Friday, April 24, 2020

Original Front Cover.


In the year 1906 the Young Men’s Christian Association of Pittsburgh, in Pennsylvania, rejected the application of an actor for membership on the ground that one of his profession could not be a moral person. Viewing the action as a slur cast on the whole theatrical profession, Mr. Henry E. Dixey, the well-known actor, offered to give one thousand dollars to charity if it could be shown that actors, man for man, were not as good as ministers of the gospel. No champion of the cloth appearing to claim Mr. Dixey’s money on that proposition, he went further and offered another thousand dollars if there could not be found a minister in jail for every state in the Union. This second challenge was likewise ignored by the clergy and the association which had provoked it, but Mr. Dixey made a few inquiries as to the proportion of ministers to actors among convicts. His research, which was far short of being thorough, discovered 43 ministers and 19 actors in jail. The investigation, so far as the ministers were concerned, could have touched only the fringe of the matter, for in eight months of the year 1914 the publishers of this work counted more than seventy reported offenses of preachers for which they were or deserved to be imprisoned, and of course the count included only those cases reported in newspapers that reached the office through an agency which scans only the more important ones. There had been nothing like a systematic reading of the press of the [6]country for these cases. Judged by 1914, the clerical convicts in 1906 must have far exceeded the number developed by Mr. Dixey’s census.
The foregoing incident is introduced here to explain the nature of this work, “Crimes of Preachers,” which, like Mr. Dixey’s challenge to the clergy in behalf of his profession, is the reply we have to make to the preachers in behalf of the unbelievers in their religion.
The clergy assume to be the teachers and guardians of morality, and assert not only that belief in their astonishing creeds is necessary to an upright life, but, by implication, that a profession of faith is in a sense a guarantee of morality. It has become traditional with them to assume that the non-Christian man is an immoral man; that the sincere believer is the exemplar of the higher life, while the “Infidel,” the unbeliever, illustrates the opposite; and that whatever of morality the civilized world enjoys today it owes to the profession and practice of Christianity





Virus misinformation flourishes in online protest groups
By AMANDA SEITZ April 21, 2020

A woman holds a sign as she attends a rally outside the Missouri Capitol to protests stay-at-home orders put into place due to the COVID-19 outbreak Tuesday, April 21, 2020, in Jefferson City, Mo. Several hundred people attended the rally to protest the restrictions and urge the reopening of businesses closed in an effort to slow the spread of the coronavirus . (AP Photo/Jeff Roberson)


CHICAGO (AP) — Hundreds, sometimes thousands, of posts fly in the new Facebook groups daily.

The coronavirus numbers are fake, some of the social media videos claim. “Social distancing is the new way to control you, your family and your behavior,” another commenter warns. Others say the pandemic is an overblown hoax.

The loose network of Facebook groups spurring protests of stay-at-home orders across the country have fast become a hotbed of misinformation, conspiracy theories and skepticism around the coronavirus pandemic. Launched in recent weeks by pro-gun advocacy groups and conservative activists, the pages are repositories of Americans’ suspicion and anxiety — often fueled by notions floated by television personalities or President Donald Trump himself and amplified by social media accounts.


In a matter of days, the Facebook pages have mobilized protests at state capitols and collectively gained an audience of nearly 1 million followers on Facebook, according to The Associated Press’ analysis of the groups.

There’s little basis in reality for many of the claims on the sites. The coronavirus has infected millions of people worldwide, and the U.S. has recorded more deaths — 43,000 — than anywhere else in the world, according to a Johns Hopkins University count. Stay-at-home orders have been used by governments across the world — and the political spectrum — to try to contain the spread, as recommended by the world’s top health officials.

But the power of suspicion is apparent in the Facebook groups. A private group was key in enlisting people for a “Liberate Minnesota” march outside Democratic Gov. Tim Walz’s home Friday, despite his order limiting large gatherings. Trump backed the protesters on Twitter, calling to “LIBERATE MINNESOTA” right before the protest kicked off.

“We recruited some trusted friends, threw it up on Facebook Sunday night,” said conservative activist Michele Even, who oversees two Facebook groups in Wisconsin and Minnesota with a collective following of 100,000. “By Friday, we had over a thousand shares for the event.”

Under pressure after a spate of nationwide protests organized on its site, Facebook said Monday that it would ban events that don’t follow social distancing rules.


“Events that defy government’s guidance on social distancing aren’t allowed on Facebook,” the company said in a brief statement that did not explain how it would evaluate whether the events violate local ordinances. Facebook said it removed postings for events in California, New Jersey and Nebraska.

Users on the platform are still promoting future stay-at-home protests in Wisconsin, Virginia and Illinois. One Facebook ad calls for people to “descend on the Capitol building and surrounding streets, either on foot or in vehicles,” this Saturday in Denver. Some Facebook users are promoting a “drive-in” protest called Operation Gridlock to clog roads surrounding state capitols.

The movement is also becoming increasingly partisan online, with prominent conservatives urging their followers to protest Democratic governors, despite stay-at-home orders coming down in nearly every state, including some led by Republican governors.

“Every patriot should go outside, socially distanced and with masks, and protest these Democrat tyrants,” Charlie Kirk wrote last Friday to his 1.7 million Twitter followers.

Twitter users are also pushing YouTube video links that describe the coronavirus as a hoax or promoting farflung theories that it was created in a lab, using the hashtags ReOpen or Gridlock, said Kathleen Carley, a researcher at Carnegie Mellon University’s CyLab Security and Privacy Institute. Trump has also floated the idea that the virus is man-made.

Nearly identical claims are also being posted across multiple platforms — from Twitter to Reddit to the Facebook groups — suggesting that the misinformation is orchestrated on some level, she added.

“There are some people in these groups that have legitimate concerns about the economy, but they’re being overwhelmed,” Carley said. “There’s a lot of these conspiracy theories, linked right into these reopen groups.”

At least some of those Facebook groups are part of a coordinated campaign.

Facebook groups in Ohio, Wisconsin, Minnesota, New York and Pennsylvania were launched by Ben Dorr and his brothers, who run pro-gun groups in several Midwestern states. The brothers have also registered several websites under the “Reopen” name that directs users to their pro-gun lobbying group and invites them to “donate” to the cause.

The Dorr brothers have spent years raising money off conservative causes like anti-abortion rights or gun rights, said Kurt Daudt, Minnesota’s Republican House minority leader. Daudt believes it’s a scam — saying he once watched them take a video outside the statehouse, claiming they were headed inside to lobby, but they left immediately after filming wrapped.

“They really try to take advantage of whatever issue people are passionate about at any given time and try to raise money for themselves,” Daudt said.

Dorr contends his Facebook groups are part of a “grassroots” movement to protest stay-at-home orders.

“We want to reopen these states, save these peoples livelihoods,” Dorr said in a phone interview with the AP.

He wouldn’t say precisely how many pages or websites he and his brothers operate. Calls to brothers Chris and Aaron Dorr were not returned.

Their Facebook groups are peppered with posts that predict the government will force people to get coronavirus vaccinations and videos that say health officials are intentionally inflating coronavirus death numbers.

Even, who helps run the Facebook groups in Minnesota and Wisconsin with the Dorrs, said she believes many people are unintentionally sharing misinformation on the pages.

“A lot of times people are posting because they’re not aware it is fake or false information,” she said.

But that false information could be driving some people to protest the stay-at-home orders, said Nir Hauser, the chief technology officer at VineSight, a company that tracks misinformation.

Hauser identified news articles of protesters who cited popular coronavirus conspiracy theories in interviews. One woman told a North Carolina TV station that “nobody is sick with COVID.”

“The stuff that we’re seeing online does eventually percolate to real people,” Hauser said. “It got them to leave the house, go out and protest.”

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Associated Press writer David Klepper contributed to this report from Providence, R.I.
‘Republicans are nervous’: Some in GOP eye protests warily

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In this April 15, 2020, photo, Steve Polet holds a sign during a protest at the State Capitol in Lansing, Mich. (AP Photo/Paul Sancya)

APRIL 23, 2020

MADISON, Wis. (AP) — The latest demonstration by right-wing groups against measures to contain the coronavirus will be held Friday in Wisconsin, where hundreds, and possibly thousands of people plan to descend on the state Capitol to protest the Democratic governor’s stay-home ordinance.

It’s expected to be among the biggest of the protests that have popped up around the U.S. in recent days. But as with some earlier events, one group will be noticeably absent: the state’s most prominent Republicans.

That includes Sen. Ron Johnson, a Trump ally, who says he’ll be sheltering in place at his home in Oshkosh about 90 miles from Madison.


“I’m neither encouraging nor discouraging them,” said Johnson, 65, whose career was launched by the tea party movement, a protest effort with ties to the current one. He urged anyone who decides to attend the protest to practice good personal hygiene and social distancing.

Johnson’s distance and ambivalence is shared by many Republicans as they warily watch the protests — with their images of gun-toting activists, the occasional Confederate flag, and protesters wearing Trump hats but no face masks. Six months away from an election, the protests are forcing some Republicans to reckon with a restless right flank advocating an unpopular opinion even as the party seeks to make gains with moderates, women and suburban voters.

Polls show the sentiment behind these groups is currently unpopular. A survey by The Associated Press-NORC Center for Public Affairs Research found only 12% of Americans say the measures in place where they live to prevent the spread of the coronavirus go too far, though Republicans are roughly four times as likely as Democrats to say so — 22% to 5%. The majority of Americans — 61% — feel the steps taken by government officials in their area are about right.

Still, a network of conservative groups has activated to support the efforts — seizing on the anxiety and distrust that comes with a moment of turmoil. Conservative groups with national networks, including FreedomWorks and Tea Party Patriots, have pushed the “reopen” message on social media.

Friday’s rally was promoted by Thomas Leager, a prominent Wisconsin gun-rights advocate. Those who are members of the Facebook group for the event or have advocated for rallying to reopen the state include Matt Batzel, the executive director of the Wisconsin chapter for American Majority, a group that helps conservative candidates get elected; Christian Gomez, research project manager at the John Birch Society; and Stephen Moore, a fellow at the conservative Heritage Foundation.


“The polls are very clear. That’s why I think Republicans are nervous about this,” said Moore, who is on Trump’s economic task force and has promoted some of the protests provided attendees should follow social distancing guidelines. “But these things can change. That’s the point of these protests — to change public opinion.”

The many unknowns of pandemic — including what the death toll might be if restrictions like stay-home orders are lifted — complicate the political calculations. And Trump himself has positioned himself on both sides of the divide in this party. After issuing guidelines for states to reopen, he tweeted support for protesters who were violating them, calling on them to “LIBERATE” three states with Democratic governors. He empathized with protesters, saying they have “cabin fever” and “want their lives back,” then criticized Georgia’s governor for reopening his state too early.

That’s left most Republicans — particularly those in tough re-election fights this fall — playing it safe by staying away from protests or from being overly vocal about reopening things.

In North Carolina, Sen. Thom Tillis, who is among the GOP senators whose elections could determine if the party keeps control of the Senate, has been repeatedly complimentary in public of Democratic Gov. Roy Cooper and his decisions.

“We need to let people know that now is not the time to let their guard down,” Tillis said on Thursday during a coronavirus conference call with constituents. He said he thinks one or two other states talking about reopening are “doing just a little bit too soon based on the data and the presidential guidelines.”

“People need to wear a mask, they need to avoid going out if they don’t need to,” Tillis said. “That’s the only way that we are ultimately going to be beat this virus and get our economy back on sound footing.”

For some Republican candidates and elected officials the protests have been a way to get attention from a vocal faction of the party. said Wisconsin-based pollster Charles Franklin.

In Minnesota, former GOP congressman and Senate candidate Jason Lewis made a protest outside the governor’s mansion one of the first stops on an RV tour of the state where he’s pushing for an end to the shutdowns. Lewis said he’s skeptical of the polling on the question, noting people are honking in support and giving thumbs up as his RV passes by, particularly in smaller towns where people feel like the restrictions are unfair and killing their businesses and livelihood.

“People are saying ‘Finally someone is saying what I feel,’” he said, predicting the shutdowns will be “the defining issue” in his race against Sen. Tina Smith.

In Maine, where moderate Republican Sen. Susan Collins is up for reelection, rural residents were behind a protest Monday in the capital city of Augusta. The event divided GOP contenders in a congressional primary: One Republican, Eric Brakey, joined the protesters, while one of his opponents skipped the event but called on others to join her in a “virtual” protest using social media.

Republican Adrienne Bennett said it’s important to be “safe and responsible.” Collins did not respond to request for comment about the protest.

Wisconsin Republicans were initially generally supportive of Democratic Gov. Tony Evers approach to fighting coronavirus, but they broke last week when he extended a stay-at-home order for another month until May 26, which was the latest in the Midwest and one of the latest in the country. This week Republican legislative leaders asked the Wisconsin Supreme Court to block the order and force the state Department of Health Services to work with them on a new approach to reopening the state.

“There’s a lot of frustration out there,” said Republican state Assembly Speaker Robin Vos, among those filed the lawsuit against Evers. “The fact that Governor Evers’ voicemail is full and people aren’t getting a reply to their emails makes people feel like they’re not being heard.”

Vos, who made headlines for declaring Wisconsin polling places safe for voters while covered in protective gear, would not say whether he will attend Friday’s rally. His counterpart in filing the lawsuit, and candidate for Congress, state Senate Majority Leader Scott Fitzgerald did not respond to requests for comment.

One of the rally’s organizers, Madison Elmer, said they were approached by at least one office holder who wanted to speak but organizers turned them down. Elmer would not identify the person. Instead, the rally will feature speeches from business owners, farmers, a doctor and a nurse.

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Burnett reported from Chicago. Associated Press reporters David Sharp in Portland, Maine and Gary Robertson in Raleigh, North Carolina contributed.
THIRD WORLD USA
AP review: State supply stocks sparse and dated before virus


By DAVID A. LIEB and CUNEYT DIL

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FILE - In this April 10, 2020, file photo, wearing protective masks ground crew at the Los Angeles International airport unload supplies of medical personal protective equipment from a China Southern Cargo plane. Before the coronavirus outbreak, many states had only a modest supply of medical equipment. An Associated Press review of more than 20 states found that many were still storing items that were left over from an influenza pandemic a decade ago and long since expired. (AP Photo/Richard Vogel, File)


JEFFERSON CITY, Mo (AP) — Last autumn, when schools were in session, sports stadiums full and no one had even heard of the COVID-19 disease, the Missouri health department made an eerily foreshadowing request.

It asked the state for $300,000 to buy supplies in case of a large-scale disease outbreak. The goal was to fill a gap between local and federal sources.

Today, as states spend billions of dollars in the fight against the coronavirus, that October funding request appears woefully insufficient. Yet it highlights a stark fact: States were not stocked for a pandemic and have been scrambling to catch up.

An Associated Press review of more than 20 states found that before the coronavirus outbreak many had at least a modest supply of N95 masks, gowns, gloves and other medical equipment. But those were often well past their expiration dates — left over from the H1N1 influenza outbreak a decade ago.

The supply shortage stemmed from a variety of factors — a decline in public health funding, a cost-saving dependence on having inventory on hand only for immediate use and a belief that the federal government could come to the rescue with its Strategic National Stockpile.

In hindsight, the federal stockpile proved insufficient for a nationwide viral outbreak, and a worldwide competition for scarce supplies revealed the folly of counting on rapid deliveries.

“You could see it in almost every state, in every locality, and the federal government level: depleting the resources, depleting the inventory, and hoping when you need them they will be available,” said Gerard Anderson, a health policy professor at Johns Hopkins University, which has tracked coronarivus cases and deaths across the world.

The crisis spawned a political blame game over the shortage of protective gear for medical workers and the hunt for ventilators. Some governors harangued the federal government for leaving them in the lurch. President Donald Trump faulted states, tweeting earlier this month: “The complainers should have been stocked up and ready long before this crisis hit.”

Before the World Health Organization issued a Jan. 9 advisory about the coronavirus emerging in China, Missouri had a supply of 663,920 N95 respirator masks, 253,800 surgical masks, 154,000 gloves, 17,424 face shields and 14,048 gowns. All were leftovers provided by the Centers for Disease Control after the H1N1 flu pandemic of 2009-2010, and well beyond their shelf life.


Other states also were relying on old supplies. Officials in California, Colorado, Connecticut, Illinois, Michigan, Nevada, New Hampshire, New Mexico, Ohio, Pennsylvania, Virginia, Vermont, Washington and West Virginia all told the AP their stashes included at least some leftovers from the H1N1 flu.

Some old N95 masks no longer sealed properly on people’s faces or had elastic bands that disintegrated. But a CDC study found that many expired masks still could work, and states distributed them to hospitals and clinics.

Missouri, like some other states, had spent nothing to replenish the expired equipment. And even when asking for $300,000 last October, the state Department of Health and Senior Services stressed it wasn’t to build a big reserve.

“Since outbreaks and the resources needed are not predictable, purchasing a large stock of supplies that could expire or become obsolete is not a responsible use of state funds,” the health agency said in a budget document submitted to Gov. Mike Parson and state lawmakers.

That funding request for the fiscal year that starts in July still was pending in the state House when Missouri’s first coronavirus case was confirmed last month. Since then, Missouri has ordered about $40 million of protective medical supplies for health care workers and emergency responders.

Missouri Health Director Randall Williams told the AP that it didn’t make sense to load up on supplies without knowing what might be needed. For example, he said, bug spray would have been more useful than face masks during the 2015-2016 epidemic of the Zika virus, which is spread by mosquitoes.

“If you spend money on prevention and whatever comes your way isn’t that, then you have less money for response” when an emergency occurs, Williams said.

Federal public health funding for states has been on a downward slide since new programs were launched after the 2001 terrorist attacks and anthrax scare. The Public Health Emergency Preparedness program provided $675 million last year — down 28% since 2003, according to the nonprofit Trust for America’s Health. The Hospital Preparedness Program provided $265 million last year — down by almost half during that same period.

Colorado used to have two medical stockpiles. But the state received minimal federal funding for storing supplies from the H1N1 pandemic and none to buy more. The stockpile in Denver was dissolved last fall and its remnants transferred to one in Grand Junction. Those supplies had all been distributed by the beginning of March, as the coranavirus was spreading.

Ohio, like many states, began storing some supplies after the 2001 terrorist attacks. But its financial commitment waned after each crisis was averted, said Deborah Arms, president of the Ohio Nurses Association, who led the state health department’s prevention division from the late 1990s to 2008.

“It’s always difficult for public health in these kinds of disasters to be able to advocate for continual funding ... for something that might take 10 years to see a result,” she said.


Michigan, which has the third-highest coronavirus death toll among U.S. states, had 53,500 gloves left over from past epidemics, 5,120 N95 masks, 5,000 surgical masks and just 500 face shields among its pre-coronavirus supplies.

The state could not afford to replace expired items or the warehouse fees for storing more, said Michigan Department of Health and Human Services spokeswoman Lynn Sutfin.

Michigan Gov. Gretchen Whitmer said the state had counted on the federal government to be prepared for a pandemic.

“No one could have said that they would come in and build a state stockpile. That’s never been the role and the assumption,” she said. “Yet if I could turn back the clock, that’s precisely what we would have started doing.”

Contrary to Trump’s assertion that states bore the primary responsibility for stockpiling medical supplies, many states had depended on the federal government to store provisions in case of emergencies.

New Hampshire’s emergency operations plans call for maintaining a small supply reserve, but then “very much relying on the national stockpile for anything more than, say a week,” said state Health and Human Services Commissioner Lori Shibinette.

Virginia Secretary of Finance Aubrey Layne said he had viewed stockpiling supplies as a federal responsibility.

“Are we probably going to start stockpiling stuff now?” Layne asked. “The answer is yes.”

Even before the latest crisis, some experts had urged stocking up as a way to lessen the disruption to supply chains and avoid having to compete with other governments for scarce equipment. A June 2009 report published in the CDC’s journal Emerging Infectious Diseases recommended a “stratified purchase plan” — buying essential items periodically as money became available.

“Supplies need to be ordered far in advance of a pandemic to avoid major problems with back orders and supply shortfalls,” the report concluded.

Instead, public health offices, hospitals and clinics have largely been ordering supplies as they are needed. But just-in-time buying doesn’t work when supply chains collapse and every state and country competes in world markets.

“We’ve short-shrifted our public health structure, because we don’t need it until it happens. But then it’s too late to build it when there’s a pandemic,” said California state Sen. Richard Pan, a pediatrician.

Sean Dunn, an Ohio lobbyist who has represented hospitals, product distributors and a health care services company, said government and health officials need to rethink their approach.

“The notion of having to keep stores of anything, until a couple of weeks ago, was an old-fashioned notion,” Dunn said. “This is going to change our mindset.”


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Dil reported from Sacramento, California.

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Julie Carr Smyth in Columbus, Ohio; Alan Suderman in Richmond, Virginia; James Anderson in Denver; David Eggert in Lansing, Michigan; and Holly Ramer in Concord, New Hampshire, contributed.
Staff count emotional cost as virus savages UK nursing homes

By JO KEARNEY and JILL LAWLESS

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In this April 20, 2020, photo, nurses guide a resident at Wren Hall nursing home in the central England village of Selston. The coronavirus pandemic is taking a huge emotional and physical toll on 
staff in Britain’s nursing homes, who often feel like they're toiling on a forgotten front line. The virus is sweeping like a scythe through Britain’s 20,000 care homes and has left thousands of elderly people sick and dead. (AP Photo/Frank Augstein)


SELSTON, England (AP) — Lucy Dawson is haunted by a sense of powerlessness.

The nurse has equipment to treat the residents of the nursing home where she works when they become sick with the coronavirus — but it doesn’t seem to make any difference.

“We’ve got fluids, or we’ve got oxygen on the go. You know, you name it, we’ve got it,” said the nurse at Wren Hall, a small home for elderly people with dementia in the central England village of Selston.

But still, “it’s bereavement after bereavement,” said Dawson, who has worked at the home for two decades. “We’re losing people that we’ve loved and looked after for years.”


The coronavirus pandemic is taking a huge emotional and physical toll on staff in Britain’s nursing homes, who often feel like they’re toiling on a forgotten front line.

The virus is sweeping like a scythe through Britain’s 20,000 care homes and has left thousands of elderly people sick and dead. At Wren Hall, 12 of 54 residents died in three weeks after contracting COVID-19.

“To be putting your heart and soul into nursing somebody to sustain life, it’s just a massive devastation when ...,” Dawson trailed off. “I’ve just got no words.”

It’s a tragedy being repeated across the U.K. and around the world. While the coronavirus causes mild to moderate symptoms in most who contract it, it can result in severe illness in some, especially older people.

Britain’s official tally of almost 19,000 coronavirus-related deaths — including at least 15 nursing home workers — counts only those who died in hospitals. Official statistics show over 1,000 more virus-related deaths in homes in England and Wales up to April 10. In Scotland, which keeps separate records, a third of virus deaths have been in homes for the elderly. It is likely that all of these counts are underestimates. The World Health Organization says up to half of COVID-19 deaths in Europe may be in nursing homes.

Each death is felt painfully at Wren Hall, a homey, close-knit place bedecked with cheerful signs — “Happiness is not a destination, it is a way of life” — where many residents and staff have lived for years.

“There’s some people in this building who I see more than my actual family,” said nursing associate Damian Mann, who has worked at the home for 11 years.

He said the outbreak had left him feeling “helpless.”


“You start to question yourself, I think, as a professional,” he said. “You come in every day and someone is dying every day that you’re here. It’s not normal for that to happen ... in this setting. So we look back and we think, is there anything we could have done?”

That frustration is compounded by physical barriers — masks, gloves and plastic aprons — and by the need to keep families away from sick relatives.

In such extreme circumstances, even a kind act can elicit pain. Care assistant Pat Cornell made cards with residents’ photos to send to family members unable to visit in person.

“The sad part is, I sent one on Friday, and the lady died on the Saturday,” Cornell said. She’s haunted by the thought that the bereaved family will be upset all over again when they get the card.

The emotional strain is intensified by a feeling among many staff — often poorly paid — that they have been overlooked. When the government offered health care workers tests for the virus, nursing home staff were not included. Homes for the elderly were also low down the pecking order for personal protective equipment, as authorities scrambled to meet the demand from hospitals.

“It was like we were the forgotten people, the people in the care homes and the staff in the care homes,” said Sally Bentley, who has worked at Wren Hall for nine years. “Like we’re expendable, really, I suppose.”

Wren Hall’s owner-manager, Anita Astle, went on TV earlier this month in desperation, seeking more protective gear. She found that suppliers had hiked their prices as much as sixfold.

Since then, the home has received donations from local people and businesses, but Astle says some items, especially gowns, are still scarce.

She said the role nursing homes are playing in the pandemic has not been fully recognized.

“People with and without COVID-19 are being discharged from hospitals to care homes to free up (hospital) beds,” she said. “We are being asked to do things in care homes that we’ve never been asked to do before, (like) verification of death.”

The British government, stung by criticism of its handling of the outbreak, has announced that nursing home staff, along with health care workers, can now be tested for the virus at drive-thru centers and mobile sites. But Astle says so far she has not managed to get anyone tested — even though more than half of Wren Hall’s 142 staff have showed symptoms at some point.

For now, the staff are coping as best they can. They are encouraged that some residents who have been sick in the home’s “red zone” are recovering and leaving isolation.

“We’ve all cried,” Cornell said. “We’ve all had — even though we shouldn’t — we’ve all had hugs, we’ve all talked about it to each other.”

But Mann worries about the lingering toll.

“The impact that it’s having on the team, even though they’re soldiering on through,” he said, “The long-term effects of it are going to be massive.”

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Lawless reported from London.

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Follow AP coverage of the virus outbreak at https://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak

Thursday, April 23, 2020

Coronavirus shakes the conceit of ‘American exceptionalism
By CALVIN WOODWARD



WASHINGTON (AP) — What if the real “invisible enemy” is the enemy from within — America’s very institutions?

When the coronavirus pandemic came from distant lands to the United States, it was met with cascading failures and incompetencies by a system that exists to prepare, protect, prevent and cut citizens a check in a national crisis.

The molecular menace posed by the new coronavirus has shaken the conceit of “American exceptionalism” like nothing big enough to see with your own eyes.

A nation with unmatched power, brazen ambition and aspirations through the arc of history to be humanity’s “shining city upon a hill” cannot come up with enough simple cotton swabs despite the wartime manufacturing and supply powers assumed by President Donald Trump.

The crisis turned doctors in the iconic American shining city, New York, into beggars with hands outstretched for ponchos because they couldn’t get proper medical gowns. “Rain ponchos!” laments tech entrepreneur Marc Andreessen. “In 2020! In America!”

It’s turned a Massachusetts hospital executive into an under-the-radar road warrior, working up a deal through a friend of a friend of an employee who heard about a warehouse more than five hours away with masks. Two tractor-trailers disguised as grocery trucks picked them up, dodged interference from Homeland Security and took separate routes back in case one load got intercepted on highways through the northeast “pandemic alley.”

“Did I foresee, as a health-system leader working in a rich, highly developed country with state-of-the-art science and technology and incredible talent, that my organization would ever be faced with such a set of circumstances?” asked Dr. Andrew W. Artenstein of Baystate Health, who was on hand at the warehouse to help score the booty. “Of course not.”

But, he said, “the cavalry does not appear to be coming.”

At the time of greatest need, the country with the world’s most expensive health care system doesn’t want you using it if you’re sick but not sick enough or not sick the right way.

The patchwork private-public health care system consumes 17% of the economy, unparalleled globally. But it wants you to stay home with your COVID-19 unless you are among the minority at risk of death from suffocation or complications. It wants you to heal from anything you can without a doctor’s touch and put off surgeries of all kinds if they can wait.

In the pandemic’s viral madhouse, the United States possesses jewels of medical exceptionalism that have long been the envy of the world, like the federal Centers for Disease Control and Prevention and the National Institutes of Health.

But where are the results?

For effective diagnostic testing, crucial in an infectious outbreak, look abroad. To the United Arab Emirates, or Germany, or New Zealand, which jumped to test the masses before many were known to be sick.

Or to South Korean exceptionalism, tapped by Maryland’s Republican governor, Larry Hogan, who accepted a planeload of 500,000 testing kits from Seoul to make up for the U.S. shortfall. The aid was dubbed Operation Enduring Friendship and annoyed Trump, the “America First” president.

Simple gloves. Complicated ventilators. Special lab chemicals. Tests. Swabs. Masks. Gowns. Face shields. Hospital beds. Emergency payouts from the government. Benefits for idled workers. Small business relief. Each has been subject to chronic shortages, spot shortages, calcified bureaucracy or some combination.

“This monumental failure of institutional effectiveness will reverberate for the rest of the decade,” Andreessen, a tech investor best known for the Netscape browser in the 1990s, said in his company newsletter.

Yet Trump uses his daily White House briefings to claim success and talk about his poll numbers, TV ratings, favorite theories about science and the praise he gets from governors, who may be at risk of seeing their states intentionally shortchanged by Washington if they don’t say something nice about him.

“A lot of people love Trump, right?” Trump asked himself at the briefing Monday.

He then answered himself. “A lot of people love me. You see them all the time, right? I guess I’m here for a reason, you know. ... And I think we’re going to win again, I think we’re going to win in a landslide.”

Connecticut Gov. Ned Lamont, a Democrat, found something nice to say about the administration this past week: It’s relaxing some regulations. “They’ve now said you can come up with your own swab,” he said. “One good thing is, the federal government is getting out of the way.”

That is one iteration of American exceptionalism now — a national government responding to a national crisis by getting out of the way.

The cavalry isn’t coming.

That’s what plunged Dr. Artenstein into his great mask caper.

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WINGING IT

If the Strategic National Stockpile has been of any benefit to Baystate Health in western Massachusetts, Artenstein, the organization’s chief physician executive, is not aware of it.

The backup emergency medical supply worked in 2015, speeding 50 doses of botulinum antitoxin to Ohio when people ate bad potatoes at a church potluck. One person died, dozens got sick, but botulism was nipped in the bud. But in today’s pandemic, the stockpile drained before the peak.

Artenstein and his team were drawn into what seemed like a zero-sum game to keep their doctors, nurses and staff protected with the most basic gear. Purchases have been known to fall apart at every stage of a transaction over the past six weeks, he said, at times because the federal government has apparently outbid his team for supplies.

So when Baystate Health learned about a large shipment of three-ply face masks and N95 respirators in the mid-Atlantic region, it was time for a road trip. Baystate Health was using up to 2,000 disposable masks a day and within several days of running out.

Two disguised trucks headed south, several members of a supply team flew down and Artenstein decided he’d best go, too, in his car. “It was felt by all that a little executive muscle might help in this situation,” he told The Associated Press, expanding on his account in The New England Journal of Medicine.

Baystate Health was paying five times the normal rate for the masks and found out that only one-quarter of the original order would be available. But the team converged at the distant warehouse and verified that the masks were good.

Then two FBI agents, on the lookout for illegal reselling, flashed their badges and began asking questions. “They were doing their job,” Artenstein said, “and that was fine with me because we were doing our job.”

But passing muster with the FBI was not the last hurdle. Homeland Security, the agents said, was considering whether masks in the shipment should be allocated elsewhere. “They had to hoist it up the chain,” he said of the agents. “The wheels turn slowly.” That took hours. “I really was nervous the whole time.”

Driving back on his own with the shipment still in limbo, Artenstein got on the phone to “try to thaw this frozen structure a little bit.” Baystate Health’s CEO contacted Rep. Richard Neal of Massachusetts, chairman of a powerful House committee, who got on the case. The shipment was eventually cleared and the trucks set off through the Northeast Corridor.

Artenstein got the call around midnight that the masks were coming off the trucks and into hospital inventory.

With that, the acute mask shortage was resolved. But when Artenstein spoke with the AP, Baystate Health was two days from running out of disposable gowns.

___

PLANNING IT

Public institutions are measured by their foresight as well as by their response. Why didn’t you see this coming? they get asked when things go wrong — when terrorists strike, hurricanes flood a city, a pandemic arrives.

The United States saw this coming 15 years ago and still wasn’t prepared.

“If a pandemic strikes, our country must have a surge capacity in place that will allow us to bring a new vaccine online quickly and manufacture enough to immunize every American against the pandemic strain,” President George W. Bush said in a call for readiness in 2005.

The principal goal was “the capacity for every American to have a vaccine in the case of a pandemic, no matter what the virus is,” said Michael Leavitt, then the health and human services secretary.

Bush announced billions of dollars for a wide-ranging plan for a pandemic like this one. It accelerated a new method of vaccine research, beefed up stockpiles and steered aid to states to build mobile hospitals and more.

Many of the needs of today were anticipated in a mix of federal and state plans. Children would be schooled remotely — TV was the medium of choice then. People would need ready access to advice about whether to leave home quarantine to seek care — in Texas, the plan was to have retired doctors staff phone banks for that purpose. If 911 dispatchers got sick, librarians would step in.

Colorado parked trailers filled with medical supplies and cots in secret locations. In emergency simulations, officials in Idaho and Hawaii dispensed M&Ms for antiviral pills.

But for all the creativity and ambition, a year later almost half the states had not spent any of their own money for the preparedness subsidized by Washington, and in the years that followed — through the Great Recession, more war, more time passing — the federal effort languished, too.

“Our country has been given fair warning of this danger,” Bush said at the launch, recalling the lethal 1918 pandemic and bird flu outbreak then spreading overseas. Americans have “time to prepare.”

But foresight became a thing of the past. And to hear Trump, it’s as if it never existed.

“Unforeseen problem,” Trump says of the pandemic. “Came out of nowhere.”

“This is something,” he said, “that you can never really think is going to happen.”

___

Associated Press writers Lauran Neergaard in Washington, Ted Anthony in Pittsburgh and Aya Batrawy in Dubai, United Arab Emirates, contributed to this report.


Coronavirus highlights role of foreign staff in British hospitals

AFP / Tolga AKMENA mural in central London shows an NHS worker
Joan Pons Laplana is a senior digital charge nurse working on the frontline in an intensive care unit treating coronavirus patients at Sheffield Teaching Hospital in the north of England.
Like many of his colleagues in the state-run National Health Service (NHS), the 45-year-old medic is not British.
The Spanish national works alongside people from Germany, Italy, Portugal, Philippines and India, as well as those from the UK.
"Sometimes the most difficult accents to understand are the British ones," Laplana, who has lived in the UK for 20 years, told AFP.
The international mix of staff at Sheffield is far from untypical in British hospitals.
Parliamentary figures published last July show that some 153,000 workers out of 1.2 million NHS staff are non-British.
"This is 13.1 percent of all staff for whom a nationality is known, or just over one in eight," it reported.
"Between them, these staff hold 200 different non-British nationalities.
Around 65,000 are nationals of other European Union countries -- 5.5 percent of NHS staff in England. Around 52,000 staff are Asian nationals, according tot the parliamentary figures.
Among the most common 16 nationalities of people working for the NHS were Indian (21,207), Nigerians (6,770) and Zimbabweans (4,049).
In addition, the health service think tank the King's Fund, calculates that beyond the NHS, around one in six of the 1.5 million people working in adult social care, in the private sector, are from overseas.
"The NHS depends on the important contribution that they (overseas workers) make," said Alex Baylis, assistant director of policy at King's.
"This has come into sharp focus in recent weeks, as all NHS staff have gone above and beyond the call of duty to look after patients who are ill with coronavirus."
- Foreign staff -
The contribution of the NHS, like health workers globally elsewhere, has been lauded during the coronavirus pandemic.
However, in the UK the role of non-British workers, and particularly those from the European Union, has been brought into sharp focus because of Brexit, where immigration was a key issue.
Britain is reliant on such workers at a time when the future of many of those people to remain in the country is uncertain after the country left the EU in January.
AFP/File / CHRIS J RATCLIFFENHS nurse and Spanish national Joan Pons Laplana says people in Britain 'will go back to blaming migrants for anything' once the coronavirus crisis passes
"Nobody has asked me where I come from in the last few weeks," said Laplana who spoke out publicly against Brexit following the 2016 referendum.
The government said on Wednesday that 69 NHS workers have died during the outbreak, including those from overseas.
They include Alice Sarupinda, a nurse from Zimbabwe, and Jenelyn Carter a healthcare assistant from the Philippines.
Since the 2016 referendum set Britain on a turbulent path to leaving the EU, there have been doubts about how the NHS will cope with any potential exodus of staff as a result.
Freedom of Information figures published in November revealed that in three years since the referendum, more than 11,600 NHS staff from the EU had left the UK, including 4,783 nurses.
Coupled with an election pledge by Boris Johnson's government to spend an extra almost £34 billion (38 billion euros, $42 billion) a year on the NHS, questions have been raised about how workforce gaps could be plugged.
"Regardless of Brexit, the NHS will continue to need staff from overseas," adds Baylis.
"With almost 100,000 vacancies, ethical international recruitment is the only realistic option for addressing the NHS's staffing shortfall for at least the next five years."
- Policy shift -
Already the urgency of coronavirus has seen a shift in government policy.
Last month, the Home Office announced that 2,800 frontline NHS workers, whose visas are due to expire this year, would be extended for 12 months free of charge so they could "focus on fighting coronavirus".
But political opponents say that is not enough.
The Liberal Democrats this week called on ministers "to give all foreign nationals working in the NHS and social care indefinite leave to remain in the UK".
The King's Fund has also called on the government to waive an annual surcharge, set to increase to £625 this year, payable by overseas NHS workers so they can access the healthcare services they help deliver.
Post coronavirus, it is clear that the treatment of international NHS workers will become a major political topic in the UK.
AFP/File / Paul ELLISThe British public has shown warm support for the NHS which employs 153,000 non-UK nationals
In a country where a weekly round of applause is held for NHS and other frontline workers, it would take a brave government to deny healthcare staff improved living and working rights and conditions.
But Laplana is unconvinced.
He said that for his two decades in the UK he did not consider himself a foreigner but "Brexit put an end to that".
"I am a sceptic," he says. "It will last for a while but then we will go back to blaming migrants for anything.

Boeing to lay off 10% of workers in civil aviation: sources

AFP/File / Jason RedmondBoeing is set to lay off workers just one day after re-opening its plants in Washington state
Boeing plans to reduce the workforce in its civil aviation unit by 10 percent to cut costs as the coronavirus causes a crisis for airlines, two sources familiar with the matter told AFP.
The layoffs would impact the unit manufacturing the troubled 737 MAX, which has been grounded for more than a year after two deadly crashes, as well as the 787 and 777 long-haul aircraft, the sources said.
The job cuts could affect up to 7,000 workers. Boeing employs more than 160,000 people worldwide, including 70,000 in Washington state, where most of its civilian aircraft are assembled. The plant in South Carolina produces only part of the 787.
The news comes just a day after the company slowly resumed production at its Puget Sound facility in Washington, with new measures to keep workers six-feet apart along with health checks and hand-washing stations.
Chief Executive David Calhoun wants to resolve the downsizing plan before Boeing embarks on complex and sensitive negotiations with the US Treasury to win in federal support for the industrial giant, the sources said.
Boeing has sought $60 billion in public aid for the US aerospace industry in light of the heavy hit to the aviation business from the coronavirus crisis.
Around $17 billion aimed at Boeing was included in the giant federal relief bill approved in late March.
But the government aid is conditional on companies agreeing not to lay off workers once they have received taxpayer dollars.
- 'Voluntary layoffs' -
A spokesman for the Boeing said the company is offering "voluntary layoff" programs, but did not confirm the size of the planned reductions.
Workers who take Boeing's voluntary layoff offer would receive a pay and benefits package as part of the program that "aims to help reduce the size of our workforce through voluntary actions and, importantly, minimize future workforce actions," the spokesman said.
The company, already under strain amid the controversy surrounding the top-selling 737 MAX and uncertainties over when the plane will return to the skies, has suffered a wave of order cancelations from airlines struggling to survive as air travel has ground to a halt amid the pandemic shutdowns.
Aircraft leasing company Avalon canceled an order for 75 of the 737 MAX planes, and the China Development Bank scrapped a request for 29 of the aircraft.
There also is uncertainty about an order from Norwegian Air for 92 MAX planes and five 787 planes after four subsidiaries filed for bankruptcy.
The spokesman said "there is no doubt the aviation industry will look very different as we eventually recover from this pandemic."
Boeing also may replace the executive in charge of the MAX program in announcements that could come when the company releases quarterly results April 29, the sources said.

In Navajo Nation, pandemic exposes water crisis and health disparities

AFP/File / MLADEN ANTONOVA Navajo farm is seen next to a rock formation in Monument Valley Navajo Tribal park, Utah, in 2014
The coronavirus is hitting the United States' largest Native American territory hard, with a spike in cases bringing long-standing disparities to the fore in a land marked by the trauma of past waves of disease.
With its towering sandstone mesas, majestic canyons and ancient ruins, the Navajo Nation is home to about 175,000 people in an area that straddles three southwestern states and is roughly the size of Scotland.
The reservation saw its first COVID-19 case on March 17 and the number has since exploded to 1,206 -- a per capita infection rate just behind the worst-hit states of New York and New Jersey.
Overall deaths remain relatively low right now at 48, but that figure is expected to increase in the coming weeks as the disease takes its toll on those who are seriously ill.
Officials and experts cite a range of factors, from chronic underfunding of the medical system that caters to Native Americans, to poor phone and internet connectivity exacerbating information gaps.
One of the starkest reasons: A lack of access to the running water health authorities have repeatedly stressed is necessary to keep the virus at bay through hand washing.
Up to "30 percent of our citizens do not have access to running water and have to haul water from 20 to 30 miles away for their drinking water and livestock," Navajo Nation President Jonathan Nez told AFP.
"Right here in the middle of the most powerful nation, the United States of America, our citizens don't have the luxury of turning on a faucet to wash your hands with soap and water."
GETTY IMAGES NORTH AMERICA/AFP/File / SPENCER PLATTA man from the Navajo Nation collects water from a public water pump on June 7, 2019 in the town of Gallup, New Mexico; up to 30 percent of Navajo Nation households dont have clean running water
That's because many native lands were passed over when the US expanded its running water and sanitation infrastructure a century ago, according to a recent report by water nonprofit DigDeep.
Native Americans are also disproportionately affected by poverty-linked health conditions that lead to more serious forms of the COVID-19 illness, such as heart disease and asthma, said Matthew Heinz, a doctor at Tucson Medical Center who has been treating members of the Apache and Tohono O'odham tribes.
In particular, they have a greater chance of having diabetes than any other US racial group, according to the Centers for Disease Control and Prevention -- a factor that has been linked to an abnormal and often deadly autoimmune response in coronavirus patients.
- Promises broken -
AFP/File / MLADEN ANTONOVRock formations are seen behind the American flag at Gouldings Lodge and Trading Post in Monument Valley Navajo Tribal park, Utah, in 2014
The Navajo Nation was established by a treaty in 1868, after its inhabitants, who also call themselves "Dine," returned to the ancestral land they were forcibly deported from four years earlier.
Like other Native American peoples, they gave up enormous tracts in land in exchange for federally supported free health care and education in perpetuity, said Allison Barlow, director of the Johns Hopkins Center for American Indian Health.
It's a promise that's never been adequately fulfilled.
A case in point: there are only 12 health care facilities across the Nation's 27,000 square miles (70,000 square kilometers).
The Indian Health Service which provides care is also dramatically under-resourced.
"The IHS average per capita spending per user today is $3,333 compared to $12,744 for Medicare (a state program for the elderly) and $9,404 for veterans' medical spending," said Barlow.
Congress has earmarked substantial relief for the tribes hit by the pandemic, with $8 billion to be released soon, "but the challenge now is to be able to spend it on what is needed, given the global shortages in supply of health care equipment and personnel," she added.
- Spotlight -
AFP/File / Eric BARADATThe sun rises over the Monument Valley in April, 2018
Another challenge: the Navajo often live in overcrowded conditions with multiple generations of family members living under one roof.
"Here, we have not just our immediate family, not just our extended family," explained Nez. "We have a clan family."
With the tribe's language endangered, elders are held in sacred esteem adding to psychological stress over fears of losing them.
Native Americans have borne the brunt of past pandemics -- the group's mortality rate during the H1N1 (swine flu) pandemic of 2009 was four times higher than all other racial categories combined, a CDC report found.
Entire communities were likewise decimated by the Spanish flu of 1918.
Since the arrival of the first European conquistadors, "they have experienced waves of decimation from 'novel viruses,' some systematically used by the colonists as germ warfare to wipe out their peoples," said Barlow.
Her organization and other non-profits are stepping in to help fill the resource gap by improving local health facilities and delivering care packages to those in need, as well as vital Personal Protective Equipment.
For Nez, the increased attention during this crisis is long overdue.
"We are the first citizens of this country, but usually we would be ignored," he said, adding that his sovereign nation was open to working with other countries.
"I hope it changes for the better."

SEE  https://plawiuk.blogspot.com/search?q=NAVAJO