Lawyers representing migrants dumped on Martha's Vineyard want Florida Gov. DeSantis criminally investigated over the 'stunt'

Natalie Musumeci
Mon, September 19, 2022 

Florida Gov. Ron DeSantis speaks at a press conference in Rockledge, Florida.Paul HennessyGetty Images

Attorneys for the migrants dumped on Martha's Vineyard want a criminal probe into the incident.


They called on state and federal prosecutors to open an investigation into the "shameful political stunt."


Last week, 50 migrants were flown to Martha's Vineyard in a move orchestrated by Florida Gov. Ron DeSantis.

Attorneys for the dozens of migrants who were dumped on the Massachusetts island of Martha's Vineyard have called on state and federal prosecutors to open a criminal probe into the "shameful political stunt" orchestrated by Republican Florida Gov. Ron DeSantis.

The Boston-based Lawyers for Civil Rights group — which says it is representing more than 30 of the migrants — sent letters to Massachusetts Attorney General Maura Healey and Massachusetts US Attorney Rachael Rollins over the weekend, saying that "criminal laws were broken by the perpetrators of this stunt."

Last week, 50 undocumented Venezuelan immigrants were flown on two chartered planes from Texas to Martha's Vineyard in a move that was organized by DeSantis. No Massachusetts officials were notified that the dozens of migrants were coming.
Related video: 46 migrants found dead inside tractor trailer in San Antonio

The immigrants have since been relocated to a military base in Cape Cod, Massachusetts.

"Our clients were induced to board airplanes and cross state lines under false pretenses," Lawyers for Civil Rights' executive director Iván Espinoza-Madrigal and the group's litigation director, Oren Sellstrom, wrote in the letters.

"Individuals, working in concert with the Florida Governor, made numerous false promises to our clients, including of work opportunities, schooling for their children, and immigration assistance, in order to induce them to travel," they said.

DeSantis' office did not immediately answer when asked for comment on the attorneys' statement.

Espinoza-Madrigal and Sellstrom pointed to how migrants were reportedly told they were going to Boston and that they could find work there.

"It was only when the flight was in mid-air that they were informed they would be flown to Martha's Vineyard, rather than to Boston as many had been told," they wrote in their letters.

"Once the planes landed, those who had induced our clients to travel under these false pretenses disappeared, leaving our clients to learn that the offers of assistance had all been a ruse to exploit them for political purposes," they said.

Espinoza-Madrigal and Sellstrom said their clients were robbed of their liberty.

"The perpetrators targeted our clients based on race and national origin in order to make the political point they wanted," they said.

Espinoza-Madrigal and Sellstrom added in their letter to Rollins, "This type of conspiracy to deprive our clients of their liberty and civil rights and interfere with federal immigration proceedings must be thoroughly investigated for violations of criminal laws."

They also said the matter must be investigated for "violations of the Massachusetts Civil Rights Act and all other applicable criminal laws" in the letter to Healey.

A spokeswoman for Healey, Chloe Gotsis, told Insider on Monday: "Our office continues to review all information relevant to this situation. We are in touch with our federal and state partners, along with attorneys representing the migrants, as we gather facts and evaluate all legal options."

The office of Rollins did not immediately respond to a request for comment by Insider on Monday.

Judge prefers a trial for DeSantis’ removal of Tampa prosecutor

Sue Carlton, Lawrence Mower, Tampa Bay Times

Mon, September 19, 2022 

TALLAHASSEE — A federal judge hearing the case of Hillsborough County’s ousted state attorney appears to favor a trial over immediately reinstating Andrew Warren to decide the issue “once and for all.”

Warren was requesting a preliminary injunction to put him back to the office Gov. Ron removed him from last month.

The twice-elected state attorney was escorted from his downtown Tampa offices Aug. 4 by an armed sheriff’s deputy. The governor accused him of refusing to enforce laws involving abortion and transgender health care, and of not prosecuting certain low-level, non-violent crimes.

Warren, a progressive Democrat, contended that his removal was a political stunt by the conservative governor with whom he had previously clashed. He said DeSantis violated his free speech rights and overstepped his authority.

Warren sued DeSantis and asked the judge for a preliminary injunction to reinstate him to his job. At a hearing Monday morning, Senior U.S. District Judge Robert L. Hinkle indicated he’d like to avoid the possible back-and-forth effect of reinstating Warren and have a trial to settle the issue “once and for all.”

Hinkle asked the attorneys how quickly they could go to trial. Warren’s attorneys said a month. DeSantis’ lawyers said three to four months, although they’d need to confer with their clients to be definitive.

“The public isn’t served by yo-yoing this office,” Hinkle said.

He said the public interest was in trying the case as soon as possible to get all the facts.

This is a developing story. Stay with tampabay.com for updates.

#BDS

Unilever violating merger deal over Israel sale - Ben & Jerry's founders on MSNBC

Sept 18 (Reuters) - The founders of ice cream maker Ben & Jerry's said on MSNBC on Sunday that parent Unilever PLC is in violation of the 2000 merger deal over its sale of Ben & Jerry's business in Israel to a local licensee who could sell their products in the West Bank.

"That agreement gave authority over the social mission to the independent board of Ben & Jerry's. Unilever has usurped their authority and reversed the decision that was made and we can't allow that to happen, we can't sit idly by," Ben Cohen said in a televised interview.

Partner Jerry Greenfield said the agreement is legally binding and needs to be adhered to.

Unilever, in contrast, has said it retained the right to make operational decisions for Ben & Jerry's, and that the sale could not be undone because it has irrevocably closed.

Ben & Jerry's said earlier this month that it plans to amend its lawsuit challenging Unilever's sale of the Israeli business in Federal court in Manhattan. Unilever must respond by Nov. 1.

In July 2021, the Burlington, Vermont based company decided to end sales in Israeli-occupied Palestinian territories, calling it "inconsistent" with the progressive values and social mission it retained the right to promote.

That decision prompted a backlash against Unilever, including divestments by pension funds from the consumer goods company and accusations of anti-Semitism by some Jewish groups. (Reporting by Alden Bentley; Editing by Christopher Cushing)

Family of American says he was freed by Taliban in swap

ERIC TUCKER and RAHIM FAIEZ

Mon, September 19, 2022 

WASHINGTON (AP) — An American contractor held hostage in Afghanistan for more than two years by the Taliban has been released in exchange for a convicted Taliban drug lord jailed in the United States, according to the man's family and U.S. officials.

Mark Frerichs, a Navy veteran who had spent more than a decade in Afghanistan as a civilian contractor, was abducted in January 2020 and was believed to have been held since then by the Taliban-linked Haqqani network.

Negotiations for his release had centered on a deal that would also involve the release of Bashir Noorzai, a notorious drug lord and member of the Taliban who told reporters in Kabul on Monday that he had spent 17 years and six months in U.S. captivity before being released.

The exchange is one of the most significant prisoner swaps to take place under the Biden administration, coming five months after a separate deal with Russia that resulted in the release of Marine veteran Trevor Reed. It took place despite concerns from his family and other advocates that the U.S. military departure from Afghanistan, and the collapse of the government there, could make it harder to bring him home and could deflect attention away from his imprisonment.

President Joe Biden, who is in the United Kingdom to attend Queen Elizabeth II’s funeral, called Frerichs’s family Monday morning to share the “good news” that his administration was able to secure his release, according to a senior administration official.

The official, who was not authorized to comment publicly and spoke on the condition of anonymity, called the decision to grant Noorzai clemency a “difficult decision” but necessary to reunite a U.S. citizen with his family.

A sister of Frerichs, who is from Lombard, Illinois, thanked U.S. government officials who helped secure her brother's release.

“I am so happy to hear that my brother is safe and on his way home to us. Our family has prayed for this each day of the more than 31 months he has been a hostage. We never gave up hope that he would survive and come home safely to us," said a statement from the sister, Charlene Cakora.

In Afghanistan, Noorzai, who was arrested in 2005 on federal heroin trafficking charges in the U.S., told reporters at a press conference that he had been released from an unspecified U.S. prison and handed over earlier in the day to the Taliban in Kabul as part of the swap. Frerichs's family and U.S. officials subsequently confirmed that Frerichs was the American who was part of the deal.

Noorzai was sentenced in 2009 to life imprisonment after being convicted in federal court in Manhattan, with Justice Department prosecutors accusing him of owning opium fields in Kandahar province and relying on a network of distributors in New York who sold the heroin. At the time of his sentencing, the then-top federal prosecutor in Manhattan said Noorzai's worldwide narcotics network supported a Taliban regime that made Afghanistan a breeding ground for international terrorism."

Frerichs, 60, had been working on civil engineering projects at the time of his Jan. 31, 2020 abduction in Kabul. He was last seen in a video posted last spring by The New Yorker i n which he appeared in traditional Afghan clothing and pleaded for his release. The publication said it obtained the clip from an unidentified individual in Afghanistan.

Until Monday, U.S. officials across two presidential administrations had tried unsuccessfully to get him home. Even before their takeover of Afghanistan in August last year, the Taliban had demanded the U.S. release Noorzai in exchange for Frerichs. But there had been no public sign of Washington proceeding with any sort of trade or exchange along those lines.

Eric Lebson, a former U.S. government national security official who had been advising Frerichs' family, said in a statement that “everything about this case has been an uphill fight.” He criticized the Trump administration for having given away "our leverage to get Mark home quickly by signing a peace accord with the Taliban without ever having asked them to return Mark first.

“Mark’s family then had to navigate two Administrations, where many people viewed Mark’s safe return as an impediment to their plans for Afghanistan,” the statement said.

The collapse of the Western-backed Afghan government and takeover by the Taliban in August 2021, raised additional concern that any progress in negotiations could be undone or that Frerichs could be forgotten.

But his name surfaced last month when President Joe Biden, who had publicly called for Frerichs' release, was said by his advisers to have pressed officials to consider any risk posed to Frerichs by the drone strike in Afghanistan that killed al-Qaida leader Ayman al-Zawahri.

The Taliban-appointed foreign minister, Amir Khan Muttaqi, also spoke at the Kabul press conference alongside Noorzai and welcomed the exchange, saying it marked the start of a “new era" in U.S.-Taliban relations.

“This can be a new chapter between Afghanistan and the United States, this can open a new door for talks between both countries,” Muttaqi said.

“This act shows us that all problems can be solved through talks and I thank both sides' teams who worked so hard for this to happen,” he added.

The Taliban also posted a brief video Monday on social media showing Noorzai’s arrival at the Kabul airport where he was welcomed by top Taliban officials, including Muttaqi.

At the press conference, Noorzai expressed thankfulness at seeing his “mujahedeen brothers" — a reference to the Taliban — in Kabul.

“I pray for more success of the Taliban,” he added. “I hope this exchange can lead to peace between Afghanistan and America, because an American was released and I am also free now.”

___

Faiez reported from Islamabad. Associated Press writer Aamer Madhani in Washington contributed to this report.

___

This story has corrected a version earlier in the day that cited Taliban claims that Noorzai was held at Guantanamo Bay; the claim was disproved by U.S. officials.

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

John Bacon, USA TODAY

Mon, September 19, 2022 

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

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

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

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

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

First special typhoon warning

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

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

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

River Surges as Typhoon Nanmadol Hits Miyazaki

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

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

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

• 
  

  Drone footage shows collapsed bridge after Taiwan quake

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

Earthquake strikes Taiwan

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

STRONG EARTHQUAKE HITS TAIWAN: Rail service disrupted, house topples

Contributing: The Associated Press

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

Nikole Killion
Tue, September 13, 2022

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

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

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

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

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

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

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

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

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

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

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

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

RIGHT TO LIFE END DEATH PENALTY

Psychologist: School shooter suffered fetal alcohol damage




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

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

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

TERRY SPENCER
Mon, September 12, 2022 

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

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

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

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

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

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

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

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

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

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

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

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


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

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

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

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

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

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

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

”I did not,” Connor responded.

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

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

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

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

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

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

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

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

Jones said he was unaware of any of those searches.

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

Testimony is scheduled to resume Wednesday morning.

LA REVUE GAUCHE - Left Comment: Search results for FASD 

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

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

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

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

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

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

This story originally appeared in Los Angeles Times.

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

Grace Toohey
Tue, September 13, 2022 

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

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

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

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

This story originally appeared in Los Angeles Times.


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


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

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

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

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

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

This story originally appeared in Los Angeles Times.