Brazil's alternative jails sans guns and violence

Brazil's APAC recovery centers focus on rehabilitation and understanding, instead of weapons and violence. An EU project hopes the idea will catch on around the world.



Sport is played in the courtyard of Colombia's Bellavista APAC: The EU finances the construction of APACs in Latin America


Marlon Samuel da Silva is wistful about his time behind bars, the daily routine, the community, the concerts he gave.

The 40-year-old spent 11 years and eight months in jail after being convicted on a drugs charge. He was only behind bars symbolically, as he spent most of his time in a special establishment where he could roam freely — with no guards or weapons. The Association for the Protection and Assistance of the Convicted (APAC), which promotes restorative justice, has set up 60 recovery centers, which currently house some 4,000 detainees.

Prisoners are not considered as criminals here. They are recuperandos, people who are in recovery, and are addressed by name. They do not wear uniforms and even help run the establishment, doing all the cooking, cleaning and washing. They do have to follow a strict routine but this is to help their rehabilitation into society.


Remembering the 'good old times' — ex-prisoner Marlon Samuel da Silva with his guitar at APAC Itauna

"It's strange to say it, but I miss the routine," said da Silva, who likes to play the guitar. "I had some wonderful times and I got around a lot." He would regularly give concerts in other APACs.

He not only misses the routine; he also misses the recognition and the feeling of self-esteem he had. "I felt valued," he recalled, explaining that this was very important for former drug addicts like him. "They can't deal with negative emotions. Positive input is very important for their recovery."

‘Even a dog wouldn't last'

Recognition and positive input are not usually part of daily life in Brazilian jails, which more often than not are associated with abuse, torture, riots and organized crime.


At APAC Piracicaba, inmates gather in a cell to pray together

Brazil has a prison population of about 760,000, which is the third-largest in the world after that of China and the US. According to the World Prison Brief, the occupancy level is 151%, compared with 121% in Colombia.

Marlon da Silva has not recovered from his experiences of the "normal system."

"I spent a year there and I suffered terribly," he said. "There are sometimes more than 30 people in a cell meant for nine. Even a dog wouldn't last."

In the APAC centers, there is no over-crowding and the recidivism rate is 15% by comparison to 85% in the mainstream establishments. The waiting lists for APAC are very long. Yet, the costs are lower. It costs the equivalent of €250 ($302) to detain somebody in an APAC for a month, as opposed to €644 in other institutions. The APACs are cheaper because there is no need to pay armed guards.


Humiliation and violence: Following a 2017 riot at Brazil's Alcacuz prison, inmates were forced to stand naked in front of heavily armed police officers

"There are no armed guards or police officers in any of the 60 APACs," said Denio Marx Menezes from the Fraternity of Assistance to the Convicted (FBAC), which runs the alternative APAC detention centers, which were set up by Catholic lawyer Mario Ottoboni in the 1970s after he became convinced that it was impossible to rehabilitate detainees in Brazil's mainstream penitentiary system. He championed the maxim: "People enter here, crimes stay outside" and opened the first APAC in Sao Jose dos Campos in 1976 in the state of Sao Paolo.

EU project to expand APACs across world

From the start, the centers were non-profits and often funded by donations. But in 2020, they were recognized by the Brazilian state and started receiving financial support. They have mushroomed around the country. "We are working with the Brazilian ministry of justice on a plan that eventually envisages a pilot unit in each Brazilian state," Denio Marx Menezes said, explaining that there were currently APACs in six of the country's 27 states and districts but that there were openings in 14 more coming up.


At APAC in the Brazilian city of Piracicaba, inmates play sports in the courtyard

Menezes is surprised by the rapid development: "When President Bolsonaro came in with a speech saying that prisoners should suffer and deserved death, we thought that a bad time was coming," he said. But not all government members agreed with this hardline, "former justice minister Sergio Moro was the first to visit an APAC center."

The APACs have also found support from the EU. In 2016, a European project looked into transposing the idea to other countries in South America as an instrument for strengthening civil society and promoting the rights of detainees. "The initiative should fight torture and all forms of abuse and promote APACs as a model that could serve worldwide as an alternative for the chaotic traditional penitentiary system."

The EU's main partner is AVSI, a Brazilian non-profit organization, while responsibility for implementing the scheme lies with the FBAC as well as the justice ministries of Brazil, Chile, Costa Rica and Columbia.

‘For every rehabilitated prisoner, there is 1 less gun'

Some critics have questioned the religious element, but FBAC's Menezes played this down. "APACs are not religious institutions," he explained. "However, they do not renounce their religious roots." In practice, not only are prisoners given the same religious support provided by the law to all detainees in the country, but there are also Bible interpretation classes and prayer groups, as well as courses offered by the UK-based non-profit organization Prison Fellowship.

Marlon Samuel da Silva became religious in jail. "I was led to God through a detour in crime," he told DW. "In the APAC, I saw a man convicted for murder care for somebody who was ill. That's God."


The APAC motto: 'People enter here, crimes stay outside'

Ever since his release in 2016, he has looked back on his experiences with longing. It's not easy "outside," he says. Former convicts and their families are not treated with understanding by society, he lamented, saying that some customers had stopped going to have their hair cut in his mother's salon.

"Society always thinks that prisoners should suffer because they deserve it," he said. "But they forget that for every rehabilitated prisoner there is one less gun on t

 

Pakistan: Talk show on taboo topics rattles conservatives

The digital talk show, Conversations with Kanwal, is shedding light on issues rarely spoken in public such as sex, marital rape and forced marriages. The show's host Kanwal Ahmed tells DW about her daring journey.

Pakistan: Talk show on taboo topics rattles conservatives | Asia| An in-depth look at news from across the continent | DW | 23.04.2021

Meet Akanksha Arora — the 34-year-old running for UN secretary-general

The Indian Canadian Akanksha Arora wants to become the first woman — and the first millennial — to lead the United Nations. She tells DW that it's time to shake things up

Meet Akanksha Arora — the 34-year-old running for UN secretary-general | Asia| An in-depth look at news from across the continent | DW | 21.04.2021

YOU CANNOT DOG EAR AN E-BOOK
Celebrating the history of the 'dog ear' bookmark on World Book Day
FRIDAY WAS WORLD BOOK DAY

The practice of folding the corners of one's book to mark a page has a name — and has been done for centuries.

A PRACTISE I CAN LAY CLAIM TOO DOING TOO OFTEN



This type of fold is known as a dog ear


Even as e-reading devices have gained popularity in recent years, many bookworms still prefer reading a good, old-fashioned printed book. April 23 is World Book Day and studies have shown that people are reading more than ever during the pandemic. Those who prefer to buy second-hand books may have come across private sellers' creative advertisements of the item's condition. "With a few dog ears here and a couple of torn pages, but otherwise in impeccable condition" one might read in a seller's description.

A dog ear is a colloquial term for the folded down corner of a book page — the way some of us, when we don't have a bookmark at hand might keep our place. The name, as one might guess comes from the folded page's resemblance to the floppy ears of most domestic dog breeds.

Irma Pince, the librarian at Hogwarts School of Witchcraft and Wizardry in the Harry Potter novels, posted an ominous warning to book defilers. "A warning if you rip, tear, shred, bend, fold, deface, disfigure, smear, smudge, throw, drop, or in any other manner damage, mistreat, or show lack of respect towards this book, the consequences will be as awful as it is within my power to make them."


Easy to see why this type of bookmark is called a dog ear

In reality, a torn page won't result in wizardly punishment, but it can come with consequences. At public libraries, book lenders who tear or rip a page, even accidentally, may be responsible for property damage and might have to provide a replacement or pay some form of compensation.

In private circles, books borrowed and returned in a damaged condition can jeopardize the continuation of friendships. Books have value, and for some, it's an emotional one.
Irreparable damage?

Unfortunately, even a smoothed out dog-ear leaves its mark on a book page for all of eternity. Are dog-ears irreparable? "In a nutshell: yes!" says Frauke Grenz from Papierwerkstatt Friedrichshagen, which restores and repairs books. "The crease injures the fibers of the paper, which unfortunately cannot be repaired."

Grenz and her team restore books, smoothing and binding pages and repairing spines. In addition to private individuals, the workshop also collaborates with libraries. They can therefore be required to restore, for example, a Bible from 1737. "With books that old, dust and dryness are aggravating factors." A dog-eared book can break when bent back if the paper is rotten, the expert told DW.


The librarian of Harry Potter's Hogwarts dealt swift punishment for damaging books

Her customers often come to the workshop with books that at first glance are not worth the trouble of refurbishing. She then initially recommends buying the book second-hand somewhere. "But if there's a dedication inside or it was left by someone's mother, the emotional attachment to the book is often so great that we get to work."

Fortunately, there are some tricks for those who want to smooth out their books' dog ears. "Ironing is a great idea if done carefully and with some blotting paper in between to dissipate the heat," recommends Grenz. However, no matter what one does, dog ear traces will not disappear completely. Grenz doesn't find this problematic: "It doesn't detract from the content. It's more important to me that the binding feels good in the hand and is not worn."
Dog ears in the 17th century

It's impossible to clearly date the first mention of a dog ear as it refers to a bent page in the history of literature. In 1838, the Grimm brothers began to compile terms for the German dictionary published in 1854, which included a mention of the "Eselsohr" or "donkey's ear," which is the German equivalent of the dog ear, as "a mark in a read book made by bending a corner of the page."

And as early as the 17th century, the poet Andreas Gryphius mentioned a dog ear in one of his writings. Although Johannes Gutenberg's letterpress printing technique was already widespread by the 15th century, in the 17th century, many people still could not afford to buy books. Reading meant getting an education and in those days, an education was a luxury. Even then, some well-off individuals apparently still bent the corners of their precious pages.


The dog ear was mentioned as early as the 17th century although few had books then

Not even digitization has fully eradicated the dog ear concept. As a tribute to analog reading, some e-book readers have digital dog-ears built into them. With a tap on the screen, a triangular bookmark appears at the corner of the screen.

That a bookish term presumably coined in the 17th century in Germany is still used today is something to celebrate. As difficult as it may be for book lovers and book aesthetes to accept bent page corners, the dog ear must respected as a part of centuries of reading culture.

This article was translated from German by Sarah Hucal.

'IT'S A JOKE' DEFENSE

Oklahoma state senator falsely implies VP Kamala Harris used sexual favors to get elected in official press release

WHICH IS NO DEFENSE AT ALL IT'S AN EXCUSE

Sarah K. Burris
April 23, 2021


Kamala Harris

Oklahoma state Sen. Nathan Dahm, a Republican from Broken Arrow, used his Earth Day legislation to make a false, sexist, and derogatory statement about Vice President Kamala Harris in an official press release.

Dahm announced legislation that would ban paper straws because he hates them. While most adults can manage drinking from a cup using their mouth, Dahm complained that he needs a plastic straw and that paper simply wouldn't do. What took a turn, however, is that Dahm made a veiled allegation about the vice president that's making his straw legislation look like a sippy cup.



Press statement from Oklahoma state Sen. Nathan Dahm (Screen capture)

"So, under the guise of helping the planet, they've banned plastic straws, resulting in who knows how many trees now being cut down to make paper straws," Dahm said in the statement. I've never met a single person who enjoys using a paper straw. They fall apart & turn to mush quicker than [President] Joe Biden trying to string together a coherent sentence. They collapse like [Sen.] Mitt Romney (R-UT) under the slightest amount of pressure, & even with [Vice President' Kamala Harris well, never mind."

In an interview with KTUL, Dahm is asked about the veiled comment about Harris.

"There's a lot of different things that could be said about that with her vast experience and how she got her start into politics," claimed Dahm. "In talking with some people, one thing that could be said, you know, you can't use a paper straw for a milkshake, but maybe Kamala Harris could because of her past experience."


Harris got her undergraduate degree at Howard University and her JD at the University of California at Hastings. She was hired first by the prosecutor's office before being elected as the District Attorney for San Francisco, where she worked for seven years before being elected to the office of the Attorney General and ultimately to U.S. Senator. Dahm graduated from A Beka Christian Academy Home School.

According to ethics filings, Dahm has been supported by companies like AT&T, QuikTrip, the Oklahoma Realtor's Association, Marathon Oil and Reynolds Tobacco.

When he heard criticism for his comments, he doubled down.



Dahm didn't explain how it was a "joke" since he told people to "do their own research." He was asked if the comments weren't sexist and answered frankly. There was also no laughing involved in his comments. Republicans often use "it was just a joke" to get out of being held accountable for their comments.


See the video of Sen. Dahm below:

US Air Force Academy grads revolt against superintendent's 'both sides' position on violent extremism

Bob Brigham
April 24, 2021


U.S. Air Force photo by A1C Jonathan Whitely


One dozen graduates of the Air Force Academy wrote an open letter against white supremacy that was published on Saturday in the Air Force Times.

"In late March, the U.S. Air Force Academy held its Department of Defense-mandated extremism stand-down training to examine and to eradicate extremism and white supremacy within the ranks. Superintendent Lt. Gen. Richard Clarke spoke of extreme ideologies on "both sides," rather than confronting the unique flavor of the extremism threat on display Jan. 6 at the U.S. Capitol," the group, led by Esteban Castellanos, wrote.

"Many USAFA graduates feel the mild response to the insurrection from the academy and its Association of Graduates failed to reflect these values and stands counter to everything they publicly expect of graduates. We are disappointed and feel that leadership has failed our graduates, the members they lead, and ultimately the citizens of this country," they explained. "Simply put, many of our leaders are underreacting to the attack. We need them to state, unequivocally, that the insurrection was wrong, intolerable and against our values and oath of service to the Constitution. They must state publicly and emphatically that those within our ranks who participate in, or are sympathetic to, the organizations that took part in the riot at the Capitol are not welcome in our ranks because they are supporting domestic insurrectionists and terrorists."

The group worried about the number of veterans who participated in the insurrection.

"Approximately one in five of the insurrectionists were veterans, according to criminal charging reports. They included at least one U.A. Air Force Academy graduate. Many more veterans are sympathetic to the insurrection, espouse the lies upon which it was based, or are participants in related causes," they explained. "Air Force Academy class Facebook pages and other social media sources show clear evidence that our officer corps members either do not take the threat seriously or support the underlying insurrectionist groups, many of which hold white supremacist ideologies."

And they wondered if there might be financial motives for failing to call out right-wing extremists.

"Where does the academy and its AOG leadership stand on white supremacy within our ranks? Are they afraid of alienating large donors that may sympathize with the terrorists' cause instead of doing the right thing?" they wondered.
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"The academy's lack of a strong rejection of the insurrection is, in effect, a political stance, one which undermines trust as well as good order and discipline within the ranks and the graduate community. Additionally, many of us, as service members of color and our allies, feel the insurrection was not only an assault on American democracy but on the value of all as equal citizens in this country. We saw our government nearly overthrown after an election victory brought about, in large part, by people of color," they wrote. "This is personal and painful for those who have served because we've fought for our Constitution and for the rights of our fellow citizens. Any more hesitation or equivocation in doing so risks losing the trust of the very Americans we have sworn to defend."

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Many U.S. Air Force Academy graduates feel the mild response to the insurrection from the academy and its Association of Graduates fails to reflect the values central to the academy's mission, the authors of this commentary write. https://trib.al/a7vf6Tx

10:43 AM · Apr 24, 2021·SocialFlow

Death toll in fire at Iraqi COVID-19 hospital surpasses 80

Ibn Khatib hospital in Baghdad, Iraq, April 25, 2021 after the fire. NOTE THE GAS CYLINDERS ARE INTACT!

By Associated Press
Published: Apr. 25, 2021 

|Updated: 8 hours ago

BAGHDAD (AP) — The death toll from a massive fire at a Baghdad hospital for coronavirus patients rose to at least 82 Sunday as anxious families searched for missing relatives and the government suspended key health officials for alleged negligence.

The flames, described by one witness as “volcanoes of fire,” swept through the intensive care unit of the Ibn al-Khatib Hospital, which tends exclusively to COVID-19 patients with severe symptoms. Officials said the blaze, which also injured 110 people, was set off by an exploding oxygen cylinder.

Nurse Maher Ahmed was called to the scene late Saturday to help evacuate patients.

“I could not have imagined it would be a massive blaze like that,” he said. The flames overwhelmed the hospital’s second floor isolation hall within three to four minutes of the oxygen cylinder exploding, he said. “Volcanoes of fire.”

Most of those killed suffered severe burns, he said. Others were overcome by smoke, unwilling to leave behind relatives hooked up to ventilators. Ahmed said the patients could not be moved. “They would have minutes to live without oxygen.”

He said he and others watched helplessly as one patient struggled to breathe amid the smoke.

Widespread negligence on the part of health officials is to blame for the fire, Iraq’s prime minister, Mustafa al-Kadhimi, said Sunday. Following a special cabinet meeting to discuss the blaze, the government suspended key officials, including the health minister and the governor of Baghdad province. Other officials, including the hospital director, were dismissed from their posts.

It took firefighters and civil defense teams until early Sunday to put out the flames.

Among the dead were at least 28 patients on ventilators, tweeted Ali al-Bayati, a spokesman of the country’s independent Human Rights Commission, a semi-official body.

Paramedics carried the bodies, many burned beyond recognition, to al-Zafaraniya Hospital, where Ahmed said forensics teams will attempt to identify them by matching DNA samples to relatives.

By midday Sunday, relatives were still searching anxiously for loved ones.

“Please, two of my relatives are missing. ... I am going to die (without news about them),” posted a young woman on social media after a fruitless search for her family members. “I hope someone can help us find Sadi Abdul Kareem and Samir Abdul Kareem, they were in the ICU.”

Rokya Kareem, 30, was looking frantically for her friend Riyam Rahman, a pharmacist, who was visiting her mother at the hospital. Rahman’s mother, Basima, was admitted to the hospital 45 days ago with complications from COVID-19.

“All we know is they were in the room next to where the fire started,” she said. “Her phone is switched off, and her family has gone to every hospital trying to find them.”

The fire happened as Iraq grapples with a severe second wave of the coronavirus pandemic. Daily virus cases now average around 8,000, the highest level since Iraq began recording infection rates early last year. At least 15,200 people have died of coronavirus in Iraq among at least 100,000 confirmed cases.

Years of sanctions and war have crippled the country’s health sector, and the latest infection wave has tested the limits of health facilities. Security concerns also plague the country as frequent rocket attacks continue to target army bases hosting foreign troops and the seat of Iraq’s government.

The deadly fire was only the latest chapter in Iraq’s poor record for public safety.

In March 2019, over 100 people died when a ferry capsized on the Tigris River near the northern city of Mosul. The boat overturned due to overcrowding and high water. A few months later, in September 2019, a fire ripped through Baghdad’s Shorja market, a major commercial area in the city, burning many shops to the ground.

Part of the problem is that laws and regulations governing public safety and health are old, said Yesar al-Maliki, an adviser to the Iraq Energy Institute.

“It has to do with the overall system. There are no detailed regulations and (standard operating procedures) on how to do basic things step by step, especially when handling risky equipment,” said Al-Maliki, who also worked in Iraq’s oil and gas industry.

“There needs to be specialists handling policy, regulation and implementation,” he said. “If there was a standard operating procedure on how to handle oxygen bottles, especially noticing wear and tear ... This wouldn’t have happened.”

The prime minster convened the special cabinet session hours after the flames broke out. In addition to suspending the health minister, Hasan al-Tamimi, and Baghdad’s governor, the cabinet ordered an investigation of the health minister and key hospital officials responsible for overseeing safety measures.

The cabinet also fired the director-general of the Baghdad health department in the al-Rusafa area, where the hospital is located, and the hospital’s director of engineering and maintenance, according to a statement from the Health Ministry and the prime minister’s office.

“Negligence in such matters is not a mistake, but a crime for which all negligent parties must bear responsibility,” al-Kadhimi said Sunday after a meeting.

The United Nations envoy to Iraq, Jeannine Hennis-Plasschaert, expressed “shock and pain” over the fire in a statement and called for stronger protection measures in hospitals.

At the Vatican, Pope Francis, who concluded a historic trip to Iraq last month, remembered those who perished in the blaze. Addressing people gathered in St. Peter’s Square for his customary Sunday appearance, Francis mentioned the news of the dead. “Let’s pray for them,’' he said.

___

Associated Press Writer Abdulrahman Zeyad contributed to this report.

Copyright 2021 The Associated Press. All rights reserved.

IN MY YOUTH I WORKED AT CHEMCICAL PLANTS LIKE LIQUID AIR, CELENESE, AT LIQUID AIR I FILLED PRESSURE TANKS USED IN BOTH HOSPITALS AS WELL AS RIG SITES, THE LATTER DID AND COULD CONTAIN ACETYLENE!! WE DID A SNIFF TEST TO MAKE SURE THERE WAS NONE IN THE TANK BECAUSE IT COULD CAUSE A VERY DANGEROUS EXPLOSION! WE ONL;Y USED BRASS HAMMERS TO RING THEM TO SEE IF THEY WERE EMPTY. ANY OTHE METAL COULD SPARK!

AN OXYGEN TANK LEAKING WITH SOMEBODY SMOKING NEARBY COULD HAVE ALSO CAUSED A SERIOUS EXPLOSION, AND WHO KNOWS WHAT THE OTHER TANKS BEING USED WERE LEAKING TOO. THE CONTAINERS I HAVE SEE ARE OLD OR USED WHO KNOWS WHAT WAS IN THEM, GREEN TANKS ARE USED FOR OXYGEN IT IS THE INTERNATIONAL COLOUR FOR COMPRESSED GAS. 

Germany, EU, US ready help for India amid deadly COVID wave

India is struggling to contain a surge in coronavirus cases with global record-high infection and death rates. Prime Minister Narendra Modi says a "storm has shaken the nation."


India has recorded more than 16.9 million coronavirus cases since the beginning of the pandemic


German Chancellor Angela Merkel said Sunday that her government was preparing emergency aid for India as the country grapples with a devastating surge in coronavirus infections.

On Sunday, India recorded a new daily high of 349,691 coronavirus cases and 2,767 deaths — the worst toll since the start of the pandemic.

"To the people of India I want to express my sympathy on the terrible suffering that COVID-19 has again brought over your communities," Merkel said in a message shared on Twitter by her spokesman Steffen Seibert.


"The fight against the pandemic is our common fight. Germany stands in solidarity with India and is urgently preparing a mission of support."

The German Defense Ministry said it's assessing the possibility of providing a mobile oxygen generator and other medical equipment.
EU, US, UK pledge immediate help

European Commission chief Ursula von der Leyen said she was alarmed by the situation in India.

"The EU is pooling resources to respond rapidly to India's request for assistance," von der Leyen said on Twitter. "We stand in full solidarity with the Indian people!"


The US will "immediately" send supplies of the raw materials needed to make vaccines, as well as therapeutics, tests, ventilators and protective equipment to India, the White House said in a statement on Sunday.

"The United States has identified sources of specific raw material urgently required for Indian manufacture of the Covishield vaccine that will immediately be made available for India," it said.

US Secretary of State Antony Blinken said on Twitter that the US will "rapidly deploy additional support to the people of India and India's health care heroes."





India has been calling for a temporary waiver on vaccine patentsto allow more countries to manufacture jabs and accelerate their rollout.

India's longtime rival, Pakistan, has also offered to deliver medical supplies following a recent thaw in relations between the nuclear-armed neighbors.

"As a gesture of solidarity with the people of India in the wake of the current wave of COVID-19, Pakistan has offered to provide relief support to India including ventilators," the Foreign Ministry said in a statement late on Saturday.

Watch video 02:46 WTO resumes discussions on scrapping vaccine patents

The UK, meanwhile, has said it was sending more than 600 pieces of medical equipment to India, including ventilators and oxygen concentrators.

France said it plans to support India with oxygen capacity in the next few days, while Russia has also pledged to assist India by sending medical equipment.
DW's view from New Delhi

DW's New Delhi bureau chief Amrita Cheema described the situation in the Indian capital as "very critical" and said, "time is of the essence."

According to Cheema, the local Delhi government believes the only way to curb infections is to "impose strict measures to prevent people-to-people contact," which it considers "the only weapon to stem the flow."

The Delhi government is urgently in need of 700 tons of liquid oxygen, Cheema told DW, adding that it has appealed to the national government as well as other state governments to send oxygen supplies.

"There is an oxygen emergency here," she said.

The Indian government has deployed military planes and trains to deliver oxygen to New Delhi, and waived customs on the import of oxygen and medical supplies. It has also mobilized its armed forces to send in more oxygen.

Prime Minister Narendra Modi said on Sunday the government was fighting with all its might.

"Our spirits were high after successfully dealing with the first wave," Modi said in a radio address. "But this storm has shaken the nation."

Modi had declared victory over coronavirus in January.

Critics have slammed his government for allowing for big religious and political gatherings to go ahead, and for failing to plan for the devastating wave the country is now facing.

INDIA HOLDS HINDU FESTIVAL KUMBH MELA DESPITE COVID-19 FEARS
Crowds gather despite pandemic
The Maha Kumbh Mela, which is considered the largest Hindu gathering in the world, is held in a 12-year cycle, across four pilgrimage sites in India. This year, the festival is being held in the holy city of Haridwar. The festival, which is classified as an Intangible Cultural Heritage by UNESCO, is attended by tens of thousands of people under normal circumstances.  PHOTOS 12345678

What is the situation right now?

The 349,691 coronavirus cases reported in India on Sunday mark a new global single-day record.

The country has more than 16.9 million infections in total, behind only the United States.

As well as the country's health care system reaching breaking point, crematoriums and burial grounds have been overwhelmed with dead bodies.

Delhi, the country's hardest-hit city, on Sunday extended its weeklong lockdown as hospitals struggled with a shortage of beds and oxygen supplies.

"We have decided to extend the lockdown by one week ... The havoc of corona[virus] continues and there is no respite. Everyone is in favor of extending the lockdown," Delhi Chief Minister Arvind Kejriwal said in a video statement.

Some 192,311 people have died of the coronavirus in India so far, although experts say the toll is likely a huge undercount.

Suspected cases are typically not included and many deaths have been attributed to underlying conditions.

mvb, dj, fb/mm (AFP, AP, dpa, Reuters)


DW RECOMMENDS


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Date 25.04.2021
Related Subjects India, Coronavirus
Keywords India, Coronavirus
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USED TO BE GOP'S FAVORITE DEMOCRAT

Joe Lieberman is lobbying Republicans to make Washington DC a state

Former Senator Joe Lieberman tapped by Democrats to pitch idea of turning Washington DC into a state to Republican lawmakers.

Ron Kampeas,

 JTA , Apr 25 , 2021 


Joe Lieberman
Official portrait; courtesy of YU


Democrats who hope to make Washington, D.C., a state have tapped Joe Lieberman, known for his cross-party outreach, to make the case to skeptical Republicans.

Forbes reported Wednesday that Sen. Tom Carper, a Delaware Democrat who is spearheading the bid in the Senate now that it has passed in the U.S. House of Representatives, has picked Lieberman to make the sale.

Lieberman, whose last acts in Congress included a D.C. statehood bill in 2012 that went nowhere, told Forbes he “would be glad” to make the case.

A close Republican friend, Sen. Lindsey Graham of South Carolina, told Forbes that Lieberman was on a mission impossible, saying the bill had “zero chance” among Senate Republicans.

Lieberman, the first Jewish candidate on a major-party ticket when he was Al Gore’s running mate in 2000, became an independent in 2006. Two years later he backed the GOP nominee for president, his friend the late Sen. John McCain, although he continued to otherwise caucus with the Democrats. Since leaving the Senate in 2012, Lieberman has led efforts to promote bipartisanship.

Despite a D.C. statehood bill passing the House on party lines this week, and despite the Democrats’ razor-thin majority in the Senate, the statehood push faces daunting prospects. The Senate is split 50-50, with Vice President Kamala Harris holding the deciding 51st vote in case of a tie, but three senators in the Democratic caucus — Joe Manchin of West Virginia, Kyrsten Sinema of Arizona and Angus King of Maine — are not yet on board.

Additionally, without the backing of 60 senators, Republicans will be able to filibuster the vote.

Republicans say the bill is a bid to add two reliably Democratic senators. Democrats say the bill would enfranchise a city with a population larger than Wyoming or Vermont and that has a black plurality.

D.C. residents vote for president, but do not have voting congressional representation.

The Lessons of the Johnson & Johnson Vaccine Saga

There were complaints that the pause would undermine confidence in vaccines. But it would have been more disastrous for the F.D.A. to be seen as ignoring or covering up the issue.

By Amy Davidson Sorkin

NEW YORKER

April 25, 2021

How do public-health authorities convey to the public when

 the benefits outweigh the risks? How do they convey, for that 

matter, when they care about the risks?

Photograph by Marco Bello / Reuters


On Friday night, the Food and Drug Administration and the Centers for Disease Control and Prevention ended their ten-day pause on the use of the Johnson & Johnson covid-19 vaccine, which is, on the whole, excellent news. The J. & J. shot (also referred to as Janssen, for the company subsidiary responsible for it) is highly effective at preventing cases of the disease, and in trials it was completely effective at preventing fatal cases. It is also the only vaccine approved in the United States (or the E.U.) that requires just a single shot, and it can be stored for three months in an ordinary refrigerator. Both of these factors make it well-suited for hard-to-reach or marginalized populations. (It is also effective against the South African variant.) The F.D.A. and the C.D.C. acted just hours after the C.D.C.’s independent Advisory Committee on Immunization Practices, or A.C.I.P., voted to reaffirm its recommendation of the vaccine for anyone over the age of eighteen, following a daylong virtual meeting that was live-streamed for the public, in which it scrutinized safety concerns around rare blood clots that mostly seem to occur in women under fifty.

But the A.C.I.P. laid out a task for public-health authorities: to communicate to women eighteen to forty-nine years old that there is a slight risk for them to be aware of, evaluate, and manage. Dr. José Romero, the Arkansas Secretary of Health and the chair of the meeting, said, “I acknowledge, as does everyone else, that these events are rare, but they are serious.” He added, “It’s our responsibility as clinicians to make sure women understand this risk and, when possible, that they have an alternative at the same site where you’re administering the vaccine.” That alternative would be the Pfizer-BioNTech or the Moderna vaccine, neither of which has been associated with the clots, and both of which are highly effective and safe. Romero was speaking at the end of the meeting and summing up what appeared to be the consensus. The vote on recommending continued use was 10–4 in favor—Romero voted yes. There was no dispute that the pause should end and that the vaccine should be made available to everyone over the age of eighteen. There was also no dispute that women should be given a clear statement about the distinct issues. The real disagreement, in the end, was about whether the best way to convey that information was to put it in the recommendation itself in some form, or in the warning label and fact sheet accompanying the vaccine. The fact-sheet party won.
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In that sense, the A.C.I.P. meeting provided a glimpse into issues that go beyond the pandemic. Nothing in the world is entirely risk-free—but risks can be managed. (There is a waiting period after covid-19 vaccinations to watch for anaphylactic reactions, for example.) How do public-health authorities convey to the public when the benefits outweigh the risks? How do they convey, for that matter, when they care about the risks? A theme of the meeting was that the nation’s system for tracking reactions to vaccines works, and works extraordinarily well. There was what epidemiologists call a “safety signal”—a few cases, a blip among millions—which was rapidly spotted and addressed. There had been complaints that the pause on the J. & J. vaccine might undermine confidence in vaccines altogether. That is short-sighted; it would have been more disastrous for the F.D.A. to be seen as ignoring or covering up the issue. The message that the F.D.A. is a stickler is not a bad one. But, if there is a single lesson to take away, it is the importance of looking at diverse populations—in terms of gender and age, in this case—in reviewing medical data. The problem that the A.C.I.P. was grappling with was not only how to talk to the public but how to reach women, give them the information they need, and respect their intelligence, autonomy, and choices.


To begin with, how rare are these clots? Since the J. & J. vaccine got its emergency-use approval, just under eight million doses have been administered. Fifteen people in the United States—all women—have experienced what is now being labelled as thrombosis with thrombocytopenia syndrome, or T.T.S. (There was an apparent case of it with a twenty-five-year-old man, but that was during the clinical trials.) At the time of the pause, the number of cases with women was six, but, largely because this side effect can appear a couple of weeks after vaccination, more have been identified since. T.T.S. is basically the presence of an already rare form of clot, in most cases in the brain, along with very low levels of platelets in the blood—a weird, dangerous combination. These are different from more common clots, such as those associated with oral contraceptives (which do not seem to be a risk factor for T.T.S.). Of those fifteen women, three have died; seven remain hospitalized, four in intensive care. The early symptoms to watch for include headache, dizziness, and abdominal pain. Prompt treatment can help.

Doctors who saw the early cases sometimes misunderstood and mistreated what was happening; several women were given heparin, which is normally a go-to treatment for clots but, in this case, makes the situation worse. That is partly why the pause was ordered. In a press conference on Friday, Dr. Rochelle Walensky, the head of the C.D.C., said that none of the women whose cases have occurred since the pause were given heparin—an indication that the pause was effective in spreading the word. According to Walensky, 1.9 people in a million who get the J. & J. vaccine seem to experience these clots. But among adult women under fifty it is seven in a million. Among women thirty to thirty-nine, it is 11.8 per million.


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These numbers sound scary, but the coronavirus is scary, too. The C.D.C. ran the numbers, looking at the risk for women under fifty of taking the J. & J. vaccine versus not being vaccinated at all. In that scenario, more women’s lives were saved by taking J. & J. That is important to emphasize, because, for some women, in some circumstances, J. & J. will be the best or the only viable option. (Again, it’s a one-and-done shot.) A woman in a region where covid-19 is rampant might make a different calculation than one in an area where it is mostly contained. When Walensky was asked flat-out, in the press conference, whether women under fifty should take “a different vaccine,” she gave a long and hedged answer that came down to the message that J. & J. should be “certainly an option” for those women.

Although scientists have not yet figured out exactly why these clots are happening, it is notable that Pfizer and Moderna use mRNA as their vaccine-delivery system, whereas J. & J. uses a modified human adenovirus. The AstraZeneca vaccine—which is not yet approved in the United States—has also had issues involving clotting, and uses a modified chimpanzee adenovirus. The numbers of these clots associated with the AstraZeneca vaccine in Europe and the U.K. is significantly higher than is the case with J. & J.—about ten and eight for every million people vaccinated, respectively. One reason for the pause was that the F.D.A. and the C.D.C. wanted to see whether J. & J.’s issue was on a similar or even greater scale; it was not. (Last week, the European Medicines Agency also said that J. & J.’s benefits outweigh its risks, and advised warnings for women under fifty; the rollout of the J. & J. vaccine is still in the very early stages in Europe, and so the E.M.A. looked at data about its use in the United States.)

One of the C.D.C. models presented at the meeting—looking at the entire U.S. population and assuming the continued use of the Moderna and Pfizer vaccines, a moderate rate of coronavirus transmission, and factors such as vaccine hesitancy and logistical challenges in distribution—suggested that resuming the use of J. & J. for everyone over the age of eighteen would lead to twenty-six cases of T.T.S. over a six-month period, but prevent more than fourteen hundred deaths from covid. A resumption that limited its use to people over fifty (some European countries have imposed a similar restriction on the AstraZeneca vaccine) would, the model suggested, result in only two cases of T.T.S., but prevent fewer deaths—about two hundred and fifty.

The A.C.I.P., again, quickly moved away from the idea of a continued pause or a partial restriction. The issue was warnings. The committee had two potential formulations for the recommendation: one simply said that the vaccine was recommended for everyone over the age of eighteen, and the other affirmed that recommendation, but added that “women aged <50 years should be aware of the increased risk of T.T.S., and may choose another covid-19 vaccine (i.e. mRNA vaccines).” There was concern that the latter would sow confusion without entirely laying out the facts. There were also questions about when women would get the warning information—would they first hear about it when they were about to get the shot?—and whether there would be other vaccines available at the site. A committee member wondered if the longer warning might better reflect what she described as two truths: the high value of the vaccine generally, and the slight risk for some women. Still, other members said that they didn’t see much difference between the two recommendations, because younger women would still get a warning directed specifically at them in the fact sheet, which they believed would be effective. They preferred the more concise option, in part because it seemed clearer.

There is something to be said for that approach, and a great deal to be said for the J. & J. vaccine. But the F.D.A. and C.D.C., in accepting the A.C.I.P. recommendations, have to take seriously the mission that they’ve been given to convey this information to women. State authorities, who have been in charge of vaccine distribution, have a job to do, too—for example, in making sure that a lack of access to a range of vaccines doesn’t mean that women’s choices are made for them. Public-health authorities and doctors may, like many members of the public, focus mostly on the headline. But the warning label contains a message for them, too.