theintercept--2020-03-20--When It Comes to Coronavirus and Pregnancy, “We Just Don’t Know a Whole Lot Yet”

Jesse Robertson was admitted to a hospital in Denver , Colorado .
She was 38 weeks pregnant with twins , and the time had come to induce labor .
“ Thankfully , I ’ ve been off work for the last couple of weeks and just basically kind of put myself on not really official bedrest , but just trying to keep these little ones quiet , ” she said before heading into delivery .
“ Keep them in there as long as possible.
” As the new coronavirus spreads across the country , the Centers for Disease Control and @ @ @ @ @ @ @ ” for preventing infection in inpatient obstetric settings , like the maternity ward Robertson checked into .
Yet little is known about how the virus impacts pregnancy .
Meanwhile , the Trump administration ’ s hostility to reproductive rights and health care has weakened the family-planning safety net .
Policies ostensibly enacted to ward off government funding for abortion have stretched thin budgets and led to staffing shortages across the system .
Now , providers and experts are concerned that the added strain of the coronavirus outbreak could leave uninsured and marginalized people @ @ @ @ @ @ @ basic health care .
Despite the heightened anxiety around spread of the virus , Robertson , who is a doctor and holds a master ’ s in public health , has kept her cool .
“ It ’ s just like the Brits say : Keep calm , carry on.
” In the Face of Uncertainty During a CDC webinar for health care providers on March 12 , Dr. Romeo Galang , part of the agency ’ s virus response team , reiterated that there is only limited information about how Covid-19 interacts @ @ @ @ @ @ @ today about Covid-19 and pregnancy is based upon very few case reports and case series … from China , ” he said .
“ The challenge with these reports is that reporting on maternal , perinatal , and neonatal outcomes have been inconsistent and details have varied.
” One case study , published by The Lancet in February , revealed no signs of “ vertical transmission ” of the infection — that it had spread from mother to child — though the study was limited to just nine pregnant women who had tested @ @ @ @ @ @ @ report , also published in The Lancet , noted that two neonatal cases of the virus had been confirmed in China , but there was no indication that they were the result of transmission via umbilical cord blood , for example , or breastmilk .
The second report suggested that the new coronavirus — officially , SARS-CoV-2 — has some similarity to the previous SARS outbreak .
Studies of that virus revealed a connection between infection and a higher risk of complications during pregnancy , including spontaneous miscarriage , preterm delivery , and @ @ @ @ @ @ @ pregnant women with Covid-19 infection in the present study had fewer adverse maternal and neonatal complications and outcomes than would be anticipated ” based on SARS .
In all , Galang said , reports from China have included at least 34 pregnant women affected by the virus , with illness onset in a range of 13 days before delivery to three days after delivery .
Almost all of the women delivered by cesarean section , some prompted by the illness and some due to other factors .
Two were put in intensive care @ @ @ @ @ @ @ a healthy baby and the other delivered a stillborn .
None of the mothers have died .
There is no data on Covid-19 infection and early pregnancy , Galang said .
“ The main take-home messages for me are that , No .
1 , we just don ’ t know a whole lot yet , ” said Dr. Michael Policar , professor emeritus of obstetrics , gynecology , and reproductive sciences at the University of California San Francisco School of Medicine , where he was a practicing OB-GYN for nearly 40 years @ @ @ @ @ @ @ been anything published in the United States.
” But , he says , what he ’ s seen and heard so far suggests that Covid-19 “ looks a lot like what happens during pregnancy with other kinds of flu virus infections.
” That means that it “ has a tendency to play out as a condition with significantly more symptoms ” in pregnant women .
“ And that would be completely expected given the fact that any woman who ’ s pregnant already has some amount of immune compromise so that she doesn @ @ @ @ @ @ @ Policar agrees that there is nothing yet to suggest that the infection can be transferred from mother to child .
But he says there are still things to watch out for , including a high fever , particularly in the first trimester , “ during the time that the organ systems are developing in the embryo and then the fetus , ” which can increase the likelihood of certain birth defects .
“ It ’ s way too early to know whether or not that ’ s going to be the case with @ @ @ @ @ @ @ with high-risk pregnancies because of underlying health issues , as well as pregnant medical practitioners who may be on the front lines of the epidemic .
“ Facilities may want to at least consider limiting exposure of pregnant health care personnel from patient care of those who have confirmed Covid-19 infections , ” Galang said during the CDC webinar .
“ This is all , of course , if it is feasible and based on staffing availability.
” Dr. Denise Jamieson , chair of the department of gynecology and obstetrics at Emory University @ @ @ @ @ @ @ part of the CDC webinar , said that given the “ paucity of data ” about Covid-19 , “ pregnant women should be considered an at-risk population for strategies focused on prevention and management.
” “ We know that pregnant women are a population who may be at increased risk of susceptibility to infection , severe illness , and mortality associated with other respiratory infections .
This is because of the physiologic changes that take place during pregnancy , including increased heart rate and oxygen consumption , decreased lung capacity , and a @ @ @ @ @ @ @ she said .
“ These changes may increase the risk of more severe disease in pregnant women compared with nonpregnant adults.
” The American College of Obstetricians and Gynecologists and the Society of Maternal-Fetal Medicine have developed an algorithm to help providers assess pregnant patients .
It ’ s a colorful flow chart that guides clinicians through various questions to determine a patient ’ s health and risk potential .
Does she have a fever ?
Is she short of breath ?
Does she have diabetes , hypertension , or HIV ?
And @ @ @ @ @ @ @ red : “ Please be advised that Covid-19 is a rapidly evolving situation and this guidance may become out of date as new information on Covid-19 in pregnant women becomes available.
” The coronavirus outbreak also has broader implications for the family-planning provider network and the low-income , uninsured or underinsured , and marginalized populations it serves .
“ For women generally , many of them see their OB-GYN more often than they see a primary care doctor or view their OB-GYN as their primary care doctor .
And that is certainly true @ @ @ @ @ @ @ family-planning clinics as well , ” said Adam Sonfield , senior policy manager at the Guttmacher Institute , which last week published a piece analyzing the possible fallout from Covid-19 on sexual and reproductive health .
“ It ’ s often their main entryway into the health care system ; it ’ s often their primary source of care or their only source of care in a given year.
” In addition to gynecological services and contraceptives , family-planning providers screen patients for a wide variety of issues .
“ And , you @ @ @ @ @ @ @ to be a stepped-up role in a crisis like this , ” Sonfield said .
Yet the network of clinics that does this work has come under increasing attack in recent years as conservative lawmakers have taken aim at the nation ’ s largest family-planning provider , Planned Parenthood .
Take , for example , the so-called domestic gag rule that the Trump administration enacted last year , which , among other things , forbids any clinic receiving Title X funding — the nation ’ s only funding stream dedicated to basic reproductive @ @ @ @ @ @ @ abortion providers .
While the restriction was aimed at Planned Parenthood , it has likely led to 981 clinics dropping out of the program .
Those providers saw roughly half of the nearly 4 million people who rely on Title X for basic health care , Sonfield said .
The rule has left six states without a single Title X provider .
“ Combine that with the added , intense strains of the Covid-19 epidemic , and it could be extremely harmful for millions of people who rely on that network for care @ @ @ @ @ @ @ lecture last week at the National Family Planning and Reproductive Health Association annual conference , Policar said the best way to mitigate any service-delivery issues would be to rely on telemedicine when possible and increase “ phone triage ” of patients before scheduled visits to determine potential risk factors .
All elective services , like routine annual checkups , should be postponed when possible .
The Trump administration ’ s war on the nation ’ s health care system is vast and ongoing .
Among other insults , it supports dismantling the Affordable @ @ @ @ @ @ @ for Medicaid that threaten to dump countless people from the rolls ; and has continued to champion deep cuts proposed to the CDC budget amid the coronavirus outbreak .
“ For the past few years , this administration has pulled every lever within its control to undermine and weaken our nation ’ s health insurance infrastructure , specifically targeting people who already face systematic barriers to care , including immigrants , people of color , young people , those with low incomes , and LGBTQ+ people , ” Zara Ahmed , a senior @ @ @ @ @ @ @ .
“ Now , the cumulative effect of years of attacks will heighten the challenges of combating an epidemic for communities that are already marginalized.
” Policar notes that access to reproductive health care will remain critical amid the viral outbreak , particularly if providers themselves become infected and further reduce the number of clinicians available to see patients .
Individuals who need routine prenatal care or contraceptives to control underlying health issues , or who are trying to prevent unintended pregnancy , have serious and ongoing needs to be met .
“ @ @ @ @ @ @ @ issue , as well as a public health issue , ” he said .
Nearly half of all U.S. pregnancies are unintended .
“ From the point of view of the patient who is motivated to prevent unintended pregnancy , every time there ’ s a barrier in front of her being able to get the services she needs , that ’ s a problem , ” he said .
Robertson said she understands that for many , accessing appropriate health care in the best of times can be difficult .
Even with @ @ @ @ @ @ @ the reproductive health care she ’ s needed hasn ’ t been easy .
“ I could go off on a tangent , ” she said .
But she said that working in a hospital helped to frame her thinking as she prepared for delivery : Maintain good hygiene ; limit the number of surfaces you touch and don ’ t touch your face ; manage the number of people you come into contact with .
In other words , deal squarely with the things you can control .
“ I think being @ @ @ @ @ @ @ and knowing what should be going on , I ’ m definitely going to be like , ‘ Hey , no offense , just want to make sure you washed your hands , ’ ” she said .
And she has a plan to maintain those protocols once the babies are home .
“ It ’ s been such a waiting game and I have a herd of people who are so excited , but at the same time , it ’ s probably better that I ’ m like , ‘ Oh @ @ @ @ @ @ @ just going to hole up and , you know , I ’ ll text you pictures .
’ ”

On Thursday morning, Jesse Robertson was admitted to a hospital in Denver, Colorado.
She was 38 weeks pregnant with twins, and the time had come to induce labor. “Thankfully, I’ve been off work for the last couple of weeks and just basically kind of put myself on not really official bedrest, but just trying to keep these little ones quiet,” she said before heading into delivery. “Keep them in there as long as possible.”
As the new coronavirus spreads across the country, the Centers for Disease Control and Prevention has put out “interim considerations” for preventing infection in inpatient obstetric settings, like the maternity ward Robertson checked into. Yet little is known about how the virus impacts pregnancy.
Meanwhile, the Trump administration’s hostility to reproductive rights and health care has weakened the family-planning safety net. Policies ostensibly enacted to ward off government funding for abortion have stretched thin budgets and led to staffing shortages across the system. Now, providers and experts are concerned that the added strain of the coronavirus outbreak could leave uninsured and marginalized people of reproductive age without ready access to basic health care.
Despite the heightened anxiety around spread of the virus, Robertson, who is a doctor and holds a master’s in public health, has kept her cool. “It’s just like the Brits say: Keep calm, carry on.”
In the Face of Uncertainty
During a CDC webinar for health care providers on March 12, Dr. Romeo Galang, part of the agency’s virus response team, reiterated that there is only limited information about how Covid-19 interacts with pregnancy. “What we know today about Covid-19 and pregnancy is based upon very few case reports and case series … from China,” he said. “The challenge with these reports is that reporting on maternal, perinatal, and neonatal outcomes have been inconsistent and details have varied.”
One case study, published by The Lancet in February, revealed no signs of “vertical transmission” of the infection — that it had spread from mother to child — though the study was limited to just nine pregnant women who had tested positive for the virus. A second report, also published in The Lancet, noted that two neonatal cases of the virus had been confirmed in China, but there was no indication that they were the result of transmission via umbilical cord blood, for example, or breastmilk.
The second report suggested that the new coronavirus — officially, SARS-CoV-2 — has some similarity to the previous SARS outbreak. Studies of that virus revealed a connection between infection and a higher risk of complications during pregnancy, including spontaneous miscarriage, preterm delivery, and intrauterine growth constriction. “However, pregnant women with Covid-19 infection in the present study had fewer adverse maternal and neonatal complications and outcomes than would be anticipated” based on SARS.
In all, Galang said, reports from China have included at least 34 pregnant women affected by the virus, with illness onset in a range of 13 days before delivery to three days after delivery. Almost all of the women delivered by cesarean section, some prompted by the illness and some due to other factors. Two were put in intensive care; of those, one woman delivered a healthy baby and the other delivered a stillborn. None of the mothers have died. There is no data on Covid-19 infection and early pregnancy, Galang said.
“The main take-home messages for me are that, No. 1, we just don’t know a whole lot yet,” said Dr. Michael Policar, professor emeritus of obstetrics, gynecology, and reproductive sciences at the University of California San Francisco School of Medicine, where he was a practicing OB-GYN for nearly 40 years. “There really hasn’t been anything published in the United States.”
But, he says, what he’s seen and heard so far suggests that Covid-19 “looks a lot like what happens during pregnancy with other kinds of flu virus infections.” That means that it “has a tendency to play out as a condition with significantly more symptoms” in pregnant women. “And that would be completely expected given the fact that any woman who’s pregnant already has some amount of immune compromise so that she doesn’t reject her own fetus.”
Policar agrees that there is nothing yet to suggest that the infection can be transferred from mother to child. But he says there are still things to watch out for, including a high fever, particularly in the first trimester, “during the time that the organ systems are developing in the embryo and then the fetus,” which can increase the likelihood of certain birth defects. “It’s way too early to know whether or not that’s going to be the case with coronavirus.”
Of greatest concern are women with high-risk pregnancies because of underlying health issues, as well as pregnant medical practitioners who may be on the front lines of the epidemic.
Of greatest concern are women with high-risk pregnancies because of underlying health issues, as well as pregnant medical practitioners who may be on the front lines of the epidemic. “Facilities may want to at least consider limiting exposure of pregnant health care personnel from patient care of those who have confirmed Covid-19 infections,” Galang said during the CDC webinar. “This is all, of course, if it is feasible and based on staffing availability.”
Dr. Denise Jamieson, chair of the department of gynecology and obstetrics at Emory University School of Medicine, who was also part of the CDC webinar, said that given the “paucity of data” about Covid-19, “pregnant women should be considered an at-risk population for strategies focused on prevention and management.”
“We know that pregnant women are a population who may be at increased risk of susceptibility to infection, severe illness, and mortality associated with other respiratory infections. This is because of the physiologic changes that take place during pregnancy, including increased heart rate and oxygen consumption, decreased lung capacity, and a shift away from cell-mediated immunity,” she said. “These changes may increase the risk of more severe disease in pregnant women compared with nonpregnant adults.”
The American College of Obstetricians and Gynecologists and the Society of Maternal-Fetal Medicine have developed an algorithm to help providers assess pregnant patients. It’s a colorful flow chart that guides clinicians through various questions to determine a patient’s health and risk potential. Does she have a fever? Is she short of breath? Does she have diabetes, hypertension, or HIV? And it comes with a warning printed in red: “Please be advised that Covid-19 is a rapidly evolving situation and this guidance may become out of date as new information on Covid-19 in pregnant women becomes available.”
Overburdened, Under the Gun
The coronavirus outbreak also has broader implications for the family-planning provider network and the low-income, uninsured or underinsured, and marginalized populations it serves.
“For women generally, many of them see their OB-GYN more often than they see a primary care doctor or view their OB-GYN as their primary care doctor. And that is certainly true with women who go to publicly funded family-planning clinics as well,” said Adam Sonfield, senior policy manager at the Guttmacher Institute, which last week published a piece analyzing the possible fallout from Covid-19 on sexual and reproductive health. “It’s often their main entryway into the health care system; it’s often their primary source of care or their only source of care in a given year.” In addition to gynecological services and contraceptives, family-planning providers screen patients for a wide variety of issues. “And, you know, that’s clearly going to be a stepped-up role in a crisis like this,” Sonfield said.
Yet the network of clinics that does this work has come under increasing attack in recent years as conservative lawmakers have taken aim at the nation’s largest family-planning provider, Planned Parenthood. Take, for example, the so-called domestic gag rule that the Trump administration enacted last year, which, among other things, forbids any clinic receiving Title X funding — the nation’s only funding stream dedicated to basic reproductive health care — from referring patients to abortion providers.
While the restriction was aimed at Planned Parenthood, it has likely led to 981 clinics dropping out of the program. Those providers saw roughly half of the nearly 4 million people who rely on Title X for basic health care, Sonfield said. The rule has left six states without a single Title X provider. “Combine that with the added, intense strains of the Covid-19 epidemic, and it could be extremely harmful for millions of people who rely on that network for care,” he said.
During a lecture last week at the National Family Planning and Reproductive Health Association annual conference, Policar said the best way to mitigate any service-delivery issues would be to rely on telemedicine when possible and increase “phone triage” of patients before scheduled visits to determine potential risk factors. All elective services, like routine annual checkups, should be postponed when possible.
“This administration has pulled every lever within its control to undermine and weaken our nation’s health insurance infrastructure.”
The Trump administration’s war on the nation’s health care system is vast and ongoing. Among other insults, it supports dismantling the Affordable Care Act; has finalized work requirements for Medicaid that threaten to dump countless people from the rolls; and has continued to champion deep cuts proposed to the CDC budget amid the coronavirus outbreak.
“For the past few years, this administration has pulled every lever within its control to undermine and weaken our nation’s health insurance infrastructure, specifically targeting people who already face systematic barriers to care, including immigrants, people of color, young people, those with low incomes, and LGBTQ+ people,” Zara Ahmed, a senior policy manager at Guttmacher, told Bustle. “Now, the cumulative effect of years of attacks will heighten the challenges of combating an epidemic for communities that are already marginalized.”
Policar notes that access to reproductive health care will remain critical amid the viral outbreak, particularly if providers themselves become infected and further reduce the number of clinicians available to see patients. Individuals who need routine prenatal care or contraceptives to control underlying health issues, or who are trying to prevent unintended pregnancy, have serious and ongoing needs to be met. “Unintended pregnancy is both a huge personal issue, as well as a public health issue,” he said. Nearly half of all U.S. pregnancies are unintended. “From the point of view of the patient who is motivated to prevent unintended pregnancy, every time there’s a barrier in front of her being able to get the services she needs, that’s a problem,” he said.
Robertson said she understands that for many, accessing appropriate health care in the best of times can be difficult. Even with an excellent health insurance plan, getting the reproductive health care she’s needed hasn’t been easy. “I could go off on a tangent,” she said.
But she said that working in a hospital helped to frame her thinking as she prepared for delivery: Maintain good hygiene; limit the number of surfaces you touch and don’t touch your face; manage the number of people you come into contact with. In other words, deal squarely with the things you can control. “I think being an advocate and working in health care and knowing what should be going on, I’m definitely going to be like, ‘Hey, no offense, just want to make sure you washed your hands,’” she said.
And she has a plan to maintain those protocols once the babies are home. “It’s been such a waiting game and I have a herd of people who are so excited, but at the same time, it’s probably better that I’m like, ‘Oh, sorry guys! We’re just going to hole up and, you know, I’ll text you pictures.’”


theintercept--2020-03-20--Introducing Somebody, an Investigative Podcast

a banging at her door shortly after 2 a.m. on March 4 , 2016 .
It was the police , and they said her son Courtney Copeland was in the hospital .
When Shapearl ’ s husband called for more information , the hospital couldn ’ t release anything over the phone .
Shapearl fell to her knees .
She felt in her heart that Courtney was already dead .
He was 22 .
Police said Courtney was shot in his car and drove to a nearby station on the Northwest Side of Chicago , where he flagged down an @ @ @ @ @ @ @ asked Shapearl if Courtney was the owner of the car — a BMW — she immediately became suspicious .
And when the city wouldn ’ t release the neighborhood camera footage showing Courtney ’ s police encounter , Shapearl reached out to the Invisible Institute , a small investigative journalism studio on the South Side of Chicago , where I work .
We decided to document her quest with an investigative podcast .
It ’ s called Somebody , and it ’ s launching on March 31 .
When I first sat down @ @ @ @ @ @ @ I wasn ’ t looking for another investigation .
I was a new mom , had recently returned to work , and I had a list of projects waiting for me .
I have no idea where that list is now .
For the last three years , investigating Courtney ’ s death has been at the top of my list , my mind , my everything .
With each passing year , as my own son grew from infant to toddler to little boy , I was often seized by a pang @ @ @ @ @ @ @ .
While I never knew Courtney when he was alive , I came to know him through photos , videos , interviews with his friends , and of course , an ongoing conversation with Shapearl .
Her heartbreak from being separated from Courtney continues to sear me and scare me — especially as I reckon with what it means to raise my son , a mixed-race boy in Chicago .
In her quest for answers , Shapearl has been unstoppable in scrutinizing the official narrative of what happened to Courtney .
I accompanied @ @ @ @ @ @ @ become the occupying force of her life .
We ’ ve shared middle-of-the-night missives , strange dreams , revelations , anxieties , fears — and above all , an obsession with finding the truth .
For Shapearl , this quest was her grief playing out , a way to be with her son in his final moments by dissecting them , second by second .
Making a podcast , while secondary to the investigation itself , was a means to an end : narrative justice .
By telling this tale , Shapearl has @ @ @ @ @ @ @ the systems of power encircling Courtney ’ s death .
And ultimately , she has found strength in other mothers around the world who have lost their children to state violence .
Bearing witness to this has molded me , both as a mother and as a journalist .
And I ’ ve learned the power of what women can do when they fight from the womb .

Subscribe to the Somebody podcast on Apple Podcasts, iHeart Radio, Google Play, Stitcher, and other platforms .
Shapearl Wells heard a banging at her door shortly after 2 a.m. on March 4, 2016. It was the police, and they said her son Courtney Copeland was in the hospital. When Shapearl’s husband called for more information, the hospital couldn’t release anything over the phone. Shapearl fell to her knees. She felt in her heart that Courtney was already dead. He was 22.
Police said Courtney was shot in his car and drove to a nearby station on the Northwest Side of Chicago, where he flagged down an officer for help. But when detectives asked Shapearl if Courtney was the owner of the car — a BMW — she immediately became suspicious. And when the city wouldn’t release the neighborhood camera footage showing Courtney’s police encounter, Shapearl reached out to the Invisible Institute, a small investigative journalism studio on the South Side of Chicago, where I work.
We decided to document her quest with an investigative podcast. It’s called Somebody, and it’s launching on March 31.
When I first sat down for coffee with Shapearl in 2017, I wasn’t looking for another investigation. I was a new mom, had recently returned to work, and I had a list of projects waiting for me. I have no idea where that list is now.
For the last three years, investigating Courtney’s death has been at the top of my list, my mind, my everything. With each passing year, as my own son grew from infant to toddler to little boy, I was often seized by a pang, something like survivor’s guilt. While I never knew Courtney when he was alive, I came to know him through photos, videos, interviews with his friends, and of course, an ongoing conversation with Shapearl. Her heartbreak from being separated from Courtney continues to sear me and scare me — especially as I reckon with what it means to raise my son, a mixed-race boy in Chicago.
In her quest for answers, Shapearl has been unstoppable in scrutinizing the official narrative of what happened to Courtney. I accompanied her in a maddening mission that has become the occupying force of her life. We’ve shared middle-of-the-night missives, strange dreams, revelations, anxieties, fears — and above all, an obsession with finding the truth.
For Shapearl, this quest was her grief playing out, a way to be with her son in his final moments by dissecting them, second by second. Making a podcast, while secondary to the investigation itself, was a means to an end: narrative justice. By telling this tale, Shapearl has uncovered new evidence and called to account the systems of power encircling Courtney’s death. And ultimately, she has found strength in other mothers around the world who have lost their children to state violence.
Bearing witness to this has molded me, both as a mother and as a journalist. And I’ve learned the power of what women can do when they fight from the womb.


theintercept--2020-03-21--State Workers Seek to Protect Labor Rights as the Coronavirus Spreads

a week after declaring a state of emergency due to the spread of Covid-19 , Minnesota ’ s Democratic Gov .
Tim Walz signed an executive order pertaining to his state ’ s 50,000 executive branch employees .
The order extended paid leave to all state employees for absences like caring for children due to school closures , and authorized agency heads to waive parts of collective bargaining agreements so as to more easily deploy workers where and when needed .
Minnesota law grants the governor such powers during such emergencies .
Publicly , unions representing these workers praised Walz @ @ @ @ @ @ @ and offered only muted concerns about the collective bargaining measures — stressing they will monitor the situation to ensure employers do not abuse their new authorities .
Privately , though , unions were taken off guard by the governor ’ s actions , and were unable to get the state to agree to establishing guardrails in the order itself around preventing employer abuse .
Workers are concerned that other states , especially less labor-friendly ones , may follow Minnesota ’ s lead , and use the pandemic as a pretext to weaken unions @ @ @ @ @ @ @ , some employers have been lobbying for a similar executive order , to free themselves of public-sector bargaining restraints .
While state employees have made clear they ’ re committed to flexibly responding to the crisis , unions understand anti-labor managers have wielded emergencies to their benefit in the past .
March 12 , state union representatives had an in-person meeting with the Minnesota Management and Budget — an agency that governs personnel and finance issues — to check in about the novel coronavirus .
In that meeting , which was described as @ @ @ @ @ @ @ individual involved who was not authorized to speak about the discussions , union reps talked primarily about paid leave , and also raised concerns around telework , and safety equipment for health and correctional workers .
There was no discussion then of potentially waiving aspects of collective bargaining , and they all planned to meet again on Tuesday , March 17 .
But on Monday , March 16 , with less than an hour ’ s notice , the MMB emailed the unions an invitation for a conference call .
It was on @ @ @ @ @ @ @ draft of their forthcoming order , though they did not provide anyone on the call with a written copy of the text .
“ It was received as a great surprise , ” said one of the participants on the call .
“ A lot of questions were thrown out , and because we did not have the physical document in front of us , a lot of the questions were just like , ‘ What did you say ?
What ’ s that phrase ?
’ ” A few hours later union @ @ @ @ @ @ @ to discuss how to respond .
They were less concerned about Walz and far more worried about how agency heads below him might interpret their new broad authorities .
Many leaders of individual state agencies have been in charge since Republican Gov .
Tim Pawlenty ’ s tenure , and are not supportive of unions .
Under the new order , employers can change schedules , work locations , or work assignments without notice , whereas in the past employees were given a notice period to rearrange their lives .
On Monday evening @ @ @ @ @ @ @ Walz ’ s chiefs of staff to request the administration publicly commit to “ working with union representatives to swiftly and fairly address issues that may come up as a result ” of this proposed order .
The unions specifically requested a sentence be added to this effect , and that the administration commit to saying this in a press conference .
But all they were able to win was the addition of a vague line saying , “ When circumstances allow , Minnesota Management and Budget will work in partnership with the @ @ @ @ @ @ @ the provisions of collective bargaining agreements or memoranda of understanding.
” When the executive order was signed on Tuesday , union leaders largely bit their tongues .
“ We are thankful for the Governor ’ s action in authorizing this new policy specifically to address COVID-19 leave , ” stated the Inter Faculty Organization , which represents employees at Minnesota ’ s seven state universities .
Walz was elected in 2018 with strong union support , and the IFO praised the paid leave measure for “ setting the standard for the rest of @ @ @ @ @ @ @ American Federation of State , County and Municipal Employees Council 5 and the Minnesota Association of Professional Employees also issued a joint statement that recognized the “ magnitude ” of the executive order .
“ We won ’ t stand in the way of the state ’ s powerful response to the crisis , but we won ’ t idly sit by if that power is abused , ” they said .
The unions emphasized they had “ worked with the State ” to ensure the changes would be only limited to dealing @ @ @ @ @ @ @ MMB Commissioner Myron Frans said his agency “ is working in strong partnership with our union partners during this rapidly evolving emergency situation .
We continue to work together with the shared goals of preventing the spread of COVID-19 , keeping employees healthy , and providing critical services to the people of Minnesota.
” So far , rank-and-file members have not reacted negatively to the order — and have been focused more on the new expansive rights around paid leave , which they are happy with .
Union leaders suspect the rubber will @ @ @ @ @ @ @ of coronavirus ramp up in Minnesota , and working conditions start to change .
“ We ’ re particularly concerned about things like conditions in prisons , where workers already deal with severe understaffing , ” said the union source .
And while their grievance procedures are technically unaffected by the executive order , the reality is the standard grievance process doesn ’ t move quickly enough during emergencies , meaning workers could be left without recourse in the event of employer abuse .
state workers in California were recently threatened that their @ @ @ @ @ @ @ waived too .
Ashley Payne , a state worker in Contra Costa County , one of the nine counties in the Bay Area , has been increasingly alarmed by the lack of safety protections for workers like herself who have been required to come into the office .
She works in her county ’ s Employment and Human Services division , where she helps administer welfare .
As an elected officer for her union , SEIU Local 1021 , Payne has been fielding concerns from colleagues about the lack of hand sanitizer , @ @ @ @ @ @ @ for social workers who have to do home visits .
On Wednesday , Annie Barrett , the division manager for Payne ’ s department , emailed staffers about working conditions under Covid-19 , and said they were “ exploring temporary telecommuter opportunities.
” Payne forwarded the email to Jeffrey Bailey , her county ’ s labor relations manager , to say that while her union strongly supports this step , she wants to make it clear in writing that SEIU 1021 does not agree to making this change permanent .
“ We will @ @ @ @ @ @ @ crisis as a pretext for ushering in permanent changes , ” she wrote .
“ We continue to expect timely notice of upcoming changes so we can Meet and Confer over changes to wages , benefits , and working conditions.
” In his emailed response , Bailey agreed the assignment of staff to work from home was temporary , but emphasized that things “ are different ” under emergency conditions ( Emphasis in original ) .
“ Furthermore , ” Bailey wrote , “ the state of California has informed us that the @ @ @ @ @ @ @ to temporarily suspend many of the provisions of the MMBA [ Meyers-Milias Brown Act , the state law governing public sector collective bargaining ] during this emergency period.
” Upon receiving this email , Payne reached out to her local ’ s leadership , who reached up the chain to the state level .
Soon after Rene Bayardo , a lobbyist with SEIU California , emailed to say his team had looked into this threat , and suggested Bailey was wrong .
“ The indication from the [ Newsom ] administration is that @ @ @ @ @ @ @ but this is NOT under consideration , ” Bayardo wrote .
Payne , who has worked at her job since 2014 , said her employer has grown far less responsive to union concerns since the Janus v. AFSCME decision in June 2018 .
“ Knowing what their track record is I ’ m not surprised they ’ re trying to bust the union , ” she said .
Rather than distancing itself from unions during the pandemic , Payne added , local government should lean into “ much closer collaboration because we know @ @ @ @ @ @ @ best to ensure safety.
” Bailey told The Intercept that he doesn ’ t have “ any direct knowledge ” of California Gov .
Gavin Newsom ’ s plans with respect to MMBA .
“ I heard about it , as we say , ‘ through the grapevine , ’ ” he wrote in an email .
“ This has been discussed widely among public agencies , but I don ’ t have any specifics or inside information .
… We are all assuming that the suspension would apply to things like the @ @ @ @ @ @ @ ” Crystal Page , a spokesperson with California ’ s Labor & Workforce Development Agency , said Newsom “ has been clear that California needs flexibility to respond ” and that he “ understands the importance of collective bargaining and the need to ensure workers have a voice on the job.
” a labor historian at University of California , Santa Barbara told The Intercept he hadn ’ t heard anything about moves to suspend collective bargaining in California , though acknowledged it is certainly not unprecedented for anti-union leaders to try and @ @ @ @ @ @ @ pointed to the aftermath of 9/11 , when Congress created the Transportation Security Administration .
Using legislative authority , a George W. Bush-appointed TSA administrator denied the 40,000 TSA workers collective bargaining rights , claiming it was necessary for national security .
It wasn ’ t until 2011 , under a new Obama appointee , that TSA workers finally won the right to bargain .
Another example was following Hurricane Katrina , when Bush unilaterally suspended federal law governing workers ’ pay on federal contracts in areas of Alabama , Florida , Louisiana @ @ @ @ @ @ @ move by calling Katrina a “ national emergency ” and said ignoring federal rules around construction costs “ will result in greater assistance to these devastated communities.
” “ People were outraged , it was just so obvious he was using it opportunistically , ” said Lichtenstein .
About six weeks later , in response to the backlash , the White House reversed course .
Payne said she worries that if labor-friendly California does follow Minnesota ’ s example , it would quickly motivate many other states to follow , particularly Republican-controlled states @ @ @ @ @ @ @ we have to hold the line , ” she said .
“ If California does it , then everyone else will be like , ‘ We should have been doing this a long time ago .
’ ”

On Tuesday, a week after declaring a state of emergency due to the spread of Covid-19, Minnesota’s Democratic Gov. Tim Walz signed an executive order pertaining to his state’s 50,000 executive branch employees. The order extended paid leave to all state employees for absences like caring for children due to school closures, and authorized agency heads to waive parts of collective bargaining agreements so as to more easily deploy workers where and when needed. Minnesota law grants the governor such powers during such emergencies.
Publicly, unions representing these workers praised Walz for his action on paid leave, and offered only muted concerns about the collective bargaining measures — stressing they will monitor the situation to ensure employers do not abuse their new authorities.
Privately, though, unions were taken off guard by the governor’s actions, and were unable to get the state to agree to establishing guardrails in the order itself around preventing employer abuse.
Workers are concerned that other states, especially less labor-friendly ones, may follow Minnesota’s lead, and use the pandemic as a pretext to weaken unions in the long term. In California, some employers have been lobbying for a similar executive order, to free themselves of public-sector bargaining restraints. While state employees have made clear they’re committed to flexibly responding to the crisis, unions understand anti-labor managers have wielded emergencies to their benefit in the past.
On Thursday, March 12, state union representatives had an in-person meeting with the Minnesota Management and Budget — an agency that governs personnel and finance issues — to check in about the novel coronavirus. In that meeting, which was described as “friendly and nonproductive” by an individual involved who was not authorized to speak about the discussions, union reps talked primarily about paid leave, and also raised concerns around telework, and safety equipment for health and correctional workers. There was no discussion then of potentially waiving aspects of collective bargaining, and they all planned to meet again on Tuesday, March 17.
But on Monday, March 16, with less than an hour’s notice, the MMB emailed the unions an invitation for a conference call. It was on that call that state officials announced the draft of their forthcoming order, though they did not provide anyone on the call with a written copy of the text.
Union leaders suspect the rubber will hit the road if and when cases of coronavirus really ramp up in Minnesota, and working conditions start to change.
“It was received as a great surprise,” said one of the participants on the call. “A lot of questions were thrown out, and because we did not have the physical document in front of us, a lot of the questions were just like, ‘What did you say? What’s that phrase?’”
A few hours later union senior staff organized another call among themselves to discuss how to respond. They were less concerned about Walz and far more worried about how agency heads below him might interpret their new broad authorities. Many leaders of individual state agencies have been in charge since Republican Gov. Tim Pawlenty’s tenure, and are not supportive of unions. Under the new order, employers can change schedules, work locations, or work assignments without notice, whereas in the past employees were given a notice period to rearrange their lives.
On Monday evening, union leaders emailed MMB officials and Walz’s chiefs of staff to request the administration publicly commit to “working with union representatives to swiftly and fairly address issues that may come up as a result” of this proposed order. The unions specifically requested a sentence be added to this effect, and that the administration commit to saying this in a press conference.
But all they were able to win was the addition of a vague line saying, “When circumstances allow, Minnesota Management and Budget will work in partnership with the labor unions affected by any adjustments to the provisions of collective bargaining agreements or memoranda of understanding.”
When the executive order was signed on Tuesday, union leaders largely bit their tongues. “We are thankful for the Governor’s action in authorizing this new policy specifically to address COVID-19 leave,” stated the Inter Faculty Organization, which represents employees at Minnesota’s seven state universities. Walz was elected in 2018 with strong union support, and the IFO praised the paid leave measure for “setting the standard for the rest of the nation.”
The executive directors of American Federation of State, County and Municipal Employees Council 5 and the Minnesota Association of Professional Employees also issued a joint statement that recognized the “magnitude” of the executive order. “We won’t stand in the way of the state’s powerful response to the crisis, but we won’t idly sit by if that power is abused,” they said. The unions emphasized they had “worked with the State” to ensure the changes would be only limited to dealing with Covid-19.
In an emailed statement MMB Commissioner Myron Frans said his agency “is working in strong partnership with our union partners during this rapidly evolving emergency situation. We continue to work together with the shared goals of preventing the spread of COVID-19, keeping employees healthy, and providing critical services to the people of Minnesota.”
Read Our Complete Coverage The Coronavirus Crisis
So far, rank-and-file members have not reacted negatively to the order — and have been focused more on the new expansive rights around paid leave, which they are happy with. Union leaders suspect the rubber will hit the road if and when cases of coronavirus ramp up in Minnesota, and working conditions start to change.
“We’re particularly concerned about things like conditions in prisons, where workers already deal with severe understaffing,” said the union source. And while their grievance procedures are technically unaffected by the executive order, the reality is the standard grievance process doesn’t move quickly enough during emergencies, meaning workers could be left without recourse in the event of employer abuse.
Some unionized state workers in California were recently threatened that their collective bargaining rights were soon to be waived too.
Ashley Payne, a state worker in Contra Costa County, one of the nine counties in the Bay Area, has been increasingly alarmed by the lack of safety protections for workers like herself who have been required to come into the office. She works in her county’s Employment and Human Services division, where she helps administer welfare.
As an elected officer for her union, SEIU Local 1021, Payne has been fielding concerns from colleagues about the lack of hand sanitizer, disinfectant wipes, and masks — including for social workers who have to do home visits.
In California, some employers have been lobbying the governor for a similar executive order, to free themselves of collective bargaining restraints.
On Wednesday, Annie Barrett, the division manager for Payne’s department, emailed staffers about working conditions under Covid-19, and said they were “exploring temporary telecommuter opportunities.” Payne forwarded the email to Jeffrey Bailey, her county’s labor relations manager, to say that while her union strongly supports this step, she wants to make it clear in writing that SEIU 1021 does not agree to making this change permanent. “We will not allow the County to exploit this crisis as a pretext for ushering in permanent changes,” she wrote. “We continue to expect timely notice of upcoming changes so we can Meet and Confer over changes to wages, benefits, and working conditions.”
In his emailed response, Bailey agreed the assignment of staff to work from home was temporary, but emphasized that things “are different” under emergency conditions (Emphasis in original).
“Furthermore,” Bailey wrote, “the state of California has informed us that the Governor intends to pass an executive order to temporarily suspend many of the provisions of the MMBA [Meyers-Milias Brown Act, the state law governing public sector collective bargaining] during this emergency period.”
Upon receiving this email, Payne reached out to her local’s leadership, who reached up the chain to the state level. Soon after Rene Bayardo, a lobbyist with SEIU California, emailed to say his team had looked into this threat, and suggested Bailey was wrong. “The indication from the [Newsom] administration is that public employers are asking to suspend MMBA but this is NOT under consideration,” Bayardo wrote.
Payne, who has worked at her job since 2014, said her employer has grown far less responsive to union concerns since the Janus v. AFSCME decision in June 2018. “Knowing what their track record is I’m not surprised they’re trying to bust the union,” she said. Rather than distancing itself from unions during the pandemic, Payne added, local government should lean into “much closer collaboration because we know our work best and we know how best to ensure safety.”
Bailey told The Intercept that he doesn’t have “any direct knowledge” of California Gov. Gavin Newsom’s plans with respect to MMBA. “I heard about it, as we say, ‘through the grapevine,’” he wrote in an email. “This has been discussed widely among public agencies, but I don’t have any specifics or inside information. … We are all assuming that the suspension would apply to things like the meet and confer obligations and notice requirements.”
Crystal Page, a spokesperson with California’s Labor & Workforce Development Agency, said Newsom “has been clear that California needs flexibility to respond” and that he “understands the importance of collective bargaining and the need to ensure workers have a voice on the job.”
Nelson Lichtenstein, a labor historian at University of California, Santa Barbara told The Intercept he hadn’t heard anything about moves to suspend collective bargaining in California, though acknowledged it is certainly not unprecedented for anti-union leaders to try and exploit crises to weaken labor.
Lichtenstein pointed to the aftermath of 9/11, when Congress created the Transportation Security Administration. Using legislative authority, a George W. Bush-appointed TSA administrator denied the 40,000 TSA workers collective bargaining rights, claiming it was necessary for national security. It wasn’t until 2011, under a new Obama appointee, that TSA workers finally won the right to bargain.
Another example was following Hurricane Katrina, when Bush unilaterally suspended federal law governing workers’ pay on federal contracts in areas of Alabama, Florida, Louisiana, and Mississippi. Bush justified his move by calling Katrina a “national emergency” and said ignoring federal rules around construction costs “will result in greater assistance to these devastated communities.”
“People were outraged, it was just so obvious he was using it opportunistically,” said Lichtenstein. About six weeks later, in response to the backlash, the White House reversed course.
Payne said she worries that if labor-friendly California does follow Minnesota’s example, it would quickly motivate many other states to follow, particularly Republican-controlled states. “This is why I feel we have to hold the line,” she said. “If California does it, then everyone else will be like, ‘We should have been doing this a long time ago.’”


theintercept--2020-03-21--Silicon Valley Megadonor Karla Jurvetson Fueled Elizabeth Warren’s Super PAC with $14 Million

Silicon Valley Megadonor Karla Jurvetson Fueled Elizabeth Warren’s Super PAC with $14 Million Donation

Karla Jurvetson , a Silicon Valley megadonor , who made over 500 donations over the last year alone , provided 96 percent of the super PAC ’ s financing through a $ 14.6 million donation .
Barbara Lee , a prominent Democratic donor in Massachusetts , and Women Vote !
— the super PAC affiliate of EMILY ’ s List , a pro-choice group previously financed by Michael Bloomberg , among other wealthy donors — also provided significant funding for Persist PAC .
In a campaign finance filing late on Friday , Persist PAC , the super PAC that attempted @ @ @ @ @ @ @ presidential campaign finally disclosed its donors .
Jurvetson is a physician and philanthropist .
A profile of the Palo Alto-based donor in the Mercury News notes that Jurveston walked door-to-door for Rep. Anna Eshoo , D-Calif. , during her undergraduate years , and has long been involved in political causes , but saw the election of President Donald Trump as a major turning point .
Over the last three years , she has lavished Democratic candidates with funding , with an eye towards supporting Democratic women , including conservative Democratic Arizona Sen. Kyrsten @ @ @ @ @ @ @ Cisneros .
Jurvetson separated from her husband Steve Jurvetson , a prominent venture capitalist , in 2017 .
She previously made headlines with an unusual donation of $ 5.4 million worth of stock options from the Chinese technology company Baidu to Women Vote !
The filing for Persist PAC , which was formed on February 18 , has been much anticipated given charges of hypocrisy leveled at the Massachusetts senator for receiving the type of loosely regulated , big-money support she has long assailed as corrosive to democracy .
The pro-Warren group staged @ @ @ @ @ @ @ , spending $ 9 million in battleground Super Tuesday states , largely on television commercials .
The late formation of the campaign committee meant that the group was able to legally delay disclosure of its donors until over a month after it was created and millions of voters had already gone to the polls .
Warren ’ s anti-super PAC rhetoric was a major feature of her campaign .
During the debate in New Hampshire in February , she challenged the other candidates on stage to “ put your money where your mouth @ @ @ @ @ @ @ .
“ We don ’ t build a democracy with Super PACS or people sucking up to billionaires , ” she tweeted .
The Persist PAC ads touted Warren ’ s humble upbringing and work on the Consumer Financial Protection Bureau .
Kristen Orthman , Warren ’ s communications director , previously told reporters that Warren “ believes Persist PAC and all other super PACs should disclose their donors before Super Tuesday.
” Warren has long opposed the intervention of super PACs in politics , going back to her first Senate race in @ @ @ @ @ @ @ with then-Sen. Scott Brown , R-Mass.
, who joined her in rejecting the influence of independent expenditures in the race .
The two candidates agreed to donate money to charity to match the outside dollars spent in the race .

In a campaign finance filing late on Friday, Persist PAC, the super PAC that attempted to revive Sen. Elizabeth Warren’s presidential campaign finally disclosed its donors.
Karla Jurvetson, a Silicon Valley megadonor, who made over 500 donations over the last year alone, provided 96 percent of the super PAC’s financing through a $14.6 million donation. Barbara Lee, a prominent Democratic donor in Massachusetts, and Women Vote! — the super PAC affiliate of EMILY’s List, a pro-choice group previously financed by Michael Bloomberg, among other wealthy donors — also provided significant funding for Persist PAC.
Jurvetson is a physician and philanthropist. A profile of the Palo Alto-based donor in the Mercury News notes that Jurveston walked door-to-door for Rep. Anna Eshoo, D-Calif., during her undergraduate years, and has long been involved in political causes, but saw the election of President Donald Trump as a major turning point. Over the last three years, she has lavished Democratic candidates with funding, with an eye towards supporting Democratic women, including conservative Democratic Arizona Sen. Kyrsten Sinema as well as progressive insurgent Jessica Cisneros.
Jurvetson separated from her husband Steve Jurvetson, a prominent venture capitalist, in 2017. She previously made headlines with an unusual donation of $5.4 million worth of stock options from the Chinese technology company Baidu to Women Vote!
The filing for Persist PAC, which was formed on February 18, has been much anticipated given charges of hypocrisy leveled at the Massachusetts senator for receiving the type of loosely regulated, big-money support she has long assailed as corrosive to democracy.
The pro-Warren group staged a last-minute intervention into the Democratic primary, spending $9 million in battleground Super Tuesday states, largely on television commercials.
The late formation of the campaign committee meant that the group was able to legally delay disclosure of its donors until over a month after it was created and millions of voters had already gone to the polls.
Warren’s anti-super PAC rhetoric was a major feature of her campaign. During the debate in New Hampshire in February, she challenged the other candidates on stage to “put your money where your mouth is” and disavow super PAC support.
“We don’t build a democracy with Super PACS or people sucking up to billionaires,” she tweeted.
The Persist PAC ads touted Warren’s humble upbringing and work on the Consumer Financial Protection Bureau.
Kristen Orthman, Warren’s communications director, previously told reporters that Warren “believes Persist PAC and all other super PACs should disclose their donors before Super Tuesday.”
Warren has long opposed the intervention of super PACs in politics, going back to her first Senate race in 2012, when she forged an agreement with then-Sen. Scott Brown, R-Mass., who joined her in rejecting the influence of independent expenditures in the race. The two candidates agreed to donate money to charity to match the outside dollars spent in the race.


theintercept--2020-03-21--Italy’s Coronavirus Nightmare Could Happen in U.S. Within Days or Weeks, Ex-CDC Chief Says

death toll grew to more than 4,000 on Friday , outpacing China , a country with more than 20 times its population .
The Italian health care system is now buckling under the weight of the pandemic .
Health care professionals are working day and night to keep critically ill Covid-19 patients alive , while wartime triage conditions have left doctors to decide who lives and who dies .
The crematorium in the hard-hit city of Bergamo is so overwhelmed that the army was brought in to deal with the corpses .
It could be a matter of weeks — @ @ @ @ @ @ @ happens here , Dr. Tom Frieden , the former director of the Centers for Disease Control and Prevention , told The Intercept .
“ Right now , the major concern that I have , and that other public health experts have , is the risk of outstripping health care capacity , ” said Frieden , who is currently a senior fellow for global health at the Council on Foreign Relations .
“ This would be catastrophic .
It ’ s what we ’ re seeing in Italy now , and it ’ s @ @ @ @ @ @ @ the U.S. soon.
” Frieden stressed the importance for healthy individuals of regular hand-washing and called for the medically vulnerable to self-isolate and stay 6 feet away from almost everyone .
“ We ’ ve seen terrible examples from Italy and Wuhan [ in China ] of thousands of health care workers getting infected , and we know that in the U.S. now , many health care workers have become infected.
” New modeling and estimates point to a nightmare scenario in which there could be a tenfold greater need in the United @ @ @ @ @ @ @ are available , Frieden said .
“ What we ’ re hoping is that kind of peak that outstrips the health care system [ as in Italy ] does not come here , ” he told The Intercept .
“ If it did , it could come in a matter of days to weeks.
” Last week , Frieden published a worst-case — but not implausible — scenario in which he warned that Covid-19 could potentially cause 1 million deaths in the United States alone .
Whether the U.S. health care system buckles @ @ @ @ @ @ @ on how vigorously and promptly we do social distancing , ” said Frieden , who was also a former commissioner of the New York City Health Department .
“ The models suggest that you have about a week from where there is unlinked community transmission to have everyone hunker down and stay home , stop working , [ and ] stop interacting socially.
” Many Americans have ignored these proscriptions , packing bars in Nashville and beaches in Miami .
Others , like President Donald Trump , have likened Covid-19 to seasonal influenza @ @ @ @ @ @ @ to Frieden .
“ This is an unprecedented pandemic .
Just to give you a sense of how unusual it is , it is the first time a new [ respiratory ] pathogen has been tracked to emerge , infect people in the lungs , and spread all around the world , ” he explained .
“ It is also the most societally disruptive infectious disease event in more than 100 years , since the great influenza pandemic of 1918 to 1919.
” In Italy , shops are shuttered , streets are deserted @ @ @ @ @ @ @ what amounts to house arrest .
An emergency law enacted last week banned civil and religious ceremonies , including funerals , to prevent the spread of Covid-19 .
But in some places — like the Sicilian town of Porto Empedocle — locals have attempted to defy the order , which carries a penalty of three months in jail .
The coronavirus spreads person to person , but much is still unknown about how infectious it is .
“ We ’ ve seen examples of about a 10 to 15 percent … household attack @ @ @ @ @ @ @ in the same household as one patient who has the disease gets it , ” Frieden explained .
He noted , however , that anecdotal evidence from cruise ships indicates that most crew members who shared rooms with someone with Covid-19 became infected themselves .
If Americans fail at social distancing , Frieden emphasized , the results could be disastrous and lead to what he calls “ an explosive transmission phase.
” This could be set off by “ super-spreading events , ” where a contaminated elevator button or doorknob leads to a @ @ @ @ @ @ @ earlier stages of the outbreak , that kind of transmission occurred , for example , when a person infected abroad returned home and transmitted the virus to their spouse or someone else in close contact .
Such a spike could overwhelm the capacity of America ’ s health care quickly .
But even if the United States avoids catastrophe in the near term , “ the risk would go on for months , ” said Frieden , “ until we have a better sense of how to control this , and a better @ @ @ @ @ @ @ arise , shut down clusters before they become outbreaks , and tamp down outbreaks before they become epidemics .
”

Italy’s reported coronavirus death toll grew to more than 4,000 on Friday, outpacing China, a country with more than 20 times its population. The Italian health care system is now buckling under the weight of the pandemic. Health care professionals are working day and night to keep critically ill Covid-19 patients alive, while wartime triage conditions have left doctors to decide who lives and who dies. The crematorium in the hard-hit city of Bergamo is so overwhelmed that the army was brought in to deal with the corpses.
It could be a matter of weeks — or even days — before something similar happens here, Dr. Tom Frieden, the former director of the Centers for Disease Control and Prevention, told The Intercept.
“Right now, the major concern that I have, and that other public health experts have, is the risk of outstripping health care capacity,” said Frieden, who is currently a senior fellow for global health at the Council on Foreign Relations. “This would be catastrophic. It’s what we’re seeing in Italy now, and it’s what we could see in communities around the U.S. soon.”
Frieden stressed the importance for healthy individuals of regular hand-washing and called for the medically vulnerable to self-isolate and stay 6 feet away from almost everyone. “We’ve seen terrible examples from Italy and Wuhan [in China] of thousands of health care workers getting infected, and we know that in the U.S. now, many health care workers have become infected.”
New modeling and estimates point to a nightmare scenario in which there could be a tenfold greater need in the United States for intensive-care beds and ventilators than are available, Frieden said. “What we’re hoping is that kind of peak that outstrips the health care system [as in Italy] does not come here,” he told The Intercept. “If it did, it could come in a matter of days to weeks.”
Last week, Frieden published a worst-case — but not implausible — scenario in which he warned that Covid-19 could potentially cause 1 million deaths in the United States alone.
Whether the U.S. health care system buckles like Italy’s “really depends on how vigorously and promptly we do social distancing,” said Frieden, who was also a former commissioner of the New York City Health Department. “The models suggest that you have about a week from where there is unlinked community transmission to have everyone hunker down and stay home, stop working, [and] stop interacting socially.”
Read Our Complete Coverage The Coronavirus Crisis
Many Americans have ignored these proscriptions, packing bars in Nashville and beaches in Miami. Others, like President Donald Trump, have likened Covid-19 to seasonal influenza. That comparison is flawed, according to Frieden. “This is an unprecedented pandemic. Just to give you a sense of how unusual it is, it is the first time a new [respiratory] pathogen has been tracked to emerge, infect people in the lungs, and spread all around the world,” he explained. “It is also the most societally disruptive infectious disease event in more than 100 years, since the great influenza pandemic of 1918 to 1919.”
In Italy, shops are shuttered, streets are deserted, and 60 million Italians are under what amounts to house arrest. An emergency law enacted last week banned civil and religious ceremonies, including funerals, to prevent the spread of Covid-19. But in some places — like the Sicilian town of Porto Empedocle — locals have attempted to defy the order, which carries a penalty of three months in jail.
The coronavirus spreads person to person, but much is still unknown about how infectious it is. “We’ve seen examples of about a 10 to 15 percent … household attack rate, which means that not everyone in the same household as one patient who has the disease gets it,” Frieden explained. He noted, however, that anecdotal evidence from cruise ships indicates that most crew members who shared rooms with someone with Covid-19 became infected themselves.
If Americans fail at social distancing, Frieden emphasized, the results could be disastrous and lead to what he calls “an explosive transmission phase.” This could be set off by “super-spreading events,” where a contaminated elevator button or doorknob leads to a large number of secondary transmissions. In earlier stages of the outbreak, that kind of transmission occurred, for example, when a person infected abroad returned home and transmitted the virus to their spouse or someone else in close contact.
Such a spike could overwhelm the capacity of America’s health care quickly. But even if the United States avoids catastrophe in the near term, “the risk would go on for months,” said Frieden, “until we have a better sense of how to control this, and a better capacity to rapidly identify cases as they arise, shut down clusters before they become outbreaks, and tamp down outbreaks before they become epidemics.”


theintercept--2020-03-21--Oakland Hospital Took in Coronavirus Cruise Patients. Now, Low on Supplies, Nurses Asked to Reuse Di

Oakland Hospital Took in Coronavirus Cruise Patients. Now, Low on Supplies, Nurses Asked to Reuse Disposable Masks.

Oakland , California hospital caring for patients being tested for Covid-19 received instructions this week to reuse disposable medical equipment , including masks and eye protection .
The hospital , Kaiser Permanente Oakland Medical Center , issued guidelines to nurses explaining how to clean single-use supplies to serve multiple patients during one shift .
Staff at the center have been caring for a number of people who were aboard the Grand Princess cruise ship , which docked in the city on March 9 after being stranded offshore for several days with 3,531 people on board .
At least 21 passengers @ @ @ @ @ @ @ privacy protections prohibit health care providers from disclosing how many patients aboard the ship are now receiving treatment at the facility .
Two nurses at the hospital spoke with The Intercept about working conditions amid the outbreak , describing hastily changing directives and frustration among nurses who feel they are being asked to endanger themselves and other patients .
Staff only started to receive training on how to care for Covid-19 patients after the first cases had already arrived at the hospital , one nurse said , asking for anonymity to avoid retaliation @ @ @ @ @ @ @ ve been blindsided the whole time , ” they said .
“ And we knew the boat was there , so I don ’ t understand why.
” Before the ship disembarked , Vice President Mike Pence , who is running the nation ’ s Coronavirus Task Force , said people would be quarantined as necessary , and every person on board would be tested .
Passengers were later informed there weren ’ t enough tests to do that .
Last week , they were told it was up to them whether or @ @ @ @ @ @ @ York Times reported .
More than ten days after the ship docked , many passengers are still quarantined at various military bases .
California Democratic Gov .
Gavin Newsom declared a state of emergency earlier this month after the first Californian died from the virus .
The man had been on the same ship for a previous cruise in February .
“ Without widespread testing , there ’ s no telling how many of us are going to silently pass Covid around , ” the nurse told The Intercept .
“ I don @ @ @ @ @ @ @ being in the front line of this , that ’ s fine .
But being grossly unprotected is not acceptable , and shouldn ’ t be acceptable.
” begins to grapple with how underprepared the medical system currently is to handle the rapid spread of Covid-19 in the United States , hospital and medical facilities are being forced to choose between risking the safety of patients and staff , or running out of critical medical supplies .
Nurses at the Oakland facility were told that new guidelines distributed to staff this week would @ @ @ @ @ @ @ and that they were crucial to keep the system from collapsing .
“ If we do not adopt these measures now , COVID-19 will pose a critical risk to the capability and sustainability of an already strained workforce and healthcare system , ” a document obtained by The Intercept reads .
The hospital had previously been following protocols aimed at protecting medical staff from airborne contamination .
The new guidelines follow those set out by the Centers for Disease Control and Prevention , which earlier this month downgraded to protocols for contamination via @ @ @ @ @ @ @ shortage of N95 masks .
That change prompted protests from other nurses ’ groups .
The CDC noted that those changes were based on supply , not science .
Hospitals in other states have adopted the droplet protocols as well .
Other countries are using stricter precautions , and the World Health Organization is reportedly considering enforcing airborne precautions .
Nurses at the Oakland facility are pushing back , saying the new guidelines do indeed increase risk .
The California Nurses Association , a union representing a number of nurses at the Oakland @ @ @ @ @ @ @ on Thursday noting concerns with the new guidelines and encouraging members to raise them with hospital executive staff , Oakland Chief Nursing Executive Darina Kavanagh and East Bay Area Vice President Ed Chan .
The union provided a pre-drafted email with the subject line : “ We Deserve a Safe Workplace.
” One of the nurses who spoke with The Intercept said that a patient of theirs had been tested for Covid-19 .
The nurse said they ’ ve been making calls to ask people for medical supplies .
“ I ’ m @ @ @ @ @ @ @ s what I ’ m doing with my time , ” they said .
“ I ’ ve been asking friends , I ’ ve been asking anyone I know that works in any business that I think uses protective equipment .
Because at this point N-95 [ masks ] would be great , but just anything would be helpful .
Gowns , anything.
” They also made a call to Newsom , the governor .
“ In other countries , they ’ re wearing full protective garb , head to toe , @ @ @ @ @ @ @ said .
“ And here , we were never wearing that .
But we need something.
” When staff first started caring for patients impacted by the pandemic , they used far more extensive protection , the nurse said : “ We were wearing full N-95 masks , face shields , head covers , thick gowns.
” Nurses were only caring for patients one-to-one , so as not to risk exposing healthy patients to others they were caring for who might be positive or in the process of getting tested .
Now , @ @ @ @ @ @ @ “ one surgical mask and a paper bag , and she has to use it for three rooms .
Two of those patients are being tested for Covid and one is not.
” “ We ’ re mixing patients , ” they said , taking a deep breath .
“ All really wild and unsafe things that we don ’ t usually do.
” The new guidelines inform nurses that N-95 protective shields and CAPRs/PAPRs , shields that enclose the entire head , are not required .
“ Regular masks are appropriate , @ @ @ @ @ @ @ reuse of PPE ” — Personal Protective Equipment — “ is expected throughout the shift , as long as they are not soiled or damaged ; reuse will require safe handling and proper storage .
When caring for cohorted patients who have the same conditions … healthcare workers can continuously wear [ PPE ] without doffing and redonning between patient contacts , as long as they are not soiled , contaminated or damaged , ” the guidelines read .
“ It is critically important that we move to these revised PPE guidelines to @ @ @ @ @ @ @ , PAPRs and CAPRs remain available so that we can safely care for our patients as cases of this virus increase.
” There ’ s no guidance on how to determine whether disposable supplies have become soiled , which is particularly tricky because potentially infectious droplets from a patient ’ s cough are invisible , the same nurse said .
At least one new study indicates that the virus can survive in aerosols and on various surfaces longer than originally thought .
The same people are caring for patients being tested for the @ @ @ @ @ @ @ , said the nurse , and exposing them to one another in the process .
At first , nurses were told they shouldn ’ t be caring for anyone except for Covid-19 patients to avoid spreading the virus .
“ But now they ’ ve kind of disregarded that .
So a lot of nurses are rejecting that .
You know , we ’ re doing our best to prevent that , ” the nurse said .
Lab staff are no longer going into rooms , the nurse said , and the hospital @ @ @ @ @ @ @ cleaning rooms or emptying biohazard bins anymore .
One of their nursing colleagues was asked to mop a room .
On Thursday , the account for Kaiser Permanente ’ s Northern California Branch , which includes the Oakland facility , tweeted that current protocols for Covid-19 patient care would ensure staff were protected .
Marc Brown , a spokesperson for the hospital , wrote in an email to The Intercept that for procedures that would generate airborne particles , staff are still using airborne protections .
“ We would not be using droplet @ @ @ @ @ @ @ put our care teams at greater risk , ” he wrote , adding that the guidelines were in line with recommendations from the World Health Organization and the CDC .
“ Experts and public health officials all over the world now have confirmed that the coronavirus is spread through respiratory droplets produced when an infected person coughs or sneezes.
” Brown said the facility understood staff concerns , and would continue to communicate with them as the situation evolved .
“ We engage with our labor leaders every week to keep them informed @ @ @ @ @ @ @ , ” Brown said .
“ It is important that all health care systems protect staff and patients based upon the science and evidence available.
” One of the nurses who spoke with The Intercept underlined that what could happen if experienced frontline nurses are directed to risk their own health .
“ The people that are working right now are the most skilled to make the decisions for critical care patients , which is what we ’ re gon na face in the hospitals , ” the nurse said .
“ And @ @ @ @ @ @ @ they ’ re not going to be able to work .
”

Nurses at an Oakland, California, hospital caring for patients being tested for Covid-19 received instructions this week to reuse disposable medical equipment, including masks and eye protection. The hospital, Kaiser Permanente Oakland Medical Center, issued guidelines to nurses explaining how to clean single-use supplies to serve multiple patients during one shift.
Staff at the center have been caring for a number of people who were aboard the Grand Princess cruise ship, which docked in the city on March 9 after being stranded offshore for several days with 3,531 people on board. At least 21 passengers tested positive for the coronavirus. Patient privacy protections prohibit health care providers from disclosing how many patients aboard the ship are now receiving treatment at the facility.
Two nurses at the hospital spoke with The Intercept about working conditions amid the outbreak, describing hastily changing directives and frustration among nurses who feel they are being asked to endanger themselves and other patients. Staff only started to receive training on how to care for Covid-19 patients after the first cases had already arrived at the hospital, one nurse said, asking for anonymity to avoid retaliation from their employer. “We’ve been blindsided the whole time,” they said. “And we knew the boat was there, so I don’t understand why.”
“Being grossly unprotected is not acceptable and shouldn’t be acceptable.”
Before the ship disembarked, Vice President Mike Pence, who is running the nation’s Coronavirus Task Force, said people would be quarantined as necessary, and every person on board would be tested. Passengers were later informed that there weren’t enough tests to do that. Last week, they were told that it was up to them whether to be tested, the New York Times reported. More than 10 days after the ship docked, many passengers are still quarantined at various military bases.
California Democratic Gov. Gavin Newsom declared a state of emergency earlier this month after the first Californian died from the virus. The man had been on the same ship for a previous cruise in February.
“Without widespread testing, there’s no telling how many of us are going to silently pass Covid around,” the nurse told The Intercept. “I don’t mind caring for people and being in the front line of this, that’s fine. But being grossly unprotected is not acceptable and shouldn’t be acceptable.”
As the nation begins to grapple with how underprepared the medical system currently is to handle the rapid spread of Covid-19 in the United States, hospital and medical facilities are being forced to choose between risking the safety of patients and staff, or running out of critical medical supplies.
Nurses at the Oakland facility were told that new guidelines distributed to staff this week would not put them at higher risk, and that they were crucial to keep the system from collapsing. “If we do not adopt these measures now, COVID-19 will pose a critical risk to the capability and sustainability of an already strained workforce and healthcare system,” a document obtained by The Intercept reads.
The hospital had previously been following protocols aimed at protecting medical staff from airborne contamination. The new guidelines follow those set out by the Centers for Disease Control and Prevention, which earlier this month downgraded to protocols for contamination via droplets and contact in response to a shortage of N95 masks. That change prompted protests from other nurses’ groups. The CDC noted that those changes were based on supply, not science.
Hospitals in other states have adopted the droplet protocols as well. Other countries are using stricter precautions, and the World Health Organization is reportedly considering enforcing airborne precautions.
Nurses at the Oakland facility are pushing back, saying that the new guidelines do indeed increase risk. The California Nurses Association, a union representing a number of nurses at the Oakland hospital, sent an email to members on Thursday noting concerns with the new guidelines and encouraging members to raise them with hospital executive staff, Oakland Chief Nursing Executive Darina Kavanagh and East Bay Area Vice President Ed Chan. The union provided a predrafted email with the subject line: “We Deserve a Safe Workplace.”
One of the nurses who spoke with The Intercept said that a patient of theirs had been tested for Covid-19. The nurse said they’ve been making calls to ask people for medical supplies.
“I’m trying to get supplies, that’s what I’m doing with my time,” they said. “I’ve been asking friends, I’ve been asking anyone I know that works in any business that I think uses protective equipment. Because at this point, N-95 [masks] would be great, but just anything would be helpful. Gowns, anything.” They also made a call to Newsom, the governor.
“In other countries, they’re wearing full protective garb, head to toe, no skin exposed,” the nurse said. “And here, we were never wearing that. But we need something.”
“ We’re mixing patients. All really wild and unsafe things that we don’t usually do.”
When staff first started caring for patients impacted by the pandemic, they used far more extensive protection, the nurse said: “We were wearing full N-95 masks, face shields, head covers, thick gowns.” Nurses were only caring for patients one to one, so as not to risk exposing healthy patients to others they were caring for who might be positive or in the process of getting tested. Now, the nurse said, a co-worker had “one surgical mask and a paper bag, and she has to use it for three rooms. Two of those patients are being tested for Covid and one is not.”
“We’re mixing patients,” they said, taking a deep breath. “All really wild and unsafe things that we don’t usually do.”
The new guidelines inform nurses that N-95 protective shields and CAPRs/PAPRs, shields that enclose the entire head, are not required. “Regular masks are appropriate,” the document says.
“The reuse of PPE” — Personal Protective Equipment — “is expected throughout the shift, as long as they are not soiled or damaged; reuse will require safe handling and proper storage. When caring for cohorted patients who have the same conditions … healthcare workers can continuously wear [PPE] without doffing and redonning between patient contacts, as long as they are not soiled, contaminated or damaged,” the guidelines read. “It is critically important that we move to these revised PPE guidelines to ensure critical supplies such as N-95 masks, PAPRs and CAPRs remain available so that we can safely care for our patients as cases of this virus increase.”
There’s no guidance on how to determine whether disposable supplies have become soiled, which is particularly tricky because potentially infectious droplets from a patient’s cough are invisible, the same nurse said. At least one new study indicates that the virus can survive in aerosols and on various surfaces longer than originally thought.
The same people are caring for patients being tested for the virus and those who aren’t, said the nurse, and exposing them to one another in the process. At first, nurses were told that they shouldn’t be caring for anyone except for Covid-19 patients to avoid spreading the virus. “But now they’ve kind of disregarded that. So a lot of nurses are rejecting that. You know, we’re doing our best to prevent that,” the nurse said.
Lab staff are no longer going into rooms, the nurse said, and the hospital’s environmental workers aren’t cleaning rooms or emptying biohazard bins anymore. One of their nursing colleagues was asked to mop a room.
On Thursday, the account for Kaiser Permanente’s Northern California Branch, which includes the Oakland facility, tweeted that current protocols for Covid-19 patient care would ensure staff were protected. Marc Brown, a spokesperson for the hospital, wrote in an email to The Intercept that for procedures that would generate airborne particles, staff are still using airborne protections. “We would not be using droplet protection protocols if it were unsafe or put our care teams at greater risk,” he wrote, adding that the guidelines were in line with recommendations from WHO and the CDC. “Experts and public health officials all over the world now have confirmed that the coronavirus is spread through respiratory droplets produced when an infected person coughs or sneezes.”
Brown said the facility understood staff concerns and would continue to communicate with them as the situation evolved. “We engage with our labor leaders every week to keep them informed and make sure there is two-way dialogue,” Brown said. “It is important that all health care systems protect staff and patients based upon the science and evidence available.”
One of the nurses who spoke with The Intercept underlined that what could happen if experienced front-line nurses are directed to risk their own health. “The people that are working right now are the most skilled to make the decisions for critical care patients, which is what we’re gonna face in the hospitals,” the nurse said. “And once those skilled workers contract Covid, they’re not going to be able to work.”