was "raining like never before" in Miyazaki, where some areas saw more than 15 inches of rain in the 24 hours through Sunday afternoon. Power lines tumbled and hundreds of thousands of homes and businesses were dark as the storm slowly rolled northward over Kyushu.

"To protect your life and the lives of your loved ones, please follow the evacuation information already issued by your local municipality immediately," the agency said. "Ensure your own safety without waiting for the announcement of a special warning."

First special typhoon warning

In Kagoshima, thousands took shelter at evacuation centers. Wind speeds of almost 115 mph were reported in parts of the region.

It was the first time the agency has issued a special typhoon warning for an area outside from Okinawa Prefecture. Flights were canceled and train service, the lifeblood of Japanese travel, was suspended in the region.

Prime Minister Fumio Kishida said he had mobilized police, firefighters, the Self-Defense Forces and other agencies.

River Surges as Typhoon Nanmadol Hits Miyazaki

Debris was seen floating in the Mimi River in Misato, Japan, after Typhoon Nanmadol tore through southern parts of the country on Monday, September 19. On Sunday, September 18, a level 5 weather alert was issued to over 100,000 residents in Kagoshima and Miyazaki prefectures, and over four million people were told to evacuate the island of Kyushu, according to

'ANGRY SEA': Huge storm floods roads, homes in Alaska as governor declares disaster

"I urge (the public) to avoid going near places posing potential dangers such as rivers and other waterways or places at risk of landslides, and to evacuate without hesitation if they feel in danger in any way," Kishida said.

• 
  

  Drone footage shows collapsed bridge after Taiwan quake

  STORY: Sunday's earthquake caused the Gaoliao Bridge in Hualien County to collapse. Several buildings were also damaged and train carriages were derailed. Taiwan's weather bureau said the epicenter was in Taitung County and followed a 6.4 magnitude temblor on Saturday (September 17) evening in the same area, which caused no casualties.

Earthquake strikes Taiwan

Less than 900 miles southwest of Japan's natural disaster, a strong earthquake struck southeastern Taiwan on Saturday evening, collapsing a house and interrupting rail service on the island. Taiwan's Central News Agency said the 6.4 magnitude shallow quake was centered north of Taitung County on the island's eastern shore.

STRONG EARTHQUAKE HITS TAIWAN: Rail service disrupted, house topples

Contributing: The Associated Press

Mary Peltola makes history as Alaska's first woman and Indigenous representative

Nikole Killion
Tue, September 13, 2022

Rep. Mary Peltola is still pinching herself after being sworn in as the newest member of Congress on Tuesday evening.

"The reality has been sinking in more and more each day," the Alaska Democrat told CBS News after winning a special election this summer to complete the term of the late Republican Congressman Don Young.

Peltola flipped the seat that had been held for Republicans for the first time in nearly five decades after beating 2008 GOP vice presidential candidate and former Alaska Governor Sarah Palin and Nick Begich III, whose uncle and grandfather previously represented the state. She is also the first Alaska Native to serve in Congress and the first female representative elected to the state's sole, at-large district.

Donning snow boots with a deep navy blue suit and large white beaded necklace, the mother of seven and grandmother of two received a standing ovation on the House floor during her swearing in, flanked by Senators Lisa Murkowski and Dan Sullivan of Alaska.

Speaker of the House Nancy Pelosi of Calif., administers the House oath of office to Rep. Mary Peltola, D-Alaska, during a ceremonial swearing-in on Capitol Hill in Washington, Tuesday, Sept. 13, 2022. / Credit: Jose Luis Magana / AP

"It is the honor of my life to represent Alaska, a place my ancestors and elders have called home for thousands of years, where to this day many people in my community carry forward our traditions of hunting and fishing," Peltola said during her inaugural speech. "I am humbled and deeply honored to be the first Alaska Native elected to this body, the first woman to hold Alaska's House seat but to be clear, I'm here to represent all Alaskans."

The 49-year-old lawmaker will have to defend the seat again in November against Palin and Begich. The five-term state legislator won last month's special election with 51.47% of the vote after a process of elimination in Alaska's new ranked-choice voting system.

"I am definitely working on building on the momentum that we gained in the special election," said Peltola, who hopes to use her short stint in Congress to convince voters to elect her to a full two-year term.

"We have shown that it is doable but I am not 100 percent confident, it is not a foregone conclusion," she noted of her prospects. "Both of my opponents are are well respected leaders in Alaska and I have respect for both of them and their supporters so I will be working as hard as I possibly can for Alaskans in these three weeks to show people throughout our state my work ethic, my commitment to our state, my dedication to the office."

Earlier this month, Palin called on Begich to drop out of the race and said "splitting the Republican vote" is the only reason a Democrat was elected to Congress. Begich said he believes he is on a "positive trajectory to win in November" and plans to travel the state.

Peltola said she believes voters are seeking a "middle of the road" candidate and are tired of divisive politics.

"Working with everyone and not seeing people in a partisan way, just seeing them as Alaskans, I think that is instructive and I think there is a high demand for that," she said.

RIGHT TO LIFE END DEATH PENALTY

Psychologist: School shooter suffered fetal alcohol damage




Marjory Stoneman Douglas High School shooter Nikolas Cruz, right, sits with Assistant Public Defender Nawal Bashimam at the defense table during the penalty phase of his trial at the Broward County Courthouse in Fort Lauderdale, Fla., Monday, Sept. 12, 2022. Cruz pleaded guilty to murdering 17 students and staff members in 2018 at Parkland's high school. 

The trial is only to determine if the 23-year-old is sentenced to death or life without parole.

 (Amy Beth Bennett/South Florida Sun-Sentinel via AP, Pool)More

TERRY SPENCER
Mon, September 12, 2022 

FORT LAUDERDALE, Fla. (AP) — Attorneys for Florida school shooter Nikolas Cruz began building their argument Monday that his birth mother's alcohol abuse left him with severe behavioral problems that eventually led to his 2018 murder of 17 people at Parkland's Marjory Stoneman Douglas High School.

Paul Connor, a Seattle-area neuropsychologist, said medical records and testimony by prior witnesses show that Brenda Woodard drank and used cocaine throughout much of her pregnancy before Cruz's birth in 1998. Woodard, a Fort Lauderdale prostitute, gave up the baby immediately after to his adoptive parents, Lynda and Roger Cruz. Woodard died last year.

Connor, testifying by Zoom, told jurors that people with fetal alcohol spectrum disorder show at a young age problems with motor skills, impulse control, socializing and paying attention — problems previous defense testimony showed Cruz had.

Cruz's preschool teachers testified he couldn't run without falling or use utensils. He was diagnosed with attention deficit hyperactivity disorder as a young child and teachers testified that he was extremely anxious and had trouble making friends.

At 5, tests showed Cruz had impairments in 10 intellectual categories including memory, reasoning, language and impulsivity, Connor said. Court records and earlier testimony showed he would have frequent outbursts in class and at home. By middle school, he was making threats.

Connor said he measured Cruz's IQ at 83, which he said matches the slightly below average intelligence many people with fetal alcohol issues often score. He said IQ tests conducted throughout Cruz's life found similar results, including one done recently by a prosecution expert.

Under cross-examination by lead prosecutor Mike Satz, Connor conceded he is not board certified in his field but said such certification is voluntary and only a state license is required to practice. He also conceded that he almost always testifies on behalf of the defense in fetal alcohol cases, not prosecutors. He will continue testifying Tuesday.

Cruz, 23, pleaded guilty in October to murdering 14 students and three staff members and wounding 17 others as he stalked a three-story classroom building with an AR-15-style semiautomatic rifle on Valentine's Day 2018. His trial is only to decide whether the former Stoneman Douglas student is sentenced to death or life without parole. For the seven-man, five-woman jury to impose a death sentence, the vote must be unanimous.

Satz finished his primary case last month. He played security videos of the shooting and showed the rifle Cruz used. Teachers and students testified about watching others die. He showed graphic autopsy and crime scene photos and took jurors to the fenced-off building, which remains blood-stained and bullet-pocked. Parents and spouses gave tearful and angry statements about their loss.

In an attempt to counter that, assistant public defender Melisa McNeill and her team have made Cruz’s history their case’s centerpiece, hoping at least one juror will vote for life.

After the defense concludes its case in the coming weeks, the prosecution will present a rebuttal case before the jury's deliberations begin.

Prosecutors push expert witness to concede testimony was incomplete picture of Stoneman Douglas shooter


David Fleshler and Rafael Olmeda, South Florida Sun Sentinel
Tue, September 13, 2022

FORT LAUDERDALE, Fla. — Parkland shooter Nikolas Cruz showed no lack of mental competence as he planned and carried out his attack on Marjory Stoneman Douglas High School, a Broward prosecutor said Tuesday.

Assistant State Attorney Mike Satz reviewed the gunman’s actions while cross-examining neurologist Paul Connor, who testified Monday that Cruz lacked the ability to quickly shift the focus of his attention and had trouble solving problems and using his working memory.

Defense lawyers are portraying Cruz as the neurologically damaged victim of his mother’s heavy drinking, part of their bid to persuade jurors to spare him from the death penalty.

But in cross-examination Tuesday, Satz got Connor to concede that many of Cruz’s neurological test scores were in the normal range. Those scores were not discussed during Connor’s direct testimony Monday.

Satz took aim at a graph prepared by Connor headed “Neuropsychological testing of Nikolas Cruz Deficits in nine of 11 domains assessed.” Under questioning from Satz, Connor acknowledged that the chart only contained results of a fraction of the tests he administered and that many of those tests contained average scores, in contrast to the below-average scores highlighted in his chart.

“Did you ask the defendant about the 17 murders committed by the defendant at Marjory Stoneman Douglas High School on Feb. 14, 2018?”

”I did not,” Connor responded.

“You saw how purposeful his actions were?” Satz asked.

”I watched the video,” Connor said. “I was not doing it to interpret it.”

”Did you see how goal-directed it was?” Satz asked. “So you can’t say whether he appeared on the video to be goal-directed and dedicated to his task?“

”I have no opinion on that,” Connor said.

Kenneth Lyons Jones, a pediatrician and one of the first two doctors in the country to identify fetal alcohol syndrome as a medical condition, was brought in Tuesday to testify with even more precision about Cruz’s ailments. He said Cruz does not have the syndrome, which has very specific characteristics, but Cruz does suffer from a related condition called alcohol related neurodevelopmental disorder.

Both fall under what Jones identified as fetal alcohol spectrum disorder. People suffering from ARND tend to be incapable of planning and organizing their thoughts, Jones said during cross examination. “I think that he lost control of himself, without any question,” he said.

But his testimony gave Satz an opening to remind the jury of just how much planning went into the Stoneman Douglas mass shooting.

Satz brought up the series of internet searches Cruz conducted prior to the massacre, again attempting to indicate a capacity for planning that would contradict the experts’ assessment of Cruz’s mental capacity. The searches included information about the mass shootings at Columbine and in Las Vegas and Aurora, Colorado.

Jones said he was unaware of any of those searches.

Jurors will later be asked to weigh the conflicting testimony about Cruz’s mental health issues to determine whether the death penalty is an appropriate punishment for the 17 murders he committed. The defense is raising fetal alcohol spectrum disorder as a possible mitigating factor the jury can consider in choosing a life sentence instead of condemning Cruz to die.

Testimony is scheduled to resume Wednesday morning.

LA REVUE GAUCHE - Left Comment: Search results for FASD 

L.A. County reports nation's first confirmed MPX death

Luke Money, Rong-Gong Lin II
Mon, September 12, 2022 

This image shows particles of the MPX virus (orange) found within an infected cell (brown), cultured in the laboratory. (National Institute of Allergy and Infectious Diseases / Associated Press)

A Los Angeles County resident has died from MPX — the nation's first confirmed fatality linked to the disease, public health officials said Monday.

Officials first publicly reported the death Thursday but said the precise cause was still being probed at that point. Further investigation from the county Department of Public Health and U.S. Centers for Disease Control and Prevention determined the death was from MPX, also known as monkeypox, according to a statement.

Another death — of an adult who was severely immunocompromised and had been diagnosed with MPX — was reported in Texas in late August. However, officials there have yet to definitively state whether that fatality was caused by the disease.


The L.A. County Department of Public Health noted that the local resident "was severely immunocompromised and had been hospitalized," but otherwise did not disclose any other details — such as the person's age, gender or city of residence — citing privacy concerns.

"Persons severely immunocompromised who suspect they have monkeypox are encouraged to seek medical care and treatment early and remain under the care of a provider during their illness," the department wrote in a statement.

Health officials in California recently started to use the name MPX — pronounced mpox — instead of monkeypox because of widespread concerns the older name is stigmatizing and racist. The World Health Organization is in the process of formally renaming the disease, which will take several months.

As of Friday, L.A. County health officials had reported 1,836 MPX cases. However, hospitalizations associated with the disease remain rare.

The rate of newly reported MPX cases also continues to slow. For the seven-day period that ended Thursday, L.A. County reported 187 new cases, a 30% decline from the prior week’s tally of 269.

Officials credited the slowdown in part to vaccination efforts and nationwide survey data suggesting gay and bisexual men have decreased their number of sexual partners and one-time sexual encounters in light of the outbreak.

Because MPX is not easily transmitted — it typically requires close skin-to-skin contact for an infection to occur, and is nowhere near as transmissible as the coronavirus — officials say spread of disease is likely to fade relatively quickly compared with more contagious illnesses.

MPX disease is characterized by virus-filled rashes and lesions that can look like pimples, bumps or blisters. It can appear first in the genital area and rectum before spreading to other parts of the body, and because the rashes can be mistaken for other skin issues, the virus can easily spread during intimate encounters. Risk is higher for people with multiple sexual partners.

“We likely will continue to see cases for a long time to come. But at least the current high number that we’re seeing, we are hoping to see that that will go down,” Dr. Rita Singhal, chief medical officer for the L.A. County Department of Public Health, said during a briefing Thursday.

In an advisory issued last week, county health officials noted severe MPX disease has been found in people with inadequately treated HIV, underscoring how essential it is that those at higher risk seek treatment.

"People with advanced or uncontrolled HIV are at risk of life-threatening disease. In previous outbreaks, the majority of monkeypox deaths have been reported in this population," health officials said in an advisory issued Friday.

L.A. County health officials are now specifically exhorting healthcare providers to use a drug called tecovirimat — commonly known as Tpoxx — in patients who have or are at risk of developing severe MPX disease.

A previous county advisory issued a month ago said only that "patients with lesions or pain that interfere with the activities of daily living and patients at high risk for severe disease" should be considered for treatment with Tpoxx.

There is no shortage of Tpoxx, but the drug has been difficult to get to patients, in part because it is not formally approved by the U.S. Food and Drug Administration to treat MPX.

If patients are unable to take the drug orally, Tpoxx should be administered intravenously. Other treatment options include Cidofovir, an antiviral medicine administered intravenously, and Vaccinia Immune Globulin.

U.S. officials also are reportedly considering broadening recommendations on who should get vaccinated against MPX to possibly include men with HIV or those recently diagnosed with other sexually transmitted diseases, the Associated Press reported.

Health officials said clinicians are required to report all MPX cases to the L.A. County Department of Public Health. If patients who are hospitalized have worsening symptoms, such as requiring intensive care, hospitals are asked to contact county health officials for consultation and to get access to more therapeutic options.

This story originally appeared in Los Angeles Times.

Nation's first MPX case in healthcare worker exposed on the job is reported in L.A. County

Grace Toohey
Tue, September 13, 2022 

Licensed vocational nurse Sophia Mineros, left, administers a dose of the Jynneos MPX vaccine to a person at an L.A. County vaccination site in East Los Angeles on Aug. 10. (Mario Tama / Getty Images)

The first U.S. healthcare worker to be infected with MPX while on the job has been reported in Los Angeles County, public health officials said Tuesday, the day after the county confirmed the nation's first MPX death.

"We have identified a healthcare worker with monkeypox who appears to have been exposed to the virus at their worksite," Dr. Rita Singhal, chief medical officer for the L.A. County Department of Public Health, said in a presentation to the Board of Supervisors. "This is the first case of monkeypox in a healthcare worker in the United States that has been linked to a worksite exposure."

Singhal said the county has consulted about the case with Centers for Disease Control and Prevention officials, but the risk of MPX for healthcare workers "remains very low."


Dr. Rochelle Walensky, the CDC director, told the Senate Health Committee on Wednesday that the lone reported case of an infected healthcare worker was the result of a "needle stick injury." Walensky did not specifically say she was referring to the L.A. County case.

Walensky expressed confidence that wearing personal protective equipment keeps healthcare workers protected against exposure.

The L.A. County Department of Public Health declined to answer additional questions Wednesday about whether Walensky was talking about the local case reported this week or elaborate on the healthcare worker's condition.

On Thursday, Singhal said at a news briefing that there have been about eight healthcare workers worldwide who have contracted MPX from workplace exposure, some of whom were infected because of a needle stick injury. "Locally for us here, it was not directly a needle stick injury, but it was an exposure at the work site," she said.

Spread of the MPX virus to healthcare employees from work site exposures is rare.

Before this year's outbreak, there was a single documented case of MPX transmission in Britain, in 2018, in which a healthcare assistant was infected after changing “presumably contaminated bedding” without wearing a mask or respirator. The worker came into contact with the sheets at a time when the patient had skin lesions but had not yet been diagnosed with MPX and placed under isolation, according to medical journals.

Health leaders in California recently started to use the name MPX, pronounced mpox, because of widespread concerns the virus' original name is stigmatizing and racist. The World Health Organization is in the process of formally renaming the disease, which will take several months.

MPX — unlike the coronavirus — is not easily transmitted, typically requiring close skin-to-skin contact with an infectious lesion. Cases in this outbreak have been confirmed primarily among men who have sex with men, as well as transgender people, as the virus can spread easily during sexual encounters — though not exclusively.

In L.A. County, 97% of MPX cases have been confirmed in men, and of cases for which sexual orientation is known, more than 90% have identified as gay or bisexual, according to the Department of Public Health.

While MPX case counts reached a total of 1,914 in L.A. County as of Wednesday, the number of new cases week-to-week has recently started to fall, a sign public health leaders across the nation are hopeful indicates reduced transmission and a sustained decline in cases. There are 4,453 confirmed or suspected cases across California.

But even as the rate of new cases slows, Singhal said disparities are growing among who is catching the virus and receiving the two-dose Jynneos vaccine.

In July — at the beginning of the local outbreak — white Angelenos made up more than 55% of new weekly MPX cases, according to data from the Public Health Department shared Tuesday. But by early September, Latino residents made up the largest proportion of MPX cases in the county, with about 55% of all new weekly cases. White residents' share had shrunk to about 20% of new weekly cases in early September, while Black residents’ share had almost doubled in two months, to about 10%.

Accounting for population, county officials found that Black Angelenos had the highest rate of cumulative MPX infections, at 26 cases for every 100,000 Black residents, while Latino residents and white residents had similar case rates, at 16 and 17 per 100,000, respectively.

Using the Healthy Places Index, or HPI — a measure that accounts for the overall public health level of a community, such as poverty and access to housing and education — county officials found that neighborhoods with the least resources have accounted for a larger share of the county's total MPX cases: about 70% as of early September.

"Over time, a higher proportion of cases have been in the two lowest HPI quartiles, or the least healthy communities," Singhal said. At the beginning of the outbreak, people living in communities with fewer resources for optimal public health made up roughly 30% of MPX cases, while those in communities with greater resources were initially more likely to contract the virus. But that flipped about two months later.

People of color have also disproportionately not received a vaccine against MPX, despite making up a majority of current cases, according to county data from last week. Latino residents make up 44% of MPX cases but only 32% of first-dose recipients; similarly, 12% of county cases are among Black residents, but only 9% of the administered first doses have gone to that demographic.

White Angelenos make up 40% of the county's first-dose recipients, though they account for less than 30% cases, the data show.

"To address the disparities in monkeypox case and vaccination rates among Latinx and Black populations, [the Department of] Public Health is working with community-based organizations to further define messaging and outreach for these populations," Singhal said. "We are meeting with stakeholders on a weekly basis to hear feedback from focus groups on how best to reach these populations."

Singhal also noted that only one-third of those eligible for a second dose of the MPX vaccine have received it, and she strongly encouraged people to get both shots to "optimize their immune response."

Barbara Ferrer, the county's public health director, said she is hopeful the agency's recent expansion of vaccine eligibility to include people who self-attest they may be at "risk for future exposure" will also help bring more people in for a shot.

Due to an initial shortage of doses, the county limited doses to those considered most at-risk to the virus — primarily gay and bisexual men or transgender people with certain sexually transmitted infections or multiple sexual partners — which she acknowledged could have been stigmatizing. Vaccine availability has since drastically increased, though officials are still not recommending widespread inoculations.

“We’ve changed our eligibility guidance to really make that much easier to people," Ferrer said Tuesday. “We’re trying desperately to listen to concerns residents are raising. ... We do have disproportionality; we need to pay a lot of attention to what people in our communities are saying would help reduce the barriers to getting vaccinated.”

Singhal also reported two MPX cases that have been confirmed in county jails and 81 among people experiencing homelessness, including seven in congregate housing, but she said there is "no evidence of spread in those settings." There have been six cases in children under the age of 18.

Throughout the entire outbreak, 66 people have been hospitalized for MPX, Singhal said, or about 4% of total cases. The person who recently died of MPX in L.A. County was "severely immunocompromised and had been hospitalized," Singhal said, and she urged those with MPX to seek medical care and treatment early, when possible.

Times staff writer Rong-Gong Lin II contributed to this report.

This story originally appeared in Los Angeles Times.


'I'm living from day to day': Isolating for MPX can put people out of work for weeks


Emily Alpert Reyes, Heidi Pérez-Moreno, Grace Toohey
September 12, 2022

Justin Bolding looks outside his West Hollywood apartment window where family and friends would talk to him while he suffered for three weeks with MPX. (Genaro Molina / Los Angeles Times)

When a doctor told Ivan that he needed to isolate himself and not share bedsheets to keep the MPX virus from spreading, he wondered: How?

"It would be absurd trying to isolate while sharing a bed," the Hayward, Calif., resident said in Spanish.

The 43-year-old man, who is gay, had been splitting a bedroom with a female friend to save money in the San Francisco Bay Area, where rents are steep. He was grateful when another friend offered him somewhere else to isolate, but then there was the money: Doctors warned that isolation might last weeks as his lesions healed, and Ivan was out of sick days at the grocery store where he works.


The virus racked him with pain and ultimately kept him away from work for three weeks — and that cost him almost $2,000 in income, said Ivan, who asked to go by only his first name to protect his privacy. Now rent is looming. A friend helped him cover his phone bill, but as of late August, he still needed $500 for a car payment.

"I just haven't gotten the money," he said.

The MPX virus has wreaked financial havoc for workers who have little paid time off to recover from illness. Healing from painful lesions can take weeks — much longer than the three days of sick leave that California generally requires from employers. Government guidelines aimed at stopping the spread of MPX — which is what the California Department of Public Health calls monkeypox — urge people to try to remain isolated at home.

“The best thing would be … for them to be able to stay home and to work remotely,” said Dr. Rita Singhal, chief medical officer for the Los Angeles County Department of Public Health. "But we know that that's not an option for everyone."

As the coronavirus sickened and sidelined Californians, state and local lawmakers set up programs that bolstered paid leave for people affected by COVID-19. In Los Angeles, for instance, which requires at least six days of paid sick leave annually for many employers, city officials decided to mandate additional COVID-19 leave for workers at large companies.

Across California, as of this year, some workers at bigger companies are eligible for up to 80 hours of paid leave if they are ill with COVID-19 or caring for a family member with the virus. But so far, state lawmakers have not set up similar programs specifically for MPX, despite an isolation period that can last as long as four weeks.

"No one should be forced to choose between complying with health orders and being able to feed themselves and pay their bills," said Samuel Garrett-Pate, managing director of external affairs at Equality California, which has advocated to extend more paid leave for people affected by the virus. "There's no reason that people affected by monkeypox — which requires a longer quarantine period — are any less deserving of that same relief than everyone who was affected by COVID-19."

Many California workers can also try to access payments for disability insurance — a program that can partially cover lost wages in the short term for Californians who are unable to work because of non-work-related illness — but that process can be cumbersome, Garrett-Pate said.

Restaurant worker Justin Bolding, who first realized he might have gotten the MPX virus when he felt unusually exhausted after a Sunday night shift, said he had phoned a state agency hundreds of times to get help with applying for the program.

“I’m still trying to get some money from losing three weeks of work,” Bolding, 37, said in August, shortly after he submitted a paper application.

Bolding had to isolate for weeks after the virus peppered his body with lesions from his head to the sole of his foot. One popped up on his nose, he said, which made him especially worried about protecting others from infection. Bolding counts himself as luckier than others who got infected, but he still had to dip into his savings as he went without his usual paychecks.

Even if workers can access them, "disability benefits don't pay your full salary, and folks are already living paycheck to paycheck," said Kathy Finn, secretary-treasurer for United Food and Commercial Workers Local 770, whose members include grocery and pharmacy workers.

California does require continued pay for healthcare workers who are exposed to some transmissible diseases on the job if a physician recommends they stay out of the workplace, which applies to MPX, said Stephen Knight, executive director of the nonprofit Worksafe.

But for others, "if public health requires workers to isolate for the general good ... then the public needs to compensate those workers to ensure that this is not a ticket to joblessness and homelessness," he said. "Otherwise people will not report they're sick."

Workers who need to take time off for MPX can also face stigma.

The virus has disproportionately affected gay and bisexual men and many cases have spread through intimate or sexual encounters, although health officials have emphasized that anyone can get the virus and that it can also be transmitted through other kinds of skin-to-skin contact.

“They don’t want to tell their employer they have monkeypox — it’s highly stigmatized. They don’t have any protected time off,” said Dr. Adam C. Lake, a physician who practices in Lancaster, Pa. And “even if you do, you have some explaining to do if you’re taking four weeks off.”

Marquiette, a 49-year-old construction worker, said that when he had to isolate for weeks after getting the virus, he quickly lost a job. “They were like, ‘You shouldn’t be taking off for so long,’” said the Los Angeles resident, who asked to use only his first name due to privacy concerns. “I had to tell them why I needed the time off — and that scared the company.”

Marquiette said a construction foreman quizzed him about how he got the virus. He said he didn’t know. “You have people looking at you crazy,” said the worker, who is heterosexual. “The first thing coming to their mind is something negative, and I couldn’t answer the questions that they asked me.”

As of late August, he had been out of work for almost three weeks, he said. “I don’t have gas to get around. I’m living from day to day. I’m having to go to pantries just to get food to survive right now.”

His landlord told him not to worry about being late on the rent. But Marquiette worries about when he will get hired again. Word of mouth travels in his field, he said.

“Now I’m blackballed and I can’t get hired nowhere,” he said.

Paul, 35, who works in the tech industry, said he “had the privilege of making up excuses” when he had to isolate, because he is supposed to come into the office only a few times a week.

“I kept getting asked, ‘When do you think you’ll be coming back in?’ " said the Los Angeles resident, who asked not to give his last name to protect his medical privacy. On video calls for work, he strategically chose clothing that would conceal his lesions and gritted his teeth through the pain, which he said was so severe that he was prescribed painkillers.

“If you had COVID, you could be honest about what’s going on,” said Paul, who is gay. But even though he works at an LGBTQ-friendly company, he didn’t want to tell co-workers he had MPX and feel them silently speculating about his sex life.

He had to isolate for 31 days as new lesions emerged and healed on his body. “Had I not had a job that allows flexibility,” he said, “I would have been screwed.”

The Centers for Disease Control and Prevention has stated that "ideally, people with monkeypox would remain in isolation for the duration of illness." The California Department of Public Health has warned that the virus can spread after symptoms begin and until all lesions are fully healed, with a new layer of skin having formed over the lesions.

Under state guidelines, people infected with MPX can return to the workplace after that happens and all other symptoms are gone for at least two days.

However, if their work does not involve physical contact or “settings of concern” such as schools, health facilities and homeless shelters — and virtual work is not possible — the state guidance says they can go back to work a few days after their fever or respiratory symptoms have disappeared, new lesions have stopped popping up for two days, and any lesions that cannot be covered are fully healed.

If they do so, they are still supposed to take precautions, including wearing a mask and covering any unhealed lesions with clothing or bandages.

Dr. Tomás Aragón, director of the California Department of Public Health, said that some MPX lesions may be in areas where there is no risk of exposing other people, and "we wanted to put together guidelines that are more practical for those situations." Before California set out its guidelines, many patients said they had gotten little leeway to exit isolation before all lesions had healed; some had been issued court orders to remain home.

In this global outbreak, the most common route of transmission has been "direct skin-to-skin contact with monkeypox lesions, and that's including sexual contact but not limited to that, as well as close contact with household or contaminated items," said Dr. Muntu Davis, county health officer for the L.A. County Department of Public Health. If lesions can be covered and someone doesn't have respiratory symptoms, "the risk should be much lower."

Aragón urged people to take advantage of any local programs that counties and others had already developed to support people amid the COVID-19 pandemic. Los Angeles County, for instance, is offering isolation housing in motels for people who are unhoused or have nowhere to safely isolate in their home during an MPX infection, according to its public health department.

In the Palm Springs area, C.J. Tobe said he knew of at least two people who had lost their jobs after getting the virus. DAP Health, the federally qualified health center where he serves as director of community health and sexual wellness, has delivered food to people unable to afford it and put up unhoused patients in hotel rooms as they wait out their isolation period.

"We're basically relaunching everything that we did through COVID to make sure that our patients, that our community members, are supported and safe," Tobe said.

Getting diagnosed with MPX "can and will be financially crippling for those without adequate financial support and/or paid leave," dozens of health and community groups warned in an August letter to state leaders.

They urged the governor to expand temporary eligibility under the state disability insurance program to cover workers who do not contribute to it, “in much the same way that eligibility for unemployment insurance was expanded during COVID-19.”

Gig workers, people working temporary jobs, and those who are self-employed are unlikely to be covered by the program as it stands, said Phil Curtis, director of government affairs for APLA Health, one of the groups that signed the letter.

The letter also urged state officials to consider providing financial relief for employers to extend paid leave to workers who need time off for MPX vaccination, testing or isolation.

When Juan fell ill with the virus, he decided not to use the five days of sick leave that his company provided because he knew he would need to isolate much longer. "I knew that if I took more than whatever sick days I had, then I would have to be short of that income and I could not afford that," said the Orange County resident, who asked to use only his first name to protect his privacy.

Instead, the 54-year-old worked from home. His doctor prescribed him painkillers, but Juan avoided taking them during the day, to avoid being groggy while working remotely. During video meetings, he shut off his camera so no one would see lesions on his face. When those meetings finally ended, he would soak in a tub to ease the pain.

"It was the only relief I really felt," he said.

Juan didn't lose out on income but had added expenses from getting groceries and other necessities delivered.

An MPX infection can be costly in other ways: Bolding, the restaurant worker, said he had to pay more than $300 out-of-pocket for a testing appointment, skin swabs and lab fees because he didn't have health insurance. And even after an infection wanes, some patients have been left with visible scars that can be costly to remove.

The financial and emotional burdens of isolating for weeks are one reason that some physicians have argued to expand access to Tpoxx, an investigational drug that has shown promise in sending lesions into retreat. Some researchers have also argued that isolation guidance is excessively strict if MPX is chiefly being spread through sexual contact rather than other forms of transmission, a question that has been the center of ongoing research and debate.

In Hayward, Ivan said that a clinic had helped him out with gift cards to try to soften the financial blow from having to stop working for weeks, but "the economic effect is huge."

Back at work, he wears a mask to protect himself, but also to hide the scars left over from the virus. As a newcomer to the country, Ivan has been frustrated with the ways it can fail workers who fall ill.

"They say that the United States is No. 1 in terms of resources," he said in Spanish. "But that's not true."

This story originally appeared in Los Angeles Times.

Los Angeles County to settle lawsuit over homeless crisis



- Jeff Page, right, also known as General Jeff, a homelessness activist and leader in the Downtown Los Angeles Skid Row Neighborhood Council, walks with U.S. District Court Judge David O. Carter, middle, and Michele Martinez, special master on the issues of homelessness, left, after a court hearing at Downtown Women's Center in Los Angeles. Los Angeles County leaders announced Monday, Sept. 12, 2022, a lawsuit settlement agreement that commits hundreds of millions of dollars to expand outreach and supportive services for homeless residents, marking the potential end of two years of litigation over the crisis of people living on the streets. (AP Photo/Damian Dovarganes, File)More


CHRISTOPHER WEBER
Mon, September 12, 2022 


LOS ANGELES (AP) — Los Angeles County leaders announced Monday a lawsuit settlement agreement that commits hundreds of millions of dollars to expand outreach and supportive services for homeless residents, marking the potential end of two years of litigation over the crisis of people living on the streets.

The deal puts LA County, operator of the local public health system, in direct partnership with the city of Los Angeles, which has committed to sheltering thousands of homeless residents as part of its settlement in the lawsuit reached earlier this year.

The suit was brought in 2020 by the LA Alliance for Human Rights, a coalition that includes businesses, residents, landlords, homeless people and others who allege that inaction by the city and county has created a dangerous environment.

The homeless population was once largely confined to downtown LA’s notorious Skid Row, but encampments have spread widely, including within sight of City Hall and the Hall of Administration, where the Los Angeles County Board of Supervisors meets.


Supervisor Holly Mitchell said the county will commit an estimated $236 million in new funding to address homelessness through 2027, with an emphasis on expanding street outreach teams to make sure people who need help get it. That's on top of more than $530 million in homelessness funding created by a sales tax approved by voters in 2017.

Mitchell said the new money will also go toward a “comprehensive suite of services” for eligible residents of the 10,200 permanent housing units and 3,100 interim shelter beds that the city of LA has committed to build under its agreement. Services will include case management, medical and mental health support, benefits advocacy, family reunification, childcare and addiction treatment.

“I cannot underscore enough how this adds to our toolkit for stemming the tidal wave of people who are experiencing homelessness,” Mitchell said at a news conference with city and county officials.

Matthew Umhofer, attorney for the alliance, said the “monumental” settlement seals the deal with the city by ensuring county support.

“But most importantly, this deal provides something that has been desperately missing on this issue for decades: real accountability in the form of supervision over the next five years by a federal judge,” he said. The county’s agreement requires the approval of U.S. District Judge David O. Carter, who is overseeing the case and will supervise the settlement’s implementation through 2027.

Los Angeles Mayor Eric Garcetti conceded there's been a collective failure of properly addressing the crisis at a local level. He said the new partnership is a step toward “putting a game plan on paper for how we can continue to march towards our ultimate goal of eliminating homelessness."

The city has said it will spend around $3 billion over five years to construct the new housing units. But the exact commitment will be based on the results of the 2022 point-in-time count of homeless people that was released last week. As of February, there were more than 69,100 homeless people in Los Angeles County, with about 42,000 within LA city limits.

Last year, Carter issued an order that would have required the city and county to offer shelter to all unhoused people on Skid Row within six months.

An appeals court struck down the order on grounds that the plaintiffs lacked standing to bring most claims. The alliance then filed an amended lawsuit.

Under the city’s agreement, announced in April and approved by the judge in June, Los Angeles will create shelter or housing for 60% of homeless people in the city who do not have a serious mental illness, substance abuse disorder or chronic physical illness.

The city, which does not have its own health department, had contended the county is obligated to provide services and housing for people with those problems but was failing.

CDC warns of increase in respiratory illness among children that could lead to polio-like muscle weakness




Matt Adams
Tue, September 13, 2022 

(WXIN) – Doctors across the U.S. have seen an increase among children of a respiratory virus that can cause polio-like muscle weakness.

In most cases, enterovirus D68 (EV-D68) causes a respiratory illness with mild symptoms. It can, however, result in a condition called acute flaccid myelitis (AFM) that can cause inflammation of the spinal cord. Those suffering from AFM can have trouble moving their arms while others experience muscle weakness. In severe cases, it can lead to respiratory failure or life-threatening neurologic complications.

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According to an alert issued by the Centers for Disease Control and Prevention last week, pediatric hospitalizations are on the rise among patients with severe respiratory illness who tested positive for rhinovirus (RV) and/or enterovirus (EV). Some of the patients have also tested positive for EV-D68 — and hospital sites are reporting a higher proportion of EV-D68 patients compared to previous years.


This isn’t the first time EV-D68 has caused problems. In 2014, an outbreak of enterovirus D68 was reported in multiple states. The outbreak involved nearly 1,400 people, although an undercount is very likely because many who experienced mild symptoms didn’t get tested.

Increased activity was also reported in 2016 and 2018, with lower circulation in 2020 likely due to COVID-19 mitigation measures.

Between July 2022 and August 2022, the number of detected EV-D68 cases was greater than the period from the three previous years (2019, 2020 and 2021). While the CDC hasn’t seen increased reports of AFM, an increase in AFM cases generally follows an increase in EV-D68 cases, the agency said.

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The CDC alert asks providers to consider EV-D68 as a possible cause of respiratory illnesses among children and warns of a potential increase in cases in the weeks to come. Common symptoms for EV-D68 include cough, shortness of breath and wheezing. Fever is present in about half of known cases.

“On rare occasions, EV-D68 may cause AFM,” the CDC noted in its alert. “This rare but serious neurologic condition primarily affects children and typically presents with sudden limb weakness.”

According to the CDC, signs of AFM include:

arm or leg weakness


pain in the neck, back, arms, or legs


difficulty swallowing or slurred speech


difficulty moving the eyes or drooping eyelids


facial droop or weakness

The agency noted that there are no available vaccines or specific treatments.

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Infants, children and teenagers are most likely to get infected. Those who suffer from asthma may be at greater risk for severe cases of EV-D68.

The CDC urges the public to follow typical prevention measures:

Wash your hands often with soap and water for 20 seconds


Avoid touching your eyes, nose and mouth with unwashed hands


Avoid close contact such as kissing, hugging, and sharing cups or eating utensils with people who are sick, and when you are sick


Cover your coughs and sneezes with a tissue or your upper shirt sleeve, not your hands


Clean and disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick


Stay home when you are sick


Consider wearing a mask around other people if you have respiratory symptoms


Contact a healthcare provider immediately if you or your child has trouble breathing or has a sudden onset of limb weakness


Ensure you or your child are following an up-to-date asthma action plan if you or your child have asthma


Stay up-to-date with all recommended vaccines

Pastor Our faith does not 'force pregnancy

and birth onto a 10-year-old little girl'

Gini Lohmann-Bauman

Mon, September 12, 2022 

Gini Lohmann-Bauman is a transformational leader, prophetic preacher, social justice witness, and Christian minister to those on the margins of society as the senior pastor of St. John’s United Church in Christ in Columbus. She lives in Westerville with her husband Gery and their daughter Katie.

As a person of faith, I know my beliefs are not in conflict with facts.

After reading “I'll take my beliefs over your 'facts' and scientific surveys, studies,” a letter to the editor by Diana Lewis, I feel compelled to explicitly state how much my faith not only aligns with facts, but also leads me to be in support of people’s right to access abortion care.

Lewis argues most Catholics, and many other people of faith, are opposed to abortion because of the Fifth Commandment. While she is certainly welcome to her opinion, it does not trump the truth. And the truth is having faith does not automatically mean opposing abortion and other forms of reproductive freedom.

More:Letters: I'll take my beliefs over your 'facts' and scientific surveys, studies

People of faith never have been, and never will be, a monolith.

Erasing the faith of millions of people simply to push a political narrative not only distorts the truth, it is morally wrong. In fact, several faiths adamantly support women having the freedom to choose or not choose pregnancy for themselves.

A May 2022 Pew survey notes 88 percent of Catholics, 87% of Black Protestants and 77% of white Evangelicals support some form of abortion access. These numbers tell a story that we do not hear often: People of faith across the board support people’s right to bodily autonomy. Supporting people having self-determination is not in contradiction to my faith.

I was taught to lead with compassion and to champion people’s right to dignity, agency, autonomy, love and self-determination. Assuming people who seek abortions are irresponsible or reckless is totally void of compassion and care. The Bible is very clear when it comes to being judgmental and it’s unreasonable to assume we are in a position to determine if a person should be able to control their bodies based on how we feel about how they got pregnant.

More:Ohio clergy: 'Trigger ban' an 'overreach by religious zealots' that would take us backward

As people of faith it is our calling to protect other’s innate dignity, to respect their moral agency and to be co-creators with God ensuring that everyone has safe, healthy and sustainable communities where they can thrive and parent if they decide to do so.

Our calling is not to force pregnancy and birth onto a 10-year-old little girl who experienced a sexual assault that already left her traumatized. Considering all she experienced, it’s unconscionable to require her to travel from Ohio to Indiana just to seek medical care. Where is the love and compassion in that?

Our faith mandates that we fight to protect basic human rights like bodily autonomy, housing, healthcare and the ability to parent or not parent how we see fit. We are not charged with expanding or even supporting barriers that further prevent us from living with the dignity that God desires.

The right to have a child, the right to not have a child and the right to parent a child or children in safe, sustainable and healthy environments should be basic human rights.

More:Rabbis: Abortion 'not only allowed but necessary' under our religious law.

We cannot allow the continuous exploitation of faith to be weaponized to create stigma around reproductive health care.

We have to counter cultural narratives that associate faith solely with opposition to abortion access and reproductive justice, we have to tell our truth about how our faith plays a role in us supporting access to abortion care.

Gini Lohmann-Bauman is a transformational leader, prophetic preacher, social justice witness, and Christian minister to those on the margins of society as the senior pastor of St. John’s United Church in Christ in Columbus. She lives in Westerville with her husband Gery and their daughter Katie.

This article originally appeared on The Columbus Dispatch: Opinion: Having faith does not automatically mean opposing abortion

Guest opinion: Unintended consequences and myths about abortions


Dr. Allen Malnak
Tue, September 13, 2022

United States Supreme Court exterior

Let me make it clear. I’d like to see the abortion number as close to zero as possible while allowing safe abortions whenever a woman feels she requires that procedure.

On June 24, 2022, the United States Supreme Court determined that abortion is not a constitutional right, effectively reversing Roe v. Wade.

Do you think there’s a girl or woman anywhere who awakens in the morning thinking, “Oh great. I can’t wait to get pregnant, so I can have an abortion”? Not likely.

Keep in mind, much evidence exists indicating restricting abortion doesn’t put an end to it. In fact, sometimes, the opposite is true.


Reproductive freedom implies that “every person can make the best decision for themselves and their family about whether and when to have a child without undue political interference.” RF should indicate freedom from both forced sterilization and compulsory motherhood.

I remember the pre-Roe vs Wade times clearly since I was involved in medicine for some twenty-three years prior to that ruling. While I never performed an abortion, as an intern at an enormous charity hospital and later as medical director of Chicago’s Mount Sinai Hospital emergency department, I witnessed close-up the disastrous results of criminal abortions. Naturally, these mostly affected the poor and minority women. Wealthier women always have and always will continue to find physicians who, for significant amounts of cash, will perform an abortion. When properly done by an experienced physician under sterile conditions, abortions are one of the safest operations with few complications. Not so when self-induced or done by “back-alley” operators.

Dr. Allen Malnak

Abortion remains a controversial and divisive issue. There are many myths and misconceptions. There are valid reasons for opposition without resorting to scare tactics using outdated or disproved medical evidence. Such is the case with the claim abortions cause breast cancer. The earlier limited studies purporting such a relationship were found to be flawed. For example, "recall bias" compromised some results. Later, more carefully performed research indicated no relationship exists.

The American Medical Association called the Dobbs decision “an attack on best medical practices and acknowledges it as a violation of human rights when the government impedes access to abortion.”

Complex medications like methotrexate can be banned because they can result in an abortion. But these meds are necessary to treat other non-related serious diseases.

Some of the problems the Supreme Court has caused include: Longer distances to travel, increased waiting for the procedure, increased financial burden, and unsafe abortions.

Here are some unintended consequences of banning abortions: harm to women’s health, including death and possible banning of in vitro fertilization.

There are too many abortion myths to discuss. They include: Abortion is high risk. Actually, it’s among the safest operations if done by a skilled operator. Most are performed in a clinic. With the use of prescription meds, many abortions are now medically induced. Abortions cause infertility. They almost never do. Abortions negatively affect mental health of the patient. If it does, it’s a rare occurrence. Most who seek an abortion are childless. In truth, about 60% have children. Most just don’t want to have children. There are many, many reasons. That is only one of them. Are abortions common in the second and third trimesters of pregnancy? Most occur during the first trimester, i.e., first 12 weeks after conception. Are most women who have abortions teens? No, only 9%.

The last myth I will discuss is that irresponsible behavior results in unplanned pregnancies. But in fact, “more than half of abortion patients used some form of contraception prior to getting pregnant.”

Dr. Allen Malnak, M.D., is a resident of Bonita Springs. Following his internship and residency, Dr. Malnak served as chief of internal medicine at U.S. Army Hospital, Fort Sill, OK, and then was a clinical investigator in liver disease at Mount Sinai Hospital, Chicago. He was a board-certified internist in the Chicago area for more than 35 years. He was a clinical instructor at Chicago Medical School for eight years and an assistant clinical professor at the Stritch School of Medicine of Loyola University for 25 years. Dr. Malnak was medical director of a number of medical organizations, including the emergency department of Mount Sinai Hospital and Principle Health Care of Illinois.

This article originally appeared on Fort Myers News-Press: Unintended consequences and myths about abortions