New wave of infections threatens to collapse Japan hospitals

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In this Feb. 5, 2020, photo, an ambulance carrying a passenger onboard cruise ship Diamond Princess arrives at a hospital in Yokohama, near Tokyo. Hospitals in Japan are increasingly turning away sick people in ambulances as the country braces for a surge in coronavirus infections. The Japanese Association for Acute Medicine and the Japanese Society for Emergency Medicine say emergency medicine has already collapsed with many hospitals refusing to treat people including those suffering strokes, heart attacks and external injuries. (Kyodo News via AP)(Sadayuki Goto/Kyodo News via AP)

TOKYO (AP) — Hospitals in Japan are increasingly turning away sick people as the country struggles with surging coronavirus infections and its emergency medical system collapses.

In one recent case, an ambulance carrying a man with a fever and difficulty breathing was rejected by 80 hospitals and forced to search for hours for a hospital in downtown Tokyo that would treat him. Another feverish man finally reached a hospital after paramedics unsuccessfully contacted 40 clinics.

The Japanese Association for Acute Medicine and the Japanese Society for Emergency Medicine say many hospital emergency rooms are refusing to treat people including those suffering strokes, heart attacks and external injuries.

Japan initially seemed to have controlled the outbreak by going after clusters of infections in specific places, usually enclosed spaces such as clubs, gyms and meeting venues. But the spread of virus outpaced this approach and most new cases are untraceable.

The outbreak has highlighted underlying weaknesses in medical care in Japan, which has long been praised for its high quality insurance system and reasonable costs. Apart from a general unwillingness to embrace social distancing, experts fault government incompetence and a widespread shortage of the protective gear and equipment medical workers need to do their jobs.

Japan lacks enough hospital beds, medical workers or equipment. Forcing hospitalization of anyone with the virus, even those with mild symptoms, has left hospitals overcrowded and understaffed.

The “collapse of emergency medicine” has already happened, a precursor to the overall collapse of medicine, the Japanese Association for Acute Medicine and the Japanese Society for Emergency Medicine said in a joint statement. By turning away patients, hospitals are putting an excessive burden on the limited number of advanced and critical emergency centers, the groups said.

“We can no longer carry out normal emergency medicine,” said Takeshi Shimazu, an Osaka University emergency doctor.

There are not enough protective gowns, masks and face shields, raising risks of infection for medical workers and making treatment of COVID-19 patients increasingly difficult, said Yoshitake Yokokura, who heads the Japan Medical Association.

In March, there were 931 cases of ambulances getting rejected by more than five hospitals or driving around for 20 minutes or longer to reach an emergency room, up from 700 in March last year. In the first 11 days of April, that rose to 830, the Tokyo Fire Department said. Department official Hiroshi Tanoue said the number of cases surged largely because suspected coronavirus cases require isolation until test results arrive.

Infections in a number of hospitals have forced medical workers to self-isolate at home, worsening staff shortages.

Tokyo’s new cases started to spike in late March, the day after the Tokyo Olympics was postponed for a year. They’ve been rising at an accelerating pace for a current total of 2,595. Most patients are still hospitalized, pushing treatment capacity to its limits.

With about 10,000 cases and 170 deaths, Japan’s situation is not as dire as New York City’s which has had more than 10,000 deaths, or Italy’s, with more than 21,000 fatalities, according to Johns Hopkins University.

But there are fears Japan’s outbreak could become much worse.

Doctors say they are stretched thin. Since it takes time for COVID-19 to be diagnosed, patients who show up at hospitals can unintentionally endanger those around them. On Thursday, the medical workers’ union demanded the government pay them high-risk allowances and provide sufficient protective gear.

Medical workers are now reusing N95 masks and making their own face shields. The major city of Osaka has sought contributions of unused plastic raincoats for use as hazmat gowns. Abe has appealed to manufacturers to step up production of masks and gowns, ventilators and other supplies.

A government virus task force has warned that, in a worst-case scenario where no preventive measures were taken, more than 400,000 could die due to shortages of ventilators and other intensive care equipment.

Prime Minister Shinzo Abe has said the government has secured 15,000 ventilators and is getting support of Sony and Toyota Motor Corp. to produce more.

Japanese hospitals also lack ICUs, with only five per 100,000 people, compared to about 30 in Germany, 35 in the U.S. and 12 in Italy, said Osamu Nishida, head of the Japanese Society of Intensive Care Medicine.

Italy’s 10% mortality rate, compared to Germany’s 1%, is partly due to the shortage of ICU facilities, Nishida said. “Japan, with ICUs not even half of Italy’s, is expected to face a fatality overshoot very quickly,” he said.

Japan has been limiting testing for the coronavirus mainly because of rules requiring any patients to be hospitalized. Surging infections have prompted the Health Ministry to loosen those rules and move patients with milder symptoms to hotels to free up beds for those requiring more care.

Calls for social distancing have not worked well enough in crowded cities like Tokyo, experts say, with many people still commuting to offices in crowded trains even after the prime minister declared a state of emergency.

Officials fear people may travel during the upcoming “golden week” holiday in early May.

“From the medical field, we are hearing cries of desperation that lives that can be saved may no longer be possible,” Abe said Friday. “I ask you all again, please refrain from going out.”
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Follow Mari Yamaguchi on Twitter at https://https.twitter.com/mariyamaguchi and Yuri Kageyama at https://twitter.com/yurikageyama

With no school, calls drop but child abuse hasn’t amid virus

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FILE - In this April 10, 2020 file photo, Adams Elementary School third-grade teacher Lisel Corneil, left, and fifth-grade teacher Allie Campbell are among educators who constructed from plastic drinking cups a "We Miss You All-Stars" message to their students in a fence in Spokane, Wash. With schools closed and teachers unable to report suspected cases of abuse and neglect, child welfare agencies have lost some of their best eyes and ears during a highly stressful time for families who have lost jobs and are locked down together at home. April is Child Abuse Prevention Month, but across the country, states are reporting fewer calls to child abuse hotlines, worrying child welfare officials that abuse is going unreported during the coronavirus pandemic. (Dan Pelle/The Spokesman-Review via AP, File)

HELENA, Mont. (AP) — With schools closed and teachers unable to report suspected cases of abuse and neglect, child welfare agencies have lost some of their best eyes and ears during a stressful time for families who have lost jobs and are locked down together during the coronavirus pandemic.

April is Child Abuse Prevention Month, and across the country, states are reporting fewer calls to child abuse hotlines, not because officials believe there are fewer cases but because they’re going unreported.

“When there are large-scale job losses in communities, child maltreatment rates go up,” said Anna Gassman-Pines, a Duke University public policy professor whose expertise includes the effect of unemployment on children. “So we all need to be thinking about, during this time of stay-at-home orders and widespread economic strain, that those are the conditions under which families with preexisting vulnerabilities might be under — a lot of increased strain and stress.”

Calls to Washington state’s child abuse hotline are down about 50%, while Montana, Oklahoma and Louisiana are reporting about a 45% reduction since schools closed last month to slow the spread of the virus. Arizona’s calls are down a third compared with previous weeks, and Nevada has seen a 14% drop compared with March 2019.

“That means many children are suffering in silence,” said Darren DaRonco, spokesman for the Arizona Department of Child Safety.

Agencies are now asking others to fill in the reporting gaps that have emerged with school closures.

“Everyone, whether you’re a store clerk, a mailman, a neighbor or a relative, everyone has the responsibility of reporting child abuse,” said New Hampshire Gov. Chris Sununu, whose state has seen calls drop by half in recent weeks. “While calls have gone down, that doesn’t mean abuse has stopped.”

Ohio Gov. Mike DeWine recently echoed that sentiment, saying “we do not have enough eyes on these children” and asking “everyone else to try to be more vigilant.”

Moira O’Neill, director of New Hampshire’s Office of the Child Advocate, said people being stuck at home and losing their routines likely has increased stresses that contribute to child abuse, such as economic insecurity and limited access to medical and mental health care.

Calls are increasing to domestic violence hotlines, an indication that some children may be trapped in unsafe homes, said Jill Cook, assistant director of the American School Counselor Association in Virginia.

“My concern is children for whom school was a safe space are now perhaps in environments where they really don’t have a lot of leverage to move or go outside or leave — that they’re in unsafe environments,” Cook said.

The organization is encouraging school counselors to make sure school websites list community and national crisis hotlines.

In New Mexico, the Children, Youth and Families Department said it “is increasing communication with domestic violence shelters, youth shelters, hospitals, police, the Department of Health and other partners involved in keeping children safe.”

The decrease in calls is more than the typical drop seen during the summer break, when agencies still receive reports from day care providers or other community members who interact with children.

Now, “not only are they out of school, but they are isolated from everybody else,” said Nikki Grossberg, deputy administrator of Montana’s Child and Family Services Division.

States are encouraging people to reach out to their extended families or others in their community if they are facing challenges that put children at higher risk of abuse and neglect, said Marti Vining, the Montana agency’s administrator.

Vining said families that are overwhelmed can call state hotlines to get referred for help with public assistance, possible child care and a plan to help them deal with stress.

“The message that we want to get out is that the challenges that our families face, they’re not going to stop just because there’s a pandemic,” Vining said. “It’s just really important that we all step up and do what we can to help support families that are maybe facing challenges.”

FILE - In this March 4, 2020 file photo, Wanda Ahasteen stops by a memorial for a 6-year-old boy in Flagstaff, Ariz. With schools closed and teachers unable to report suspected cases of abuse and neglect, child welfare agencies have lost some of their best eyes and ears during a highly stressful time for families who have lost jobs and are locked down together at home. April is Child Abuse Prevention Month, but across the country, states are reporting fewer calls to child abuse hotlines, worrying child welfare officials that abuse is going unreported during the coronavirus pandemic. (Jake Bacon/Arizona Daily Sun via AP, File)
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Associated Press reporters Holly Ramer in Concord, New Hampshire; Andrew Welsh-Huggins in Columbus, Ohio; Susan Montoya Bryan in Albuquerque, New Mexico; Bob Christie in Phoenix and Michelle Price in Las Vegas contributed to this story

10 years after BP spill: Oil drilled deeper; rules relaxed

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FILE - This April 21, 2010 file photo shows oil in the Gulf of Mexico, more than 50 miles southeast of Venice on Louisiana's tip, as the Deepwater Horizon oil rig burns. Ten years after an oil rig explosion killed 11 workers and unleashed an environmental nightmare in the Gulf of Mexico, companies are drilling into deeper and deeper waters where the payoffs can be huge but the risks are greater than ever. (AP Photo/Gerald Herbert, File)


NEW ORLEANS (AP) — Ten years after an oil rig explosion killed 11 workers and unleashed an environmental nightmare in the Gulf of Mexico, companies are drilling into deeper and deeper waters, where the payoffs can be huge but the risks are greater than ever.

Industry leaders and government officials say they’re determined to prevent a repeat of BP’s Deepwater Horizon disaster. It spilled 134 million gallons of oil that fouled beaches from Louisiana to Florida, killed hundreds of thousands of marine animals and devastated the region’s tourist economy.

Yet safety rules adopted in the spill’s aftermath have been eased as part of President Donald Trump’s drive to boost U.S. oil production. And government data reviewed by The Associated Press shows the number of safety inspection visits has declined in recent years, although officials say checks of electronic records, safety systems and individual oil rig components have increased.

Today companies are increasingly reliant on production from deeper and inherently more dangerous oil reserves, where drill crews can grapple with ultra-high pressures and oil temperatures that can top 350 degrees (177 degrees Celsius).

Despite almost $2 billion in spending by the industry on equipment to respond to an oil well blowout like BP’s, some scientists, former government officials and environmentalists say safety practices appear to be eroding. And there are worries that cleanup tactics have changed little in decades and are likely to prove as ineffective as they were in 2010.

In this June 3, 2010 file photo, a Brown Pelican is mired in oil from the Deepwater Horizon oil spill, on the beach at East Grand Terre Island along the Louisiana coast.(AP Photo/Charlie Riedel, File)

“I’m concerned that in the industry, the lessons aren’t fully learned — that we’re tending to backslide,” said Donald Boesch, a marine science professor at the University of Maryland who was on a federal commission that determined the BP blowout was preventable.

Regulators and industry leaders say they’ve employed lessons from the April 20, 2010, disaster to make deep-water drilling safer by setting tougher construction and enforcement standards.

“I think the event 10 years ago really initiated kind of a new day in offshore safety,” said Debra Phillips, of the American Petroleum Institute, a standards-setting trade association.

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Companies have a financial interest in preventing a repeat of the 2010 disaster, which cost BP more than $69 billion in cleanup, fines, fees and settlements. Questions over environmental effects linger, and litigation continues over health problems suffered by cleanup workers.


Competing oil giants joined in the disaster’s wake to create the Marine Well Containment Co., which has equipment and vessels positioned regionwide to quickly corral oil if another major spill occurs.

“All of (the) industry wanted to make sure that nothing like it could ever happen again,” said CEO David Nickerson, at the company’s complex near Corpus Christi on Texas’ coast.

He was dwarfed by “capping stacks”″ — multistory structures of piping, valves and gauges designed to be lowered to halt a major high-pressure blowout.

The hope is that such equipment won’t be needed. Yet the Trump administration has relaxed rules adopted in 2016, including the frequency of drilling rig safety tests. That’s projected to save energy companies roughly $1.7 billion in compliance costs over a decade.

An AP review found the number of safety inspection visits by the U.S. Bureau of Safety and Environmental Enforcement — created after the spill — went down more than 20% over the past six years in the Gulf.

Industry advocates say inspection figures reflect greater emphasis on complex systems that influence safety rather than minor technical matters, and note there are fewer, if bigger, active oil platforms. They say the administration’s rule changes allow companies to deviate from “one-size-fits-all” standards not always suited to water pressure and other conditions at individual wells.

“Sometimes, when the regulations are quite prescriptive, it can actually inadvertently deteriorate safety,” said Phillips, of the American Petroleum Institute.

In this July 13, 2017, released by the U.S. Bureau of Safety and Environmental Enforcement, An oil industry facility in the Gulf of Mexico is seen. (U.S. Bureau of Safety and Environmental Enforcement via AP)

Environmentalists and critics say the changes appear to be eroding safety practices adopted after the spill.

“The industry itself is in the lead in trying to reduce its risk and protect its workers,” said Bob Deans of the National Resources Defense Council, one of several environmental groups suing over Trump administration changes. “The problem comes when you’re behind schedule, over budget and pressure comes from on top to get the job done and move on to the next project. That was the problem on Deepwater Horizon.″

The federal commission that studied the accident and the federal judge who oversaw myriad lawsuits put the blame on BP for poor management. In a key court ruling, U.S. District Judge Carl Barbier said “profit-driven decisions” on the rig were made in “conscious disregard of known risks.”

Debate over the strength of regulation and industry safety consciousness goes on as wells close to shore run dry and companies drill in deeper waters farther offshore.

The average depth of deep water drilling steadily increased, from about 3,500 feet (1,070 meters) beneath the surface in 1999 to more than 4,600 feet (1,400 meters) in 2019, according to an AP analysis of data from the U.S. Interior Department’s Bureau of Ocean Energy Management.

That’s an increase of about 32%.

Drilling deeper makes well sites harder to reach in a blowout or other accident.

FILE - This April 21, 2010 file photo shows the Deepwater Horizon oil rig burning after an explosion in the Gulf of Mexico, off the southeast tip of Louisiana. Ten years after an oil rig explosion killed 11 workers and unleashed an environmental nightmare in the Gulf of Mexico, companies are drilling into deeper and deeper waters where the payoffs can be huge but the risks are greater than ever. (AP Photo/Gerald Herbert, File)

In the past year, the industry began producing crude for the first time from ultra-high pressure crude reserves in the Gulf. Overall production hit a record 2 million barrels a day before the coronavirus pandemic caused demand to plummet.

Pressures in those wells can approach 20,000 pounds per square inch, compared with almost 12,000 pounds for Deepwater Horizon.

“Higher risk, higher pressure, higher temperatures, more reliance on technology — it’s just a tougher environment to operate in,” said Lois Epstein, a civil engineer at the Wilderness Society who served on a government advisory committee post-spill.

Trump administration changes have intensified debate over how tightly the government should regulate, and what decisions should be left to industry professionals.

Much of the discussion centers on rules intended to keep wells under control, such as requirements for blowout preventers that failed in the spill.

The 2016 rule required companies to test the blowout preventers every 14 days. The Trump administration allows companies to test every 21 days, saying more frequent testing would risk equipment failure.

As deep-water activity has expanded, the number of inspections carried out by the government’s safety bureau has declined.

Inspections fell from 4,712 in 2013 to 3,717 in 2019, according to government data reviewed by AP.

Bureau spokesman Sandy Day said the inspection figures reflect visits by inspectors to rigs, platforms and other facilities. Day said the data doesn’t reflect electronic records reviewed remotely or the increased time spent at each facility and all inspection tasks performed. Those, he said, have increased from 9,287 in 2017 to 12,489 last year. The agency didn’t provide a breakdown.

“While on the facility we did numerous inspections of different items,” Day said, including equipment for preventing blowouts, fires, spills, or other major accidents. He said electronic records allow more work to be done from shore, rather than digging through paperwork on site.

The number of warnings and citations issued to companies for safety or environmental violations peaked in 2012 and has since fallen even faster than inspections. The decline accelerated under the current administration, agency documents show.

Fewer inspection visits and fewer citations suggests the safety improvements that took hold after the 2010 spill are unraveling, said Matt Lee-Ashley, former deputy chief of staff at the Interior Department.

“There is a value in having inspectors on board frequently. You have to establish a culture of enforcement,” said Lee-Ashley, now with the Center for American Progress, a left-leaning advocacy group.


Industry representatives maintain that inspection numbers don’t automatically translate to less effective oversight. Inspectors are less interested than in the past in technical violations and are focused on making sure comprehensive safety systems are in place to prevent major accidents, said Erik Milito, of industry trade group the National Ocean Industries Association.

“If you think about going out with a checklist and see if there are enough eyewash bottles, everybody has steel-toed shoes — you can do that, and bounce around from facility to facility,” he said. “But there’s got to be an emphasis on your more significant potential incidents, potential blowouts.”

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At the center of the debate is the agency formed to enforce offshore safety after Deepwater Horizon, the Bureau of Safety and Environmental Enforcement, and its director under Trump, Scott Angelle.

Angelle, a former Louisiana official who was a paid board member for an oil logistics company, has faced criticism from Democratic lawmakers and environmentalists for pushing through the relaxed safety rules against agency staff advice.

During a hearing last month before the House Natural Resources Committee, Rep. Mike Levin, D-Calif., accused Angelle of trying to hide information that didn’t support the administration’s goal of loosening regulations for petroleum companies.

Angelle said initial staff recommendations to keep the two-week testing frequency for blowout preventers “were not ready and ripe.” His office later released an Argonne National Laboratory study that concluded relaxing the testing regimen would have cost benefits and could improve safety, since frequent equipment testing can cause wear and tear that results in accidents.

Michael Bromwich, the safety agency’s director under Obama, credited the industry for taking action after the spill to overhaul drilling. But as time passed, Bromwich said companies became complacent and are now overseen by a man he calls an industry booster.

“You need to have somebody who believes in the regulatory mission and who doesn’t view themselves and doesn’t view their agency as a cheerleader for the industry,” Bromwich said.

Requests over several weeks to interview Angelle were declined. Spokesman Day said the director wants to make the bureau a “do-it-all” agency that can protect safety and the environment while advancing Trump’s goal of U.S. “energy dominance” globally.

Even if companies are prepared for another Deepwater Horizon, they could be overwhelmed by other accidents, such as of one of the Gulf’s frequent underwater mudslides wiping out a cluster of wellheads on the seafloor, said Florida State University oceanographer Ian MacDonald.

That could trigger a blowout that would be harder to stop due to the damaged wellheads being possibly hundreds of feet deep in muddy debris, said MacDonald, who helped determine the magnitude of the 2010 spill.

In addition to having ships and barges standing by to capture oil that escapes from accidents, the industry has stockpiled chemical dispersants to break up oil and it can mobilize thousands of workers to clean up crude that reaches the shore.

But the heavy use of dispersants during Deepwater Horizon stirred controversy both over its effectiveness and biological effects. And scientists say the technology applied to shore cleanups remains as rudimentary as it was 10 years ago.

Crews relied heavily on hand tools such as shovels and absorbent paper towels sometimes called “oil diapers.” Much of the crude was deemed unrecoverable and left to break down over time.

“It’s something you could have done 100 years ago,” said Louisiana State University engineering professor John Pardue. “We’re still moving oil around with minimum wage workers with their hands.”

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Brown reported from Billings, Montana. Janet McConnaughey contributed to this story from New Orleans.

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Follow Kevin McGill on Twitter: @mcgill56 and Matthew Brown on Twitter: @matthewbrownap

White House moves to weaken EPA rule on toxic compounds

FILE - In this June 17, 2019, file photo in Washington, a label states that these pans do not contain PFAS, perfluoroalkyl and polyfluoroalkyl substances. The White House has intervened to weaken one of the few public health protections pursued by its own administration. Documents released Friday, April 17, 2020, show the White House stepped in to limit the scope of a pending rule that would target imports of products tainted with PFAS, used in nonstick and stain-resistant frying pans, rugs, and countless other consumer products. (AP Photo/Ellen Knickmeyer, File)


WASHINGTON (AP) — The Trump White House has intervened to weaken one of the few public health protections pursued by its own administration, a rule to limit the use of a toxic industrial compound in consumer products, according to communications between the White House and Environmental Protection Agency.

The documents show that the White House Office of Management and Budget formally notified the EPA by email last July that it was stepping into the crafting of the rule on the compound, perfluoroalkyl and polyfluoroalkyl substances, used in nonstick and stain-resistant frying pans, rugs, and countless other consumer products.

The White House repeatedly pressed the agency to agree to a major loophole that could allow substantial imports of the PFAS-tainted products to continue, greatly weakening the proposed rule. EPA pushed back on the White House demand for the loophole, known as a “safe harbor” provision for industry.

Pushed again in January, the agency responded, “EPA opposes proposing a safe harbor provision, but is open to a neutrally-worded request for comment from the public” on the White House request.

The rule is one of the few concrete steps that the Trump administration has taken to deal with growing contamination by PFAS industrial compounds. The EPA has declared dating back to 2018 that consumer exposure to the substances was a “national priority” that the agency was confronting “aggressively.”

Delaware Sen. Tom Carper, the ranking Democrat on the Environment and Public Works Committee, who obtained the documents revealing the White House intervention, and public-health advocates say the White House action was led by Nancy Beck, a former chemical industry executive now detailed to President Donald Trump’s Council of Economic Advisers.

In a letter sent Friday to the EPA, Carper charged the White House pressure amounts to unusual intervention in what had been the EPA’s in-house efforts to regulate imports tainted with the compound. Trump has nominated Beck to lead the Consumer Product Safety Commission, a government panel charged with protecting Americans from harm by thousands of kinds of consumer goods.

Asked about the White House actions, EPA spokeswoman Corry Schiermeyer said in an email that “consulting with other federal agencies on actions is a normal process across government,” and that “EPA is often required to engage in an interagency review process led by OMB.”

“It is routine for the agency to receive input from all of our stakeholders, including our federal partners,” Schiermeyer wrote.

The EPA did not respond to a question about whether Beck led the White House intervention. Emails sent for comment to the White House, the White House Office of Management and Budget and Beck were not immediately answered.

Carper obtained pages of back-and-forth proposed changes, redline drafts and other communications between the White House Office of Management and Budget, the EPA and others on the draft rule. No authors are listed in many of the final rounds of White House edits, drafts and proposals and EPA’s responses.

Carper wrote to EPA Administrator Andrew Wheeler on Friday to object to the White House push for weakening of the rule, newly revealed in the documents. Carper said it appeared that Beck, who was moved to the White House from a top regulatory job at the Trump EPA, “sought to make it more difficult for EPA to use its authority ... to protect Americans from these harmful substances.”

While thousands of kinds of PFAS compounds are still in use in the United States, the new EPA rule would set up agency oversight of imports of products that use a few kinds of the compounds that manufacturers agreed to phase out in this country starting in 2006. Those versions remain in production in some parts of the world.

In addition to the safe harbor loophole, another change sought by the White House would raise the technical bar for EPA to consider blocking any of the tainted products.

The agency agreed to rewrite the rule to include a third White House request, narrowing the range of imported products that would fall under the rule.

The official public comment period for the current form of the rule ends Friday, moving the proposal close to crafting of its final form. Congress, impatient for the Trump administration to start bringing the PFAS compounds under federal regulation, has ordered the administration to get a final rule out by mid-summer.

Even if the rule goes out in its current form, applying to fewer kinds of product imports, “it would certainly be better than where we are without it,” although “scaled back significantly from what it was originally,” said Richard Denison, lead senior scientist at the Environmental Defense Fund advocacy group, and a longtime monitor of the EPA’s regulation of toxic substances.

But if the final rule includes the other two key changes being pushed by the White House “it could even do more damage than good,” Denison said.

Industries also would be likely to push for those two exceptions in regulations of future substances, Denison said. “Those two provisions would establish precedence that the EPA has never used for 40 years..”

Industries produce thousands of versions of the man-made compounds. They are used in countless products, including nonstick cookware, water-repellent sports gear, cosmetics, and grease-resistant food packaging, along with firefighting foams.

Public health studies on exposed populations have associated them with an array of health problems, including some cancers, and weakened immunity. The advent of widespread testing for the contaminant over the past few years found it in high levels in many public water systems around the country. The administration initially sought in 2018 to suppress a federal toxicology warning on the danger of the compounds, then publicly vowed action.

Racial toll of virus grows even starker as more data emerges

By KAT STAFFORD, MEGHAN HOYER and AARON MORRISON

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People wait for a distribution of masks and food from the Rev. Al Sharpton in the Harlem neighborhood of New York, after a new state mandate was issued requiring residents to wear face coverings in public due to COVID-19, Saturday, April 18, 2020. "Inner-city residents must follow this mandate to ensure public health and safety," said Sharpton. The latest Associated Press analysis of available data shows that nearly one-third of those who have died from the coronavirus are African American, even though blacks are only about 14% of the population. (AP Photo/Bebeto Matthews)

As a clearer picture emerges of COVID-19’s decidedly deadly toll on black Americans, leaders are demanding a reckoning of the systemic policies they say have made many African Americans far more vulnerable to the virus, including inequity in access to health care and economic opportunity.

A growing chorus of medical professionals, activists and political figures is pressuring the federal government to not just release comprehensive racial demographic data of the country’s coronavirus victims, but also to outline clear strategies to blunt the devastation on African Americans and other communities of color.

On Friday, the Centers for Disease Control and Prevention released its first breakdown of COVID-19 case data by race, showing that 30% of patients whose race was known were black. The federal data was missing racial information for 75% of all cases, however, and did not include any demographic breakdown of deaths.

The latest Associated Press analysis of available state and local data shows that nearly one-third of those who have died are African American, with black people representing about 14% of the population in the areas covered in the analysis.

Roughly half the states, representing less than a fifth of the nation’s COVID-19 deaths, have yet to release demographic data on fatalities. In states that have, about a quarter of the death records are missing racial details.





Health conditions that exist at higher rates in the black community -- obesity, diabetes and asthma -- make African Americans more susceptible to the virus. They also are more likely to be uninsured, and often report that medical professionals take their ailments less seriously when they seek treatment.

“It’s America’s unfinished business -- we’re free, but not equal,” civil rights leader Rev. Jesse Jackson told the AP. “There’s a reality check that has been brought by the coronavirus, that exposes the weakness and the opportunity.”


This week, Jackson’s Rainbow PUSH Coalition and the National Medical Association, a group representing African American physicians and patients, released a joint public health strategy calling for better COVID-19 testing and treatment data. The groups also urged officials to provide better protections for incarcerated populations and to recruit more African Americans to the medical field.

Jackson also expressed support for a national commission to study the black COVID-19 toll modeled after the Kerner Commission, which studied the root causes of race riots in African American communities in the 1960s and made policy recommendations to prevent future unrest.


Daniel Dawes, director of Morehouse College’s School of Medicine’s Satcher Health Leadership Institute, said America’s history of segregation and policies led to the racial health disparities that exist today.

“If we do not take an appreciation for the historical context and the political determinants, then we’re only merely going to nibble around the edges of the problem of inequities,” he said.

The release of demographic data for the country’s coronavirus victims remains a priority for many civil rights and public health advocates, who say the numbers are needed to address disparities in the national response to the pandemic.

The AP analysis, based on data through Thursday, found that of the more than 21,500 victims whose demographic data was known and disclosed by officials, more than 6,350 were black, a rate of nearly 30%. African Americans account for 14.2% of the 241 million people who live in the areas covered by the analysis, which encompasses 24 states and the cities of Washington D.C., Houston, Memphis, Pittsburgh and Philadelphia — places where statewide data was unavailable.

The nation had recorded more than 33,000 deaths as of Thursday.

In some areas, Native American communities also have been hit hard. In New Mexico, Native Americans account for nearly 37% of the state’s 1,484 cases and about 11% of the state’s population. Of the 112 deaths where race is known in Arizona, 30 were Native Americans.

After Democratic lawmakers introduced legislation this week to try to compel federal health officials to post daily data breaking down cases and deaths by race, ethnicity and other demographics, the CDC released only caseload data that — similar to the AP’s analysis of deaths —show 30% of 111,633 infected patients whose race is known were black. African American patients in the 45-to-64 and 65-to-74 age groups represented an even larger share of the national caseload.

The lawmakers sent a letter last month to Health and Human Services Secretary Alex Azar urging federal release of the demographic data. And Joe Biden, the former vice president and presumptive Democratic presidential nominee, also called for its release.

Meanwhile, some black leaders have described the Trump administration’s response to COVID-19 as inadequate, after what they said was a hastily organized call with Vice President Mike Pence and CDC Director Robert Redfield last week.

According to a recording of the call obtained by the AP, Redfield said the CDC has been collecting demographic data from death certificates but that the comprehensiveness of the data depends on state and local health departments, many of which are overburdened by virus response. No plan was offered to help health officials in hard-hit communities collect the data, leaders who were on the call said.

Kristen Clarke, president of the Lawyers’ Committee for Civil Rights Under Law, which took part in the call, said African Americans “have every reason to be alarmed at the administration’s anemic response to the disproportionate impact that this crisis is having on communities of color.”

Mistrust runs deep among residents in many communities.

St. Louis resident Randy Barnes is grappling not just with the emotional toll of losing his brother to the coronavirus, but also with the feeling that his brother’s case was not taken seriously.

Barnes said the hospital where his brother sought treatment initially sent him home without testing him and suggested he self-quarantine for 14 days. Five days later, his brother was back in the hospital, where he was placed on a ventilator for two weeks. He died April 13. Barnes’ brother and his wife also were caring for an 88-year-old man in the same apartment, who died from the virus around the same time.

“Those people are not being tested. They’re not being cared for,” Barnes said.

Eugene Rush lives in one of the areas outside large urban cities that have been hit hard with coronavirus cases. He is a sergeant for the sheriff’s department in Michigan’s Washtenaw County, west of Detroit, where black residents account for 46% of the COVID-19 cases but represent only 12% of the county’s population.

Rush, whose job includes community engagement, was diagnosed with COVID-19 near the end of March after what he initially thought was just a sinus infection. He had to be hospitalized twice, but is now on the mend at home, along with his 16-year-old son, who also was diagnosed with COVID-19.

“I had a former lieutenant for the city of Ypsilanti who passed while I was in the hospital and I had some fraternity brothers who caught the virus and were sick at the hospital,” Rush said. “At that point, I said, ‘Well, this is really, really affecting a lot of people’ and they were mostly African American. That’s how I knew that it was really taking a toll a little bit deeper in the African American community than I realized.”

___

Stafford and Morrison are members of the AP’s Race and Ethnicity team. Stafford reported from Detroit, Morrison from New York and Hoyer from Washington. Associated Press writers Noreen Nasir in Chicago, Claudia Lauer in Philadelphia, Regina Garcia Cano in Washington, Chris Grygiel in Seattle and Kimberlee Kruesi in Nashville, Tennessee, contributed.

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Study: Ritual human sacrifice maintained social stratification

THE EARLIEST PROFESSION WAS THE SHAMAN, DRUID, WHICH BECAME THE PRIESTHOOD
"Human sacrifice provided a particularly effective means of social control," said researcher Russell Gray.

Ritual sacrifice helped maintain social order in early Austronesian societies. Photo by tlorna/Shutterstock

AUCKLAND, New Zealand, April 5 (UPI) -- New research suggests a strong link between ritual human sacrifice and social hierarchy.

Researchers from the University of Auckland confirmed the correlation while analyzing the traditional cultures of Austronesia -- a region encompassing dozens of islands, including those of Micronesia, Melanesia and Polynesia.

The scientists used prior ethnographic research to plot the changes in social stratification and the use of ritual sacrifice. Cultures that featured human sacrifice were more likely to be strongly stratified. More egalitarian cultures were less likely to use sacrifice.

Their analysis also showed the two cultural phenomena co-evolved. Ritual sacrifice ensured that socially stratified cultures would remain so.

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Though methods of sacrifice varied across Austronesia cultures -- burning, drowning, strangulation, bludgeoning, live burial, decapitation -- the victims and perpetrators were largely the same. Those killed were typically of low social status, often slaves. The perpetrators were mostly of high stature, chiefs or priests.

"By using human sacrifice to punish taboo violations, demoralize the underclass and instill fear of social elites, power elites were able to maintain and build social control," researcher Joseph Watts, a professor at the University of Auckland's School of Psychology, explained in a news release.

Watts is the lead author of new paper on the findings, published this week in the journal Nature.

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"Human sacrifice provided a particularly effective means of social control because it provided a supernatural justification for punishment," added co-author Russell Gray. "Rulers, such as priests and chiefs, were often believed to be descended from gods and ritual human sacrifice was the ultimate demonstration of their power."

Computer models helped Watts, Gray and their colleagues decipher the order of evolutionary changes and determine that changes in ritual sacrifice preceded social change -- not the other way around.

"What we found was that sacrifice was the driving force, making societies more likely to adopt high social status and less likely to revert to egalitarian social structure," said co-author Quentin Atkinson.

Toxic mineral selenium to blame for spinal deformities in California Delta fish

Scientists found selenium exposure was responsible for spinal deformities in juvenile Sacramento splittail, fish native to the California Delta. Photo by Fred Feyrer / U.S. Geological Survey

Feb. 24 (UPI) -- Exposure to elevated levels of the toxic mineral selenium caused fish native to the Sacramento-San Joaquin Delta, sometimes called the California Delta, to develop spinal deformities.

In 2011, biologists collected hundreds of minnows, juvenile forms of the Sacramento splittail, from the California Delta. Of the approximately 1,000 specimens studied, 80 percent had deformed spines.

"This was not just a few fish, it was the majority of them," Fred Feyrer, fish biologist at the U.S. Geological Survey's California Water Science Center, said in a news release.

Feyrer is co-author of a new study, published Monday in the journal Environmental Science and Technology, detailing the dangers of selenium exposure for fish in the Sacramento-San Joaquin Delta.

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To pinpoint where the fish were exposed to the toxins responsible for their deformities, scientists exposed test fish to selenium in the lab and developed methods for measuring the chemical signatures trapped in layers of the minnows' ear bones, or otoliths.

"We found that the otoliths record a diary of selenium exposure from birth to death, and were the key to unraveling this mystery," said lead study author Rachel C. Johnson, a research biologist at NOAA Fisheries' Southwest Fisheries Science Center and the University of California Davis.

Using the methods they perfected in the lab, scientists used high-intensity X-rays at Cornell University's Cornell High Energy Synchrotron Source to measure selenium concentrations in the otoliths of the juvenile fish originally collected from the California Delta.

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The results showed the fish were exposed to selenium from their mothers and while feeding in the San Joaquin River.

"They got it from both directions," Johnson said.

Another study, published late last year in the journal Science of the Total Environment, showed adult splittail were exposed to elevated levels of selenium while feeding in the San Francisco Estuary. Scientists suspect the fish are exposed to the naturally occurring toxin while eating Asian clams. The filter feeding clams, which concentrate selenium from the river water, are a favorite food source of the splittail.

When the clam-eating splittails lay eggs, the selenium gets passed on to the next generation, leading to spinal deformities.

Researchers also previously found evidence that birds exposed to selenium concentrated in agricultural runoff suffered deformities in the 1980s.

Scientists still aren't sure of the causes of the elevated selenium levels in the Sacramento-San Joaquin Delta. The element is essential to life, but it is toxic at high concentrations. Though selenium is naturally occurring, it can also be leached from coal ash and crude oil processing, as well as mining and metal smelting.

Finding living evidence of selenium exposure is rare, as most fish exposed to the toxin quickly perish or get eaten by a predator. It's possible scientists have missed the signs of previous episodes of selenium exposure.

"Was this a one-time event?" said co-author Robin Stewart, a research hydrologist at the U.S. Geological Survey. "What we don't know is how frequently this could be happening, because no one is out there looking for these fish before they disappear."

Sweet potatoes came to Polynesia before humans did, study suggests
Scientists studied Polynesian sweet potatoes collected by Captain Cook in 1769.

Rows of sweet potatoes are pictured growing in Peru. Photo by Oxford University

April 13 (UPI) -- The sweet potato made its way to Polynesia without human assistance, new research suggests, colonizing the islands prior to the arrival of the first humans.

When European explorers first visited Polynesia, they found an abundance of sweet potatoes, a root vegetable native to the Americas. Researchers led by a team at Britain's University of Oxford have interpreted their discovery as proof of early contact between Polynesians and Americans prior to the arrival of European explorers and colonists.

New genomic evidence, however, undermines such an interpretation. Analysis of the remains of Polynesian sweet potatoes collected by Captain Cook in 1769 showed the vegetables were of a variety that colonized before the arrival of the earliest Polynesia peoples.

Researchers sequenced the genomes of several varieties of sweet potatoes, both planted and wild varieties, using historic and modern samples. Their analysis, published this week in the journal Current Biology, linked the historic wild varieties with the cultivated crop.

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The research suggests that wild sweet potatoes came to Polynesia through natural means. It's possible the seeds were carried to the islands by migrating birds. Scientists also determined that several other species of morning glories closely related to wild sweet potatoes colonized Polynesia during pre-human times.

"The sweet potato's early presence in Polynesia has been widely interpreted as strong evidence for human contact between Polynesia and America in the Pre-Columbian era," Pablo Muñoz-Rodríguez, a researcher at Oxford, said in a news release. "However, our finding is that the plant probably reached the Pacific Islands through natural dispersal by birds, wind or sea currents in pre-human times, as did several other species of morning glory."

Survey shows pollution in Gulf 10 years after Deepwater Horizon spill

Researcher Erin Pulster, marine scientist at the University of South Florida, is pictured identifying fish specimens alongside research partners from the National Autonomous University of Mexico. Photo by USF

April 15 (UPI) -- For the first time, scientists have a conducted a Gulf-wide survey of oil pollution among fish populations.

The massive study -- comprising samples from 2,500 fish representing 91 species spread across 359 locations in the Gulf of Mexico -- suggests contamination from oil pollution remains widespread roughly 10 years after the Deepwater Horizon spill.

Researchers published the results of the record survey on Wednesday in the journal Scientific Reports.

"This is the largest comprehensive fish survey ever conducted in a large marine ecosystem and provides the first spatial and temporal baselines for polycyclic aromatic hydrocarbon in fishes in the Gulf of Mexico," study author Erin L. Pulster, marine scientist and postdoctoral researcher at the University of South Florida, told UPI in an email.

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Polycyclic aromatic hydrocarbons, or PAHs, are one of the most toxic chemical components found in crude oil. The toxins, which have been linked to heart disease and cancers in humans, get trapped in the bile of fish.

"This study demonstrates the chronic and widespread oil pollution in this ecosystem," Pulster said. "Given the extensive oil and gas extraction activities in the Gulf of Mexico for the last eight decades, it is unclear why this has not been conducted prior to the Deepwater Horizon oil spill."

The new survey revealed elevated levels of PAH in every surveyed fish species living in the Gulf, but the highest levels were found in yellowfin tuna, golden tilefish and red drum.

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Elevated levels were expected in tilefish, which spend most of their lives stirring up seafloor sediment, where oil pollution settles. But researchers were surprised to find such elevated PAH levels in tuna, which live their lives in the water column, where oil pollution tends to persist for only short amounts of time.

As part their research, scientists also mined data from previous PAH exposure surveys. The research team found evidence of elevated PAH levels in the tissue and bile of 10 popular grouper species.

"The elevated and increasing PAH levels in fish is the result of a combination of sources which include both anthropogenic and natural sources," Pulster said. "Anthropogenic sources include the Deepwater Horizon oil spill, leaking infrastructure, riverine discharge, marine vessel traffic and the resuspension of contaminated sediments. Natural sources are mainly natural oil seeps and submarine groundwater discharge located throughout the Gulf of Mexico."

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Not all fish populations show the same levels of contamination. Scientists measure higher concentrations of the toxins near places with greater oil and gas activity. Researchers also found PAH hotspots among fish populations near coastal cities like Tampa Bay, which suggests urban runoff can exacerbate oil pollution problems.

"The continued degradation of the Gulf of Mexico ecosystem is demonstrated by the chronic, widespread oil pollution," Pulster said.

Despite the alarming results, scientists suggest the evidence of PAH contamination is more concerning for the health of Gulf ecosystems and fish populations than the health and safety of consumers of Gulf seafood. Toxin levels in the flesh of commercial fish species are closely monitored and PAH levels in fish flesh remain below public health advisory levels.

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However, prolonged exposure to elevated PAH and other oil-related toxins can cause the liver to shutdown, threatening the health of fish in the Gulf. Previous studies have revealed 50 to 80 percent population declines in deep water, or mesopelagic, fish populations near the Deepwater Horizon blowout site.

Researchers hope their baseline study of PAH contamination among Gulf fish is only the beginning of a more robust monitoring effort.

"Providing funding is available, our research efforts will continue to monitor and evaluate PAH levels in fish and the subsequent sub lethal effects," Pulster said. "Additionally, a major research focus will be geared toward identifying the sources of PAHs in surface waters that are impacting pelagic [openwater] species."

Genomics help scientists estimate the population size of the first Samoans


The earliest population of Samoans measured between 700 and 3,000 individuals, according to a new study. Photo by Charles S. Greene/Talofa, Samoa: A Summer Sail to an Enchanted Isle/Wikimedia Commons
April 15 (UPI) -- New genomic analysis has allowed scientists to estimate the population size of the first Samoans to arrive on the Pacific island some 3,000 years ago.

From approximately 3,000 to 1,000 years ago, between 700 and 3,400 people lived on the island of Samoa. Roughly 1,000 years ago, the island's population exploded from a few thousand to 10,000 individuals.

By analyzing the genomes of 1,197 individuals living in Samoa, scientists were able to gain new insights into one of the last major migrations of humans into previously uninhabited territories.

The results of the genomic analysis -- published this week in the journal PNAS -- could also help researchers explore links between early human history in Samoa and the modern health problems, including obesity, hypertension and Type 2 diabetes, that currently plague the island nation.

"These findings are relevant for our ongoing public health research in Samoan populations because they highlight the importance of population history and size in influencing our ability to identify the effect of novel genetic variations, and their interactions with 21st century environments on population health," study co-author Stephen McGarvey, professor of epidemiology and of anthropology at Brown University, said in a news release.

The prevalence of obesity in Samoa has led to record rates of related problems, including diabetes, cardiovascular disease, kidney disease and cancer, according to McGarvey, who has been studying the island's health issues for many years.

"Smaller populations and the evolutionary mechanisms resulting from them, including genetic drift from bottlenecks and natural selection from novel challenging environments such as experienced by the first settlers of Samoa, make it easier to detect new gene variants and different frequencies of known variants that affect cardiometabolic disease risk factors now in the 21th century," McGarvey said.

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The latest genomic data showed modern Samoans get most of their genetic heritage from from Austronesian lineages. Samoans are the descendants of the aboriginal peoples of Taiwan, the islands of Southeast Asia, coastal New Guinea and other Oceanic islands.

The analysis also showed modern Samoans only derive 24 percent of their genome from the people of Papua New Guinea. Most other Polynesian groups share most larger portions of their ancestry with Papuans.

In addition to revealing the ancestry of modern Samoans, the latest data revealed evidence of the population decline that followed the arrival of the earliest European visitors. Hundreds of Samoans died from diseases brought by the first Europeans. Around 150 years ago, the island's population stabilized and began to grow once more.

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"These findings indicate that the modern Samoan population is a result of these demographic dynamics from the earliest times 3,000 years ago to the very recent colonial period in the 19th century," McGarvey said. "Any questions about putative genetic influences and their interactions with modern ways of life must be asked in the context of population history."
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