npr--2020-10-05--Trump's COVID-19 Diagnosis Recalls History Of Secrecy On Presidential Health

No sooner had it become known that President Trump had tested positive for the coronavirus than controversy arose over the amount and detail and truthfulness of the information about his condition that was coming from the White House .
The timeline of Trump 's diagnosis and treatment over the past few days continues to evolve .
His medical team 's briefings from Walter Reed National Military Medical Center have at times resulted in more confusion than clarity .
In the latest example , White House physician Sean Conley 's Sunday press conference — like his Saturday one — seemed to @ @ @ @ @ @ @ He said the president had received supplemental oxygen , after declining to confirm that on Saturday , and announced that Trump had started taking a steroid after a second drop in his oxygen levels .
Conley explained some of his Saturday statements as `` trying to reflect the upbeat attitude '' of the doctors and Trump .
In an additional display of optimism , Trump even left the medical center to drive by and wave to supporters gathered outside on Sunday .
In a rare move , the White House did not inform @ @ @ @ @ @ @ the excursion .
None of opaqueness should come as surprise , though .
Few occasions of historical importance have been so shrouded in secrecy — and even outright deception — as the health emergencies of world leaders .
The U.S. may have been more transparent about these events than most countries , but , even here , the truth has only come to light over time .
`` This is one precedent this president is following , '' says Barbara Perry , director of Presidential Studies at the University of Virginia 's Miller @ @ @ @ @ @ @ has a right to know the health of their presidents , especially now , given that voters are also just weeks away from deciding at the ballot box who is most fit to inhabit the Oval Office .
`` They used to say when the president gets a cold , the stock market drops , '' Perry says .
`` It really has an impact on people 's lives , whether it 's the economy , or in this instance , it would help us to know , is he now even capable @ @ @ @ @ @ @ few of the more egregious cases of obfuscation in the past , when the health of the president was in question while he was in office .
As coincidence would have it , the news of Trump 's diagnosis broke 101 years to the day President Woodrow Wilson suffered a stroke that nearly killed him and paralyzed his whole left side .
While far from being the first health crisis Wilson had experienced – he may have had the `` Spanish flu '' earlier that same year — it was by far the @ @ @ @ @ @ @ , '' writes historian Thomas J .
Knock , `` Wilson was but a frail husk of his former self , a tragic recluse in the White House shielded by his wife and doctor . ''
Edith Wilson was `` the arbiter of what and whom the president saw , '' according to Knock and other chroniclers of the period , although allegations that she ran the government may have been overblown .
It seems incredible to us now that a president could serve out the last 17 months of his term so @ @ @ @ @ @ @ But neither the vice president at the time , Thomas R. Marshall , or the Cabinet members or congressional leaders saw fit to intervene or raise formal objections .
Neither did they have a clear constitutional instrument by which to do so .
The White House was also able to conceal the health problems of Wilson 's successor , Warren G. Harding , including the heart disease that led to his fatal heart attack in 1923 .
As Harding toured the West Coast , reporters in Seattle had been told Harding had suffered @ @ @ @ @ @ @ caused him to cancel a visit to Portland .
Arriving in San Francisco , Harding walked from the train to a car and suffered a relapse .
Doctors treated him for heart problems and pneumonia .
When he died in his hotel four days later of cardiac arrest , reporters were told the president had suffered a cerebral hemorrhage .
As for the public , it had far less information about goings-on in Washington during Wilson 's time than now .
In the 19th and early 20th century , the nation was not @ @ @ @ @ @ @ on the president 's activities .
Radio and TV were still some years away , and when newspapers paid attention to Washington , they tended to focus on important decisions in Congress , federal courts or government agencies .
The idea of the White House as a `` beat '' did not begin until late in the 1800s .
The nascent White House Correspondents Association had just 11 members at its birth in 1914 , and there would not be a formal position of White House press secretary until 1929 .
There had @ @ @ @ @ @ @ strove to find the truth about the physical condition of various presidents .
In one notable case , a Philadelphia newspaper reporter named E.J .
Edwards learned that President Grover Cleveland 's 1893 `` fishing trip '' on the yacht of a friend had in fact had a different purpose .
A team of surgeons had accompanied the president on the four-day excursion and removed a cancerous growth from the roof of his mouth .
The public was never told .
And when Edwards learned the truth from a medical professional involved , @ @ @ @ @ @ @ and his reputation assaulted — by the president himself .
White House reporting had become more extensive by the time Franklin D. Roosevelt took the oath in 1933 .
Press conferences were now `` a thing , '' and FDR held lengthy , chatty sessions with reporters in his office – under his own strict rules of disclosure and attribution .
He also initiated the custom of an annual `` press reception . ''
But his main contribution to White House communications was an end-run around the press in the form of radio @ @ @ @ @ @ @ They were wildly successful , helping FDR build a direct relationship with ordinary citizen-voters that stood him in good stead through the Depression and the Second World War .
FDR also benefited from a set of informal rules by which the press , and later the radio correspondents and commentators , largely did not focus on his physical disabilities .
A polio victim in his young adulthood , FDR used a wheelchair much of the time .
But photographs of him in the chair rarely saw the light of day .
Later in @ @ @ @ @ @ @ maladies pursued him and limited his ability to handle the Second World War and negotiations over a postwar world map , FDR 's well-practiced obfuscation kept that information from general view .
Even his vice president , Harry S. Truman , was shocked when Roosevelt 's death was announced less than three months after he was inaugurated for his fourth term .
Rarely has the actual condition of a president 's health been more at odds with his image than was the case with President John F. Kennedy in the early 1960s .
@ @ @ @ @ @ @ , JFK made youth and `` vigor '' themes of his campaign and early months in office .
But Kennedy himself was far from the physical ideal he sought to project .
As biographer Michael Kazin has noted , the young JFK `` suffered from a variety of ailments that frequently confined him to bed and plagued him throughout his life . ''
Many of these were typical childhood ailments such as chicken pox , measles and ear infections .
But he also contracted scarlet fever , a life-threatening disease in 1920 .
@ @ @ @ @ @ @ to JFK 's medical history .
He detailed how Kennedy had dealt with fevers as well as issues of the stomach , colon and adrenal glands .
At 30 he was diagnosed with Addison 's disease , an endocrine disorder that could have ended his life even earlier than an assassin 's bullet did in 1963 — especially given the added presence of hypothyroidism .
The contentions between his doctors and their competing prescriptions were also a factor in his performance in office .
But absolutely none of this reached the public during @ @ @ @ @ @ @ nor in his three years in the White House .
When he needed treatments , reporters were told it related to chronic and severe back pain , which could be vaguely attributed to his exploits as a Navy hero in the Second World War .
The full story of JFK 's illnesses would not be told for decades .
President Ronald Reagan took the oath of office in January 1981 and just two months later was shot at close range by a deranged young man outside a Washington , D.C. , hotel .
@ @ @ @ @ @ @ , where TV cameras recorded him walking in the door — but did not see him collapse a few steps inside .
At that point , a bullet in his chest was close to costing him his life .
According to Del Quintin Wilber , a Washington Post reporter who wrote a book about that day called Rawhide Down , Reagan lost almost half his blood volume and came within seconds of dying .
What the public saw and heard , however , was far different .
White House spokesmen described a plucky @ @ @ @ @ @ @ `` I hope you 're all Republicans , '' he reportedly said ) and his wife ( `` Honey , I forgot to duck '' ) .
In reality , the president was desperately close to death .
But that went largely unreported for nearly 30 years , while the tale of his miraculous resilience persisted throughout his lifetime .
Later , in Reagan 's second term , there were signs of deteriorating mental acuity .
In his reelection campaign of 1984 he showed lapses of memory and awareness .
In 1988 , @ @ @ @ @ @ @ .
Bush , his vice president , who had been nominated by his party to succeed him .
But that story , too , went largely unreported .
The former president was officially diagnosed with Alzheimer 's Disease in 1994 , five years after leaving office .

Trump's COVID-19 Diagnosis Recalls History Of Secrecy On Presidential Health
Enlarge this image toggle caption Alex Edelman/Getty Images Alex Edelman/Getty Images
No sooner had it become known that President Trump had tested positive for the coronavirus than controversy arose over the amount and detail and truthfulness of the information about his condition that was coming from the White House.
The timeline of Trump's diagnosis and treatment over the past few days continues to evolve. His medical team's briefings from Walter Reed National Military Medical Center have at times resulted in more confusion than clarity.
In the latest example, White House physician Sean Conley's Sunday press conference — like his Saturday one — seemed to raise more questions than it answered.
He said the president had received supplemental oxygen, after declining to confirm that on Saturday, and announced that Trump had started taking a steroid after a second drop in his oxygen levels. Conley explained some of his Saturday statements as "trying to reflect the upbeat attitude" of the doctors and Trump.
In an additional display of optimism, Trump even left the medical center to drive by and wave to supporters gathered outside on Sunday. In a rare move, the White House did not inform reporters that the president would be taking the excursion.
None of opaqueness should come as surprise, though. Few occasions of historical importance have been so shrouded in secrecy — and even outright deception — as the health emergencies of world leaders. The U.S. may have been more transparent about these events than most countries, but, even here, the truth has only come to light over time.
"This is one precedent this president is following," says Barbara Perry, director of Presidential Studies at the University of Virginia's Miller Center.
Perry says the American public has a right to know the health of their presidents, especially now, given that voters are also just weeks away from deciding at the ballot box who is most fit to inhabit the Oval Office.
"They used to say when the president gets a cold, the stock market drops," Perry says. "It really has an impact on people's lives, whether it's the economy, or in this instance, it would help us to know, is he now even capable of governing?"
Here are a few of the more egregious cases of obfuscation in the past, when the health of the president was in question while he was in office.
Exhibit A: The incapacity of Woodrow Wilson
Enlarge this image toggle caption AP AP
As coincidence would have it, the news of Trump's diagnosis broke 101 years to the day President Woodrow Wilson suffered a stroke that nearly killed him and paralyzed his whole left side.
While far from being the first health crisis Wilson had experienced – he may have had the "Spanish flu" earlier that same year — it was by far the worst.
"From that point on," writes historian Thomas J. Knock, "Wilson was but a frail husk of his former self, a tragic recluse in the White House shielded by his wife and doctor." Edith Wilson was "the arbiter of what and whom the president saw," according to Knock and other chroniclers of the period, although allegations that she ran the government may have been overblown.
It seems incredible to us now that a president could serve out the last 17 months of his term so diminished in his presence and power. But neither the vice president at the time, Thomas R. Marshall, or the Cabinet members or congressional leaders saw fit to intervene or raise formal objections. Neither did they have a clear constitutional instrument by which to do so.
The White House was also able to conceal the health problems of Wilson's successor, Warren G. Harding, including the heart disease that led to his fatal heart attack in 1923. As Harding toured the West Coast, reporters in Seattle had been told Harding had suffered "an acute gastrointestinal attack" that caused him to cancel a visit to Portland.
Arriving in San Francisco, Harding walked from the train to a car and suffered a relapse. Doctors treated him for heart problems and pneumonia. When he died in his hotel four days later of cardiac arrest, reporters were told the president had suffered a cerebral hemorrhage.
Reporting on the president
As for the public, it had far less information about goings-on in Washington during Wilson's time than now. In the 19th and early 20th century, the nation was not accustomed to daily or even weekly reports on the president's activities. Radio and TV were still some years away, and when newspapers paid attention to Washington, they tended to focus on important decisions in Congress, federal courts or government agencies.
toggle caption AP
The idea of the White House as a "beat" did not begin until late in the 1800s. The nascent White House Correspondents Association had just 11 members at its birth in 1914, and there would not be a formal position of White House press secretary until 1929.
There had been earlier cases of individual reporters who strove to find the truth about the physical condition of various presidents. In one notable case, a Philadelphia newspaper reporter named E.J. Edwards learned that President Grover Cleveland's 1893 "fishing trip" on the yacht of a friend had in fact had a different purpose.
A team of surgeons had accompanied the president on the four-day excursion and removed a cancerous growth from the roof of his mouth. The public was never told. And when Edwards learned the truth from a medical professional involved, his reported story was flatly denied — and his reputation assaulted — by the president himself.
The hidden conditions of FDR
Enlarge this image toggle caption AP AP
White House reporting had become more extensive by the time Franklin D. Roosevelt took the oath in 1933. Press conferences were now "a thing," and FDR held lengthy, chatty sessions with reporters in his office – under his own strict rules of disclosure and attribution. He also initiated the custom of an annual "press reception."
But his main contribution to White House communications was an end-run around the press in the form of radio addresses called "fireside chats." They were wildly successful, helping FDR build a direct relationship with ordinary citizen-voters that stood him in good stead through the Depression and the Second World War.
FDR also benefited from a set of informal rules by which the press, and later the radio correspondents and commentators, largely did not focus on his physical disabilities. A polio victim in his young adulthood, FDR used a wheelchair much of the time. But photographs of him in the chair rarely saw the light of day.
Later in this presidency, as a variety of maladies pursued him and limited his ability to handle the Second World War and negotiations over a postwar world map, FDR's well-practiced obfuscation kept that information from general view. Even his vice president, Harry S. Truman, was shocked when Roosevelt's death was announced less than three months after he was inaugurated for his fourth term.
The unhealthy side of John F. Kennedy
toggle caption AP
Rarely has the actual condition of a president's health been more at odds with his image than was the case with President John F. Kennedy in the early 1960s. Just 43 when he was elected president, JFK made youth and "vigor" themes of his campaign and early months in office.
But Kennedy himself was far from the physical ideal he sought to project. As biographer Michael Kazin has noted, the young JFK "suffered from a variety of ailments that frequently confined him to bed and plagued him throughout his life." Many of these were typical childhood ailments such as chicken pox, measles and ear infections. But he also contracted scarlet fever, a life-threatening disease in 1920.
Historian Robert Dallek devoted an entire book to JFK's medical history. He detailed how Kennedy had dealt with fevers as well as issues of the stomach, colon and adrenal glands. At 30 he was diagnosed with Addison's disease, an endocrine disorder that could have ended his life even earlier than an assassin's bullet did in 1963 — especially given the added presence of hypothyroidism. The contentions between his doctors and their competing prescriptions were also a factor in his performance in office.
But absolutely none of this reached the public during Kennedy's active years in politics, nor in his three years in the White House. When he needed treatments, reporters were told it related to chronic and severe back pain, which could be vaguely attributed to his exploits as a Navy hero in the Second World War. The full story of JFK's illnesses would not be told for decades.
The near-death of Ronald Reagan
toggle caption The White House via AP
President Ronald Reagan took the oath of office in January 1981 and just two months later was shot at close range by a deranged young man outside a Washington, D.C., hotel. Reagan was rushed to a nearby hospital, where TV cameras recorded him walking in the door — but did not see him collapse a few steps inside.
At that point, a bullet in his chest was close to costing him his life. According to Del Quintin Wilber, a Washington Post reporter who wrote a book about that day called Rawhide Down, Reagan lost almost half his blood volume and came within seconds of dying.
What the public saw and heard, however, was far different. White House spokesmen described a plucky patient who bantered with the surgeons ("I hope you're all Republicans," he reportedly said) and his wife ("Honey, I forgot to duck").
In reality, the president was desperately close to death. But that went largely unreported for nearly 30 years, while the tale of his miraculous resilience persisted throughout his lifetime.
Later, in Reagan's second term, there were signs of deteriorating mental acuity. In his reelection campaign of 1984 he showed lapses of memory and awareness. In 1988, he mispronounced the name of George H.W. Bush, his vice president, who had been nominated by his party to succeed him.
But that story, too, went largely unreported. The former president was officially diagnosed with Alzheimer's Disease in 1994, five years after leaving office.
NPR producer Sam Gringlas contributed to this report.


npr--2020-10-05--Stripper Polls: The Racy Voting PSA That's Actually All About The Issues

Stripper Polls : The Racy Voting PSA That 's Actually All About The Issues In an election season where get out the vote messaging is seemingly ceaseless , a 90-second video featuring more than a half dozen dancers testifying to the importance of down ballot races may be the most provocative .
In the video , a woman in knee high , lace up boots walks away from the camera , toward a stage decorated with patriotic bunting .
She wraps one of her hands around a silver pole .
The beat drops , the woman and other dancers begin @ @ @ @ @ @ @ is a simple one : `` Get Your Booty To The Poll . ''
It 's a different kind of voting PSA , one that has stirred up a conversation about who shows up in elections and who is n't being reached by the current outreach efforts .
WARNING : The video below contains content that may be inappropriate for some readers .
The video , directed by Angela Barnes , has gone viral online , despite being intended for an Atlanta-based audience , with a limited promotional strategy so far .
Barnes @ @ @ @ @ @ @ wanted to make this video to fill a gap in traditional get out the vote messaging that she feels largely fails to reach Black men .
But she said she wanted to target a more specific , smaller demographic within the subset of potential Black male voters , and so she chose to center the video in Atlanta 's booming strip club scene .
`` Atlanta has a strip club culture .
People go out and go on dates at strip clubs , people get married and have funerals at strip clubs , @ @ @ @ @ @ @ , explained .
`` You know , people do n't go there just to see like , naked people .
You go there for the vibe . ''
Some of the dancers featured in the video have worked in Atlanta area clubs , Barnes said , while others are competitive dancers .
As they perform a series of pole tricks , the dancers articulate why it is so important to engage in local elections and vote for down-ballot candidates .
`` A district attorney decides not to prosecute , '' one dancer says @ @ @ @ @ @ @ or not to go after dirty cops .
Do you know who elects the DA ?
We do , but you do n't want to vote . ''
`` Ca n't make it rain if you 're locked up on some bulls*** , '' another dancer observes .
Barnes ' argument about failure to engage black men has some resonance in political circles .
Black Americans are one of the Democratic Party 's most loyal constituencies .
But when it comes to who turns out to vote , there is a gap between @ @ @ @ @ @ @ Pew Research Center estimated that in 2016 , 54 % of eligible Black men said they had voted .
Meanwhile 64 % of eligible Black women said they had voted .
And that represents a much larger gender gap than for white or Hispanic voters .
While this ad is focused on candidates and issues down the ballot , the candidates at the top of the 2020 ballot — President Donald Trump and former Vice President Joe Biden — have each seen their campaigns make explicit appeals to Black men .
The video @ @ @ @ @ @ @ some louder than others .
The film producer Tariq Nasheed , who often traffics in online conspiracy , was among those critical of the PSA online , arguing on Twitter that , `` Instead of talking about our tangibles , this is what the white Democrats think will appeal to us . ''
Though she did not address him by name , Barnes pushed back on Nasheed 's critique , noting that both she and producer Paul Fox are Black and added that `` we 're not backed by anybody . ''
These @ @ @ @ @ @ @ that Barnes said she wanted to avoid and are one of the reasons that she and her team chose to make this ad nonpartisan .
`` People do n't really like to be told who to vote for , and my concern was that if we made this one side or the other , people would think , 'Oh , they 're just trying to get us to vote for them , ' '' she said .
`` And it 's funny because it ended up kind of happening anyway . ''
Barnes @ @ @ @ @ @ @ self funded the video and are unaffiliated with any organization , and a GoFund Me backing the project has raised more than $ 13,000 .
Others have criticized the ad for being too explicit and playing into stereotypes about Black men .
Mondale Robinson of the Black Male Voter Project , who consulted on the ad , pushed back on that criticism .
`` If LeBron James had on a Lakers jersey talking politics right now , no one is going to say anything , '' Robinson said .
`` So , if @ @ @ @ @ @ @ and talking about issues that are important , then your real problem is not with the issues or the sisters talking about the issues .
It 's something deeply embedded in you , in what is considered decent work and not decent work . ''
Robinson , who just wrapped up a multi-state tour aimed at engaging Black men this election season , said that the ad is effective because it speaks to issues that Black men in the state care about , and does so in a culturally relevant way .
The @ @ @ @ @ @ @ abolishing the cash bail system , trades being taught in school and criminal justice reform were things that came up in the conversations that Robinson 's group spearheaded with Black men across the state of Georgia .
But he also cautioned that without regular , repeated conversations with and for Black men about issues they actually care about , they wo n't engage when it 's time to vote .
`` The national election wo n't excite Black men .
That is not to say that Black men wo n't participate in the @ @ @ @ @ @ @ it wo n't be the reason that they do , '' he said .

Stripper Polls: The Racy Voting PSA That's Actually All About The Issues
In an election season where get out the vote messaging is seemingly ceaseless, a 90-second video featuring more than a half dozen dancers testifying to the importance of down ballot races may be the most provocative.
In the video, a woman in knee high, lace up boots walks away from the camera, toward a stage decorated with patriotic bunting. She wraps one of her hands around a silver pole.
The beat drops, the woman and other dancers begin to perform, and the repeated message is a simple one: "Get Your Booty To The Poll." It's a different kind of voting PSA, one that has stirred up a conversation about who shows up in elections and who isn't being reached by the current outreach efforts.
WARNING: The video below contains content that may be inappropriate for some readers.
Go Vote YouTube
The video, directed by Angela Barnes, has gone viral online, despite being intended for an Atlanta-based audience, with a limited promotional strategy so far.
Barnes said that she and producer Paul Fox wanted to make this video to fill a gap in traditional get out the vote messaging that she feels largely fails to reach Black men. But she said she wanted to target a more specific, smaller demographic within the subset of potential Black male voters, and so she chose to center the video in Atlanta's booming strip club scene.
"Atlanta has a strip club culture. People go out and go on dates at strip clubs, people get married and have funerals at strip clubs," Barnes, who is from Atlanta, explained. "You know, people don't go there just to see like, naked people. You go there for the vibe."
Some of the dancers featured in the video have worked in Atlanta area clubs, Barnes said, while others are competitive dancers. As they perform a series of pole tricks, the dancers articulate why it is so important to engage in local elections and vote for down-ballot candidates.
"A district attorney decides not to prosecute," one dancer says in the video. "Including whether or not to go after dirty cops. Do you know who elects the DA? We do, but you don't want to vote."
"Can't make it rain if you're locked up on some bulls***," another dancer observes.
Barnes' argument about failure to engage black men has some resonance in political circles. Black Americans are one of the Democratic Party's most loyal constituencies. But when it comes to who turns out to vote, there is a gap between Black men and Black women.
The Pew Research Center estimated that in 2016, 54% of eligible Black men said they had voted. Meanwhile 64% of eligible Black women said they had voted. And that represents a much larger gender gap than for white or Hispanic voters.
While this ad is focused on candidates and issues down the ballot, the candidates at the top of the 2020 ballot — President Donald Trump and former Vice President Joe Biden — have each seen their campaigns make explicit appeals to Black men.
The video has not been without its critics, some louder than others. The film producer Tariq Nasheed, who often traffics in online conspiracy, was among those critical of the PSA online, arguing on Twitter that, "Instead of talking about our tangibles, this is what the white Democrats think will appeal to us."
Though she did not address him by name, Barnes pushed back on Nasheed's critique, noting that both she and producer Paul Fox are Black and added that "we're not backed by anybody."
These types of critiques are precisely the kind that Barnes said she wanted to avoid and are one of the reasons that she and her team chose to make this ad nonpartisan.
"People don't really like to be told who to vote for, and my concern was that if we made this one side or the other, people would think, 'Oh, they're just trying to get us to vote for them,'" she said. "And it's funny because it ended up kind of happening anyway."
Barnes has said that she and Fox largely self funded the video and are unaffiliated with any organization, and a GoFund Me backing the project has raised more than $13,000.
Others have criticized the ad for being too explicit and playing into stereotypes about Black men. Mondale Robinson of the Black Male Voter Project, who consulted on the ad, pushed back on that criticism.
"If LeBron James had on a Lakers jersey talking politics right now, no one is going to say anything," Robinson said. "So, if they have a problem with sisters dancing and talking about issues that are important, then your real problem is not with the issues or the sisters talking about the issues. It's something deeply embedded in you, in what is considered decent work and not decent work."
Robinson, who just wrapped up a multi-state tour aimed at engaging Black men this election season, said that the ad is effective because it speaks to issues that Black men in the state care about, and does so in a culturally relevant way.
The issues highlighted in the ad, including abolishing the cash bail system, trades being taught in school and criminal justice reform were things that came up in the conversations that Robinson's group spearheaded with Black men across the state of Georgia.
But he also cautioned that without regular, repeated conversations with and for Black men about issues they actually care about, they won't engage when it's time to vote.
"The national election won't excite Black men. That is not to say that Black men won't participate in the national election, that is to say it won't be the reason that they do," he said.


npr--2020-10-05--Some Health Workers Suffering From Addiction Steal Drugs Meant For Patients

Some Health Workers Suffering From Addiction Steal Drugs Meant For Patients When Kristin Waite-Labott , a nurse in Wisconsin , began stealing fentanyl and morphine from her hospital 's medical supply cabinets , she found it was relatively easy to cover her tracks .
Her drug inventory paperwork often did n't add up , but she found coworkers willing to cover for her .
`` They trusted me '' she said .
`` Unfortunately I was taking advantage of that trust and that happens all the time . ''
But Waite-Labott 's addiction to fentanyl quickly spiraled out of control @ @ @ @ @ @ @ I instantly craved more .
It 's so powerful and deadly , '' she said .
Waite-Labott eventually lost her job and spent time in jail before entering recovery and regaining her nursing license .
She works now helping other health workers who struggle with addiction and says she 's still haunted by the thought of patients she might have harmed .
`` I do n't know that I made any errors , '' she said .
`` But I ca n't be certain of that because I was under the influence at @ @ @ @ @ @ @ number of health industry experts and researchers who warn this kind of on-the-job drug theft by health workers may be increasing .
`` It 's extremely common and the consequences can be very very grave , '' said Kimberly New , an expert on medical drug misuse , known in the industry as diversion .
Harm to patients from drug diversion can be severe .
In extreme cases , health workers divert so much medication , patients wind up undergoing cancer treatments or post-surgical recovery without pain relief .
`` Patients will be @ @ @ @ @ @ @ receive the doses that they were supposed to receive , '' New said .
`` The diverter has progressed to the point where they 're no longer willing to share with the patients . ''
Studies by the Centers for Disease Control and Prevention and the Mayo Clinic also found healthcare workers who steal drugs frequently tamper with medications , leaving them contaminated .
`` I go and take a fentanyl vial , I administer the entire vial to myself and I refill the vial with water , '' New said , describing @ @ @ @ @ @ @ patients have been infected with blood-born pathogens . ''
The Mayo Clinic study found as many as 28,000 hospital patients were put at risk of contracting Hepatitis C over a 10-year period because of this kind of drug theft and tampering .
Last year , physicians at a Roswell Park Comprehensive Cancer Center in Buffalo , N.Y. , reported six of their patients contracted a rare bacterial blood infection after a nurse replaced opioid medications with tap water .
`` We share our experience to alert health care providers , '' the doctors @ @ @ @ @ @ @ Medicine .
`` [ I ] n this age of profound prevalence of opioid addiction , drug diversion is an important consideration when a cluster of waterborne bacteremia is identified . ''
For doctors and nurses , lives destroyed and careers ended Consequences for healthcare workers can also be devastating .
Two years ago , Denise Keller got a call from the University of Texas Southwest Medical Center in Dallas where her daughter Iyesha worked as a nurse .
`` When I first heard from the hospital , they were like , there @ @ @ @ @ @ @ .
Iyesha Keller , who was 36 , had overdosed on a variety of drugs , including fentanyl , likely stolen from her hospital 's supply of pain medication .
`` She died on the floor of a bathroom at her hospital .
If all this was in her system how did she do her job ? ''
Denise Keller asked .
Iyesha Keller was the second nurse to die from a fentanyl overdose at UT Southwestern Medical Center over a two-year period .
Last year , a nurse at Parker Adventist Hospital @ @ @ @ @ @ @ in federal prison after she stole fentanyl from her facility 's intensive care unit , replacing doses of medication with saline .
In that case , the hospital 's automated drug inventory system identified the theft .
But experts told NPR many healthcare facilities still lack proper controls and security systems needed to spot drug diversion .
Only `` a fraction '' of hospital drug thefts are discovered In one case at a hospital in Massachusetts , two nurses were able to steal more than 16,000 Oxycodone opioid pills before being detected .
@ @ @ @ @ @ @ Atlanta paid $ 4.3 million in federal fines after `` tens of thousands '' of opioid medications were stolen over a four-year period .
`` Hospitals put lives at risk when they fail to maintain accurate record-keeping of their inventory , '' the Drug Enforcement Agency 's Robert J. Murphy said in a 2018 statement .
The frequency of drug diversion in hospitals and clinics is debated but last year the Joint Commission , a nonprofit that provides accreditation to thousands of hospitals and clinics , issued a warning that `` only a @ @ @ @ @ @ @ are ever caught . ''
This summer Kit Check , a company that monitors drug inventories at hundreds of U.S. hospitals , raised another red flag .
They issued a report showing tens of thousands of unexplained `` variances '' where high risk medications could n't be accounted for by healthcare facilities .
`` There 's a 111,000 instances here where the folks that were reviewing [ drug inventories ] could not figure out why the math did n't add up , '' said Kit Check CEO Kevin McDonald .
All hospitals and @ @ @ @ @ @ @ have some kind of security and inventory system for opioids and other controlled medications .
But Mark Fan , a researcher at North York General Hospital in Toronto says those systems often break down .
`` We know that staff are really overworked , they 're under a lot of time pressure .
It 's not uncommon for people to let things slide , '' Fan said .
He published a study in the Journal of Hospital Medicine last year warning that drug theft in US hospitals appears to be `` accelerating .
@ @ @ @ @ @ @ in hospital oversight The DEA told NPR it investigated roughly 3,600 cases of alleged drug theft at healthcare facilities over the last five years , including 280 cases so far in 2020 .
But Tim McDermott , the DEA 's assistant administrator for diversion control , said his agency 's attention is largely focused elsewhere .
`` We do n't spend a lot of time targeting hospital employees or clinic employees , '' he said .
`` That is not where our biggest problem is in the United States right now . ''
@ @ @ @ @ @ @ overdose deaths caused each year by illegal street fentanyl pose a far deadlier risk than fentanyl and other opioids misused by workers within the healthcare industry .
McDermott said the DEA believes the overall rate of drug diversion within the healthcare industry remains `` very low . ''
But he acknowledged the DEA ca n't say with confidence how big the problem of hospital drug theft has become .
That 's because hospitals and clinics are largely responsible for self-policing .
If medical facilities do n't detect and report a problem , the @ @ @ @ @ @ @ chance of learning about it .
`` So it limits the ability of us as an agency to see diversion that is being done whether it 's a a clinic , whether it 's at a hospital , '' McDermott told NPR .
The DEA has reportedly opened an investigation into drug security practices at UT Southwestern Medical Center in Dallas , where nurse Iyesha Keller died of a a fentanyl overdose in 2018 .
Federal officials declined to confirm a probe is underway and the hospital did n't respond to NPR 's @ @ @ @ @ @ @ .
But Keller 's mom , Denise , said she hopes someone will find out what went wrong at her daughter 's hospital and make things safer for staff and patients .
`` This hospital is having deaths , medications are disappearing and no one is able to stop and do anything about it , '' Keller told NPR .
`` It does n't make any sense . ''

Some Health Workers Suffering From Addiction Steal Drugs Meant For Patients
Enlarge this image toggle caption Kaz Fantone/NPR Kaz Fantone/NPR
When Kristin Waite-Labott, a nurse in Wisconsin, began stealing fentanyl and morphine from her hospital's medical supply cabinets, she found it was relatively easy to cover her tracks.
Her drug inventory paperwork often didn't add up, but she found coworkers willing to cover for her.
"They trusted me" she said. "Unfortunately I was taking advantage of that trust and that happens all the time."
But Waite-Labott's addiction to fentanyl quickly spiraled out of control.
"Taking it one time, I instantly craved more. It's so powerful and deadly," she said.
Waite-Labott eventually lost her job and spent time in jail before entering recovery and regaining her nursing license.
She works now helping other health workers who struggle with addiction and says she's still haunted by the thought of patients she might have harmed.
"I don't know that I made any errors," she said. "But I can't be certain of that because I was under the influence at work."
NPR found a growing number of health industry experts and researchers who warn this kind of on-the-job drug theft by health workers may be increasing.
"It's extremely common and the consequences can be very very grave," said Kimberly New, an expert on medical drug misuse, known in the industry as diversion.
Patients in pain, patients taking contaminated medications
Harm to patients from drug diversion can be severe. In extreme cases, health workers divert so much medication, patients wind up undergoing cancer treatments or post-surgical recovery without pain relief.
"Patients will be left to linger in pain and not receive the doses that they were supposed to receive," New said. "The diverter has progressed to the point where they're no longer willing to share with the patients."
Studies by the Centers for Disease Control and Prevention and the Mayo Clinic also found healthcare workers who steal drugs frequently tamper with medications, leaving them contaminated.
"I go and take a fentanyl vial, I administer the entire vial to myself and I refill the vial with water," New said, describing a typical scenario. "Unfortunately many patients have been infected with blood-born pathogens."
The Mayo Clinic study found as many as 28,000 hospital patients were put at risk of contracting Hepatitis C over a 10-year period because of this kind of drug theft and tampering.
Last year, physicians at a Roswell Park Comprehensive Cancer Center in Buffalo, N.Y., reported six of their patients contracted a rare bacterial blood infection after a nurse replaced opioid medications with tap water.
"We share our experience to alert health care providers," the doctors wrote in The New England Journal of Medicine. "[I]n this age of profound prevalence of opioid addiction, drug diversion is an important consideration when a cluster of waterborne bacteremia is identified."
For doctors and nurses, lives destroyed and careers ended
Consequences for healthcare workers can also be devastating. Two years ago, Denise Keller got a call from the University of Texas Southwest Medical Center in Dallas where her daughter Iyesha worked as a nurse.
"When I first heard from the hospital, they were like, there's an accident," Keller recalled.
Iyesha Keller, who was 36, had overdosed on a variety of drugs, including fentanyl, likely stolen from her hospital's supply of pain medication.
"She died on the floor of a bathroom at her hospital. If all this was in her system how did she do her job?" Denise Keller asked.
Iyesha Keller was the second nurse to die from a fentanyl overdose at UT Southwestern Medical Center over a two-year period.
Last year, a nurse at Parker Adventist Hospital in Denver was sentenced to 44 months in federal prison after she stole fentanyl from her facility's intensive care unit, replacing doses of medication with saline.
In that case, the hospital's automated drug inventory system identified the theft. But experts told NPR many healthcare facilities still lack proper controls and security systems needed to spot drug diversion.
Only "a fraction" of hospital drug thefts are discovered
In one case at a hospital in Massachusetts, two nurses were able to steal more than 16,000 Oxycodone opioid pills before being detected. Another hospital, Effingham Health System in Atlanta paid $4.3 million in federal fines after "tens of thousands" of opioid medications were stolen over a four-year period.
"Hospitals put lives at risk when they fail to maintain accurate record-keeping of their inventory," the Drug Enforcement Agency's Robert J. Murphy said in a 2018 statement.
The frequency of drug diversion in hospitals and clinics is debated but last year the Joint Commission, a nonprofit that provides accreditation to thousands of hospitals and clinics, issued a warning that "only a fraction of those who are diverting drugs are ever caught."
This summer Kit Check, a company that monitors drug inventories at hundreds of U.S. hospitals, raised another red flag.
Health Coronavirus Pandemic Compounds Another Ongoing Crisis: The Opioid Epidemic Coronavirus Pandemic Compounds Another Ongoing Crisis: The Opioid Epidemic Listen · 9:31 9:31
They issued a report showing tens of thousands of unexplained "variances" where high risk medications couldn't be accounted for by healthcare facilities.
"There's a 111,000 instances here where the folks that were reviewing [drug inventories] could not figure out why the math didn't add up," said Kit Check CEO Kevin MacDonald.
All hospitals and clinics are required by federal law to have some kind of security and inventory system for opioids and other controlled medications. But Mark Fan, a researcher at North York General Hospital in Toronto says those systems often break down.
"We know that staff are really overworked, they're under a lot of time pressure. It's not uncommon for people to let things slide," Fan said.
He published a study in the Journal of Hospital Medicine last year warning that drug theft in U.S. hospitals appears to be "accelerating."
The DEA plays little direct role in hospital oversight
The DEA told NPR it investigated roughly 3,600 cases of alleged drug theft at healthcare facilities over the last five years, including 280 cases so far in 2020.
But Tim McDermott, the DEA's assistant administrator for diversion control, said his agency's attention is largely focused elsewhere.
"We don't spend a lot of time targeting hospital employees or clinic employees," he said. "That is not where our biggest problem is in the United States right now."
In sheer numbers, the thousands of overdose deaths caused each year by illegal street fentanyl pose a far deadlier risk than fentanyl and other opioids misused by workers within the healthcare industry.
McDermott said the DEA believes the overall rate of drug diversion within the healthcare industry remains "very low." But he acknowledged the DEA can't say with confidence how big the problem of hospital drug theft has become.
That's because hospitals and clinics are largely responsible for self-policing. If medical facilities don't detect and report a problem, the DEA and other law enforcement have little chance of learning about it.
"So it limits the ability of us as an agency to see diversion that is being done whether it's a a clinic, whether it's at a hospital," McDermott told NPR.
The DEA has reportedly opened an investigation into drug security practices at UT Southwestern Medical Center in Dallas, where nurse Iyesha Keller died of a a fentanyl overdose in 2018.
Federal officials declined to confirm a probe is underway and the hospital didn't respond to NPR's repeated phone calls and emails seeking comment.
But Keller's mom, Denise, said she hopes someone will find out what went wrong at her daughter's hospital and make things safer for staff and patients.
"This hospital is having deaths, medications are disappearing and no one is able to stop and do anything about it," Keller told NPR. "It doesn't make any sense."


npr--2020-10-05--Facebook Keeps Data Secret, Letting Conservative Bias Claims Persist

Sen. Roger Wicker hit a familiar note when he announced on Thursday that the Commerce Committee was issuing subpoenas to force the testimony of Facebook Chief Executive Mark Zuckerberg and other tech leaders .
Tech platforms like Facebook , the Mississippi Republican said , `` disproportionately suppress and censor conservative views online . ''
When top tech bosses were summoned to Capitol Hill in July for a hearing on the industry 's immense power , Republican Congressman Jim Jordan made an even blunter accusation .
`` I 'll just cut to the chase , Big Tech is out to get @ @ @ @ @ @ @ That 's not a hunch .
That 's not a suspicion .
That 's a fact . ''
But the facts to support that case have been hard to find .
NPR called up half a dozen technology experts , including data scientists who have special access to Facebook 's internal metrics .
The consensus : There is no statistical evidence to support the argument that Facebook does not give conservative views a fair shake .
When Republicans claim Facebook is `` biased , '' they often collapse two distinct complaints into one @ @ @ @ @ @ @ deliberately scrubs right-leaning content from its site .
There is no proof to back this up .
Secondly , Republicans suggest that conservative news and perspectives are being throttled by Facebook , that the social network is preventing the content from finding a large audience .
That claim is not only unproven , but publicly available data on Facebook shows the exact opposite to be true : conservative news regularly ranks among some of the popular content on the site .
Now , there are some complex layers to this , but former @ @ @ @ @ @ @ conservative bias argument would be easier to talk about — and easier to debunk — if Facebook was more transparent .
The social network keeps secret some of the most basic data points , like what news stories are the most viewed on Facebook on any given day , leaving data scientists , journalists and the general public in the dark about what people are actually seeing on their News Feeds .
There are other sources of data , but they offer just a tiny window into the sprawling universe of nearly 3 @ @ @ @ @ @ @ point out that the public metrics available are of limited use , yet it does so without offering a real solution , which would be opening up some of its more comprehensive analytics for public scrutiny .
Until they do , there 's little to counter rumors about what thrives and dies on Facebook and how the platform is shaping political discourse .
`` It 's kind of a purgatory of their own making , '' said Kathy Qian , a data scientist who co-founded Code for Democracy .
What the available data @ @ @ @ @ @ @ often-cited data point on what is popular on Facebook is a tracking tool called CrowdTangle , a startup that Facebook acquired in 2016 .
New York Times journalist Kevin Roose has created a Twitter account where he posts the top ten most-engaging posts based on CrowdTangle data .
These lists are dominated mostly by conservative commentators like Ben Shapiro and Dan Bongino and Fox News .
They resemble a `` parallel media universe that left-of-center Facebook users may never encounter , '' Roose writes .
Yet these lists are like looking at Facebook @ @ @ @ @ @ @ like MIT 's Jennifer Allen , who used to work at Facebook and now studies how people consume news on social media .
CrowdTangle , Allen says , does not provide the whole story .
That 's because CrowdTangle only captures engagement — likes , shares , comments and other reactions — from public pages .
But just because a post provokes lots of reactions does not mean it reaches many users .
The data does not show how many people clicked on a link , or what the overall reach of the @ @ @ @ @ @ @ people see on Facebook is from their friends , not public pages .
`` You see these crazy numbers on CrowdTangle , but you do n't see how many people are engaging with this compared with the rest of the platform , '' Allen said .
Another point researchers raise : All engagement is not created equal .
Users could `` hate-like '' a post , or click like as a way of bookmarking , or leave another reaction expressing disgust , not support .
Take , for example , the laughing-face emoji @ @ @ @ @ @ @ I agree with this ' or 'This is so hilarious untrue , ' '' said data scientist Qian .
`` It 's just hard to know what people actually mean by those reactions . ''
It 's also hard to tell whether people or automated bots are generating all the likes , comments and shares .
Former Facebook research scientist Solomon Messing conducted a study of Twitter in 2018 finding hat bots were likely responsible for 66 % of link shares on the platform .
The tactic is employed on Facebook , too @ @ @ @ @ @ @ ' and other borderline scam-like activity are unfortunately common and you can buy fake engagement easily on a number of websites , '' Messing said .
Brendan Nyhan , a political scientist at Dartmouth College , is also wary about drawing any big conclusions from CrowdTangle .
`` You ca n't judge anything about American movies by looking at the top ten box films hits of all time , '' Nyhan said .
`` That 's not a great way of understanding what people are actually watching .
There 's the same risk @ @ @ @ @ @ @ as on the side of liberals' Experts agree that a much better measure would be a by-the-numbers rundown of what posts are reaching the most people .
So why does n't Facebook reveal that data ?
In a Twitter thread back in July , John Hegeman , the head of Facebook 's NewsFeed , offered one sample of such a list , saying it is `` not as partisan '' as lists compiled with CrowdTangle data suggest .
But when asked why Facebook does n't share that broader data with the public , @ @ @ @ @ @ @ be , some experts say , that Facebook fears that data will be used as ammunition against the company at a time when Congress and the Trump administration are threatening to rein in the power of Big Tech .
`` They are incredibly concerned about being seen as on the side of liberals .
That is against the profit motive of their business , '' Dartmouth 's Nyhan said of Facebook executives .
`` I do n't see any reason to see that they have a secret , hidden liberal agenda , but @ @ @ @ @ @ @ transparent . ''
Facebook has been more forthcoming with some academic researchers looking at how social media affects elections and democracy .
In April 2019 , it announced a partnership that would give 60 scholars access to more data , including the background and political affiliation of people who are engaging content .
One of those researchers is University of Pennsylvania data scientist Duncan Watts .
`` Mostly it 's mainstream content , '' he said of the most viewed and clicked on posts .
`` If anything , there is a bias @ @ @ @ @ @ @ While Facebook posts from national television networks and major newspapers get the most clicks , partisan outlets like the Daily Wire and Brietbart routinely show up in top spots , too .
`` That should be so marginal that it has no relevance at all , '' Watts said of the right-wing content .
`` The fact that it is showing up at all is troubling . ''
'More false and misleading content on the right' Accusations from Trump and other Republicans in Washington that Facebook is a biased referee of its content @ @ @ @ @ @ @ network takes action against a conservative-leaning posts that violate its policies .
Researchers say there is a reason why most of the high-profile examples of content warnings and removals target conservative content .
`` That is a result of there just being more false and misleading content on the right , '' said researcher Allen .
`` There are bad actors on the left , but the ecosystem on the right is just much more mature and popular . ''
Facebook 's algorithms could also be helping more people see right-wing content that @ @ @ @ @ @ @ she added .
Because of the sheer amount of envelope-pushing conservative content , some of it veering into the realm of conspiracy theories , the moderation from Facebook is also greater .
Or as Nyhan put it : `` When reality is asymmetric , enforcement may be asymmetric .
That does n't necessarily indicate a bias . ''
The attacks on Facebook over perceived prejudice against conservatives has helped fuel the push in Congress and the White House to reform Section 230 of the Communications and Decency Act of 1996 , which allows @ @ @ @ @ @ @ post and gives tech companies the freedom to police its sites as the companies see fit .
Joe Osborne , a Facebook spokesman , in a statement said the social network 's content moderation policies are applied fairly across the board .
`` While many Republicans think we should do one thing , many Democrats think we should do the exact opposite .
We 've faced criticism from Republicans for being biased against conservatives and Democrats for not taking more steps to restrict the exact same content .
Our job is to create @ @ @ @ @ @ @ equally to everyone . ''
Osborne confirmed that Facebook is exploring ways to make more data available in the platform 's public tools , but he declined to elaborate .
Watts , University of Pennsylvania data scientist who studies social media , said Facebook is sensitive to Republican criticism , but no matter what decision they make , the attacks will continue .
`` Facebook could end up responding in a way to accommodate the right , but the right will never be appeased , '' Watts said .
`` So it 's @ @ @ @ @ @ @ give us more , you have to give us more , ' '' he said .
`` And it creates a situation where there 's no way to win arguments based on evidence , because they can just say , 'Well , I do n't trust you . '
''

Facebook Keeps Data Secret, Letting Conservative Bias Claims Persist
Enlarge this image toggle caption Jeff Chiu/AP Jeff Chiu/AP
Sen. Roger Wicker hit a familiar note when he announced on Thursday that the Commerce Committee was issuing subpoenas to force the testimony of Facebook Chief Executive Mark Zuckerberg and other tech leaders.
Tech platforms like Facebook, the Mississippi Republican said, "disproportionately suppress and censor conservative views online."
When top tech bosses were summoned to Capitol Hill in July for a hearing on the industry's immense power, Republican Congressman Jim Jordan made an even blunter accusation.
"I'll just cut to the chase, Big Tech is out to get conservatives," Jordan said. "That's not a hunch. That's not a suspicion. That's a fact."
But the facts to support that case have been hard to find. NPR called up half a dozen technology experts, including data scientists who have special access to Facebook's internal metrics. The consensus: There is no statistical evidence to support the argument that Facebook does not give conservative views a fair shake.
Let's step back for a moment.
When Republicans claim Facebook is "biased," they often collapse two distinct complaints into one. First, that the social network deliberately scrubs right-leaning content from its site. There is no proof to back this up. Secondly, Republicans suggest that conservative news and perspectives are being throttled by Facebook, that the social network is preventing the content from finding a large audience. That claim is not only unproven, but publicly available data on Facebook shows the exact opposite to be true: conservative news regularly ranks among some of the popular content on the site.
Now, there are some complex layers to this, but former Facebook employees and data experts say the conservative bias argument would be easier to talk about — and easier to debunk — if Facebook was more transparent.
The social network keeps secret some of the most basic data points, like what news stories are the most viewed on Facebook on any given day, leaving data scientists, journalists and the general public in the dark about what people are actually seeing on their News Feeds.
There are other sources of data, but they offer just a tiny window into the sprawling universe of nearly 3 billion users. Facebook is quick to point out that the public metrics available are of limited use, yet it does so without offering a real solution, which would be opening up some of its more comprehensive analytics for public scrutiny.
Until they do, there's little to counter rumors about what thrives and dies on Facebook and how the platform is shaping political discourse.
"It's kind of a purgatory of their own making," said Kathy Qian, a data scientist who co-founded Code for Democracy.
What the available data reveals about possible bias
Perhaps the most often-cited data point on what is popular on Facebook is a tracking tool called CrowdTangle, a startup that Facebook acquired in 2016.
New York Times journalist Kevin Roose has created a Twitter account where he posts the top ten most-engaging posts based on CrowdTangle data. These lists are dominated mostly by conservative commentators like Ben Shapiro and Dan Bongino and Fox News. They resemble a "parallel media universe that left-of-center Facebook users may never encounter," Roose writes.
Yet these lists are like looking at Facebook through a soda straw, says researchers like MIT's Jennifer Allen, who used to work at Facebook and now studies how people consume news on social media. CrowdTangle, Allen says, does not provide the whole story.
That's because CrowdTangle only captures engagement — likes, shares, comments and other reactions — from public pages. But just because a post provokes lots of reactions does not mean it reaches many users. The data does not show how many people clicked on a link, or what the overall reach of the post was. And much of what people see on Facebook is from their friends, not public pages.
"You see these crazy numbers on CrowdTangle, but you don't see how many people are engaging with this compared with the rest of the platform," Allen said.
Another point researchers raise: All engagement is not created equal.
Users could "hate-like" a post, or click like as a way of bookmarking, or leave another reaction expressing disgust, not support. Take, for example, the laughing-face emoji.
"It could mean, 'I agree with this' or 'This is so hilarious untrue,'" said data scientist Qian. "It's just hard to know what people actually mean by those reactions."
It's also hard to tell whether people or automated bots are generating all the likes, comments and shares. Former Facebook research scientist Solomon Messing conducted a study of Twitter in 2018 finding hat bots were likely responsible for 66% of link shares on the platform. The tactic is employed on Facebook, too.
"What Facebook calls 'inauthentic behavior' and other borderline scam-like activity are unfortunately common and you can buy fake engagement easily on a number of websites," Messing said.
Brendan Nyhan, a political scientist at Dartmouth College, is also wary about drawing any big conclusions from CrowdTangle.
"You can't judge anything about American movies by looking at the top ten box office films hits of all time," Nyhan said. "That's not a great way of understanding what people are actually watching. There's the same risk here."
'Concerned about being seen as on the side of liberals'
Experts agree that a much better measure would be a by-the-numbers rundown of what posts are reaching the most people. So why doesn't Facebook reveal that data?
In a Twitter thread back in July, John Hegeman, the head of Facebook's NewsFeed, offered one sample of such a list, saying it is "not as partisan" as lists compiled with CrowdTangle data suggest.
But when asked why Facebook doesn't share that broader data with the public, Hegeman did not reply.
It could be, some experts say, that Facebook fears that data will be used as ammunition against the company at a time when Congress and the Trump administration are threatening to rein in the power of Big Tech.
"They are incredibly concerned about being seen as on the side of liberals. That is against the profit motive of their business," Dartmouth's Nyhan said of Facebook executives. "I don't see any reason to see that they have a secret, hidden liberal agenda, but they are just so unwilling to be transparent."
Facebook has been more forthcoming with some academic researchers looking at how social media affects elections and democracy. In April 2019, it announced a partnership that would give 60 scholars access to more data, including the background and political affiliation of people who are engaging content.
One of those researchers is University of Pennsylvania data scientist Duncan Watts.
"Mostly it's mainstream content," he said of the most viewed and clicked on posts. "If anything, there is a bias in favor of conservative content."
While Facebook posts from national television networks and major newspapers get the most clicks, partisan outlets like the Daily Wire and Brietbart routinely show up in top spots, too.
"That should be so marginal that it has no relevance at all," Watts said of the right-wing content. "The fact that it is showing up at all is troubling."
'More false and misleading content on the right'
Accusations from Trump and other Republicans in Washington that Facebook is a biased referee of its content tend to flare up when the social network takes action against a conservative-leaning posts that violate its policies.
Researchers say there is a reason why most of the high-profile examples of content warnings and removals target conservative content.
"That is a result of there just being more false and misleading content on the right," said researcher Allen. "There are bad actors on the left, but the ecosystem on the right is just much more mature and popular."
Facebook's algorithms could also be helping more people see right-wing content that's meant to evoke passionate reactions, she added.
Because of the sheer amount of envelope-pushing conservative content, some of it veering into the realm of conspiracy theories, the moderation from Facebook is also greater.
Or as Nyhan put it: "When reality is asymmetric, enforcement may be asymmetric. That doesn't necessarily indicate a bias."
The attacks on Facebook over perceived prejudice against conservatives has helped fuel the push in Congress and the White House to reform Section 230 of the Communications and Decency Act of 1996, which allows platforms to avoid lawsuits over what users post and gives tech companies the freedom to police its sites as the companies see fit.
Joe Osborne, a Facebook spokesman, in a statement said the social network's content moderation policies are applied fairly across the board.
"While many Republicans think we should do one thing, many Democrats think we should do the exact opposite. We've faced criticism from Republicans for being biased against conservatives and Democrats for not taking more steps to restrict the exact same content. Our job is to create one consistent set of rules that applies equally to everyone."
Osborne confirmed that Facebook is exploring ways to make more data available in the platform's public tools, but he declined to elaborate.
Watts, University of Pennsylvania data scientist who studies social media, said Facebook is sensitive to Republican criticism, but no matter what decision they make, the attacks will continue.
"Facebook could end up responding in a way to accommodate the right, but the right will never be appeased," Watts said. "So it's this constant pressure of 'you have to give us more, you have to give us more,'" he said. "And it creates a situation where there's no way to win arguments based on evidence, because they can just say, 'Well, I don't trust you.'"


npr--2020-10-05--Street Food: Cities Turn Parking Spaces Into Dining Spots And No One Seems To Mind

Street Food : Cities Turn Parking Spaces Into Dining Spots And No One Seems To Mind In crowded cities , finding street parking can be a bit of a sport .
In South Philly , it 's almost a religion .
And like in many communities across America , a reliable wave of outrage greets proposals to reduce street parking — whether it 's for bike lanes , bikeshare stands or green space .
But something strange happened this summer .
Just ask Randy Rucker , the chef and owner of River Twice on East Passyunk Ave .
The restaurant @ @ @ @ @ @ @ many as four cars used to squeeze in , in a neighborhood where every parking spot is prized .
Rucker was ready to deal with the backlash .
But to his surprise , there was none .
`` No one 's knocking on my door cussing at me , '' Rucker said .
`` It 's been a positive experience so far , believe it or not . ''
He 's not alone .
Scores of cities around the world dramatically shifted their policies to encourage outdoor dining , which public health officials @ @ @ @ @ @ @ .
In Philadelphia , more than 400 businesses have taken advantage of a program allowing them to set up tables in parking spots .
And the typical frustration over parking changes has simply not materialized .
`` There 's been a lot of tolerance for things that are unusual , '' said Mike Carroll , the city 's deputy managing director for transportation , infrastructure , and sustainability .
`` Residents have not complained in a big way about this . ''
The lack of outrage might be partly due to the lack @ @ @ @ @ @ @ TomTom , Philadelphia 's streets are about half as congested as they were pre-pandemic .
`` It would be a different story if people were moving their car more often and trying to find parking , and were fighting for those parking spots , '' said Richard Shephard , as he sat in a converted parking spot at the South Philly restaurant Flannel .
`` But since they pretty much are stationary at this point in time , I do n't think people are too upset by it . ''
But even people @ @ @ @ @ @ @ frustration over parking are n't protesting against the restaurant expansions .
One big reason why : They know the pandemic poses an existential threat to local restaurants .
Marc Grika , the owner of Flannel , said his quickly built patio has slowed the bleeding for his business .
`` On a busy weekend , like when it 's not raining , we can even break even — which is really a thrill , '' he said , with a rueful laugh .
Residents are well aware of what 's at stake .
@ @ @ @ @ @ @ said Brian Persons , as he sat at a table set up in the road by the restaurant Pistolas Del Sur , a few blocks away .
`` As a parker , it does take up spots .
But I 'm grateful ... .
that we can dine and we can help make them survive . ''
The next challenge for Philadelphia , like many other cities , is to figure out how to sustain outdoor dining through the frigid winter and even into next year .
And after that ?
Many local @ @ @ @ @ @ @ to repurpose parking could lead to long-term changes in how street space is allocated , as some bike and pedestrian advocates , as well as city planners , have long pushed for .
`` I hope that this gives Philadelphians the opportunity to view some of these changes that they 've been a little bit afraid of and to enjoy them and to see how vibrant they can make our city , '' said Jamie Gauthier , a member of the Philadelphia city council and an urban planner by trade .
Danielle Renzulli @ @ @ @ @ @ @ Steps Down just north of the Italian Market , was initially hesitant to expand into the street .
It was n't just resident outrage she was worried about ; nearby businesses also value the fact that there are spaces where their customers can park .
But after she set up her tables , surrounded by a reed barrier and decorated with strings of lights , she has n't received a single complaint .
`` Actually , I 've gotten a lot of compliments on it , '' she said .
`` We all @ @ @ @ @ @ @ added .
`` And it was not bad at all.
``

Street Food: Cities Turn Parking Spaces Into Dining Spots And No One Seems To Mind
Enlarge this image toggle caption Hannah Yoon for NPR Hannah Yoon for NPR
In crowded cities, finding street parking can be a bit of a sport. In South Philly, it's almost a religion.
And like in many communities across America, a reliable wave of outrage greets proposals to reduce street parking — whether it's for bike lanes, bikeshare stands or green space.
But something strange happened this summer.
Just ask Randy Rucker, the chef and owner of River Twice on East Passyunk Ave. The restaurant placed tables in the street where as many as four cars used to squeeze in, in a neighborhood where every parking spot is prized.
Rucker was ready to deal with the backlash. But to his surprise, there was none.
"No one's knocking on my door cussing at me," Rucker said. "It's been a positive experience so far, believe it or not."
Enlarge this image toggle caption Hannah Yoon for NPR Hannah Yoon for NPR
He's not alone. Scores of cities around the world dramatically shifted their policies to encourage outdoor dining, which public health officials say is much safer than gathering indoors.
In Philadelphia, more than 400 businesses have taken advantage of a program allowing them to set up tables in parking spots.
And the typical frustration over parking changes has simply not materialized.
"There's been a lot of tolerance for things that are unusual," said Mike Carroll, the city's deputy managing director for transportation, infrastructure, and sustainability. "Residents have not complained in a big way about this."
The lack of outrage might be partly due to the lack of traffic. According to mapping company TomTom, Philadelphia's streets are about half as congested as they were pre-pandemic.
"It would be a different story if people were moving their car more often and trying to find parking, and were fighting for those parking spots," said Richard Shephard, as he sat in a converted parking spot at the South Philly restaurant Flannel. "But since they pretty much are stationary at this point in time, I don't think people are too upset by it."
Enlarge this image toggle caption Hannah Yoon for NPR Hannah Yoon for NPR
But even people who are driving and who still feel frustration over parking aren't protesting against the restaurant expansions. One big reason why: They know the pandemic poses an existential threat to local restaurants.
Marc Grika, the owner of Flannel, said his quickly built patio has slowed the bleeding for his business. "On a busy weekend, like when it's not raining, we can even break even — which is really a thrill," he said, with a rueful laugh.
Residents are well aware of what's at stake.
"It is a nuisance," said Brian Persons, as he sat at a table set up in the road by the restaurant Pistolas Del Sur, a few blocks away. "As a parker, it does take up spots. But I'm grateful .... that we can dine and we can help make them survive."
Enlarge this image toggle caption Hannah Yoon for NPR Hannah Yoon for NPR
The next challenge for Philadelphia, like many other cities, is to figure out how to sustain outdoor dining through the frigid winter and even into next year.
And after that? Many local leaders are hoping that the current willingness to repurpose parking could lead to long-term changes in how street space is allocated, as some bike and pedestrian advocates, as well as city planners, have long pushed for.
"I hope that this gives Philadelphians the opportunity to view some of these changes that they've been a little bit afraid of and to enjoy them and to see how vibrant they can make our city," said Jamie Gauthier, a member of the Philadelphia city council and an urban planner by trade.
Danielle Renzulli, who owns a bar called 12 Steps Down just north of the Italian Market, was initially hesitant to expand into the street. It wasn't just resident outrage she was worried about; nearby businesses also value the fact that there are spaces where their customers can park.
But after she set up her tables, surrounded by a reed barrier and decorated with strings of lights, she hasn't received a single complaint. "Actually, I've gotten a lot of compliments on it," she said.
"We all probably imagine the worst," she added. "And it was not bad at all. "


npr--2020-10-05--3 Scientists Win Nobel Prize For Hepatitis C Virus Discovery

Three scientists Monday won the 2020 Nobel Prize in physiology or medicine for discovering the hepatitis C virus , which led to the development of a test to prevent the spread of the virus and drugs that have saved millions of lives , the Nobel Assembly said .
Harvey Alter of the National Institutes of Health ; Michael Houghton , who is now at the University of Alberta in Canada ; and Charles Rice , who is now at Rockefeller University in New York , will share the 10 million Swedish krona ( $ 1.1 million ) prize .
Hepatitis @ @ @ @ @ @ @ can be fatal .
The virus is transmitted through contaminated water and bodily fluids , including blood .
The discovery led to a test for the virus , which is now widely used to protect people from becoming infected through blood transfusions .
The discovery also led to antiviral drugs to treat the infection .
`` For the first time in history , the disease can now be cured , raising hopes of eradicating hepatitis C virus from the world population , '' the Nobel Committee said in a statement .
As is @ @ @ @ @ @ @ the Karolinska Institute in Stockholm .
The Nobels in physics , chemistry , literature and peace will be awarded this week , and the prize in economics will awarded next Monday .
Since 1901 , the Nobel Prize in physiology or medicine has been awarded to 219 scientists , including 12 women .
The youngest laureate was 32 years old ; the oldest 87 .
The World Health Organization estimates that 71 million people worldwide have chronic hepatitis C , which can lead to liver cancer and cirrhosis .
There are approximately 400,000 @ @ @ @ @ @ @ to WHO .
In the U.S. , there are more than 50,000 cases of hepatitis C each year , a rate that continues to rise as the opioid epidemic endures , according to the Centers for Disease Control and Prevention .
While the drugs for hepatitis C are effective , their high cost — at tens of thousands of dollars per course of treatment — has limited their use both in the U.S. and in the developing world .
The price has come down as more drugs are developed , but cost remains @ @ @ @ @ @ @ the disease .
Untreated , the virus continues to spread through drug use and sexual activity .
Alter 's studies at NIH of transfusion-associated hepatitis `` demonstrated that an unknown virus was a common cause of chronic hepatitis , '' according to the Nobel Assembly .
Houghton used an untested strategy to isolate the genome of the new virus .
He did his work at the Chiron Corp. in Emeryville , Calif. Rice , working at Washington University in St. Louis , provided the final evidence showing that the hepatitis C virus alone @ @ @ @ @ @ @ been a virus that has been a plague affecting millions of people , and still is unfortunately , '' Thomas Perlmann , secretary-general of the Nobel Assembly , said during an interview after the announcement .
Houghton , who is in his 60s , was born in the United Kingdom .
Alter was born in 1935 and Rice in 1952 , both in the United States .
`` Prior to their work , the discovery of the hepatitis A and B viruses had been critical steps forward , but the majority of blood-borne @ @ @ @ @ @ @ assembly says .
`` The discovery of the hepatitis C virus revealed the cause of the remaining cases of chronic hepatitis and made possible blood tests and new medicines that have saved millions of lives , '' according to the announcement .

3 Scientists Win Nobel Prize For Hepatitis C Virus Discovery
toggle caption Markus Marcetic/Courtesy of Myntverket (Swedish Mint)
Three scientists Monday won the 2020 Nobel Prize in physiology or medicine for discovering the hepatitis C virus, which led to the development of a test to prevent the spread of the virus and drugs that have saved millions of lives, the Nobel Assembly said.
Harvey Alter of the National Institutes of Health; Michael Houghton, who is now at the University of Alberta in Canada; and Charles Rice, who is now at Rockefeller University in New York, will share the 10 million Swedish krona ($1.1 million) prize.
Hepatitis C causes serious liver disease, which can be fatal. The virus is transmitted through bodily fluids, including blood. The discovery led to a test for the virus, which is now widely used to protect people from becoming infected through blood transfusions. The discovery also led to antiviral drugs to treat the infection.
"For the first time in history, the disease can now be cured, raising hopes of eradicating hepatitis C virus from the world population," the Nobel Committee said in a statement.
As is customary, the announcement was made at the Karolinska Institute in Stockholm. The Nobels in physics, chemistry, literature and peace will be awarded this week, and the prize in economics will awarded next Monday.
Since 1901, the Nobel Prize in physiology or medicine has been awarded to 219 scientists, including 12 women. The youngest laureate was 32 years old; the oldest 87.
The World Health Organization estimates that 71 million people worldwide have chronic hepatitis C, which can lead to liver cancer and cirrhosis. There are approximately 400,000 deaths annually from the disease, according to WHO.
In the U.S., there are more than 50,000 cases of hepatitis C each year, a rate that continues to rise as the opioid epidemic endures, according to the Centers for Disease Control and Prevention.
While the drugs for hepatitis C are effective, their high cost — at tens of thousands of dollars per course of treatment — has limited their use both in the U.S. and in the developing world. The price has come down as more drugs are developed, but cost remains a significant barrier to many people with the disease. Untreated, the virus continues to spread through drug use and sexual activity.
Alter's studies at NIH of transfusion-associated hepatitis "demonstrated that an unknown virus was a common cause of chronic hepatitis," according to the Nobel Assembly. Houghton used an untested strategy to isolate the genome of the new virus. He did his work at the Chiron Corp. in Emeryville, Calif. Rice, working at Washington University in St. Louis, provided the final evidence showing that the hepatitis C virus alone could cause hepatitis.
"This has been a virus that has been a plague affecting millions of people, and still is unfortunately," Thomas Perlmann, secretary-general of the Nobel Assembly, said during an interview after the announcement.
Houghton, who is in his 60s, was born in the United Kingdom. Alter was born in 1935 and Rice in 1952, both in the United States.
"Prior to their work, the discovery of the hepatitis A and B viruses had been critical steps forward, but the majority of blood-borne hepatitis cases remained unexplained," the assembly says.
"The discovery of the hepatitis C virus revealed the cause of the remaining cases of chronic hepatitis and made possible blood tests and new medicines that have saved millions of lives," according to the announcement.


npr--2020-10-04--Despite Risks To Others, Trump Leaves Hospital Suite To Greet Supporters

Despite Risks To Others , Trump Leaves Hospital Suite To Greet Supporters Updated at 7:53 a.m .
ET Monday Despite indications from doctors that he is still facing serious challenges from the coronavirus and could spread the disease to others , President Trump briefly left Walter Reed National Military Medical Center on Sunday evening to wave to supporters gathered outside .
A masked Trump was seen waving to small crowds from a black SUV .
Other images showed Secret Service personnel in the vehicle with personal protective equipment on to protect themselves from the high exposure risk of riding in @ @ @ @ @ @ @ tested positive for the virus .
Right before the drive-by , the president tweeted a video in which he thanked the doctors and staff at Walter Reed for treating him for COVID-19 and said he was about to `` make a little surprise visit '' outside to greet supporters .
`` We 're going to pay a little surprise to some of the great patriots that we have out on the street , and they 've been out there for a long time and they 've got Trump flags and they love our @ @ @ @ @ @ @ I learned a lot about COVID .
I learned it by really going to school .
This is the real school .
This is n't the , 'let 's read the book ' school , '' he said .
Trump has been briefed extensively about the pandemic by members of his White House coronavirus task force and other advisers .
`` I get it , and I understand it , and it 's a very interesting thing I 'm going to be letting you know about it , '' Trump said .
Dr. @ @ @ @ @ @ @ Walter Reed who is also chief of disaster medicine at George Washington University , lambasted the move as being made for `` political theater . ''
`` That Presidential SUV is not only bulletproof , but hermetically sealed against chemical attack .
The risk of COVID-19 transmission inside is as high as it gets outside of medical procedures .
The irresponsibility is astounding .
My thoughts are with the Secret Service forced to play , '' he wrote on Twitter .
White House spokesman Judd Deere said the excursion had been cleared by @ @ @ @ @ @ @ precautions were taken in the execution of this movement to protect the president and all those supporting it , including PPE , '' he said in a statement .
The president very rarely makes any movement in public without a press pool .
In this case , the pool was not informed of the president leaving Walter Reed .
`` President Trump took a short , last-minute motorcade ride to wave to his supporters outside and has now returned to the Presidential Suite inside Walter Reed , '' Deere said in a separate @ @ @ @ @ @ @ is outrageous for the president to have left the hospital — even briefly — amid a health crisis without a protective pool present to ensure that the American people know where their president is and how he is doing , '' the White House Correspondents ' Association said in a statement .
`` Now more than ever , the American public deserves independent coverage of the president so they can be reliably informed about his health . ''
His brief visit outside came hours after Trump 's medical team told reporters that the @ @ @ @ @ @ @ levels over the course of his COVID-19 diagnosis , is being treated with a steroid , and could be discharged from Walter Reed as early as Monday .
Medical experts raised skepticism about such a quick release given the other details shared by the president 's medical team .

Despite Risks To Others, Trump Leaves Hospital Suite To Greet Supporters
Enlarge this image toggle caption Tyrone Turner/WAMU Tyrone Turner/WAMU
Updated at 7:53 a.m. ET Monday
Despite indications from doctors that he is still facing serious challenges from the coronavirus and could spread the disease to others, President Trump briefly left Walter Reed National Military Medical Center on Sunday evening to wave to supporters gathered outside.
A masked Trump was seen waving to small crowds from a black SUV. Other images showed Secret Service personnel in the vehicle with personal protective equipment on to protect themselves from the high exposure risk of riding in an enclosed vehicle with someone who has tested positive for the virus.
Right before the drive-by, the president tweeted a video in which he thanked the doctors and staff at Walter Reed for treating him for COVID-19 and said he was about to "make a little surprise visit" outside to greet supporters.
"We're going to pay a little surprise to some of the great patriots that we have out on the street, and they've been out there for a long time and they've got Trump flags and they love our country," Trump said.
"I learned a lot about COVID. I learned it by really going to school. This is the real school. This isn't the, 'let's read the book' school," he said.
Trump has been briefed extensively about the pandemic by members of his White House coronavirus task force and other advisers.
"I get it, and I understand it, and it's a very interesting thing I'm going to be letting you know about it," Trump said.
Some experts swiftly characterized Trump's drive-by greeting as reckless.
Dr. James Phillips, an attending physician at Walter Reed who is also chief of disaster medicine at George Washington University, lambasted the move as being made for "political theater."
"That Presidential SUV is not only bulletproof, but hermetically sealed against chemical attack. The risk of COVID-19 transmission inside is as high as it gets outside of medical procedures. The irresponsibility is astounding. My thoughts are with the Secret Service forced to play," he wrote on Twitter.
White House spokesman Judd Deere said the excursion had been cleared by the medical team beforehand.
"Appropriate precautions were taken in the execution of this movement to protect the president and all those supporting it, including PPE," he said in a statement.
Enlarge this image toggle caption Tyrone Turner/WAMU Tyrone Turner/WAMU
The president very rarely makes any movement in public without a press pool. In this case, the pool was not informed of the president leaving Walter Reed.
"President Trump took a short, last-minute motorcade ride to wave to his supporters outside and has now returned to the Presidential Suite inside Walter Reed," Deere said in a separate statement after the trip.
"It is outrageous for the president to have left the hospital — even briefly — amid a health crisis without a protective pool present to ensure that the American people know where their president is and how he is doing," the White House Correspondents' Association said in a statement. "Now more than ever, the American public deserves independent coverage of the president so they can be reliably informed about his health."
His brief visit outside came hours after Trump's medical team told reporters that the president experienced two drops in his oxygen levels over the course of his COVID-19 diagnosis, is being treated with a steroid, and could be discharged from Walter Reed as early as Monday. Medical experts raised skepticism about such a quick release given the other details shared by the president's medical team.


npr--2020-10-05--Not 'Out Of The Woods Yet': Trump's Health Remains At Risk, Doctors Say

Not 'Out Of The Woods Yet ' : Trump 's Health Remains At Risk , Doctors Say President Trump was discharged from Walter Reed National Military Medical Center and returned to the White House on Monday evening .
He gave reporters a double thumbs-up on his way through the doors , and his doctors earlier on Monday said , `` He 's up and back to his old self . ''
But he 's a few days into his diagnosis with COVID-19 , a novel disease that doctors are still learning how best to treat .
And , medical experts @ @ @ @ @ @ @ a danger zone .
At Monday 's press briefing , though largely optimistic about the president 's condition , his physician , Sean Conley , said he `` may not be out of the woods yet . ''
`` I would also agree with the medical team that just because he 's going home , he 's not completely out of the woods , '' says Dr. Faisal Masud , medical director of critical care at Houston Methodist Hospital .
`` He has to demonstrate continuous success and no lung issue because , @ @ @ @ @ @ @ have long-term lung impact . ''
At Monday 's press briefing , Conley said Trump 's oxygen levels were healthy and he was breathing well , but Conley declined to answer a reporter 's question about whether there is evidence of pneumonia on the president 's lung scans .
The president did have a fever , fatigue and a mild cough late last week but has n't had fever in 72 hours , his doctors said .
It 's a good sign that he was well enough to be discharged , says Colleen @ @ @ @ @ @ @ associate chief medical officer at Emory University Hospital in Atlanta .
But even patients with COVID-19 who have mild symptoms at first can suddenly worsen , she says .
`` Individuals that have mild disease to start out with , just mild symptoms , they can in a week or so feel worse , worse enough to be in an ICU , '' she says .
However , she notes , most people with mild symptoms do n't get the kind of aggressive treatment that Trump received .
He has received an experimental @ @ @ @ @ @ @ and the steroid dexamethasone — all treatments generally reserved for patients hospitalized with severe symptoms .
So , she says , it 's hard to know what to expect in the coming days .
`` It 's possible that [ the interventions ] could make him better sooner , '' she says .
`` [ But ] we do n't know really what happens to people that have mild disease and then get treatment with antibody medications , antivirals or steroids .
I think we 're sort of a little bit in a @ @ @ @ @ @ @ sure . ''
And , Kraft adds , the president 's medical team `` is going to be very vigilant about his symptoms '' in the coming days .
`` So he 'll be getting his vitals checked at least every day or every couple times a day in order to make sure nothing is happening . ''
He will also need to complete his course of medications — the remdesivir and dexamethasone — she adds .
Masud notes that recovering COVID-19 patients who were hospitalized need to be closely monitored in case @ @ @ @ @ @ @ .
Some of the common symptoms among people who take a turn for the worse are confusion , issues with memory , fatigue and not being able to catch their breath , he says .
The above symptoms , if they presented themselves , could also indicate a secondary infection , he adds , because a small percentage of COVID-19 patients go on to develop secondary bacterial infection .
Though Trump is not on oxygen now , his physicians did disclose he had `` several little temporary drops in his oxygen '' and @ @ @ @ @ @ @ if he had a patient with Trump 's profile — male , over 70 years and overweight — who was hospitalized for a few days and received aggressive treatments , he would want to monitor the patient 's oxygen levels closely even after the patient went home .
`` We like to watch them for a day or two to make sure there 's no relapse , because we 've had patients who relapsed also and required oxygen , especially when they become active .
...
They get tired and they ca n't @ @ @ @ @ @ @ he would also monitor markers of inflammation `` to see if they 're trending downwards nicely or not . ''
That would suggest the infection is going away .
When speaking with reporters , Conley said the president would be closely monitored by the medical team at the White House at least through the weekend .
`` If we can get through Monday with him remaining the same or improving , better yet , then we will all take that final big sigh of relief , '' he said .
Masud says it @ @ @ @ @ @ @ to get plenty of rest and adequate sleep , as `` one of the key things which has been shown to help patients recover is having good sleep , long duration of sleep , '' he says .
With a grueling election season ahead of him , lack of sleep and adequate breaks could hurt Trump 's recovery , he adds .
`` And I would not wish for the president to have any of those setbacks . ''

Not 'Out Of The Woods Yet': Trump's Health Remains At Risk, Doctors Say
Enlarge this image toggle caption Alex Brandon/AP Alex Brandon/AP
President Trump was discharged from Walter Reed National Military Medical Center and returned to the White House on Monday evening. He gave reporters a double thumbs-up on his way through the doors, and the White House physician earlier on Monday said, "He's up and back to his old self."
But he's a few days into his diagnosis with COVID-19, a novel disease that doctors are still learning how best to treat. And, medical experts say, he may still be in a danger zone.
At Monday's press briefing, though largely optimistic about the president's condition, his physician, Sean Conley, said he "may not be out of the woods yet."
"I would also agree with the medical team that just because he's going home, he's not completely out of the woods," says Dr. Faisal Masud, medical director of critical care at Houston Methodist Hospital. "He has to demonstrate continuous success and no lung issue because, you know, some of these patients have long-term lung impact."
At Monday's press briefing, Conley said Trump's oxygen levels were healthy and he was breathing well, but Conley declined to answer a reporter's question about whether there is evidence of pneumonia on the president's lung scans.
The president did have a fever, fatigue and a mild cough late last week but hasn't had fever in 72 hours, his doctors said.
It's a good sign that he was well enough to be discharged, says Colleen Kraft, an infectious disease physician and associate chief medical officer at Emory University Hospital in Atlanta. But even patients with COVID-19 who have mild symptoms at first can suddenly worsen, she says.
"Individuals that have mild disease to start out with, just mild symptoms, they can in a week or so feel worse, worse enough to be in an ICU," she says.
However, she notes, most people with mild symptoms don't get the kind of aggressive treatment that Trump received. He has received an experimental antibody treatment, a course of remdesivir and the steroid dexamethasone — all treatments generally reserved for patients hospitalized with severe symptoms. So, she says, it's hard to know what to expect in the coming days.
"It's possible that [the interventions] could make him better sooner," she says. "[But] we don't know really what happens to people that have mild disease and then get treatment with antibody medications, antivirals or steroids. I think we're sort of a little bit in a data-free zone, where we're not sure."
And, Kraft adds, the president's medical team "is going to be very vigilant about his symptoms" in the coming days. "So he'll be getting his vitals checked at least every day or every couple times a day in order to make sure nothing is happening."
Masud notes that recovering COVID-19 patients who were hospitalized need to be closely monitored in case they get worse, especially older adults.
Symptoms to watch for are confusion, issues with memory, fatigue and not being able to catch their breath, he says.
Some of these symptoms, if they presented themselves, could also indicate a secondary infection, he adds, because a small percentage of COVID-19 patients go on to develop secondary bacterial infection.
Though Trump is not on oxygen now, his physicians did disclose he had "several little temporary drops in his oxygen" and took supplemental oxygen twice.
Masud says if he had a patient with Trump's profile — male, over 70 years and overweight — who was hospitalized for a few days and received aggressive treatments, he would want to monitor the patient's oxygen levels closely even after the patient went home.
"We like to watch them for a day or two to make sure there's no relapse, because we've had patients who relapsed also and required oxygen, especially when they become active. ... They get tired and they can't catch their breath."
Masud says he would also monitor markers of inflammation "to see if they're trending downwards nicely or not." That would suggest the infection is going away.
When speaking with reporters, Conley said the president would be closely monitored by the medical team at the White House at least through the weekend. "If we can get through Monday with him remaining the same or improving, better yet, then we will all take that final big sigh of relief," he said.
Masud says it's important for patients recovering from COVID-19 to get plenty of rest and adequate sleep, as "one of the key things which has been shown to help patients recover is having good sleep, long duration of sleep," he says.
With a grueling election season ahead of him, lack of sleep and adequate breaks could hurt Trump's recovery, he adds. "And I would not wish for the president to have any of those setbacks."