npr--2020-03-05--Face Masks: Not Enough Are Made In America To Deal With Coronavirus

Face Masks : Not Enough Are Made In America To Deal With Coronavirus He 's executive vice president of Texas-based Prestige Ameritech , one of the few manufacturers of respirators and surgical face masks still making them in the United States .
`` I 've got requests for maybe a billion and a half masks , if you add it up , '' he says .
That 's right — 1.5 billion .
Since the coronavirus started spreading in January , Bowen says he 's gotten at least 100 calls and emails a day .
`` Normally , I do @ @ @ @ @ @ @ .
Bowen is at the center of a major problem that the coronavirus has made crystal clear : There are n't enough domestic manufacturers for critical medical supplies like face masks .
And even if production ramps up , it 's unlikely to be enough in the current outbreak .
Usually , businesses want orders to spike — they hope customers line up for their products .
But Bowen is not pleased .
His company simply ca n't keep up with demand .
3M — one of the biggest mask makers — is @ @ @ @ @ @ @ it 's stepping up production at its factories around the world , but it ca n't fulfill all the new orders .
The World Health Organization this week warned against hoarding and panic-buying of critical protective gear .
`` Without secure supply chains , the risk to healthcare workers around the world is real , '' WHO Director-General Dr Tedros Adhanom Ghebreyesus said .
`` Industry and governments must act quickly to boost supply , ease export restrictions and put measures in place to stop speculation and hoarding . ''
Concern about shortages @ @ @ @ @ @ @ nurses is prompting hospitals around the world to clamor for medical supplies as the coronavirus continues its infectious spread .
In response , the Trump administration is looking at ways to rapidly expand domestic production , but the economics of the face-mask business makes that difficult .
This is a cycle familiar to Bowen .
During what he calls `` peacetime , '' when there are no outbreaks , there are few buyers of masks .
During an epidemic , there 's suddenly limitless demand .
`` Imagine if , all at once @ @ @ @ @ @ @ , '' Bowen says .
`` The skateboarding industry is not set up for spikes like that , and neither is the mask-making industry . ''
Prestige Ameritech , for example , owns a limited number of machines that assemble , sew and shape the masks .
A decade ago , it ramped up production in response to the swine flu outbreak by buying more machines and hiring 150 new workers .
`` We made a really big mistake , '' Bowen says of that decision .
It took about four months to @ @ @ @ @ @ @ as long as a school bus and cost as much as $ 1 million .
By the time they were ready , the swine flu crisis had ended , demand vaporized , and Prestige Ameritech almost went bankrupt .
`` One day — and it is literally almost like one day — it just quits .
The demand is over , the phones stop ringing , '' Bowen says .
To make matters worse , the hospitals and medical supply companies suddenly had a glut of masks ; they stopped buying for months @ @ @ @ @ @ @ But the recent shortages also show how a lack of steady orders can create a sudden national security risk .
The seeds of that problem , says Bowen , can be traced back 15 years .
That 's when many mask factories moved overseas , where masks could be made at a fraction of Bowen 's costs .
Most notably , he says , Kimberly-Clark , which used to be one of the industry leaders , moved its operations .
`` The surgical mask supply went from being 90 % U.S.-made to being @ @ @ @ @ @ @ year , '' Bowen says .
For years , Bowen tried to get the government to pay attention to this issue .
He wrote letters to Presidents Obama and Trump , warning an epidemic could prompt China to stop exporting its supply , leaving American health care in a bind .
He wanted the U.S. government to mandate hospitals buy more American-made products .
`` If every hospital would pay just a few cents more for a mask , there would n't be an issue here , '' he says .
The coronavirus @ @ @ @ @ @ @ he has the administration 's attention .
Last week , Health and Human Services Secretary Alex Azar told the House Appropriations Committee the country needs 25 times more masks than it currently has stockpiled .
The Strategic National Stockpile is essentially the country 's emergency medicine cabinet , with reserves of vaccines and medical supplies stowed in warehouses around the country .
Steven Adams , the stockpile 's acting director , says the government now realizes it needs more mask factories in the U.S. `` Coronavirus has made the theoretical risks seem far @ @ @ @ @ @ @ most of us , '' he says .
The government is looking to buy half a billion domestically made medical masks — a purchase that will take months or years to receive , after this crisis passes .
`` Our hope is that this can be a step and start moving the balance back toward a greater percentage being produced in the U.S. , '' Adams says .
And he hopes it will also better prepare the country for the next outbreak .

Not Enough Face Masks Are Made In America To Deal With Coronavirus
Enlarge this image toggle caption Tom Pennington/Getty Images Tom Pennington/Getty Images
Mike Bowen's been a very busy man.
He's executive vice president of Texas-based Prestige Ameritech, one of the few manufacturers of respirators and surgical face masks still making them in the United States.
"I've got requests for maybe a billion and a half masks, if you add it up," he says. That's right — 1.5 billion.
Since the coronavirus started spreading in January, Bowen says he's gotten at least 100 calls and emails a day.
"Normally, I don't get any," he says.
Bowen is at the center of a major problem that the coronavirus has made crystal clear: There aren't enough domestic manufacturers for critical medical supplies such as face masks. And even if production ramps up, it's unlikely to be enough in the current outbreak.
Usually, businesses want orders to spike — they hope customers line up for their products.
But Bowen is not pleased.
His company simply can't keep up with demand. 3M — one of the biggest mask makers — is in the same predicament. It says it's stepping up production at its factories around the world, but it can't fulfill all the new orders.
The World Health Organization this week warned against hoarding and panic-buying of critical protective gear.
"Without secure supply chains, the risk to health care workers around the world is real," WHO Director-General Dr Tedros Adhanom Ghebreyesus said. "Industry and governments must act quickly to boost supply, ease export restrictions and put measures in place to stop speculation and hoarding."
Concern about shortages of face masks used by doctors and nurses is prompting hospitals around the world to clamor for medical supplies as the coronavirus continues its infectious spread.
In response, the Trump administration is looking at ways to rapidly expand domestic production, but the economics of the face-mask business makes that difficult.
This is a cycle familiar to Bowen. During what he calls "peacetime," when there are no outbreaks, there are few buyers of masks. During an epidemic, there's suddenly limitless demand.
"Imagine if, all at once, millions of people wanted to skateboard," Bowen says.
"The skateboarding industry is not set up for spikes like that, and neither is the mask-making industry."
Enlarge this image toggle caption Tom Pennington/Getty Images Tom Pennington/Getty Images
Prestige Ameritech, for example, owns a limited number of machines that assemble, sew and shape the masks. A decade ago, it ramped up production in response to the swine flu outbreak by buying more machines and hiring 150 new workers.
"We made a really big mistake," Bowen says of that decision. It took about four months to build the new machines, which are as long as a school bus and cost as much as $1 million.
By the time they were ready, the swine flu crisis had ended, demand vaporized, and Prestige Ameritech almost went bankrupt. "One day — and it is literally almost like one day — it just quits. The demand is over, the phones stop ringing," Bowen says.
To make matters worse, the hospitals and medical supply companies suddenly had a glut of masks; they stopped buying for months.
That was a business headache. But the recent shortages also show how a lack of steady orders can create a sudden national security risk.
The seeds of that problem, says Bowen, can be traced back 15 years. That's when many mask factories moved overseas, where masks could be made at a fraction of Bowen's costs.
Most notably, he says, Kimberly-Clark, which used to be one of the industry leaders, moved its operations.
"The surgical mask supply went from being 90% U.S.-made to being 95% foreign-made in literally one year," Bowen says.
For years, Bowen tried to get the government to pay attention to this issue. He wrote letters to Presidents Obama and Trump, warning that an epidemic could prompt China to stop exporting its supply, leaving American health care in a bind.
He wanted the U.S. government to mandate that hospitals buy more American-made products.
"If every hospital would pay just a few cents more for a mask, there wouldn't be an issue here," he says.
The coronavirus is proving Bowen right. Now, he has the administration's attention.
Last week, Health and Human Services Secretary Alex Azar told the House Appropriations Committee that the country needs 25 times more masks than it currently has stockpiled.
The Strategic National Stockpile is essentially the country's emergency medicine cabinet, with reserves of vaccines and medical supplies stowed in warehouses around the country.
Steven Adams, the stockpile's acting director, says the government now realizes it needs more mask factories in the U.S. "Coronavirus has made the theoretical risks seem far more real, I think, to most of us," he says.
The government is looking to buy half a billion domestically made medical masks — a purchase that will take months or years to receive, after this crisis passes.
"Our hope is that this can be a step and start moving the balance back toward a greater percentage being produced in the U.S.," Adams says. And he hopes it will also better prepare the country for the next outbreak.


npr--2020-03-05--A Push To Get More Women On Corporate Boards Gains Momentum

A Push To Get More Women On Corporate Boards Gains Momentum When Silicon Valley-based Adesto Technologies invited Susan Uthayakumar to join its all-male board last year , she had no idea California had just passed a gender quota .
She 's the country president and CEO of Schneider Electric Canada , where she 's spent the last several years working in IoT , or the Internet of things , which powers devices like smart speakers and Internet-connected doorbells .
`` The reason I was brought on board to the Adesto board is because I had the IoT experience .
That @ @ @ @ @ @ @ I 'm actually being asked to give my voice quite a bit , '' Uthayakumar said .
`` The board is very welcoming . ''
Lately , a lot of accomplished female executives have gotten similar calls to join boards of companies headquartered in California .
Among the largest 3,000 largest U.S. publicly traded companies , only about one in five board members are women , according to Equilar , which tracks corporate governance data .
And it says nearly one in 10 boards have no women .
In 2018 , California became @ @ @ @ @ @ @ in boardrooms with the passage of a bill called SB 826 .
The measure , requires publicly traded companies based there to have at least one female board director — or face a $ 100,000 fine .
At the time , the bill 's sponsor , State Sen. Hannah-Beth Jackson , called it a `` giant step forward for women . ''
Multiple studies show that corporations with female directors are more profitable , Jackson noted .
If supercharging the push toward gender parity on boards was the goal , it appears to @ @ @ @ @ @ @ 2020 Women on Boards has been tracking changes at more than 400 major California companies .
Before the law , 75 firms lacked a female board member , the group found .
By the middle of 2019 , two-thirds of those companies had added at least one woman to their boards .
The law gave companies until Dec. 31 , 2019 , to comply .
The idea is gaining traction elsewhere , where similar legislation being introduced in Massachusetts , New Jersey and Washington .
And companies outside of California are also moving @ @ @ @ @ @ @ boardroom .
TheBoardlist , a database that companies can search to find female directors , has experienced a 20 % increase in inquiries — and not just in California .
`` I think there was this halo effect simply because the topic has been discussed so much more in the last year or two , '' said Shannon Gordon , CEO of theBoardlist .
`` Companies are kind of coming around to the value of diversity on boards . ''
In January , Goldman Sachs CEO David Solomon turned heads when he announced @ @ @ @ @ @ @ stop taking companies public in the U.S. and Europe unless they have at least one diverse board member .
`` I look back at the IPOs [ initial public offerings ] over the last four years and the performance of IPOs where there 's been a woman on the board in the U.S. is significantly better than the performance of IPOs where there has n't been a woman on the board , '' Solomon told CNBC .
In his announcement , he cited his experience with his own board at Goldman Sachs .
@ @ @ @ @ @ @ 11 .
We have a black lead director .
I really value the diverse perspectives I 'm getting which are helping me run the company , '' Solomon added .
Former DuPont CEO Ellen Kullman , one of the four women on the Goldman Sachs board , said California 's law forces companies that resist change to take action .
Companies have long chosen board members based on their network of friends and acquaintances .
`` That 's where I think the history has led to mostly male boards , '' Kullman said @ @ @ @ @ @ @ of mouth and you ask the men , historically , they have given a lot of names of other men .
So now , we need to do the same . ''
Kullman , who serves on a total of four corporate boards , says she has developed a network of female executives and is giving recommendations to companies looking for female board members .
`` I 'm not taking on any more boards .
I 've got plenty .
But if people come to me with opportunities , I want to be @ @ @ @ @ @ @ , or six different women , '' Kullman said .
But in the year since its passage , critics have lodged a handful of lawsuits challenging California 's law on grounds that it 's discriminatory .
The Pacific Legal Foundation sued California in November on behalf of electronics manufacturer OSI Systems shareholder Creighton Meland , a retired corporate lawyer .
The suit argues that California 's gender mandate for boards is unconstitutional .
`` The law violates the 14th Amendment 's promise of equal treatment before the law .
And it actually forces @ @ @ @ @ @ @ of sex , '' said Anastasia Boden , a senior attorney at the Pacific Legal Foundation .
Plus , Boden says , mandating gender diversity ultimately hurts women `` by relegating them to quota hires and making them seem like space fillers . ''
As the data trickles in on the first full year of California 's law , companies are now looking ahead to complying with the second leg of the law .
By the end of next year , it calls for California-based companies to have at least two female directors @ @ @ @ @ @ @ three female directors on boards with six or more members .
The law cites studies showing that having a critical mass creates an environment where women are no longer viewed as outsiders .
`` There 's a 30 % rule .
When you have a minimum of 30 % , that 's when you see a transformation of culture and a true transformation of how business operates , '' says Shelley Zalis , CEO of The Female Quotient , a company aimed at advancing gender equality .
`` But we have to start @ @ @

A Push To Get More Women On Corporate Boards Gains Momentum
Enlarge this image toggle caption Richard Drew/AP Richard Drew/AP
Updated at 12:55 p.m. ET
When Silicon Valley-based Adesto Technologies invited Susan Uthayakumar to join its all-male board last year, she had no idea California had just passed a gender quota.
She's the country president and CEO of Schneider Electric Canada, where she's spent the last several years working in IoT, or the Internet of things, which powers devices like smart speakers and Internet-connected doorbells.
"The reason I was brought on board to the Adesto board is because I had the IoT experience. That background is there for me, so I'm actually being asked to give my voice quite a bit," Uthayakumar said. "The board is very welcoming."
Lately, a lot of accomplished female executives have gotten similar calls to join boards of companies headquartered in California.
Among the largest 3,000 largest U.S. publicly traded companies, only about one in five board members are women, according to Equilar, which tracks corporate governance data. And it says nearly one in 10 boards have no women.
In 2018, California became the first state to mandate gender diversity in boardrooms with the passage of a bill called SB 826. The measure, requires publicly traded companies based there to have at least one female board director — or face a $100,000 fine.
At the time, the bill's sponsor, State Sen. Hannah-Beth Jackson, called it a "giant step forward for women." Multiple studies show that corporations with female directors are more profitable, Jackson noted.
If supercharging the push toward gender parity on boards was the goal, it appears to be working.
The nonprofit advocacy group 2020 Women on Boards has been tracking changes at more than 400 major California companies. Before the law, 75 firms lacked a female board member, the group found. By the middle of 2019, two-thirds of those companies had added at least one woman to their boards. The law gave companies until Dec. 31, 2019, to comply.
A report this month by the California secretary of state found that 282 publicly held corporations in the state reported compliance with the law, up from 173 in July 2019.
The idea is gaining traction elsewhere, where similar legislation being introduced in Massachusetts, New Jersey and Washington.
And companies outside of California are also moving to add more female representation in the boardroom.
TheBoardlist, a database that companies can search to find female directors, has experienced a 20% increase in inquiries — and not just in California.
"I think there was this halo effect simply because the topic has been discussed so much more in the last year or two," said Shannon Gordon, CEO of theBoardlist. "Companies are kind of coming around to the value of diversity on boards."
In January, Goldman Sachs CEO David Solomon turned heads when he announced that this summer, the bank will stop taking companies public in the U.S. and Europe unless they have at least one diverse board member.
"I look back at the IPOs [initial public offerings] over the last four years and the performance of IPOs where there's been a woman on the board in the U.S. is significantly better than the performance of IPOs where there hasn't been a woman on the board," Solomon told CNBC.
In his announcement, he cited his experience with his own board at Goldman Sachs.
"We have four women out of 11. We have a black lead director. I really value the diverse perspectives I'm getting which are helping me run the company," Solomon added.
Former DuPont CEO Ellen Kullman, one of the four women on the Goldman Sachs board, said California's law forces companies that resist change to take action. Companies have long chosen board members based on their network of friends and acquaintances.
"That's where I think the history has led to mostly male boards," Kullman said. "Because if it's word of mouth and you ask the men, historically, they have given a lot of names of other men. So now, we need to do the same."
Kullman, who serves on a total of four corporate boards, says she has developed a network of female executives and is giving recommendations to companies looking for female board members.
"I'm not taking on any more boards. I've got plenty. But if people come to me with opportunities, I want to be able to point to four, five, or six different women," Kullman said.
But in the year since its passage, critics have lodged a handful of lawsuits challenging California's law on grounds that it's discriminatory.
The Pacific Legal Foundation sued California in November on behalf of electronics manufacturer OSI Systems shareholder Creighton Meland, a retired corporate lawyer. The suit argues that California's gender mandate for boards is unconstitutional.
"The law violates the 14th Amendment's promise of equal treatment before the law. And it actually forces people to make decisions on the basis of sex," said Anastasia Boden, a senior attorney at the Pacific Legal Foundation.
Plus, Boden says, mandating gender diversity ultimately hurts women "by relegating them to quota hires and making them seem like space fillers."
As the data trickles in on the first full year of California's law, companies are now looking ahead to complying with the second leg of the law. By the end of next year, it calls for California-based companies to have at least two female directors on five-member boards, and at least three female directors on boards with six or more members.
The law cites studies showing that having a critical mass creates an environment where women are no longer viewed as outsiders.
"There's a 30% rule. When you have a minimum of 30%, that's when you see a transformation of culture and a true transformation of how business operates," says Shelley Zalis, CEO of The Female Quotient, a company aimed at advancing gender equality. "But we have to start somewhere."


npr--2020-03-05--What To Know About The Election Security Situation After Super Tuesday

What To Know About The Election Security Situation After Super Tuesday The big picture on election security in the 2020 campaign after Super Tuesday : Could be worse — but also could be better .
The biggest day of voting so far in this year 's race was n't problem-free : Officials dealt with problems in Texas , California and North Carolina , plus tornadoes disrupted the vote in middle Tennessee .
And , as national security officials acknowledged before and during the vote on Tuesday , foreign malefactors continue to try to influence the information environment in the United @ @ @ @ @ @ @ media .
Even so , Americans appear to have been able to cast a ballot as they wished without major cyberattacks , information dumps or other mischief like that seen in the wave of active measures launched by Russia in 2016 .
So far .
`` Tuesday may have been a success , from the perspective of foreign influence — but folks ought to remain vigilant , '' said David Levine , a former elections supervisor who now serves as elections integrity fellow with the Alliance for Securing Democracy , a group in @ @ @ @ @ @ @ took place around the country were connected with elections equipment systems , shortages of poll workers and long lines of voters .
They followed comparatively smooth primaries in South Carolina and New Hampshire , a comparatively smooth caucus in Nevada and the high-profile implosion of Iowa 's caucuses — itself the result of problems with an app used to tally and report caucus results .
With public confidence in elections already shaken by the 2016 experience , even innocent problems or disruptions can have a corrosive effect , Levine said .
Counties and @ @ @ @ @ @ @ executing well in states that still are scheduled to vote between now and November — but they also can inadvertently fuel suspicions , he said .
`` It 's really important that local elections officials have an opportunity to assess what worked , what did n't and work assiduously to try and mitigate these issues , '' Levine said .
`` The perception of interference can be as dangerous as interference — the administration of elections need to be as seamless as possible .
Long lines at polling places can mean people choosing @ @ @ @ @ @ @ or not vote in future ... it has the ability to undermine the democratic process and play into the hands of foreign adversaries . ''
Russian , Chinese , Iranian and potentially other cyber-specialists are interested in influencing or disrupting the presidential election , national security officials warn .
Intelligence officials reportedly briefed members of Congress that Russia 's preferred outcome this year mirrors that of 2016 : a Trump victory .
But that country 's operatives also are working to boost Democratic hopeful Bernie Sanders ; Sanders has acknowledged receiving a protective @ @ @ @ @ @ @ Sanders both say they want no foreign help winning in 2020 .
What hostile governments wants is less a certain political outcome than `` to cause confusion and create doubt in our system , '' Secretary of State Mike Pompeo and other officials said on Monday .
Pompeo and the heads of defense and intelligence said they 're responding across the board .
Federal , state and local officials are coordinating in a way they never have before .
Big Tech platforms say they 're working within their own networks to clamp down @ @ @ @ @ @ @ campaigns are trying to make themselves harder targets for cyberattacks than before .
But the enemy also gets a vote , as Pentagon officials like to observe , and officials and observers suggest that influence-mongers are changing their tactics in response to the American countermeasures .
For example , Twitter 's head of site integrity , Yoel Roth , told NPR that his network traces few or no posts directly to Russia as was the case before .
Now , he believes , influence specialists are seeking to do more to amplify real @ @ @ @ @ @ @ Twitter is deploying a new policy on Thursday aimed at flagging what it considers deceptive material .
It and Facebook have faced criticism from members of Congress and outside groups for being too sluggish and too conservative about policing disinformation .
Both companies say they 're trying to balance what they call their values and practices with the need to be responsible and help the government .
They 've both made regular reports of expunging numbers of fake accounts they say are connected with influence activity ; one page that Facebook deactivated last @ @ @ @ @ @ @ although the company said it was n't connected with foreign interference .
Are more clandestine activities taking place out of sight ?
If national security leaders are correct and more nations than Russia are attempting to influence Americans — what novel tactics are now in store ?
And can a lower but still steady volume of disinformation and agitation still have an effect ?
`` If you can look like a million humans , what can you do ? ''
asked Tamer Hassan , co-founder and CEO of White Ops , a cybersecurity @ @ @ @ @ @ @ and inauthentic activity .
`` The answer is a lot of different things . ''
The effects of what Hassan call `` computational influence '' can be vast , he said .
Creators of malware establish huge networks of compromised systems that they can use , or lease to others , to influence the apparent popularity of material online .
There are bots that can help with financial fraud , bots that can elevate social media posts and even bots designed to listen to music over streaming services to make it appear more @ @ @ @ @ @ @ observers said disclosures like those made by national security officials about continued interference activity are constructive , but the implications of being able to influence and shape perceptions online are profound — and that 's not going away .
`` Awareness is always the first step , but we are a long way from solving the problem and wrapping our arms around it , '' Hassan said .
`` It 's a difficult problem to solve because we are built psychologically to influence each other .
Often , popularity and trends matter .
@ @ @ @ @ @ @ or political beliefs and political groups like our own democracy are based off of some level of influence and espousing ideas — so it becomes a much more difficult problem . ''

What To Know About The Election Security Situation After Super Tuesday
Enlarge this image toggle caption John Edelson/AFP via Getty Images John Edelson/AFP via Getty Images
The big picture on election security in the 2020 campaign after Super Tuesday: could be worse — but also could be better.
The biggest day of voting so far in this year's race wasn't problem-free: Officials dealt with problems in Texas, California and North Carolina, plus tornadoes disrupted the vote in middle Tennessee.
And, as national security officials acknowledged before and during the vote on Tuesday, foreign malefactors continue to try to influence the information environment in the United States via agitation and disinformation on social media.
Even so, Americans appear to have been able to cast a ballot as they wished without major cyberattacks, information dumps or other mischief like that seen in the wave of active measures launched by Russia in 2016. So far.
"Tuesday may have been a success, from the perspective of foreign influence — but folks ought to remain vigilant," said David Levine, a former elections supervisor who now serves as elections integrity fellow with the Alliance for Securing Democracy, a group in Washington.
The problems and disruptions that took place around the country were connected with elections equipment systems, shortages of poll workers and long lines of voters.
They followed comparatively smooth primaries in South Carolina and New Hampshire, a comparatively smooth caucus in Nevada and the high-profile implosion of Iowa's caucuses — itself the result of problems with an app used to tally and report caucus results.
With public confidence in elections already shaken by the 2016 experience, even innocent problems or disruptions can have a corrosive effect, Levine said.
Counties and local jurisdictions can buy back goodwill by executing well in states that still are scheduled to vote between now and November — but they also can inadvertently fuel suspicions, he said.
"It's really important that local elections officials have an opportunity to assess what worked, what didn't and work assiduously to try and mitigate these issues," Levine said.
"The perception of interference can be as dangerous as interference — the administration of elections need to be as seamless as possible. Long lines at polling places can mean people choosing to leave lines and not vote, or not vote in future ... it has the ability to undermine the democratic process and play into the hands of foreign adversaries."
The influencing machine
Russian, Chinese, Iranian and potentially other cyberspecialists are interested in influencing or disrupting the presidential election, national security officials warn.
Intelligence officials reportedly briefed members of Congress that Russia's preferred outcome this year mirrors that of 2016: a Trump victory. But that country's operatives also are working to boost Democratic hopeful Bernie Sanders; Sanders has acknowledged receiving a protective briefing from federal officials.
Trump and Sanders both say they want no foreign help winning in 2020. What hostile governments want is less a certain political outcome than "to cause confusion and create doubt in our system," Secretary of State Mike Pompeo and other officials said on Monday.
Pompeo and the heads of defense and intelligence said they're responding across the board.
Federal, state and local officials are coordinating in a way they never have before. Big Tech platforms say they're working within their own networks to clamp down on disinformation and agitation. And political campaigns are trying to make themselves harder targets for cyberattacks than before.
But the enemy also gets a vote, as Pentagon officials like to observe, and officials and observers suggest that influence-mongers are changing their tactics in response to the American countermeasures.
For example, Twitter's head of site integrity, Yoel Roth, told NPR that his network traces few or no posts directly to Russia as was the case before. Now, he believes, influence specialists are seeking to do more to amplify real divisive material posted by real Americans.
Twitter is deploying a new policy on Thursday aimed at flagging what it considers deceptive material. It and Facebook have faced criticism from members of Congress and outside groups for being too sluggish and too conservative about policing disinformation.
Both companies say they're trying to balance what they call their values and practices with the need to be responsible and help the government.
They've both made regular reports of expunging numbers of fake accounts they say are connected with influence activity; one page that Facebook deactivated last month had more than 50,000 followers — although the company said it wasn't connected with foreign interference.
Unknown unknowns
Many questions, however, remain.
Are more clandestine activities taking place out of sight? If national security leaders are correct and more nations than Russia are attempting to influence Americans — what novel tactics are now in store? And can a lower but still steady volume of disinformation and agitation still have an effect?
"If you can look like a million humans, what can you do?" asked Tamer Hassan, co-founder and CEO of White Ops, a cybersecurity company focused on understanding and countering bot and inauthentic activity. "The answer is a lot of different things."
The effects of what Hassan call "computational influence" can be vast, he said.
Creators of malware establish huge networks of compromised systems that they can use, or lease to others, to influence the apparent popularity of material online.
There are bots that can help with financial fraud, bots that can elevate social media posts and even bots designed to listen to music over streaming services to make it appear more popular, he said.
Election security observers said disclosures like those made by national security officials about continued interference activity are constructive, but the implications of being able to influence and shape perceptions online are profound — and that's not going away.
"Awareness is always the first step, but we are a long way from solving the problem and wrapping our arms around it," Hassan said.
"It's a difficult problem to solve because we are built psychologically to influence each other. Often, popularity and trends matter. It helps us make decisions. Advertising or political beliefs and political groups like our own democracy are based off of some level of influence and espousing ideas — so it becomes a much more difficult problem."


npr--2020-03-05--Humorous Highway Signs Aim To Steer Drivers Safely Down The Old Town Road

Humorous Highway Signs Aim To Steer Drivers Safely Down The Old Town Road Drive down any U.S. interstate and there 's a good chance you will see a pun or a funny reference on the next electronic message board you spot .
Such messages have become ubiquitous across the country lately .
But besides getting a snicker , what 's behind these roadside bits , and are they making drivers behave any differently ?
They are known as Dynamic Message Signs , and they usually remind drivers about speed limits or traffic delays .
Though the technology has been around @ @ @ @ @ @ @ across the country have been taking a different tack with their messaging in a bid for more eyeballs .
A recent message that was flashing out across Illinois expressways is a perfect example of this .
It read , `` Got The Munchies ?
Get Food Delivered .
Do n't Drive High ! ''
Since Illinois legalized marijuana this year , transportation officials have been trying to get people to avoid driving stoned , so why not appeal to a stoner 's love for snacking ?
Elmo Bruggink , an Illinois tourist from @ @ @ @ @ @ @ message .
His home country is a place that has long been dealing with drivers who smoke weed , but Bruggink said officials have n't tried humor yet .
`` We had marijuana legalized , I think , 50 years ago , '' Bruggink said .
`` I think it 's like alcohol , if you try to beat it you get a lot of criminality , but you have to use it wisely . ''
Highway messages touch on all sorts of topics .
Some are puns , some are really clever @ @ @ @ @ @ @ this one : `` Treat Your Kids Like A Fanny Pack : Buckle Up In Back . ''
It 's Guy Tridgell 's job at the Illinois Department of Transportation to come up with message ideas like these .
He said inspiration comes from everywhere .
`` When Loyola University was in the Final Four , somebody on the Secretary 's team came up with the idea of 'Buckle Up If You Like To Ramble On , ' Loyola 's the Ramblers , '' Tridgell explained .
`` That was something we were @ @ @ @ @ @ @ a day and [ we ] got some pretty nice publicity for it . ''
His colleague , Operations Director Kyle Armstrong , explained unsafe drivers have made some of the state 's roads dangerous , and that funny and topical messages are aimed at saving lives .
`` We have nearly 1,000 fatalities on Illinois roadways a year , and we 're just looking for any way to get that number down to zero .
That is the ultimate goal , '' Armstrong said .
Mississippi officials , meanwhile , have been @ @ @ @ @ @ @ with other states .
One of their ideas referenced the Star Wars series The Mandalorian .
It read : `` Baby Yoda Uses The Force But Still Needs A Carseat . ''
That got lots of love on Twitter , and Chris Turner with Mississippi 's DOT said it 's still one of his favorites .
`` If one kid got a car seat , or one parent decided to put their child in a car seat rather than in the front seat [ because of that sign ] , then we succeeded @ @ @ @ @ @ @ board the funny messaging trend is the Arizona Department of Transportation , which picked up the idea at an industry conference in 2015 .
Communications Manager Kevin Biesty said comedy and road safety are n't so different : it 's all about timing .
`` But the one missing link is the one who controls the whole thing , and that 's the person behind the wheel , '' he said .
`` How do we get across to people , at a time when people are inundated with messages , to at @ @ @ @ @ @ @ safety ? ''
But a big question lingers around all of this : do funny signs about seatbelts or distracted driving make a difference in changing behavior or is it just another distraction for drivers ?
The Federal Highway Administration has surveyed thousands of people and more than 80 % of them said they understood the messages on highway signs .
That 's true even when they have to think hard to get the joke .
Another study showed dynamic signs pull the eye in , making drivers pay more attention to what @ @ @ @ @ @ @ , Kevin Biesty conceded it 's hard to know if road signs are preventing crashes , but the bigger point is getting drivers to change their mindsets .
`` If you were to walk into a child care facility today and smoke a cigarette , everybody in that room would look at you with horror , '' Biesty reasoned .
`` We need to make it socially unacceptable for people to do things on the roadway that put everybody at risk . ''
That means , in their universal quest to make roads @ @ @ @ @ @ @ on the jokes .
And as a reminder to everyone who 's looking at this on their cellphone while driving : `` Cousin Eddie Says Twitter 's Full : Put The Phone Down . ''

Humorous Highway Signs Aim To Steer Drivers Safely Down The Old Town Road
Enlarge this image toggle caption Sam Dunklau/NPR Illinois Sam Dunklau/NPR Illinois
Drive down any U.S. interstate and there's a good chance you will see a pun or a funny reference on the next electronic message board you spot. Such messages have become ubiquitous across the country lately.
But besides getting a snicker, what's behind these roadside bits, and are they making drivers behave differently?
They are known as dynamic message signs, and they usually remind drivers about speed limits or traffic delays. Though the technology has been around for decades, in recent years states across the country have been taking a different tactic with their messaging in a bid for more eyeballs.
A recent message that was flashing out across Illinois expressways is a perfect example of this. It read, "Got The Munchies? Get Food Delivered. Don't Drive High!"
Since Illinois legalized marijuana this year, transportation officials have been trying to get people to avoid driving stoned, so why not appeal to a stoner's love for snacking?
Elmo Bruggink, an Illinois tourist from the Netherlands, weighed in on the message. His home country is a place that has long been dealing with drivers who smoke weed, but Bruggink said officials haven't tried humor yet.
"We had marijuana legalized, I think, 50 years ago," Bruggink said. "I think it's like alcohol; if you try to beat it you get a lot of criminality, but you have to use it wisely."
Highway messages touch on all sorts of topics. Some are puns, some are really clever, some are just direct, like this one: "Treat Your Kids Like A Fanny Pack: Buckle Up In Back."
It's Guy Tridgell's job at the Illinois Department of Transportation to come up with message ideas like these. He said inspiration comes from everywhere.
"When Loyola University was in the Final Four, somebody on the secretary's team came up with the idea of 'Buckle Up If You Like To Ramble On.' Loyola's the Ramblers," Tridgell explained. "That was something we were able to turn around probably in about a day, and [we] got some pretty nice publicity for it."
His colleague, Operations Director Kyle Armstrong, explained unsafe drivers have made some of the state's roads dangerous, and that funny and topical messages are aimed at saving lives.
"We have nearly 1,000 fatalities on Illinois roadways a year, and we're just looking for any way to get that number down to zero. That is the ultimate goal," Armstrong said.
Mississippi officials, meanwhile, have been using social media to share safety messages with other states. One of their ideas referenced the Star Wars series The Mandalorian. It read: "Baby Yoda Uses The Force But Still Needs A Carseat."
Enlarge this image Sam Dunklau/NPR Illinois 91.9 FM Sam Dunklau/NPR Illinois 91.9 FM
That got lots of love on Twitter, and Chris Turner with Mississippi's Department of Transportation said it's still one of his favorites.
"If one kid got a car seat, or one parent decided to put their child in a car seat rather than in the front seat [because of that sign], then we succeeded," Turner said.
Also on board the funny messaging trend is the Arizona Department of Transportation, which picked up the idea at an industry conference in 2015. Communications Manager Kevin Biesty said comedy and road safety aren't so different: it's all about timing.
"But the one missing link is the one who controls the whole thing, and that's the person behind the wheel," he said. "How do we get across to people, at a time when people are inundated with messages, to at least get them thinking and talking about safety?"
But a big question lingers around all of this: Do funny signs about seat belts or distracted driving make a difference in changing behavior, or is it just another distraction for drivers?
The Federal Highway Administration has surveyed thousands of people, and more than 80% of them said they understood the messages on highway signs. That's true even when they have to think hard to get the joke. Another study showed dynamic signs pull the eye in, making drivers pay more attention to what they're saying.
Back in Arizona, Kevin Biesty conceded it's hard to know if road signs are preventing crashes, but the bigger point is getting drivers to change their mindsets.
"If you were to walk into a child care facility today and smoke a cigarette, everybody in that room would look at you with horror," Biesty reasoned. "We need to make it socially unacceptable for people to do things on the roadway that put everybody at risk."
That means, in their universal quest to make roads safer, state DOTs will keep bringing on the jokes.
And as a reminder to everyone who's looking at this on their cellphone while driving: "Cousin Eddie Says Twitter's Full: Put The Phone Down."


npr--2020-03-05--Sabrina Ionescu's Decision To Play Another Season For Oregon Could Net A Championship

Sabrina Ionescu 's Decision To Play Another Season For Oregon Could Net A Championship It 's March and for college basketball fans , that mean Madness is coming .
When the women 's tournament begins in a little over two weeks , the University of Oregon and star guard Sabrina Ionescu should generate a lot of attention .
She led the Ducks to last season 's Final Four and was named national player-of-the-year .
Ionescu then delayed a professional career to return for her senior season .
It appears it was a good decision .
Number three ranked Oregon is @ @ @ @ @ @ @ accolades keep growing for Ionescu , on and off the court .
It could be argued that one memorable day last month justified Ionescu 's decision to come back for this final season .
The day started with her speaking to a worldwide audience at the memorial for Kobe Bryant and his daughter , Gianna .
Kobe had become Ionescu 's friend and mentor over the past year .
Hours later , Ionescu was in uniform , playing for the Ducks — and making history .
With a third-quarter rebound against Stanford , @ @ @ @ @ @ @ Division 1 college basketball — woman or man — to have at least 2,000 points , 1,000 assists and 1,000 rebounds in a career .
Those watching Ionescu that day saw the kind of poise and focus that 's not common in most 22-year-olds .
But for those who 've watched her for years , like Oregon associate head coach Mark Campbell , it was n't surprising .
`` Her whole career and her whole life , '' Campbell says , `` every time there 's been an opportunity to seize the moment @ @ @ @ @ @ @ . ''
Coming back this year also allowed Ionescu to have a proper senior send off .
Last Sunday , after her final regular season game , she stood on her home court in Eugene , Oregon , and scanned the sellout crowd of 12,634 .
`` Wow , the house that we built .
This is crazy ! ''
she told fans .
`` Coming in my freshman year , '' Ionescu said , `` and seeing all these empty seats and having my friends be able to sit wherever they want @ @ @ @ @ @ @ who texted me first for tickets ! ''
Indeed , she and her teammates – she always mentions teammates – took a not-very-good women 's team four years ago , and made it elite .
This season , the women 's team averaged just under 11,000 fans at home games in Matthew Knight Arena .
On the road , they were must-see in their Pac-12 conference .
According to Oregon head coach Kelly Graves , the team boosted attendance in their opponents ' arenas by 75 % .
Ionescu has driven that attention @ @ @ @ @ @ @ of awards and records .
The ones that set her apart as a generational college basketball talent , include the 2k , 1k , 1k achievement , and , what appears to be an untouchable 26 career triple doubles – 26 games where she had double figures in points , rebounds and assists .
The next closest college player is Kyle Collinsworth , who racked up 12 triple doubles playing for Brigham Young University .
Fewer than half of Ionescu 's total .
Ionescu 's being recognized beyond the college ranks .
Along @ @ @ @ @ @ @ 's also gotten shout outs from NBA superstars Lebron James and Steph Curry .
`` She 's changing the game , '' says Graves .
`` There 's no player in the history of college women 's basketball that 's getting the attention she is . ''
Graves says it 's `` not just because she 's a great player . ''
`` She 's getting crossover support from some of the greatest men 's basketball players in the world .
Icons ... and that just does not happen , '' he says @ @ @ @ @ @ @ think , making an impact for our sport that I think will be long lasting . ''
Go to any basketball game and listen .
When you hear a cheer , normally that means someone scored .
Crowds do n't tend to cheer the pass that comes right before — the assist .
Yes , she scores a lot , whether driving to the hoop or launching long-range three-pointers .
And she rebounds a lot .
But Ionescu leads the NCAA in assists .
And while that may not get her extra cheers @ @ @ @ @ @ @ share of ooohs and ahhhhs , often from her legions of approving young female fans .
Like 12-year-old Grace Winebarger .
She and her father drove nearly 300 miles , one way , to watch Sunday 's game .
`` I just like how she sees everything , '' says Grace , adding , `` how she can visualize how things are going to happen . ''
Oregon coach Campbell confirms that Ionescu 's greatest skills are her passing and court vision .
He was the first college coach to watch her , @ @ @ @ @ @ @ in Walnut Creek , California .
Campbell remembers a player flying around the court in a saggy basketball jersey .
`` You could n't have predicted that she would become this , '' Campbell says .
`` It 's not like the first time I saw her I said 'there 's the future of women 's basketball . '
What you saw was a young kid that had just an incredible competitive spirit and a unique bball IQ .
That 's a gift . ''
It 's a gift honed by hard , @ @ @ @ @ @ @ Ionescu learned , in large part , from her Romanian immigrant parents .
Ionescu 's climb to the top of women 's college basketball has n't always been smooth .
She told the Washington Post last year that her middle school in California initially did n't have enough girls for a team .
When her request to play on the boy 's team was denied , she was told she `` should be playing with dolls . ''
Instead of playing with dolls , she played with other girls , who she recruited @ @ @ @ @ @ @ now , '' Ionescu says , `` I wish I could go back and just tell those people they had made a mistake . ''
She continued her climb , and , as is often the case with elite , laser-focused athletes , Ionescu at times lacked patience with fellow players who were less gifted or put less work into the game .
Oregon head coach Graves told The Athletic , `` She was a tough teammate early on .
If someone did n't have the same level of commitment she did , @ @ @ @ @ @ @ Even last season , during Oregon 's run to the Final Four , Ionescu snarled at a teammate during a loss late in the regular season .
The following day , the team met with a leadership expert and that reportedly helped smooth the rough edges .
`` From there , we became closer as a group , '' Ionescu was quoted as saying .
Now , she 's as fiery as ever on the court .
But deeply affected by Kobe Bryant 's death .
She spoke recently about her decision to @ @ @ @ @ @ @ unfinished business '' — winning a national championship .
`` That was really the goal , up until obviously a month ago , '' Ionescu said .
`` And then you kind of realize that there are so many more things that are important besides that final outcome .
And nothing 's really promised , nothing 's guaranteed . ''
If it sounds like Ionescu has new perspective , she does .
But she also has that thing .
The rare ability to seize major moments .
And that should give every upcoming @ @ @ @ @ @

Sabrina Ionescu's Decision To Play Another Season For Oregon Could Net A Championship
Enlarge this image toggle caption Thomas Boyd/AP Thomas Boyd/AP
It's March and for college basketball fans, that mean Madness is coming.
When the women's tournament begins in a little over two weeks, the University of Oregon and star guard Sabrina Ionescu should generate a lot of attention. She led the Ducks to last season's Final Four and was named national player-of-the-year. Ionescu then delayed a professional career to return for her senior season.
It appears it was a good decision.
Number three ranked Oregon is primed for a championship run and the accolades keep growing for Ionescu, on and off the court.
Seizing moments
It could be argued that one memorable day last month justified Ionescu's decision to come back for this final season.
The day started with her speaking to a worldwide audience at the memorial for Kobe Bryant and his daughter, Gianna. Kobe had become Ionescu's friend and mentor over the past year.
Hours later, Ionescu was in uniform, playing for the Ducks — and making history. With a third-quarter rebound against Stanford, Ionescu became the first player ever in Division 1 college basketball — woman or man — to have at least 2,000 points, 1,000 assists and 1,000 rebounds in a career.
Those watching Ionescu that day saw the kind of poise and focus that's not common in most 22-year-olds. But for those who've watched her for years, like Oregon associate head coach Mark Campbell, it wasn't surprising.
"Her whole career and her whole life," Campbell says, "every time there's been an opportunity to seize the moment, it's what she's done."
A house the Ducks built
Coming back this year also allowed Ionescu to have a proper senior send off.
Last Sunday, after her final regular season game, she stood on her home court in Eugene, Oregon, and scanned the sellout crowd of 12,634.
"Wow, the house that we built. This is crazy!" she told fans.
"Coming in my freshman year," Ionescu said, "and seeing all these empty seats and having my friends be able to sit wherever they want. Now they're all fighting over who texted me first for tickets!"
Indeed, she and her teammates – she always mentions teammates – took a not-very-good women's team four years ago, and made it elite. This season, the women's team averaged just under 11,000 fans at home games in Matthew Knight Arena. On the road, they were must-see in their Pac-12 conference. According to Oregon head coach Kelly Graves, the team boosted attendance in their opponents' arenas by 75%.
Ionescu has driven that attention, evidenced by her seemingly endless haul of awards and records. The ones that set her apart as a generational college basketball talent, include the 2k, 1k, 1k achievement, and, what appears to be an untouchable 26 career triple doubles – 26 games where she had double figures in points, rebounds and assists. The next closest college player is Kyle Collinsworth, who racked up 12 triple doubles playing for Brigham Young University. Fewer than half of Ionescu's total.
Ionescu's being recognized beyond the college ranks. Along with her Kobe Bryant connection, she's also gotten shout outs from NBA superstars Lebron James and Steph Curry.
"She's changing the game," says Graves. "There's no player in the history of college women's basketball that's getting the attention she is."
Graves says it's "not just because she's a great player."
"She's getting crossover support from some of the greatest men's basketball players in the world. Icons...and that just does not happen," he says. "So she is, I think, making an impact for our sport that I think will be long lasting."
Passing and vision
Go to any basketball game and listen.
When you hear a cheer, normally that means someone scored. Crowds don't tend to cheer the pass that comes right before — the assist.
Meaning, Ionescu is seriously under-cheered.
Yes, she scores a lot, whether driving to the hoop or launching long-range three-pointers. And she rebounds a lot. But Ionescu leads the NCAA in assists. And while that may not get her extra cheers, the nifty passes do generate their share of ooohs and ahhhhs, often from her legions of approving young female fans.
Like 12-year-old Grace Winebarger. She and her father drove nearly 300 miles, one way, to watch Sunday's game.
"I just like how she sees everything," says Grace, adding, "how she can visualize how things are going to happen."
Oregon coach Campbell confirms that Ionescu's greatest skills are her passing and court vision. He was the first college coach to watch her, when she was a skinny 9th grader in Walnut Creek, California. Campbell remembers a player flying around the court in a saggy basketball jersey.
"You couldn't have predicted that she would become this," Campbell says. "It's not like the first time I saw her I said 'there's the future of women's basketball.' What you saw was a young kid that had just an incredible competitive spirit and a unique bball IQ. That's a gift."
It's a gift honed by hard, hard work which, Campbell says, Ionescu learned, in large part, from her Romanian immigrant parents.
Not always a smooth climb
Ionescu's climb to the top of women's college basketball hasn't always been smooth.
She told the Washington Post last year that her middle school in California initially didn't have enough girls for a team. When her request to play on the boy's team was denied, she was told she "should be playing with dolls."
"Seriously," Ionescu says, "word-for-word."
Instead of playing with dolls, she played with other girls, who she recruited to play.
"It's funny now," Ionescu says, "I wish I could go back and just tell those people they had made a mistake."
She continued her climb, and, as is often the case with elite, laser-focused athletes, Ionescu at times lacked patience with fellow players who were less gifted or put less work into the game.
Oregon head coach Graves told The Athletic, "She was a tough teammate early on. If someone didn't have the same level of commitment she did, she couldn't understand why."
Even last season, during Oregon's run to the Final Four, Ionescu snarled at a teammate during a loss late in the regular season. The following day, the team met with a leadership expert and that reportedly helped smooth the rough edges.
"From there, we became closer as a group," Ionescu was quoted as saying.
Now, she's as fiery as ever on the court. But deeply affected by Kobe Bryant's death.
She spoke recently about her decision to return this season, to complete "unfinished business" — winning a national championship.
"That was really the goal, up until obviously a month ago," Ionescu said. "And then you kind of realize that there are so many more things that are important besides that final outcome. And nothing's really promised, nothing's guaranteed."
If it sounds like Ionescu has new perspective, she does. But she also has that thing. The rare ability to seize major moments.
And that should give every upcoming tournament opponent cause for concern.


npr--2020-03-05--Trump Administration Announces New Scrutiny Of Nursing Homes

The Centers for Medicare & Medicaid Services is ordering health inspectors to focus on infection-control practices at nursing homes and hospitals , particularly those where coronavirus infections have been identified among patients or in the community , CMS Administrator Seema Verma announced Wednesday .
`` We are hyperfocused on infection control right now , '' Verma said .
`` Our role in this is to say , 'Were there some breaches of protocol ?
Was this facility following the guidelines that are in place ?
Was there handwashing ?
Were they changing gloves ?
Were they doing laundry appropriately ?
@ @ @ @ @ @ @ The heightened regulatory attention comes after the deaths of five people who had lived at Life Care Center of Kirkland , Wash .
They all had contracted COVID-19 , a respiratory illness caused by the coronavirus .
Verma said inspectors would be dispatched to that nursing home to see whether staff there had followed infection control rules .
She noted that the facility was cited for lapses last year , although inspectors subsequently determined the errors had been corrected .
In a call with reporters , nursing home industry leaders said they supported @ @ @ @ @ @ @ White House officials in a Wednesday meeting to address other problems , including potential shortages of supplies , such as masks and gowns , if the contagion continues to spread .
`` The links in that [ supply ] chain are getting a little weaker , '' said Randy Bury , president of the Evangelical Lutheran Good Samaritan Society , which runs skilled rehabilitation facilities and other elderly care centers in 24 states .
CMS on Wednesday also issued guidance clarifying that nursing homes have the authority to bar visitors in an effort @ @ @ @ @ @ @ should screen each one to find out if they traveled to certain countries within the preceding 14 days or if they showed symptoms of respiratory illness .
Nursing home representatives welcomed that action , saying some family members and other visitors have been resistant in recent days to answer questions or follow protocols .
`` Some of them have been quite reluctant to comply , '' said Janet Snipes , the executive director of Holly Heights Nursing Center in Denver .
Mark Parkinson , president of the American Health Care Association , an @ @ @ @ @ @ @ the coronavirus crisis has passed , state lawmakers need to examine how low reimbursement from state Medicaid programs was hindering the quality of care for nursing home residents .
`` The Medicaid system for long-term care is chronically underfunded , '' he said during the telephone press conference .
`` We have been telling people that , ultimately , this would have consequences . ''
Health inspections regularly turn up lapses in infection control at nursing homes , which are cited more than any other type of deficiency .
In the past three @ @ @ @ @ @ @ 61 % , have been cited for errors in hygiene or other infection prevention and control rules , including 3,528 nursing homes that were cited more than once , according to a Kaiser Health News analysis .
The facilities with lower staffing levels were more likely to be found in violation .
Nearly all were lower-level violations that do not carry the threat of fines and rarely influence the star rating system used by Medicare 's Nursing Home Compare website .
In its 2019 inspection of the Kirkland facility , the state labeled @ @ @ @ @ @ @ caused `` minimal harm or potential for actual harm . ''
The facility was fined , but that was for other , largely unrelated violations that inspectors uncovered during their visit , records from Washington state show .
Already , there are 8,200 health inspectors at state health agencies , which routinely conduct the probes under contract with CMS .
Going forward , federal health officials will also be involved in the visits , Verma said , as well as those from private accrediting organizations .
`` We 're starting with a special @ @ @ @ @ @ @ those where there has been some type of situation or in areas where we have seen some community spread , '' Verma said .
`` We 'll also be particularly looking at those institutions that have had some concerns in the past , where there have been some previous violations . ''
However , the specific instructions require inspectors to put a higher priority on regularly scheduled surveys and visits to newly opened facilities than to visits to sites previously cited for infection control violations .
The new guidance suspends most inspections that @ @ @ @ @ @ @ the most serious ones , which involve allegations of abuse , neglect or actions that place residents in imminent jeopardy .
Kaiser Health News is a nonprofit , editorially independent program of the Kaiser Family Foundation .
KHN is not affiliated with Kaiser Permanente .

Trump Administration Announces New Scrutiny Of Nursing Homes
Enlarge this image toggle caption shapecharge/Getty Images shapecharge/Getty Images
The Centers for Medicare & Medicaid Services is ordering health inspectors to focus on infection-control practices at nursing homes and hospitals, particularly those where coronavirus infections have been identified among patients or in the community, CMS administrator Seema Verma announced Wednesday.
"We are hyperfocused on infection control right now," Verma said. "Our role in this is to say, 'Were there some breaches of protocol? Was this facility following the guidelines that are in place? Was there hand-washing? Were they changing gloves? Were they doing laundry appropriately? Was food handled appropriately?'"
The heightened regulatory attention comes after the deaths of five people who had lived at Life Care Center of Kirkland, Wash. They all had contracted COVID-19, a respiratory illness caused by the new coronavirus. Verma said inspectors would be dispatched to that nursing home to see whether staff there had followed infection-control rules. She noted that the facility was cited for lapses last year, although inspectors subsequently determined the errors had been corrected.
In a call with reporters, nursing home industry leaders said they supported the inspection directive, but they asked White House officials in a Wednesday meeting to address other problems, including potential shortages of supplies, such as masks and gowns, if the contagion continues.
"The links in that [supply] chain are getting a little weaker," said Randy Bury, president of the Evangelical Lutheran Good Samaritan Society, which runs skilled rehabilitation facilities and other elderly care centers in 24 states.
CMS on Wednesday also issued guidance clarifying that nursing homes have the authority to bar visitors in an effort to protect residents from infection — and should screen each one to find out if they traveled to certain countries within the preceding 14 days or if they showed symptoms of respiratory illness.
Nursing home representatives welcomed that action, saying some family members and other visitors have been resistant in recent days to answering questions or following protocols.
"Some of them have been quite reluctant to comply," said Janet Snipes, the executive director of Holly Heights Nursing Center in Denver.
Mark Parkinson, president of the American Health Care Association, an industry trade group, said that after the coronavirus crisis has passed, state lawmakers need to examine how low reimbursement from state Medicaid programs was hindering the quality of care for nursing home residents.
"The Medicaid system for long-term care is chronically underfunded," he said during the telephone press conference. "We have been telling people that, ultimately, this would have consequences."
Health inspections regularly turn up lapses in infection control at nursing homes, which are cited more than any other type of deficiency. In the past three years, 9,372 nursing homes, or 61%, have been cited for errors in hygiene or other infection prevention and control rules, including 3,528 nursing homes that were cited more than once, according to a Kaiser Health News analysis. The facilities with lower staffing levels were more likely to be found in violation.
Nearly all were lower-level violations that do not carry the threat of fines and rarely influence the star rating system used by Medicare's Nursing Home Compare website. In its 2019 inspection of the Kirkland facility, the state labeled the infection-control violations as low-level because they caused "minimal harm or potential for actual harm." The facility was fined, but that was for other, largely unrelated violations that inspectors uncovered during their visit, records from Washington state show.
Already, there are 8,200 health inspectors at state health agencies, which routinely conduct the probes under contract with CMS. Going forward, federal health officials will also be involved in the visits, Verma said, as well as those from private accrediting organizations.
"We're starting with a special focus on nursing homes and hospitals — those where there has been some type of situation or in areas where we have seen some community spread," Verma said. "We'll also be particularly looking at those institutions that have had some concerns in the past, where there have been some previous violations."
However, the specific instructions require inspectors to put a higher priority on regularly scheduled surveys and visits to newly opened facilities than to visits to sites previously cited for infection-control violations. The new guidance suspends most inspections that are based on complaints, except for the most serious ones, which involve allegations of abuse, neglect or actions that place residents in imminent jeopardy.
Kaiser Health News is a nonprofit, editorially independent program of the Kaiser Family Foundation. KHN is not affiliated with Kaiser Permanente.


npr--2020-03-05--10 Census Facts That Bust Common Myths About The 2020 U.S. Head Count

10 Census Facts That Bust Common Myths About The 2020 U.S. Head Count Making sense of the census can be @ @ @ @ @ , the national head count comes around once every 10 years .
That 's enough @ @ @ @ @ and for newcomers to settle into life here without ever encountering the constitutional mandate , @ @ @ @ @ and federal tax dollars are distributed .
There are a lot of basics to understand @ @ @ @ @ the count ramps up , you 'll likely see and hear misinformation — and some @ @ @ @ @ social media and in conversations , and NPR is here to set the record straight @

10 Census Facts That Bust Common Myths About The 2020 U.S. Head Count
Enlarge this image toggle caption Mandel Ngan/AFP via Getty Images Mandel Ngan/AFP via Getty Images
Updated on March 6 at 10:10 a.m. ET
Making sense of the census can be difficult.
In the U.S., the national head count comes around once every 10 years. That's enough time for memories to fade and for newcomers to settle into life here without ever encountering the constitutional mandate, which determines how political representation and federal tax dollars are distributed.
There are a lot of basics to understand about the census. As the count ramps up, you'll likely see and hear misinformation — and some disinformation — swirling around on social media and in conversations, and NPR is here to set the record straight.
1. The 2020 census form does not include a citizenship question.
Federal courts have permanently blocked plans by President Trump's administration to add to the 2020 census forms the question, "Is this person a citizen of the United States?" The administration is moving forward with gathering existing government records to produce data about the U.S. citizenship status of every person living in the country.
2. The census does not start on Census Day (April 1).
It officially kicked off on Jan. 21 in the most remote parts of Alaska. Most households in the country are expected to be able to start responding on March 12. April 1 is a reference date, and households are supposed to include everyone living in the home as of that date on the census form.
3. The census does not count only U.S. citizens.
It counts every person living in the country on Census Day, including unauthorized immigrants and green card holders. Since the 14th Amendment was ratified after the Civil War, the census has been required to count the "whole number of persons" living in each state. The Constitution's "Indians not taxed" clause no longer excluded some American Indians from the count by 1940, when the Census Bureau began trying to include all Native Americans in the numbers used for reapportioning congressional seats. International visitors on vacation or work trips to the U.S., however, are not counted. The Census Bureau has a more detailed breakdown of who is and isn't counted, as well as where. Each resident is supposed to be counted where the person usually lives and sleeps. For the 2020 head count, the Census Bureau is continuing to count prisoners where they are incarcerated. Military service members temporarily deployed overseas will be counted at their home bases and ports in the United States.
4. The Census Bureau does not keep your individually identifiable data confidential forever.
Census records identifying individuals are ultimately transferred from the Census Bureau to the National Archives and Records Administration, which releases the information to the public 72 years after it's collected. Federal law restricts access to data identifying individuals until then. Still, the Census Bureau can release information about specific demographic groups at a level as detailed as a neighborhood.
5. The 2020 census is not the first online U.S. census.
There was an online option for the 2000 census, although it was available only for the short version of that year's form and only in English. The 2020 census is set to be the first primarily online count to allow all U.S. households to reply through the Internet. The bureau is also collecting responses on paper, over the phone and in person.
6. The census is not voluntary, but every person is not required to fill out a census form.
Although the federal government has rarely enforced penalties, federal law requires U.S. residents age 18 and older to answer questions for the census. But one person can answer questions on behalf of other members of the same household. When the Census Bureau releases updates on 2020 census response rates, those are percentages of households, not people.
7. The census does not consider "Hispanic or Latino" a race.
Federal standards set by the White House's Office of Management and Budget require the census and other federal surveys to categorize "Hispanic or Latino" as an ethnicity to allow Latinx people to identify with any race. There was a proposal to change how the census collects data on Latinx identity, but the OMB has not made public whether it has approved that proposal.
8. The census does not ask about your religion, political affiliation or income.
Federal law prohibits the Census Bureau from including a question about religious affiliation on a form that all U.S. households are required to fill out. The 2020 census does not ask about the number of toilets, desks or beds in your home, although some of these topics have come up on past census forms and the Census Bureau's American Community Survey. The questions the 2020 census does ask are listed here.
9. The exact number of dollars in federal funding guided by census data is not known.
The Census Bureau often cites more than $675 billion a year as the estimated amount of federal government spending that is distributed to states and local communities based in part on census data. But Andrew Reamer, a longtime researcher on census-guided funding who's based at George Washington University's Institute of Public Policy, has used more recent data to produce a more comprehensive estimate, currently at more than $1.5 trillion a year.
10. The census is not the American Community Survey.
Both are conducted by the Census Bureau. The census goes out to every household once a decade. The American Community Survey goes out to about 1 in 38 households every year.


npr--2020-03-05--When Coronavirus Struck Seattle, This Lab Was Ready To Start Testing

When Coronavirus Struck Seattle , This Lab Was Ready To Start Testing It 's been a busy week at the virology lab run by UW Medicine , which includes the University of Washington 's medical school and hospitals .
`` We 've already gone to three shifts , '' says Dr. Keith Jerome , a professor in the department of laboratory medicine who runs the lab .
`` People are going to be here basically all the time . ''
The lab is processing about 100 coronavirus tests a day .
But it 's prepared to do more than 1,000 @ @ @ @ @ @ @ that to 4,000 , Jerome says .
The demand for tests is rising .
Seattle is at the center of a coronavirus outbreak that has already claimed the lives of 10 people in Washington state .
One reason the lab is ready to test lots of people is its state-of-the-art equipment , including twin devices that extract genetic material from specimens .
`` That all happens robotically , '' Jerome says , as he gives me a tour of the lab 's testing area .
`` You can see the arms here moving @ @ @ @ @ @ @ working on 96 specimens at a time .
We have two of them .
This is part of the magic of moving so many specimens through this laboratory . ''
In another area of the lab is a room full of instruments that take bits of genetic material from a virus and make millions of copies .
That 's critical for detecting an infection , Jerome says .
`` Right now this is our limiting factor , '' he says , adding that they 've already asked to borrow more of the instruments @ @ @ @ @ @ @ .
But the lab 's readiness also is the result of months of planning .
Jerome and other virologists started the process in January , after hearing reports about the coronavirus outbreak in China .
`` Our opinion was , this is probably not going to be a problem , this is probably going to be a waste of our effort and some money , but we owe it to the people of our area to be prepared , '' he says .
So the scientists developed an assay and began using it @ @ @ @ @ @ @ .
At first , the tests found no infections , says Dr. Alex Greninger , the lab 's assistant director .
Then , on Feb. 28 , one came back positive .
`` That was on Friday at 4 p.m. , '' he says .
`` And then Saturday morning the FDA came out with a new regulation that allowed us to perform testing . ''
The change at the Food and Drug Administration was a new policy that allowed sophisticated labs like the one at UW Medicine to develop and use their @ @ @ @ @ @ @ reviewed them .
On Monday and Tuesday , the lab quietly began accepting specimens for clinical use and preparing for high-volume testing .
`` It was intense , '' Greninger says , adding that he and colleagues were working past midnight to make sure the system functioned properly .
But the hard part was n't the testing itself , Greninger says , but the logistics .
For example , `` how many swabs you 're going to take from each patient , how you 're going to handle sending results and samples to @ @ @ @ @ @ @ he says .
Then on Wednesday , Jerome and Greninger held a press conference to announce that the lab was officially open for business .
Now they are expecting an avalanche of specimens .
And that 's a good thing , Jerome says .
`` Access to testing is really the major tool we have right now to fight this new coronavirus , '' he says Even with the lab 's increased capacity , though , testing remains limited to people who have symptoms including fever and a dry cough .
`` My @ @ @ @ @ @ @ can get one , '' Jerome says .
`` And that might be different than everyone who wants a test . ''
Local doctors say the lab will make a huge difference .
`` It 's a game changer , '' says Dr. Seth Cohen , medical director for infection prevention at UW Medical Center Northwest .
`` Previously when we would send those tests to the [ Centers for Disease Control and Prevention ] in Atlanta it was taking three to five days to get those tests back . ''
Now results @ @ @ @ @ @ @ And that means doctors and hospitals can focus resources on the patients who are truly infected .
Conserving scarce resources will become critical if the coronavirus continues to spread , Cohen says .
`` We did not plan on being at the epicenter of one of the outbreaks in the United States , '' Cohen says .
`` And we are preparing for the worst . ''

When Coronavirus Struck Seattle, This Lab Was Ready To Start Testing
Enlarge this image toggle caption Jonathan Hamilton/NPR Jonathan Hamilton/NPR
It's been a busy week at the virology lab run by UW Medicine, which includes the University of Washington's medical school and hospitals.
"We've already gone to three shifts," says Dr. Keith Jerome, a professor in the department of laboratory medicine who runs the lab. "People are going to be here basically all the time."
The lab is processing about 100 coronavirus tests a day. But it's prepared to do more than 1,000 a day immediately and could quickly increase that to 4,000, Jerome says.
The demand for tests is rising. Seattle is at the center of a coronavirus outbreak that has already claimed the lives of 10 people in Washington state.
One reason the lab is ready to test lots of people is its state-of-the-art equipment, including twin devices that extract genetic material from specimens.
"That all happens robotically," Jerome says, as he gives me a tour of the lab's testing area. "You can see the arms here moving back and forth. This robot is working on 96 specimens at a time. We have two of them. This is part of the magic of moving so many specimens through this laboratory."
In another area of the lab is a room full of instruments that take bits of genetic material from a virus and make millions of copies. That's critical for detecting an infection, Jerome says.
"Right now this is our limiting factor," he says, adding that they've already asked to borrow more of the instruments from other labs affiliated with the university.
But the lab's readiness also is the result of months of planning.
Jerome and other virologists started the process in January, after hearing reports about the coronavirus outbreak in China.
"Our opinion was, this is probably not going to be a problem, this is probably going to be a waste of our effort and some money, but we owe it to the people of our area to be prepared," he says.
So the scientists developed an assay and began using it test specimens sent in for research purposes.
At first, the tests found no infections, says Dr. Alex Greninger, the lab's assistant director. Then, on Feb. 28, one came back positive.
"That was on Friday at 4 p.m.," he says. "And then Saturday morning the FDA came out with a new regulation that allowed us to perform testing."
National Delays In Coronavirus Testing Create Confusion, Raise Questions Delays In Coronavirus Testing Create Confusion, Raise Questions Listen · 3:41 3:41
The change at the Food and Drug Administration was a new policy that allowed sophisticated labs like the one at UW Medicine to develop and use their own coronavirus tests before the agency had reviewed them.
On Monday and Tuesday, the lab quietly began accepting specimens for clinical use and preparing for high-volume testing.
"It was intense," Greninger says, adding that he and colleagues were working past midnight to make sure the system functioned properly.
But the hard part wasn't the testing itself, Greninger says, but the logistics.
For example, "how many swabs you're going to take from each patient, how you're going to handle sending results and samples to the state public health lab," he says.
Then on Wednesday, Jerome and Greninger held a press conference to announce that the lab was officially open for business.
Now they are expecting an avalanche of specimens. And that's a good thing, Jerome says.
"Access to testing is really the major tool we have right now to fight this new coronavirus," he says
Even with the lab's increased capacity, though, testing remains limited to people who have symptoms including fever and a dry cough.
"My goal is everyone who needs a test can get one," Jerome says. "And that might be different than everyone who wants a test."
Local doctors say the lab will make a huge difference.
"It's a game changer," says Dr. Seth Cohen, medical director for infection prevention at UW Medical Center Northwest. "Previously when we would send those tests to the [Centers for Disease Control and Prevention] in Atlanta it was taking three to five days to get those tests back."
Now results often come back the same day. And that means doctors and hospitals can focus resources on the patients who are truly infected.
Conserving scarce resources will become critical if the coronavirus continues to spread, Cohen says.
"We did not plan on being at the epicenter of one of the outbreaks in the United States," Cohen says. "And we are preparing for the worst."


npr--2020-03-05--How Russia Is Trying To Boost Bernie Sanders' Campaign

How Russia Is Trying To Boost Bernie Sanders ' Campaign It 's 2016 all over again — at least from Russia 's perspective .
Russia 's state-sponsored messaging about Bernie Sanders ' presidential campaign was more neutral in the fall .
But over the past six weeks , this coverage has shifted to mirror pro-Sanders talking points first used in the last presidential campaign , said Clint Watts of the Foreign Policy Research Institute , who has been monitoring Russian interference continuously .
`` What 's really come on strong just in the last 30 to 45 days are very @ @ @ @ @ @ @ about Sanders , '' Watts told NPR .
While Sanders has acknowledged on the campaign trail that he was briefed by the intelligence community about Russia 's efforts to boost his campaign , he has been steadfastly opposed to that support , saying at a recent debate : `` Hey , Mr. Putin , if I 'm president of the United States , trust me , you 're not going to interfere in any more American elections . ''
It is n't clear precisely how much Russia is doing to help Sanders via @ @ @ @ @ @ @ security officials warned on Monday that social media agitation and disinformation have continued through this year 's presidential race .
A statement signed by top Trump administration officials stressed that foreign actors were spreading `` false information and propaganda about political processes and candidates on social media in hopes to cause confusion and create doubt in our system . ''
That includes an ever-changing number of candidates and topics based on Russian strategic goals , including reportedly the reelection of President Trump .
Following the 2016 presidential election , the intelligence community devoted @ @ @ @ @ @ @ Russian meddling to RT 's efforts to influence politics and fuel divisions in the United States .
While monitoring coverage on Russian news agencies RT and Sputnik , Watts has noticed an ongoing trend : While most coverage remains neutral , Sanders receives substantially better coverage than his opponents .
According to figures released by Watts ' organization , Sanders received a higher percentage of positive coverage — more than 2 1/2 times — than any other Democratic candidate , and even more than President Trump .
And , Watts adds , `` @ @ @ @ @ @ @ the two networks ] have been more negative about everyone else . ''
Do n't see the graphic above ?
Click here .
Jessica Brandt , head of research and policy for the Alliance for Securing Democracy , has monitored Russian government messaging to examine their narratives about Sanders .
`` Those [ narratives ] tend to be that the corporate media and the Democratic establishment , the DNC and elites , are rigging the system against him and endeavoring to deny him a win , '' Brandt said .
The Mueller investigation @ @ @ @ @ @ @ a Kremlin-linked `` troll farm '' based in St. Petersburg , had tried to boost Sanders over then-candidate Hillary Clinton in 2016 .
`` One of the things I think Russia looks at when they see Bernie is that he 's someone who 's talking about a rigged system .
He 's talking about the elite are n't with you , '' said Mieke Eoyang , vice president of the National Security Program at Third Way , a center-left think tank that opposes a Sanders candidacy .
Another way to gauge the nature @ @ @ @ @ @ @ by examining inauthentic social media accounts that have been taken down for having ties to foreign influence operations .
For example , in October Facebook announced that it had suspended dozens of Instagram accounts originating in Russia but targeted at an American audience , with apparent links to the Internet Research Agency .
Facebook shared its data with Graphika , a social media analytics firm , which said that four of the suspended accounts had a focus on praising Sanders .
He was the only candidate on the Democratic side who was a @ @ @ @ @ @ @ to a Graphika report .
And in some cases , these accounts plagiarized memes and comments directly from the Sanders campaign .
One post read : `` Millions of people in America want to get an education .
And Bernie Sanders is their last hope . ''
The Sanders campaign contends that Russia is trying to do its best to sow discord in the race — not elect Bernie Sanders .
And campaign co-chair Rep. Ro Khanna argues that the senator has been a fervent advocate of solutions to foreign interference .
`` @ @ @ @ @ @ @ of election security .
What we need is paper ballots .
What we need is investments in our election infrastructure .
What we need is smart regulation against disinformation campaigns , '' Khanna told NPR .

How Russia Is Trying To Boost Bernie Sanders' Campaign
Enlarge this image toggle caption Kate Flock/Bloomberg via Getty Images Kate Flock/Bloomberg via Getty Images
It's 2016 all over again — at least from Russia's perspective.
Russia's state-sponsored messaging about Bernie Sanders' presidential campaign was more neutral in the fall.
But over the past six weeks, this coverage has shifted to mirror pro-Sanders talking points first used in the last presidential campaign, said Clint Watts of the Foreign Policy Research Institute, who has been monitoring Russian interference continuously.
"What's really come on strong just in the last 30 to 45 days are very similar narratives that we saw in 2016 about Sanders," Watts told NPR.
While Sanders has acknowledged on the campaign trail that he was briefed by the intelligence community about Russia's efforts to boost his campaign, he has been steadfastly opposed to that support, saying at a recent debate: "Hey, Mr. Putin, if I'm president of the United States, trust me, you're not going to interfere in any more American elections."
It isn't clear precisely how much Russia is doing to help Sanders via the anonymity of cyberspace, but national security officials warned on Monday that social media agitation and disinformation have continued through this year's presidential race.
A statement signed by top Trump administration officials stressed that foreign actors were spreading "false information and propaganda about political processes and candidates on social media in hopes to cause confusion and create doubt in our system."
That includes an ever-changing number of candidates and topics based on Russian strategic goals, including reportedly the reelection of President Trump.
Following the 2016 presidential election, the intelligence community devoted a substantial portion of its assessment on Russian meddling to RT's efforts to influence politics and fuel divisions in the United States.
While monitoring coverage on Russian news agencies RT and Sputnik, Watts has noticed an ongoing trend: While most coverage remains neutral, Sanders receives substantially better coverage than his opponents.
According to figures released by Watts' organization, Sanders received a higher percentage of positive coverage — more than 2 1/2 times — than any other Democratic candidate, and even more than President Trump.
And, Watts adds, "the important part is that they [the two networks] have been more negative about everyone else."
Loading...
Don't see the graphic above? Click here.
Jessica Brandt, head of research and policy for the Alliance for Securing Democracy, has monitored Russian government messaging to examine their narratives about Sanders.
"Those [narratives] tend to be that the corporate media and the Democratic establishment, the DNC and elites, are rigging the system against him and endeavoring to deny him a win," Brandt said.
The Mueller investigation found that the Internet Research Agency, a Kremlin-linked "troll farm" based in St. Petersburg, had tried to boost Sanders over then-candidate Hillary Clinton in 2016.
"One of the things I think Russia looks at when they see Bernie is that he's someone who's talking about a rigged system. He's talking about the elite aren't with you," said Mieke Eoyang, vice president of the National Security Program at Third Way, a center-left think tank that opposes a Sanders candidacy.
Another way to gauge the nature of Russia's support for Sanders is by examining inauthentic social media accounts that have been taken down for having ties to foreign influence operations.
For example, in October Facebook announced that it had suspended dozens of Instagram accounts originating in Russia but targeted at an American audience, with apparent links to the Internet Research Agency.
Facebook shared its data with Graphika, a social media analytics firm, which said that four of the suspended accounts had a focus on praising Sanders.
toggle caption Screenshot of October 2019 Graphika report
He was the only candidate on the Democratic side who was a focus of these fake accounts, according to a Graphika report. And in some cases, these accounts plagiarized memes and comments directly from the Sanders campaign.
One post read: "Millions of people in America want to get an education. And Bernie Sanders is their last hope."
The Sanders campaign contends that Russia is trying to do its best to sow discord in the race — not elect Bernie Sanders.
And campaign co-chair Rep. Ro Khanna argues that the senator has been a fervent advocate of solutions to foreign interference.
"Sen. Sanders has been at the forefront of election security. What we need is paper ballots. What we need is investments in our election infrastructure. What we need is smart regulation against disinformation campaigns," Khanna told NPR.