vox--2020-10-20--3 of Trump’s signature immigration policies are on the line at the Supreme Court

After the election , the Supreme Court will hear three major cases about immigration policies that seek to keep immigrants arriving on the southern border out and erode the political influence of unauthorized immigrants living in the US .
If President Donald Trump loses the election next month , Joe Biden as president is likely to at least attempt to reverse the policies in question , making the cases moot .
But if Trump wins , the cases would be decided next year , potentially enabling his attempts to further his restrictionist immigration agenda in a second term .
The @ @ @ @ @ @ @ about Trump ’ s attempt to exclude unauthorized immigrants from 2020 census population counts that will be used to draw congressional districts .
States with large populations of unauthorized immigrants — California and Texas among them — could lose seats in Congress as a result .
The justices announced Monday that they would hear two new cases as well , one of which concerns Trump ’ s attempt to divert billions in Pentagon funds for the construction of a wall on the southern border — a rallying cry among his base in 2016 @ @ @ @ @ @ @ his Migration Protection Protocols ( MPP ) , also known as the “ Remain in Mexico ” policy , under which thousands of asylum seekers have been forced to wait in Mexico , often for months on end , for a chance to obtain protection in the US .
Biden has vowed to end the Remain in Mexico policy and revoke Trump ’ s census memorandum , if that ’ s possible .
He has also criticized the border wall as a colossal waste of taxpayer money since most contraband is smuggled through @ @ @ @ @ @ @ of unauthorized immigrants living in the US arrived legally but overstayed their visas .
And even if Trump prevails , it ’ s not clear that the Supreme Court would rule in his favor , even with the president ’ s nominee Amy Coney Barrett on the bench .
The Supreme Court has upheld some of Trump ’ s signature immigration policies , including his travel ban policy .
But it has also thwarted him at key moments : It has temporarily prevented him from ending the Deferred Action for Childhood Arrivals program @ @ @ @ @ @ @ young unauthorized immigrants to live and work in the US , and blocked him from putting a citizenship question on the 2020 census , which experts said would depress response rates in immigrant communities .
In those rulings against Trump , Chief Justice John Roberts joined the court ’ s liberals and cast deciding votes .
It ’ s not clear whether Barrett would play a similar role or if she would tip the scales in favor of conservatives on these high-profile immigration cases .
The fate of Trump ’ s border wall @ @ @ @ @ @ @ trail in 2016 , Trump made building the border wall a centerpiece of his platform .
He pledged that Mexico would pay for it , but that never came to pass ; instead , the administration transferred $ 2.5 billion in Pentagon funds in order to construct it after Congress refused to fully fund the project .
California , New Mexico , and environmental groups including the Sierra Club challenged the administration ’ s use of those funds , claiming that it did not have the authority to make the transfer .
Lower @ @ @ @ @ @ @ Court could overturn those rulings , announcing on Monday that it would hear the case .
The Secretary of Defense is permitted by law to transfer military funds appropriated by Congress if higher funding priorities arise due to “ unforeseen military requirements ” and , critically , if Congress has not objected .
But as the environmental groups have argued , the border wall was one of Trump ’ s longtime political goals — not a response to an unanticipated military threat — and one that Congress rejected in the 2019 budget it @ @ @ @ @ @ @ request .
The administration has argued , on the other hand , that the border wall is a legitimate response to the national emergency concerning unauthorized immigration and drug smuggling across the southern border , which Trump declared in February 2019 .
Though that emergency declaration remains in effect , migration appears to have drastically dropped over the last year .
The US apprehended 400,651 people at the southern border over fiscal year 2020 , which ended on September 30 — less than half the number apprehended in 2019 .
The justices have @ @ @ @ @ @ @ : They intervened at an earlier stage of the lawsuit , permitting construction of the border wall to continue while the case made its way through the lower courts .
That has given Trump license to speed up construction ahead of the election , often cutting through national forests and wildlife preserves to do so .
The Remain in Mexico policy is essential to Trump ’ s strategy on the border The Supreme Court will also weigh in on Trump ’ s Remain in Mexico program , one of Trump ’ s core @ @ @ @ @ @ @ went into effect in January 2019 .
Since then , more than 60,000 asylum seekers have been sent back to Mexico , where they ’ re under threat from drug cartels and kidnappers and are dependent on volunteers for basic supplies .
The American Civil Liberties Union , among others , has challenged the policy on the basis that it has resulted in asylum seekers being sent back to their persecutors .
But the Trump administration has credited the program as one of its key tools in reducing the number of migrants coming @ @ @ @ @ @ @ their reasoning , the justices previously allowed the program to remain in effect while the appeals process played out .
Before MPP , migrants who waited in line at the border , as well as those who were apprehended between ports of entry , would have been held at a US Customs and Border Protection processing facility until a border agent determined whether they should be released , transferred to immigration detention , or deported .
But under MPP , they were mostly turned away at the border and allowed to enter the @ @ @ @ @ @ @ hearings .
Since the pandemic hit , however , the administration has turned to other methods of keeping them out .
US Customs and Border Protection invoked public health authorities to turn away asylum seekers who might be carrying the coronavirus .
Some of them are still waiting in Mexican border towns , where they have limited access to legal counsel and reside in tent encampments .
Trump wants to weaponize the census against immigrants Last week , the justices announced that they would review a case over Trump ’ s memorandum excluding @ @ @ @ @ @ @ census population counts for the purposes of redrawing congressional districts in 2021 — a transparent attack on their political power that was struck down by lower courts .
The justices will hear arguments in the case on November 30 , ahead of a December 31 federal deadline for sending the population counts to Congress .
Most states currently draw congressional districts , determining the areas that each elected official represents based on total population , including unauthorized immigrants .
Current maps are due to be redrawn across the country in 2021 after the @ @ @ @ @ @ @ , and the stakes are high : Each redistricting has a lasting influence on who is likely to win elections , which communities will be represented in Congress , and , ultimately , what laws will be passed .
Trump ’ s attempt to exclude unauthorized immigrants would reduce the counts in areas where foreign-born populations have traditionally settled — primarily Democrat-run cities — and therefore undermine their political power relative to more rural , Republican-run areas .
But it could also impact red states with large immigrant populations , including Texas .
@ @ @ @ @ @ @ law , the president has the final say over who must be counted in the census .
In a written statement issued after he signed the memorandum in July , Trump said that allowing unauthorized immigrants to be counted would undermine American representative democracy and create “ perverse incentives ” for those seeking to come to the US .
“ There used to be a time when you could proudly declare , ‘ I am a citizen of the United States , ’ ” Trump said in the statement .
“ But now @ @ @ @ @ @ @ erase the existence of this concept and conceal the number of illegal aliens in our country .
This is all part of a broader left-wing effort to erode the rights of Americans citizens , and I will not stand for it.
” But on September 10 , a panel of three federal judges found that Trump ’ s memorandum skirted the federal government ’ s constitutional obligation to count every person , no matter their immigration status , in the census every 10 years .
Will you help keep Vox free for all @ @ @ @ @ @ @ middle of one of the most consequential presidential elections of our lifetimes .
It ’ s essential that all Americans are able to access clear , concise information on what the outcome of the election could mean for their lives , and the lives of their families and communities .
That is our mission at Vox .
But our distinctive brand of explanatory journalism takes resources .
Even when the economy and the news advertising market recovers , your support will be a critical part of sustaining our resource-intensive work .
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After the election, the Supreme Court will hear three major cases about immigration policies that seek to keep immigrants arriving on the southern border out and erode the political influence of unauthorized immigrants living in the US.
If President Donald Trump loses the election next month, Joe Biden as president is likely to at least attempt to reverse the policies in question, making the cases moot. But if Trump wins, the cases would be decided next year, potentially enabling his attempts to further his restrictionist immigration agenda in a second term.
The justices previously agreed to hear a case about Trump’s attempt to exclude unauthorized immigrants from 2020 census population counts that will be used to draw congressional districts. States with large populations of unauthorized immigrants — California and Texas among them — could lose seats in Congress as a result.
The justices announced Monday that they would hear two new cases as well, one of which concerns Trump’s attempt to divert billions in Pentagon funds for the construction of a wall on the southern border — a rallying cry among his base in 2016. The other is a challenge to his Migration Protection Protocols (MPP), also known as the “Remain in Mexico” policy, under which thousands of asylum seekers have been forced to wait in Mexico, often for months on end, for a chance to obtain protection in the US.
Biden has vowed to end the Remain in Mexico policy and revoke Trump’s census memorandum, if that’s possible. He has also criticized the border wall as a colossal waste of taxpayer money since most contraband is smuggled through ports of entry and the vast majority of unauthorized immigrants living in the US arrived legally but overstayed their visas.
And even if Trump prevails, it’s not clear that the Supreme Court would rule in his favor, even with the president’s nominee Amy Coney Barrett on the bench.
The Supreme Court has upheld some of Trump’s signature immigration policies, including his travel ban policy. But it has also thwarted him at key moments: It has temporarily prevented him from ending the Deferred Action for Childhood Arrivals program, which has allowed more than 700,000 young unauthorized immigrants to live and work in the US, and blocked him from putting a citizenship question on the 2020 census, which experts said would depress response rates in immigrant communities.
In those rulings against Trump, Chief Justice John Roberts joined the court’s liberals and cast deciding votes. It’s not clear whether Barrett would play a similar role or if she would tip the scales in favor of conservatives on these high-profile immigration cases.
The fate of Trump’s border wall rests with the justices
On the campaign trail in 2016, Trump made building the border wall a centerpiece of his platform. He pledged that Mexico would pay for it, but that never came to pass; instead, the administration transferred $2.5 billion in Pentagon funds in order to construct it after Congress refused to fully fund the project.
California, New Mexico, and environmental groups including the Sierra Club challenged the administration’s use of those funds, claiming that it did not have the authority to make the transfer. Lower courts have agreed, but the Supreme Court could overturn those rulings, announcing on Monday that it would hear the case.
The Secretary of Defense is permitted by law to transfer military funds appropriated by Congress if higher funding priorities arise due to “unforeseen military requirements” and, critically, if Congress has not objected. But as the environmental groups have argued, the border wall was one of Trump’s longtime political goals — not a response to an unanticipated military threat — and one that Congress rejected in the 2019 budget it passed after Trump had made the funding request.
The administration has argued, on the other hand, that the border wall is a legitimate response to the national emergency concerning unauthorized immigration and drug smuggling across the southern border, which Trump declared in February 2019. Though that emergency declaration remains in effect, migration appears to have drastically dropped over the last year. The US apprehended 400,651 people at the southern border over fiscal year 2020, which ended on September 30 — less than half the number apprehended in 2019.
The justices have already hinted at how they might rule: They intervened at an earlier stage of the lawsuit, permitting construction of the border wall to continue while the case made its way through the lower courts.
That has given Trump license to speed up construction ahead of the election, often cutting through national forests and wildlife preserves to do so.
The Remain in Mexico policy is essential to Trump’s strategy on the border
The Supreme Court will also weigh in on Trump’s Remain in Mexico program, one of Trump’s core policies on the southern border, which went into effect in January 2019. Since then, more than 60,000 asylum seekers have been sent back to Mexico, where they’re under threat from drug cartels and kidnappers and are dependent on volunteers for basic supplies.
The American Civil Liberties Union, among others, has challenged the policy on the basis that it has resulted in asylum seekers being sent back to their persecutors. But the Trump administration has credited the program as one of its key tools in reducing the number of migrants coming across the southern border.
Without explaining their reasoning, the justices previously allowed the program to remain in effect while the appeals process played out.
Before MPP, migrants who waited in line at the border, as well as those who were apprehended between ports of entry, would have been held at a US Customs and Border Protection processing facility until a border agent determined whether they should be released, transferred to immigration detention, or deported. But under MPP, they were mostly turned away at the border and allowed to enter the US only to attend their immigration court hearings.
Since the pandemic hit, however, the administration has turned to other methods of keeping them out. US Customs and Border Protection invoked public health authorities to turn away asylum seekers who might be carrying the coronavirus. Some of them are still waiting in Mexican border towns, where they have limited access to legal counsel and reside in tent encampments.
Trump wants to weaponize the census against immigrants
Last week, the justices announced that they would review a case over Trump’s memorandum excluding unauthorized immigrants living in the US from census population counts for the purposes of redrawing congressional districts in 2021 — a transparent attack on their political power that was struck down by lower courts. The justices will hear arguments in the case on November 30, ahead of a December 31 federal deadline for sending the population counts to Congress.
Most states currently draw congressional districts, determining the areas that each elected official represents based on total population, including unauthorized immigrants. Current maps are due to be redrawn across the country in 2021 after the results of the 2020 census come in, and the stakes are high: Each redistricting has a lasting influence on who is likely to win elections, which communities will be represented in Congress, and, ultimately, what laws will be passed.
Trump’s attempt to exclude unauthorized immigrants would reduce the counts in areas where foreign-born populations have traditionally settled — primarily Democrat-run cities — and therefore undermine their political power relative to more rural, Republican-run areas. But it could also impact red states with large immigrant populations, including Texas.
The administration has argued that, by law, the president has the final say over who must be counted in the census.
In a written statement issued after he signed the memorandum in July, Trump said that allowing unauthorized immigrants to be counted would undermine American representative democracy and create “perverse incentives” for those seeking to come to the US.
“There used to be a time when you could proudly declare, ‘I am a citizen of the United States,’” Trump said in the statement. “But now, the radical left is trying to erase the existence of this concept and conceal the number of illegal aliens in our country. This is all part of a broader left-wing effort to erode the rights of Americans citizens, and I will not stand for it.”
But on September 10, a panel of three federal judges found that Trump’s memorandum skirted the federal government’s constitutional obligation to count every person, no matter their immigration status, in the census every 10 years.


vox--2020-10-20--“We just don’t know what’s happening in our bodies”: Covid-19 long-haulers are still suffering

Share All sharing options for : “ We just don ’ t know what ’ s happening in our bodies ” : Covid-19 long-haulers are still suffering On March 15 , Melanie Montano woke up with a fever and chills .
Her Covid-19 symptoms progressed quickly ; she lost her sense of smell and taste and had trouble breathing .
Seven months later , she ’ s still struggling with fevers , brain fog , fatigue , and pain in her arms and legs .
She ’ ll feel better some days , only to feel worse the next , @ @ @ @ @ @ @ ” With 8 million cases of Covid-19 now confirmed in the US , stories like Montano ’ s are becoming increasingly common .
But you might not know it from listening to President Trump .
In his first extended statement in October since his own diagnosis , he falsely implied that everyone infected with the coronavirus can expect a rapid and full recovery .
“ Now what happens is you get better , ” he said .
“ That ’ s what happens , you get better.
” For many diagnosed with Covid-19 @ @ @ @ @ @ @ truth .
Preliminary research suggests at least 10 percent of people — and possibly many more — may continue to have symptoms for at least two months after infection .
“ When Trump says ‘ don ’ t be afraid of it ’ — I ’ ve been so angry in the last week , I ’ m just trying to calm down , ” says Kate Meredith of Beverly , Massachusetts , who has been experiencing Covid-19 symptoms since mid-March .
To this day , Meredith has fevers four to five days @ @ @ @ @ @ @ one flight of stairs and can ’ t breathe , ” she says .
She also now has tachycardia , a heart condition where standing up too quickly makes her heart rate jump to 140 .
Since March , she has been to the emergency room three times , and to the doctor 35 times .
She still gets debilitating headaches almost daily , and has run out of her two and a half months of medical leave .
Meredith and Montano are among thousands of people who have continued to experience extended @ @ @ @ @ @ @ coronavirus infection .
As new information emerges about the many , varied impacts that can linger , patients are facing doubt from doctors and structural failures that loom over an uncertain future .
What percentage of Covid-19 patients have persistent symptoms ?
There have been a number of studies now trying to answer this question , but there isn ’ t consensus about the true prevalence of long-term Covid-19 symptoms .
Much of the preliminary research has been limited to small numbers of patients , and many focus on hospitalized patients , obscuring @ @ @ @ @ @ @ example , one study out of Wuhan , China , of 153 non-hospitalized confirmed coronavirus patients found that 22 percent of patients had experienced symptom relapse , and 11 percent of patients had symptoms for more than eight weeks .
( It also found a whopping 77 percent of patients had neurological symptoms . )
Other research focusing on outcomes for severely ill Covid-19 patients who were hospitalized reports worse odds , like one study in Italy that found 87.4 percent of people had not totally recovered after 60 days .
( That @ @ @ @ @ @ @ any illness can take weeks or months ; for example , only 33 percent of sepsis patients have returned to work within three months . )
Of the 143 patients in the study , 55 percent still had three or more symptoms , like fatigue , chest pain , and shortness of breath , at day 60 .
Another study followed hospitalized patients for nearly twice as long , 111 days .
They also found that 55 percent of patients continued to have fatigue , 42 percent had shortness of breath , and @ @ @ @ @ @ @ Yet another study of more than 112 hospitalized and 2,001 non-hospitalized patients in the Netherlands found that only 0.7 percent of people were symptom-free 79 days after their infection .
( The most common symptoms were fatigue and difficulty breathing , although the number of symptoms people experienced decreased over time . )
Studies that include non-hospitalized patients can have limitations in how they find participants , and in their sample sizes .
The COVID Symptom Study , for instance , has asked people to self-report their symptoms into an app after their @ @ @ @ @ @ @ people in the US , UK , and Sweden , the researchers found that approximately 10 percent of people experience prolonged illness for more than three weeks after Covid-19 .
But many users have reported frustration with the app not including certain symptoms , or needing to answer questions daily that didn ’ t feel applicable , so user retention suffered .
The National Institutes of Health recently updated its Covid-19 guidelines to include a description of persistent symptoms .
These state that neurologic and psychiatric symptoms have been reported in coronavirus patients @ @ @ @ @ @ @ depression , particularly in younger patients .
They add that patients may experience “ headaches , vision changes , hearing loss , loss of taste or smell , impaired mobility , numbness in extremities , tremors , myalgia , memory loss , cognitive impairment , and mood changes for up to 3 months ” after their initial illness .
No one has yet defined how long “ long Covid ” might last — many of the studies simply stopped tracking people after a set time .
But research on other severe coronaviruses like @ @ @ @ @ @ @ hospitalized patients had chronic fatigue symptoms 3.5 years after their diagnosis .
Clinicians and patients don ’ t know what this might mean for Covid-19 patients with persistent symptoms .
Leonard Jason , a professor of psychology at DePaul University and director for the Center for Community Research , is enrolling participants in two studies to try to help understand risk factors in both children and adults with long Covid .
“ There ’ s almost no questions that have been answered , ” he says .
“ We really don ’ t @ @ @ @ @ @ @ or lung problems may have sustained damage to their organs , but many people are also experiencing symptoms without good explanations , he says .
“ Some people stay ill , even when they seem okay ” from clinical tests , he said .
“ That ’ s a massive challenge.
” Mike Ryan , the executive director of WHO ’ s Health Emergencies Program , said at a press conference that right now , long Covid is a risk “ that you can not quantify.
” But , he said , it @ @ @ @ @ @ @ stop the spread of the virus .
“ We need to avoid all Covid-19 infections , both in terms of reducing transmission but also in reducing the long-term health impacts of this disease.
” Who is most at risk of developing long Covid ?
Long-term Covid-19 is not equally distributed among the population .
Just like the initial viral severity , these lingering symptoms seem to hit those with certain risk factors more frequently .
The World Health Organization says that risk factors for persistent symptoms include high blood pressure , obesity , @ @ @ @ @ @ @ previously healthy and active people have also had long-term issues .
In one study of 139 hospitalized patients in Wuhan , the median age of those with persistent symptoms was 55 , and half previously had one or more other conditions , like hypertension , diabetes , or heart disease .
But the study only looked at patients with severe initial symptoms .
The US Centers for Disease Control and Prevention conducted a telephone survey of 292 adults who ’ d tested positive for Covid-19 from April to June — including those with @ @ @ @ @ @ @ found that two weeks after their diagnosis , 35 percent of people weren ’ t back to normal , and between the ages of 18 and 34 , 20 percent of people reported prolonged symptoms .
About half were women , and Hispanic and Black people were overrepresented .
To truly answer the question of who is most at risk , scientists will need to do longitudinal studies tracking large groups of Covid-19 patients with both mild and severe symptoms , for months or even years .
These studies would ideally include biologic @ @ @ @ @ @ @ symptoms and medical histories .
Then they ’ ll need to use analysis methods to eliminate confounding factors in order to identify what might put people at risk .
Although the little research there has been on long Covid has focused on adults , children can also have persistent symptoms .
For example , Courtney — a mother in Calgary , Canada , who asked that she and her son be identified by their middle names for the sake of her children ’ s privacy — can recite the dates and details of @ @ @ @ @ @ @ .
“ I ’ ve told this story so many times because we ’ ve been in and out of the hospital for months , ” she says .
All three of her young children got sick with Covid-19 in early February .
One of her 1.5-year-old twins , Alexander , got better — only to get a high fever and full-body rash about a month later .
Although he wasn ’ t able to get a Covid-19 test , his infectious disease team and pediatrician now both believe Alexander actually had MIS-C @ @ @ @ @ @ @ with the coronavirus — or possibly long Covid .
Since April , he ’ s been hospitalized three times and to the ER twice more , and continues to have persistent skin lesions , conjunctivitis , and chronic fatigue .
He has nightmares from the trauma of visiting the hospital at least once a week for eight months .
“ He wakes up screaming , ‘ No , no , ow , ow , ’ ” Courtney says .
No one can tell her when he might improve .
“ Just because we @ @ @ @ @ @ @ Covid-19 negatively affects babies and children doesn ’ t mean they are somehow immune.
” Kate Meredith ’ s daughter , who ’ s 12 , also got Covid-19 , two weeks after Meredith did .
While she initially had a mild case , seven months later she continues to have extreme fatigue and tachycardia .
On her first day of in-person classes this fall , she fell asleep .
“ How do you explain that to teachers ?
” Meredith asks .
There ’ s currently little conclusive data on how many @ @ @ @ @ @ @ in part because it ’ s a population that frequently has mild or no symptoms — making initial testing and later complications like MIS-C more difficult to diagnose .
Jason , who is studying children ’ s risk factors for long Covid , says , “ If kids don ’ t recover from an illness , that ’ s really significant , ” adding that long-Covid children will need lots of additional support .
“ You have to be very concerned that these kids don ’ t end up continuing a downward cycle @ @ @ @ @ @ @ navigate doubt and difficulty in the medical system Because symptoms can be varied , long-Covid patients have also had to seek out multiple medical specialists who may not communicate much with one another .
For example , Meredith still has neurological , pulmonary , and cardiac symptoms .
“ Should I go see a neurologist ?
” she asks .
“ All these smaller symptoms require so much specialized attention.
” Even with a positive test , she ’ s encountered doubt in the doctors she ’ s turned to .
“ Obviously @ @ @ @ @ @ @ of doctors , ” she says .
“ We just don ’ t know what ’ s happening in our bodies.
” Many with long-term symptoms are also having trouble proving they ever had Covid-19 , since , due to testing scarcity , many have been unable to get a test .
When Matt Kuzelka got sick in March , he struggled to find somewhere to get tested , while trying to isolate himself from his wife and three kids in their small Brooklyn apartment .
When he was finally able to find @ @ @ @ @ @ @ Manhattan , he asked the center how he was supposed to travel there .
“ They said , ‘ You can take the subway or Uber , ’ ” he recounts , “ but I knew I had it .
I was like , ‘ What about the driver ?
’ and they said , ‘ He ’ s just going to have to take his chances.
’ ” Kuzelka ultimately decided not to take the risk of exposing anyone else .
“ Obviously this is uncharted territory for a lot of doctors @ @ @ @ @ @ @ what ’ s happening in our bodies.
” Seven months later , he ’ s having trouble navigating the additional medical care he now needs , like cardiac MRIs .
“ It ’ s been harder to navigate the world of health care needs because I don ’ t have a positive Covid test.
” For others , their struggle has been complicated by deeper systemic issues .
Montano , who has asthma , needed a doctor ’ s referral in order to get tested in New Jersey in March .
But her @ @ @ @ @ @ @ give her one .
“ He thought I was being theatrical and told me to take a nap , ” she says .
Less than a week later , Montano was taken to the hospital by ambulance , where she was initially put on supplemental oxygen — but rather than being admitted , she was sent home to her elderly mother without any additional treatment .
Montano , who describes herself as a light-skinned mixed-race woman , describes a feeling of helplessness in trying to get medical care .
“ You don ’ @ @ @ @ @ @ @ you don ’ t want to overstep with your family , there ’ s this facade you want to uphold to save face , and also you have to admit that you ’ re just human .
But how do you admit you ’ re just human when you ’ re treated less than human ?
” she says .
In addition to being disproportionately exposed to the virus , Montano says , “ Black and Latino communities don ’ t get treated as timely or as well.
” “ I ’ m @ @ @ @ @ @ @ ” To try to help patients get more coordinated care , several post-Covid care clinics have popped up around the country ; one at Mount Sinai initially required a positive Covid-19 test , although it has since opened its criteria .
Their waitlist for new patients is now at least six weeks , according to Gothamist .
While patients wait , there ’ s the added economic and family stress of being sick for so long .
“ It ’ s just been this surreal extended medical nightmare for both of us , @ @ @ @ @ @ @ I haven ’ t even looked at all the bills yet ; it terrifies me.
” She ’ s a single mom , and when she was really ill , her daughter — who at one point Meredith had to leave at home alone as she drove herself to the ER — asked , “ What happens if you die ?
” “ I downplayed it , but I ’ ve been worried about my future .
If I were to have debilitating symptoms , would I have a job left ?
Would @ @ @ @ @ @ @ her ?
” Meredith pauses .
“ I ’ m still not sure what the future entails.
” Because the truth is that because this is an entirely new illness , no one can tell long-Covid patients if they will return to their normal selves , or how long that might take to happen .
This makes moving forward into a life shaped by their disease more difficult .
Especially without a visible illness , Jason says , “ Our society does not value people who are sick .
If you don ’ @ @ @ @ @ @ @ , you ’ re basically falling out of the mainstream and in a very vulnerable situation.
” Lois Parshley is a freelance investigative journalist .
Follow her Covid-19 reporting on Twitter @ loisparshley .
Help keep Vox free for all Millions turn to Vox each month to understand what ’ s happening in the news , from the coronavirus crisis to a racial reckoning to what is , quite possibly , the most consequential presidential election of our lifetimes .
Our mission has never been more vital than it is in this moment @ @ @ @ @ @ @ But our distinctive brand of explanatory journalism takes resources .
Even when the economy and the news advertising market recovers , your support will be a critical part of sustaining our resource-intensive work .
If you have already contributed , thank you .
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Share All sharing options for: “We just don’t know what’s happening in our bodies”: Covid-19 long-haulers are still suffering
On March 15, Melanie Montano woke up with a fever and chills. Her Covid-19 symptoms progressed quickly; she lost her sense of smell and taste and had trouble breathing.
Seven months later, she’s still struggling with fevers, brain fog, fatigue, and pain in her arms and legs. She’ll feel better some days, only to feel worse the next, in what she calls the “coronacoaster.”
With 8 million cases of Covid-19 now confirmed in the US, stories like Montano’s are becoming increasingly common. But you might not know it from listening to President Trump. In his first extended statement in October since his own diagnosis, he falsely implied that everyone infected with the coronavirus can expect a rapid and full recovery. “Now what happens is you get better,” he said. “That’s what happens, you get better.”
For many diagnosed with Covid-19, nothing could be further from the truth. Preliminary research suggests at least 10 percent of people — and possibly many more — may continue to have symptoms for at least two months after infection.
“When Trump says ‘don’t be afraid of it’ — I’ve been so angry in the last week, I’m just trying to calm down,” says Kate Meredith of Beverly, Massachusetts, who has been experiencing Covid-19 symptoms since mid-March.
To this day, Meredith has fevers four to five days a week. “I go up one flight of stairs and can’t breathe,” she says. She also now has tachycardia, a heart condition where standing up too quickly makes her heart rate jump to 140. Since March, she has been to the emergency room three times, and to the doctor 35 times. She still gets debilitating headaches almost daily, and has run out of her two and a half months of medical leave.
Meredith and Montano are among thousands of people who have continued to experience extended symptoms or suffered relapses after an initial coronavirus infection. As new information emerges about the many, varied impacts that can linger, patients are facing doubt from doctors and structural failures that loom over an uncertain future.
What percentage of Covid-19 patients have persistent symptoms?
There have been a number of studies now trying to answer this question, but there isn’t consensus about the true prevalence of long-term Covid-19 symptoms. Much of the preliminary research has been limited to small numbers of patients, and many focus on hospitalized patients, obscuring what happens to milder cases.
For example, one study out of Wuhan, China, of 153 non-hospitalized confirmed coronavirus patients found that 22 percent of patients had experienced symptom relapse, and 11 percent of patients had symptoms for more than eight weeks. (It also found a whopping 77 percent of patients had neurological symptoms.)
Other research focusing on outcomes for severely ill Covid-19 patients who were hospitalized reports worse odds, like one study in Italy that found 87.4 percent of people had not totally recovered after 60 days. (That said, recovery from intensive care for any illness can take weeks or months; for example, only 33 percent of sepsis patients have returned to work within three months.) Of the 143 patients in the study, 55 percent still had three or more symptoms, like fatigue, chest pain, and shortness of breath, at day 60.
Another study followed hospitalized patients for nearly twice as long, 111 days. They also found that 55 percent of patients continued to have fatigue, 42 percent had shortness of breath, and 34 percent reported loss of memory.
Yet another study of more than 112 hospitalized and 2,001 non-hospitalized patients in the Netherlands found that only 0.7 percent of people were symptom-free 79 days after their infection. (The most common symptoms were fatigue and difficulty breathing, although the number of symptoms people experienced decreased over time.)
Studies that include non-hospitalized patients can have limitations in how they find participants, and in their sample sizes. The COVID Symptom Study, for instance, has asked people to self-report their symptoms into an app after their diagnosis. Analyzing data from 4 million people in the US, UK, and Sweden, the researchers found that approximately 10 percent of people experience prolonged illness for more than three weeks after Covid-19. But many users have reported frustration with the app not including certain symptoms, or needing to answer questions daily that didn’t feel applicable, so user retention suffered.
The National Institutes of Health recently updated its Covid-19 guidelines to include a description of persistent symptoms. These state that neurologic and psychiatric symptoms have been reported in coronavirus patients, including high rates of anxiety and depression, particularly in younger patients. They add that patients may experience “headaches, vision changes, hearing loss, loss of taste or smell, impaired mobility, numbness in extremities, tremors, myalgia, memory loss, cognitive impairment, and mood changes for up to 3 months” after their initial illness.
No one has yet defined how long “long Covid” might last — many of the studies simply stopped tracking people after a set time. But research on other severe coronaviruses like SARS shows that 40 percent of previously hospitalized patients had chronic fatigue symptoms 3.5 years after their diagnosis. Clinicians and patients don’t know what this might mean for Covid-19 patients with persistent symptoms.
Leonard Jason, a professor of psychology at DePaul University and director for the Center for Community Research, is enrolling participants in two studies to try to help understand risk factors in both children and adults with long Covid. “There’s almost no questions that have been answered,” he says. “We really don’t know a lot.”
People with cardiac or lung problems may have sustained damage to their organs, but many people are also experiencing symptoms without good explanations, he says. “Some people stay ill, even when they seem okay” from clinical tests, he said. “That’s a massive challenge.”
Mike Ryan, the executive director of WHO’s Health Emergencies Program, said at a press conference that right now, long Covid is a risk “that you cannot quantify.” But, he said, it’s still a huge reason to stop the spread of the virus. “We need to avoid all Covid-19 infections, both in terms of reducing transmission but also in reducing the long-term health impacts of this disease.”
Who is most at risk of developing long Covid?
Long-term Covid-19 is not equally distributed among the population. Just like the initial viral severity, these lingering symptoms seem to hit those with certain risk factors more frequently.
The World Health Organization says that risk factors for persistent symptoms include high blood pressure, obesity, and mental health conditions. But many previously healthy and active people have also had long-term issues.
In one study of 139 hospitalized patients in Wuhan, the median age of those with persistent symptoms was 55, and half previously had one or more other conditions, like hypertension, diabetes, or heart disease. But the study only looked at patients with severe initial symptoms.
The US Centers for Disease Control and Prevention conducted a telephone survey of 292 adults who’d tested positive for Covid-19 from April to June — including those with both mild and severe cases. They found that two weeks after their diagnosis, 35 percent of people weren’t back to normal, and between the ages of 18 and 34, 20 percent of people reported prolonged symptoms. About half were women, and Hispanic and Black people were overrepresented.
To truly answer the question of who is most at risk, scientists will need to do longitudinal studies tracking large groups of Covid-19 patients with both mild and severe symptoms, for months or even years. These studies would ideally include biologic samples over time as well as self-reported symptoms and medical histories. Then they’ll need to use analysis methods to eliminate confounding factors in order to identify what might put people at risk.
Although the little research there has been on long Covid has focused on adults, children can also have persistent symptoms. For example, Courtney — a mother in Calgary, Canada, who asked that she and her son be identified by their middle names for the sake of her children’s privacy — can recite the dates and details of her son’s ordeal by heart. “I’ve told this story so many times because we’ve been in and out of the hospital for months,” she says.
All three of her young children got sick with Covid-19 in early February. One of her 1.5-year-old twins, Alexander, got better — only to get a high fever and full-body rash about a month later.
Although he wasn’t able to get a Covid-19 test, his infectious disease team and pediatrician now both believe Alexander actually had MIS-C, a rare but severe condition associated with the coronavirus — or possibly long Covid. Since April, he’s been hospitalized three times and to the ER twice more, and continues to have persistent skin lesions, conjunctivitis, and chronic fatigue. He has nightmares from the trauma of visiting the hospital at least once a week for eight months.
“He wakes up screaming, ‘No, no, ow, ow,’” Courtney says. No one can tell her when he might improve. “Just because we don’t have the data that Covid-19 negatively affects babies and children doesn’t mean they are somehow immune.”
Kate Meredith’s daughter, who’s 12, also got Covid-19, two weeks after Meredith did. While she initially had a mild case, seven months later she continues to have extreme fatigue and tachycardia. On her first day of in-person classes this fall, she fell asleep. “How do you explain that to teachers?” Meredith asks.
There’s currently little conclusive data on how many children may suffer from persistent symptoms, in part because it’s a population that frequently has mild or no symptoms — making initial testing and later complications like MIS-C more difficult to diagnose.
Jason, who is studying children’s risk factors for long Covid, says, “If kids don’t recover from an illness, that’s really significant,” adding that long-Covid children will need lots of additional support. “You have to be very concerned that these kids don’t end up continuing a downward cycle of loss and stress.”
Long-Covid patients navigate doubt and difficulty in the medical system
Because symptoms can be varied, long-Covid patients have also had to seek out multiple medical specialists who may not communicate much with one another.
For example, Meredith still has neurological, pulmonary, and cardiac symptoms. “Should I go see a neurologist?” she asks. “All these smaller symptoms require so much specialized attention.” Even with a positive test, she’s encountered doubt in the doctors she’s turned to.
“Obviously this is uncharted territory for a lot of doctors,” she says. “We just don’t know what’s happening in our bodies.”
Many with long-term symptoms are also having trouble proving they ever had Covid-19, since, due to testing scarcity, many have been unable to get a test.
When Matt Kuzelka got sick in March, he struggled to find somewhere to get tested, while trying to isolate himself from his wife and three kids in their small Brooklyn apartment. When he was finally able to find an opening at a testing center in Manhattan, he asked the center how he was supposed to travel there. “They said, ‘You can take the subway or Uber,’” he recounts, “but I knew I had it. I was like, ‘What about the driver?’ and they said, ‘He’s just going to have to take his chances.’” Kuzelka ultimately decided not to take the risk of exposing anyone else.
“Obviously this is uncharted territory for a lot of doctors. We just don’t know what’s happening in our bodies.”
Seven months later, he’s having trouble navigating the additional medical care he now needs, like cardiac MRIs. “It’s been harder to navigate the world of health care needs because I don’t have a positive Covid test.”
For others, their struggle has been complicated by deeper systemic issues. Montano, who has asthma, needed a doctor’s referral in order to get tested in New Jersey in March. But her now ex-primary care physician initially refused to give her one. “He thought I was being theatrical and told me to take a nap,” she says. Less than a week later, Montano was taken to the hospital by ambulance, where she was initially put on supplemental oxygen — but rather than being admitted, she was sent home to her elderly mother without any additional treatment.
Montano, who describes herself as a light-skinned mixed-race woman, describes a feeling of helplessness in trying to get medical care. “You don’t want to be too vocal, you don’t want to overstep with your family, there’s this facade you want to uphold to save face, and also you have to admit that you’re just human. But how do you admit you’re just human when you’re treated less than human?” she says. In addition to being disproportionately exposed to the virus, Montano says, “Black and Latino communities don’t get treated as timely or as well.”
“I’m still not sure what the future entails”
To try to help patients get more coordinated care, several post-Covid care clinics have popped up around the country; one at Mount Sinai initially required a positive Covid-19 test, although it has since opened its criteria. Their waitlist for new patients is now at least six weeks, according to Gothamist.
While patients wait, there’s the added economic and family stress of being sick for so long. “It’s just been this surreal extended medical nightmare for both of us,” Meredith says, adding, “I haven’t even looked at all the bills yet; it terrifies me.” She’s a single mom, and when she was really ill, her daughter — who at one point Meredith had to leave at home alone as she drove herself to the ER — asked, “What happens if you die?”
“I downplayed it, but I’ve been worried about my future. If I were to have debilitating symptoms, would I have a job left? Would I be able to take care of her?” Meredith pauses. “I’m still not sure what the future entails.”
Because the truth is that because this is an entirely new illness, no one can tell long-Covid patients if they will return to their normal selves, or how long that might take to happen. This makes moving forward into a life shaped by their disease more difficult.
Especially without a visible illness, Jason says, “Our society does not value people who are sick. If you don’t have a credible, understood illness, you’re basically falling out of the mainstream and in a very vulnerable situation.”
Lois Parshley is a freelance investigative journalist. Follow her Covid-19 reporting on Twitter @loisparshley.


vox--2020-10-20--2020’s psychedelic drug ballot measures, explained

This November , voters in two states could take significant steps toward ending the US ’ s near-total criminal prohibition of psychedelic drugs .
In Oregon , voters will decide on a ballot measure that would allow psilocybin mushrooms , also known as magic mushrooms , to be used for medical purposes .
In Washington , DC , voters could , in effect , decriminalize a range of psychedelic plants and fungi .
The measures are seen by many activists as the next stage in scaling back America ’ s war on drugs , now that marijuana legalization has already @ @ @ @ @ @ @ in four more in the November election .
Polls show strong support for marijuana legalization , but it ’ s unclear how much public backing there is for measures decriminalizing psychedelics or legalizing them for medicinal purposes .
Denver became the first US city to vote to decriminalize psychedelic mushrooms in 2019 , but no state has decriminalized or legalized psychedelic substances for medical use .
But activists may have an advantage in Oregon and Washington , DC — both of which are very liberal , and were among the first jurisdictions to @ @ @ @ @ @ @ DC , due to a bill passed by Congress , still prohibits sales ) .
The Oregon and DC , measures , then , stand to set the stage for future drug policy reform efforts .
If two progressive places move forward with their measures , that may signal a wider public appetite for expanding access to psychedelic drugs .
If the measures fail — especially in an election year that currently seems very favorable to more progressive causes — drug policy reformers almost certainly have their work cut out for them .
@ @ @ @ @ @ @ mushrooms for medical purposes Oregon ’ s Measure 109 would create a program for administering psilocybin products , such as magic mushrooms , to patients for medical purposes .
Unlike medical marijuana laws , this wouldn ’ t mean that patients could just get a doctor ’ s recommendation and then buy psilocybin at a dispensary .
Instead , they ’ d be able to buy , possess , and consume the psychedelic drug at a “ psilocybin service center ” in which they ’ d be supervised and guided through their trips @ @ @ @ @ @ @ t set limits on which conditions would let patients qualify , but they ’ d have to be 21 or older , and the Oregon Health Authority would set up regulations .
There ’ s a growing body of research for this type of approach .
The idea is that a person taking psychedelics on their own can have a bad or even traumatic experience .
But under proper supervision , a trained facilitator can guide someone to make the most of the experience .
The studies done so far tended to be @ @ @ @ @ @ @ — with potential benefits for a range of mental health conditions , including depression , anxiety , PTSD , and addiction .
Unlike other medications for such conditions , the research indicates that just one or two doses can have effects for years or even decades .
The research is so promising , in fact , that the Food and Drug Administration has allowed psychedelic treatments with psilocybin and MDMA ( also known as ecstasy or molly ) to go forward in clinical trials .
There ’ s a chance that , regardless @ @ @ @ @ @ @ year , these drugs could be legal for medical use in some capacity in the coming years .
Why does this seem to work ?
In short , psychedelic treatments appear to offer a greater sense of perspective — a decoupling of the mind and ego , described as “ ego dissolution ” — that helps people work through serious mental health conditions .
Some of the early studies looked at the effects on cancer patients , who dealt with serious , understandable dread over their potentially imminent deaths .
In 2015 , @ @ @ @ @ @ @ on early participants ’ experiences : A woman I ’ ll call Deborah Ames , a breast-cancer survivor in her sixties ( she asked not to be identified ) , described zipping through space as if in a video game until she arrived at the wall of a crematorium and realized , with a fright , “ I ’ ve died and now I ’ m going to be cremated .
The next thing I know , I ’ m below the ground in this gorgeous forest , deep woods , loamy and @ @ @ @ @ @ @ me and I ’ m seeing the trees growing , and I ’ m part of them .
It didn ’ t feel sad or happy , just natural , contented , peaceful .
I wasn ’ t gone .
I was part of the earth.
” Several patients described edging up to the precipice of death and looking over to the other side .
Tammy Burgess , given a diagnosis of ovarian cancer at fifty-five , found herself gazing across “ the great plain of consciousness .
It was very serene and @ @ @ @ @ @ @ could reach out and touch anyone I ’ d ever known .
When my time came , that ’ s where my life would go once it left me and that was O.K.
” For the skeptical , this can sound a bit strange .
But advocates and experts point out that what matters here is whether these experiences that might seem fishy to skeptics are real for the patients .
If someone genuinely believes they saw God or the face of death , and that helped them get through a mental health @ @ @ @ @ @ @ good therapy even if it doesn ’ t meet a rigid understanding of secular and scientific principles .
“ What it represents in the brain , we ’ re not really sure , ” James Rucker , a clinical lecturer at King ’ s College London who worked on a psychedelic-depression study , previously told me .
“ The way they describe it is often symbolic of what ’ s going on in their head .
Take the goddess leading you through .
Maybe it ’ s the goddess leading you through your @ @ @ @ @ @ @ if you take the metaphor like that.
” Critics worry that a program like the one Oregon activists have proposed could end up going very wrong .
If facilitators aren ’ t properly trained , if patients aren ’ t properly vetted for conditions like schizophrenia , or if psychedelic drugs end up outside of these facilities , that could lead to a lot of bad trips and scary anecdotes — the kind that shut down research into psychedelics in the 1960s and ’ 70s , leading to their total prohibition .
Advocates @ @ @ @ @ @ @ these concerns , which is why many argue that it ’ s important to set up a solid structure for how the drugs are administered to people .
They don ’ t want a medical marijuana model for psychedelics .
“ Above and beyond anything else , it ’ s essential to preserve strong safety parameters , ” Charles Grob , who ’ s led much of the recent psychedelic research , previously told me .
“ Without that , the work really can not proceed.
” For Oregon , the question is @ @ @ @ @ @ @ to voters .
It ’ s at least convincing enough for the Oregon Democratic Party , which endorsed the measure .
But with no polls so far this year investigating the public ’ s opinion of the measure , whether it will succeed is an open question .
Initiative 81 in Washington , DC , would decriminalize several psychedelics In the nation ’ s capital , activists are taking a different approach : With Initiative 81 , they ’ re hoping to effectively decriminalize several psychedelic substances .
Technically , the measure would @ @ @ @ @ @ @ of laws against the non-commercial cultivation , distribution , possession , and use of “ entheogenic plants and fungi , ” and ask prosecutors to also drop cases related to these same substances .
In practice , advocates say DC would no longer enforce laws against these psychedelic drugs .
But the measure wouldn ’ t allow commercial sales of the drugs — so don ’ t expect psychedelic dispensaries to pop up .
Advocates argue that these plant- and fungi-based drugs aren ’ t very dangerous , and that they would even @ @ @ @ @ @ @ are backed by some evidence . )
So , advocates say , law enforcement shouldn ’ t prioritize action against psychedelic substances .
And any problems the drugs do cause , like a bad trip , can be handled on a case-by-case basis — by public health agencies or other social services rather than by law enforcement .
Opponents worry that decriminalization could lead to more drug use and , perhaps , an increase in bad or even violent psychedelic experiences .
Indeed , these concerns are why some advocates of medical psychedelics @ @ @ @ @ @ @ allowed in supervised , controlled settings .
It ’ s possible drug use will rise if the initiative is successful : In Portugal , the decriminalization of all drugs — which was coupled with boosts to drug addiction treatment and harm reduction services — seemed to lead to more lifetime drug use overall but less problematic use .
( Like DC ’ s initiative , Portugal does not allow commercial sales . )
It ’ s also possible this change has almost no effect at all .
In the three years before Denver @ @ @ @ @ @ @ s police arrested about 50 people a year for the possession or sale of shrooms , and prosecutors acted on only 11 of those cases , out of thousands of arrests overall in the city each year .
( DC ’ s police department didn ’ t respond to a public records request for similar data for the District . )
Washington , DC , wouldn ’ t be the first city to enact such a measure , following the lead of Denver and some other cities .
But it would be the @ @ @ @ @ @ @ an effort .
It ’ s unclear if DC ’ s measure will pass .
The one poll on the issue found up to 60 percent support , but it was commissioned by the campaign .
If it does pass , the measure could face two extra hurdles : the DC Council and Congress , either of which could move to overturn the measure even if voters approve it .
Again , it ’ s unclear if either would actually make such a move .
This is part of a broader effort to @ @ @ @ @ @ @ the past decade , progressives have increasingly called to “ end the war on drugs ” — citing , in particular , the vast racial disparities in anti-drug law enforcement .
While some lawmakers have taken up that call , legislation has often lagged behind what progressive activists — and voters — support .
So activists and voters have begun to take matters into their own hands with ballot measures .
Marijuana legalization is one such example .
There ’ s a lot of support for marijuana legalization , with even a majority @ @ @ @ @ @ @ skeptical of drug policy reform , backing the change in public polls .
Yet progressive politicians have lagged behind voters on this issue — for instance , former Vice President Joe Biden , the Democratic nominee for president , opposes marijuana legalization ( though he backs decriminalization ) .
Rather than wait for politicians to catch up , activists have gone through the state ballot initiative process to get the change they want .
In 2012 , that approach made Colorado and Washington the first two states to legalize marijuana .
Nine more @ @ @ @ @ @ @ followed ( although two states , Illinois and Vermont , did so through their legislatures ) .
Four other states have legalization measures on the ballot this year .
Given their successes with marijuana , drug policy reformers are now looking for other ways to scale back the war on drugs through ballot measures .
That includes the psychedelic drug ballot measures , as well as another measure in Oregon that would decriminalize all drugs .
The question now is if the voters will be as receptive of these ideas as drug policy @ @ @ @ @ @ @ do prove receptive , that could make Oregon ’ s Measure 109 and DC ’ s Initiative 81 the beginning of a broader push for both decriminalization and legalization in the next few years .
But it all begins with Oregon and DC this November .
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This November, voters in two states could take significant steps toward ending the US’s near-total criminal prohibition of psychedelic drugs.
In Oregon, voters will decide on a ballot measure that would allow psilocybin mushrooms, also known as magic mushrooms, to be used for medical purposes. In Washington, DC, voters could, in effect, decriminalize a range of psychedelic plants and fungi.
The measures are seen by many activists as the next stage in scaling back America’s war on drugs, now that marijuana legalization has already reached 11 states and could be legalized in four more in the November election.
Polls show strong support for marijuana legalization, but it’s unclear how much public backing there is for measures decriminalizing psychedelics or legalizing them for medicinal purposes. Denver became the first US city to vote to decriminalize psychedelic mushrooms in 2019, but no state has decriminalized or legalized psychedelic substances for medical use.
But activists may have an advantage in Oregon and Washington, DC — both of which are very liberal, and were among the first jurisdictions to legalize cannabis for recreational uses (although DC, due to a bill passed by Congress, still prohibits sales).
The Oregon and DC, measures, then, stand to set the stage for future drug policy reform efforts. If two progressive places move forward with their measures, that may signal a wider public appetite for expanding access to psychedelic drugs. If the measures fail — especially in an election year that currently seems very favorable to more progressive causes — drug policy reformers almost certainly have their work cut out for them.
Measure 109 in Oregon would allow magic mushrooms for medical purposes
Oregon’s Measure 109 would create a program for administering psilocybin products, such as magic mushrooms, to patients for medical purposes. Unlike medical marijuana laws, this wouldn’t mean that patients could just get a doctor’s recommendation and then buy psilocybin at a dispensary. Instead, they’d be able to buy, possess, and consume the psychedelic drug at a “psilocybin service center” in which they’d be supervised and guided through their trips by trained facilitators. There aren’t set limits on which conditions would let patients qualify, but they’d have to be 21 or older, and the Oregon Health Authority would set up regulations.
There’s a growing body of research for this type of approach. The idea is that a person taking psychedelics on their own can have a bad or even traumatic experience. But under proper supervision, a trained facilitator can guide someone to make the most of the experience. The studies done so far tended to be small, but they’re promising — with potential benefits for a range of mental health conditions, including depression, anxiety, PTSD, and addiction. Unlike other medications for such conditions, the research indicates that just one or two doses can have effects for years or even decades.
The research is so promising, in fact, that the Food and Drug Administration has allowed psychedelic treatments with psilocybin and MDMA (also known as ecstasy or molly) to go forward in clinical trials. There’s a chance that, regardless of what voters decide in Oregon this year, these drugs could be legal for medical use in some capacity in the coming years.
Why does this seem to work? In short, psychedelic treatments appear to offer a greater sense of perspective — a decoupling of the mind and ego, described as “ego dissolution” — that helps people work through serious mental health conditions. Some of the early studies looked at the effects on cancer patients, who dealt with serious, understandable dread over their potentially imminent deaths. In 2015, Michael Pollan wrote in the New Yorker on early participants’ experiences:
A woman I’ll call Deborah Ames, a breast-cancer survivor in her sixties (she asked not to be identified), described zipping through space as if in a video game until she arrived at the wall of a crematorium and realized, with a fright, “I’ve died and now I’m going to be cremated. The next thing I know, I’m below the ground in this gorgeous forest, deep woods, loamy and brown. There are roots all around me and I’m seeing the trees growing, and I’m part of them. It didn’t feel sad or happy, just natural, contented, peaceful. I wasn’t gone. I was part of the earth.” Several patients described edging up to the precipice of death and looking over to the other side. Tammy Burgess, given a diagnosis of ovarian cancer at fifty-five, found herself gazing across “the great plain of consciousness. It was very serene and beautiful. I felt alone but I could reach out and touch anyone I’d ever known. When my time came, that’s where my life would go once it left me and that was O.K.”
For the skeptical, this can sound a bit strange. But advocates and experts point out that what matters here is whether these experiences that might seem fishy to skeptics are real for the patients. If someone genuinely believes they saw God or the face of death, and that helped them get through a mental health issue, then that’s a good therapy even if it doesn’t meet a rigid understanding of secular and scientific principles.
“What it represents in the brain, we’re not really sure,” James Rucker, a clinical lecturer at King’s College London who worked on a psychedelic-depression study, previously told me. “The way they describe it is often symbolic of what’s going on in their head. Take the goddess leading you through. Maybe it’s the goddess leading you through your depression and out the other side — if you take the metaphor like that.”
Critics worry that a program like the one Oregon activists have proposed could end up going very wrong. If facilitators aren’t properly trained, if patients aren’t properly vetted for conditions like schizophrenia, or if psychedelic drugs end up outside of these facilities, that could lead to a lot of bad trips and scary anecdotes — the kind that shut down research into psychedelics in the 1960s and ’70s, leading to their total prohibition.
Advocates and experts in the field actually share these concerns, which is why many argue that it’s important to set up a solid structure for how the drugs are administered to people. They don’t want a medical marijuana model for psychedelics.
“Above and beyond anything else, it’s essential to preserve strong safety parameters,” Charles Grob, who’s led much of the recent psychedelic research, previously told me. “Without that, the work really cannot proceed.”
For Oregon, the question is whether all of that will be convincing to voters. It’s at least convincing enough for the Oregon Democratic Party, which endorsed the measure. But with no polls so far this year investigating the public’s opinion of the measure, whether it will succeed is an open question.
Initiative 81 in Washington, DC, would decriminalize several psychedelics
In the nation’s capital, activists are taking a different approach: With Initiative 81, they’re hoping to effectively decriminalize several psychedelic substances.
Technically, the measure would force local police to deprioritize the enforcement of laws against the non-commercial cultivation, distribution, possession, and use of “entheogenic plants and fungi,” and ask prosecutors to also drop cases related to these same substances.
In practice, advocates say DC would no longer enforce laws against these psychedelic drugs. But the measure wouldn’t allow commercial sales of the drugs — so don’t expect psychedelic dispensaries to pop up.
Advocates argue that these plant- and fungi-based drugs aren’t very dangerous, and that they would even benefit some people. (Both claims are backed by some evidence.) So, advocates say, law enforcement shouldn’t prioritize action against psychedelic substances. And any problems the drugs do cause, like a bad trip, can be handled on a case-by-case basis — by public health agencies or other social services rather than by law enforcement.
Opponents worry that decriminalization could lead to more drug use and, perhaps, an increase in bad or even violent psychedelic experiences. Indeed, these concerns are why some advocates of medical psychedelics say that these substances should only be allowed in supervised, controlled settings.
It’s possible drug use will rise if the initiative is successful: In Portugal, the decriminalization of all drugs — which was coupled with boosts to drug addiction treatment and harm reduction services — seemed to lead to more lifetime drug use overall but less problematic use. (Like DC’s initiative, Portugal does not allow commercial sales.)
It’s also possible this change has almost no effect at all. In the three years before Denver decriminalized psilocybin mushrooms, the city’s police arrested about 50 people a year for the possession or sale of shrooms, and prosecutors acted on only 11 of those cases, out of thousands of arrests overall in the city each year. (DC’s police department didn’t respond to a public records request for similar data for the District.)
Washington, DC, wouldn’t be the first city to enact such a measure, following the lead of Denver and some other cities. But it would be the closest thing to a state approving such an effort.
It’s unclear if DC’s measure will pass. The one poll on the issue found up to 60 percent support, but it was commissioned by the campaign.
If it does pass, the measure could face two extra hurdles: the DC Council and Congress, either of which could move to overturn the measure even if voters approve it. Again, it’s unclear if either would actually make such a move.
This is part of a broader effort to scale back the war on drugs
Over the past decade, progressives have increasingly called to “end the war on drugs” — citing, in particular, the vast racial disparities in anti-drug law enforcement. While some lawmakers have taken up that call, legislation has often lagged behind what progressive activists — and voters — support. So activists and voters have begun to take matters into their own hands with ballot measures.
Marijuana legalization is one such example. There’s a lot of support for marijuana legalization, with even a majority of Republicans, who are typically more skeptical of drug policy reform, backing the change in public polls. Yet progressive politicians have lagged behind voters on this issue — for instance, former Vice President Joe Biden, the Democratic nominee for president, opposes marijuana legalization (though he backs decriminalization).
Rather than wait for politicians to catch up, activists have gone through the state ballot initiative process to get the change they want. In 2012, that approach made Colorado and Washington the first two states to legalize marijuana. Nine more states, and DC, have since followed (although two states, Illinois and Vermont, did so through their legislatures). Four other states have legalization measures on the ballot this year.
Given their successes with marijuana, drug policy reformers are now looking for other ways to scale back the war on drugs through ballot measures. That includes the psychedelic drug ballot measures, as well as another measure in Oregon that would decriminalize all drugs. The question now is if the voters will be as receptive of these ideas as drug policy reformers hope they are.
If voters do prove receptive, that could make Oregon’s Measure 109 and DC’s Initiative 81 the beginning of a broader push for both decriminalization and legalization in the next few years. But it all begins with Oregon and DC this November.