SPECIAL K
More Than Just a Trip: Why Does Ketamine Work for Depression When Nothing Else Does?

BETTER LIVING THROUGH CHEMISTRY

Darisse Smith GIZMONDO 3/10/2020

Even though depression is a common and debilitating mental illness, the last groundbreaking medication released for it was Prozac, approved in 1987. Throughout the last 20 years, though, research scientists have discovered that ketamine, a common anesthetic and, at times, a recreational drug, is a rapid and effective medication for treatment-resistant depression. As we’re learning deeper about why, we turn specifically to its dissociative effects for clues.

“In my experience, patients who have high positive regard for the hallucinogenic—mystical and transcendental—experience also tend to have better antidepressant response to ketamine infusion,” Mark Niciu, assistant professor of psychiatry at the University of Iowa and one of the main authors of a 2015 study that found a correlation between ketamine and dissociation, told Gizmodo. Ketamine’s effectiveness, Niciu claimed, can depend on the patient’s mindset. There are several factors to continue investigating, which may yield treatment for a large population of patients for whom nothing has worked so far.

In 2000, Robert Berman and his colleagues at Yale ran a small study testing the effectiveness of ketamine in patients with treatment-resistant depression. They discovered that the ketamine significantly reduced their patients’ depressive symptoms, according to a widely accepted questionnaire, the Hamilton Depression Rating Scale. Until this study, ketamine was known in a few different ways. It is an anesthetic and non-opioid painkiller that was released in the late 1960s and is often used in emergency rooms. The more adventurous among us might know ketamine as Special K, a rave drug often snorted that causes euphoria, hyper energy, hallucinations, and dissociation—an experience where the user is unaware of time, their body, or surroundings.

Because of its reputation as a club drug, ketamine carries a large stigma, even though its recreational use involves much higher doses than what’s used to treat depression. Larger amounts of ketamine can result in more unpleasant side effects, such as muscle spasms, dizziness, loss of balance, slurred speech, and nausea, along with hallucinations or dissociation.

Some doctors believe that these spiritual experiences help patients gain a new perspective.

Despite the lower doses used to treat depression, patients still experience dissociation, though the low dose leads to a more pleasant outcome for the patient. Some researchers have theorized that dissociation actually improves its effectiveness as an antidepressant. During ketamine-induced dissociation, patients feel disconnected from what’s going on around them. They also might have ethereal visions, feel warm and comforted, and might even claim to have seen relatives who have passed. Some doctors believe that these spiritual experiences help patients gain a new perspective.

Depression is a mental illness that is largely misunderstood. Those who suffer from depression experience myriad symptoms, many of which can be contradictory, such as apathy and restlessness, sleeping too much or too little, loss of appetite or overeating, anxiety, hopelessness, irritability, sadness, and trouble concentrating. Research scientists have discovered that depression is actually more of a combination of mental health disorders, and it is the umbrella label for them.

Currently, the gold standard treatment for depression is usually some form of psychotherapy and medications, including selective serotonin reuptake inhibitors (SSRIs) like Prozac or Zoloft, serotonin norepinephrine reuptake inhibitors (SNRIs), such as Cymbalta or Pristiq, or norepinephrine dopamine reuptake inhibitors (NDRIs), such as Wellbutrin. According to the National Institute of Mental Health, in a 2017 nationwide survey, 11 million Americans experienced depression with severe impairment, and of those, one-third experienced treatment-resistant depression. Once all options of medication and therapy are exhausted, those with treatment-resistant depression have only a few options, including electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). During ECT, doctors induce a small seizure in their anesthetized patient in order to reset neurophysiologic and neurochemical processes in the brain. In rTMS, a magnetic coil is placed near the patient’s forehead and is designed to stimulate the regions of the brain that control mood. Though both of these treatments can be effective, they also have potential side effects. ECT can result in headaches, nausea and disorientation in the short term and memory loss and impaired cognition long-term. In rTMS, patients can experience headaches, scalp pain, and spasms in the facial muscles.

The ketamine treatment should be peaceful.

Most ketamine treatments occur in a specialized ketamine clinic. There are hundreds of these clinics throughout the United States. In order to prepare for the infusion, a nurse will establish an IV, as well as monitors to track heart, blood pressure, pulse oximetry, and respiratory rate. The doctor will administer a low dose, usually around 0.5 mg/kg. The ketamine treatment should be peaceful. Often, patients wear an eye mask and listen to relaxing music. A nurse is in the room throughout the treatment, especially since heart rate and blood pressure tend to increase as the ketamine takes effect. The treatment itself lasts approximately 40 minutes, and the patient is monitored for another 20 to 40 minutes after the infusion. Many patients experience relief immediately, compared to traditional antidepressants, which can take several weeks or even several months to work. According to Sam Ko, a doctor who owns Reset Ketamine, a ketamine clinic in Palm Springs, California, not everyone experiences dissociation or an ethereal experience, but those who do typically have a positive encounter.

How Is Taking Ketamine for Depression Different From Falling Into a K-Hole?

In the 2015 study from the National Institute of Mental Health, David Luckenbaugh and his associates ran a clinical trial that tested the correlation between a patient’s experience of dissociation and its antidepressant impact, if any. Researchers administered a low-dose, 40-minute IV infusion of ketamine to 108 treatment-resistant subjects with either depression or bipolar disorder, all of whom at the time had moderate or severe depression. Traditionally, ketamine doctors give their patients a series of IV infusions, but to simplify results, Luckenbaugh and his team administered just one round of ketamine. Researchers also measured the subjects’ blood pressure and pulse throughout the infusion as a control measure, and to compare with patients’ dissociation. Their increased blood pressure and pulse did not correspond with an improved depression score. Using the Clinician Administered Dissociative States Scale and the Hamilton Depression Rating Scale, researchers discovered that after 40 minutes of treatment, patients reported a statistically significant correlation between a higher level of dissociation and improved symptoms of depression.

Because ketamine works so quickly and so distinctively, and has such different side effects than traditional antidepressants, ketamine research has led scientists to gain more insight into the root of depression in the brain. They generally acknowledge that they still have much to learn in explaining how and why ketamine works, but almost certainly they know that ketamine works in the glutamate system. In previous autopsies of people who have died by suicide, doctors found that they had higher levels of glutamate in their brains. N-methyl-D-asparate receptors, or NMDA, are in the glutamate system, and when glutamate levels in the brain get too high, the NMDA receptors are overstimulated, leading to depression, as well as several other disorders of the nervous system, such as Alzheimer’s and Parkinson’s disease. Ketamine is considered an NMDA antagonist, which means it blocks glutamate, lowering the levels of glutamate and reducing depressive symptoms. Researchers are trying to figure out how exactly ketamine works, but in witnessing its effectiveness, research psychiatrists are learning a completely different way to treat resistant mood disorders such as depression. Niciu, one of the authors of the dissociation study, told Gizmodo that ketamine also improves symptoms of bipolar disorder, PTSD, obsessive compulsive disorder, social anxiety disorders, and addiction.

Researchers are trying to figure out how exactly ketamine works, but in witnessing its effectiveness, research psychiatrists are learning a completely different way to treat resistant mood disorders such as depression.

A brain of a person with depression often has weakened or broken synapses that contribute to their symptoms. These synapses are junctions between two nerve cells, and, when healthy and active, they contribute to good mental health. When someone is depressed, it causes chronic stress, and these synapses become less active. Scientists continue to find that ketamine actually strengthens the faulty synapses and can build new ones. Todd Gould is an associate professor of psychiatry at the University of Maryland School of Medicine, and he clarified how ketamine heals certain parts of the brain: “I’d use the term strengthening synapses. You can create new synapses as well. Stress and depression weaken synapses, and then ketamine strengthens those synapses.” The glutamate system is also responsible for the dissociative response, as it affects sections of the brain that provide learning and memory, emotion, and perception of pain. Their interconnectedness in the glutamate system could explain how dissociation could reduce a patient’s symptoms of depression.

Psychedelic Drugs May Help the Brain Repair Itself, Study Finds

While some researchers believe there is a link between dissociation and ketamine’s antidepressant impact, many others dispute this finding. In a 2011 study led by researchers at Yale University’s School of Medicine, the psychiatrists conducted proton imaging of subjects’ brains before, during and after ketamine treatments. Throughout the infusion, subjects filled out various rating scale forms to measure their level of depression, anxiety, and dissociation. Subjects only indicated dissociation 20 minutes after the IV infusion. These researchers concluded that there was no correlation, since subjects still had antidepressant benefits, even after the disconnectedness subsided. Even those who did not feel detached benefited from ketamine’s antidepressant impact. Brandon Kitay, an assistant professor of psychiatry at Yale, told Gizmodo, “The fact that you have less of a dissociative experience, let’s say, over time, and can still have just as much efficacy, again speaks to me that it probably is not required for results.”

One aspect of ketamine treatment that can only be anecdotally measured is a patient’s transformation after treatment. Researchers at Boston Children’s Hospital and the Texas Tech Health Sciences Center conducted a study in November 2019 that examined the impact of ketamine and dissociation in military combat veterans with PTSD, and they had surprising results. Doctors gave 30 veterans a series of six one-hour IV infusions. The specific goal of each infusion was to induce dissociation. For this study, researchers predicted that the dissociation under ketamine would offer the veterans a life-changing, transformative experience. Most veterans reported a remarkable change, where they had reduced symptoms of PTSD and established a reset of their negative thoughts and behaviors.

“In my experience, patients who have high positive regard for the hallucinogenic—mystical and transcendental—experience also tend to have better antidepressant response to ketamine infusion.”

While neuroscientists continue to examine how ketamine works in the brain, front-line doctors often witness immeasurable results from ketamine, especially when patients experience dissociation. Ko describes the level of dissociation as more of a gradient than a yes or no answer. With each infusion, he tries to find the “sweet spot” where patients feel detached but are able to explain and remember the experience. Ko strongly believes that ketamine can be a catalyst for personal improvement. “So this includes things like, hey, I’m going to start going for a walk or I’m going to change my diet. I’m going to start engaging in more social activities.”

Ketamine can even be life-changing in the worst of cases, such as for people struggling with suicidal ideations. Researchers have speculated that the NMDA receptor is also tied up with suicidal thoughts and ketamine’s ability to block glutamate can significantly lessen the severity of these intrusive thoughts. The debate on the relationship between dissociation and antidepressant effects will continue, but the debate in itself has led to further research on how ketamine works so fully and so rapidly.

Ketamine Is Now an FDA-Approved Depression Treatment, but Who Will Be Able to Get It?

Even so, the current administration of ketamine precludes many sufferers from benefiting. Pure ketamine is still not approved by the FDA for depression, although a ketamine-like drug, called esketamine, has recently been approved and is available in certain markets. An IV infusion of ketamine requires close monitoring, and a patient must be available sometimes for a few hours per treatment. Many of the researchers in the field hope for more studies on medications that are glutamate blockers, which would serve as a more viable alternative to ketamine.

The inclusion or exclusion of the dissociative side effects in these future trials will all depend on ongoing research. One thing is for sure: Future research will further expose how ketamine works, and as these discoveries are examined, new and less-invasive medications could come to market and potentially improve the symptoms of those suffering from treatment-resistant depression. The difference could be life-altering.

KEEP YOUR CAT(S) INSIDE
When cats are free to roam, wildlife suffers

By Ashley Strickland, CNN

When your house cat trots outside for a neighborhood stroll, it doesn't end well for birds, bunnies, squirrels and other wildlife. And now, thanks to a new study, we know how much damage our feline friends can do. 

© Roland Kays/North Carolina State University

In fact, they kill even more prey than wild predators similar in size to cats, and they don't have to go far to do it. The average range for pet cats allowed outside is about 328 feet from the house they live in.

"We found that house cats have a two- to 10-times larger impact on wildlife than wild predators -- a striking effect," said Roland Kays, lead study author and zoologist at the North Carolina Museum of Natural Sciences.

To track the behavior of house cats who were allowed to go outside, 925 cats across six countries were fitted with unobtrusive GPS devices. Scientists and citizen scientists used the data to track how far the cats ranged, as well as any prey they captured and brought home across rural and urban areas in the US, the UK, Australia and New Zealand.

The study published Wednesday in the journal Animal Conservation.

"Since they are fed cat food, pets kill fewer prey per day then wild predators, but their home ranges were so small that this effect on local prey ends up getting really concentrated," Kays said. "Add to this the unnaturally high density of pet cats in some areas, and the risk to bird and small mammal population gets even worse."

The study did not include feral cats.

On average, the study found that house cats killed anywhere between 14.2 to 38.9 prey per 100 acres, per year. That averages out to about 3.5 prey each month per cat. The researchers believe this large number is due to the fact that neighborhoods can include a high density of cats -- more so than wild predators living in the wild.

"We knew cats were killing lots of animals -- some estimates show that cats in North America kill from 10 to 30 billion wildlife animals per year -- but we didn't know the area in which that was happening, or how this compared with what we see in nature," Kays said.

Much of the damage occurred in areas that already disrupt wildlife. This includes housing developments, because they disturb natural habitats.

And cats weren't deterred from their ranging based on other predators, like coyotes, in the areas they lived.

"As a result, pet cats around the world have an ecological impact greater than native predators but concentrated within about 100 meters of their homes," the authors wrote in the study.

The authors also noted that it's difficult to tell which native species might persist or recolonize urban areas if domestic cats weren't around.

The study cited that domestic cats are one of the most abundant carnivores on Earth, accounting for up to 600 million pet cats around the world. And that can spell doom for native species. On the bright side, this doesn't impact species living in larger protected areas, because the cats were killing prey in urban and suburban habitats.

Some of the native species found at risk in the study included Brushtail possums in South Australia, as well as endangered rodents and rabbits in North America. This is because domestic cats are opportunistic hunters who pursue small mammals that they can easily catch and kill.

Keeping cats indoors could prevent the impact on wildlife, the researchers said.

"Because the negative impact of cats is so local, we create a situation in which the positive aspects of wildlife, be they the songs of birds or the beneficial effects of lizards on pests, are least common where we would appreciate them most," said Rob Dunn, study co-author and William Neal Reynolds Distinguished Professor of Applied Ecology at North Carolina State University.

"Humans find joy in biodiversity, but we have, by letting cats go outdoors, unwittingly engineered a world in which such joys are ever harder to experience."

The First Stegosaur Tracks in Scotland Were Just Discovered on This Windy Island
Mike McRae

Stand on the wind-swept crags lining Scotland's western coast today, and you'd be lucky to spot a puffin or two. But the closer we look, the more evidence we find it was once home to an incredibly diverse array of ancient beasts.© Warpaintcobra/istock/Getty Images Artist impression of a stegosaur

The discovery of new sets of fossilised tracks has expanded the list of potential dinosaur populations that roamed what is now the Isle of Skye. Among them are tracks left by an animal that would have belonged to one of the most famous plate-backed herbivore suborders, Stegosauria.

Scottish and Brazilian researchers have spent the past couple of years analysing two recently found tracksites at a spot on the island's north-eastern coast called Rubha nam Brathairean, or Brothers' Point.

"These new tracksites give us a much clearer picture of the dinosaurs that lived in Scotland 170 million years ago," says University of Edinburgh palaeontologist Stephen Brusatte.

Back then, the lands making up the British Isles were nothing like they are today. Jurassic Scotland sat far closer to the equator, roughly in alignment with where Greece is today. Warm seas and a sub-tropical climate established ecosystems that were bustling with life.

Still, just because it was a virtual paradise doesn't mean it's been perfect for preserving the remains of ancient life. The Jurassic isn't exactly fossil friendly as it is, but Scotland has always seemed especially thin on dinosaur tracks and bones.

In spite of a rich history of fossil hunting throughout much of the United Kingdom, the first clear traces of dinosaur wildlife in Scotland were finally uncovered in the early 1980s when palaeontologists John Hudson and Julian Andrews found the "unmistakable print from a large dinosaur" in a fallen limestone block at Brothers' Point.

Since then, a plethora of tracks belonging to a wide range of long-necked sauropods and fleet-footed theropods have been identified, turning the Isle of Skye into a landmark site for Jurassic researchers.

The most recent additions include teapot-sized holes that haven't been found elsewhere on the island – impressions that are described in palaeontological terms as belonging to a category called Deltapodus.


a close up of a sign: stegosaur footprints skye
© Provided by ScienceAlert
stegosaur footprints skye Deltapod tracks on Isle of Skye (dePolo et al., PLOS One, 2020)

"These discoveries are making Skye one of the best places in the world for understanding dinosaur evolution in the Middle Jurassic," says Brusatte.

Without a means of narrowing down the exact species of dinosaur responsible, the researchers are careful about jumping to any conclusions.

But it's fair to say that this group includes a type of cow-sized dinosaur famed for its lines of geometric plates adorning its spine, and a wicked clump of 'thagomising' spines on its tail.

The team also uncovered another potentially new addition to the list, in the form of large imprints of something with three stubby toes possibly belonging to a group of heavyweight herbivores called ornithopods.

"We knew there were giant long-necked sauropods and jeep-sized carnivores, but we can now add plate-backed stegosaurs to that roster, and maybe even primitive cousins of the duck-billed dinosaurs too," says Brusatte.

Not only do the tracks provide tantalising evidence that stegosaurs once trod along the muddy Scottish coastline, the age of the tracks provides some of the earliest evidence of this particular dinosaur's existence.

Only last year, a species of stegosaur was dug up in the Middle Atlas Mountains of Morocco. At an estimated age of around 168 million years old, the fossilised remains of Adratiklit boulahfa are officially the oldest of its kind.

These tracks at Brother's Point are closer to 170 million years old. While there's no way to confirm what kind of stegosaur might have left them behind, it does help establish timelines and distributions describing their evolution.

"In particular, Deltapodus tracks give good evidence that stegosaurs lived on Skye at this time," says the study's lead author, Paige dePolo from the University of Edinburgh.

With such a rich assortment of tracks being found across the island, this part of Scotland is representative of an important period in evolutionary history, where the late Jurassic's zoo of classic creatures was just beginning to develop their famous characteristics and spread out around the globe.

This research was published in PLOS One.

Due to Coronavirus, Trump to Change Mexico Border Controls

Zolan Kanno-Youngs, Michael D. Shear and Maggie Haberman

WASHINGTON — The Trump administration plans to immediately turn back all asylum seekers and other foreigners trying to cross the southwestern border illegally, saying they cannot risk allowing the coronavirus to spread through detention facilities and among Border Patrol agents, four administration officials said on Tuesday.
© Doug Mills/The New York Times President Trump and his administration are said to be planning to turn back all asylum seekers and other foreigners trying to cross the southwestern border illegally.

The officials said the ports of entry would remain open to American citizens, green card holders and some foreigners with proper documentation. Some foreigners would be blocked, including Europeans currently subject to earlier travel restrictions enacted by the administration. The entryways will also be open to commercial traffic.

But under the new rule, set to be announced in the next 48 hours, Border Patrol agents would immediately return to Mexico anyone who tries to cross the southern border between the legal ports of entry. Under the policy, asylum seekers would not be held for any length of time in an American facility nor would they be given due process. Once caught, they would be driven to the nearest port of entry and returned to Mexico without further detention.

Although they advised that details of the policy could change before the announcement, administration officials said the effort was critical to avert an outbreak of the coronavirus inside detention facilities along the border.

Such an outbreak could spread quickly through the immigrant population and could infect large numbers of Border Patrol agents, leaving the defenses at the southwestern border weakened, the officials argued. Administration officials say many of the migrants who cross the border are already sick or lack sufficient documents detailing their medical history.

Confirmed cases of the virus in Mexico stand at 82, compared with around 5,600 in the United States and more than 470 in Canada.

Some details of the new rule remained unclear, including whether foreigners seeking asylum or other protections at the ports of entry would be turned back immediately.

But President Trump has suggested multiple times that he could close the border, hoping to crack down on illegal immigration and pressure Mexico to do more to curb the northward flow of migrants.

Long before the coronavirus outbreak, he admonished his top advisers at the Department of Homeland Security about stopping illegal immigration by saying he wanted to “shut it down.” Last spring, as the number of migrants crossing from Central America surged, the president repeatedly threatened to close the border, offering a top official a pardon for the task.

“This is our new statement: The system is full,” the president said last April.

At the time, top aides to the president convinced him that it was not legal to simply turn away all migrants seeking to enter the country. International treaties and American law require asylum seekers to have an opportunity to present their case, although a related policy now allows the administration to make some wait on the Mexican side of the border for their asylum hearings.

The Trump administration has previously tried to push through a policy that would deny asylum to migrants who illegally crossed the southwestern border, an effort the Supreme Court refused to allow in 2018.

But officials insisted on Tuesday that the new policy was not meant to achieve the president’s immigration goals. They said it was driven by the president’s health advisers and would be in effect only as long as the coronavirus remains a threat to the United States.

Officials said the new policy would be based on authorities that can be granted to public health officials in the time of a medical or health emergency, not on immigration laws that the administration has repeatedly cited as justification for past actions at the border. Another official said the administration would invoke a federal legal code that says if the surgeon general identifies “any communicable disease in a foreign country,” he or she can prohibit people from that country from entering the United States.

The new policy also applies to the northern border with Canada, which has already closed its borders to most foreigners — but not Americans — in an attempt to keep the virus at bay. Officials said Mr. Trump would soon also take separate action to further insulate the United States from the possibility of the virus spreading from Canada.

In the next 24 hours, one official said, the United States and Canada plan to issue a joint statement saying that they are suspending nonessential travel between the two countries. That would allow trade to continue, but would restrict flights and border crossings for things like vacations.

Migrants who crossed the border last year were detained for days, weeks or even months. But as the number of such crossings reached its highest point in more than a decade last spring, the crowded and cramped facilities drew widespread condemnation amid photographs of children living in dirty conditions with no soap or toothpaste.

The officials also expressed concern about the health risk of sending migrant children to facilities around the country that are run by the Department of Health and Human Services.

At the same time, officials said that they did not want to return to a policy of letting migrants remain free in the United States while they awaited hearings in the immigration courts, a policy Mr. Trump has derided as “catch and release.” Doing so could allow migrants with the coronavirus to add to the burden on American hospitals, officials said.

© Jose Luis Gonzalez/Reuters A woman wearing a protective mask walking toward El Paso at the international border bridge Paso del Norte, as seen last week from Ciudad Juarez, Mexico.

Border crossings have declined drastically since last spring after the administration enacted aggressive policies, like forcing asylum seekers to wait in Mexico as their immigration cases are adjudicated.

The coronavirus outbreak has also halted a Trump administration program that had diverted to Guatemala more than 900 asylum seekers trying to enter the United States. The government there suspended the flights as a way to prevent the domestic spread of the virus.

Zolan Kanno-Youngs and Michael D. Shear reported from Washington, and Maggie Haberman from New York

Democrats say Mnuchin squeezed paid sick leave program

GOP SCREWS AMERICAN WORKERS, SURPRISE

Last-minute negotiations between Democratic leaders and the White House have downsized the scope of a paid leave program for workers affected by the coronavirus outbreak, angering some Democrats who see it as a major concession to the White House.

 

© Susan Walsh/AP Photo Treasury Secretary Steven Mnuchin.

The House on Monday night approved a slate of last-minute “technical” corrections to a sweeping aid package, paving the way for swift adoption by the Senate. But several Democrats and progressive advocates say changes pushed by the White House are actually significant revisions to the bill’s paid leave program, undermining one of their top priorities in the package.
“I think the changes the Republicans insisted on made this far worse,” Rep. Stephanie Murphy, who has pushed for far more expansive paid sick and medical leave provisions in the package, said in an interview Tuesday.

“The intent of the package was to provide workers the support they needed to stay home and prevent the spread of this disease,” Murphy said, adding that Democrats would push to restore the provisions in future bills. “We have a chance to take another swing at it. My hope is that we can get Republicans to understand the public health rationale.”

The latest version of the bill, which the Senate is expected to pass this week, includes a major change to federal paid sick leave and family medical leave policy for affected workers, a program long championed by Democrats.

The legislation initially allowed workers up to 10 weeks of paid leave — as part of the federal family and medical leave program — for three different scenarios: if they become sick or are forced to be quarantined, if they are caring for a sick person, or if they are caring for a child whose school or daycare has been closed.

Under the latest changes, however, there is only one category that qualifies for the extended family and medical leave: Individuals who are taking care of children.

Pelosi appeared to address the criticism from some in her caucus in a statement on Tuesday, in which she vowed to push for expanded paid leave in the next package.

“As the House develops our third Families First package, we are working to advance additional steps to expand the emergency leave mandate,” Pelosi wrote, laying out several provisions, including allowing workers who are sick to access longer term leave.

Democratic negotiators have also stressed that the core tenet of the program — paid sick leave for 14 days — remains intact, potentially helping as many as 87 million people during the public health crisis.

Pelosi was also able to secure other victories in the bill, such as ensuring that individuals who take paid medical leave remain entitled to health care coverage from their employer, which the White House had proposed rolling back. Democrats also upped the size of a tax credit for businesses who continue to offer health coverage to their employees, helping to defray the costs.

Still, several Democrats have been privately livid at the changes to the paid leave program, which was approved when members were back in their districts. And Democratic lawmakers and aides say the concession may be all for naught now that Senate negotiators are talking about combining the House-passed bill with a third major stimulus package and passing it all as one measure this week.

Democrats have complained that they already made major concessions in talks with Mnuchin as they tried to clear the package with House Republicans. The paid sick leave plan envisioned by Democrats had initially been far more dramatic — an entirely new program run by the Social Security Administration. But Republicans had revolted, and eventually both sides agreed to instead bolster tax credits to help businesses expand existing programs.
Now, Democrats say, Mnuchin has again moved the goal posts in an attempt to sell the package to Senate Republicans, some of whom remain skeptical about the costs on small businesses.

“It drives me crazy that it's been sold as a technical change. It's not. It's a major change,” one Democratic aide familiar with the negotiations said. “We had already moved a couple miles from what we introduced. Now we're talking about different worlds. This is extremely narrow now. “

The most recent version of the bill has also sparked confusion over a provision allowing small businesses to obtain exemptions from providing paid leave. The Labor Department can issue regulations exempting certain companies with fewer than 50 employees from requirements that they offer paid family leave and paid sick leave — an apparent difference from the original legislation allowing exemptions from paid family leave only, advocates said.

"We think that paid sick time and family leave are pretty essential ingredients in how we’re going to be able to manage this," said Amanda Ballantyne, the national director of small business advocacy group Main Street Alliance. "Exempting employers of 50 and fewer exempts a massive part of our workforce."

In another significant change, the corrected version of the bill eliminates a provision that would have prevented states from receiving greater federal Medicaid funding if those states checked beneficiaries' eligibility more than once a year.

Several states conduct such checks multiple times per year, meaning the initial version could have deprived them of crucial funding ahead of an expected surge of coronavirus patients.

Senate Democrats led by Sen. Kirsten Gillibrand are expected on Tuesday afternoon to unveil new legislation designed to expand paid leave to all American workers.

  
INJUSTICE

"Please have mercy": Minutes before Nathaniel Woods' execution, murder victim's sister begged an Alabama official to spare him
Gus Garcia-Roberts, USA TODAY

© Provided by The Montgomery Advertiser Nathaniel Woods never pulled the trigger, but the accomplice law sent him to death rowTen minutes before Nathaniel Woods was scheduled to be executed for his role in the 2004 murder of three police officers, the chief of staff to the Governor of Alabama received a desperate phone call from the sister of one of the slain cops.

Her plea: Spare his life.

“He didn’t kill my brother, and he didn’t kill the other officers, may they rest in peace,” Kimberly Chisholm Simmons, the sister of murdered officer Harley Chishom III, pleaded during the call that started around 5:50 p.m on Thurs., Mar. 5. “I’m asking for mercy, and I believe my brother would want me to take a stance because of the man he was.”

Gov. Kay Ivey’s chief of staff, Jo Bonner, said he would relay the message to other officials and suggested that Simmons should expect a call back.

But the murder victim’s sister never heard from another Alabama official, even after a temporary U.S. Supreme Court stay bought Woods a few more hours. Its justices ultimately elected not to intervene in his execution, and at 9:01 p.m., Woods, 43, died by lethal injection.

The extraordinary eleventh-hour phone conversation, which was tape recorded by Woods’ attorney and shared with USA TODAY, has not been previously reported.

The call was the result of back-channel negotiations in which Woods’ attorney, Lauren Faraino, was informed by sources connected to the highest levels of Alabama government within an hour of her client’s scheduled execution that he could be spared if a victim’s family member begged for his life.

For those close to Woods, and undoubtedly the condemned man himself, the failed call for mercy was only one of several moments of emotional whiplash during the last day of his life. The prospect that Woods would be allowed to live was repeatedly held before them and then yanked away.

The Supreme Court stay caused his family members to celebrate, believing that he had been spared. His family learned within hours that his execution was still imminent.

Woods’ imam, who was set to witness his execution, said he was sent away from the prison and told he could return if the execution occurred. But the imam was notified too late, and Woods was executed without his spiritual advisor present.

Woods’s case attracted national attention — including from high-profile supporters such as Martin Luther King III and Kim Kardashian — due to claims of police misconduct, flimsy evidence and poor representation during his 2005 trial.

Prosecutors acknowledged that Woods didn’t pull the trigger that ended the lives of the three police officers, instead convincing a jury that he had lured them into being killed by another man. The confessed shooter, Kerry Spencer, who is himself on death row, has said that Woods was “actually 100 percent innocent.”

It’s unclear what steps Bonner took, if any, after receiving the call from Simmons. He did not respond to an interview request for this story. His cell phone number that Simmons used that night — and that Woods’ own sister also said she subsequently called to beg for mercy, and that was then tweeted out to the world by King III — has since been disconnected.

A spokesperson for Ivey also declined to make the governor available, instead re-sending a statement she had issued the night of Woods’ execution.

“This is not a decision that I take lightly, but I firmly believe in the rule of law and that justice must be served,” read the statement, adding that the governor’s “thoughts and most sincere prayers are for the families” of the officers. “May the God of all comfort be with these families as they continue to find peace and heal from this terrible crime.”

Not all of Chisholm’s siblings feel the way his older sister Kimberly does about Woods’s capital punishment. At a press conference following Woods's execution, members of Chisholm’s family cheered the outcome.

“One cop killer down as we patiently wait for the next one,” said Starr Sidelinker, sister to Harley and Kimberly.

Faraino, Woods’ attorney, said her client’s last hours alive, while his family hung on every development, were “the cruelest moments I’ve ever been through in my life.”

© Courtesy Kimberly Chisholm Simmons Kimberly Chisholm Simmons and her brother Harley Chisholm III before his murder.

Simmons’ involvement in the final day of Woods’ life started a few weeks earlier, when she received a letter at her home in Florida from authorities stating that Woods was set to be executed.

Simmons hadn’t closely followed the case since Woods’ conviction, and she said that the murder of her police officer brother — who she called “Buddy" — had fractured her family. Although her sisters were eager for retribution, Simmons felt compelled to send an email to a non-profit death penalty website with the hope that it might reach Woods before he was put to death.

“I forgive him for any involvement he had personally I don't feel he's guilty as much as Spencer,” Simmons wrote. “Only God knows the truth of what has really happened and if it's in God's plan he will stay his execution. But I want him to know he is Forgiven by me.”

The email was forwarded to Woods’ attorney, Faraino, the day before his scheduled execution. Faraino makes her living in finance, and her pro bono legal work for Woods was a no-frills family affair. Her mother pulled legal files at the courthouse and her stepfather, Bart Starr Jr. — the son of a revered Alabama and Green Bay Packer quarterback and member of the Pro Football Hall of Fame — worked the phones with well-placed friends to lobby for mercy for the death row inmate.

Starr Jr. was at Faraino’s Birmingham home with less than an hour to go before Woods’ execution when one of those calls bore fruit. A prominent political donor told Starr his brother, an Alabama state senator, had conveyed that government officials might consider a stay if a victim’s family member pleaded for it.

Faraino frantically emailed Simmons: "I am pleading with you, please give me a call.” The victim’s sister readily agreed to ask Alabama authorities to spare Woods’ life.

Faraino's audio recorder caught the frenzied next hour. While Simmons waited on the other line, Faraino dialed numbers attempting to reach an Alabama official but only found switchboards and office voicemails.

At around 5:45 p.m. — roughly fifteen minutes before Woods’s scheduled execution — Faraino heard Starr Jr. yell out: “What?”

“Oh, no, no, no, no, no,” Faraino said, weeping as she told Simmons, “I think they’re executing him right now.”

But Faraino’s mother informed the lawyer it was actually good news. Supreme Court Justice Clarence Thomas had issued a temporary stay of execution.

Simmons began celebrating. “God loves Nathaniel Woods,” she said.

Members of Woods’ family learned of the stay from their cell phones and interpreted it as a lasting measure. Earlier that afternoon, Woods, seven family members and his imam had joined him for what was supposed to be his last meal, and he had for the first time met his grandson. Now, his family and friends were overjoyed that it wouldn’t also be the last time.

“I’m shaking, I’m just so excited I don’t know what to do, you know?” family friend Jasmine Walters said moments after they learned of the stay. “I’m just so grateful. I’m so, so grateful.”

But Faraino was aware that the Supreme Court’s stay was only a temporary, interim step to allow the justices a couple of hours to decide whether to intervene, which was a long shot.

Her efforts to reach an Alabama official before the stay might be lifted got a break when her stepfather ran to her office with Bonner’s cell phone number, obtained via a former University of Alabama football player.

After Bonner picked up, he declined to put Gov. Ivey on the phone with Simmons, saying that she was on another phone call.

Simmons emphasized to Bonner that all she was asking for was a renewed look at Woods’ case. “I think they need to go over the evidence that they have brought forth,” Simmons said. “I mean, it’s not going to hurt nothing.”

“I’m begging the courts,” she added. “Please have mercy.”

Bonner, a former Congressman, responded dispassionately. “Have you communicated in writing this request?” he asked. Bonner said that though he wasn’t doubting Simmons was who she said she was, her identity may have to be verified. “Because of the severity of this we have gotten calls from all over the country from people purporting to know things that they may or may not know.”

But Bonner said he would convey Simmons’ plea to the state attorney general and the governor’s legal counsel. He took down her number and said representatives from those offices “may give you a call to get some additional information.”

Two hours passed with no Alabama official calling Simmons. At 8:06 p.m., the Supreme Court issued a one-sentence decision denying Woods’s stay of execution, removing the only remaining obstacle to his death.

Woods’s sister, Pamela, said she also reached Bonner on the cell phone number, asking to speak to Gov. Ivey. “I begged, I screamed, I cried,” Pamela Woods said. “He would not let me talk to her. He just said ‘No.’ I begged him, screaming, ‘Please, let me speak to her,’ and he told me, ‘No.’ And he hung up in my face.”

Simmons said that she could tell during her conversation with Bonner that it would likely have little effect. “I sensed, you know, ‘You’re not going to stop this, lady,’” she said. “They’re going to take this man no matter what I say. It’s already in their hearts to kill him.”
© Garcia-Roberts, Gus Nathaniel Woods with family members during his final visitation.

Nathaniel Woods’s imam, Yusef Maisonet, said he was told to leave the prison following the issuance of the Supreme Court stay, and to expect an official to call him and escort him back in if the execution went forward later that night.

But instead, the imam said nobody called him until shortly before Woods was returned to the execution chamber at close to 9 pm. By then, thinking that the execution was off, Maisonet had returned to his home in Mobile, more than fifty miles away.

As a result, Woods was executed without his spiritual advisor as a witness.

“I feel that they did purposefully keep me out” of the prison during Woods’s execution, Maisonet told USA TODAY last week.

Samantha Rose, a spokesperson for the Alabama Department of Corrections (DOC), disputed Maisonet’s account. She said in a statement that after Maisonet was asked to wait in a certain area for the execution, he “elected to leave this location on his own accord without speaking to security staff. When security staff arrived to take him to the execution, the Imam was no longer onsite… We will not speculate on the reasons why this Imam chose to leave when he did.”

Maisonet said he had spoken at length with Woods about topics including what he wanted done with his body. Before the day of the execution, Maisonet wrote to the Holman warden requesting that Woods’s corpse not be autopsied following his death “since it is against our religious beliefs and the cause of death will be known.”

Alabama officials nonetheless performed the autopsy on Friday, Mar. 6, according to Fairano. Alabama DOC spokesperson Rose said that decision was “at the direction” of Escambia County District Attorney Stephen Billy.

Billy’s office did not respond to a message seeking comment for this story. In a letter to Faraino before the autopsy was completed, Billy said it was his “policy to order autopsies on all executions… to confirm the cause and manner of death.”

“It is not my intention of changing my position on this matter,” Billy wrote to the lawyer, “and would appreciate you not contacting my office again regarding this issue.”

Faraino said she has not yet been informed of what the coroner found to be the official cause of Woods' death.

This article originally appeared on USA TODAY: "Please have mercy": Minutes before Nathaniel Woods' execution, murder victim's sister begged an Alabama official to spare him

Cats and dogs abandoned at the start of the coronavirus outbreak are now starving or being killed
By Allen Kim, CNN



a person holding a cat: A member of Vshine, one of HSI's partner groups in China, tends to a pet cat that was left behind during the Wuhan coronavirus outbreak.3 SLIDES © Vshine

A member of Vshine, one of HSI's partner groups in China, tends to a pet cat that was left behind during the Wuhan coronavirus outbreak.

The novel coronavirus has infected more than 100,000 people around the globe, killing more than 4,000. But it's not just humans impacted by the spread of the pandemic.

Many animals in Wuhan, the Chinese city that is the epicenter of the coronavirus outbreak, have died or are at risk of dying after residents evacuated their homes in the wake of the lockdown, animal advocates have said.

"We know that many dogs and cats have been left behind in apartments in Wuhan, in particular, when residents were evacuated, but also in other areas such as Beijing, Dalian, Xi'an," Wendy Higgins, director of international media at Humane Society International, told CNN.

"Estimates are impossible, but we do know that in Wuhan, for example, animal activists have assisted with animals in upwards of 1,000 apartments. So, the numbers nationwide will be significant."
No water or food

The primary risk most animals face is an obvious one: starvation.

Residents who were forced to leave their pets behind typically left enough food and water to last them for a few days, thinking they would be able to return soon, some animal advocates told CNN


But nearly a month after they evacuated, many residents have not returned home.

Vshine Animal Protection Association, a China-based animal welfare and environmental organization which partners with Humane Society International, estimated that the number of dogs and cats left behind in apartments in Hubei cities are in the tens of thousands.

"Things can get worse if the epidemic remains uncontrolled," Deng Fang, chief of staff for Vshine Animal Protection Association, told CNN.

Many worried residents have contacted organizations like Vshine to ask employees to check in on their pets. Vshine has received at least 400 calls for help in the city of Dailan alone, and they have helped save at least 380 dogs and cats that were left behind, Fang said.
Unfounded fears that pets can spread the virus

In late February, Hong Kong's Agriculture, Fisheries and Conservation Department (AFCD) said that samples from a dog's nasal and oral cavities had tested "weak positive" for novel coronavirus.


However, pet owners don't need to panic just yet, as CNN reported last week. Pets can catch other known coronaviruses, and while the infections can become severe neither has been shown to spread to humans.

News to stay informed. Advice to stay safe.
Click here for complete coronavirus coverage from Microsoft News




"At present, the AFCD does not have evidence that pet animals can be infected with COVID-19 virus or can be a source of infection to people," the AFCD said in a statement.

Hong Kong SPCA Society for the Prevention of Cruelty to Animals (SPCA) issued a similar reminder.

"Members of the public are advised to differentiate that 'being infected' does not equal being infectious and capable of spreading the Covid-19 virus," SPCA wrote in a Facebook post.

Such fears have caused incidents of violence toward animals in China, Fang and Higgins said, and a local government officials have posted notices warning pet owners to keep animals inside.

In a notice that Fang shared with CNN, a group that listed its name as the Urban Construction Administration stated it would start to kill cats and dogs that were outside of homes in order to prevent the transmission of the coronavirus disease.

She also shared a notice from city officials in Hongjiang, in Hunan province, which states that pets in public areas or unattended animals would be killed without exception.

In another county in Zhejiang, a province with the most infections after Hubei, authorities warned dogs that are found in public would be exterminated, according to Reuters.

Some have even went so far as to find tiny masks for their pets, the wire service said.

"I'm worried about my dog being hated by the neighbourhood," Beijinger Wang Fengyun said, adding that while he hasn't found any animal-grade facial protection, he made one himself with a paper cup

COMPASSIONATE CAPITALISM

 (CHINESE NOT AMERICAN)
Chinese billionaire Jack Ma donates masks, test kits to all countries in Africa

Chinese billionaire and co-founder of Alibaba, Jack Ma, says he will donate masks, test kits and protective suits to all countries in Africa to help the continent in its fight against the novel coronavirus.

© PHILIPPE LOPEZ/AFP via Getty Images Jack Ma, CEO of Chinese e-commerce giant Alibaba, speaks during his visit at the Vivatech startups and innovation fair, in Paris on May 16, 2019. (Photo by Philippe LOPEZ / AFP) (Photo credit should read PHILIPPE LOPEZ/AFP via Getty Images)

Ma's foundation will donate at total of 1.1 million testing kits, six million masks, and 60,000 protective suits and face shields.

They will also work with local medical institutions on the continent to provide online training material for coronavirus clinical treatments.

"The world cannot afford the unthinkable consequences of a COVID-19 pandemic in Africa," he said in a statement tweeted Monday.

Africa has so far confirmed more than 300 cases, Egypt being the hardest hit with 110 cases.

The items will be delivered to Addis Ababa, Ethiopia, where Prime Minister Abiy Ahmed will oversee the distribution of the supplies to other African countries, Ma said.

On Friday, the billionaire founder of Alibaba said he would donate 500,000 coronavirus testing kits and one million face masks to the United States. 

He has also shared his plans to give to Europe as well as Iran.

"Now it is as if we were all living in the same forest on fire. As members of the global community, it will be irresponsible of us to sit on the fence, panic, ignore facts, or fail to act. We need to take action now," Ma said.

A chilling scientific paper helped upend U.S. and U.K. coronavirus strategies
William Booth Washington Post 3/17/2020

LONDON —Immediately after Boris Johnson completed his Monday evening news conference, which saw a somber prime minister encourage his fellow citizens to avoid "all nonessential contact with others," his aides hustled reporters into a second, off-camera briefing. 

© Richard Pohle/Pool/EPA-EFE/Shutterstock From left, chief medical officer Chris Whitty, British Prime Minister Boris Johnson and chief scientific officer Patrick Vallance give a news conference on the coronavirus pandemic in London, March 16, 2020.

That session presented jaw-dropping numbers from some of Britain’s top modelers of infectious disease, who predicted the deadly course of coronavirus could quickly kill hundreds of thousands in both the United Kingdom and the United States, as surges of sick and dying patients overwhelmed hospitals and critical care units.

The new forecasts, by Neil Ferguson and his colleagues at the Imperial College COVID-19 Response Team, were quickly embraced by Johnson’s government to design new and more-extreme measures to suppress the spread of the virus.

The report is also influencing planning by the Trump administration. Deborah Birx, who serves as the coordinator of the White House coronavirus task force, cited the British analysis at a news conference Monday, saying her task force was especially focused on the report’s conclusion that an entire household should self-quarantine for 14 days if one of its members is stricken by the virus.

The Imperial College group reported that if nothing was done by governments and individuals and the pandemic remained uncontrolled, then 510,000 would die in Britain and 2.2 million in the United States over the course of the outbreak.

These kinds of numbers are deeply concerning for countries with top-drawer health-care systems. They are terrifying for less-developed countries, global health experts say.

If Britain and the United States pursued much more ambitious measures to mitigate the spread of coronavirus, to slow but not necessarily stop epidemic over the coming few months, they could reduce mortality by half, to 260,000 people in the United Kingdom and 1.1 million in the United States.

Finally, if the British government quickly went all-out to suppress viral spread — aiming to reverse epidemic growth and reduce the case load to a low level — then the number of dead in the country could drop to below 20,000. To do this, the researchers said, Britain would have to enforce social distancing for the entire population, isolate all cases, demand household quarantines of households where anyone is sick, and close all schools and universities — and do this not for weeks but for 12 to 18 months, until a vaccine is available.

“We might be living in a very different world for a year or more,” Ferguson told reporters.

The modelers did not give numbers for the United States for the most intense suppression efforts.

The researchers reminded governments that these forecasts are based on current observed trends in China, South Korea, Britain and Italy but that much remains unknown about the virus.

The Imperial College report was, however, responsible in large part for Johnson’s turnaround decision to begin rolling out what 10 Downing Street described as life-altering, “drastic” measures to control the spread of the novel coronavirus, aides said.

On Monday night, Johnson urged his fellow citizens to immediately start to avoid “all nonessential contact with others,” work from home and self-isolate now if they are elderly or suffer from underlying medical conditions. All the measures are voluntary, but Johnson warned that his government had the power to make them mandatory.

© Hannah Mckay/Reuters People at London’s Liverpool Street Station during rush hour as the number of coronavirus cases grow around the world.Johnson said that healthy and asymptomatic Britons should avoid pubs, clubs and theaters. In London, the bars were still open Monday. Most schools, museums and restaurants were, too.

If Britain had continued on the go-slow, step-by-step course that it set just days ago, the Imperial College modeling envisioned hundreds of thousands of deaths and a tidal wave of cases that would overwhelm the National Health Service and its hospitals, which currently have 5,000 ventilators on hand for a population of 66 million.

The British forecast also appears to have influenced thinking at the White House. On Monday evening in Washington, President Trump said that Americans should avoid gathering in groups of more than 10 people, eating in restaurants or taking nonessential trips — his most significant push yet to combat a viral outbreak.

At a news conference Monday at the White House, Birx said her group has been working with modelers around the globe, including in Britain.

© Jabin Botsford/The Washington Post President Trump listens as Deborah Birx, White House coronavirus response coordinator, announces that the outbreak could last months and that gatherings should be limited to 10 people, during a White House briefing on March 16.

“So, we had new information coming out from a model, and what had the biggest impact in the model is social distancing, small groups, not going in public in large groups. But the most important thing was if one person in the household became infected, the whole household self-quarantined for 14 days. Because that stops 100 percent of the transmission outside of the household,” she said.

To suppress spread in Britain, widespread school and university closings might also be necessary, though Ferguson worried about its impact on staffing at NHS hospitals, where as many as a third of nurses have school-age children, the Guardian newspaper reported.

In their forecast, the modelers envision that strict measures over the coming months will occasionally be loosened, but as soon as they are, viral spread could come roaring back.

“The major challenge of suppression is that this type of intensive intervention package . . . will need to be maintained until a vaccine becomes available (potentially 18 months or more), given that we predict that transmission will quickly rebound if interventions are relaxed,” the study concludes.

“Intermittent social distancing — triggered by trends in disease surveillance — may allow interventions to be relaxed temporarily in relatively short time windows, but measures will need to be reintroduced if or when case numbers rebound,” the research team said.

william.booth@washpost.com

BECAUSE OF COURSE HE DOES

Trump attacks Democratic Michigan Governor Whitmer on Twitter over coronavirus response

Paul Egan, Detroit Free Press

President Donald Trump on Tuesday attacked Michigan Gov. Gretchen Whitmer on Twitter after Whitmer was critical of the president's and the federal government's response to the coronavirus pandemic. 

© Michigan Executive Office of the Governor Governor

Gretchen Whitmer provided an update on the state’s response to COVID-19.

"Failing Michigan Governor must work harder and be much more proactive," Trump tweeted. "We are pushing her to get the job done. I stand with Michigan!"

Failing Michigan Governor must work harder and be much more proactive. We are pushing her to get the job done. I stand with Michigan!— Donald J. Trump (@realDonaldTrump) March 17, 2020

Whitmer, who on Monday criticized Trump and the federal government on national television for being unprepared for the crisis, said on MSNBC on Tuesday she was surprised when Trump said, in a conference call with the nation's governors Monday, that they should try to get respirators and other needed items on their own.

"To hear the leader of the federal government tell us to work around the federal government because it's too slow — it's kind of mind-boggling," Whitmer said.

Whitmer responded to Trump on Twitter Tuesday.

"Now that I’ve got your attention, Mr. President — attack tweets won’t solve this crisis," the governor said. "But swift and clear guidance, tests, personal protective equipment, and resources would."

Now that I’ve got your attention, Mr. President - attack tweets won’t solve this crisis. But swift and clear guidance, tests, personal protective equipment, and resources would.

FYI - here’s what I’ve done so far ⬇️ https://t.co/LZkN0U490p— Governor Gretchen Whitmer (@GovWhitmer) March 17, 2020

Though his approach has changed in recent days, Trump initially downplayed the significance of the virus and dismissed Democratic concerns about his handling of coronavirus as "their new hoax."

Whitmer appeared on national TV one day after she ordered all restaurants, bars, gyms, and many other public spaces to close or partially close to slow the spread of the coronavirus. Restaurants are limited to carry out or delivery services. Schools across the state were closed last week.

As of Sunday evening, the state has 54 reported positive COVID-19 cases.