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Hospitals suffer 46% spike in Covid-19 patients

MILWAUKEE – The patient who died Tuesday morning at Aurora St. Luke Medical Center was taken out of her room under a white sheet. A nurse, holding back tears, stood silently in the hallway as the outline of the body passed – one more death in an eight-month pandemic that has no end in sight.

“Those moments struck the soul,” said Jodie Gord, a nurse manager who oversees a team of about 120 people at Milwaukee Hospital.

The Aurora St. Luke is far from the only one to be put to the test. Hospitals across the United States are reeling from the rampant spread of the coronavirus, many of which are in areas of the country that had initially been spared the worst.

As election day approaches, President Trump played down the sharp rise in cases, attributing much to an increase in testing. But the number of people hospitalized with the virus tells a different story, increasing by around 46 percent from a month ago and raising concerns about the ability of regional health systems to meet overwhelming demand.

The explosion in the number of cases indicates a new volatile phase of the pandemic, after previous waves hit major cities such as New York, then Sun Belt states like Florida and Arizona. As some of these places have started to get the virus under control, rising hospitalizations are crippling some cities with fewer resources.

In El Paso, where the number of people hospitalized for Covid-19 has more than tripled in the past three weeks, doctors at the University Medical Center have started airlifting some patients to hospitals as far as San Antonio while treating others in a field hospital in a nearby parking lot. Across the border in Mexico, the mayor of Ciudad Juárez, himself hospitalized after testing positive for the virus for the second time, is calling for a temporary ban on US citizens from entering his city.

“We’ve never seen this in El Paso,” said Dr. Joel Hendryx, chief medical officer of the University Medical Center, one of the largest hospitals along the border. Citing the need for field hospitals, Dr Hendryx contrasted starkly with the city’s earlier push in July, when mitigation measures lowered the number of cases.

Dr Hendryx’s hospital had 195 cases of the coronavirus hospitalized on Tuesday compared to 30 about a month ago. In addition to the parking lot tents, El Paso officials are converting the downtown convention center into a 50-bed hospital. Hundreds of health workers from other parts of Texas are deploying to El Paso, including an ambulance strike team with paramedics from the Houston area.

The situation is also becoming critical in states such as Idaho, Missouri, New Mexico and Utah, with frontline workers exhausted and hospitals struggling to find replacements for those who test positive every day.

At St. Luke’s Magic Valley Medical Center in Twin Falls, Idaho, where more than a third of patients have Covid-19, administrators send children to a hospital in Boise, a two-hour drive away. The influx of patients from rural areas with poor health infrastructure is also weighing on hospitals in Wisconsin, where cases are up 53% from two weeks ago.

Nationwide, the number of cases has reached frightening new levels in recent days, with the seven-day average of new cases surpassing 70,000 for the first time in the pandemic. Twenty-six states have reached or near a record high number of new infections. More than 500,000 cases were announced last week. And exactly zero states are seeing sustained declines in the number of cases.

On a per capita basis, small towns and rural counties in the Upper Midwest and Mountain West are in greatest difficulty. North Dakota, South Dakota, Wisconsin and Montana lead the country in terms of new infections per capita. Of the 12 metropolitan areas with the highest rates of new cases in the past two weeks, 10 are in North Dakota or Wisconsin.

But the dismal trend lines are not limited to these regions. North Carolina, New Mexico, Pennsylvania, Rhode Island and West Virginia recently set seven-day records for new cases. And more and more big cities are starting to take off, with alarming trends emerging in Chicago, Milwaukee and Newark.

And while the increase in the number of cases has not been accompanied by a sharp increase in deaths, that trend is starting to change. Around 800 deaths are now recorded across the country every day, far less than in the spring but up slightly from the start of the month.

Cities across the country are rushing to impose new restrictions. In Idaho, Gov. Brad Little backed off on the reopening, but stopped ahead of a statewide mask tenure. Mr Little limited indoor gatherings to 50 people, demanded masks in long-term care facilities and imposed new restrictions on how bars and restaurants could serve their customers.

In Newark, all non-essential businesses will be required to close at 8 p.m. starting Tuesday. Chicago Mayor Lori Lightfoot has imposed a curfew under which non-essential businesses must close from 10 p.m. to 6 a.m., and bars without a food license are no longer allowed to serve customers inside.

In Fargo, ND, Mayor Tim Mahoney used his emergency powers to serve the state’s first mask term. The mayors of Nixa and Ozark in Missouri have imposed mask warrants after calls from nearby hospitals overwhelmed by coronavirus hospitalizations.

On one of the floors of the intensive care unit at Aurora St. Luke in Milwaukee, the mood was grim Tuesday morning as doctors and nurses made their rounds. Twenty of the 24 beds were full and many patients were on ventilators.

But the staff put on a brave face. They gave patients in the hallways a thumbs up, entered the rooms to greet others, and helped a woman eat breakfast.

Before noon, an older woman was transferred to the ICU from the Covid-19 floor. Within 30 minutes of her arrival, a beep sounded sent staff members running into her room, frantically grabbing personal protective equipment.

The patient’s oxygen levels had dropped to dangerously low levels, and she was going into cardiac arrest. A nurse practitioner called the patient’s family, making it clear that there was a possibility that they might not.

A staff member cut back on the woman in hopes of keeping her alive. After several minutes, his condition stabilized – for now.

She was the second patient to need such care in just three hours. When the nurses and doctors moved away to breathe, the woman was lying on the bed, now intubated, her eyes glassy and her face pale. It was difficult to see clear signs of breathing.

Some of the staff patted each other on the back. Others took deep breaths. A healthcare worker came out of the patient’s room, holding a small plastic bag in his hand. Inside was jewelry to give to the family, said Ms Gord, the nurse in charge, in case the woman died.

Staff still appeared to be in shock over the death of the other patient that morning. She had become dear to the intensive care team, said Ms Gord, who stood quietly and with obvious emotion as the stretcher passed. “Bless her soul,” she whispered. “Sweet little lady.

Staff members said they were struggling with constant exhaustion. “What will happen when we can’t take care of these patients?” said Dr Pedro Salinas, an intensive care specialist, who is worried about how long the staff can take. “They are emotionally and mentally exhausted.”

The prospect of ending up in an overcrowded hospital ward makes some virus patients reluctant to register. At El Paso hospital, staff said some Covid-19 patients were arriving at the emergency room so weakened they needed it. intubation almost immediately.

Sandra Garcia, 31, an El Paso resident who tested positive for the coronavirus last week, said she had struggled with fatigue, shortness of breath and loss of taste and smell, but had refrained from seeking treatment in crowded city hospitals.

In the meantime, she is caring for a 13-year-old girl who also has Covid-19 and 5-year-old twins, who are all studying online from home. Ms Garcia said she wondered why Dee Margo, the mayor of El Paso, had not ordered the city to be closed to curb the spike in cases.

“He’s just trying to get re-elected and it’s disgusting,” Ms. Garcia said.

Last week, Mr. Margo announced new restrictions such as closing parks to the league and tournaments, but said an order for the city’s complete closure is expected to come from the governor of Texas.

Dr German Hernandez, a nephrologist who has treated patients at several hospitals in El Paso, said the situation was so dire that patients on oxygen were being kept in rooms in the trauma area of ​​the university medical center. He said it could be devastating in the event of a disaster such as the August 2019 mass shooting at a Walmart in the city that left 23 people dead.

“God forbid that we have another shoot on August 3 because we can’t handle it right now,” Dr Hernandez said. “We don’t have a tampon.”

Giulia McDonnell Nieto del Rio reported from Milwaukee, Simon romero from El Paso and Mike Baker from Seattle. Erin Coulehan contribution to El Paso reports, Mitch smith from Chicago, and Lucy tompkins from New York.

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I agree with this message. Now remember your secret envelope.

welcome to On politics. I’m Nick Corasaniti, your host on Tuesdays for all media and messaging coverage. I’m writing from Philadelphia, where I moved for the rest of the race and where I fed heavily on the real Philadelphia sandwich: roast pork, provolone, and broccoli rabe!

The warning was familiar to all Pennsylvania voters who suffered a commercial break this fall – “I’m Joe Biden, and I approve of this message” – but the publicity that preceded it did not take hold. view of President Trump’s leadership, nor did he offer any testimony to the good faith of Mr. Biden’s middle class.

Instead, a blue outline of the state of Pennsylvania appeared on screen, and a narrator calmly explained the importance of making sure anyone voting by mail correctly uses the secret envelope.

With just one week of the end of a multibillion-dollar political advertising season, campaigns have started using their paid media operations to boost their voting efforts. Like so many others in 2020, it’s a change from the norm: Traditionally, campaigns have relied on their field teams on the ground, not their TV commercials, to try to get voters to the polls. .

But a few unique elements of this election make advertising for the vote a necessary expense. First and foremost, in the midst of a pandemic, operations on the ground cannot knock on doors and provide rides to polling places on the scale needed for a modern campaign.

And with the electorate increasingly polarized, all the closing ads aimed at persuading undecided voters are fighting for a relatively small audience.

“There just aren’t that many compelling targets,” said Michael Beach, a Republican advertising strategist. “Even in television commercials, early voting was mentioned in many of these commercials, and traditionally it would not have been.”

With so many people voting by mail this year, campaigns have new opportunities to keep tabs on voters throughout stages of the process – by sending voters targeted ads encouraging them to request ballots, then sending them back. encouraging the return of these ballots.

Most “chase” programs, as they are called, are run online, often through Facebook. Because many states offer data on who requested and returned a ballot, campaigns can target ads directly to those voters on Facebook. Once a voter returns a ballot, campaigns can remove that person from their target list and not waste money on a vote already cast.

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“We can target you every step of the way,” Richard Walters, the Republican National Committee chief of staff, told me earlier this month. “We know when you requested the ballot and we know that we must continue to follow you until your ballot is returned and until we can see that it has been returned. “

Digital ballot hunting programs, while not entirely new, are significantly expanded during this electoral cycle. The Trump and Biden campaigns contain dozens of advertisements asking voters to “Secure Your Ballot Safe Today!” and warning that “time is running out to return your ballot!” (The Biden campaign even highlighted its pursuit agenda in a fundraising speech.)

While TV ads cannot be targeted with the same precision, there have been advances in data analysis that have allowed for more targeted presentations. Mr Beach, through his company Cross Screen Media, has compiled lists of probable early voters and swing voters in three major markets in Battlefield State: Detroit, Phoenix and Charlotte, North Carolina His team found that early voters tended to be older and watch cable and local news a lot, which are traditionally more expensive political advertising spaces.

But when the public believed to have voted early was taken off the lists, the landscape changed dramatically: ESPN, E! and Comedy Central became the most popular channel among swing voters in those three markets who had probably not yet voted.

So, perhaps “SportsCenter” viewers can expect to see more ads with state-specific voting instructions. But the most traditional advertising wars do not give up. The television in the background of my Philadelphia apartment just sounded that Mr. Biden “would be a president for all Americans” as I wrote that last sentence.

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There are few characteristics more important to Mr. Trump than maintaining an appearance of tenacity. The Biden campaign has brought in Dave Bautista, the 6-foot-6 former professional wrestler turned Hollywood actor, to cut that narrative in a new commercial.

The message: Mr. Bautista opens the ad with a flex and a shout. Then he makes a distinction between Mr. Trump and Mr. Biden: “It’s easy to lie to people; it’s easy to intimidate people, ”he says. “That doesn’t make you a badass. It’s easy to tell someone what they want to hear. It’s not easy to tell someone what they need to hear.

As a map shows an increase in coronavirus cases across the country, Mr Bautista says what America needs is “someone who’s going to have a plan so that we can get back on track. rails”. The announcement ends with Mr. Bautista’s return to the concept of harshness, praising Mr. Biden as a leader who “returns in this fight for the Americans.”

Takeaway meals: Professional wrestling is a popular form of entertainment among white males, a constituency in which Mr. Biden constantly follows Mr. Trump, and a testimonial from one of World Wrestling Entertainment’s legends is clearly aimed at this audience. But the announcement also comes as the Biden campaign avoids emphasizing negative posts, with 40% of its ads being entirely positive.

Mr. Bautista’s early criticism, cutting off Mr. Trump’s proud assertions of tenacity, borrows a little from previous negative advertisements from groups like the Lincoln Project that both criticized the president and sought to get under his skin.


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How Mitch McConnell gave Justice Amy Coney Barrett’s quick confirmation

WASHINGTON – Hours after Judge Ruth Bader Ginsburg died last month, Senator Mitch McConnell was on the phone with President Trump, assuring him Senate Republicans would not hesitate to fill the suddenly vacant post despite the election imminent.

But he offered a word of warning to the president: “It will be the hardest fight of my life,” said McConnell, according to an aide. “We have to play this perfectly.”

There were good reasons to be careful. Mr. McConnell, a Kentucky Republican and majority leader, moved just as quickly in 2016 to prevent President Barack Obama from filling a Supreme Court seat nine months before the election, saying voters should decide who would choose next judge. Now he was proposing to brazenly reverse course and muscle through a candidate who would cement a conservative court majority amid the presidential vote and a pandemic that had reached the Senate.

This approach would set in motion the most partisan Supreme Court confirmation in modern history, a sprint that tore Senate practice apart and circumvented some obscure rules. This sparked outrage from Democrats who called the whole process illegitimate and set a tight schedule that could have been derailed by a number of unexpected events.

But on Monday night, as Senator Chuck Schumer of New York, the Democratic leader, denounced Justice Amy Coney Barrett’s confirmation to the Supreme Court as one of the “darkest days” in Senate history, Mr. McConnell was seated near the Senate. , smiling and laughing to himself knowing he was minutes away from a vote that would fulfill his highest purpose.

For Mr McConnell, Monday was a day of celebration as he achieved what he couldn’t even have imagined four years ago, when he decided to capitalize on Donald J. Trump’s presidency and his formidable power in the Senate to give a deep and lasting conservative imprint. on federal courts. Three Supreme Court justices, 53 appeals court judges and dozens of new young Tories presiding over district courts: all have been delivered under the close supervision and direction of Mr McConnell.

“I certainly didn’t expect to have three Supreme Court justices,” McConnell said in an interview on Tuesday, as he relished an achievement that he said placed him in the top row of the leaders. Senate of History. “At the risk of playing my own horn, look at the majority leaders since LBJ and find another who may have done something as important as this.

His success could come at a great cost to Republicans, perhaps with the loss of their Senate majority next Tuesday and certainly with an even more bitter Senate by the harsh partisanship and tough tactics Mr. McConnell employed to install the judge. Barrett in the field a week before the election. Depending on the results, then there could be a profound restructuring of the Senate and the court itself if Democrats take the White House and the Senate and seek to readjust a judicial system that they say has been unfairly biased towards the right.

Mr McConnell’s steadfast emphasis on installing federal judges rather than seeking a legislative compromise has won him appreciation from a Republican right-wing who has at times mistrusted him, but now credits him with the erection of a judicial firewall against liberal policies if Democrats take control of the government.

This has earned him the contempt of Democrats, who say they have sullied the Senate and the Supreme Court with his tactics.

“The majority leader, more than any other actor, turned what was once the overwhelming bipartisan confirmation of a qualified candidate – and bipartisan ratification of judicial independence – into an all-partisan exercise that destroyed the constitutional responsibility of the Senate to advise and consent and now risks destroying the credibility of the Supreme Court and lower courts as well, ”said Senator Michael Bennet, Democrat of Colorado.

Mr McConnell said it was the Democrats who made the process fail. He regularly recites a practical story that traces democratic guilt for judicial wars to the rejection of Judge Robert Bork by the Senate in 1987. Perhaps more importantly, Mr. McConnell claims he cares little about what his enemies say so much. ‘he’s on the winning side.

“It is a difficult business that we are all engaged in and we expect to be criticized,” he said. “The more impact we have, the stronger the voices of the opposition. It goes with the grass.

The overhaul of the courts by Mr McConnell was the result of a strategic plan developed by a man who became obsessed with the role of the Senate in staffing the federal judiciary in his early days as a staff assistant under the Nixon administration. While he could not predict that his blockade of Mr. Obama’s 2016 candidate, Judge Merrick B. Garland, would pay political dividends, the vacant post was credited with the Conservative support needed to elect Mr. Trump in 2016.

As Mr. Trump made his way to the White House, Mr. McConnell immediately began planning with Donald F. McGahn II, the new White House lawyer, to set up a confirmation assembly line to occupy the dozens of Lower Federal Court seats which Mr. McConnell had. vacant during the last two years of the Obama presidency. Republicans have changed long-standing Senate practices to speed up their work by denying Democrats the procedural tools to block candidates.

“Obviously the president receives a tremendous amount of credit because he makes the appointments, but the value Senator McConnell brought to the project should not be underestimated,” said McGahn, who now works in the industry. private. “It is clear without him, the success of the president would not have happened.”

The judicial juggernaut appeared to peak in June, when the Senate filled the final opening of a federal circuit court, fulfilling Mr. McConnell’s goal of “leaving no vacancies behind.” But he had no intention of being caught off guard if the opportunity presented itself for the ultimate prize: a seat on the Supreme Court.

Before returning to Kentucky in August for the summer vacation, Mr McConnell met with senior advisers to plan for the possibility of a Supreme Court opening, aides said. They had no inside knowledge of Judge Ginsburg’s declining health, but Mr McConnell wanted to be ready since his colleagues would be scattered. He quickly decided that any statement should include an explicit guarantee of a vote to fill a vacant post before the end of the year.

Given what transpired with Judge Garland in 2016, such a pledge was sure to spark Democratic outrage and provoke cries of hypocrisy. But Mr McConnell called on his colleagues to urge them to reserve judgment on what should be done in the event of a vacancy.

Then, at around 7:25 p.m. on September 18, Andrew Ferguson, lead counsel for Mr McConnell and former clerk of the Supreme Court, informed the senator that he had learned from his contacts with the court that Justice Ginsburg had passed away. .

“We have to fill it out,” McConnell said immediately. His point of view was quickly conveyed to Mark Meadows, the White House chief of staff, who was traveling with the president. In less than two hours, Mr McConnell released a statement praising Judge Ginsburg and promising a vote to take his seat, as he had planned.

The next day, Mr McConnell launched a concerted campaign for Judge Barrett, whom he had seen since the spring as the next candidate and now considered the best candidate to get through a fast-track schedule. Despite the White House’s interest in others, such as Judge Barbara Lagoa in Florida and Judge Allison Jones Rushing in North Carolina, Mr McConnell insisted on Judge Barrett, arguing that she was a famous figure. due to its previous confirmation for the United States Court of Appeals. for the Seventh Circuit and that it was very popular in conservative legal circles. Mr McConnell has vowed to have another chance to defend Judge Barrett if the president favors another candidate.

Mr McConnell wanted a pre-election vote because he feared that the wait after the ballot – when it could potentially energize Republican voters – could also make confirmation more precarious if his party lost the Senate or the White House.

“I wanted to make sure we had enough time to adjust the average time between appointment and confirmation, so that we could deal with the argument that we were somehow outside the realm of how these appointments have. been treated in the past, ”he said.

Despite the animosity from Democrats and their allies, Mr McConnell said he did not expect the rushed confirmation to significantly influence the election. And while expressing concern about potential changes from the Democrats in retaliation – such as removing filibuster and adding court seats – he said they were being considered even before Judge Barrett was considered. .

“They no longer need provocation over what they already threatened to do,” said McConnell.

Whatever happened, his mark on the justice system was, he said, “the most important achievement of my career. I am proud of it and I feel good. “

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The Anxious Person’s Guide to the 2020 Election

The Anxious Person’s Guide to the 2020 Election Common Questions on Voters’ Minds As Election Day Approaches By Matt Flegenheimer, Gabriel Gianordoli, Denise Lu and Eden Weingart

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Time is running out, the mail is slow and the courts keep changing the rules. What should voters do?

Just over a week into the election campaign, the Supreme Court ruled on Monday that Wisconsin election officials could not accept any ballots arriving after the polls closed on November 3.

While the decision was widely expected, it only added to confusion among voters in an electoral process made particularly difficult by the pandemic. Michigan voters faced a similar problem when an appeals court ruled that the state could not accept ballots after election day. And Pennsylvania voters remain concerned as a new challenge to extending their voting deadline has been filed in federal court.

Then there are the uncertainties as to whether the Postal Service can be counted to deliver the ballots by next Tuesday in many other states. Here are the options for those who want to make sure their vote counts.

The Postal Service sent a letter to states in August, recommending that they tell voters to send their ballots out by Tuesday, a week before election day, if they wanted to make sure they arrived at time.

The Postal Service reported that on-time delivery rates for first-class mail are well below its target in October.

According to a press release on Friday, during the week of October 10, the most recent for which data is available, the Postal Service saw on-time first-class mail delivery drop to 85.6%, or nearly from a low of 83%. during the summer peak of the pandemic in July.

Normally, the agency reports on-time delivery, defined as within two days, at rates above 95%.

Data compiled by the New York Times that tracks on-time delivery rates reveals stubbornly persistent multi-day delays throughout October, with major battlefield states including Wisconsin, Michigan, Ohio, Pennsylvania, and North Carolina face continuing problems.

Anticipating the pressure to send ballots to election commissions as quickly and efficiently as possible, the Postal Service has implemented measures to sort and expedite election-specific mail, which is often labeled and barcoded, making it easier monitoring and prioritization.

According to court filing data the agency provided during a lawsuit over operational changes that led to delays in September, the Postal Service said on-time delivery of election mail reached 97.2% to the era, even though the overall on-time delivery for first-class mail was only 84.2% then.

“It’s treated differently,” said Michael Plunkett, president of the Postal Trade Association. “They are doing things to identify it and isolate it in the network and devote resources to making sure factories are cleared of election mail on a daily basis.”

To be on the safe side, some experts recommend voters who have the option of delivering ballots directly to election officials or to collection points themselves.

“I would not be mailing a ballot under this circumstance, and I think for anyone who can, vote in person or drop it in a box,” said Paul F. Steidler, a senior researcher who studies the operations and policies of the postal service at the Lexington Institute, a research group.

If a voter has already received a ballot and can’t send it in time to make sure it arrives on polling day, a drop box is the best bet. Pennsylvania, Michigan, and Wisconsin, among others, have set up drop boxes in counties or municipalities where a voter can cast a ballot. These secure drop boxes will receive ballots until polling day and will not be subject to any mail delay. County electoral offices also accept postal ballots.

If a voter does not feel comfortable voting by mail ballot now, there are still other options.

In Wisconsin, people who have already requested a ballot but have not yet returned it can show up and vote early until November 1, or vote in person on election day. They can also vote in person if they have received their ballot but have not yet returned it by mail and do not need to present it themselves at the polls.

In Pennsylvania, voters must bring their package of mail-in ballots, including the two envelopes, to a polling station on election day and return it to be voided by election officials. After signing an affidavit guaranteeing that they have not voted by mail, voters can vote in person on the machines. Without an absent ballot, a voter will have to vote provisionally on polling day.

Voters in Michigan have a similar option to Pennsylvania, where they can take a postal ballot on election day to overturn it and then vote in person. Voters who do not have their ballot can sign an affidavit at their polling station and then vote normally.

Experts also warned voters on Monday not to turn to private carriers like UPS or FedEx to handle ballots after a photo circulated on social media showing singer Lady Gaga holding her ballot and a FedEx envelope. Some states do not accept ballots if they are delivered by a private carrier. And states generally require that voting envelopes bear a postmark, which only the Postal Service can apply.

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Video: Obama campaigns for Biden, slams pandemic handling

new video loaded: Obama campaigns for Biden, slams on dealing with pandemic

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transcription

Obama campaigns for Biden, slams on dealing with pandemic

Former President Barack Obama delivered remarks in Orlando, Florida on behalf of Joseph R. Biden Jr. on Tuesday and criticized the White House’s handling of the coronavirus pandemic.

Black unemployment hit nearly 17% during the Great Recession 10 years ago. And through a lot of hard work, Joe Biden and I helped bring him down. More than 225,000 people in this country have died, more than 100,000 small businesses have closed. Half a million jobs have disappeared in Florida alone. Think about it. And what, what’s his final point – that people are too focused on Covid? He said this at one of his rallies. Covid, Covid, Covid he complains. He is jealous of the media coverage of Covid. His chief of staff, on a news program, said, “We are not going to control the pandemic.” He just said this. Yes he did. And yes, we noticed it, you are not going to control the pandemic. Listen, winter is coming. They wave the white flag of surrender. Here is the truth. The pandemic would have been difficult for any president. But the idea that somehow this White House did anything but screw this thing up completely is absurd.

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AIDS pioneer Dr. Joyce Wallace dies at 79

Dr. Joyce Wallace, a Manhattan internist who treated prostitutes for AIDS, sometimes brought prostitutes home with her when they had nowhere to go.

Once, when his son, Ari Kahn, was around 12 years old, Dr Wallace, who had to go to the hospital to see his patients, left him at home with a prostitute who was HIV positive and undergoing drug withdrawal. ‘heroin. It was not clear who should take care of whom. Ari ended up making pizza for both of them. Upon her return, Dr. Wallace took the prostitute to a drug rehab center; the woman eventually overcame her addiction and got a job at a research foundation that Dr. Wallace had created.

“On the one hand, it was extremely irresponsible,” Kahn said of the incident in an interview. On the other hand, he said, it was typical of his mother’s extraordinary capacity for empathy, and she helped a lot of people.

Dr. Wallace died on October 14 in a Manhattan hospital. She was 79 years old.

Mr. Kahn said the cause was a heart attack.

Dr. Wallace was not a conventional mother. She was not a conventional doctor either. Among the first to report the deadly disease known as AIDS, she tried to stop its spread among thousands of New York prostitutes.

The belly of the city was his clinic. She drove in a white Dodge van offering tests for HIV, the virus that causes AIDS, and handing out condoms, in addition to running a needle exchange program and trying to persuade prostitutes to come out. streets and take them to shelters.

“They are our responsibility,” she told The New Yorker in 1993. “They are not disposable women.

A writer for The New Yorker, Barbara Goldsmith, followed her for several months and produced a graphic 17-page account of Dr. Wallace’s encounters with prostitutes, many of whom are homeless and many addicted to drugs. At the time, AIDS was the leading cause of death in the city among women aged 20 to 29.

“Joyce Wallace tends to be seen as an eccentric fanatic who deals with a group of illegal, transient and often despised women,” Ms. Goldsmith wrote.

“As in the early days of the AIDS crisis, when the establishment failed to respond,” she added, “the burden of activism fell not on the most skilled or the most organized, but on those who care ”.

After the New Yorker article appeared, singer and actress Bette Midler purchased the rights to Dr. Wallace’s life story, according to Dr. Wallace’s daughter Julia Query. Ms Midler wanted to make and star in a film about Dr Wallace, Ms Query said, but the film was never made.

Dr Wallace began practicing medicine in the late 1970s in Greenwich Village, where many of his patients were gay men. In the spring of 1981, before AIDS was recognized, she was one of a handful of doctors in New York and San Francisco who said they discovered Kaposi’s sarcoma, a rare and often rapidly fatal form of cancer, among their patients. patients.

On July 3, 1981, she was among the researchers who published one of the first reports linking Kaposi’s sarcoma to immunocompromised gay men. The disease would become a telltale sign of HIV

Dr Wallace was particularly interested in how AIDS affects women. Once a test was developed, she began offering prostitutes $ 20 or a McDonald’s coupon to allow her to draw their blood.

Her studies have found high correlations between HIV and intravenous drug use. She planned to set up a drop-in center on the Lower East Side to provide prostitutes with a hot shower, clean clothes, food and, if drug-free, transitional housing.

“I want to give girls a place where they can start to make a new life,” she told the New York Times in 1991 as she remodeled an old brothel for this purpose.

Local residents rose up in anger and blocked this proposal, just as other residents would block his similar proposals in the West Village and Washington Heights – even as Dr Wallace received awards for his work and grants for pursue its projects. In June 1994, Mirabella magazine named Dr Wallace one of its “100 Intrepid Wives” for his determination to help prostitutes over neighbors’ objections.

Prevented from installing these homes, Dr. Wallace had to work in a mobile van, from which she offered a range of social services. Her goal, she told The Times in 1992, was not to stop transactions between prostitutes and their clients, but to make them more secure.

To that end, she also started the Treatment Readiness Program, an alternative sentencing project in Manhattan Criminal Court in which prostitutes were given condoms and AIDS prevention and drug treatment literature. instead of being sent to jail.

Joyce Irene Malakoff was born November 25, 1940 in Philadelphia but grew up in Queens. His father, Samuel Malakoff, was a teacher in a vocational high school. Her mother, Henrietta Yetta (Hameroff) Malakoff, was a speech therapist.

Joyce was 12 in 1954 when one of her younger brothers, 8-year-old Lee, fell ill with leukemia and died the following year. This trauma motivated her to become a doctor.

She graduated from Queens College in 1961 with a degree in history, then studied medicine at Columbia University’s School of General Studies. She received her medical degree from the State University of New York Health Science Center in Brooklyn, known as Downstate, in 1968.

A brief first marriage in the 1950s ended in annulment. Her marriage in 1964 to Lance Wallace, a researcher, ended in divorce in 1973. She married Arthur Kahn, a stockbroker, in 1979; they separated in 1983 and subsequently divorced.

In addition to his son and daughter, Dr. Wallace is survived by four grandchildren.

She did her internship and residencies in New York and Long Island. With the fantasy of becoming a country doctor, she opened a private practice in North Conway, NH, in 1973, but lasted barely a year before deciding that she was not suited to small town life and moved to Manhattan, where she established her practice in the village.

She founded the Sexually Transmitted Disease Research Foundation in 1982 and served as its President and then Executive and Medical Director until 2003. She has held academic positions at Mount Sinai School of Medicine, New York Medical College and at the State University of New York at Stony Brook.

Most of the awards Dr. Wallace received recognized his courage and determination in the face of great difficulty. One was the Brooke Russell Astor Award, a $ 10,000 gift given to an unsung hero who is “relentless” in improving the quality of life in New York City.

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As elections approach, Trump makes final push against climate science

“The real issue at stake is the national climate assessment,” said Judith Curry, former president of the School of Earth and Atmospheric Sciences at the Georgia Institute of Technology, who said she had been in contact with Dr. Maue, the new chief scientist. “This is what the powers that be are trying to influence.”

Besides Dr Curry, the strategy was described by Myron Ebell, director of the Competitive Enterprise Institute and a former member of Mr Trump’s transition team, and John Christy, professor of atmospheric sciences at the University of Alabama at Huntsville.

According to E&E News, Dr Christy, a critic of past national climate assessments, said he was invited by the White House this summer to take a leadership position at NOAA, but declined the offer. He said he understood the role was to change the agency’s approach to climate assessment.

Ms Curry and the others have said if Mr Trump wins re-election, further changes to NOAA will include removing long-time climate assessment authors and adding new authors who question the degree warming, the extent to which it is caused by human activities and the danger they pose to human health, national security and the economy.

A biased or diminished climate assessment would have far-reaching implications.

It could be used in court to strengthen the positions of fossil fuel companies sued for climate damage. It could thwart efforts by Congress to reduce carbon emissions. And, ultimately, it could weaken what’s known as the “finding of endangerment,” a 2009 Environmental Protection Agency scientific finding that greenhouse gases endanger health. public and thus force the federal government to regulate carbon dioxide emissions under the Clean Air Act.

Other changes in the work could include shifting funding from NOAA to researchers who reject the established scientific consensus on climate change and eliminating the use of certain scientific models that project dire consequences for the planet if countries are doing little to reduce carbon dioxide pollution.

Dr. Noble, the new chief of staff, has already pushed for a new layer of control over the grants NOAA awards for climate research, according to people familiar with the discussions.

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Trump appointee rescinds rule protecting government news outlets from federal tampering

WASHINGTON – The head of the U.S. Agency for World Media on Monday overturned a rule that protects government-funded news outlets, including Voice of America, from federal tampering.

The official, Michael Pack, defended the move as a way to improve management, but critics have expressed fears that it could turn news outlets under his jurisdiction into a pro-Trump public relations branch.

Mr Pack said the arrangement, known as a firewall, made his agency “difficult to manage.” He added that the news organizations he oversees – which include Voice of America, Radio Free Europe / Radio Liberty, Middle East broadcast networks, Radio Free Asia and the Office of Cuba Broadcasting – “are not commercial information companies ”. He said the firewall rule, which prevented him from overseeing the editorial staff of these media, “threatened constitutional values.”

Mr Pack’s action, announced on Monday evening, raised concern among some lawmakers and former Voice of America officials, who warned the move could undermine the integrity and authority of the organs press releases funded by the United States. The media Mr. Pack oversees provides news to more than 350 million people around the world every week, many in censored companies that have no other access to unbiased information.

David B. Ensor, director of Voice of America from 2011 to 2015, said, “This is terrible news. The firewall distinguishes Voice of America from authoritarian radio and broadcast organizations. “

A lawmaker said the law behind the firewall regulations was still in effect.

“While Mr. Pack can huff and puff,” said Rep. Eliot L. Engel, the New York Democrat who chairs the House Foreign Affairs Committee, “he cannot bring down that wall.”

Voice of America acting director Elez Biberaj said Mr Pack’s decision “would not allow government officials to tamper with or distort VOA content,” adding that he was “fully committed to protecting the journalistic integrity of VOA ”.

The concept of a firewall to protect the editorial independence of US-funded news organizations has its origins in the Voice of America charter signed in 1976 by President Gerald Ford. In 1994, lawmakers strengthened the editorial independence of these media outlets after the adoption of the International Broadcasting Law.

In June, days before Mr. Pack took over the management of the U.S. Agency for World Media, his bipartisan board of directors codified editorial protections into federal regulations, which stipulate that a firewall separating political and editorial sides of the agency is “essential to guarantee the credibility and therefore the effectiveness of journalism” of these media.

“The firewall makes it clear that decisions about who writes what is left to journalists and not politicians,” said David Kligerman, who drafted the June regulations and was subsequently suspended from his role as legal advisor at the agency by Mr. Pack. “When you watch the state sponsored broadcast of undemocratic regimes like Russia or China, they don’t have such protections.”

Mr Pack’s attempts to control the editorial operations of the news organizations he oversees have drawn a rare bipartisan reprimand from his leadership.

In one of Mr Pack’s first moves after taking office, he fired the heads of the four news outlets and an internet technology association under his supervision. It also replaced the bipartisan council that oversees organizations with allies in the Trump administration.

Earlier this month, five employees Mr Pack suspended sued him and his key associates, claiming they had broken the law by repeatedly violating the firewall rule. The trial detailed incidents in which Mr. Pack or his associates attempted to exercise control over journalists critical of his tenure. One example was an aide’s attempt to investigate White House Voice of America bureau chief Steve Herman after signing a letter in August saying Mr. Pack risked “crippling the media.”

“Michael Pack turns VOA into a propaganda machine,” said Bricio Segovia, former White House correspondent for the point of sale’s Spanish-language television service, “and he’s not even trying to hide it anymore.”

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Video: Watch Full Video: Biden Speaks in Georgia

A week before election day, Democratic presidential candidate Joseph R. Biden Jr. delivered a campaign speech in Warm Springs, Ga. By Reuters.