This is what happens when you hire an inexperienced child to cover up historic corruption and ineptitude.
Reuters photographer Jonathan Ernst on Thursday captured a closeup of White House press secretary Kayleigh McEnany’s briefing binder, showing the labeled topical tabs through which she frequently flips to find canned answers and other propaganda.
… reuters photographer jonathan ernst got this shot today of press secy. kayleigh mcenany's briefing materials which include topic headings for:
Mediaite reports: During her tenure, McEnany has developed a reputation for flipping open her briefing book after a particularly confrontational question and reading verbatim from pre-written responses, which often included canned attacks on the press or praise from allies. … McEnany’s tabs include a number evergreen topics, but several recent ones as well. “Covid” and “Test” as well as “PPE,” “Masks,” “CDC,” and “Cases” suggest a healthy amount of prepared remarks on the raging pandemic. But also included in the binder were more ephemeral topics, like “Goya” about the controversy over the Trump-led counter-backlash to a liberal boycott of the food company, “Mary” which, presumably, refers to the president’s niece and her damning tell-all book, and “Hogan,” which likely alluded to Maryland Gov. Larry Hogan’s scathing Washington Post essay condemning Trump’s pandemic response.
The other day, McEnany appeared to read from the “LGBT” section when she responded to a question about Trump’s ban on transgender troops by saying, “I haven’t talked to him about that specific policy, but this president is proud that in 2019 we launched a global initiative to end the criminalization of homosexuality throughout the world. He has a great record when it comes to the LGBT community. The Trump administration eased a ban on blood donations from gay and bisexual men and he launched a plan to end the AIDS epidemic by 2030, so we’re very proud of our achievements.”
This book might explain the vacant dingbat look we get just before she answers with a lie. She has to find the pre- written blurb to make sure she gets the lie correct. It’s all just a spectacle to keep us distracted from the corruption.
If Iran were doing this to another country, it'd be called terrorism and result in crippling boycotts.
First responders gather at the scene of an explosion at the Sina At’har health center in the north of Iran’s capital Tehran on June 30, 2020. | Amir Kholousi/ISNA/AFP via Getty Images
Experts say the suspected sabotage is part of Israel’s long-term efforts to delay any and all of Iran’s nuclear development.
For weeks, Iran has faced a deadly wave of explosions and fires at sensitive military and civilian sites, including one incident that caused immense damage to an important nuclear facility. No one officially knows why it’s happening or who is responsible — but many believe Israel, with the Trump administration’s tacit or even direct support, is behind it all.
On June 26, a massive explosion rocked the Khojir missile-production complex, a location considered vital to Iran’s missile capabilities. Four days later, another blast — this time at a medical clinic north of the capital, Tehran — killed 19 people.
On July 2, an explosion and fire occurred at the underground Natanz nuclear facility, a key component to the country’s uranium-enrichment efforts. What actually transpired is unclear, but a Middle Eastern official — believed to be the head of Israeli intelligence, Yossi Cohen — told the New York Times last week that Israel had detonated a bomb. Analysts differ on the extent of the damage, but assessments say centrifuge production may have been delayed a few months or even a few years as a result of the explosion and fire.
New images show the scale of the destruction from the explosion at Iran's Natanz nuclear facility on July 2. There may be further damage to the facility's underground elements, which aren't visible from above.
It’s possible all of this is a coincidence. With a reeling economy and a devastating coronavirus outbreak, perhaps the Islamic Republic has merely struggled to maintain sensitive facilities that require constant upkeep. Accidents do happen.
But current and former US and Israeli officials as well as experts I spoke to are pretty certain Israel is responsible for the incidents at the military and nuclear sites (but not the clinic or the port or plant), with or without Washington’s explicit approval.
“There is a pattern of escalation and a context that would suggest a motive on the Israeli side to target the Iranians,” said Dalia Dassa Kaye, the director of the Center for Middle East Public Policy at the RAND Corporation.
Such a move would send an unmistakable signal to Tehran. “The message is: ‘You can’t control your country. We can hit you whenever we want, wherever we want,’” said Eric Brewer, who worked on Iran issues as a member of Trump’s National Security Council.
The direct consequences of that signal, though, are unclear. Some suspect Tehran may activate its proxies in Iraq to attack Americans or launch a cyberattack against Israel. It’s also possible Iran will look the other way, as the lack of a known attacker both leaves the regime devoid of a clear target and provides it the political space not to retaliate.
But no one believes these moves will actually convince Iran to back down and suspend all nuclear activity. If anything, the country might start sprinting toward the bomb.
“Covert operations will only undermine long-term nonproliferation efforts,” Mahsa Rouhi, an expert on Iran’s nuclear program at the International Institute for Strategic Studies, wrote Wednesday in the Bulletin of the Atomic Scientists. “Hardline voices in Tehran will become more motivated to rapidly advance Iran’s nuclear program.”
Which means if Israel (maybe with the US) truly is behind these events in Iran, it’s taking quite the gamble.
Why it’s possible Israel was behind several of the recent explosions in Iran
Israel has long targeted nuclear programs in the Middle East in secret, open, and openly secret ways.
In the early 2000s, Israeli spy chiefs hatched a plan to assassinate Iranian nuclear scientists, a campaign Jerusalem has never formally acknowledged. In 2012, a top official at Natanz — Mostafa Ahmadi Roshan — was killed in a mysterious explosion. His death followed two other suspected killings over the previous two years.
But that wasn’t all: In 2009, Israel joined the US in using a cyber weapon, known as Stuxnet, to destroy about 1,000 of Iran’s 6,000 centrifuges.
Why would Israel resort to such bold methods? Simply put, officials in Jerusalem worry Iran could more credibly threaten Israel’s existence if it had a nuclear weapon. There’s real justification for that concern: Just last year, for example, a top Iranian general told local reporters, “Our strategy is to erase Israel from the global political map.”
When it became clear two of the recent explosions in Iran happened at a missile site (Khojir) and a key uranium enrichment facility (Natanz), all eyes turned to Israel as the likely culprit.
“Israel as well as the US have a clear interest in stopping, or at least disrupting, Iran’s weapons production capability, and in particular nuclear weapons and ballistic missiles,” retired Israel Defense Forces Lt. Col. Raphael Ofek, who served in Israeli military intelligence and in the prime minister’s office, told me.
.@Maxar company releases tonight new image of the area that was his by an explosion near #Tehran this weekend: the explosion at Khojir missile base completely destroyed on builsing and a large burn area
Nuclear experts at the Institute for Science and International Security on July 8 assessed that the facility had sustained “significant, extensive, and likely irreparable, damage to its main assembly hall section” which “was critical to the mass production of advanced centrifuges.” (Research and development of those centrifuges was permitted under the terms of the Iran nuclear deal, experts told me.)
“The building’s replacement would be expected to take at least a year, if not longer,” the nuclear analysts concluded.
And per Ofek, the explosion “won’t dramatically disrupt Iran’s advanced centrifuges program,” but “it may delay the deployment of the latest models of these machines for a year or two.”
Such assessments are important, former US Ambassador to Israel Daniel Shapiro told me. Israeli officials believe that if those advanced centrifuges were ever installed and operated at full capacity, it “might allow Iran to break out not with just one bomb, but with an arsenal” of nuclear weapons, he said. Delaying that possibility, then, is certainly a clear and vital Israeli goal.
It’s therefore plausible that Israel was involved in the explosions at the missile and nuclear facilities — though there is no official confirmation that’s the case — and that the US may have given some kind of thumbs-up to such efforts. Tehran, importantly, surely suspects Jerusalem.
“Regardless of whether these are part of a Western sabotage effort ... Iran is going to believe that they are,” Brewer, who now works on nuclear issues at the Center for Strategic and International Studies, told me. “Given that these are hitting all across Iran at military and civilian locations, that is going to cause Iran’s threat perceptions to spike.”
But those perceptions depend greatly on the kind of campaign Iran thinks Israel might be waging.
“War between the wars”
It’s worth keeping in mind that Israel and Iran have been engaged in a shadow war for decades, yet no major fight has erupted in years.
In 2006, Israel and Iran’s proxy in Lebanon, Hezbollah, battled in a month-long war during which the militant group fired more than 4,000 rockets into Israel and Israeli forces fired around 7,000 bombs and missiles into Lebanon.
About 160 Israeli troops and civilians died, according to the Israel Ministry of Foreign Affairs, and about 1,100 Lebanese — most of them civilians — perished, per Human Rights Watch, a US-headquartered advocacy organization. HRW also reports about 4,400 Lebanese were injured, and around 1 million people were displaced.
Mahmoud Zayyat/AFP via Getty Images
Supporters of the Lebanese Shiite movement Hezbollah watch a video screening of a speech by the group’s head, Hassan Nasrallah, to mark the 11th anniversary of the end of the 2006 war with Israel, in the village of Khiam in southern Lebanon on August 13, 2017.
After that battle, Israel became more wary of Iran placing weaponry near its territory. It’s why Israeli warplanes have consistently bombed locations in Syria in recent years, for example, both to destroy weapons shipments and deter further movement of Iranian proxies and officials there.
Israeli officials see the persistent thwarting of Iranian intentions, especially after the 2006 conflict, as the “war between the wars.”
As Shapiro, the former American ambassador to Israel, explained it to me, the concept “reflects the Israeli philosophical approach to buy time and maybe indefinitely push off future wars — and if they occur, to make them as short as possible.” Following this strategy allows Israel to increase its own capabilities, gather intelligence, and gain a greater military advantage against Iran over time.
Degrading Iran’s nuclear and missile program via covert means fits within this framework. Jerusalem is able to keep Tehran from gaining power at minimal expense and without much public fuss, thereby lowering Iran’s confidence it could defeat Israel in a war, should one break out.
That plan seems to be working for the moment. “At end of the war in 2006, if you had told most Israeli officials that there wouldn’t be another war on that border [with Lebanon] after 14 years, they wouldn’t have believed you,” Shapiro said.
The question now is if Iran views the possible Israeli actions through that lens, or as something more sinister.
Iran likely won’t respond forcefully — for now
Since Trump withdrew from the Iran nuclear deal two years ago, the US and Iran have been engaged in tit-for-tat escalations.
They’re based on a fundamental disagreement: Washington and Jerusalem want Tehran to give up its nuclear program entirely, as well as to curb its other activities such as missile development and support for violent groups in the region; Iran sees those activities as critical to its survival and as an important pillar of its power and reach, however, and wants sanctions lifted without having to give up those activities.
The US responded by killing Maj. Gen. Qassem Soleimani, the head of Iran’s paramilitary forces, in January. Undeterred, Iran continued its offensive actions, using a cyberweapon to attack Israel’s water supply in May, a strike that potentially could have sickened hundreds of people.
Officials in Iran might therefore see the Khojir and Natanz explosions as part of that fight, thereby compelling them to respond in a bigger way in the tit-for-tat. However, most experts believe Iran will see the incidents in the context of its long-running nuclear feud with Israel.
If that’s the case, it would be good news. What Israel may have done “is a slight escalation, but it’s not really that surprising and not really uncharacteristic of what you’ve seen in the recent history,” Ilan Goldenberg, the Defense Department’s Iran team chief from 2009 to 2012, told me. “All these activities are being done in a way that makes it hard for Iran to retaliate, and gives them space to not retaliate.”
Indeed, the Iranian regime is faltering under sustained economic pressure from the United States, one of the world’s worst coronavirus outbreaks, and political protests. It may not have the time or desire to engage in a massive fight with Israel right now.
Between the deniability of Israel and America’s involvement, and the fact that the possible attacks fit into a longstanding pattern, Tehran may not feel compelled to respond immediately and in a dramatically forceful way.
That’s not to say Iran will stand by idly forever. Iranian Foreign Ministry spokesperson Abbas Mousavi vowed this week that “if a regime or a government is involved in the Natanz incident, Iran will react decisively.”
And if Israel and the US continue to hit Iran while it’s down, it may have no choice but to get back up, including potentially launching more cyberattacks or even pushing to develop a nuclear weapon before Israel can do anything about it. Any of those moves would be very provocative — and perhaps make an already dangerous situation much worse.
“The Iranians don’t want this to spiral,” the RAND Corporation’s Kaye told me, “but the longer this persists, the harder it will be for Iran to pretend this isn’t happening.”
“It’s a humiliation at a certain point,” she said.
Support Vox’s explanatory journalism
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Enlarge / An Ars-branded Yubikey. (credit: Steven Klein)
Almost three years ago, Google introduced its Advanced Protection Program (APP), a security plan for high-risk users that requires hardware keys for account access and is arguably the industry's most effective way to stop account takeovers in their tracks. But until now there was a major flaw that held APP back: its iPhone and iPad offerings were prohibitively limited for most users. Now that this has changed—more on the change in a bit—I feel comfortable recommending APP much more widely.
Those attacks presented targets with convincing emails purportedly from Google. They warned, falsely, that the target's account password had been obtained by an outsider and should immediately be changed. When Hillary Clinton's presidential campaign chairman John Podesta and other Democrats complied, they effectively surrendered their passwords to hackers. Although hackers have many ways to compromise accounts, phishing remains one of the most popular, both because it's easy and because the success rate is so high.
Yep. The entire project proves that Trump is the rule, not the exception.
President-elect Trump and Melania arrive to attend an inauguration concert at the Lincoln Memorial on January 19, 2017. | Mandel Ngan/AFP via Getty Images
The Lincoln Project’s goal is to get Trump out of office. But some argue its members helped him get in.
One tweet describes President Trump’s campaign as a “criminal enterprise.” An ad — with the hashtag #TrumpIsNotWell — shows the president struggling to walk down a ramp, and another mocks the size of the crowd at Trump’s rally in Tulsa, saying, “You’ve probably heard this before, but it was smaller than we expected.”
They’re all from a political action group called the Lincoln Project, and according to co-founder Reed Galen, they’re meant for one specific audience: Trump himself.
“We have what we call ‘an audience of one’ strategy, which is clearly aimed at the president,” Galen told me.
The Lincoln Projectis made up of former Republicans who are avowed “NeverTrump” conservatives. The group brought in $16.8 million between April and June of this year, much of which came from small donors giving $200 or less. But most of the ads are digital, never reaching television screens.
And a lot of that money has been spent on ads like this one, posted to Twitter following the president’s decision to commute the sentence of former campaign associate Roger Stone.
Trump’s campaign manager is a felon. His deputy campaign manager is a felon. His national security advisor is a felon. His foreign policy advisor is a felon. His personal lawyer is a felon. His long time advisor is a felon.
— The Lincoln Project (@ProjectLincoln) July 12, 2020
The “#TrumpIsNotWell” ad appears to have so incensed the president that he spent several minutes of his June 20 rally speech in Tulsa, Oklahoma, discussing his ability to drink water and walk down a ramp.
The Lincoln Project’s primary purpose is, as the founders wrote in a December 2019 New York Times op-ed announcing the project, “defeating President Trump and Trumpism at the ballot box and to elect those patriots who will hold the line.” As former Republicans, the members of the Lincoln Project believe their ads can destabilize the president and appeal to Trump-skeptical conservatives, giving them room to vote against Trump and for Joe Biden.
In a text, Lincoln Project communications director Keith Edwards told me that the project had no plans beyond defeating Trump. “We are focused [on] making sure Trump is a one-term president and ensuring Biden takes the oath of office in January. We’re not thinking of anything beyond that.”
But some observers have argued that the campaign operatives responsible for the Lincoln Project are, through their deep ties to the pre-Trump GOP, indirectly responsible for his rise. Lincoln Project board members helped George H.W. Bush win office in 1988 and George W. Bush win reelection in 2004, as well as down-ballot races where their ads often featured the same kind of fear-mongering they now appear to abhor.
In short, many of those behind the project worked on Republican presidential campaigns and, before Trump, often sounded very much like Trump.
So do the operators who helped create the current iteration of the Republican Party hold the keys to stopping it?
Defeating Trump, Republican-style
The Lincoln Project was founded by eight former Republican operatives, most prominent among them George Conway (married to White House counselor Kellyanne Conway), former Republican political strategist Rick Wilson, former New Hampshire GOP chairperson Jennifer Horn, and Steve Schmidt, best known for his work on the late Sen. John McCain’s 2008 presidential campaign (where he helped select Sarah Palin as McCain’s vice president).
As former Republican political strategists, the backers of the Lincoln Project believe they have a unique understanding of how Trump, and ideally Republicans more broadly, think. Their television ad buys have largely been centered on Massachusetts, New Jersey, and Washington, DC, making it clear that their goal is to get many of their ads before Trump himself.
Galen told me that if they were Democrats, their ads might be more easily dismissed by Trump and the GOP more broadly. “I think it’s the idea that the apostates are taking on the head of the GOP church [that] is the unique thing that [Trump] probably can’t understand and certainly his people don’t know how to react to.”
The ads themselves are often dark and strident, in some ways mirroring Republican attack ads the strategists behind the Lincoln Project may have once used against Democrats. In Galen’s terms, the ads “[speak] to Republican voters with Republican language and Republican iconography.”
For example, in 2002, Lincoln Project founder Rick Wilson worked on the Senate campaign for Republican Rep. Saxby Chambliss and helped produce an ad against then-Sen. Max Cleland that implied Cleland opposed the creation of the Department of Homeland Security and thus was leaving America vulnerable to terror.
In a 2015 interview with the HuffPost, Wilson said of the ad, “[It] was built ugly. The ad was built to look like it was primitive and quick and knocked off instantaneously. It is an ugly ad. ... We knew back then that saying the words ‘against the president’s vital homeland security efforts’ [would work]” against Cleland.
In Politico, Joanna Weiss argued in favor of the Lincoln Project’s ethos:
The secret of fearmongering is a willingness to go there, and that’s where the Republicans of the Lincoln Project might have an advantage over Trump’s left-leaning opponents. The group’s founders aren’t calibrating their ads around a Democratic base that mistrusts the military, delves into nuance or shies away from causing offense. That leaves ample room for dog-whistle symbols that range from clichés to horror-movie tropes: One ad accuses Trump of being played by China and ends with the image of the White House, the entire screen tinted red.
And at least one ad appears to have resulted in a major shake-up at the Trump campaign. According to the Wall Street Journal, campaign manager Brad Parscale was replaced in part because of this ad, which implied Parscale was using Trump to get rich.
The Lincoln Project’s purpose: Irritate Trump?
The criticisms of the Lincoln Project are numerous. Some have pointed to the group’s finances, noting that while the group has raised millions of dollars (particularly after Trump attacked the Lincoln Project on Twitter), much of that money has gone to what seem like extremely high ad production costs and to firms run by members of the Lincoln Project’s board. As detailed by Open Secrets:
The Lincoln Project reported spending nearly $1.4 million through March. Almost all of that money went to the group’s board members and firms run by them. The super PAC spent nearly $1 million with Summit Strategic Communications, a firm run by Lincoln Project treasurer Reed Galen. Another $215,000 went to Tusk Digital, a company run by Lincoln Project adviser Ron Steslow. Both companies received little business from other federal committees since Trump’s inauguration.
That seven-figure spending, noted earlier by campaign finance expert Rob Pyers on Twitter, comes as the group spends relatively little on direct political activity. The super PAC shelled out $364,000 to Galen and Steslow’s companies to run independent expenditures opposing Trump and his Republican allies in Congress. But just 52 percent of that money went to buying and placing ads, with the rest spent on producing the ads themselves.
The notion that the Lincoln Project is a scam PAC created purely to enrich its board found credence with Trump allies, including Republican National Committee chair Ronna McDaniel, who described the group as such in a scathing Daily Caller op-ed in April.
As the Daily Beast’s Lachlan Markay detailed, that isn’t exactly true. Instead, the Lincoln Project uses a complex subcontractor arrangement to move money to external companies hired to work on ads, since political groups don’t have to disclose their subcontractors. It’s a strategy also used by the Trump campaign, and it means that the financial dealings alone aren’t enough to show that the group isn’t actually doing something.
If the point of the Lincoln Project is in part to draw the ire of the president and his allies, then their mission has been well accomplished. Attacks on the Lincoln Project (and on NeverTrump Republicans more broadly) have mounted from a host of right-leaning outlets, many of which deem them “insignificant” while devoting significant space to denouncing their efforts.
The right-leaning group Club for Growth even made an attack ad aimed at the Lincoln Project, calling it “bad for America”:
Then there’s the president himself, who tweeted a denunciation of their efforts in early May (which, of course, only drew more attention to them).
A group of RINO Republicans who failed badly 12 years ago, then again 8 years ago, and then got BADLY beaten by me, a political first timer, 4 years ago, have copied (no imagination) the concept of an ad from Ronald Reagan, “Morning in America”, doing everything possible to....
But irritating the president, a notoriously thin-skinned person, isn’t much of an accomplishment. And as the HuffPost’s Kevin Robillard argued, making ads that get a lot of attention on Twitter might be a good way of making an audience already predisposed to dislike Trump share them, but it’s less likely to get the attention of voters, the vast majority of whom are not on Twitter.
“Good political ad makers & managers are operatives who put aside what personally appeals to them or the Twitterverse & go with the message that moves voters,” Anne Caprara, a Democratic operative who now serves as the chief of staff to Illinois Gov. J.B. Pritzker, wrote on Twitter on Thursday night. “But while YOU may think that fancy new anti-Trump ad is so hard hitting & cathartic (‘OMG THIS AD!’) - the voter you need to persuade might find it offensive or off putting or just dumb.”
(Robillard also noted that the group had spent just $2.4 million on television advertising as of early July, much of that spending coming on ads broadcast on Fox News in Washington, DC, aimed at the network’s most famous viewer: Donald Trump.)
Galen and others supportive of the Lincoln Project have argued that it is giving Republicans, as one Democratic strategist told Robillard, “a safe space for Republicans to express their concerns about the president.”
However, the Lincoln Project has recently sworn to go after not just Trump but Republican members of Congress who are supportive of the president, including Sens. Ted Cruz and Mitch McConnell. In an ad posted online last week, it argues that viewers can “never, ever” trust those members again.
In doing so, the Lincoln Project may gain support from Democrats but lose credence with anti-Trump conservatives who have not disavowed the partyor its policy priorities writ large, conservative writer Henry Olsen argued in the Washington Post (in a piece titled “Never Trumpers are Democrats in Republican clothing”):
The year’s Senate races offer a fresh indication of their real motives. The project’s newest television ad names 15 Republican senators whom voters should oppose, including 13 up for reelection. Their sin? Backing Trump on matters such as impeachment. The fact that nearly all Republican voters both approve of Trump’s job performance and opposed impeachment doesn’t seem to matter to those who claim to represent true Republican values.
“Frankly, all they do is make me angry”
Liberals who oppose the Lincoln Project object to its core conceit: Trump, and Trumpism, are a cancer on the Republican Party, and by removing him and his ideas, things can perhaps go back to normal. In the conservative group’s mindset, Republican presidential candidates like John McCain and presidents like George W. Bush exemplified the best of American conservatism, while Trump is an aberration: a former reality show host with divorces, affairs, and affronts to “traditional morality” aplenty.
But as historian Eric Foner argued in 2016, Trump can be seen as “the logical conclusion of a lot of things the Republican Party has been doing” for decades, with predecessors like Richard Nixon’s “law and order” presidential campaign, rife with racist implications, and populist appeal as a businessman railing against Washington corruption. To many liberals, Trump isn’t an aberration; he’s the culmination of a decades-long political project.
The Lincoln Project and its GOP exiles, writer Eoin Higgins argued on July 12 in the newsletter Welcome to Hell World, are an example of a “memory hole” in action: Everything that happened before Trump (like the Iraq War or the existence of the Bush administration or the murder of Trayvon Martin) has been forgotten by liberals allying with the group and sharing their ads in service of getting Trump out of office.
The fact is that the coalition is made up of people who until very recently were happily ensconced in the GOP—meaning that it’s not the policies pursued and beliefs espoused by Trump that are the issue. It’s just his delivery. This is not an abstract issue. The president is part and parcel of the entire Republican project and its logical conclusion after five decades of cultivating an increasingly enraged white base filled with economic and cultural grievances for which the GOP has blamed on the uneven but inexorable march to greater equality in American society.
Higgins also detailed examples of Lincoln Project members using offensive and bigoted language on Twitter — for example, founder Rick Wilson repeatedly calling people “retards,” attacking Muslims, and mocking news coverage of Trayvon Martin’s killing in 2012.
This week, Ben Howe, a video editor who worked with the Lincoln Project, was pushed out after the news outlet the 19th emailed the Lincoln Project evidence of tweets in which Howe had called people “vaginas” and “twats.” He also had defended in graphic language the 2014 police shooting of unarmed teenager Michael Brown, saying he would have shot Brown as well. Alex Griswold, a writer at the Washington Free Beacon, argued that Howe had used no less incendiary language on Twitter than Wilson had.
There is no way that taken as a whole, Ben Howe's Twitter history is more offensive or vitriolic than Rick Wilson's. https://t.co/8dEygL01pp
Higgins told me that the Lincoln Project’s ads were an appeal to liberals who believe that conservatives are their ideological opponents but not their enemies. “The commercials are part of a general effort by LP to present Trump as an aberration, a mistake, something out of the right-wing mainstream,” he said, “rather than the logical endpoint of the GOP and the direct ideological heir of the movement that began in earnest with Ronald Reagan.”
When I asked him about the ads themselves, he said, “Frankly all they do is make me angry by pretending there’s any major difference between Reagan [or] George W. Bush and Trump other than style.” He added, “I’m clearly not the target audience.”
He compared efforts to create alliances between liberals and the Lincoln Project to those who suggest alliances between the left and alt-right figures. “I find it unacceptable for mainstream liberals to ally with this group of bigots. Doing so is dangerous as it both drives the Democratic Party even further to the right and mainstreams the abhorrent views of the group’s leaders to an audience of presumably more left-leaning folks.”
The Lincoln Project did not respond to a request for comment on members’ past offensive remarks, as of this writing.
The Lincoln Project has a distinct focus: Beat Trump. As Galen told me, “You can’t beat the guy with high-mindedness. You can’t beat the guy with platitudes. You can’t beat the guy with calling him names.” He added later during our conversation, “it is our job to prosecute the case against Donald Trump. We will do things that will, in our mind, boost Joe Biden’s prospects and image with ... Republican and independent voters.”
But the Lincoln Project appears to hope defeating Trump and securing the White House for Joe Biden would restore some semblance of order. Trump is the problem, not the Republican Party, not movement conservatism, not the conservative organizations and super PACs to which many of those who stand behind the Lincoln Project once belonged.
Galen told me that, over the next few weeks, the Lincoln Project will be rolling out ads aimed at “soft Republicans who maybe were never comfortable with Trump but weren’t going to vote for Hillary Clinton, and conservative-leaning independents, who, again, maybe never really liked the guy.” To get an idea of how these ads might prove effective with those audiences, I spoke to Jonathan Haidt, a social psychologist and professor of ethical leadership at New York University’s Stern School of Business, and Christopher Federico, a researcher on political psychology.
After viewing some of the Lincoln Project’s ads, Haidt said they were powerful because they focus on moral characteristics that tend to be held by conservatives, like group loyalty, respect for authority and tradition, and a sense of sanctity or purity. He told me that the ads make the “intuitively compelling conservative case” that “Trump has violated conservative morality, over and over again.”
He added, “The fact that the message comes from people who identify as Republicans is extremely important, it makes the message much more sincere. It is conservatives expressing conservative values, rather than liberals in some ad agency trying to simply push conservative buttons.”
Federico agreed, telling me, “A major factor in partisan politics is what we call ‘partisan motivated reasoning’ — a tendency to interpret the world, new information, and persuasive messages in ways that support one’s prior identity. If it is clear to a person that a message is coming from the out-party (i.e., to a Republican that a persuasive message is coming from Democrats or liberals), a ‘perceptual screen’ will go up and the information or message will be disregarded or heavily counter-argued.”
In his view, the backers of the Lincoln Project being former Republicans helped to turn off the “perceptual screen”: “In other words, it sends a signal from folks with ties to the Republican or conservative in-group that it does not make you a bad Republican or a bad conservative to oppose Trump.”
But I wondered if the perception of these ads by some observers — praiseworthy and effective efforts to take down a bad president — was also a product of a certain psychology. As the Atlantic’s Andrew Ferguson put it, “like a Trump rally, the ads work exclusively on the predispositions of the faithful.” In other words, are people who oppose Trump praising these ads as uniquely effective or, in Weiss’s words, as proof that “Republicans are better at this than Democrats,” an example of motivated reasoning on behalf of people who, again, hate Trump?
Haidt told me, “In general, people say they like mavericks — people who show independence and think for themselves — but mostly or only when the maverick comes from the other side. We’re not so fond of people on our own side who depart from the team’s position.”
But by going after conservative members of Congress, the Lincoln Project may lose Trump-skeptical Republicans. By its very nature, the group has already lost the support of Trump’s most vociferous critics on the left; it appeals most to moderates who hate Trump and are active on Twitter. In some ways, the Lincoln Project is aimed at itself.
Support Vox’s explanatory journalism
Every day at Vox, we aim to answer your most important questions and provide you, and our audience around the world, with information that has the power to save lives. Our mission has never been more vital than it is in this moment: to empower you through understanding. Vox’s work is reaching more people than ever, but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn. Your financial contribution will not constitute a donation, but it will enable our staff to continue to offer free articles, videos, and podcasts at the quality and volume that this moment requires. Please consider making a contribution to Vox today.
Since the beginning of July, Covid-19 cases in the state have gone up nearly 60 percent, with hospitalizations and deaths rapidly rising as well. Florida now has 20 percent more daily new Covid-19 cases than Arizona, 70 percent more than Texas, and more than double California. Florida drew headlines on Sunday for surpassing the record for the highest number of new cases reported in one day, previously held by New York (though that was driven largely by Florida having much more testing than New York did at the peak of its outbreak).
The percentage of positive tests is now nearly 19 percent, which is almost four times the recommended maximum of 5 percent. The high rate — an indicator of how widespread infection is, as well as whether an area is conducting enough testing — suggests Florida still doesn’t have enough testing to match its Covid-19 outbreak. As bad as things are in Florida, the state is likely undercounting the number of cases.
It wasn’t always going this way. Just weeks ago, Gov. Ron DeSantis made media rounds boasting about Florida’s response to the coronavirus pandemic, rebuking those who had criticized the state’s actions, and bragging that his state had managed to keep Covid-19 cases low despite a slower, less-aggressive lockdown and a quicker reopening than other places.
In a May article from the conservative National Review — titled “Where Does Ron DeSantis Go to Get His Apology?” — DeSantis said he “was doing a good job,” spending much of the article arguing that his critics were wrong and that he’d been purportedly driven by the data and science in his response.
DeSantis bragged about how quickly the state was able to reopen due to his great response to the pandemic, saying that “what we did in March and April is the equivalent of what New York will be or California, when they go to phase three” — in reference to California’s slower-moving phased plan for reopening.
Now, though, experts say it’s that rapid reopening — mixed with public complacency that the virus had been defeated and lackluster action in the previous months — that led Florida to its current crisis.
Florida “defiantly reopened in the name of rejuvenating their economy relatively early,” C. Brandon Ogbunu, a computational biologist at Yale, told me. “The prediction was quite clear that they would have a bad wave at some point.”
Florida was relatively late in closing down statewide, but it was also among the first to reopen. The state also reopened very quickly — letting restaurants, bars, and other businesses reopen, sometimes at high or full capacity, within weeks of ending its lockdown. That fast pace of reopening not only made it easier for people to infect each other with the coronavirus, but also made it much harder to evaluate, due to lags in coronavirus case reporting, if each phase of reopening was leading to uncontrollable growth in infections.
At the same time, the public didn’t follow precautions. Fueled by politics and complacency, Floridians are, anecdotally, very inconsistent in physical distancing and wearing masks, experts said. Data also suggests that people in the state were much quicker to go out, once the lockdown ended, than most other states.
“I feel like we came out of the stay-at-home [order] and just thought, ‘Oh, it’s not a big deal anymore,’” Cindy Prins, an epidemiologist at the University of Florida, told me. People “went back to what they were doing before — those activities they were doing before — without modifying this time.”
Recognizing the surge in cases, the state suspended alcohol consumption at bars on June 26. But the state has resisted further action, with DeSantis declaring the state is “not going back” on reopening and moving ahead with reopening schools.
Even if Florida’s government and residents were to act now, though, the effects of the state’s quick reopening will likely linger for weeks as Covid-19 takes time to show symptoms and spread to others. That’s why, experts say, Florida should take more action sooner rather than later — as it’s now stuck with rising cases, hospitalizations, and deaths in the days or weeks to come. More targeted measures now, the thinking goes, could help the state avoid the worst and, potentially, another full stay-at-home order.
DeSantis’s office didn’t return requests for comment.
Like the surge in Arizona and California, Florida’s rising Covid-19 outbreak demonstrates the need for constant vigilance in the fight against the coronavirus. It’s now clear that as the governor and public grew complacent in their efforts, the virus slowly spread across the population. We’re now seeing the consequences — and the important lesson behind them.
“Don’t get comfortable,” Prins said. “Don’t think that just because you controlled it you can continue to control it.”
Florida reopened too quickly
DeSantis initially saw it as a bragging point, but Florida’s quick reopening is one of the big reasons, experts said, that the state is now experiencing a huge outbreak.
Florida was slow to close in the beginning of the pandemic. While California, for example, closed on March 19 and New York on March 22, Florida took until April to issue a stay-at-home order. Those few weeks can really matter with Covid-19: When the number of cases can double within just 24 to 72 hours, days and weeks matter.
But at least in Florida, cases did stay relatively low through March and April — with the caveat that low testing capacity back then meant many cases were very likely missed.
Then, Florida was one of the first states to reopen. Its stay-at-home order expired on May 4, a little more than a month after it went into effect.
Unlike other states that have seen a surge in cases, like Arizona, Florida actually did see its reported Covid-19 cases drop during its full lockdown before it moved to reopen. That put it in line with what experts and the White House recommended: a two-week decline in cases before reopening. The drop happened as Florida’s Covid-19 testing numbers increased and the positive rate fell, indicating the decline in cases was genuine.
But after the state reopened, cases began to surge in June.
German Lopez/Vox
Where Florida went wrong, experts say, is it let its guard down. The state reopened very quickly. Between early May and early June, the state went from a full lockdown to letting gyms, salons, bars, and indoor dining at restaurants to reopen. This made it difficult to track the full effects of each phase of reopening — a process experts say requires weeks or even more than a month to fully gauge.
“When you have a low level of cases in a state, and you have a virus that takes two weeks to replicate, and people are going to transmit to each other, you have to give it time to see the number of cases come up to know that maybe we have an issue,” Prins said, arguing that six weeks are necessary to see the full effects of each phase of reopening.
But many Floridians seemed to embrace the state’s reopening. Based on restaurant data from OpenTable, Florida was among a handful of states — most of which are now experiencing major outbreaks — to see people start trickling back out to restaurants in the first full week of May. By June, dine-in was down around 60 to 70 percent compared to the same period last year in Florida; in comparison, it was down by more than 80 percent in California and 90 percent to 100 percent in New York and New Jersey.
The result: Floridians were increasingly out and about, interacting and infecting each other with the coronavirus. Friends and families began gathering again, especially as they celebrated Memorial Day and the summer kicked off. As they came together — in poorly ventilated homes, restaurants, and bars, in close proximity to people they don’t live with, often for hours at a time — people spread the virus more frequently.
The research backs this up. One study in Health Affairs concluded:
Adoption of government-imposed social distancing measures reduced the daily growth rate by 5.4 percentage points after 1–5 days, 6.8 after 6–10 days, 8.2 after 11–15 days, and 9.1 after 16–20 days. Holding the amount of voluntary social distancing constant, these results imply 10 times greater spread by April 27 without SIPOs (10 million cases) and more than 35 times greater spread without any of the four measures (35 million).
The flipside, then, is likely true: Easing lockdowns likely led to more virus transmission.
This is also what researchers saw in previous disease outbreaks.
Several studies of the 1918 flu pandemic found that quicker and more aggressive steps to enforce social distancing saved lives in those areas. But this research also shows the consequences of pulling back restrictions too early: A 2007 study in JAMA found that when St. Louis, Missouri — widely praised for its response to the 1918 pandemic — eased its school closures, bans on public gatherings, and other restrictions, it saw a rise in deaths.
Here’s how that looks in chart form, with the dotted line representing excess flu deaths and the black and gray bars showing when social distancing measures were in place. The peak came after those measures were lifted, and the death rate fell only after they were reinstated.
This did not happen only in St. Louis. Analyzing data from 43 cities, the JAMA study found this pattern repeatedly across the country. Howard Markel, a co-author of the study and the director of the University of Michigan’s Center for the History of Medicine, described the results as a bunch of “double-humped epi curves” — officials instituted social distancing measures, saw flu cases fall, then pulled back the measures and saw flu cases rise again.
Florida is now seeing that in real time: Social distancing worked at first. But as the state relaxed social distancing, it quickly saw cases rise.
“We know what has worked,” Ogbunu said. “It’s very, very clear now that states that were defiant with regard to their social distancing policies are suffering the consequences for it.”
Floridians didn’t always follow public health advice
On top of the policy response, experts worry that Floridians never really got the message that precautions against Covid-19 would be needed for months and possibly years to come (until a vaccine or effective treatment is available). In some ways, it seems the public came under the impression that drastic action was only needed during the one-month lockdown — hence the rush back to restaurants, bars, and other indoor venues when Florida reopened, with at best spotty adherence to physical distancing and wearing a mask.
Studies suggest that, for the general public, physical distancing and masking really do work. A review of the research published in The Lancet found that “evidence shows that physical distancing of more than 1 m is highly effective and that face masks are associated with protection, even in non-health-care settings.”
But, experts said, it’s on them and public officials to get the word out about what the public needs to do. To this end, Florida hasn’t done a good job — especially to the extent DeSantis and local, state, and federal officials played into the politicization of such measures.
“We didn’t have a population that knew and believed that this virus is dangerous,” Aileen Maria Marty, an infectious diseases specialist at the University of Miami, told me. “They took the virus for granted.”
One factor is the recommended precautions, including physical distancing but especially masks, became politicized. President Donald Trump has by and large refused to wear a mask in public, even saying that people wear masks to spite him and suggesting, contrary to the evidence, that masks do more harm than good. DeSantis, a Trump ally, joined the president in the Oval Office in April to boast about Florida’s response to Covid-19, claim that the state’s light touch was correct, and that, relative to other states, “Florida’s done better.”
This kind of politicization created pockets of resistance, particularly among conservatives who see social distancing, masks, and other steps as an overreaction to Covid-19 and the policies requiring such measures as government overreach. Most recently, this was seen in an anti-mask “freedom rally” in a Florida restaurant, which organizers advertised as a “mask free zone.” One organizer compared the enforcement of state restrictions on restaurants to “tyranny,” the “Gestapo,” and “Nazi Germany.”
Beyond politicization, there has been complacency and fatigue toward stricter Covid-19 measures. Surveys from Gallup found that just 39 percent of people were “always” social distancing in late June, compared with 65 percent in early April; the number of people who “sometimes,” “rarely,” or “never” practice social distancing increased from 7 to 27 percent in the same time frame.
This may be particularly true for younger people, many of whom perhaps feel that they’re less vulnerable to Covid-19 than older populations. It’s no coincidence, then, that coronavirus cases in Florida disproportionately rose at first among younger people. But the problem is that young people can still get sick, suffer long-term complications, and die from Covid-19. They can also spread the virus to older populations that are more vulnerable — which in Florida increasingly seems to be happening.
When recommendations were followed, experts worried that the measures were sometimes carried out incorrectly. Anecdotally, it’s common for people to wear masks inappropriately — to the point they’re not covering their nose or even mouth. That, experts argued, comes down to an education problem.
Other factors, beyond policy and the public response to Covid-19, likely played a role as well in the rise in cases. While summer in other parts of the country lets people go outside more often — where the coronavirus is less likely to spread — triple-digit temperatures in Florida can actually push people inside, where poor ventilation and close contact is more likely to lead to transmission.
Some officials in Florida have argued that Black Lives Matter protests played a role in the new outbreak. But the research and data so far suggest the demonstrations didn’t lead to a significant increase in Covid-19 cases, thanks to protests mostly taking place outside and participants embracing steps, such as wearing masks, that mitigate the risk of transmission.
Florida now has to deal with the consequences
In response to the surge in cases, DeSantis on June 26 effectively closed bars across the state.
He argued the move was needed due to people disobeying social distancing guidance, forcing further action. “People weren’t following it,” he claimed. “There was widespread noncompliance, and that led to issues. If folks just follow the guidelines, we’re going to be in good shape. When you depart from that, then it becomes problematic.”
DeSantis, however, has so far resisted going further. He hasn’t moved to close down the state more widely, as California’s governor did, and instead pushed forward with schools reopening as soon as possible. And he’s rejected a statewide mask mandate — which could reduce transmission, based on studies of states and of Germany.
Anything Florida does at this point isn’t too little, but it is likely too late
“We need to immediately have a civil order about wearing masks in the same way we have civil penalties for running a stop sign,” Marty said. “It is a reasonable request that we do to protect ourselves and others.”
It’s probably too late to completely reverse the outbreak. Because people can spread the virus without showing symptoms, can take up to weeks to show symptoms or get seriously ill, and there’s a delay in when new cases and deaths are reported, Florida is bound to see days or weeks of new infections and deaths even if DeSantis suddenly closes the state back down.
That gets to a point that experts often make about disease outbreaks: It’s important to act before it’s obviously a problem.
“One of the things I’ve learned in any outbreak is that if it seems you overreacted, you’ve done a good job,” Krutika Kuppalli, an infectious disease specialist and a fellow in the Emerging Leaders in Biosecurity Initiative at the Johns Hopkins Center for Health Security, told me. What looks like overreaction, she added, means that “we prevented things from becoming a catastrophe. We don’t want to wait until things are a catastrophe and then react, because that’s too late.”
In that sense, any action Florida takes would help, but those results could take weeks to really reverse trends. So anything Florida does at this point isn’t too little, but it is likely too late.
But to make sure things don’t get much worse, experts have called for more aggressive steps. Some have asked for more targeted restrictions, particularly on indoor venues. They support statewide mask mandates. They want more aggressive education, along with more testing, tracing, and isolation of the sick, all of which is currently held back by big delays in testing results.
If the state government doesn’t act, experts said local officials could — and some cities and counties are already imposing stricter standards, including mask mandates.
Short of government action, experts urged the public to take precautions against Covid-19 more seriously. People should wear masks, prioritize outdoor venues over indoor spaces, keep 6 feet from each other, avoid touching their faces, and wash their hands. How well a community as a whole does all of that could dictate how bad things get — and could help make up, at least partially, for government inaction.
The goal now is to avoid things getting so out of control that another stay-at-home order is necessary. Everyone wants to avoid this, but the reality is that it may be the only way to stop an outbreak if it gets too bad — which is damaging not just for public health but for other parts of American life, too.
“Dead people don’t shop. They don’t spend money. They don’t invest in things,” Jade Pagkas-Bather, an infectious diseases expert and doctor at the University of Chicago, told me. “When you fail to invest in the health of your population, then there are longitudinal downstream effects.”
But as Florida gets worse by the day, it gets closer to requiring drastic measures to reclaim control of the pandemic. If Florida’s leaders had acted sooner or more cautiously, maybe much of this could have been prevented. Instead, they bragged about how great the state was doing, and now Floridians are suffering a predictable, preventable crisis.
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Very nice. 2FA really should be required on everything, and enough with the text message bullshit.
Enlarge / The flag of the Islamic Republic of Iran.
Iranian state hackers got caught with their pants down recently when researchers uncovered more than 40GB of data, including training videos showing how operatives hack adversaries’ online accounts and then cover their tracks.
The operatives belonged to ITG18, a hacking group that overlaps with another outfit alternatively known as Charming Kitten and Phosphorous, which researchers believe also works on behalf of the Iranian government. The affiliation has long targeted US presidential campaigns and US government officials. In recent weeks, ITG18 has also targeted pharmaceutical companies. Researchers generally consider it a determined and persistent group that invests heavily in new tools and infrastructure.
In May, IBM’s X-Force IRIS security team obtained the 40GB cache of data as it was being uploaded to a server that hosted multiple domains known to be used earlier this year by ITG18. The most telling contents were training videos that captured the group’s tactics, techniques, and procedures as group members performed real hacks on email and social media accounts belonging to adversaries.
So stop using Twitter to fucking conduct foreign policy.
Wednesday’s Twitter hack has exposed a gaping weakness for the U.S. and its most powerful leaders — their reliance on a private company to secure their communications with the public.
The attack showed that Twitter couldn’t even protect former President Barack Obama’s account from spreading a Bitcoin scam, while the company’s efforts to plug the breach silenced President Donald Trump’s tweets, stifled National Weather Service tornado alerts and left some lawmakers still locked out as of Thursday afternoon.
And it prompted lawmakers to raise an uncomfortable question: What’s to stop a more insidious group of hackers from using leaders’ trusted Twitter accounts to spread lies about national emergencies, wars or the November election?
“Let’s imagine that at 4 p.m. on Election Day, Barack Obama’s Twitter account sends revised polling locations to 20,000 Black voters in Florida,” senior House Intelligence Committee member Jim Himes (D-Conn.) said Thursday during a Third Way webinar on election interference.
Such an incident would prompt “litigation that would make Bush v. Gore … look like a walk in the park,” Himes said. “The degree of uncertainty is horrifying.”
The GOP-led Senate Intelligence Committee and other congressional panels asked Twitter on Thursday for briefings on the cyberattack. The FBI announced that it had opened a probe into the breach, whose perpetrators may have made off with as much as $118,000 from victims who sent Bitcoin to the hacked Twitter accounts.
Beyond the immediate search for the perpetrators, the episode highlighted the risks of outsourcing key government functions to social media platforms — a concern that Twitter inadvertently amplified when it froze verified accounts as part of its response Wednesday night. Senate Intelligence Vice Chairman Mark Warner (D-Va.) and Ohio Rep. Jim Jordan, the top Republican on the House Judiciary Committee, were among the lawmakers who said they were still unable to get back into their accounts Thursday.
The scope of the attack, and Twitter’s initial comments, suggested that the intruders had obtained the passwords of some of Twitter’s most trusted employees — enabling the kind of disinformation operation that has inspired years of anxious theorizing among security professionals. The breach also underscored that Twitter’s process of “verifying” accounts belonging to prominent people doesn’t come with any special protections — although Trump’s account reportedly has its own security measures.
Lawmakers taking stock of all those troubling facts warned about the havoc that a future Twitter hack could wreak.
Himes said he worried far more about an “irreversible, quick” attack, such as a burst of fake tweets on Election Day, than about the more widely discussed risk of hackers breaching a voter registration database and tampering with records.
Other lawmakers imagined equally grim scenarios. “Imagine a civil defense chief’s twitter account being hacked, or a Commanding General,” tweeted Sen. Brian Schatz (D-Hawaii).
Government agencies have their own sordid history of breaches, including the White House, the State Department and the federal personnel office that houses employees’ security clearance files, but lawmakers’ concerns about Twitter reflect a different trend: In recent years, governments have outsourced key tasks, from communications to data storage, to tech companies beyond their direct control.
The latest bipartisan uproar comes as intelligence officials warn that foreign government hackers and trolls are using social networks to stir up controversy and spread disinformation ahead of November’s elections. This misuse of Facebook, Twitter and other large platforms, which reached a zenith during the 2016 presidential campaign, has led to extensive congressional oversight. Wednesday’s mass hack seems likely to produce more scrutiny.
“The ability of bad actors to take over prominent accounts, even fleetingly, signals a worrisome vulnerability in this media environment — exploitable not just for scams, but for more impactful efforts to cause confusion, havoc, and political mischief,” said Warner, the top Democrat on the Senate Intelligence Committee, which released a report last October on the Russian government’s 2016 disinformation operations.
So far, the 2020 election has not seen any public revelations of activity approaching the coordinated cyberattacks of 2016. But security experts warned that the latest evidence of weaknesses at Twitter would only compound the public’s fear and mistrust.
Lawmakers wasted no time requesting answers. Barely hours after hackers began seizing the accounts of prominent figures such as Obama, Bill Gates and rapper Kanye West to propagate a Bitcoin scam, Sen. Josh Hawley (R-Mo.) sent Twitter CEO Jack Dorsey a letter asking for details about the breach. On Thursday, Senate Commerce Chairman Roger Wicker (R-Miss.) and House Oversight Committee ranking member James Comer (R-Ky.) requested briefings from Twitter. So did Senate Intelligence, according to a person familiar with the matter who was not authorized to speak publicly.
“Millions of your users rely on your service not just to tweet publicly but also to communicate privately through your direct message service,” wrote Hawley, a top critic of social media giants. “A successful attack on your system’s servers represents a threat to all of your users’ privacy and data security.”
“[I]t cannot be overstated how troubling this incident is, both in its effects and in the apparent failure of Twitter’s internal controls to prevent it,” Wicker wrote to Dorsey.
So far, however, lawmakers have announced no new push for legislation to address incidents like the mass hacking, such as stringent cybersecurity requirements for social media employees.
The breach also raised the question of what else the hackers may have been able to do with the compromised accounts besides tweet from them. Sen. Ron Wyden (D-Ore.), an Intelligence Committee member and leading cybersecurity advocate, criticized Twitter for failing to encrypt users’ private direct messages despite a promise from Dorsey in September 2018.
“While it still isn't clear if the hackers behind yesterday's incident gained access to Twitter direct messages, this is a vulnerability that has lasted for far too long, and one that is not present in other, competing platforms,” Wyden said in a statement.
Twitter said late Wednesday that the hackers had mounted “a coordinated social engineering attack” against company employees with administrator privileges, suggesting that the hackers had tricked employees into handing over their passwords so they could manipulate accounts from the inside. As Twitter scrambled to contain the hack, it deleted tweets showing screenshots of the administrator tools that it later admitted were abused in the breach.
Twitter’s explanation placed the spotlight on so-called phishing attacks, which use misleading messages to co-opt well-meaning employees, but an anonymous person claiming to have participated in the hack told Vice that the attackers had instead bribed a Twitter employee.
Trusted employees abusing their powers represent the nightmare scenario for tech companies, even as phishing attacks — such as the malicious email that ensnared Hillary Clinton campaign chairman John Podesta in 2016 — have received more public attention. Internet services have a long history of insider abuse, including social networks MySpace, Snapchat and Facebook and the video game Roblox.
In the past, Twitter has faced problems with both insider threats and poor handling of its account management tools. In 2011, the company settled Federal Trade Commission allegations that it failed to protect its administrator systems. And in 2017, a disgruntled Twitter employee briefly disabled Trump’s account before leaving the company, an incident that spurred the creation of the special protections that the president’s account now enjoys.
Despite a steady drumbeat of digital attacks on prominent figures’ social media accounts, Twitter has declined to offer special security features for those users. Google, by contrast, created an Advanced Protection Program for journalists, politicians, human-rights activists and members of other frequently targeted groups.
At least one prominent Twitter user has no plans to abandon the platform, despite the security breach. White House press secretary Kayleigh McEnany told reporters Thursday that Trump “will remain on Twitter.”
Cristiano Lima, Martin Matishak and Andrew Desiderio contributed to this story.
Except conservatives aren't actually conservative. They're reactionary, and the sacred Pentagon is Exhibit 1.
In just the past few months, Congress has appropriated nearly $3 trillion dollars to fight the economic and public health impacts of the Covid-19 pandemic. This is on top of a terrible budget deal last year that blew through spending caps imposed by the 2011 Budget Control Act. With little end in sight to the pandemic and its associated recession, Congress is likely to spend even more in the months to come.
With resources more limited than ever, areas of the budget that were off-limits for years should now be more closely scrutinized. At the top of that list should be the single largest part of the federal discretionary budget, an entire category of spending that has long been off the table: the Pentagon.
For years, Congress overinvested in the Pentagon in an attempt to prevent potential attacks on our shores, while failing to prepare for other existential risks that would threaten our prosperity and way of life. Now, Congress appears ready to authorize three-quarters of a trillion dollars for defense spending alone in the upcoming fiscal year. Nearly one of every 10 of those dollars will go to an Overseas Contingency Operations account that lawmakers in both parties acknowledge is a slush fund. This is on top of a base budget that will almost certainly be higher than ever.
The organizations we represent care deeply about fiscal responsibility and limited government, but too often fiscal conservatives within Congress ignore the waste and unchecked growth of the Pentagon. The truth is that we are now in an unprecedented crisis, one that has resulted in huge outlays to combat a global pandemic and keep a faltering economy from collapse. At a time of enormous deficits and record debt, this can no longer be acceptable.
Republicans in Congress need to start tackling the Pentagon budget just as boldly as they do other areas of discretionary spending. Doing so would put our nation on a better fiscal path and create opportunities for unlikely political alliances. Conservative figures like Sen. Rand Paul (R-Ky.) and former Rep. Mick Mulvaney (R-S.C.) for years advocated restraint at the Pentagon; two of the most recent efforts to restrain the Pentagon’s budget in the coming year come from staunchly progressive members of Congress: Sen. Bernie Sanders (I-Vt.) and Rep. Barbara Lee (D-Calif.).
Sanders has introduced an amendment to cut the defense budget by 10 percent and to reinvest those funds “in cities and towns that we've neglected and abandoned for far too long.” Lee, for her part, introduced a resolution identifying nearly $350 billion in cuts for this fiscal year, and another amendment, co-sponsored by Rep. Mark Pocan (D-Wis.), would reduce the Pentagon budget by 14 percent.
Our organizations rarely agree with Sanders or Lee, and these particular legislative efforts fall short in a number of ways. For example, we would prefer that Sanders’ amendment invest the vast majority of his proposed cut into reducing the historic deficits projected for 2020 and 2021. Lee’s resolution points out some low-hanging fruit for lawmakers looking to trim the Pentagon budget, but goes too far for us by aiming to slash the Pentagon by almost half in just one year.
However, these proposals are not without merit, and there should be substantial room for compromise. Sanders and Lee are taking defense budget policy in the right direction, raising important questions and aiming for bold and significant changes at a time when doing so couldn’t be more critical.
There is no shortage of opportunities to reform and reduce the size of the Pentagon, the world’s largest bureaucracy, in a way that is in line with conservative principles and goals. The Guide for a Strong America is one resource for conservatives willing to take on the fight. Indeed, this process is exactly how we should be examining the hundreds of billions of dollars in nondefense discretionary spending, too—focusing on those items that are working and taking a scalpel to those that aren’t.
A robust debate is already happening on the right. In addition to our organizations, conservative groups including FreedomWorks, Concerned Veterans for America and Americans for Tax Reform have voiced support for putting Pentagon spending cuts on the table, while the Charles Koch Institute and Defense Priorities have made compelling cases for strategic restraint. There are some current Republican and bipartisan amendments that would advance the cause by boosting Defense Department audit efforts and reining in off-book accounts. And Sens. Chuck Grassley (R-Iowa), Mike Enzi (R-Wyo.), and Mike Braun (R-Ind.) have also taken some laudable steps to improve DoD’s inconsistent audit efforts.
Congress also needs another 10 years of discretionary budget caps, and even stronger enforcement to limit cheating on those caps (as happened in the past). Many Democrats will have to sacrifice unchecked growth in nondefense spending, and defense hawks in both parties will have to sacrifice unchecked growth for Pentagon priorities that aren’t making us any safer.
But in a post-coronavirus world, all expenditures can and must be on the table. Congress is already changing its old ways of doing business before our eyes, with things like virtual committee meetings and even remote voting. It’s long past time to reconsider old habits when it comes to one of our nation’s most bloated federal departments.
Republican Party fortunes have taken a decisive turn for the worse. Gallup released remarkable data Thursday showing a dramatic 13-point shift in party affiliation since the beginning of the year.
In January, the GOP had a two-point edge on Democrats in terms of voters who either identified as Republicans or leaned Republican—47%-45%. Now Democrats and Democratic leaners enjoy an 11-point edge, 50%-39%. Check out the graph below.
What's so stunning is that it's not just Trump shedding support, it's the entire Republican brand. Think about that. Heading into the GOP-led Senate's January impeachment trial, more Americans generally embraced Republicans than Democrats. But after Senate Republicans acquitted Trump in early February in their sham, no-witness trial, party support shifts in favor of Democrats.
By March, as the coronavirus starts grabbing more headlines, Democrats gain a two-point edge. Democrats then nudge up slightly in April.
But around May, Republicans really begin to tank. That plunge comes in the wake of news in late April that the coronavirus death toll surpassed the 58,220 Americans who died in the Vietnam War. In early May, it becomes clear that Trump and the White House have simply surrendered to the virus and pivoted toward reopening state economies without any national testing/tracing plan in place. At that point, Republicans at both the state and federal levels become willing accomplices in Trump's reckless scheme to reopen America before any of the proper tools are in place.
In addition, George Floyd's brutal death on May 25 at the hands of Minneapolis police officers sparks national outrage, and Trump starts implementing an authoritarian crackdown to combat nationwide protests, most of which are peaceful.
It's during that late May/June timeframe that GOP affiliation plummets five points in a month while Democratic affiliation rises three points. Just wow.
Party affiliation does fluctuate in the Gallup surveys dating back to 1991, but the outfit says "double-digit Democratic advantages have been relatively uncommon." Democrats held a 10-point advantage in January 2019 just after they routed Republicans in the 2018 midterms.
"Four months before Election Day, Democrats appear to be as strong politically now as they were in 2018 when they reclaimed the majority in the House of Representatives and gained seven governorships they previously did not hold," Gallup writes.
Congrats, Republicans. Couldn't be happening to a nicer crew of folks.
Enlarge / NEW YORK, NEW YORK - MAY 25: The Statue of Liberty is seen behind refrigeration trucks that function as temporary morgues at the South Brooklyn Marine Terminal during the coronavirus pandemic. (credit: Getty | Noam Galai)
Officials in Texas and Arizona have requested refrigerated trucks to hold the dead as hospitals and morgues become overwhelmed by victims of the raging COVID-19 pandemic.
“In the hospital, there are only so many places to put bodies,” Ken Davis, chief medical officer of Christus Santa Rosa Health System in the San Antonio area, said in a briefing this week. “We're out of space, and our funeral homes are out of space, and we need those beds. So, when someone dies, we need to quickly turn that bed over.
“It’s a hard thing to talk about,” Davis added. “People's loved ones are dying."
If you could take the two most defining catastrophes of Trump’s period in the White House—the one that brought him in the door, and the one that may help carry him out—and smash them together into one godawful Frankenstein of 2020 on a plate, what would that look like? Now you know. The U.K.’s National Cyber Security Centre has published a report showing that Russian hackers are attacking not just governments, not just social media, but companies and organizations directly involved in trying to develop a vaccine for COVID-19.
We already knew that Russia was trying to destroy American democracy. And recent months have made it clear that Russia was engaged in trying to murder Americans through a proxy war in which they offer bounties to terrorists. Now it seems that Russia is attempting to kill everyone—or to at least keep much of the world swimming in chaos, illness, and economic disaster—by directly interfering in the development of a vaccine. And it’s not just any group of Russian hackers. The U.K. report specifically mentions “Cozy Bear,” the same group that worked to put Donald Trump in the White House.
Cozy Bear, also called APT29, is a part of the Russian Intelligence Service with direct connection into the military. As the report points out, they’ve been Russia’s all-purpose, go-to bad actors when it comes to attacking governments, peeking into diplomatic secrets, messing with electrical grids, and basically stealing any intellectual property worth taking. When it comes to COVID-19, they’re not just hacking into those busy working on potential vaccines—the group has also infiltrated organizations involved in tracking the pandemic, and national and international efforts to formulate a response.
The full report (pdf) specifically mentions cyber attacks on vaccine research and development not just in the U.K., but also in Canada and the United States. To that end, Russia has deployed a number of techniques including the use of both spear phishing and custom malware to access local networks and databases. Once into a network, APT29 uses “anonymizing services” to maintain a persistent presence, and an open pipeline, without making themselves visible.
At present, it seems that the major purpose of the infiltration is to provide Russia with an inside track on both responses to dealing with the pandemic and progress on developing a vaccine—which is more than what’s available to American researchers. However, the persistent access means that the hackers might also interfere with everything from data collected by ongoing trials to internal orders for supplies. This access raises serious concerns over a capability that could be used to hinder development or plant false information.
Why would Russia want to do this? For the same reasons that they’ve been paying Taliban militia not just to shoot Americans, but to derail the process of negotiating a U.S. exit strategy from Afghanistan. Chaos and disruption in the West benefits Vladimir Putin. The destruction of U.S. wealth and weakening of the U.S. military benefit Putin. Keeping the U.S. and Europe entangled in a pandemic benefits Putin. Every Donald Trump misstep benefits Putin. With Trump making an unprecedented number of calls to Putin over the last three months, it should be expected that he’s been getting some “advice” on how to position U.S. troops to control U.S. cities—the perfect use for American forces as far as Putin is concerned.
Of course, prolonging the pandemic also threatens to kill tens of thousands of Russians, but what does Putin care about that? It’s not as if he’s been accurately reporting Russian deaths from COVID-19 so far. And Russian leaders have always been willing to sacrifice a few thousand, or million, of the masses to reach their goals.
Here’s how CBS News’ Mark Knoller described the props: “On South Lawn, WH seeks to make a political point by setting up a crane lifting the weights of regulation from the bed of a ‘red’ truck, while showing the burden of regulations weighing down a ‘blue’ truck.”
On South Lawn, WH seeks to make a political point by setting up a crane lifting the weights of regulation from the bed of a "red" truck, while showing the burden of regulations weighing down a "blue" truck. pic.twitter.com/OoWmRPnWum
usually used for welcoming foreign leaders on state visits and landing Marine One for presidential flights, the space is being used to by the Trump White House for a not at all subtle political stunt https://t.co/CxtOILqvV4
A more appropriate demonstration would be for no one knowing how to operate the crane, the weights being released prematurely rupturing the gas tanks as the flat bed trucks explode, and Trump officials standing on the side with no one doing anything.
On Thursday, the U.S. Supreme Court refused to overturn a ruling from the 11th Circuit Court of Appeals that had itself blocked a lower court ruling that had struck down the Florida GOP's modern-day poll tax, meaning that the voting restriction is guaranteed to remain in effect for the Aug. 18 primary and likely for November, too. The lower court had struck down this law as an unconstitutional poll tax, but the Republican majority 11th Circuit stayed that ruling while Republicans appeal, and the 11th Circuit won't hear the appeal on the merits until the same day as the Aug. 18 primary.
Before voters passed the 2018 initiative, Florida disenfranchised one in 10 adults, the highest proportion of any state, including one in five Black adults—five times the rate of white adults in Florida. This racial discrimination was no accident, either, since Florida’s lifetime voting ban was a product of the Jim Crow era.
However, because Republicans dominate the federal judiciary and Trump has flipped the 11th Circuit from a majority of Democratic appointees to a majority of Republican ones, and the Supreme Court’s Republican majority has ruled against voting rights in every single case this year. Republican judges now appear highly likely to ensure that this law remains in effect for November even if they ultimately side with the plaintiffs on the merits, an outcome that itself is still very much in doubt given Chief Justice John Roberts’ career-long crusade against voting rights.
Consequently, the poll tax will prevent thousands of Florida citizens from exercising their rights this year despite the Constitution's 24th Amendment banning the disenfranchising of voters "by reason of failure to pay any poll tax or other tax." This ruling reinforces the urgency of Democrats winning the presidency and Senate in November so that they may begin reshaping the federal judiciary to ensure it upholds the right to vote.
Ahead of this holiday season's new Xbox Series X console launch, Microsoft has confirmed a surprising change on the production side: the discontinuation of two existing Xbox One console versions.
Following a report from The Verge, Xbox representatives confirmed directly to Ars Technica that the company will no longer produce either 2017's Xbox One X or 2019's Xbox S All-Digital Edition. The company described this discontinuation as "the natural step of stopping production" due to "ramp[ing] into the future with Xbox Series X," only to then confirm that an older version of the console, 2016's Xbox One S, will still be produced worldwide.
"Gamers can check with their local retailers for more details on Xbox One hardware availability," an Xbox rep said to Ars Technica. So if you're interested in the Xbox One X, now might be the time to snap one up.
The nonpartisan Government Accountability Office (GAO) says in a new report that Customs and Border Protection (CBP) failed to provide consistent medical care to detained people at its facilities after a number of children horrifically died under the agency’s watch in beginning in late 2018. This was despite being given over $110 million in emergency funding by Congress.
Mirroring past reporting, the GAO also confirmed that border officials made a deliberate, inhumane decision to ignore a Centers for Disease Control and Prevention recommendation to give detained people flu vaccinations following the flu death of one of those children. “CBP decided not to implement a recommendation from CDC to offer influenza vaccines to individuals in custody but did not document how it arrived at this decision,” the report said.
The GAO found that while Congress gave CBP emergency funding “to enhance medical care and services for individuals in its custody” after Jakelin Ameí Rosmery Caal Maquin and Felipe Gómez Alonzo became the first children to die while in federal immigration custody in a decade in late 2018, investigators said the agency failed to consistently follow its own medical directives, leaving nearly 150 children to fall through the cracks during a one-week period alone.
“Our review of Border Patrol records from a one-week period in February 2020 found that 143 of 373 apprehended children under age 18 who were processed at Border Patrol stations without contracted medical providers did not receive a health interview or medical assessment referral at those stations,” the report said. “This included 116 children under age 13, and 27 children ages 13 through 17.”
Jakelin was seven when she died under border officials’ watch in December 2018. Felipe was eight when he died later that same month.
“CBP did not document how it weighed costs and benefits in deciding not to offer the influenza vaccine,” the GAO said, writing that CBP documents stated “that vaccinating apprehended individuals would pose operational, medical, legal, and logistical challenges.” About that: physicians with a humanitarian medical group basically begged Trump administration officials to let them give detained kids and adults flu shots for free, but were blocked.
CBP did, however, promote a vaccine program for its own workers. In a separate report last month, the GAO found CBP violated law by using the emergency funding Congress gave it to stop the deaths of people in its custody to instead support a vaccine program for its employees, as well as pay for a canine program, dirt bikes, and computer network upgrades.
The latest GAO report also said that while “CBP was directed to report deaths of individuals in its custody to Congress,” at least 11 in-custody deaths were not properly documented in the past several years. “GAO’s review of CBP documentation and reports to Congress showed that 31 individuals died in custody along the southwest border from fiscal years 2014 through 2019, but CBP documented 20 deaths in its reports.”
One death along the southern border just days ago shows the need to shine a light on this secrecy. Borderzine reports a woman with severe head injuries was found by border agents on July 8. She died shortly after being transported to a hospital. “Scant information is available regarding her identity, and it appears that no law enforcement agency is investigating her death,” the report said.
“Incidents like this—in which no press release disclosed her death, no agency has claimed responsibility for investigating it, and no public identification of the woman has been made—begs the question: how many migrants die and then fall through the cracks of complex bureaucracy, with far-away family members left wondering what happened?” the Borderzine report asked.
In the middle of a devastating pandemic and a searing economic crisis, the White House has an urgent question for its colleagues across the administration: Are you loyal enough to President Donald Trump?
The White House’s presidential personnel office is conducting one-on-one interviews with health officials and hundreds of other political appointees across federal agencies, an exercise some of the subjects have called “loyalty tests” to root out threats of leaks and other potentially subversive acts just months before the presidential election, according to interviews with 15 current and former senior administration officials.
The interviews are being arranged with officials across a wide range of departments including Health and Human Services, Defense, Treasury, Labor and Commerce and include the top tier of Trump aides: Senate-confirmed appointees. Officials are expected to detail their career goals and thoughts on current policies, said more than a dozen people across the administration with knowledge of the meetings.
White House officials have said the interviews are a necessary exercise to determine who would be willing to serve in a second term if President Donald Trump is reelected. But officials summoned for the interviews say the exercise is distracting from numerous policy priorities, like working to fight the pandemic, revitalizing the economy or overhauling regulation, and instead reflect the White House’s conviction that a “deep state” is working to undermine the president.
It’s “an exercise in ferreting out people who are perceived as not Trump enough,” said one person briefed on the meetings.
“If they’re spending time trying to hunt down leakers, that’s time they’re taking away from advancing an agenda,” said a former senior administration official who’s spoken with officials undergoing the interviews. “And that’s irresponsible.”
The interview process, along with White House chief of staff Mark Meadows’ ongoing hunt for leakers, shows how the White House — less than four months before the presidential election — remains consumed by loyalty and optics despite urgent policy problems such as a raging coronavirus pandemic, nationwide worries about reopening schools and historically high unemployment. This week’s White House drama over Anthony Fauci, the nation’s top infectious-disease doctor, highlighted the persistent internal concern about whether government officials are in line with Trump’s preferred policy approaches — such as the president’s desire to downplay the latest coronavirus surges.
The reinterviewing exercise is being led by Johnny McEntee, a 30-year-old who's been a Trump aide since the 2016 campaign and was installed earlier this year as chief of the White House personnel office and is responsible for filling thousands or jobs across the federal agencies.
The interviews can take the form of general questions, such as an appointee’s career goals, but can also veer into territory meant to test a person’s perceived loyalty, like asking for the appointee's thoughts on the U.S. relationship with China or probing questions about why an appointee was chosen for his or her current job. Interviewers have also asked people to give examples of ways they are supporting the administration.
“It just seems like you could be a rocket scientist, but all they care about is whether you are MAGA,” said one senior administration official familiar with the interview process. “It is fair to do something to prepare to fill jobs in a second term, but right now, it is hard to know what the metrics are with this personnel office for being successful. There is no set criteria for what makes a good political appointee.”
McEntee, a former body man for Trump, did not respond to a request for comment. A White House official who defended the process said it’s part of the personnel office’s preparations for a second term, including gauging the officials’ postelection plans.
The head of the presidential personnel office under President Barack Obama called the interviews unusual. “I could definitely see that kind of questioning being uncomfortable and creating unease among political appointees,” said Rudy Mehrbani, who also vetted appointees while in the White House counsel’s office under Obama. “If you are working in one subject area like Peace Corps or USAID, that does not mean you are signing on to the administration’s position on funding for reproductive rights.”
Political appointees at the Defense Department, including a top layer of officials — undersecretaries — are going through reinterviews with the White House personnel office this month, according to a current Defense official and two former officials. During the interviews, the representatives from the personnel office are forcing senior leaders to answer questions about their loyalty to the president with an eye toward keeping their jobs in a second Trump term, the people said.
Pentagon spokesman Jonathan Hoffman countered that the interviews with the White House personnel office were set up by the Defense department “so that our political appointees could discuss second-term opportunities at the department and throughout the administration.“
In other areas of the government, the personnel tests come at a moment when Trump appointees are already struggling to manage portfolios that have ballooned during the pandemic. For instance, HHS staff have now spent more than five months juggling the round-the-clock response to the coronavirus while handling other ongoing policy goals, like the president’s focus on securing lower drug prices before the election — a balancing act that officials described as exhausting even before facing de facto loyalty tests.
Five political appointees in disparate roles across HHS said they’d either scheduled their meetings with the personnel office or were awaiting an appointment.
The interviews also have exposed some Trump appointees to unexpected risks: Labor Department officials were forced to quarantine after meeting with a White House personnel staffer who later tested positive for the novel coronavirus, Bloomberg Law first reported.
“You would think they would want to shore up the bench in response to the pandemic or start getting ready to fill expected gaps because people get sick or they leave,” Mehrbani added. “In the run up to a transition, historically, there is lots of turnover. Those are the things the personnel office should be tending to.”
For Trump‘s true believers, the interviews are viewed as a mandatory part of working in the Trump administration.
“If we’re going to extend this amount of capital on you, and push for you, they should ask more questions. I’m glad they’re doing it finally,” one White House official said. “The fact that PPO is finally considering whether people are aligned with the president — it’s long overdue.”
In recent months, we have watched our friends and families repost on social media “news” articles, YouTube videos, questionable websites and other sources on the topic of the Novel Coronavirus 2019, also called SARS-CoV-2, the virus that causes COVID-19 syndrome. This last week, we watched our Facebook and Twitter feeds explode with conversation responding to images of large gatherings of gay men on Fire Island and other common ‘gay’ destinations over the 4th of July weekend. These men appear to be ignoring recommendations for social distancing and not wearing facemasks during the current pandemic. We feel it is our duty as physicians who are also gay men to write this letter to address the pandemic as it relates to you, our fellow gay men.
We will use ‘COVID-19’ in this letter to refer to the SARS-CoV-2 virus as well as the syndrome it causes for the purpose of simplicity.
Before we go further, however, we want to recognize COVID-19 has affected all groups under the LGBTQIAP+ rainbow as well as cis-gender heterosexuals. But it has not affected all demographic groups the same, particularly in the United States. COVID-19 has disproportionately affected the Black and Latinx communities compared to other racial groups, as well as people with lower incomes. Trying to address the multitude of health disparities this pandemic has highlighted cannot be done in one letter, and we feel attempting to do so would do those communities a great disservice. Medicine is guilty of many of the race-related and societal problems brought forth by the Black Lives Matter movement. Doctors and other healthcare professionals still have a great deal of work to do to better care for these communities and populations.
That said, we would like to share the following based on our experience in medicine. We want you to know:
COVID-19 is real.
The first case of COVID-19 in the United States was identified in January of this year. As of the date of this letter, there are over 3 million total confirmed cases of COVID-19 in the U.S., which is roughly the size of the entire population of Puerto Rico. COVID-19 has killed over 135,000 Americans. These are confirmed infections – we are not incentivized to attribute a patient’s death to COVID-19 if the diagnosis is not confirmed with laboratory studies. This pandemic is real, and we are very concerned about it.
2.Otherwise healthy people are at risk for infection, death and long-term health problems because of COVID-19.
Older adults and people with underlying health conditions are at greatest risk of dying from this disease or having severe health complications. But younger people (middle-aged and younger adults) are not immune to death and severe debilitation from COVID-19. Even in children with COVID-19 some develop severe COVID-19-related illness called multisystem inflammatory syndrome.
For instance, in a recent report printed in the Journal of the American Medical Association (JAMA), over 16,000 patients in the Northern California Kaiser Permanente health system were tested for COVID-19 in March 2020. 1299 tested positive, and about 500 of those patients were admitted to the hospital. A quarter of the admitted patients were under the age of 50.
When we discuss underlying health conditions, many people envision advanced cancers, heart disease, dementia and other diseases with high rates of mortality on their own. However, most of the underlying conditions of patients requiring hospitalization are common in younger demographics. Another study out of JAMA looked at 5700 New Yorkers hospitalized with COVID-19. Like Northern California, roughly a quarter of these patients were under the age of 50. Over 56% had underlying high blood pressure, 9% had asthma, and 84% had never smoked a cigarette in their life. There are, however, many serious and even fatal cases in people with no prior medical history.
It is important to realize that having an underlying health condition does not mean you are imminently dying. People with underlying health conditions, such as diabetes, high blood pressure, heart disease or cancer, live normal lives. Many of them may not even know that they have an underlying illness at all. However, COVID-19 infection can cause a rapid, tragic death in these susceptible populations.
We do not yet know enough about COVID-19 to predict who will get sick and who will die. Even if you are fortunate to be asymptomatic or only mildly ill from COVID-19, you may easily pass it on to someone you love or a stranger who will die, regardless of your intentions.
3.We do not fully understand the long-term effects of COVID-19; however, they can be very serious.
Death counts dominate much of the public discussion around COVID-19, and yet it is too soon to understand the intermediate and long-term effects experienced by COVID-19 survivors. It seems apparent that there will be long-lasting health consequences of COVID-19 for some. We are seeing neurologic impairment from large strokes, even in young people without other symptoms. Others develop chronic lung damage requiring long-term dependence on a ventilator (breathing machine), cognitive impairment, and/or blood clots resulting in the need for limb amputation.
People with chronic diseases who survive COVID-19 are at high risk of worsening health, even if they had a mild case of COVID-19. As a result, COVID-19 can yield significant deterioration in quality of life after surviving infection.
4.We are only just beginning to understand what medications may be effective against COVID-19.
There are no FDA-approved therapies for treatment or prevention of COVID-19.
Over the last five months, there has been an avalanche of information about possible treatments in the press and scientific literature; there are ~800 active studies of treatments related to COVID-19 on ClinicalTrials.gov, a federal registry required of all clinical trials. It is important to remember that information is in constant flux. Here’s what we know:
Remdesivir (Veklury), a drug previously studied as a treatment for Ebola, may shorten the time it takes for symptoms to resolve and may reduce the risk of dying from COVID-19. Much more research is needed to better understand who might benefit from this medication.
Hydroxychloroquine (Plaquenil) received attention in the media and from politicians. Because of the severity of rare side-effects and lack of evidence of therapeutic benefit, national guidelines now recommend against its use for treatment of COVID-19. Additionally, there is no evidence that hydroxychloroquine is effective as a preventive agent, either.
There are additional medications that may be effective in some situations, like tocilizumab (Actemra), dexamethasone (a common corticosteroid), and convalescent plasma from COVID-19-recovered donors, all for people with severe COVID-19 admitted to a hospital, and more research is still needed.
5.There is no definitive evidence that HIV and HIV PrEP medications are protective against COVID-19.
Many gay men are prescribed emtricitabine/tenofovir disoproxil fumarate (also known as Truvada, or simply, PrEP) as pre-exposure prophylaxis to help reduce the risk of HIV transmission to HIV-negative individuals. Truvada is part of a class of medications known as antiretrovirals. These medications are also used to treat people infected with HIV.
A recent study of more than 75,000 HIV-positive people in Spain showed an apparently lower risk of getting or being hospitalized with COVID-19 for those people taking Truvada over other antiretrovirals. However, the study did not account for the underlying reasons that people might be on one anti-retroviral versus another, which may also affect their risk of getting COVID-19. Further, in evaluating studies, we always use great caution against assuming results in one population (here, people with HIV) would be seen in another population (people without HIV).
In other words, there is no conclusive evidence that Truvada will prevent COVID-19 and clinical trials are needed.
6.Continue to social distance, wear a facemask, wash your hands, and seek medical aid if you feel ill.
Let’s be honest: adjusting your daily routines and habits to help slow the spread of COVID-19 is frustrating and annoying for all of us, but it should also not be considered optional.
Continue to social distance:
It is understandable that many of us have strong urges for increased socialization after months of isolation, especially as temperatures rise in many parts of the country. Several men within our community were upset by the images of large social gatherings on the 4th of July, not only for the risks that attendees posed to the vulnerable members of our community, but also to our family and friends outside of the gay community.
We strongly recommend continued social distancing whenever possible. Studies have shown it is possible to spread the virus even before your symptoms develop, or even if you are asymptomatic never develop symptoms at all. Several states that have reopened are now seeing spikes in not only positive tests, but also hospitalizations, including the filling of intensive care units. This phenomenon cannot be attributed to increased testing alone. There is still great concern that asymptomatic people who feel well are spreading COVID-19 to vulnerable people.
Even small gatherings pose a risk. This is particularly true if you spend time with multiple different small groups, which increases your risk exponentially. Just because you know a person does not mean that you know all of that person’s social and casual contacts. Encounters with the people you see regularly, like roommates or family members, come with renewed risks in every new encounter, and it is up to each of us to mitigate those risks.
COVID-19 is a respiratory-born illness that you contract primarily through your mouth and nose, which is why it is imperative to wear face masks or other facial coverings when around others who also should be wearing masks. Masks are safe to wear, even with severe, underlying respiratory illness, like asthma or allergies. The mask needs to cover both your nose and mouth. Anatomically, our nasal passages and mouth meet to form the oropharynx, which then leads down to the trachea and ultimately the lungs. The mask you are wearing is rendered useless if your nose is exposed.
And contrary to what many people are spreading on social media, face masks do not pose a risk to your health. Our heart, lungs and kidneys work together to keep our bodies’ levels of oxygen and carbon dioxide in balance. A mask will not interfere with this process. Further, you cannot get sick by breathing in your own “fumes” – if you’re already infected, breathing in your own air will not make you more prone to getting sick.
It can be hard to be the person who asks others to mask up, but this is a time for leadership. A concern for others should be our guiding principle.
Perform frequent hand hygiene:
We also strongly encourage the frequent use of hand sanitizer and especially hand washing. The COVID-19 virus can affect nearly every organ in the body, including our digestive tract. Unfortunately, and disturbingly, fecal matter is virtually everywhere, and hand washing is the best way to clean your hands of it.
If you feel ill, contact your doctor or call 9-1-1:
Finally, if you are feeling ill, contact your doctor or local health department to be evaluated and possibly tested for COVID-19. Symptoms include fever, coughing, shortness of breath, nausea, vomiting, diarrhea, fatigue, body aches, nasal congestion, sore throat, headache, and loss of the sense of taste and/or smell. You may have several or just one of these symptoms if infected, or even none. Access to lab tests vary, and we wish we could test everyone who wants to be tested. Please understand that your healthcare provider may not be able to obtain a test for you. For the same reason, emergency departments may also not be able to test patients if they have only mild symptoms.
Seek immediate medical attention via 9-1-1 or your nearest emergency room if you are having trouble breathing, blue coloration to your lips or face, persistent pain/pressure in your chest, confusion, severe or sudden onset headache, slurred speech, drooping of your face, dizziness or weakness in your extremities. Extreme fatigue and dehydration are also concerning.
7.Face masks are safe even while exercising indoors.
Exercise is good for endorphin generation which lead to improved self-esteem, better coping skills, and disease reduction. The health benefits of exercise are numerous, and for many, exercise is also a way to socialize.
Unfortunately, there is an unfounded belief among some people that wearing a cloth facemask will endanger their personal well-being while exercising. Are they uncomfortable? Yes. But there is zero physiologic basis to believe this practice can lead to toxic levels of carbon dioxide in the body.
A face mask will not protect you from contracting the virus, but it will aid in curtailing your moist air droplets, with any adherent infectious agents, from infecting others, particularly those also wearing masks. During exercise, your respiratory rate and volume go up, increasing your release of droplets/aerosolized agents. We applaud establishments that are doing things like requiring masks, checking temperatures, limiting entry and lowering class sizes. Use your best judgment to do the things you enjoy.
8.The COVID-19 pandemic has profoundly impacted many people beyond its immediate health effects.
For many, COVID-19 has caused significant distress due to social distancing, restrictions on businesses being open, disruption in financial income, political concerns and a multitude of other reasons. These disruptions to normal life affect both physical health and wellness, with potential for repercussions long-after the pandemic is over. Like you, our lives have also been disrupted, and we want the pandemic to end as soon as possible.
Perhaps with a few exceptions, we who sign below are not economists, business experts, or politicians. We are all physicians. Among us are diverse experts in the diagnosis and treatment of disease with extensive training in human biology and pathophysiology, microbiology, immunology, epidemiology, public health, pharmacology, and performing (and critically evaluating) scientific research. By signing below, we attest to the information in this letter.
As members of your community, we implore you to reduce the spread of COVID-19. We ask that you be considerate and supportive of the people around you. Be critical of what you read and hear, and try to ensure your information is coming from reputable sources. And when in doubt, we hope you will defer to us, we who put our own health and the health of our loved ones at risk treating people with COVID-19. By June 6, 2020, over 600 US healthcare workers died from this virus, a number that is undoubtedly significantly higher today.
We will continue to better understand and combat this disease on our end so that you can keep yourselves, your loved ones, your community and society safer. We wish you great health, and we ask you for your trust and faith in our efforts. And when you need us, have no doubt that we will be here for you.
Wishing you good health and with great sincerity, we sign this letter to you.
Michael Casner, MD, MA Emergency Medicine Kansas City, MO, USA Peter M. Sadow, MD, PhD Head & Neck Pathology, Mass General Hospital, Harvard Medical Schol Boston, MA, USA Christopher Woodrell, MD Hospice and Palliative Medicine New York, NY, USA Jay Wong Medical Student Baldwin, NY, USA Michael Petrus-Jones, DO, MPH Pediatrics Houston, Texas Peter Tomaselli, MD Emergency Medicine Philadelphia, PA, USA Eric Kaiser, MD/PhD Neurology Philadelphia, PA Adnan Karavelic Pathology Corner Brook, Newfoundland, Canada David Goodyear, M.D OB/GYN Chicago, IL Daniel W. HIcks MD Psychiatry Washington, DC Benjamin Gardner, MD Emergency Medicine Omaha, NE, USA David Rowen MD Medical Officer Sydney NSW Australia Ross Gaudet, MD Anesthesia Critical Care San Francisco, CA Connor Ratchford, MD Washington, DC Lawrence E. Fried, MD Pediatric Neurology, Epilepsy Philadelphia, PA, USA Ron Balassanian, MD Pathology, University of California San Francisco San Francisco California Nicholas Orozco, MD MS Emergency Medicine Los Angeles, CA US Bryan Knight BSc, MB, ChB, M Med Path, PhD, FRCPA, FIAC. Pathology Wollongong, NSW, Australia Derrick Nitsche, MD Emergency Medicine New York, NY Abdallah Karam, MD Internal Medicine US Zach Spoehr-Labutta, MD Pediatrics La Grande, OR, USA Adam Weeks, DNP, FNP-BC Family Practice Longview, WA Ken Sutha, MD, PhD Pediatric Nephrology Menlo Park, CA Gregg Helland, MD Emergency Medicine Atlanta/Chicago/Boston, USA Adam Safdi, MD Nephrology Reno, NV, USA Ludwing Salamanca, MD, PhD Psychiatrist New York, NY Philipp Hannan, MD Emergency Medicine, Emergency Medical Services Tucson, Arizona Tyler Scoresby MD Otolaryngology Arlington, TX Erick Meléndez, MD Psychiatry New York, New York P.J. Tiberio, M.D., Ph.D. Pulmonary and Critical Care Medicine Pittsburgh, PA Ryan Stork, MD Physical Medicine & Rehabilitation Houston, Texas Paul G Stevens MD Radiology San Francisco, CA USA Corey Tapper, MD MS Internal Medicine Washington, DC Erick Ducut, MD Psychiatry San Francisco, CA Gregg Cohan MD Pulmonary/Internal Medicine Long Beach, Ca Matthew Truesdale, MD Urologist Clearwater, FL Brian Thomas Fletcher MD Emergency Medicine West Hollywood CA Henry Ng, MD , MPH Internal Medicine and Pediatrics Cleveland, Ohio, United States Kevin A Slavin, MD Pediatric Infectious Diseases Hackensack, NJ, USA Brian Vu, DO ObGyn US Mick Kastner, MD Emergency Medicine New Jersey Dan Nguyen, MD Family/HIV/Addiction Medicine Austin, TX Franco Chevalier, MD Internal Medicine Boca Raton, FL USA Joseph R Lewis, DO Surgical Critical Care, Acute Care Surgery Southampton, NY Gregory K. Todd, JD, MD,FACP Internal Medicine Tallhassee, FL Matthew Hutcherson, MD Physical Medicine and Rehabilitation Toledo, Ohio Kory Tillery, MD, MBA Internal Medicine Albuquerque, NM, USA Aaron F. Grober, MD Cardiology and Internal Medicine San Francisco, CA, USA Garrett Snoeyenbos, MD Pediatrics South Korea Michael Daniels Podiatry United States Danny Choy, DO Emergency Medicine New York, NY, USA Shayne Ladak, MD CMD Physical Medicine and Rehabilitate Durham, NC Jose L. Aguilar, MD Psychiatry, Addiction Medicine San Bernardino, CA Nigel Stippa, MD Ophthalmology Pittsfield MA Chris Esguerra, MD MBA Psychiatry Pasadena, CA, USA Nick Powers, MD Infectious Diseases Greensboro, NC, USA Richard Mehlman, MD Internal Medicine Los Angeles, CA Adam Lerman MS3 Medical Student Livingston NJ H. Todd Kepler, DO, MBA Family Medicine Dayton, Ohio Daniel Simpson, DO Emergency Medicine Philadelphia, PA, USA James Touchstone, M.D. Anesthesiologist San Diego, Ca Brad Deal, MD CCHP Adult, Child, Adolescent, & Correctional Psychiatry San Francisco, CA Jose Perez-Coste Internal Medicine Charlotte, NC Matthew Riddle, MD Emergency Medicine and Medical Toxicology San Diego, California, USA Luca Pauselli, MD Psychiatry New York, NY, USA Shubham Agrawal MBBS Vadodara, Gujarat India William Korey, MD Emergency Medicine Ft Lauderdale, Fl John M. Cruz, M.D. Child, Adolescent and Adult Psychiatry Union City, CA Andrew O’Brien, MD Hematology Indianapolis, IN, USA Paul Krieger MD Emergency Medicine New York, NY Thomas Klein Family Practice/HIV Chicago Illinois Reza Safavi, MD Psychiatry Houston, Tx Ron Carzoli MD and Julius Gorospe MD Neonatology/Family Medicine Jacksonville Beach FL Tom Klarquist MD Internal Medicine and HIV Chicago, Illinois Oscar A. Sanchez MD Physical Medicine and Rehabilitation Denver, Colorado. J Harrison Collins, MD Psychiatry Visalia, CA Derek Blechinger, MD MPH Internal Medicine, Preventive Medicine, HIV Specialist San Francisco, CA, USA Bojan Hrpka DO Family Medicine Kalamazoo, MI Tomas Lazo, MD Anesthesiology and Perioperative Medicine Portland, OR, United States Keith A. Chadwick, MD Otolaryngology New York, NY, United States Alan Drucker, MD Psychiatry Palm Springs CA Kalvin Yu, MD Infectious Disease & Epidemiology Los Angeles, California Gideon Levinson Medical Student Chicago, IL Hafiz Hussein MRCPI Cardiology Ireland Dan Karasic, MD Psychiatrist San Francisco Joseph Reses, MD Anesthesiology Augusta, GA, USA and Livingston, UK Humberto Temporini, MD Psychiatry Sacramento, CA, USA Mike Tracy, DO Physical Medicine and Rehabilitation Denver, Colorado. Bruce Kaczmarek, MD Emergency Medicine Washington, DC Carlos Julio Aponte MD, FACP Rheumatology Fairview Park OH Tyler Shapiro M.D. Emergency Medicine Philadelphia, Pa Timothy Hembree DO PhD Internal Medicine United States Albert Phan, DO Family medicine US Joseph Bautista, MD, FHM, FACP Internal Medicine/Hospitalist Exeter, NH Mark J Milstein, MD, FAAN Neurology New York, NY, USA Nick Okeson, D.O. Family Medicine Largo, FL Francesco Laterza, MD Internal medicine Philadelphia, PA Joseph D. Zibrak Pulmonary and Critical Care Boston, MA Flavio Casoy, MD Psychiatry New York, NY Fred Gonzales, MD Obstetrics & Gynecology Cincinnati, Ohio Brice Morey, DO Family Medicine Florence, South Carolina, U.S. John A Manos, MD Internal Medicine Salt Lake City, UT Shant Adamian DO OB/GYN Milwaukee, Wisconsin Miguel Dario Cantu, MD Pathology/Hematopathology New York, NY Philip Cheng, MD Urology, Men’s Health Basking a Ridge, NJ, USA Jason D. Hall, MD, JD Anesthesiology Tampa, FL Joshua St. Louis, MD, MPH, AAHIVS Family Medicine, HIV Primary Care Cambridge, MA, USA Jacob W Charny, MD Dermatology Chicago, IL Christopher Ruland MD, MS Orthopedic Surgery New York Edward S. Goldberg, MD Internal medicine/gastroenterology New York, NY USA Rhodes Hambrick, MD Pediatrics Boston, MA Justin Geisler, M.D. Internal Medicine/Emergency Medicine Augusta, GA Hein Latt, M.D. Psychiatry New York, New York Joshua M. Cohen, MD, MPH, FAHS Neurology and Headache Medicine New York, NY David S. Reitman, MD Adolescent Medicine, Pediatrics Washington, DC David Doobin, MD Ophthalmology NY, NY Ben Sokoloff, DO, AAHIVM Internal Medicine Portland, OR Matthew Molin DO Family Medicine Des Moines, IA Jacob Tigner MD Internal Medicine Minneapolis, MN G. Scott Sawyer, M.D. Ophthalmologist Houston, Texas, USA Duane Dilworth, M.D. Dermatology St. Louis, MO Taylor Dean Carlsen, MBS, MD/MBA Candidate Undetermined Jersey City, NJ USA Austin Vangelena Medical Student US Jonathan Ausman, MSC, MD OBGYN Kingston, Ontario, Canada Phillip Nguyen M.D. DABFM Family Medicine Washington DC Zachary Pittsenbarger, MD Pediatric emergency medicine Chicago, Illinois USA James Montgomery, MD Psychiatry Dallas, TX, US Matthew Hernandez, MD, PhD Pathology, Microbiology New York, NY Michael Kung, MD Pediatrics Los Angeles, CA Brian C Chen MD FASA FAACD Anesthesiology Anchorage, Alaska, USA Troy Gurney, MD Ophthalmology Houston, TX Nathan B. Williams, D.O. Family Medicine/Osteopathic Neuromusculoskeletal Medicine Fort Worth, Texas, USA Brian D. Robinson, M.D. Anatomic Pathology New York, NY, USA Kenneth Leong, DO, MPH HIV Specialist, Internal Medicine Sam Francisco, CA Aaron K Jenkins, MD Child Psychiatry Pittsburgh, PA Dorjee Norbu MD Psychiatry/Family Medicine Cincinnati, OH John H Purvis, MD Pediatrics Memphis, TN Alex Mauricio Gale, MD Pediatrics Worcester, MA, USA Naresh Ramarajan MD Emergency Medicine, Internal Medicine Boston Ronnie Rivera Emergency Medicine Los Angeles, CA Michael H. Secrist, M.D. Interventional Radiology Seal Beach, California, USA Matthew Gill, DO Family Medicine Los Angeles, California Daniel Kirkley; PA-C Internal Medicine & Trauma Charlotte, NC Steven Kahn, MD Dermatology Chicago, IL Michael Morris Family Medicine Minneapolis, MN Adam Z. Kawalek MD Internal Medicine Los Angeles, CA Robert Bright, MD Psychiatry Scottsdale, AZ Steven Edens, MD Ophthalmology Little Rock, AR Robert Killian MD/MPH Family Medicine United States Lonny J. Behar, M.D. Psychiatry Summit, New Jersey Amilcar A. Tirado, MD, MBA Psychiatry New York, NY, USA Farzad Alikozai Internal Medicine Kentucky Kenneth Schultz, D.P.M. Podiatric Physician Kansas City, MO Hirak Der-Torossian, MD San Diego, CA Ravi Saksena M.D. Pediatrics Brooklyn, NY Jeffrey D Mariano MD, AGSF Internal/Geriatrics & Palliative Medicine Los Angeles, California David Witzel, MD MPH Ophthalmology Poughkeepsie, New York USA Felipe Espinoza MD Radiology Palm Springs, CA Erik Eckhert MD MS Internal Medicine Palo Alto, CA, USA Keith Luckett, MD Infectious Diseases Cincinnati, OH, USA Van Hung Nguyen, MD Pediatric Pathology Canada Rashaan Marsan, MD/PhD Internal Medicine & Sports Medicine Atlanta, Georgia, USA Nathan Steiner, MD Anesthesiology Chicago, IL Jean-Luc Banks Medical Student Chapel Hill, NC Tyler Darnell, MD Emergency Medicine Portland, OR Neil Modi, DO Internal Medicine Los Angeles, CA Joshua R Gonzalez MD Urology & Sexual Medicine Los Angeles, CA, USA Jeremy Applebaum, MD Obstetrics and Gynecology Philadelphia, PA Zachary Long, MD Family Medicine US Scott Walker MD, MPH Psychiatry Fort Lauderdale, FL, USA Mark Shamoun, MD Pediatric Hematology/Oncology Detroit, MI, USA Andrew Lelin, MD, MA Psychiatry New York, NY Ram Sharma, MD, MPH OBGYN Orlando, FL Ryan Perdomo, MD Emergency Medicine Riverside,CA Patrick McLendon DO Pulmonology/Intensive Care Colorado, USA Jeremy Kidd, MD, MPH Psychiatry New York, NY, USA Nikhil Ranadive, MD, MS Emergency Medicine Fresno, CA, USA Ryan L Musolf, DO Diagnostic/Interventional Radiology Grand Rapids, MI, USA Travis Roark, MD Internal Medicine San Diego, CA Richard Strathmann, MD, FACOG OB/Gyn Naples, FL Mauricio Chacon / General physician Chicago Illinois R Voisine MD, BS. Pharmacy Anesthesiology Cape Elizabeth , Maine Daniel Fast MD Psychiatry Palm Springs CA Russell Simons, BS Fourth Year Medical Student Chicago, IL Dr. Aakash Goyal, DO Family Medicine Washington DC Joseph Di Vito MD Professor of Radiology&OB/GYN, AECOM New York, NY Perry Tsai, MD PhD Psychiatry Chicago, IL, USA Timothy Chandler DO Internal Medicine Lancaster, CA Cristian Serna-Tamayo, MD Medical oncology/palliative care/geriatrics Washington, DC A Ryan Sharma, MD, MPH Hospital Medicine San Francisco, CA Daniel Robinson, MD, FACEP Emergency Medicine Seattle, WA Derrick A. Strunk, M.D. Palliative Medicine Cincinnati, OH USA Chase TM Anderson, MD, MS Psychiatry San Francisco, California Joseph Ho, MD Ophthalmology-Vitreoretinal Surgery La Jolla, CA I.J. Frame, MD, PhD Clinical Pathology, Medical Microbiology Jackson, MS; United States David Wayne Tindle, MD, MEd., B.S. Aerospace Medicine Sumter, SC Joel Nkosi MBCHB Cum Laude, DABIM, FRCP(C) Internal/Emergency Medicine Winnipeg, Manitoba, Canada Justin Cohenour, MD Internal Medicine, Hospitalist Minneapolis, MN USA Maximilian Staebler, MD Resident, General Surgery New York City, NY 10032 Eric Colletti, MD Family Medicine Odessa, TX Daniel Fuchs, DO Emergency Medicine Denver, CO James C. League-Pascual, MD, MS Pediatrics Alexandria, VA Kusuma Nio, MD Trauma Surgery/ Surgical Critical Care New York, NY Orlando R. Ortiz, MD Adult, Child, and Adolescent Psychiatry Portland, OR, United States
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Richardson S, Hirsh JS, and Narasimhan M. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. Journal of the American Medical Association 2020;323(20):2052-2059.
Rubin EJ, Baden LR, Morrissey S. Audio Interview: A Covid-19-Related Syndrome in Children. N Engl J Med. 2020;383(1):e10. doi:10.1056/NEJMe2024117
Well now is just a great time for a key member of the Trump administration's Health and Human Services (HHS) team to be under a big corruption shadow. The HHS inspector general has found that Seema Verma, who is in charge of the Centers for Medicare and Medicaid Services (CMS), used her position to steer millions of dollars in federal contracts to friends. More than $5 million in taxpayer money went to communications consultants apparently hired to burnish Verma's image, who circumvented civil servants in the CMS communications department
"CMS improperly administered the contracts and created improper employer-employee relationships between CMS and the contractors," the inspector general wrote. "CMS's administration of these contracts put the Government at increased risk for waste and abuse." In her first two years, the report finds, Verma frequently circumvented the civil servants in the communications department and personally directed her hand-picked contractors to write her speeches, secure media appearances, and "even accompan[ied] one for a 'Girl's Night Out' networking event."
One of the contractors is Marcus Barlow, a Republican strategist and Verma's spokesman in her former role running a healthcare consulting firm based in Indiana. Verma wanted Barlow to run her official communications, but she was overruled by the White House because Barlow had publicly said: "I am not, nor will I ever be a Donald Trump supporter. I find him to be offensive and ignorant." Verma, who is closely aligned with Vice President Mike Pence, didn't get Barlow as her communications chief, but instead gave him a contract and appears to have flouted rules governing that contract by putting him in charge of staff.
The inspector general included communications between two senior CMS civil servants after Barlow told them that he needed to see and clear any tweets sent out on the CMS account. "I'm trying to figure out if it is legal for a contractor to direct federal personnel," one of them wrote in August 2017 to the other, who responded: "I have been wondering the same thing." The first official minimized the exchange later, telling auditors for the inspector general that he'd had an "emotional reaction" and didn't believe the contractor was trying to direct him. Nonetheless, a contractor should not be directing civil service officials.
The inspector general’s report also included Verma's recommendation to contractors that they hire Washington, D.C.-based communications expert Pam Stevens to set up Verma's media appearances. Stevens created a publicity plan to put Verma in magazines like Glamour, get her invited to glitzy public events like the Kennedy Center Honors, and to get her put on "Power Women" lists. None of which does anything about providing health care for people in a global pandemic or developing a healthcare plan for the contingency that Trump prevails in court and destroys the Affordable Care Act.
HHS spokesperson Michael Caputo responded in a very Trumpian way to the inspector general’s report—he attacked the watchdog. "The President, Vice-President and the Secretary have enormous confidence in Administrator Verma and the great work she has done, and will continue to do, for the American people," he said. "But confidence in the Inspector General? Not so much." That could be an indication that the long-simmering pissing match between Verma and HHS Secretary Alex Azar has been extinguished. They do have a common enemy now: transparency.
Never mind making sure people can afford to live and eat and have shelter. Never mind making sure people do live by providing enough money for testing and contact tracing and treatment for coronavirus. Never mind making sure state, local, and tribal governments can stay afloat. No, the new priority for Senate Majority Leader Mitch McConnell is sacrificing the nation's schoolchildren, teachers, and school staff to the altar of Donald Trump. His new make-or-break deal for funding anything else is going to be tied to forcing schools to reopen, by "attaching incentives or conditions to tens of billions of dollars in new aid as part of the next coronavirus relief bill," according to TheWashington Post's sources.
McConnell himself told reporters Wednesday, "There's going to be a heavy emphasis in the bill I'm going to unfold next week on education. I know it will be costly. […] We need to find a way to safely get back to work, and we feel, I feel, like the federal government will have to play a financial role in helping to make that possible." Oh, okay. He "feels like" the government should play a financial role in making people work. But he doesn't feel government should play a role in fighting this goddamned virus! What McConnell is doing here is helping Trump pretend like the virus isn't raging all over the country, that it won't still be raging six weeks from now because nobody has done a thing to stop it, and that it will be fine to reopen schools and send millions of children and teachers to their potential COVID-related deaths.
The Post reports that they're looking at "somewhere between $50 billion and $100 billion for elementary and secondary schools, with one person familiar with the talks saying the target was about $70 billion." They might throw in another $20 to $30 billion for higher education, Republican officials told the Post. The American Federation of Teachers, the people who actually work in schools, estimate that K-12 schools will need an average of $1.2 million each in order to reopen safely. That's $116.5 billion in total. Which is a lot more than $70 billion.
McConnell, asked about what he'd say to parents and teachers who fear reopening schools in this pandemic, quipped, "I think they fear, more, children being stuck at home this fall." Fucking ghoul. He also said, "We can't have a normal country unless kids are in school. And of course, that has an impact on jobs because kids and school and jobs are interconnected in every single way. Because it affects both parents to get back to work if the kids are home."
What we really can't have is a normal country—as long as Mitch McConnell is in charge of the Senate.
A Florida school superintendent claims he was “set up” and used as “a political pawn” after he sparked controversy by saying that being gay is a choice, and citing “God” as evidence to support his opinion.
Bill Husfelt, the Republican superintendent of schools in Bay County, made the statements at a board meeting Tuesday in response to questions from Cindy Wilker, president of the LGBTQ Center of Bay County.
Wilker began her remarks during the public comments portion of the meeting by noting that Husfelt, who is seeking re-election to a fourth four-year term in August, recently keynoted an event hosted by a man with ties to racist hate groups. During the event, Husfelt reportedly said he doesn’t think systemic racism is a problem in America, although there may be “a few bad apples.”
Then, Wilker said she had asked Husfelt at another recent GOP event whether he believes being gay is a choice, and he said yes. She asked him to repeat his answer at the school board meeting.
“You did ask me that. I said yes,” Husfelt responded, according to a video from the school board meeting posted to Facebook by the LGBTQ Center.
“What evidence do you use to support that determination?” Wilker said. “What book do you use to support that determination? I’m relying on the American Medical Association, the American Academy of Pediatrics, the American Association of School Administrators, the American Counseling Association, the American Federation of Teachers, the American Psychological Association, the American School Counselor Association, the American School Health Association, the Interfaith Alliance, the National Association of School Psychologists, the National Association of Secondary School Principals, the National Association of Social Workers, the National Education Association, and the Social Work Association of America, and on and on and on. And I’d like to know, on the other hand, who are you relying on?”
“God,” Husfelt responded.
Husfelt later told WMBB-TV: “She asked me do you believe a gay person, I can’t remember all the language, do you believe it’s a choice or are they born with it, I said that it’s a personal choice. This was set up as a political pawn to try to get me to say something or do something that would cause some controversy. … I love all students. It doesn’t mean that I’m anti-student because someone might be gay or something like that. I’m not. You won’t find where I’ve ever treated anyone unfairly. We have gay alliance clubs in many of the schools.”
Wilker told the station she plans to ask Husfelt’s opponent in the August GOP primary, Judy Vandergrift, the same question. She also noted that unlike 65 other school districts in Florida, Bay County’s has declined to participate in an LGBTQ guest speaker program.
“He’s had 12 years to make things better for the LGBTQ community; he hasn’t done that,” Wilker said of Husfelt.
Yep. Cops are involved in WAY too many situations that don't need a gun. Let others deal with situations that don't require immediate threat of state-sanctioned murder.
A protester wears a mask and holds a homemade sign that says, “Defund the Police” as they perform a peaceful protest walk across the Brooklyn Bridge on June 19. | Ira L. Black/Corbis via Getty Images
Even with deep disagreements, an emerging dialogue around defunding non-criminal services appears promising.
A recent political ad, sponsored by the conservative State Government Leadership Foundation, imagines the hellscape of a post-police Minneapolis. A terrified white woman jolts awake at 2 am during a home invasion. She alerts her husband. She grabs her phone. She calls the police. But it’s too late. They have all been defunded. A dispatcher informs her that a “human resources” specialist can’t help her right now as the camera pans over her sleeping child, the burglar advancing ominously. “Radical liberals are fighting for a police-free future,” the narrator intones. “Don’t let them put your family in danger.”
There is one thing — and only one thing — the ad gets right: On all sides, in all directions, the debate over the future of policing remains a debate over safety, driven by communities who desperately, deeply want to feel safe.
In the aftermath of George Floyd’s killing at the hands of police, virtually every faction in American politics — from Trump Republicans to Biden Democrats, from Cato libertarians to intersectional Marxists — says they want to change policing.
On one end of the spectrum stand abolitionists, who want to “delegitimize the police.” These activists demand an entirely new public safety system based on social and economic equity, bolstered by a network of nonviolent emergency responders. They are offering more than a different vision for public safety — they are offering a different vision for the composition, and fundamental assumptions, of society. They have a different view of what causes crime. In the world they imagine, America would spend much more on education, health care, and infrastructure, and nothing on police departments as we currently know them.
On the other end stand reformers, who want to “restore legitimacy to the police.” This group seeks to implement procedural reforms to make officers more accountable and effective. They also, in general, want to spend more on policing. Presumptive Democratic presidential nominee Joe Biden’s plan, for instance, spends more on education and health care and infrastructure, but also more on policing: He’s proposed a $300 million increase to the Community Oriented Policing Services (COPS) program.
Countless opinions dot the range between — in particular, the “defund the police” movement (more on that in a moment). Much of the debate remains contentious, particularly on how best to defeat violent crime. Yet even amid consternation, bad faith, polarization, disagreement, and partisanship, a common refrain cuts across the parties: America relies too heavily on the police for non-criminal services.
“We need alternatives to policing,” says Thenjiwe McHarris, an activist in the Movement for Black Lives and a police abolitionist. “If someone is sleeping on a bench, if there’s a mental health issue, policing is the one tactic — often a failed tactic — used in our communities for the range of needs our people have.”
“The reality is we have turned to police to handle a lot of problems in society that nobody else wanted to do — to handle issues around substance abuse, to handle issues around the homeless, to handle issues around mental health,” says Laurie Robinson, who chaired President Obama’s Task Force on 21st Century Policing, which produced the basic agenda of the police reform movement. “I think they would be very happy to hand off these responsibilities.”
Likewise, former NYPD sergeant and Burlington Police Chief Brandon del Pozo asked: “Why are we still asking the police as untrained interventionists to deal with people who are overdosing and using drugs or as barely trained crisis interventionists to deal with mental health when we can piggyback or create separate apparatuses that handle that for us?”
This cross-coalitional interest in reassigning nonviolent services presents the most promising opportunity for ambitious change to a country rollicked by weeks, and years, of protest against racist policing. In an opening bid, abolitionists have suggested rerouting 50 percent of police budgets to other civil services.
But understanding the areas for compromise also requires seeing where the different visions conflict. So let’s go through them in turn.
Reforming the police
The police reform movement stands atop two premises. Good policing is good. Reams of research show it does, in fact, reduce violent crime. But bad policing is bad. It’s bad on its own terms, because it harms the people it brutalizes, and it’s bad because it delegitimizes the police in the eyes of the community they’re meant to serve.
In Milwaukee, for instance, an important study showed that 911 calls fell after a publicized case of police brutality. The harm of bad policing, in other words, was both the police brutality and the severing of the relationship between the community and the public agency meant to keep them safe.
Police reformers, then, are trying to do two things at the same time: Make sure there are enough police to keep violent crime low, and make sure those police are both well-trained enough and tightly constrained enough not to abuse their power.
The Obama administration’s Task Force on 21st Century Policing formed just after the 2014 uprising in Ferguson, Missouri, and published its report immediately after the 2015 Baltimore uprising. Its policy goals were a shift in policing culture, use of force, transparency, and fairness. As with universal pre-K, a $15 minimum wage, free community college, and a federal jobs program, the report articulated a progressive vision that was never fully achieved. Yet today, as establishment politicians respond to protesters’ calls for change, the task force’s report still offers a window into how traditional reformers imagine a new American policing paradigm.
“The reality is we have turned to police to handle a lot of problems in society that nobody else wanted to do — to handle issues around substance abuse, to handle issues around the homeless, to handle issues around mental health”
Among the report’s 59 recommendations were that officers “acknowledge the role of policing in past and present injustice and discrimination”; avoid violence against “children, elderly persons, pregnant women, people with physical and mental disabilities, limited English proficiency, and others”; and “adopt and enforce policies prohibiting profiling and discrimination based on race, ethnicity, national origin, religion, age, gender, gender identity/expression, sexual orientation, immigration status, disability, housing status, occupation, or language fluency.”
The task force envisioned officers who are friendly, mentally well-adjusted, highly trained “guardians.” Through incentives, curriculums, and hiring programs, departments would create officers who prioritize deescalation and nonviolent intervention, abide by strict anti-discrimination laws, operate under strong transparency protocols, and stand accountable to local civilians.
Under this plan, police are not abolished; they are enlightened.
The authors also call for expanding the use of social workers and other nonviolent crisis specialists to supplement police officers. The report recommends reducing crime “through a variety of programs that focus on public health, education, mental health, and other programs not traditionally part of the criminal justice system.” This broader response to crime represents an area of overlap with the more progressive protests demanding alternatives to policing.
Robinson, the co-chair of the task force, says the ethos of the document has entered into the bloodstream of American policing. Citing a survey of 47 of the largest law enforcement agencies in the United States from 2015 to 2017 conducted by the Major Cities Chiefs Association (MCCA) and the National Police Foundation, Robinson notes that 39 percent of the departments updated their use of force policies and incorporated deescalation training. The survey also reported that officer-involved shootings during this period dropped by 21 percent.
While these data points highlight good news, Robinson also underscores that administrative barriers prevented the policy recommendations from becoming universal policing standards across the country.
“We have a highly decentralized system,” she says. “We have 18,000 separate and very independent state and local law enforcement agencies that are operated and run by, in our case, many local independent mayors and city managers who are responsible for operating and overseeing those local departments.” This fragmented bureaucracy clashing and the strength of police unions makes even the more modest reforms suggested in the policing task force more difficult to enact. But Robinson — and Obama — remains optimistic that the report’s recommendations remain the right path forward.
“We know there are specific evidence-based reforms that if we put [them] in place today would build trust, save lives, would not show an increase in crime,” Obama said in a statement following George Floyd’s death. “Those are included in the 21st-Century Policing Task Force report.”
Thomas Abt, another Obama administration alum and author of Bleeding Out, a book on policing urban violence,said in principle he supports conversations around what roles police served and how they might be scaled back. Yet he remains worried about the tenor of the current defunding conversation.
“I am supportive of asking these big questions about whether we can start winnowing down the police role. But you don’t do that by just slashing police budgets, without a broader conversation about who’s going to step up and fill the gap,” Abt says.
“I worry that people don’t understand what it takes to set up a first responder operation. It took us well over a century to put together police, fire, EMT,” he continues. “To have a government service capable of responding in real time to these things is an enormous undertaking.”
Abt and other more traditional reformers continued to see a central role for American police in society. Abt supports a mix of police reforms to increase transparency and curtail the use of force while also deploying surges of concentrated policing in the most violent neighborhoods.
But to the defunders and abolitionists, reform has been tried, and it has been found wanting. This year, the police department in Tucson, Arizona, was noted as “progressive” and “reform-minded” and had “banned chokeholds and shooting at moving vehicles, embracing a range of measures aimed at reducing police violence,” according to the New York Times. Yet local officers still killed Carlos Ingram-Lopez, a Latino man who was reportedly naked and experiencing a mental health crisis when he was killed, and withheld the video for months. Likewise, in Minneapolis, Minnesota, which was celebrated for its progressive mayor, a former civil rights attorney, and their reform-minded police chief, city employees still killed George Floyd.
Citing reform failures, many activists want to go further.
What it means to “defund the police”
Last month, the Washington Post published an article that cautioned that after a recession budget crunch, Vallejo, California, “defunded its police department” and officer killings shot up, while crime enforcement plummeted. “Vallejo’s experience offers a glimpse of what a reduced police presence on America’s streets could mean as defunding continues to gain traction,” the piece warned.
But austerity-driven disinvestment is not the future defunders want. (It also does not accurately represent the public policy vision that defund advocates are fighting for, as the Washington Post later clarified in the article.)
“Part of the push here is that we know what we want to defund — the other part about the demands for what we need,” says defund advocate and Illinois state Sen. Robert Peters (D). “Folks often get caught up in this ‘oh, my god’ of demanding to defund the police. People need to know there’s a whole host of other demands attached to that, which are about uplifting community.”
In essence, defunding exists as a suite of public policy ideas premised on investments in individual well-being, community infrastructure, alternative first responder services, and divestment from the use of lethal force.
Kerem Yucel/AFP via Getty Images
Lewiee Blaze, 22, a rapper and activist, attaches a sign reading “Police Abolition Now, Justice for George Floyd” to a fence in Minneapolis, Minnesota, on June 7.
Defunders don’t just emphasize expanding social programs and investments but also removing money from police departments. They argue that the swelling police budgets fuel violence and corruption.
Advocates like the Center for Popular Democracy’s Kumar Rao argue that police departments run on a broken financial feedback loop where, after poorly policing communities of color and running up huge legal fees for abuse, torture, and unjust killings, departments are rewarded with larger budgets the next year, funding a cycle of violence.
“Part of the problem here is the amount of money that has gone toward policing over the last several decades,” says Rao. “We’re now reaching a point where we spend over $100 billion every year on policing. That kind of spending on policing has entrenched an institution and has made it ultimately unaccountable.”
For Rao, increasing police budgets increases the number of officers, which increases the scope of officers’ duties, which increases officers’ interactions with civilians, which increases opportunities for police violence.
Beyond issues of corruption, defunders also argue that reliance on police departments is poor execution of public policy because police specialize in violent crime, but violent crime only represents a small portion of the sprawling civil services they perform. They believe the money could be used more effectively elsewhere.
Take traffic, for example, where police spend nearly 20 percent of their time working in some cities. Experts like Transportation Alternatives deputy director Marco Conner DiAquoi argue that it is both safer and more efficient for cities to manage traffic through transportation infrastructure investments, automated enforcement, and specialized civilian first responders rather than through police.
“Police officer-based enforcement is less effective than infrastructural alternatives, like street redesigns and automated enforcement, and puts people of color at risk,” DiAquoi and co-authors write in “The Case for Self-Enforcing Streets.” The report, published in June by Transportation Alternatives, seeks to remedy the ways in which enforcement of traffic laws leads to discretionary and often biased policing of minorities.
In New York City, DiAquoi argues, many of the violations that are cited in minority neighborhoods are the natural upshot of poor infrastructure in segregated communities — elements like a bike lane, quality sidewalks, or well-designed streets. DiAquoi and the other co-authors make a case for reallocating “significant portions” of the NYPD’s budget to the Department of Transportation to “increase investments in street design and automated enforcement to create ‘self-enforcing’ streets” which would “reduce the ability of police officers to violate civil rights, cause property damage, or otherwise participate in sueable offenses.”
Decriminalization illuminates another part of the vision behind defunding. Defunders — like many others — believe the war on drugs has been racist and ineffective, and we should simply end it. And if we end it, it makes sense for police budgets, which have grown in part because of the drug war, to be cut.
In Alex Vitale’s The End of Policing, the Brooklyn College sociologist explains how Portugal successfully decriminalized drug use in 1999; it handed over drug harm reduction to health officials, reaping “very favorable” results, with most drug use “now treated as a health problem.”
“Studies have found significant reductions in heroin addiction, overdoses, and disease transmission,” Vitale writes of the country. “In 1999, Portugal had the highest rate of HIV infection among injecting drug users in the European Union; by 2009, the number of newly diagnosed HIV cases among drug users had decreased substantially.” Likewise, reporting on Portugal’s decriminalization of drugs for the New York Times, journalist Nicholas Kristof found “the number of heroin users there fell by three-quarters, and the overdose fatality rate was the lowest in Western Europe.”
“Meanwhile, after decades of policing, the United States was losing about 70,000 Americans a year from overdoses,” Kristof continued. “In effect, Portugal appeared to be winning the war on drugs by ending it.”
Even scholars like Stanford University’s Keith Humphreys, who has been skeptical of the methodology used in the Portugal research, note that similar results can be seen in the United States. Citing data from the Criminal Justice Statistics Center, Humphreys notes that after California lawmakers decriminalized marijuana, the state saw decreased interaction with the police. According to the study, marijuana possession arrests in California dropped by 86 percent after the law decriminalizing possession of small amounts of the drug. “We don’t need Portugal,” says Humphreys. “We, in the United States, have done these things. I think we could probably start moving on to what happened in California.”
“There was no evidence of substitution effect, either,” he adds. “Some people worry that the police will just find another reason to arrest the same person — you know, get you for jaywalking or whatever. But that doesn’t seem to have been the case.”
“There’s police time involved in making those arrests,” Humphreys says. “If you’re going to cut the police force or defund them more, this might be a way to do it without doing any real damage to public health. At least for cannabis, people may use it a little more, but it doesn’t seem to be they use a lot more than that. I think a lot of people would see that as a reasonable trade.”
Crucially, Humphreys also argues that investing in health responses to drug abuse indirectly lowers interaction with the police, as users who successfully undergo treatment decrease the criminal and antisocial behaviors affiliated with narcotic use and trade.
Here, again, the case for defunding the police rests on the concept that it is more effective and efficient to shift responsibility away from officers and departments to civil service and care workers specifically trained to handle medical and logistical problems. Repeating this policy thought experiment across mental health, domestic counseling, homelessness, and more, defunders outline the playbook to move away from policing.
Many of these advocates still see a role for police officers, albeit a significantly diminished one. They view officers as a last resort, reserved for the most serious crimes, and for true emergencies as opposed to the roles they currently serve as default first responders. In this way, they differ from the abolitionists.
The abolitionist vision
In interviews, advocates of defunding the police speak very favorably of abolitionists, and vice versa.In fact, in the short term, there is virtually no policy difference between many defunders and abolitionists. This symmetry can be seen in the recent vote by the Seattle City Council to cut the city’s Police Department by 50 percent and reroute that money to social programs. This policy action, led in part by non-abolitionists elected officials, mirrors the policy recommendation of Mariame Kaba, the prison industrial complex abolitionist who recommended a 50 percent defund this summer in the New York Times.
That said, the long-term difference between those who want to defund and those who want to abolish is that the former believe police to be necessary in the case of true violence and extreme emergencies. Abolitionists don’t; they ultimately call for alternative interventions, even for violent crimes.
In addition to all the critiques levied by defunders, abolitionists contend that the police remain an inherently racist institution, with its legacy stretching back to slave patrols, a history of supporting white supremacy groups like the Ku Klux Klan, and contemporary patterns of the racialized brutality on Black, brown, Indigenous, and vulnerable communities.
Jason Redmond/AFP via Getty Images
The Seattle City Council recently voted to cut its police department’s budget by half and invest that money in social programs.
Abolitionists describe ending the police as an integral part of America’s “third Reconstruction,” where in addition to full citizenship and economic rights, Black people and all people will be free of wanton state violence at the hands of the police.
Police and prison abolition can be traced in the modern context to radical Black feminist and anti-capitalist thinkers like Angela Davis. In her 2003 book Are Prisons Obsolete?, Davis pushed readers to question their acceptance of the carceral state, principally prisons, in American life.
“In most circles prison abolition is simply unthinkable and implausible. Prison abolitionists are dismissed as utopians and idealists whose ideas are at best unrealistic and impracticable, and, at worst, mystifying and foolish,” she wrote.
“This is a measure of how difficult it is to envision a social order that does not rely on the threat of sequestering people in dreadful places designed to separate them from their communities and families,” she continued. “The prison is considered so ‘natural’ that it is extremely hard to imagine life without it.”
The same goes for police. Abolitionists envision ending both police and prisons as the next critical chapter in the Black freedom struggle following up on the end of slavery and Jim Crow. They believe that much of the crime that police officers respond to reflects broader conditions, disinvestments, and oppressions present across society, which are then used as justification for the policing and carceral states. Police, in this telling, mask deep societal sins, and only by removing them can we see the real work and transformation needed.
In the Boston Review, attorney and activist Derecka Purnell outlines what the road to police abolition might mean in broad strokes:
Police abolition could mean and require society to decrease and eliminate its reliance on policing. Rather than re-center police as a public good, the nation must become good and public. The prison–industrial complex must be dissolved. Communities must rebuild labor organizing to shift capital, and the state must drastically disrupt rising wealth inequality. Congress may have to pass laws around prison labor, voting rights, gun ownership, and campaign finance, and decriminalize thousands of behaviors. Social workers and activists must work with communities to find solutions for patriarchal, homophobic, and mental health–based violence. Police abolition advocates and scholars have robust visions for the future beyond transformation.
The vision is sweeping. Foundational to police abolition is what Purnell describes as eliminating “reliance on policing.” Kaba describes this idea as wanting not merely to “close police departments” but “to make them obsolete.” This is abolition as innovation. It is social engineering calling for a bold public policy action to address chronic social and economic issues and provide for basic human needs.
In this view, the primary aim centers on preventing criminogenic preconditions (joblessness, underinsurance, etc.) that lead to the violence for which people rely on the police. To the degree that violent crime persists even during and after these policies take effect, activists favor what they described as non-carceral interventions.
The Breathe Act, introduced by Reps. Rashida Tlaib and Ayanna Pressley, promotes programs that view violent crime as akin to a public health problem, requiring public health-style responses. Violence, in this view, spreads like a virus, and successful violence interruption programs rapidly deescalate neighborhood tensions following a shooting to stop the further transmission of violent retaliation. A recent memo from Data for Progress outlines the successful pilot programs using violence interruption to curb shootings in the neighborhoods with the highest levels of gun violence.
It summarized:
Repeated evaluations of Cure Violence have shown that it significantly reduces violence. In West Chicago’s West Garfield Park, the program reduced shootings by 67% in its first year. A NIJ/ Northwestern University evaluation found that Cure Violence reduced shootings across Chicago by 41% to 73%. Other studies have also found that Cure Violence reduced shootings in cities like New York and Philadelphia.
Similarly, a 2017 UCLA analysis on violence interruption described the program as an effective way to curb violence by “tasking civilian community interventions workers to mediate conflict and control rumors following a reported gang crime.”
“Our analyses of quasi-experimental interventions in Los Angeles indicates that civilian Community Intervention Workers, tasked by the Gang Reduction Youth Development program, cut gang retaliations by 45.3%, independently of the effects of policing,” the authors wrote.
The Breathe Act leans on such non-policing alternatives to transition away from police solutions to crime. It also calls to expand Medicaid, implement a living wage, create targeted job programs for the long-term unemployed, and other economic justice initiatives.
“You can tell a lot about a country based on how it allocates its resources. We’re saying that now is a time when we target budget, local and federal — where we say, divest from these institutions that have been harming us and invest in what our communities have always needed and will continue to need,” says Thenjiwe McHarris, the abolitionist and Movement for Black Lives activist. “We actually want to have access to safety. And what that means for us is a divestment from policing, and the institution of policing and an investment in what our communities need: quality housing, quality education, health services, particularly in the midst of a pandemic.”
While abolitionists like McHarris have radical political aspirations, they remain committed to translating that vision into more immediate policy. Beyond the Breathe Act, abolition goals articulated in the Movement for Black Lives platform and in the more recent 8 to Abolition campaign outline first steps municipalities can take toward reducing, and eventually ending, the need for police.
Critics of police abolition remain skeptical about these activists’ ability to create alternative forms of care and emergency response to address violent crime. These traditional policymakers fear reducing the police force will result in spiking neighborhood violence. Since clearance rates and crime reporting in low-income communities of color remain abysmally low, abolition advocates often embrace a new policy framework.
Activists view the abolish mission as part of a multigenerational Black freedom struggle, and a radical tradition. “It’s a marathon, it’s not a sprint. We’re inside of a particular opening. It was decades to get us here. We’re all inside of multi-decade strategies,” says McHarris.
Defunding non-criminal services — much of police work — appears promising
Sharp, and even seemingly irreconcilable, differences exist in the competing visions of reform, defunding, and abolition. Yet the shortcomings of the American police system — and American public policy more broadly — stretch so wide that it creates a significant zone of overlap. Policing fails to address much of American inequality, dysfunction, and civil disorder. We have asked them to do too much, and we have neglected the investments and institutions that would make their presence less necessary.
More than half of police work addresses non-criminal issues according to an analysis of public records by the New York Times and an observational study in Criminal Justice Review. Likewise, policing scholars like NYU Law’s Barry Friedman argue that “crimefighting actually is a very small part of what police do every day.”
Moreover, officers themselves often question the utility of using police for issues like mental health and homelessness. “I’m not even saying now that the budgets shouldn’t be looked at, and seeing if there’s another way to do that,” Vince Champion of the International Brotherhood of Police Officers said on a recent episode of The Daily. “Look, a lot of officers, we’re social workers. We’re marriage counselors. We’re doctors sometimes. We’re more than actually what we were trained to be. I mean, we try to train for everything that we can, but we just can’t be.”
Then-President Barack Obama echoed a similar sentiment in his 2016 Dallas police speech, when he castigated America for underinvesting in schools, allowing poverty, underfunding drug treatment and mental health programs, not regulating guns, and then telling the police “you’re a social worker; you’re the parent; you’re the teacher; you’re the drug counselor.”
Converting common sense into consensus policy remains a daunting task for a country ailed by overlapping health and economic crises and diminishing political capacity.
This is a difficult debate on its own terms, happening at many levels simultaneously. Racial justice activists seek to address the problem at the scale at which it exists — that is, on the scale of multigenerational theft, divestment, and discrimination. For many, this is too daunting to contemplate and too complicated to legislate. But it doesn’t make it any less necessary.
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Utards in full bloom. Those idiots will be dying off in droves
Hundreds of people packed into a county commission meeting in Utah on Wednesday to protest Republican Gov. Gary Herbert’s requirement that students wear masks in school this fall.
The meeting of the Utah County Commission in Provo was ultimately postponed because the crowd was not in compliance with social-distancing guidelines. Members of the standing-room-only crowd reportedly pulled tape off seats meant to enforce social distancing, and almost none wore masks.
Even though the meeting was postponed, the protesters spoke for hours after two commissioners agreed to listen to their concerns. One woman spit gum into a mask and called it “garbage” before wadding it up, according to a report from the Salt Lake Tribune. Others referred to COVID-19 “a hoax” and “a political stunt,” and said wearing masks would “rewire” children’s brains and leave their minds “broken.”
One teacher who opposes the mask requirement noted that students aren’t allowed to wear them on Halloween — “Why change that now?” she said. When another teacher spoke in support of the mask requirement, the crowd shouted her down and told her to find another job.
The protesters were led by Commissioner Bill Lee, who addressed them outside before the meeting and wants the county to send a letter to the state seeking a “compassionate exemption” from the school mask requirement.
But after the protesters packed into the meeting room, County Commissioner Tanner Ainge immediately made a motion to adjourn. “This is the exact opposite of what we need to be doing,” Ainge said. “We should be physically distancing and wearing masks. This room is not complying with those health guidelines.”
More from the Tribune: They wore “Trump 2020” hats and carried little American flags, and every time someone said “freedom” or “constitutional rights” the whole room cheered. Almost no one wore a mask; those who did had them pulled under their chins. … When the meeting started, Commissioner Tanner Ainge declared he wouldn’t support so many people in the boardroom not social distancing. He made a motion to adjourn and hear the proposal from Lee another day in a bigger space. The board’s third member, Nathan Ivie, voted in favor and Lee against. After the 2-1 decision, Ainge walked out. … A torrent of boos followed with shouts of “Down with Tanner Ainge” and “He’s trying to silence us” and “Vote him out.” One teacher said, “Our classrooms are fuller than this.”
As he left the meeting, Ainge was confronted by a protester who subsequently experienced a panic attack and had be taken to a hospital by paramedics.
KSL.com reports: Denna Robertson, one of the rally organizers, said she’s “absolutely” comfortable sending children back to school without masks. She said wearing masks is not a public health issue because she believes COVID-19 was manufactured in a lab. “Coronavirus is man-made. It’s a weaponized virus,” Robertson said. She accused Dr. Anthony Fauci, the nation’s top infectious disease expert, and business magnate and philanthropist Bill Gates of being part of creating the virus to usher in “a new world order” by reducing the world population to 5 million people. Robertson, who’s also a mother and grandmother, said she isn’t concerned about contracting the virus from one of her grandchildren. “If I’m infected with COVID, it’s because I’ve not been taking care of my immune system. You know how your immune system gets strong? It’s by being in the dirt and getting exposed to bacteria and viruses,” Robertson said.
Watch a report from the local ABC affiliate, and check out a few more reactions from Twitter, below.
Ironically this is the same school district that mandates modesty & punishes attire that “attracts undue attention” including low necklines. I guess collarbones are scandalous but dying from an infectious disease because someone won’t cover their mouth is perfectly acceptable. pic.twitter.com/yQAHbl8nhJ
When did so many Utah County residents stop listening to their Mormon leaders, who asked church members in an email to wear face coverings in public "for the blessing and benefit of all."https://t.co/q4LXlIPHuB
Racism, and being defended to the death by the GOP
On Monday, the Washington Redskins announced it would be choosing a new name, finally caving to activist and sponsor pressure to replace the anti-Native American slur with another mascot. It’s not clear whether the name change will fully root out the problem. Already, the team’s coach has said he wants the new name to “continue honoring and supporting Native Americans,” which suggests some continuation of Native American references in a replacement mascot. The claim that the name somehow “honors” Native Americans also suggests that the team leaders haven’t fully reckoned with the problems with their mascot.
Supporters have made that same defense with increasing intensity in recent weeks, but it is no less galling than the name itself. “The epithet is not, was not and will not be an honorific,” Suzan Shown Harjo, a Native activist who has spent her career challenging American-Indian themed mascots in courts and at universities, wrote in an opinion piece calling for the name to be dropped.
The name change occurred in a summer that America has started a long-overdue reckoning with the question of who we honor, and why. The mass protests following the killing of George Floyd pivoted, soon afterward, to the over 700 statues of Confederate leaders and soldiers still standing in the United States.Supporters of the monuments said that getting rid of them would amount to “erasing” history—not quite the “honor” we hear about with Native American-themed sports teams, but derived from the same instinct to preserve a collective memory, without careful thought to the values these relics also express.
In many ways, the Indian names and the Confederate monuments sound like separate issues. The monuments were dedicated to specific individuals, and in that sense do reflect a real moment in history; the Indian-themed teams and imagery that have come to define large parts of American culture, on the other hand, were not ever about a real historical moment. But it’s fitting that the nation is tackling both at once: Both Confederate monuments and Indian sports teams date back to roughly the same time, about a century ago, when Jim Crow laws were fully taking root, the KKK was flourishing and the West was declared won. Historian Frederick Jackson Turner had called the frontier “closed,” and the last battles and massacres were quickly receding into memory. Indian people were confined to reservations, their children stolen away and placed in boarding schools.
Both the teams and the monuments are expressions of values that date from an earlier time, values intimately connected with two distinct manifestations of white supremacy—slavery and conquest. And both are united by the post-hoc justifications that obscure the original motivations for them. Confederate statues erected in the 1920s weren’t really about the war. And Indian mascots adopted around the same time weren’t really about honoring the spirit of a people.
As most people following the conversation over Confederate monuments know, most of those statues were not built immediately after the Civil War, but rather in the early 1900s and the 1950s and '60s—both times of heated civil rights tension. The first ones were memorials, not monuments, if we take seriously the elegant distinction offered by art critic Arthur Danto: “We erect monuments so that we shall always remember, and build memorials so that we shall never forget.” In other words, memorials are commemorative prompts; monuments assertively demonstrate a community’s cohesion through the honoring of certain events or individuals. The early memorials were associated with cemeteries and gravestones, and it was only in the 1870s and the end of Reconstruction that they began migrating to courthouse lawns and city squares and taking the aggressive shape of the monumental statue. By 1890, with the elevation of Robert E. Lee above what would become Richmond’s Monument Avenue, the movement was in full swing and it continued through the 1930s, sponsored by the United Daughters of the Confederacy and other Southern organizations.
The statues did not really seek to commemorate that old Civil War history. Rather, they asserted the then-contemporary values of Jim Crow segregation while serving as an exclusionary warning to African Americans. “These statues were meant to create legitimate garb for white supremacy,” James Grossman, executive director of the American Historical Association, told NPR. “Why would you put a statue of Robert E. Lee or Stonewall Jackson in 1948 in Baltimore?”
Around the monuments one could build team spirit, a cultural infrastructure of stories, songs and rituals articulating the values of white supremacy. Like a game day pennant, the Confederate battle flag served as a portable bit of memorabilia. You could put it on your house or car—or carry it out of the South, far from the statues. Unity, we are reminded, is not inevitably a force for good. Now, having been pushed to see things anew, many Americans look at the courthouse square and find a clearer vision: those honored men—those mascots of white supremacy—were traitors, slaveholders, racists.
The wave of Confederate statues rose and crested in the same years that Indian sports teams got their nicknames. The Boston Braves began playing under that name in 1871. The Cleveland Indians followed in 1915, and the Chicago Black Hawks in 1926, with the Boston (and soon Washington)Braves adopting the Redskins name in 1933. Throughout the early 1900s, the roster of Indian team names grew to include Warriors, Redmen, Chiefs, Savages, Thunderbirds and Tomahawks. And over the next decades, these bled down to the high school and junior high level, creating an ecosystem of symbols and imagery so dense it came to seem utterly natural and normal.
That symbolic infrastructure extended beyond mascots. It included the Indian head penny and the Buffalo nickel, the Indian-themed summer camp, an “Indianist” movement in music and “primitivism” in painting, exotic tourism to the Southwest, jokes, postcards and novelties, maybe an “Indian Corner” that filled one’s home with Native crafts.
And just like the Confederate statues reflected the triumph of racial hierarchy, Native American team names started in the midst of the final conquest of Western tribes, and intensified after the turn of the century, when Indian people became the objects of nostalgia, pathos and authenticity for white Americans struggling with the trials of modernity. Reservation land that had been held collectively was being divided up into allotments, which were rapidly transferred through graft and force to a new batch of non-Native settlers. And government boarding schools—aiming to use sports, music and vocational training to force Indian assimilation—introduced some of the earliest teams to be named “Indians.” This embrace of the “Indian” is an embrace of an Indian thought to be disappeared. And so, while Confederate monuments celebrate the triumph of one race over another, Native American imagery—while vastly more complicated—also celebrates the conquest of one people at the hands of another.
Washington’s NFL team has announced it will find a new name. So far, the effort seems to be imprisoned by the old language of “honoring” Native Americans. The new name, we are told, will “honor” both Indian people and the military. That combination suggests that the alliterative “Warriors” may lie in D.C.’s future.
But why not let this myth go? A football team’s name does not honor anything, nor should it have to. None of the early sports team nicknames—including all those Indians—aimed to honor. They sought to create an imagined community around the color of their players’ socks. Or local geography or industry. Or charismatic critters. Mascots should be local, quirky, maybe even fun. (Cheers, for instance, for the Traverse City Pit Spitters baseball team!)
Given the history, Washington should flee from anything to do with Native peoples. “Warriors” would be a cynical slap in the face, encouraging fans to continue erasing and dishonoring Indians, now under the banner of a slightly less racist name. Likewise, everyone involved should think long and hard about adopting a name like Red Tails, which has already fallen into the trap of “honoring”—in this case the Tuskegee Airmen. Or even worse, the Codetalkers, after the (mostly) Dine soldiers of World War II. If we want to honor these people, let’s put up new statues. Let’s not pretend to honor them by pasting their names on a football team and making them into mascots.
President Donald Trump said Tuesday he would welcome retired Lt. Gen. Michael Flynn back into his administration now that the former national security adviser’s legal troubles are on the verge of receding.
The president’s comments come as Trump and his allies have worked to lionize Flynn as a victim of "deep state" investigations.
“He’s gone through hell. He’s been destroyed, but he’ll make a comeback,” Trump told CBS News during a Tuesday interview at the White House. “He’s going to make a great comeback.”
When asked whether he would take Flynn back at the White House, Trump replied, “I would.”
Flynn, a former director of the Defense Intelligence Agency, supported Trump’s 2016 campaign and served as the president’s first national security adviser. But the president removed Flynn in February 2017 — less than a month into his tenure — after revelations that Flynn misled Vice President Mike Pence about his December 2016 conversations with then-Russian Ambassador Sergey Kislyak.
Flynn later pleaded guilty to lying to the FBI about the nature of his conversations with Kislyak. The former national security adviser later tried to withdraw his guilty plea before the Justice Department sought to drop its case against Flynn at the urging of Attorney General William Barr.
Last month, Flynn received a boost when a federal appeals court ordered Flynn’s case dismissed. Judge Emmet Sullivan, however, is asking the U.S. Court of Appeals for the D.C Circuit to review the dismissal.
POLITICO recently reported that Trump allies are lobbying the campaign to let Flynn hit the trail for the president.
Trump lavished praise on Flynn in his interview with CBS and said Flynn was mistreated by investigators.
“I think he’s a great gentleman. He’s been in the military for many, many decades, actually,” Trump told CBS. “Highly respected. What Gen. Flynn went through is so unfair. And he’s still going through it.”
Trump’s warmth toward Flynn mirrors his public feelings toward some other former advisers who were investigated by prosecutors. Last week, Trump commuted the prison sentence of Roger Stone, his longtime informal political adviser who was found guilty of impeding investigations into alleged ties between the Trump campaign and Russia.
Two advocacy groups have filed a complaint with the Department of Homeland Security watchdog saying that U.S. border officials forcibly separated a pregnant Honduran asylum-seeker from her family after they asked for safety at the U.S. border, ultimately forcing her and her U.S. citizen newborn back into Mexico just two days after she gave birth in a U.S. hospital.
“The Office of Inspector General complaint calls for an urgent investigation of the U.S. Border Patrol’s treatment of this family, including the forced expulsion of the newborn U.S. citizen and his mother to Mexico, as well as the forced removal of the father and son,” the Jewish Family Service of San Diego (JFS) and ACLU Foundation of San Diego & Imperial Counties (ACLUF-SDIC) said. They wrote “both the father and mother expressed their fear of returning to Mexico,” but were sent back by officials anyway.
The Jewish Family Service of San Diego and ACLU Foundation of San Diego & Imperial Counties said in a statement that the then-pregnant mother, partner, and 9-year-old son fled to the U.S. a year ago, “after gangs extorted them, made repeated death threats, beat the nine-year old with a gun (requiring several stitches) and took over their house.” But like tens of thousands of other asylum-seekers, the family was forced by the Trump administration to wait out their cases in Mexico.
When March came around, the family followed the rules and boarded a taxi to go to a U.S. port of entry to be escorted to their immigration hearing, only to be “accosted and detained by a group of armed men who attempted to extort them,” the document said. “They were detained by these men for more than an hour before they were finally freed.” Not only had they been violently accosted, the family later found out their court date had been cancelled due to the novel coronavirus pandemic. No one from the government had told them.
No longer able to tolerate unsafe conditions while still waiting in Mexico, the family again tried to present themselves to U.S. officials on June 27. “The Border Patrol immediately separated the family,” JFS and ACLUF-SDIC said in the statement.
“The mother, who was experiencing pain after falling during their journey, was sent to the hospital. Despite their objections, the father and son were forced to return to Mexico in the middle of the night. At the hospital, the mother gave birth to her son—a natural-born U.S. citizen. Two days later, the Border Patrol forced both to return to Mexico as well. Notably, this U.S. citizen child does not have legal immigration status in Mexico.”
The groups said that during each encounter with U.S. border officials, the family insisted they were scared of being sent back to Mexico. They were ignored in violation of law, the organizations said: “The complaint notes that the Border Patrol twice failed to ensure that the family had access to non-refoulement interviews, a violation of U.S. law and agency policy.”
This family that now includes a U.S.-born citizen is still waiting in Mexico, unlawfully sent back to danger.
“This case reflects many of the lived horrors of both the so-called ‘Migrant Protection Protocols’ and Border Patrol impunity,” ACLUF-SDIC senior staff attorney Mitra Ebadolahi said in the statement. “No family should have to endure what this family has experienced. Together with Jewish Family Service, we are demanding a full investigation. The agency must be held to account for its disregard of basic human rights and its policy and legal transgressions.”
A health care worker in the Covid-19 Unit at United Memorial Medical Center in Houston, Texas, on July 2. | Mark Felix/AFP via Getty Images
If hospitalizations continue to rise, health care workers in Arizona, Texas, and California fear they’ll be completely overwhelmed.
With Covid-19 hospitalizations steadily approaching a record high in the US, states like Arizona have activated emergency plans and requested refrigerated trucks to prepare for overflow at morgues. Doctors there say packed emergency rooms and ICUs are forcing them to prioritize the sickest patients, leaving other ill patients to deteriorate while waiting for care they’d ordinarily receive right away.
Hospitals in hot spots across the country are expanding and even maxing out their staff, equipment, and beds, with doctors warning that the worst-case scenario of hospital resources being overwhelmed is on the horizon if their states don’t get better control of the coronavirus.
“With Covid, a lot of times people who aren’t sick enough yet get pushed to the back, and then they can become really, really sick unfortunately because we were focusing our efforts on the people who are on the brink of death,” an emergency room doctor at the Banner Health system in the Phoenix metro area, who asked to go unnamed fearing retaliation from his employer, told Vox.
“The fear is we are going to have to start sharing ventilators, or we’re gonna have to start saying, ‘You get a vent, you don’t.’ I’d be really surprised if in a couple weeks we didn’t have to do that,” says Murtaza Akhter, an emergency medicine physician at Valleywise Health Medical Center in Phoenix.
It’s not just Arizona. Doctors and hospital experts in Texas and Southern California say capacity is a major concern for them as well, particularly if new daily cases keep rising. Several counties in California are facing major outbreaks of the virus, with hospital resources stretched thin to care for the sickest patients.
States have started to roll back their reopenings in recognition of the intensity of current transmission. California Gov. Gavin Newsom announced Monday he would order some businesses to close again. Texas Gov. Greg Abbott has finally issued a statewide mask mandate and closed certain establishments. Arizona Gov. Doug Ducey also reimposed some restrictions, though has refused to require residents to wear masks in public spaces, instead asking for voluntary compliance with public health experts’ advice.
The question is, will it be enough?
“If things continue to get worse,” John Swartzberg, a clinical professor emeritus at UC Berkeley’s School of Public Health, says, medical care for Covid-19 patients “will get much more draconian.”
When New York and New Jersey raced to expand hospital capacity in April to handle the crush of Covid-19 patients, Sunbelt states largely avoided the big spring wave. But after their governors moved forward with reopening in May even though they didn’t meet the public health criteria set by the federal government to stay safe, three states in particular — Arizona, Texas, and Florida — saw significant increases in new cases.
Experts say these outbreaks are largely driven by people flocking to newly reopened restaurants, bars, gyms, and other high-risk indoor spaces, as well as weakly enforced or nonexistent face mask mandates. Now, with new cases and hospitalizations rising in 44 US states and territories, many fear some hot spots may be faced with even bigger surges, with less ability to expand capacity than hospital-dense New York City.
Hospitalizations nationwide are now quickly on their way to exceeding the peak of 59,539 on April 15, hitting 56,147 on Wednesday, according to the Covid Tracking Project.
Christina Animashaun/Vox
Hospital organizations in Florida say facilities there can still expand capacity if needed. But they, like other hot spot hospitals, are starting to cut back on elective surgeries and procedures — leading them to furlough staff in some cases to compensate for massive losses in revenue — to accommodate the rising tide of Covid-19 patients.
And most worrying for the states now battling major outbreaks is that, unlike in April, when most of the country was in lockdown, there’s no clear sense of when the current outbreaks will peak or decline. With only partial social distancing measures in place and inconsistent mask use, the virus may continue to spread, leading to an unabated wave of severe illness requiring hospitalization, more deaths, and more long-term complications requiring medical care.
Here’s a closer look at how some hospitals in Arizona, Florida, Texas, and Southern California are handling the pressures of the latest surge of Covid-19 patients, and why it may get worse in the coming weeks.
Arizona doctors say the surge is forcing them to make brutal decisions in patient care. Meanwhile, morale is dangerously low.
As Vox’s German Lopez has reported, Arizona’s Covid-19 outbreak has lately been the worst in the country, with the highest test positivity rate of all the states: 24.7 percent of tests coming back positive (nearly five times the recommended maximum of 5 percent), compared with 18.7 percent in Florida and 17 percent in Texas, according to Johns Hopkins.
It also, until very recently, had the highest number of daily cases per 100,000 people. (As of Wednesday, Florida was in the lead, with 54 new cases per day per 100,000 people, compared with Arizona’s 48, according to data compiled by the Washington Post.)
Whichever metric you’re looking at, the implication is the same: The virus continues to spread rapidly in the state, despite the governor’s (relatively weak) efforts to discourage indoor gatherings and ensure widespread face mask use since reopening. Meanwhile, hospitalizations are rising steeply following the upward trend in new cases. The heat wave underway, which is forcing more people indoors, isn’t helping, either.
The unchecked transmission of the virus in the state and resulting pressure on hospitals are particularly infuriating to some emergency room and ICU staff, who say they are losing hope that they will get any relief from the surge of severely ill Covid-19 patients anytime soon. And they’re having to make decisions on the fly that they’re uncomfortable making.
“Sending people with Covid home with oxygen tanks because we don’t have the resources for them? This is something I’ve never done in my life before,” says Akhter of Valleywise Health. “This is crazy. And this is gonna be even worse in a couple of weeks. So far we’re trying to hold steady, but how long will that last?”
The psychological toll, he says, is serious too.
“To come off a shift and be like, ‘I’m losing hope’ — that’s a dangerous place to be in,” he says. “I don’t want to feel that way. And that’s because despite the horrible numbers, despite the fact I’m still getting the Covid cases [in the ER], despite what we’ve been saying to the media from the front line, I drive home from work and I literally see lots of people congregating together closely and in the grocery store not wearing masks.”
Another ICU doctor in Phoenix, who spoke on the condition of anonymity because his employer has forbidden staff to speak to the media, described increasingly low morale among health care workers in the state.
“I think a lot of us feel as if our community has abandoned us almost, because there’s a lot of fake news about how masks are not helping the spread,” he says. “I think there’s just a sense of abandonment almost where we feel like we don’t have the support of our community; this individual selfishness that we’re seeing in society is really upsetting. And I think psychologically it’s really affecting a lot of my nurses and staff.” Some of them, he says, are so frustrated and worried about getting sick themselves that they’re not coming to work as much, calling in sick, or just cutting their hours.
Akhter thinks there are a lot of people in Arizona who still don’t believe Covid-19 is bad. “If their mother gets sick, even with non-Covid, with appendicitis, for example, what do they think is going to happen if there are no hospital beds? I don’t know what else to say other than, like, ‘What if your loved one gets sick, where do you think she’s gonna go?’”
Some of his colleagues in emergency and critical care medicine say they are already running out of ICU beds. “We have patients who are admitted to the ICU, but there isn’t a physical ICU bed for them,” says the ER doctor at Banner Health who asked not to be named. “So they physically stay in the ER. And they have been staying in the ER for over 24 hours because there is nowhere else for these patients to go. And then we’re using ventilators that have previously been retired, that are more likely to cause lung injury on patients, because, again, there’s no other option, no other way.”
The crunch on beds is getting so tight that Tucson Mayor Regina Romero recently told CNN that Pima County might have to send patients to other states for care. “Any day, we’re going to have to be sending patients to other states because of our lack of capacity,” she says.
Banner Health system, the largest hospital network in the state, says it has been able to expand capacity so far to keep up with the heightened demand from Covid-19 patients, moving them and resources between hospitals to keep volumes balanced and manageable. In recent weeks, it has also brought in about 400 travel nurses and respiratory therapists from out of state, spokesperson Becky Armendariz told Vox over email. But she didn’t rule out the possibility of exceeding capacity. “It is certainly possible for us to reach max capacity if the trend in cases continues.”
The only way to avoid that at this point, the doctors say, is for more people to start wearing face masks and for officials to enforce mandates at the city level.
“If Arizona does not mask up, we are in big, big trouble,” says the ICU doctor. “That’s the ground reality of the situation.”
Florida hospitals are walking a path “with a precipice on either side”
In terms of sheer numbers of new cases, Florida — the third most populous state in the country — has consistently been in the lead this summer, with a record high of 15,300 new daily cases on Saturday. (On Tuesday, the number of new daily cases fell to 10,101.) More than 4,400 Floridians have died due to the virus, with an average of 81 deaths per day in recent weeks.
According to Justin Senior — CEO of the Safety Net Hospital Alliance of Florida, which advocates on behalf of 14 hospitals in the state that provide care regardless of patients’ ability to pay — the state’s hospital capacity has not been reached yet and there will still be many hospital and ICU beds available if hospitalizations continue to rise rapidly.
Even so, Senior says hospitals are in a precarious place, “with a precipice on either side” as they try to juggle the needs of non-Covid-19 patients with the rising number of Covid-19 patients. If they postpone elective procedures, like certain surgeries, they lose revenue at a time when they’re still reeling from losing, by his estimate, $5 billion to $6 billion overall from March to May when the state shut down. If they don’t postpone those procedures, it’s harder to care for patients in a Covid-19 surge, he says.
“This is the path that the hospitals are trying to walk, because you don’t want another shutdown completely when there aren’t enough patients to avoid layoffs and avoid a really bad financial situation on one side, and of course, overcapacity and overtaxing of resources with too many Covid patients on the other side,” he says.
In Florida, Senior says, staff is the biggest concern for hospitals at the moment — in particular making sure that they don’t burn out and have enough PPE to stay protected from the coronavirus. “This is a really stressful situation, and there’s a real recognition of that.”
According to CBS Local in Miami, Florida Gov. Ron DeSantis has requested that the Federal Emergency Management Agency (FEMA) send 1,500 nurses to the state to relieve the pressure on overworked hospital staff. “As of Monday morning, FEMA had not approved the request,” CBS reports. “DeSantis, meanwhile, said he is sending 100 nurses under contract with the state to Miami-Dade County.”
Some hospitals, particularly in Miami-Dade County, are already dialing back on some elective procedures to lessen the strain on staff and other resources. “The next step would be to declare surge capacity — this actually creates additional capacity by allowing a hospital to temporarily deal with an emergency by doubling up patient rooms and relaxing staffing ratios to exceed the hospital’s normal bed count,” he says. “You can’t keep that up for long. A final step would be to bring in field hospitals and significant outside resources.”
On Monday, Senior warned Vox that he was worried about hospitalizations exceeding 500 per day. “If daily hospitalizations shoot up over 500 a day, there will be serious stress ahead,” he says. “800 or 1,000 and it will be a wild ride.”
Unfortunately, the state is heading in that direction. On Tuesday, Florida hit 533 hospitalizations:
“If it grows exponentially from here, there’s no denying, you know, we’re gonna have to relook at everything at the beginning of August,” Senior notes.
Texas hospitals warn they are running out of staff, PPE, drugs, and other supplies
Texas hospitals thought they had already seen the worst of Covid-19 in the spring. This latest surge has surpassed that first surge several times over.
During the first wave, from late February to early May, Houston Methodist Hospital peaked with about 250 coronavirus patients. Today, they have nearly 700. “There are too many Covid patients, full stop,” Roberta Schwartz, executive vice president at Houston Methodist, told me. “We ran full before, we’re running full-plus now.”
Their experience mirrors the statewide trends: Hospitalizations in Texas had topped out at about 1,800 in early May, but now, after cases began to accelerate dramatically, they’ve surpassed 10,000.
“Every day, or every other day, we’re turning another unit of this hospital into Covid units,” Schwartz says. “It’s slowly starving out the other services that we offer.”
She ticked through the list: Half a dozen of the hospitals’ medical surgical units are now being used to house Covid-19. An orthopedics unit has been shut down and flipped for patients who require high-oxygen flow. Cardiology units have also shortened their surgery schedules so that their space can be used for the coronavirus surge.
Schwartz and John Henderson, president and CEO of the Texas Organization of Rural and Community Hospitals, say their hospitals are in better shape now with personal protective equipment than they were in March and April.
But that could change as the crisis gets worse. Schwartz says her facilities have sometimes had trouble getting gowns and disinfectant wipes. Henderson says he “got a couple of SOS calls this week.”
Staffing is a universal problem. Houston Methodist has already brought in out-of-state nurses and asked its administrative staff with nursing certifications to start doing medical work again. Nurses are also being asked to work longer and overnight shifts.
Rural hospitals in Texas aren’t running out of beds yet, but they are running into a staffing shortage. These facilities might typically have five patients in a given unit, and the hospitals have staffed them accordingly. But now, there might be as many as 20 patients.
“You’re working every nurse as much as you can work them and still not meeting the need,” Henderson says.
It’s not clear where more staff could come from. The state has already sent about 2,300 volunteers to the Rio Grande Valley, one of the hardest-hit areas in the state.
“Other areas are requesting that workforce support,” Henderson says. “But there’s not much more in terms of resources to be sent.”
Another concern is ventilators. Rural hospitals in Texas would ordinarily transfer their patients in serious condition, the kind who might be on a ventilator for days, to a larger hospital in the city. But because urban hospitals are already overrun with Covid-19 patients themselves, there is nowhere for the rural hospitals to send their patients. Instead, they are forced to keep those patients, causing their beds to fill up even more quickly.
And while the current coronavirus patients are younger than those seen in the spring, Henderson says his hospitals don’t have enough of the nasal oxygen hookups that are used to help those patients breathe on their own and prevent them from being put on a ventilator.
“They’ve shown to be effective but everybody’s trying to get them,” he says.
Hospitals are putting lessons from the early weeks of the crisis to use. Remdesivir, an antiviral treatment prescribed to Covid-19 patients with low blood oxygen or who need breathing assistance from a mechanical ventilator, is protocol now. The University Health System in San Antonio, which got firsthand experience in the initial wave when it was asked to treat some of the first patients from Wuhan and the Diamond Princess cruise ship, has adapted its standard of care to include remdesivir, anti-inflammatory drugs, and putting patients on their stomachs to help them breathe. They have also reduced their use of ventilators, only using them when absolutely necessary.
But those improvements in treatment require adequate staffing and supplies to implement them. And as the crisis grows, supples are starting to run low.
“We still don’t have a steady stream of enough remdesivir,” Schwartz at Houston Methodist says.
That is the situation on the ground as of early July. Cases are continuing to climb in Texas, and more people are expected to end up in the hospital as a result. The emergency plan to set up temporary facilities in convention centers or sports venues is suddenly on the table.
Hospitals like Memorial Hermann in Houston have already activated their surge capacity plans, but that might not be enough if current trends continue.
“We remain concerned about the current growth rate in new cases and the demand for hospitalization, as we could reach the limit of our surge expansion plans if the current trends do not reverse,” Drew Munhausen, a spokesperson for the hospital, says in an email.
The hope is that new cases will start to level off soon, now that Gov. Abbott has reimposed some social distancing restrictions and established a statewide mask mandate. But for now, Texas hospitals are just waiting and hoping and preparing.
“If you’re counting hospital admissions and ICU patients on vents, you’re weeks behind. We’re chasing it right now,” Henderson says. “There’s no optimism today for what the rest of July looks like.”
The worst-case scenario, in these moments, is that people will die who otherwise wouldn’t have because the shortage of beds or supplies or staff will lead to suboptimal care.
Even fear itself can be devastating to public health. As ProPublica and NBC News reported, the number of Houstonians dying at home has spiked in recent weeks, suggesting people who either had Covid-19 or another life-threatening condition didn’t make it to the hospital in time.
“When you are unable to take care of patients in the optimal circumstances, you do worry that you are not able to do as good of a job in not-optimal circumstances,” Schwartz says. “And we are about to get into not-optimal circumstances.”
It could be a difficult few weeks ahead. Youyang Gu’s Covid-19 Projections currently expects cases in Texas to peak at the beginning of August and deaths to peak in mid-August.
In Imperial County, California, a run on ventilators
El Centro Regional Medical Center in Imperial County, one of California’s biggest Covid-19 hot spots right now, has already brushed up against its worst-case scenario.
About 60 percent of the patients in the medical center were infected with the coronavirus as of last week, and there aren’t enough ventilators, Adolphe Edward, the hospital’s CEO, told Vox. The medical center serves a largely Hispanic community, with many patients who have diabetes or other preexisting conditions that make them more vulnerable to the virus and who require mechanical ventilator support for their breathing when the disease takes a turn for the worse.
The hospital recently saw its available ventilators dwindle to one. Edward convened an impromptu committee to evaluate the patients currently on ventilators so they could prioritize if another patient who needed one came through their door. They checked their lung capacity and considered whether they could risk taking one or two of the patients off the ventilator if the need arose.
Luckily, Edward figured out a workaround. He called another nearby hospital and asked if they had any ventilators available. They had two, which they shipped over to El Centro. For now, the machines are still there, though Edward says he and the other hospital have stayed in constant contact in case the ventilators need to be transferred again.
Edward sounds exasperated describing that makeshift solution and he wonders why the federal government hasn’t started manufacturing “half a million or a million” ventilators to meet the need that hospitals like his have.
“Somebody’s gotta figure that out,” he says. (The Trump administration signed contracts in April under the Defense Production Act that are supposed to yield a little fewer than 150,000 ventilators by the end of 2020.)
Statewide, only about 30 percent of all available units are currently in use, according to NPR. But there have been surges of patients in some regions like Imperial County that have nearly overwhelmed local hospitals. About 30 percent of ICU beds are still open statewide as well, but those numbers could start shrinking as the state outbreak shifts from the younger cohort less prone to serious complications to older people who are more likely to require hospitalization and ventilation.
A California plan to stockpile ventilators never materialized, and the available capacity could be stretched with the hardest-hit areas exporting their patients to facilities in other parts of the state.
El Centro Regional Medical Center is moving patients out of its building at a rate Edward would ordinarily have found unfathomable. During normal times, the hospital might send out one or two patients a day, he says. Nowadays, they’re averaging between six and eight.
“If you had told me at the beginning we’d be transferring that many patients, I would have told you: I don’t know what you’re drinking,” Edward says.
For the time being, hospitals elsewhere in the state have the extra space to accommodate them. But the worry is if the outbreak keeps spreading, that excess capacity will evaporate very quickly.
New Covid-19 cases and deaths in California are currently expected to peak by August or early September, according to Youyang Gu’s Covid-19 Projections, meaning the new surge has not peaked yet.
More hospitals could be faced with the kind of difficult decisions that Edward and his team were nearly forced to make.
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Anthony Fauci isn’t about to quit, despite the White House’s clumsy attempts to stain his public image. More so now than at any other point in their uneasy partnership, it seems that if President Donald Trump wants to be rid of Fauci, he’ll need to fire him. In recent days especially, the White House has stepped up efforts to discredit Fauci, a move he describes as “bizarre.”
“Ultimately, it hurts the president to do that,” Fauci told The Atlantic in a series of interviews this week. “When the staff lets out something like that and the entire scientific and press community push back on it, it ultimately hurts the president.”
He described the White House attacks against him as “nonsense” and “completely wrong.” He also seemed dismayed that they are coming at a time when COVID-19 is surging across the country, deaths are once again rising, and Americans remain deeply confused about how to keep themselves and their loved ones safe.
Targeting Fauci seems like a tragic misuse of White House time and energy if officials’ aim is to defeat the coronavirus. But Trump appears more concerned with discrediting Fauci. Over the weekend, the White House sent multiple news outlets a document that smacked of opposition research. It carried a list of statements Fauci had made about COVID-19, purporting to show that he had contradicted himself about the outbreak and that he “has been wrong on things.” In one example from an NBC interview in February, the White House omitted Fauci’s full quote, giving the impression that he’d misjudged the outbreak’s danger. Peter Navarro, Trump’s top trade adviser, wrote an op-ed for USA Today yesterday claiming that Fauci has been “wrong about everything I have interacted with him on.” (A Trump communications aide tried to distance the White House from the op-ed this morning.)
The attempt to discredit Fauci’s public-health expertise is a political move, and one with disastrous implications. As much as Trump wants and needs Americans to see the virus as a nuisance that’s soon to be overcome, Fauci is a recurring reminder that the crisis remains a grave and enduring threat, and that Trump has mishandled the pandemic. The Americans who believe the White House’s anti-science campaign risk cutting themselves off from potentially life-saving information.
“I cannot figure out in my wildest dreams why they would want to do that,” Fauci told The Atlantic, in reference to the White House document. “I think they realize now that that was not a prudent thing to do, because it’s only reflecting negatively on them.
“I can’t explain Peter Navarro,” he added. “He’s in a world by himself.”
My colleague Ed Yong and I spoke with Fauci in two interviews over the past 24 hours—about the oppo against him, the private discussion he had later with White House Chief of Staff Mark Meadows, and the nation’s faltering response to the virus’s resurgence. What follows is an edited and combined transcript of our conversations.
The Atlantic: In your 36-year history as director of the National Institute of Allergy and Infectious Diseases, has anything like this ever happened to you? What do you think about the White House’s claim that you made inaccurate statements about the pandemic?
Anthony Fauci: I stand by everything I said. Contextually, at the time I said it, it was absolutely true … [The White House document] is totally wrong. It’s nonsense. It’s completely wrong. The whole thing is wrong. The whole thing is incorrect.
The Atlantic: You are the government’s top health adviser, and the government you’re trying to advise is actively trying to discredit you. How do you work like that?
Fauci: Well, that is a bit bizarre. And I have to tell you, I think if I sit here and just shrug my shoulders and say, “Well, you know, that’s life in the fast lane ...”
I think if you sit down and talk to the people who are involved in that list that came out, they are really, I think, taken aback by what a big mistake that was. I think if you talk to reasonable people in the White House, they realize that was a major mistake on their part, because it doesn’t do anything but reflect poorly on them. And I don’t think that that was their intention. I cannot figure out in my wildest dreams why they would want to do that. I think they realize now that that was not a prudent thing to do, because it’s only reflecting negatively on them.
I can’t explain Peter Navarro. He’s in a world by himself. So I don’t even want to go there.
The Atlantic: You met Monday with Mark Meadows, the White House chief of staff. What did you tell him?
Fauci: I said that that was not particularly a good thing to do. Ultimately, it hurts the president to do that. When the staff lets out something like that and the entire scientific and press community push back on it, it ultimately hurts the president. And I don’t really want to hurt the president. But that’s what’s happening. I told him I thought it was a big mistake. That doesn’t serve any good purpose for what we’re trying to do.
The Atlantic: Did Meadows offer an explanation or an apology?
Fauci: No. There was no apology. He said that he didn’t know about it.
The Atlantic: Given this experience, do you still want to work with the administration? Have you thought about resigning?
Fauci: No. I think the problem is too important for me to get into those kinds of thoughts and discussions. I just want to do my job. I’m really good at it. I think I can contribute. And I’m going to keep doing it.
The Atlantic: There’s been some reporting that the Trump administration has tried to cut back on your TV interviews. Isn’t it important at this moment for the nation and the world to hear from you?
Fauci: I can’t make a comment on that, but I think you know what the answer to that is.
The Atlantic: Can you update us on your relationship with the president?
Fauci: Well, the scene has changed a bit. When we were having frequent press briefings, I had the opportunity to have a personal one-on-one to talk to the president. I haven’t done that in a while. But a day does not go by that I am not in contact with Debbie Birx [the White House coronavirus-response coordinator], with Bob Redfield [the director of the Centers for Disease Control and Prevention], or Steve Hahn [the commissioner of the Food and Drug Administration] and others. My input to the president goes through the vice president. But clearly, the vice president—literally every day—is listening to what we have to say, there’s no doubt about that.
The Atlantic: Do you know why it is that you don’t talk to President Trump more often?
The Atlantic: Everyone who knows you has talked about the fact that you are indefatigably honest; that is your reputation, someone who always tells the truth. Can you tell us the truth about the federal response to the pandemic?
Fauci: When you look at the numbers, obviously, we’ve got to do better. We’ve got to almost reset this and say, “Okay, let’s stop this nonsense.” We’ve got to figure out, How can we get our control over this now, and, looking forward, how can we make sure that next month, we don’t have another example of California, Texas, Florida, and Arizona? So rather than these games people are playing, let’s focus on that.
The Atlantic: How much worse do you expect the pandemic to get? How do we get back to a better place?
Fauci: By pushing a reset button, I don’t mean everybody locking down again. We’ve got to call a time-out and say, “If you’re going to open, we’ve got to get everybody on the same team.” I’m not going to name any states—that’s not helpful—but some states did, in fact, prematurely jump over some checkpoints.
Even though we are in the middle of a setback now—you can’t deny that; look at the numbers, you’re dealing with 40,000 to 60,000 infections in a day—it doesn’t mean we’re going to be defeated. But states that are in trouble right now, if those states pause and say, “Okay, we’re going to do it right, everyone wear a mask, bars closed, no congregating in crowds, keep your distance, protect the vulnerable”—if we do that for a few weeks in a row, I’ll guarantee you those numbers will come down.
The Atlantic: We recently published a piece about burnout among public-health experts trying to fight this pandemic. You clearly have been very much a part of that. How are you doing? How are you coping?
Fauci: I’m doing okay; I’m doing fine. I am running a bit on fumes, but as they say, the fumes are really thick. It’s enough to keep me going. I wish we didn’t have a lot of those distractions, which I think are noise that gets in the way. But I put that aside, try not to let it bother me, and just move ahead.
Hovertext: Maybe there's a multiverse out there, just so you can know that some you somewhere didn't do that one embarrassing thing you always think about.
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