A muscle cramp is a sudden and involuntary contraction of one or more of your muscles. If you’ve ever been awakened in the night or stopped in your tracks by a sudden charley horse, you know that muscle cramps can cause severe pain. Though generally harmless, muscle cramps can make it temporarily impossible to use the affected muscle.
Long periods of exercise or physical labor, particularly in hot weather, can lead to muscle cramps. Some medications and certain medical conditions also may cause muscle cramps. You usually can treat muscle cramps at home with self-care measures.
Symptoms
Most muscle cramps develop in the leg muscles, particularly in the calf. Besides the sudden, sharp pain, you might also feel or see a hard lump of muscle tissue beneath your skin.
When to see a doctor
Muscle cramps usually disappear on their own and are rarely serious enough to require medical care. However, see your doctor if your cramps:
Cause severe discomfort
Are associated with leg swelling, redness or skin changes
Are associated with muscle weakness
Happen frequently
Don’t improve with self-care
Aren’t associated with an obvious cause, such as strenuous exercise
Overuse of a muscle, dehydration, muscle strain or simply holding a position for a prolonged period can cause a muscle cramp. In many cases, however, the cause isn’t known.
Although most muscle cramps are harmless, some may be related to an underlying medical condition, such as:
Inadequate blood supply. Narrowing of the arteries that deliver blood to your legs (arteriosclerosis of the extremities) can produce cramp-like pain in your legs and feet while you’re exercising. These cramps usually go away soon after you stop exercising.
Nerve compression. Compression of nerves in your spine (lumbar stenosis) also can produce cramp-like pain in your legs. The pain usually worsens the longer you walk. Walking in a slightly flexed position — such as you would use when pushing a shopping cart ahead of you — may improve or delay the onset of your symptoms.
Mineral depletion. Too little potassium, calcium or magnesium in your diet can contribute to leg cramps. Diuretics — medications often prescribed for high blood pressure — also can deplete these minerals.
Risk factors
Factors that might increase your risk of muscle cramps include:
Age. Older people lose muscle mass, so the remaining muscle can get overstressed more easily.
Dehydration. Athletes who become fatigued and dehydrated while participating in warm-weather sports frequently develop muscle cramps.
Pregnancy. Muscle cramps also are common during pregnancy.
Medical conditions. You might be at higher risk of muscle cramps if you have diabetes, or nerve, liver or thyroid disorders.
Prevention
These steps may help prevent cramps:
Avoid dehydration. Drink plenty of liquids every day. The amount depends on what you eat, your sex, your level of activity, the weather, your health, your age and medications you take. Fluids help your muscles contract and relax and keep muscle cells hydrated and less irritable. During activity, replenish fluids at regular intervals, and continue drinking water or other fluids after you’re finished.
Stretch your muscles. Stretch before and after you use any muscle for an extended period. If you tend to have leg cramps at night, stretch before bedtime. Light exercise, such as riding a stationary bicycle for a few minutes before bedtime, also may help prevent cramps while you’re sleeping.
You could be out for a run or drifting off to sleep when it happens: The muscles of your calf or foot suddenly become hard, tight, and painful. You are having a muscle cramp.
How can you stop it and prevent another one from happening?
Sometimes called “charley horses” — particularly when they’re in the calf muscles – cramps are caused by muscle spasms – involuntary contractions of one or more muscles.
Almost everyone gets a muscle cramps, which come without warning. What causes them, and what can you do to relieve them?
What Causes Muscle Cramps?
Many things can trigger a muscle cramp. They include:
For a charley horse in the calf or a cramp in the back of the thigh (hamstring), try this stretch: Put your weight on the affected leg and bend your kneeslightly. Or, sit or lie down with your leg out straight and pull the top of your foot toward your head.
For a cramp in the front of the thigh (quadriceps), hold on to a chair to steady yourself and pull your foot back toward your buttock.
You can also massage the muscle, ice it, or try taking a bath with Epsom salt.
In most cases, you can take care of a leg cramp. It will likely stop within minutes. But if you get them often and for no clear reason, tell your doctor.
http://bit.ly/AdrenalBodyTypeKit Take Dr. Berg’s Advanced Evaluation Quiz: http://bit.ly/EvalQuiz Your report will then be sent via email analyzing 104 potential symptoms, giving you a much deeper insight into the cause-effect relationship of your body issues. It’s free and very enlightening. Dr. Berg talks about the Adrenal Body Type. This type has a series of symptoms: 1. Belly Fat 2. Low tolerance to stress 3. Asthma 4. Allergies 5. High blood pressure 6. Low vitamin D 7. Buffalo hump 8. Diabetes 9. Inflammation 10. Acid reflux Here’s what to do: 1. Low intensity exercise 2. Sleep more 3. No sugar 4. Lots of greens (7-10 cups of vegetables) 5. Protein 3-6oz 6. The Adrenal Body Type Kit Dr. Eric Berg DC Bio: Dr. Berg, 51 years of age is a chiropractor who specializes in weight loss through nutritional and natural methods. His private practice is located in Alexandria, Virginia. His clients include senior officials in the U.S. government and the Justice Department, ambassadors, medical doctors, high-level executives of prominent corporations, scientists, engineers, professors, and other clients from all walks of life. He is the author of The 7 Principles of Fat Burning, published by KB Publishing in January 2011. Dr. Berg trains chiropractors, physicians and allied healthcare practitioners in his methods, and to date he has trained over 2,500 healthcare professionals. He has been an active member of the Endocrinology Society, and has worked as a past part-time adjunct professor at Howard University. DR. BERG’S VIDEO BLOG: http://www.drberg.com/blog FACEBOOK: http://www.facebook.com/DrEricBerg TWITTER: http://twitter.com/DrBergDC YOUTUBE: https://www.youtube.com/user/drericbe… ABOUT DR. BERG: http://www.drberg.com/dr-eric-berg/bio DR. BERG’S SEMINARS: http://www.drberg.com/seminars DR. BERG’S STORY: http://www.drberg.com/dr-eric-berg/story DR. BERG’S CLINIC: https://www.drberg.com/dr-eric-berg/c… DR. BERG’S HEALTH COACHING TRAINING: http://www.drberg.com/weight-loss-coach DR. BERG’S SHOP: http://shop.drberg.com/ DR. BERG’S REVIEWS: http://www.drberg.com/reviews
What To Do If You Have Adrenal Fatigue
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Breathing Exercises For Sleep
How to Sleep Super Fast – MUST WATCH!
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Barry Sears, Ph.D. (born June 6, 1947, Long Beach, California)[1] is an American biochemist and author, best-known for creating and promoting the Zone diet, a fad diet which is not well supported by medical evidence.[2]
As stated in several of his books, the Zone diet was born of his desire to avoid an early death from a premature heart attack, a fate of which all other men in his family had been early victims. In more recent years, Sears has popularized the use of high-dose Omega-3 fatty acids and polyphenols to further reduce inflammation. He recently revealed in an interview that he began studying lipids primarily because of their complexity.[3]
He released his first book in 1995, The Zone: A Dietary Road Map. It went on to sell over 2 million hardback copies and was a #1 New York Times bestseller. Since then he has frequently appeared in the United States media, including CNN, Forbes and Good Morning America.
Career & Zone diet
Sears began his business career in 1976, as the founder and president of one of the first biotechnology startup companies in Massachusetts developing lipid-based delivery systems for cancer drugs.[1] In 1982, the Nobel Prize in medicine was awarded for the discoveries of the role that specialized hormones, known as eicosanoids that are derived from lipids, play in the development of cardiovascular disease, diabetes, auto-immune diseases, and cancer. Sears believed that the drug delivery principles could be applied to diet, in order to control the levels of eicosanoids to ultimately control inflammation.[4]
In 1995, Sears released his first book, The Zone: A Dietary Road Map.[5]
The Zone, went on to become a #1 New York Times best-seller and sold over 2 million copies in the United States. In 1997, Sears released his second book, Mastering the Zone. The book again went on to become another New York Times bestseller and sold over 1 million copies in the United States.[4]
Sears continued to apply his dietary approach to other areas of health influenced by inflammation, and published his first book on anti-aging, The Anti-Aging Zone, in 1999.[4][6][7]
Over the next decade, Sears studied and released a number of books based on what he said was the linkage between diet and inflammation.[8]
In 2008, he released the book Toxic Fat: When Good Fat Turns Bad that described obesity as a form of cancer. Sears released his most recent book, The Mediterranean Zone in 2014, focusing on the role of polyphenols in the inflammatory response.[5] Currently, Sears has published 15 books that have sold more than 6 million copies in the United States. Sears continues his research as the President of the non-profit Inflammation Research Foundation in Peabody, Massachusetts.[4]
Jump up^DeBruyne L, Pinna K, Whitney E (2011). “Chapter 7: Nutrition in practice — Fad Diets”. Nutrition and Diet Therapy. Nutrition and Diet Therapy. Cengage Learning. p. 209. ISBN1-133-71550-8. “a fad diet by any other name would still be a fad diet.” And the names are legion: the Atkins Diet, the Cheater’s Diet, the South Beach Diet, the Zone Diet. Year after year, “new and improved” diets appear …
Inflammation (from Latininflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants,[1]and is a protective response involving immune cells, blood vessels, and molecular mediators. The function of inflammation is to eliminate the initial cause of cell injury, clear out necrotic cells and tissues damaged from the original insult and the inflammatory process, and to initiate tissue repair.
The classical signs of inflammation are heat, pain, redness, swelling, and loss of function. Inflammation is a generic response, and therefore it is considered as a mechanism of innate immunity, as compared to adaptive immunity, which is specific for each pathogen.[2] Too little inflammation could lead to progressive tissue destruction by the harmful stimulus (e.g. bacteria) and compromise the survival of the organism. In contrast, chronic inflammation may lead to a host of diseases, such as hay fever, periodontitis, atherosclerosis, rheumatoid arthritis, and even cancer (e.g., gallbladder carcinoma). Inflammation is therefore normally closely regulated by the body.
Inflammation can be classified as either acute or chronic. Acute inflammation is the initial response of the body to harmful stimuli and is achieved by the increased movement of plasma and leukocytes (especially granulocytes) from the blood into the injured tissues. A series of biochemical events propagates and matures the inflammatory response, involving the local vascular system, the immune system, and various cells within the injured tissue. Prolonged inflammation, known as chronic inflammation, leads to a progressive shift in the type of cells present at the site of inflammation, such as mononuclear cells, and is characterized by simultaneous destruction and healing of the tissue from the inflammatory process.
Inflammation is not a synonym for infection. Infection describes the interaction between the action of microbial invasion and the reaction of the body’s inflammatory response — the two components are considered together when discussing an infection, and the word is used to imply a microbial invasive cause for the observed inflammatory reaction. Inflammation on the other hand describes purely the body’s immunovascular response, whatever the cause may be. But because of how often the two are correlated, words ending in the suffix -itis (which refers to inflammation) are sometimes informally described as referring to infection. For example, the word urethritis strictly means only “urethral inflammation”, but clinical health care providers usually discuss urethritis as a urethral infection because urethral microbial invasion is the most common cause of urethritis.
It is useful to differentiate inflammation and infection as there are many pathological situations where inflammation is not driven by microbial invasion – for example, atherosclerosis, type III hypersensitivity, trauma, ischaemia. There are also pathological situations where microbial invasion does not result in classic inflammatory response—for example, parasitosis, eosinophilia.
All the above signs may be observed in specific instances, but no single sign must, as a matter of course, be present.[5]These are the original, or “cardinal signs” of inflammation.[5]*
Functio laesa is an apocryphal notion, as it is not unique to inflammation and is a characteristic of many disease states.[6]**
Infected ingrown toenail showing the characteristic redness and swelling associated with acute inflammation
Acute inflammation is a short-term process, usually appearing within a few minutes or hours and begins to cease upon the removal of the injurious stimulus.[7] It involves a coordinated and systemic mobilisation response locally of various immune, endocrine and neurological mediators of acute inflammation. In a normal healthy response, it becomes activated, clears the pathogen and begins a repair process and then ceases.[8] It is characterized by five cardinal signs:[9]
An acronym that may be used to remember the key symptoms is “PRISH”, for pain, redness, immobility (loss of function), swelling and heat.
The traditional names for signs of inflammation come from Latin:
The first four (classical signs) were described by Celsus (ca. 30 BC–38 AD),[11] while loss of function was added later by Galen[12] even though the attribution is disputed and the origination of the fifth sign has also been ascribed to Thomas Sydenham[13] and Virchow.[7][9]
Redness and heat are due to increased blood flow at body core temperature to the inflamed site; swelling is caused by accumulation of fluid; pain is due to the release of chemicals such as bradykinin and histamine that stimulate nerve endings. Loss of function has multiple causes.[9]
At the onset of an infection, burn, or other injuries, these cells undergo activation (one of the PRRs recognize a PAMP or DAMP) and release inflammatory mediators responsible for the clinical signs of inflammation. Vasodilation and its resulting increased blood flow causes the redness (rubor) and increased heat (calor). Increased permeability of the blood vessels results in an exudation (leakage) of plasma proteins and fluid into the tissue (edema), which manifests itself as swelling (tumor). Some of the released mediators such as bradykinin increase the sensitivity to pain (hyperalgesia, dolor). The mediator molecules also alter the blood vessels to permit the migration of leukocytes, mainly neutrophils and macrophages, outside of the blood vessels (extravasation) into the tissue. The neutrophils migrate along a chemotactic gradient created by the local cells to reach the site of injury.[7] The loss of function (functio laesa) is probably the result of a neurological reflex in response to pain.
In addition to cell-derived mediators, several acellular biochemical cascade systems consisting of preformed plasma proteins act in parallel to initiate and propagate the inflammatory response. These include the complement system activated by bacteria and the coagulation and fibrinolysis systems activated by necrosis, e.g. a burn or a trauma.[7]
The acute inflammatory response requires constant stimulation to be sustained. Inflammatory mediators are short-lived and are quickly degraded in the tissue. Hence, acute inflammation begins to cease once the stimulus has been removed.[7]
Vascular component
Vasodilation and increased permeability
As defined, acute inflammation is an immunovascular response to an inflammatory stimulus. This means acute inflammation can be broadly divided into a vascular phase that occurs first, followed by a cellular phase involving immune cells (more specifically myeloid granulocytes in the acute setting). The vascular component of acute inflammation involves the movement of plasma fluid, containing important proteins such as fibrin and immunoglobulins (antibodies), into inflamed tissue.
Upon contact with PAMPs, tissue macrophages and mastocytes release vasoactive amines such as histamine and serotonin, as well as eicosanoids such as prostaglandin E2 and leukotriene B4 to remodel the local vasculature. Macrophages and endothelial cells release nitric oxide. These mediators vasodilate and permeabilize the blood vessels, which results in the net distribution of blood plasma from the vessel into the tissue space. The increased collection of fluid into the tissue causes it to swell (edema). This exuded tissue fluid contain various antimicrobial mediators from the plasma such as complement, lysozyme, antibodies, which can immediately deal damage to microbes, and opsonise the microbes in preparation for the cellular phase. If the inflammatory stimulus is a lacerating wound, exuded platelets, coagulants, plasmin and kinins can clot the wounded area and provide haemostasis in the first instance. These clotting mediators also provide a structural staging framework at the inflammatory tissue site in the form of a fibrin lattice – as would construction scaffolding at a construction site – for the purpose of aiding phagocytic debridement and wound repair later on. Some of the exuded tissue fluid is also funnelled by lymphatics to the regional lymph nodes, flushing bacteria along to start the recognition and attack phase of the adaptive immune system.
Acute inflammation is characterized by marked vascular changes, including vasodilation, increased permeability and increased blood flow, which are induced by the actions of various inflammatory mediators. Vasodilation occurs first at the arteriole level, progressing to the capillary level, and brings about a net increase in the amount of blood present, causing the redness and heat of inflammation. Increased permeability of the vessels results in the movement of plasma into the tissues, with resultant stasis due to the increase in the concentration of the cells within blood – a condition characterized by enlarged vessels packed with cells. Stasis allows leukocytes to marginate (move) along the endothelium, a process critical to their recruitment into the tissues. Normal flowing blood prevents this, as the shearing force along the periphery of the vessels moves cells in the blood into the middle of the vessel.
The kinin system generates proteins capable of sustaining vasodilation and other physical inflammatory effects.
The coagulation system or clotting cascade, which forms a protective protein mesh over sites of injury.
The fibrinolysis system, which acts in opposition to the coagulation system, to counterbalance clotting and generate several other inflammatory mediators.
Cleaves to produce C3a and C3b. C3a stimulates histamine release by mast cells, thereby producing vasodilation. C3b is able to bind to bacterial cell walls and act as an opsonin, which marks the invader as a target for phagocytosis.
Stimulates histamine release by mast cells, thereby producing vasodilation. It is also able to act as a chemoattractant to direct cells via chemotaxis to the site of inflammation.
A protein that circulates inactively, until activated by collagen, platelets, or exposed basement membranes via conformational change. When activated, it in turn is able to activate three plasma systems involved in inflammation: the kinin system, fibrinolysis system, and coagulation system.
A complex of the complement proteins C5b, C6, C7, C8, and multiple units of C9. The combination and activation of this range of complement proteins forms the membrane attack complex, which is able to insert into bacterial cell walls and causes cell lysis with ensuing bacterial death.
Cleaves the soluble plasma protein fibrinogen to produce insoluble fibrin, which aggregates to form a blood clot. Thrombin can also bind to cells via the PAR1 receptor to trigger several other inflammatory responses, such as production of chemokines and nitric oxide.
Cellular component
The cellular component involves leukocytes, which normally reside in blood and must move into the inflamed tissue via extravasation to aid in inflammation. Some act as phagocytes, ingesting bacteria, viruses, and cellular debris. Others release enzymatic granules that damage pathogenic invaders. Leukocytes also release inflammatory mediators that develop and maintain the inflammatory response. In general, acute inflammation is mediated by granulocytes, whereas chronic inflammation is mediated by mononuclear cells such as monocytes and lymphocytes.
Leukocyte extravasation
Neutrophils migrate from blood vessels to the infected tissue via chemotaxis, where they remove pathogens through phagocytosis and degranulation
Various leukocytes, particularly neutrophils, are critically involved in the initiation and maintenance of inflammation. These cells must be able to move to the site of injury from their usual location in the blood, therefore mechanisms exist to recruit and direct leukocytes to the appropriate place. The process of leukocyte movement from the blood to the tissues through the blood vessels is known as extravasation, and can be broadly divided up into a number of steps:
Leukocyte margination and endothelial adhesion: The white blood cells within the vessels which are generally centrally located move peripherally towards the walls of the vessels.[14] Activated macrophages in the tissue release cytokines such as IL-1 and TNFα, which bind to their respective G protein-coupled receptors on the endothelial wall. Signal transduction induces the immediate expression of P-selectin on endothelial cell surfaces. This receptor binds weakly to carbohydrate ligands on the surface of leukocytes and causes them to “roll” along the endothelial surface as bonds are made and broken. Cytokines from injured cells induce the expression of E-selectin on endothelial cells, which functions similarly to P-selectin. Cytokines also induce the expression of integrin ligands such as ICAM-1 and VCAM-1 on endothelial cells, which mediate the adhesion and further slow leukocytes down. These weakly bound leukocytes are free to detach if not activated by chemokines produced in injured tissue. Activation increases the affinity of bound integrin receptors for ICAM-1 and VCAM-1 on the endothelial cell surface, firmly binding the leukocytes to the endothelium.
Migration across the endothelium, known as transmigration, via the process of diapedesis: Chemokine gradients stimulate the adhered leukocytes to move between adjacent endothelial cells. The endothelial cells retract and the leukocytes pass through the basement membrane into the surrounding tissue using adhesion molecules such as ICAM-1.[14]
Movement of leukocytes within the tissue via chemotaxis: Leukocytes reaching the tissue interstitium bind to extracellular matrix proteins via expressed integrins and CD44 to prevent them from leaving the site. A variety of molecules behave as chemoattractants, for example, C3a or C5, and cause the leukocytes to move along a chemotactic gradient towards the source of inflammation.
Upon endocytic PRR binding, actin–myosincytoskeletal rearrangement adjacent to the plasma membrane occurs in a way that endocytoses the plasma membrane containing the PRR-PAMP complex, and the microbe. Phosphatidylinositol and Vps34–Vps15–Beclin1 signalling pathways have been implicated to traffic the endocytosed phagosome to intracellular lysosomes, where fusion of the phagosome and the lysosome produces a phagolysosome. The reactive oxygen species, superoxides and hypochlorite bleach within the phagolysosomes then kill microbes inside the phagocyte.
Phagocytic efficacy can be enhanced by opsonization. Plasma derived complement C3b and antibodies that exude into the inflamed tissue during the vascular phase bind to and coat the microbial antigens. As well as endocytic PRRs, phagocytes also express opsonin receptors Fc receptor and complement receptor 1 (CR1), which bind to antibodies and C3b, respectively. The co-stimulation of endocytic PRR and opsonin receptor increases the efficacy of the phagocytic process, enhancing the lysosomal elimination of the infective agent.
These cells contain a large variety of enzymes that perform a number of functions. Granules can be classified as either specific or azurophilic depending upon the contents, and are able to break down a number of substances, some of which may be plasma-derived proteins that allow these enzymes to act as inflammatory mediators.
Stored in preformed granules, histamine is released in response to a number of stimuli. It causes arteriole dilation, increased venous permeability, and a wide variety of organ-specific effects.
Antiviral, immunoregulatory, and anti-tumour properties. This interferon was originally called macrophage-activating factor, and is especially important in the maintenance of chronic inflammation.
Able to mediate leukocyte adhesion and activation, allowing them to bind to the endothelium and migrate across it. In neutrophils, it is also a potent chemoattractant, and is able to induce the formation of reactive oxygen species and the release of lysosomal enzymes by these cells.
These three Cysteine-containing leukotrienes contract lung airways, increase micro-vascular permeability, stimulate mucus secretion, and promote eosinophil-based inflammation in the lung, skin, nose, eye, and other tissues.
Potent stimulator of neutrophil chemotaxis, lysosome enzyme release, and reactive oxygen species formation; monocyte chemotaxis; and with even greater potency eosinophil chemotaxis, lysosome enzyme release, and reactive oxygen species formation.
Metabolic precursor to 5-Oxo-eicosatetraenoic acid, it is a less potent stimulator of neutrophil chemotaxis, lysosome enzyme release, and reactive oxygen species formation; monocyte chemotaxis; and eosinophil chemotaxis, lysosome enzyme release, and reactive oxygen species formation.
Potent vasodilator, relaxes smooth muscle, reduces platelet aggregation, aids in leukocyte recruitment, direct antimicrobial activity in high concentrations.
Both affect a wide variety of cells to induce many similar inflammatory reactions: fever, production of cytokines, endothelial gene regulation, chemotaxis, leukocyte adherence, activation of fibroblasts. Responsible for the systemic effects of inflammation, such as loss of appetite and increased heart rate. TNF-α inhibits osteoblast differentiation.
Morphologic patterns
Specific patterns of acute and chronic inflammation are seen during particular situations that arise in the body, such as when inflammation occurs on an epithelial surface, or pyogenic bacteria are involved.
Granulomatous inflammation: Characterised by the formation of granulomas, they are the result of a limited but diverse number of diseases, which include among others tuberculosis, leprosy, sarcoidosis, and syphilis.
Fibrinous inflammation: Inflammation resulting in a large increase in vascular permeability allows fibrin to pass through the blood vessels. If an appropriate procoagulative stimulus is present, such as cancer cells,[7] a fibrinous exudate is deposited. This is commonly seen in serous cavities, where the conversion of fibrinous exudate into a scar can occur between serous membranes, limiting their function. The deposit sometimes forms a pseudomembrane sheet. During inflammation of the intestine (Pseudomembranous colitis), pseudomembranous tubes can be formed.
Purulent inflammation: Inflammation resulting in large amount of pus, which consists of neutrophils, dead cells, and fluid. Infection by pyogenic bacteria such as staphylococci is characteristic of this kind of inflammation. Large, localised collections of pus enclosed by surrounding tissues are called abscesses.
Serous inflammation: Characterised by the copious effusion of non-viscous serous fluid, commonly produced by mesothelial cells of serous membranes, but may be derived from blood plasma. Skin blisters exemplify this pattern of inflammation.
Ulcerative inflammation: Inflammation occurring near an epithelium can result in the necrotic loss of tissue from the surface, exposing lower layers. The subsequent excavation in the epithelium is known as an ulcer.
Inflammatory disorders
Inflammatory abnormalities are a large group of disorders that underlie a vast variety of human diseases. The immune system is often involved with inflammatory disorders, demonstrated in both allergic reactions and some myopathies, with many immune system disorders resulting in abnormal inflammation. Non-immune diseases with causal origins in inflammatory processes include cancer, atherosclerosis, and ischaemic heart disease.[7]
A large variety of proteins are involved in inflammation, and any one of them is open to a genetic mutation which impairs or otherwise dysregulates the normal function and expression of that protein.
Examples of disorders associated with inflammation include:
Atherosclerosis, formerly considered a bland lipid storage disease, actually involves an ongoing inflammatory response. Recent advances in basic science have established a fundamental role for inflammation in mediating all stages of this disease from initiation through progression and, ultimately, the thrombotic complications of atherosclerosis. These new findings provide important links between risk factors and the mechanisms of atherogenesis. Clinical studies have shown that this emerging biology of inflammation in atherosclerosis applies directly to human patients. Elevation in markers of inflammation predicts outcomes of patients with acute coronary syndromes, independently of myocardial damage. In addition, low-grade chronic inflammation, as indicated by levels of the inflammatory marker C-reactive protein, prospectively defines risk of atherosclerotic complications, thus adding to prognostic information provided by traditional risk factors. Moreover, certain treatments that reduce coronary risk also limit inflammation. In the case of lipid lowering with statins, this anti-inflammatory effect does not appear to correlate with reduction in low-density lipoprotein levels. These new insights into inflammation in atherosclerosis not only increase our understanding of this disease but also have practical clinical applications in risk stratification and targeting of therapy for this scourge of growing worldwide importance.[15]
Allergies
An allergic reaction, formally known as type 1 hypersensitivity, is the result of an inappropriate immune response triggering inflammation, vasodilation, and nerve irritation. A common example is hay fever, which is caused by a hypersensitive response by mast cells to allergens. Pre-sensitised mast cells respond by degranulating, releasing vasoactive chemicals such as histamine. These chemicals propagate an excessive inflammatory response characterised by blood vessel dilation, production of pro-inflammatory molecules, cytokine release, and recruitment of leukocytes.[7] Severe inflammatory response may mature into a systemic response known as anaphylaxis.
Other hypersensitivity reactions (type 2 and type 3) are mediated by antibody reactions and induce inflammation by attracting leukocytes that damage surrounding tissue.[7]
Myopathies
Inflammatory myopathies are caused by the immune system inappropriately attacking components of muscle, leading to signs of muscle inflammation. They may occur in conjunction with other immune disorders, such as systemic sclerosis, and include dermatomyositis, polymyositis, and inclusion body myositis.[7]
Leukocyte defects
Due to the central role of leukocytes in the development and propagation of inflammation, defects in leukocyte functionality often result in a decreased capacity for inflammatory defense with subsequent vulnerability to infection.[7] Dysfunctional leukocytes may be unable to correctly bind to blood vessels due to surface receptor mutations, digest bacteria (Chédiak–Higashi syndrome), or produce microbicides (chronic granulomatous disease). In addition, diseases affecting the bone marrow may result in abnormal or few leukocytes.
Pharmacological
Certain drugs or exogenous chemical compounds are known to affect inflammation. Vitamin A deficiency causes an increase in inflammatory responses,[16] and anti-inflammatory drugs work specifically by inhibiting the enzymes that produce inflammatory eicosanoids. Certain illicit drugs such as cocaine and ecstasy may exert some of their detrimental effects by activating transcription factors intimately involved with inflammation (e.g. NF-κB).[17][18]
Cancer
Inflammation orchestrates the microenvironment around tumours, contributing to proliferation, survival and migration.[19] Cancer cells use selectins, chemokines and their receptors for invasion, migration and metastasis.[20] On the other hand, many cells of the immune system contribute to cancer immunology, suppressing cancer.[21] Molecular intersection between receptors of steroid hormones, which have important effects on cellular development, and transcription factors that play key roles in inflammation, such as NF-κB, may mediate some of the most critical effects of inflammatory stimuli on cancer cells.[22] This capacity of a mediator of inflammation to influence the effects of steroid hormones in cells, is very likely to affect carcinogenesis on the one hand; on the other hand, due to the modular nature of many steroid hormone receptors, this interaction may offer ways to interfere with cancer progression, through targeting of a specific protein domain in a specific cell type. Such an approach may limit side effects that are unrelated to the tumor of interest, and may help preserve vital homeostatic functions and developmental processes in the organism.
According to a review of 2009, recent data suggests that cancer-related inflammation (CRI) may lead to accumulation of random genetic alterations in cancer cells.[23]
HIV and AIDS
It has long been recognized that infection with HIV is characterized not only by development of profound immunodeficiency but also by sustained inflammation and immune activation.[24][25][26] A substantial body of evidence implicates chronic inflammation as a critical driver of immune dysfunction, premature appearance of aging-related diseases, and immune deficiency.[24][27] Many now regard HIV infection not only as an evolving virus-induced immunodeficiency but also as chronic inflammatory disease.[28] Even after the introduction of effective antiretroviral therapy (ART) and effective suppression of viremia in HIV-infected individuals, chronic inflammation persists. Animal studies also support the relationship between immune activation and progressive cellular immune deficiency: SIVsm infection of its natural nonhuman primate hosts, the sooty mangabey, causes high-level viral replication but limited evidence of disease.[29][30] This lack of pathogenicity is accompanied by a lack of inflammation, immune activation and cellular proliferation. In sharp contrast, experimental SIVsm infection of rhesus macaque produces immune activation and AIDS-like disease with many parallels to human HIV infection.[31]
Delineating how CD4 T cells are depleted and how chronic inflammation and immune activation are induced lies at the heart of understanding HIV pathogenesis––one of the top priorities for HIV research by the Office of AIDS Research, National Institutes of Health. Recent studies demonstrated that caspase-1-mediated pyroptosis, a highly inflammatory form of programmed cell death, drives CD4 T-cell depletion and inflammation by HIV.[32][33][34] These are the two signature events that propel HIV disease progression to AIDS. Pyroptosis appears to create a pathogenic vicious cycle in which dying CD4 T cells and other immune cells (including macrophages and neutrophils) release inflammatory signals that recruit more cells into the infected lymphoid tissues to die. The feed-forward nature of this inflammatory response produces chronic inflammation and tissue injury.[35] Identifying pyroptosis as the predominant mechanism that causes CD4 T-cell depletion and chronic inflammation, provides novel therapeutic opportunities, namely caspase-1 which controls the pyroptotic pathway. In this regard, pyroptosis of CD4 T cells and secretion of pro-inflmammatory cytokines such as IL-1β and IL-18 can be blocked in HIV-infected human lymphoid tissues by addition of the caspase-1 inhibitor VX-765,[32] which has already proven to be safe and well tolerated in phase II human clinical trials.[36] These findings could propel development of an entirely new class of “anti-AIDS” therapies that act by targeting the host rather than the virus. Such agents would almost certainly be used in combination with ART. By promoting “tolerance” of the virus instead of suppressing its replication, VX-765 or related drugs may mimic the evolutionary solutions occurring in multiple monkey hosts (e.g. the sooty mangabey) infected with species-specific lentiviruses that have led to a lack of disease, no decline in CD4 T-cell counts, and no chronic inflammation.
Resolution of inflammation
The inflammatory response must be actively terminated when no longer needed to prevent unnecessary “bystander” damage to tissues.[7] Failure to do so results in chronic inflammation, and cellular destruction. Resolution of inflammation occurs by different mechanisms in different tissues. Mechanisms that serve to terminate inflammation include:[7][37]
Acute inflammation normally resolves by mechanisms that have remained somewhat elusive. Emerging evidence now suggests that an active, coordinated program of resolution initiates in the first few hours after an inflammatory response begins. After entering tissues, granulocytes promote the switch of arachidonic acid–derived prostaglandins and leukotrienes to lipoxins, which initiate the termination sequence. Neutrophil recruitment thus ceases and programmed death by apoptosis is engaged. These events coincide with the biosynthesis, from omega-3 polyunsaturated fatty acids, of resolvins and protectins, which critically shorten the period of neutrophil infiltration by initiating apoptosis. As a consequence, apoptotic neutrophils undergo phagocytosis by macrophages, leading to neutrophil clearance and release of anti-inflammatory and reparative cytokines such as transforming growth factor-β1. The anti-inflammatory program ends with the departure of macrophages through the lymphatics.[48]
”
— Charles Serhan
Connection to depression
There is evidence for a link between inflammation and depression.[49] Inflammatory processes can be triggered by negative cognitions or their consequences, such as stress, violence, or deprivation. Thus, negative cognitions can cause inflammation that can, in turn, lead to depression.[50][51][dubious– discuss] In addition there is increasing evidence that inflammation can cause depression because of the increase of cytokines, setting the brain into a “sickness mode”.[52] Classical symptoms of being physically sick like lethargy show a large overlap in behaviors that characterize depression. Levels of cytokines tend to increase sharply during depressive episodes in manics and drop off during remission.[53] Furthermore, it has been shown in clinical trials that anti-inflammatory medicines taken in addition to antidepressants not only significantly improves symptoms but also increases the proportion of subjects positively responding to treatment.[54] Inflammations that lead to serious depression could be caused by common infections such as those caused by a virus, bacteria or even parasites.[55]
Systemic effects
An infectious organism can escape the confines of the immediate tissue via the circulatory system or lymphatic system, where it may spread to other parts of the body. If an organism is not contained by the actions of acute inflammation it may gain access to the lymphatic system via nearby lymph vessels. An infection of the lymph vessels is known as lymphangitis, and infection of a lymph node is known as lymphadenitis. When lymph nodes cannot destroy all pathogens, the infection spreads further. A pathogen can gain access to the bloodstream through lymphatic drainage into the circulatory system.
When inflammation overwhelms the host, systemic inflammatory response syndrome is diagnosed. When it is due to infection, the term sepsis is applied, with the terms bacteremia being applied specifically for bacterial sepsis and viremia specifically to viral sepsis. Vasodilation and organ dysfunction are serious problems associated with widespread infection that may lead to septic shock and death.
Inflammation often affects the numbers of leukocytes present in the body:
Leukocytosis is often seen during inflammation induced by infection, where it results in a large increase in the amount of leukocytes in the blood, especially immature cells. Leukocyte numbers usually increase to between 15 000 and 20 000 cells per microliter, but extreme cases can see it approach 100 000 cells per microliter.[7] Bacterial infection usually results in an increase of neutrophils, creating neutrophilia, whereas diseases such as asthma, hay fever, and parasite infestation result in an increase in eosinophils, creating eosinophilia.[7]
With the discovery of interleukins (IL), the concept of systemic inflammation developed. Although the processes involved are identical to tissue inflammation, systemic inflammation is not confined to a particular tissue but involves the endothelium and other organ systems.
Chronic inflammation is widely observed in obesity.[56][57] The obese commonly have many elevated markers of inflammation, including:[58][59]
Low-grade chronic inflammation is characterized by a two- to threefold increase in the systemic concentrations of cytokines such as TNF-α, IL-6, and CRP.[62] Waist circumference correlates significantly with systemic inflammatory response.[63] A predominant factor in this correlation is due to the autoimmune response triggered by adiposity, whereby immune cells may mistake fatty deposits for intruders. The body attacks fat similar to bacteria and fungi. When expanded fat cells leak or break open, macrophages mobilize to clean up and embed into the adipose tissue. Then macrophages release inflammatory chemicals, including TNF-α and IL-6. TNF’s primary role is to regulate the immune cells and induce inflammation. White blood cells then assist by releasing more cytokines. This link between adiposity and inflammation has been shown to produce 10–35% of IL-6 in a resting individual, and this production increases with increasing adiposity.[64]
In the obese mouse models, inflammation and macrophage-specific genes are upregulated in white adipose tissue (WAT). There were also signs of dramatic increase in circulating insulin level, adipocyte lipolysis and formation of multinucleate giant cells.[66] The fat-derived protein called angiopoietin-like protein 2 (Angptl2) elevates in fat tissues. Higher than normal Angptl2 level in fat tissues develop inflammation as well as insulin and leptin resistance. Stored fat secretes Leptin to signal satiety. Leptin resistance plays a role in the process where appetite overrules the message of satiety. Angptl2 then starts an inflammatory cascade causing blood vessels to remodel and attract macrophages. Angptl2 is an adipocyte-derived inflammatory mediator linking obesity to systemic insulin resistance.[67] It is possible that, as an inflammatory marker, leptin responds specifically to adipose-derived inflammatory cytokines.
C-reactive protein (CRP) is generated at a higher level in obese people. It raises when there is inflammation throughout the body. Mild elevation in CRP increase risk of heart attacks, strokes, high blood pressure, muscle weakness and fragility.[citation needed]
Hyperglycemia induces IL-6 production from endothelial cells and macrophages.[68] Meals high in saturated fat, as well as meals high in calories have been associated with increases in inflammatory markers.[69][70]While the inflammatory responses are acute and arise in response to overeating, the response may become chronic if the overeating is chronic.
Bente Klarlund Pedersen wrote in 2013 that interstitial abdominal adiposity (also referred to as accumulated intra-abdominal fat) is a major and possibly primary factor in increasing systemic risk for multiple inflammatory diseases. However, she indicates that this is mediated via TNF-α, rather than Interleukin 6, which she identified as a myokine in 2003.[71] Dr. Pedersen concludes: “Until the beginning of this millennium, it was commonly thought that the increase in IL-6 during exercise was a consequence of an immune response due to local damage in the working muscles and it was hypothesized that macrophages were responsible for this increase. However, an early study demonstrated that IL-6 mRNA in monocytes did not increase as a result of exercise.”[72]
Dr. Pedersen continues (in the same article): “Patients with diabetes have a high protein expression of TNF-α in skeletal muscle and increased TNF-α levels in plasma, and it is likely that adipose tissue, which produces TNF-α, is the main source of the circulating TNF-α. In vitro studies demonstrate that TNF-α has direct inhibitory effects on insulin signaling. In addition, TNF-α infusion in healthy humans induces insulin resistance in skeletal muscle, without an effect on EGP [endogenous glucose production]. It has also been proposed that TNF-α causes insulin resistance indirectly in vivo by increasing the release of FFAs from adipose tissue. TNF-α increases lipolysis in human and 3T3-L1 adipocytes. However, TNF-α has no effect on muscle fatty acid oxidation, but increases fatty acid incorporation into diacylglycerol, which may be involved in the development of the TNF-α-induced insulin resistance in skeletal muscle. In addition, evidence suggests that TNF-α plays a direct role in linking insulin resistance to vascular disease. Moreover, in CVDs, activated immune cells also play major roles, particularly in the etiology of atherosclerosis. Importantly, also tumor initiation, promotion, and progression is stimulated by systemic elevation of proinflammatory cytokines.”[72]
Outcomes
Scars present on the skin, evidence of fibrosis and healing of a wound
The outcome in a particular circumstance will be determined by the tissue in which the injury has occurred and the injurious agent that is causing it. Here are the possible outcomes to inflammation:[7]
Resolution
The complete restoration of the inflamed tissue back to a normal status. Inflammatory measures such as vasodilation, chemical production, and leukocyte infiltration cease, and damaged parenchymal cells regenerate. In situations where limited or short-lived inflammation has occurred this is usually the outcome.
Fibrosis
Large amounts of tissue destruction, or damage in tissues unable to regenerate, cannot be regenerated completely by the body. Fibrous scarring occurs in these areas of damage, forming a scar composed primarily of collagen. The scar will not contain any specialized structures, such as parenchymal cells, hence functional impairment may occur.
Abscess formation
A cavity is formed containing pus, an opaque liquid containing dead white blood cells and bacteria with general debris from destroyed cells.
Chronic inflammation
In acute inflammation, if the injurious agent persists then chronic inflammation will ensue. This process, marked by inflammation lasting many days, months or even years, may lead to the formation of a chronic wound. Chronic inflammation is characterised by the dominating presence of macrophages in the injured tissue. These cells are powerful defensive agents of the body, but the toxins they release (including reactive oxygen species) are injurious to the organism’s own tissues as well as invading agents. As a consequence, chronic inflammation is almost always accompanied by tissue destruction.
Examples
Inflammation is usually indicated by adding the suffix “itis“, as shown below. However, some conditions such as asthma and pneumonia do not follow this convention. More examples are available at list of types of inflammation.
The Dietary Inflammatory Index (DII) is a score (number) that describes the potential of diet to modulate systemic inflammation within the body. As stated chronic inflammation is linked to most chronic diseases including arthritis, many types of cancer, cardiovascular diseases, inflammatory bowel diseases, and diabetes.[73]
It has been known for many decades both that inflammation is linked to health and that diet is a major determinant of inflammation. Until the invention of the DII by scientists led by James R. Hébert at the Statewide South Carolina Cancer Prevention and Control Program in the University of South Carolina,[74] no indicator of diet-related inflammation had ever been devised. The DII is unique among dietary indices in that it is based on results of studies published in the peer-reviewed literature and not any of the three methods typically used to create a dietary index; i.e., Basing it on 1) a particular cuisine or foodway (e.g., the Mediterranean, Macrobiotic or South Asian diet); 2) dietary guidelines (e.g., the Healthy Eating Index, which is based on the US Dietary Guidelines); or 3) results from a particular study (which reflect biases related to sample selection, response set biases such as social desirability). By contrast, the DII: 1) is grounded in peer-reviewed literature focusing specifically on inflammation (thus obviating idiosyncrasies of specific dietary assessment methods and limitations of exposure differences within populations); 2) can be adapted to virtually any dietary assessment method capable of providing estimates of nutrient intake; and 3) has been standardized to dietary intake from representative populations around the world, thus facilitating easy quantitative comparisons across studies.
Since its invention in 2004 and the publication of a now-defunct earlier-version of the DII in December 2009,[75] the DII went through a major overhaul, resulting in a new version that replaced the old version, published first on-line in 2013 and then in hard copy in 2014.[76] This new version is superior to the earlier one in a number of ways: 1) it is based on a larger, more robust literature (see Derivation/ Computation) of 1,943 (vs. 927) articles that were reviewed and scored; 2) creation of a global dataset based on intake measures from populations in 11 countries around the world, thus allowing comparison of results from studies conducted anywhere in the world; and 3) scoring such that lower, more negative, scores indicate anti-inflammation, while higher, more positive, scores are more pro-inflammatory.[76]
This new, improved version of the DII has been subjected to construct validation, which tested (and subsequently confirmed) its ability to predict blood levels of inflammatory markers. The first of these tests showed the DII could predict repeat measures of c-reactive protein (CRP) from the Seasonal Variation of Blood Cholesterol, an intensive follow-up study of 559 adult men and women conducted in Massachusetts.[77][78] The second, based on data from 2,567 women across the USA participating in the Women’s Health Initiative Observational Study from 1993–1998, showed the DII’s ability to predict levels of interleukin (IL)-6 and tumor necrosis factor-alpha receptor-2 (TNFα-R2) and a combined inflammatory biomarker score (consisting of IL-6, TNFα-R2, and CRP).[79] Subsequently, the DII has been shown to have positive associations with IL-6 and homocysteine in the Asklepios Study in Belgium,[80][81] CRP among police officers in Buffalo, NY, USA[82] and inversely correlated with SNP rs2243250 in IL-4 among controls in the Bellvitge Colorectal Cancer Study in Spain.[83]
Derivation and computation
Briefly, based on a search of the literature from 1950 to the end of 2010, 45 food parameters were identified among foods, nutrients, and other food components that were associated with 6 plasma inflammatory markers (IL-1β, IL-4, IL-6, IL-10, TNF-α and CRP). A specific article inflammatory effect score for each food parameter on the basis of the literature review and taking into account the quality and number of published papers (1,943 articles were reviewed and scored). For each study participant in a study, the dietary data is first linked to a global database that was developed based on 11 datasets from around the world (US – NHANES; UK – The National Diet & Nutrition Survey; Bahrain – National Nutrition Survey for Adult Bahrainis; Mexico – Mexican National Health and Nutrition Survey; Australia – National Nutrition Survey; South Korea – KNHANES; Taiwan – Nutrition and Health Survey in Taiwan; India – Indian Diet Study; New Zealand – National Nutrition Survey) and thus provides a robust estimate of the mean and the standard deviation of these 45 parameters.2 Each subject’s exposure relative to the “standard global mean” is expressed as a z-score that is derived by subtracting the “standard global mean” from the amount reported, and dividing this value by its standard deviation. To minimize the effect of “right skewing”, this value was then converted to a centered percentile score. The subject’s DII score was computed by multiplying these values by the specific article inflammatory effect score for each food parameter and then summing together all these 45 values according to the following formula, DII=b1*n1+b2*n2………..b45*n45, where bi refers to the literature-derived inflammatory effect score for each of the evaluated food parameter and ni refers to the food parameter-specific centered percentile, which were derived from the dietary data, per each i from 1 to 45.[76]
Accuracy
The DII is uniquely and strongly based on empirical evidence available in the peer-reviewed literature on the relationships between dietary factors and important inflammatory markers (see Derivation/ Computation). It is important to note, however, that, as an index that superimposes on a method of dietary assessment, the DII is dependent on the accuracy of the dietary assessment method used. The DII cannot make up for deficiencies/ inaccuracies in measuring dietary intake.
Disease prevention and causation
Besides studies focusing on markers of inflammation in blood, the DII has been associated with a large number of actual health outcomes including:
components of the metabolic syndrome, in a Spanish cohort[84] and among US police officers;[84]
lung cancer and other respiratory conditions in Italy;[86]
esophageal cancer in Sweden,[87] Italy,[88] and Iran;[89]
colorectal cancer, in two populations of US women,[90][91] Italian men and women,[92] men and women in the National Institutes of Health-American Association of Retired Persons Diet and Health Study[93] and a case-control study in Spain;[93]
female breast cancer in Germany[94] and Sweden;[95]
cardiovascular diseases, in the PREvencio´n con DIeta MEDiterra´nea (PREDIMED) Trial[99] and the Seguimiento Universidad de Navarra (SUN) cohort[100] in Spain, and a follow-up study of Australian men;[101]
Besides dietary factors, physical activity, fitness, sleep, shift work, and stress can affect inflammation. Also, there are auto-immune and other conditions that can influence inflammation. It has been shown that these other factors also may be related to the DII.[107]
Advantages and disadvantages of the DII
Advantages of the DII over other indices include that it: 1) focuses on a particular and very important mechanism of how dietary components affect health through inflammation; 2) is grounded in peer-reviewed literature focusing specifically on inflammatory markers known to affect health well-being; 3) can be adapted to virtually any dietary assessment method that provides estimates of nutrient intake; and 4) is standardized to dietary intake from representative populations around the world, thus facilitating easy quantitative comparisons across studies.
Disadvantages include that: 1) it is dependent on the quality of the dietary assessment upon which the computation is based (it cannot make up for deficiencies in the methods of obtaining the dietary data); and 2) it is not focused specifically on other effects of diet, though it is correlated (r (correlation coefficient) around │0.50│) with other diet indices that purport to assess diet quality.[84][103][108]
Criticism and alternatives
Criticisms include that the DII is not up to date. It must be noted that though the index was refined by the inclusion of three more years (from 2008 through 2010) of publications and more than doubling of the literature base, no major change in the overall thrust of the literature base was evident.
Exercise and inflammation
Exercise-induced acute inflammation
Acute inflammation of the muscle cells, as understood in exercise physiology,[109] can result after inducedeccentric and concentric muscle training. Participation in eccentric training and conditioning, including resistance training and activities that emphasize eccentric lengthening of the muscle including downhill running on a moderate to high incline can result in considerable soreness within 24 to 48 hours, even though blood lactate levels, previously thought to cause muscle soreness, were much higher with level running. This delayed onset muscle soreness (DOMS) results from structural damage to the contractile filaments and z-disks, which has been noted especially in marathon runners whose muscle fibers revealed remarkable damage to the muscle fibers after both training and marathon competition[citation needed]. The onset and timing of this gradient damage to the muscle parallels the degree of muscle soreness experienced by the runners.
Z-disks are the point of contact for the contractile proteins. They provide structural support for transmission of force when muscle fibers are activated to shorten. However, in marathon runners and those who subscribe to the overload principle to enhance their muscles, show moderate Z-disk streaming and major disruption of thick and thin filaments in parallel groups of sarcomeres as a result of the force of eccentric actions or stretching of tightened muscle fibers.
This disruption of muscle fibers triggers white blood cells to increase following induced muscle soreness, leading to the inflammatory response observation from induced muscle soreness. Elevations in plasma enzymes, myoglobinemia, and abnormal muscle histology and ultrastructure are concluded to be associated with inflammatory response. High tension in the contractile-elastic system of muscle results in structural damage to the muscle fiber and plasmalemma and its epimysium, perimysium, and/or endomysium. The mysium damage disrupts calcium homeostasis in injured fibers and fiber bundles, resulting in necrosis that peaks about 48 hours after exercise. The products of macrophage activity and intracellular contents (such as histamines, kinins, and K+) accumulate outside cells. These substances then stimulate free nerve endings in the muscle; a process that appears accentuated by eccentric exercise, in which large forces are distributed over a relatively small cross-sectional area of the muscle[citation needed].
Post-inflammatory muscle growth and repair
There is a known relationship between inflammation and muscle growth.[110] For instance, high doses of anti-inflammatory medicines (e.g., NSAIDs) are able to blunt muscle growth.[111][112] Cold therapy has been shown to negatively affect muscle growth as well. Reducing inflammation results in decreased macrophage activity and lower levels of IGF-1[113] Acute effects of cold therapy on training adaptations show reduced satellite cell proliferation.[114] Long term effects include less muscular hypertrophy and an altered cell structure of muscle fibers.[115]
It has been further theorized that the acute localized inflammatory responses to muscular contraction during exercise, as described above, are a necessary precursor to muscle growth.[116] As a response to muscular contractions, the acute inflammatory response initiates the breakdown and removal of damaged muscle tissue.[117] Muscles can synthesize cytokines in response to contractions,[118][119][120] such that the cytokines interleukin-1 beta (IL-1β), TNF-α, and IL-6 are expressed in skeletal muscle up to 5 days after exercise.[117]
In particular, the increase in levels of IL-6 (interleukin 6), a myokine, can reach up to one hundred times that of resting levels.[120] Depending on volume, intensity, and other training factors, the IL-6 increase associated with training initiates about 4 hours after resistance training and remains elevated for up to 24 hours.[121][122][123]
These acute increases in cytokines, as a response to muscle contractions, help initiate the process of muscle repair and growth by activating satellite cells within the inflamed muscle. Satellite cells are crucial for skeletal muscle adaptation to exercise.[124] They contribute to hypertrophy by providing new myonuclei and repair damaged segments of mature myofibers for successful regeneration following injury- or exercise-induced muscle damage;[125][126][127] high-level powerlifters can have up to 100% more satellite cells than untrained controls.[128][129]
A rapid and transient localization of the IL-6 receptor and increased IL-6 expression occurs in satellite cells following contractions.[121] IL-6 has been shown to mediate hypertrophic muscle growth both in vitro and in vivo.[124] Unaccustomed exercise can increase IL-6 by up to sixfold at 5 hours post-exercise and threefold 8 days after exercise.[130] Also telling is the fact that NSAIDs can decrease satellite cell response to exercise,[111] thereby reducing exercise-induced protein synthesis.[112]
The increase in cytokines (myokines) after resistance exercise coincides with the decrease in levels of myostatin, a protein that inhibits muscle differentiation and growth.[123] The cytokine response to resistance exercise and moderate-intensity running occur differently, with the latter causing a more prolonged response, especially at the 12–24 hour mark.[123]
Developing research has demonstrated that many of the benefits of exercise are mediated through the role of skeletal muscle as an endocrine organ. That is, contracting muscles release multiple substances known as myokines, including but not limited to those cited in the above description, which promote the growth of new tissue, tissue repair, and various anti-inflammatory functions, which in turn reduce the risk of developing various inflammatory diseases. The new view that muscle is an endocrine organ is transforming our understanding of exercise physiology and with it, of the role of inflammation in adaptation to stress.[72]
Chronic inflammation and muscle loss
Both chronic and extreme inflammation are associated with disruptions of anabolic signals initiating muscle growth. Chronic inflammation has been implicated as part of the cause of the muscle loss that occurs with aging.[110][131] Increased protein levels of myostatin have been described in patients with diseases characterized by chronic low-grade inflammation.[132] Increased levels of TNF-α can suppress the AKT/mTOR pathway, a crucial pathway for regulating skeletal muscle hypertrophy,[133] thereby increasing muscle catabolism.[134][135][136] Cytokines may antagonize the anabolic effects of insulin-like growth factor 1 (IGF-1).[137][138] In the case of sepsis, an extreme whole body inflammatory state, the synthesis of both myofibrillar and sarcoplasmic proteins are inhibited, with the inhibition taking place preferentially in fast-twitch muscle fibers.[137][139] Sepsis is also able to prevent leucine from stimulating muscle protein synthesis.[118] In animal models, when inflammation is created, mTOR loses its ability to be stimulated by muscle growth.[140]
Exercise as a treatment for inflammation
Regular physical activity is reported to decrease markers of inflammation,[141][142][143] although the correlation is imperfect and seems to reveal differing results contingent upon training intensity. For instance, while baseline measurements of circulating inflammatory markers do not seem to differ greatly between healthy trained and untrained adults,[144][145] long-term training may help reduce chronic low-grade inflammation.[146]On the other hand, levels of the anti-inflammatory myokine IL-6 (interleukin 6) remained elevated longer into the recovery period following an acute bout of exercise in patients with inflammatory diseases, relative to the recovery of healthy controls.[146] It may well be that low-intensity training can reduce resting pro-inflammatory markers (CRP, IL-6), while moderate-intensity training has milder and less-established anti-inflammatory benefits.[144][147][148][149] There is a strong relationship between exhaustive exercise and chronic low-grade inflammation.[150] Marathon running may enhance IL-6 levels as much as 100 times over normal and increases total leuckocyte count and neturophil mobilization.[150]
Regarding the above, IL-6 had previously been classified as a proinflammatory cytokine. Therefore, it was first thought that the exercise-induced IL-6 response was related to muscle damage.[151] However, it has become evident that eccentric exercise is not associated with a larger increase in plasma IL-6 than exercise involving concentric “nondamaging” muscle contractions. This finding clearly demonstrates that muscle damage is not required to provoke an increase in plasma IL-6 during exercise. As a matter of fact, eccentric exercise may result in a delayed peak and a much slower decrease of plasma IL-6 during recovery.[152]
Recent work has shown that both upstream and downstream signalling pathways for IL-6 differ markedly between myocytes and macrophages. It appears that unlike IL-6 signalling in macrophages, which is dependent upon activation of the NFκB signalling pathway, intramuscular IL-6 expression is regulated by a network of signalling cascades, including the Ca2+/NFAT and glycogen/p38 MAPK pathways. Thus, when IL-6 is signalling in monocytes or macrophages, it creates a pro-inflammatory response, whereas IL-6 activation and signalling in muscle is totally independent of a preceding TNF-response or NFκB activation, and is anti-inflammatory.[153]
Several studies show that markers of inflammation are reduced following longer-term behavioural changes involving both reduced energy intake and a regular program of increased physical activity, and that, in particular, IL-6 was miscast as an inflammatory marker. For example, the anti-inflammatory effects of IL-6 have been demonstrated by IL-6 stimulating the production of the classical anti-inflammatory cytokines IL-1ra and IL-10.[153] As such, individuals pursuing exercise as a means to treat the causal factors underlying chronic inflammation are pursuing a course of action strongly supported by current research, as an inactive lifestyle is strongly associated with the development and progression of multiple inflammatory diseases. Note that cautions regarding over-exertion may apply in certain cases, as discussed above, though this concern rarely applies to the general population.
Signal-to-noise theory
Given that localized acute inflammation is a necessary component for muscle growth, and that chronic low-grade inflammation is associated with a disruption of anabolic signals initiating muscle growth, it has been theorized that a signal-to-noise model may best describe the relationship between inflammation and muscle growth.[154] By keeping the “noise” of chronic inflammation to a minimum, the localized acute inflammatory response signals a stronger anabolic response than could be achieved with higher levels of chronic inflammation.
Non-steroidal anti-inflammatory drugs (NSAIDs) alleviate pain by counteracting the cyclooxygenase (COX) enzyme. On its own, COX enzyme synthesizes prostaglandins, creating inflammation. In whole, the NSAIDs prevent the prostaglandins from ever being synthesized, reducing or eliminating the pain.
Some common examples of NSAIDs are aspirin, ibuprofen, and naproxen. The newer specific COX-inhibitors are not classified together with the traditional NSAIDs even though they presumably share the same mode of action.
On the other hand, there are analgesics that are commonly associated with anti-inflammatory drugs but that have no anti-inflammatory effects. An example is paracetamol (known as acetaminophen in the U.S). As opposed to NSAIDs, which reduce pain and inflammation by inhibiting COX enzymes, paracetamol has – as early as 2006 – been shown to block the reuptake of endocannabinoids,[1][2] which only reduces pain, likely explaining why it has minimal effect on inflammation; paracetamol is sometimes combined with an NSAID (in place of an opioid) in clinical practice to enhance the pain relief of the NSAID while still receiving the injury/disease modulating effect of NSAID-induced inflammation reduction (which is not received from opioid/paracetamol combinations).[3]
Side-effects
Long-term use of NSAIDs can cause gastric erosions, which can become stomach ulcers and in extreme cases can cause severe haemorrhage, resulting in death. The risk of death as a result of GI bleeding caused by the use of NSAIDs is 1 in 12,000 for adults aged 16–45.[4] The risk increases almost twentyfold for those over 75.[4] Other dangers of NSAIDs are exacerbating asthma and causing kidney damage.[4] Apart from aspirin, prescription and over-the-counter NSAIDs also increase the risk of myocardial infarction and stroke.[5]
ImSAIDs are a class of peptides being developed by IMULAN BioTherapeutics, LLC, which were discovered to have diverse biological properties, including anti-inflammatory properties. ImSAIDs work by altering the activation and migration of inflammatory cells, which are immune cells responsible for amplifying the inflammatory response.[10][11] The ImSAIDs represent a new category of anti-inflammatory and are unrelated to steroid hormones or non-steroidal anti-inflammatories.
The ImSAIDs were discovered by scientists evaluating biological properties of the submandibular gland and saliva. Early work in this area demonstrated that the submandibular gland released a host of factors that regulate systemic inflammatory responses and modulate systemic immune and inflammatory reactions. It is now well accepted that the immune, nervous, and endocrine systems communicate and interact to control and modulate inflammation and tissue repair. One of the neuroendocrine pathways, when activated, results in the release of immune-regulating peptides from the submandibular gland upon neuronal stimulation from sympathetic nerves. This pathway or communication is referred to as the cervical sympathetic trunk-submandibular gland (CST-SMG) axis, a regulatory system that plays a role in the systemic control of inflammation.[12]
Early work in identifying factors that played a role in the CST-SMG axis lead to the discovery of a seven amino acidpeptide, called the submandibular gland peptide-T. SGP-T was demonstrated to have biological activity and thermoregulatory properties related to endotoxin exposure.[13] SGP-T, an isolate of the submandibular gland, demonstrated its immunoregulatory properties and potential role in modulating the cervical sympathetic trunk-submandibular gland (CST-SMG) axis, and subsequently was shown to play an important role in the control of inflammation.
One SGP-T derivative is a three-amino acid sequence shown to be a potent anti-inflammatory molecule with systemic effects. This three-amino acid peptide is phenylalanine–glutamine–glycine (FEG) and its D-isomeric form (feG) have become the foundation for the ImSAID category.[14] Cellular Effects of feG: The cellular effects of the ImSAIDs are characterized in a number of publications. feG and related peptides are known to modulate leukocyte (white blood cells) activity by influencing cell surface receptors to inhibit excessive activation and tissue infiltration.
One lead ImSAID, the tripeptide FEG (Phe-Glu-Gly) and its D-isomer feG are known to alter leukocyte adhesion involving actions on αMβ2 integrin, and inhibit the binding of CD16b (FCyRIII) antibody to human neutrophils.[15] feG has also been shown to decrease circulating neutrophil and eosinophil accumulation, decrease intracellular oxidative activity, and reduce the expression of CD49d after antigen exposure.[16][17][18]
Bioactive compounds
Many bioactive compounds showed anti-inflammatory activities on albino rat. Anti-inflammatory activity of Plumbago zeylanica consists of Bioactive compound Plumbagin showed high activity in very low concentration.[19] More recently plumericin from the Amazonian plant Himatanthus sucuuba has been described as a potent anti-inflammatory agent in vitro and in vivo.[20]
Long-term effects
Anti-inflammatory treatment trials for existing Alzheimer’s disease have typically shown little to no effect on halting or reversing the disease.[21][22] Research and clinical trials continue.[23] Two studies from 2012 and 2013 found regular use of aspirin for over ten years is associated with an increase in the risk of macular degeneration.[24][25]
Ice treatment
Applying ice, or even cool water, to a tissue injury has an anti-inflammatory effect and is often suggested as an injury treatment and pain management technique for athletes. One common approach is rest, ice, compression and elevation. Cool temperatures inhibit local blood circulation, which reduces swelling in the injured tissue.
Coal tar has been used for centuries for its anti-inflammatory and analgesic effects. Oral administration for central effects is now rare as coal tar also contains a range of dangerous and carcinogenic compounds, and does not allow for the administration of standardized doses, although some doctors readily utilize coal tar preparations for topical administration (ex. Denorex, Psoriasin) in the treatment of skin conditions such as eczema and atopic dermatitis. Many modern analgesics and anti-inflammatory agents (ex. paracetamol, and its previously used predecessor phenacetin) are derived from compounds which were originally discovered during studies to elucidate the chemicals responsible for the tars reputed health benefits.[29][30]
Prostaglandins are hormone-like substances that affect the body in variety of ways, also regulating inflammatory mediation. An anti-flammatory diet includes fewer foods that create inflammation-causing prostaglandins (PGE2) in the body, and more foods that create anti-inflammatory prostaglandins (PGE1 and PGE3).[31][not in citation given]
Suggested diets to reduce inflammation include those rich in vegetables and low in simple carbohydrates and fats, such as saturated fats and trans fats.[32] Anti-inflammatory foods include most colorful fruits and vegetables, oily fish (which contain higher levels of omega-3 fatty acids), nuts, seeds, and certain spices, such as ginger, garlic and cayenne. Extra-virgin olive oil contains the chemical oleocanthal that acts similarly to ibuprofen. Those following an anti-inflammatory diet will avoid refined oils and sugars, and show a preference for so-called anti-inflammatory foods in their meal choices.[33][34]
Omega-3 fatty acids have been shown to disrupt inflammation cell signaling pathways by binding to the GPR120 receptor.[35] This benefit however can be inhibited or even reversed if the ratio of Omega-6/Omega-3 is too high as Omega-6 serves as a precursor to inflammatory chemicals (prostaglandin and leukotriene eicosanoids) in the body.[36][37] A high proportion of omega-6 to omega-3 fat in the diet shifts the physiological state in the tissues toward the pathogenesis of many diseases: prothrombotic, proinflammatory and proconstrictive.[36] Omega-6 competes with Omega-3 for the same rate limiting factor which is required for the health-benefits of Omega-3, directly reducing the action of Omega-3 in addition to pharmacologically counteracting Omega-3 benefits through its own action as a pro-inflammatory agent.
Developing research has demonstrated that many of the benefits of exercise are mediated through the role of skeletal muscle as an endocrine organ. That is, contracting muscles release multiple substances known as myokines which promote the growth of new tissue, tissue repair, and various anti-inflammatory functions, which in turn reduce the risk of developing various inflammatory diseases.[38]
Interactions with NSAIDs
Patients on NSAIDs should seek to avoid excessive consumption of Omega-6 containing foods. Although many such foods contain the anti-inflammatory Omega-3 as well, low doses of Omega-6 interfere with Omega-3’s ability to reduce inflammation, while higher doses are capable of completely inhibiting the effects of most currently-used anti-inflammatory agents (cyclooxygenase 1 inhibitors, cyclooxygenase 2 inhibitors, and antileukotrienes).[39][40][41]
The concomitant use of NSAIDs with alcohol and/or tobacco products significantly increases the already elevated risk of peptic ulcers during NSAID therapy.[42]
NSAID painkillers may interfere with and reduce the efficacy of SSRI antidepressants through inhibiting TNFα and IFNγ, both of which are cytokine derivatives.[43]
Scott Carl Sigler is a contemporary American author of science fiction and horror as well as an avid podcaster. Scott is the New York Times #1 bestselling author of sixteen novels, six novellas, and dozens of short stories. He is the co-founder of Empty Set Entertainment, which publishes his young adult Galactic Football League series. He lives in San Diego.
Life and work
Raised in Cheboygan, Michigan Sigler’s father passed his love of classic monster films along to his son. His mother, a school teacher, encouraged his reading offering him any book he wanted.[1] Sigler wrote his first monster story, “Tentacles”, at the age of eight.[2] Sigler didn’t travel far for college having attended Olivet College (Olivet, MI) and Cleary College (Ann Arbor, MI) where he earned a BA in Journalism and a BS in Marketing. Scott has had a varied career path having worked fast food, picking fruit, shoveling horse manure, a sports reporter, director of marketing for a software company, software startup founder, marketing consultant, guitar salesman, bum in a rock band,[3] and currently as a social media strategist. He now resides in San Diego, California with his dog, Reesie.
EarthCore was originally published in 2001 by iPublish, an AOL/Time Warner imprint.[4] With the novel doing well as a promotional ebook, Time Warner was planning on publishing the novel. With the economic slump following September 11, 2001 terrorist attacks, Time Warner did away with the imprint in 2004. Scott then decided to start podcasting his novel in March, 2005 as the world’s first podcast-only novel[5] to build hype and garner an audience for his work. Sigler considered it a “no brainer” to offer the book as a free audio download. Having searched for podcast novels and finding none, Sigler decided to be the first.[6][7] Sigler was able to get EarthCore offered as a paid download on iTunes in 2006.[8] After EarthCore’s success (EarthCore had over 10,000 subscribers[9]), Sigler released Ancestor, Infected, The Rookie, Nocturnal, and Contagious via podcast.[10]
Sigler released an Adobe PDF version of Ancestor in March 2007 through Sigler’s own podcast as well as others. Ancestor was released on April 1, 2007 to much internet hype and, despite having been released two weeks earlier as a free ebook, reached #7 on Amazon.com‘s best-seller list and #1 on Sci-Fi, Horror and Genre-Fiction on the day of release.[11] Sigler is leveraging new media to keep in-touch with his fans, regularly talking with them using social networking sites, via email, and IM. Scott Sigler was featured in a New York Times article on March 1, 2007 by Andrew Adam Newman, which was covering authors using podcasting innovations to garner a broader audience.[12]
In March 2014, Executive Editor Mark Tavani at Ballantine Bantam Dell bought World Rights to a science fiction trilogy by Sigler. In the first book, Alive, a young woman awakes trapped in a confined space with no idea who she is or how she got there. She soon frees other young adults in the room and together they find that they are surrounded by the horrifying remains of a war long past … and matched against an enemy too horrible to imagine. Further adventures will follow in two more books, Alight and Alone. The books will be published under the Del Rey imprint.[13] On Wednesday, July 15, 2016, it was announced that Alive made #1 on the New York Times Bestseller list in the Young Adult E-Book category.[14]
Sigler calls Stephen King a “‘master craftsman’, who writes from the ‘regular guy’ strata from which he hails. His older stuff had no pretense, no ‘higher message,’ no ‘I’m extremely important’ attitude, just rock-solid storytelling and character development. He also would whack any character at any time, and that’s what hooked you in – when characters got into trouble, you didn’t know if they’d live, unlike 99% of the books out there that are trying to develop franchise characters.” According to Sigler, Jack London‘s “The Sea Wolf totally changed my views on life”. Sigler saw King Kong (1976 version) when he was a little kid. He said it, “Scared the crap out of me. I hid behind my dad’s shoulder and begged to leave the theatre. As soon as we were out, I asked when we could see it again – that was the moment I knew I wanted to tell monster stories. I wanted to have that same impact on other people.”
Awards
Sigler has been a runner up in both the 2006 and 2007 Parsec Awards. In 2006 Sigler was a runner up for his short story Hero in the Best Fiction (Short) category and for Infected in the Best Fiction (Long) category. In 2007 Sigler was a runner up for The Rookie in the Best Speculative Fiction Story (Novel Form) category. In 2008 Sigler’s Contagious, the sequel to Infected was listed at 33 on the New York Times best sellers list.
In 2008 Sigler broke through and won the Parsec Award for Red Man in the Best Speculative Fiction Story (Short Form) category. He followed up with another win in 2009 for Eusocial Networking in the Best Speculative Fiction Story (Novella Form) category. 2010 saw him continue to win in the Best Speculative Fiction Story (Short Form) category with his podcast, The Tank, and in 2011 he again took out the Best Speculative Fiction Story (Novella Form) category with Kissyman & the Gentleman.
On July 31, 2015, Scott was inducted into the inaugural class of the Academy of Podcasters Hall of Fame at a ceremony in Fort Worth, Texas.[15]
See the Scott Sigler bibliography page for more detailed information about the above novels and his many other works, including novellas related to the Galactic Football League series, short story collections, other short stories, upcoming projects, etc.
Adaptations
Film
In May, 2007 the novel Infected was optioned by Rogue Pictures and Random House Films;[17] however, the option lapsed in April 2010.[citation needed] The short story Sacred Cow was made into an online only mini-film by StrangerThings.tv and was Stranger Things debut episode.[18] “Cheating Bastard”, a short film about a couple in love with football and their obsession with it, was created by Brent Weichsel and released via Sigler’s RSS feed.
Graphic novel
In 2010 work began on a graphic novel adaptation of Sigler’s Infected.[19] The first issue was released August 1, 2012,[20]but the series was put on hold indefinitely due to delays with subsequent issues.[21]
Recordings
Albums
The Crucible (2016) by Separation Of Sanity. Scott’s original spoken word appears on four tracks: The Pact, Pandemic (inspired by his novel of the same name), Bag Of Blood (his major appearance on the album), and End Of Days.
Readings
Scott reads Union Dues – Off White Lies by Jeffrey R. DeRego on Escape Pod, Episode 49, on April 13, 2006.
Scott reads Reggie vs. Kaiju Storm Chimera Wolf by Matthew Wayne Selznick on Escape Pod, Episode 117, on August 2, 2007.
The Pronk Pops Show 551, October 12, 2015, Story 1: President Obama Stalls Islamic State While He Runs Out The Clock On His Failed Presidency — Who is next? President Trump — Obama A Real Loser — Leading On Climate Change — Give Me A Break! — Videos
60 Minutes in 60 Seconds (Day 36)
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“60 Minutes” interview: President Obama
Dr David Evans on Global Warming
50 to 1 Project – David Evans Interview
Freeman Dyson on the Global Warming Hysteria April, 2015
High Hopes and Missed Opportunities in Iraq
Emma Sky: “The Unraveling”
Reflections on the Future of War with Gen. Raymond Odierno
Thomas Barnett: Rethinking America’s military strategy
Donald Trump Iran Deal FULL SPEECH, Against Iran Nuclear Agreement at Tea Party Rally Sept. 9, 2015
The Iran Nuclear Deal
Iran and the Bomb
Climate Change in 12 Minutes – The Skeptic’s Case
Climategate: What They Aren’t Telling You!
Krauthammer: ‘Sputtering’ Obama Admin Has No Idea What to Do About Russia, Syria
Donald Trump Fox & Friends RIPS Obama 60 Minute Interview & Biden’s Low Poll Numbers FULL Interview
Donald trump Meet The Press FULL Interview 10/4/2015
60 Minutes Host Destroys Barack Obama On Syria
60 Minutes Host Embarrasses Barack Obama On Syria II
Background Articles and Videos
MAJOR REDUCTIONS IN CARBON EMISSIONS ARE NOT WORTH THE MONEY DEBATE: PETER HUBER
MAJOR REDUCTIONS IN CARBON EMISSIONS ARE NOT WORTH THE MONEY DEBATE: PHILIP STOTT
Professor Fred Singer on Climate Change Pt 1
Professor Fred Singer on Climate Change Pt 2
Global Warming, Lysenkoism & Eugenics Prof Richard Lindzen
Interview with Professor Richard Lindzen
Richard Lindzen, Ph.D. Lecture Deconstructs Global Warming Hysteria (High Quality Version)
Global Warming – Michael Crichton
Michael Crichton | States of Fear: Science or Politics?
Dr Roy Spencer on Global Warming Part 1 of 6
Dr Roy Spencer on Global Warming Part 2 of 6
Dr Roy Spencer on Global Warming Part 3 of 6
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Sen. Inhofe To Investigate ClimateGate
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ManBearPig, Climategate and Watermelons: A conversation with author James Delingpole
James Delingpole: Great Britain, the Green Movement, and the End of the World
George Carlin on Global Warming
Americans Skeptical of Science Behind Global Warming
“…Most Americans (52%) believe that there continues to be significant disagreement within the scientific community over global warming.
While many advocates of aggressive policy responses to global warming say a consensus exists, the latest Rasmussen Reports national telephone survey finds that just 25% of adults think most scientists agree on the topic. Twenty-three percent (23%) are not sure. …”
Steve Kroft: The last time we talked was this time last year, and the situation in Syria and Iraq had begun to worsen vis-Ã -vis ISIS. You had just unveiled a plan to provide air support for troops in Iraq, and also some air strikes in Syria, and the training and equipping of a moderate Syrian force. You said that this would degrade and eventually destroy ISIS.
President Barack Obama: Over time.
Steve Kroft: Over time. It’s been a year, and–
President Barack Obama: I didn’t say it was going to be done in a year.
Steve Kroft: No. But you said…
President Barack Obama: There’s a question in here somewhere.
…
Steve Kroft: Who’s going to get rid of them?
President Barack Obama: Over time, the community of nations will all get rid of them, and we will be leading getting rid of them. But we are not going to be able to get rid of them unless there is an environment inside of Syria and in portions of Iraq in which local populations, local Sunni populations, are working in a concerted way with us to get rid of them.
On the “moderate opposition” in Syria:
Steve Kroft: You have been talking about the moderate opposition in Syria. It seems very hard to identify. And you talked about the frustrations of trying to find some and train them. You got a half a billion dollars from Congress to train and equip 5,000, and at the end, according to the commander CENTCOM, you got 50 people, most of whom are dead or deserted. He said four or five left?
President Barack Obama: Steve, this is why I’ve been skeptical from the get go about the notion that we were going to effectively create this proxy army inside of Syria. My goal has been to try to test the proposition, can we be able to train and equip a moderate opposition that’s willing to fight ISIL? And what we’ve learned is that as long as Assad remains in power, it is very difficult to get those folks to focus their attention on ISIL.
Steve Kroft: If you were skeptical of the program to find and identify, train and equip moderate Syrians, why did you go through the program?
President Barack Obama: Well, because part of what we have to do here, Steve, is to try different things. Because we also have partners on the ground that are invested and interested in seeing some sort of resolution to this problem. And–
Steve Kroft: And they wanted you to do it.
President Barack Obama: Well, no. That’s not what I said. I think it is important for us to make sure that we explore all the various options that are available.
Steve Kroft: I know you don’t want to talk about this.
President Barack Obama: No, I’m happy to talk about it.
Steve Kroft: I want to talk about the– this program, because it would seem to show, I mean, if you expect 5,000 and you get five, it shows that somebody someplace along the line did not– made– you know, some sort of a serious miscalculation.
President Barack Obama: You know, the– the– Steve, let me just say this.
Steve Kroft: It’s an embarrassment.
President Barack Obama: Look, there’s no doubt that it did not work. And, one of the challenges that I’ve had throughout this heartbreaking situation inside of Syria is, is that– you’ll have people insist that, you know, all you have to do is send in a few– you know, truckloads full of arms and people are ready to fight. And then, when you start a train-and-equip program and it doesn’t work, then people say, “Well, why didn’t it work?” Or, “If it had just started three months earlier it would’ve worked.”
Steve Kroft: But you said yourself you never believed in this.
President Barack Obama: Well– but Steve, what I have also said is, is that surprisingly enough it turns out that in a situation that is as volatile and with as many players as there are inside of Syria, there aren’t any silver bullets. And this is precisely why I’ve been very clear that America’s priorities has to be number one, keeping the American people safe. Number two, we are prepared to work both diplomatically and where we can to support moderate opposition that can help convince the Russians and Iranians to put pressure on Assad for a transition. But that what we are not going to do is to try to reinsert ourselves in a military campaign inside of Syria. Let’s take the situation in Afghanistan, which I suspect you’ll ask about. But I wanted to use this as an example.
Steve Kroft: All right. I feel like I’m being filibustered, Mr. President.
President Barack Obama: No, no, no, no, no. Steve, I think if you want to roll back the tape, you’ve been giving me long questions and statements, and now I’m responding to ’em. So let’s– so– if you ask me big, open-ended questions, expect big, open-ended answers. Let’s take the example of Afghanistan. We’ve been there 13 years now close to 13 years. And it’s still hard in Afghanistan. Today, after all the investments we have there, and we still have thousands of troops there. So the notion that after a year in Syria, a country where the existing government hasn’t invited us in, but is actively keeping us out, that somehow we would be able to solve this quickly– is–
Steve Kroft: We didn’t say quickly.
President Barack Obama: –is– is– is an illusion. And– and–
Steve Kroft: Nobody’s expecting that, Mr. President.
President Barack Obama: Well, the– no, I understand, but what I’m– the simple point I’m making, Steve, is that the solution that we’re going to have inside of Syria is ultimately going to depend not on the United States putting in a bunch of troops there, resolving the underlying crisis is going to be something that requires ultimately the key players there to recognize that there has to be a transition to new government. And, in the absence of that, it’s not going to work.
On Russia:
Steve Kroft: One of the key players now is Russia.
President Barack Obama: Yeah.
Steve Kroft: A year ago when we did this interview, there was some saber-rattling between the United States and Russia on the Ukrainian border. Now it’s also going on in Syria. You said a year ago that the United States– America leads. We’re the indispensible nation. Mr. Putin seems to be challenging that leadership.
President Barack Obama: In what way? Let– let’s think about this– let– let–
Steve Kroft: Well, he’s moved troops into Syria, for one. He’s got people on the ground. Two, the Russians are conducting military operations in the Middle East for the first time since World War II–
President Barack Obama: So that’s–
Steve Kroft: –bombing the people– that we are supporting.
President Barack Obama: So that’s leading, Steve? Let me ask you this question. When I came into office, Ukraine was governed by a corrupt ruler who was a stooge of Mr. Putin. Syria was Russia’s only ally in the region. And today, rather than being able to count on their support and maintain the base they had in Syria, which they’ve had for a long time, Mr. Putin now is devoting his own troops, his own military, just to barely hold together by a thread his sole ally. And in Ukraine–
Steve Kroft: He’s challenging your leadership, Mr. President. He’s challenging your leadership–
President Barack Obama: Well Steve, I got to tell you, if you think that running your economy into the ground and having to send troops in in order to prop up your only ally is leadership, then we’ve got a different definition of leadership. My definition of leadership would be leading on climate change, an international accord that potentially we’ll get in Paris. My definition of leadership is mobilizing the entire world community to make sure that Iran doesn’t get a nuclear weapon. And with respect to the Middle East, we’ve got a 60-country coalition that isn’t suddenly lining up around Russia’s strategy. To the contrary, they are arguing that, in fact, that strategy will not work.
Steve Kroft: My point is– was not that he was leading, my point is that he was challenging your leadership. And he has very much involved himself in the situation. Can you imagine anything happening in Syria of any significance at all without the Russians now being involved in it and having a part of it?
President Barack Obama: But that was true before. Keep in mind that for the last five years, the Russians have provided arms, provided financing, as have the Iranians, as has Hezbollah.
Steve Kroft: But they haven’t been bombing and they haven’t had troops on the ground–
President Barack Obama: And the fact that they had to do this is not an indication of strength, it’s an indication that their strategy did not work.
Steve Kroft: You don’t think–
President Barack Obama: You don’t think that Mr. Putin would’ve preferred having Mr. Assad be able to solve this problem without him having to send a bunch of pilots and money that they don’t have?
Steve Kroft: Did you know he was going to do all this when you met with him in New York?
President Barack Obama: Well, we had seen– we had pretty good intelligence. We watch–
Steve Kroft: So you knew he was planning to do it.
President Barack Obama: We knew that he was planning to provide the military assistance that Assad was needing because they were nervous about a potential imminent collapse of the regime.
Steve Kroft: You say he’s doing this out of weakness. There is a perception in the Middle East among our adversaries, certainly and even among some of our allies that the United States is in retreat, that we pulled our troops out of Iraq and ISIS has moved in and taken over much of that territory. The situation in Afghanistan is very precarious and the Taliban is on the march again. And ISIS controls a large part of Syria.
President Barack Obama: I think it’s fair to say, Steve, that if–
Steve Kroft: It’s– they– let me just finish the thought. They say your–
President Barack Obama: You’re–
Steve Kroft: –they say you’re projecting a weakness, not a strength–
President Barack Obama: –you’re saying “they,” but you’re not citing too many folks. But here–
Steve Kroft: No, I’ll cite– I’ll cite if you want me, too.
President Barack Obama: –here– yes. Here–
Steve Kroft: I’d say the Saudis. I’d say the Israelis. I’d say a lot of our friends in the Middle East. I’d say everybody in the Republican party. Well, you want me to keep going?
President Barack Obama: Yeah. The– the– if you are– if you’re citing the Republican party, I think it’s fair to say that there is nothing I’ve done right over the last seven and a half years. And I think that’s right. It– and– I also think what is true is that these are the same folks who were making an argument for us to go into Iraq and who, in some cases, still have difficulty acknowledging that it was a mistake. And Steve, I guarantee you that there are factions inside of the Middle East, and I guess factions inside the Republican party who think that we should send endless numbers of troops into the Middle East, that the only measure of strength is us sending back several hundred thousand troops, that we are going to impose a peace, police the region, and– that the fact that we might have more deaths of U.S. troops, thousands of troops killed, thousands of troops injured, spend another trillion dollars, they would have no problem with that. There are people who would like to see us do that. And unless we do that, they’ll suggest we’re in retreat.
Steve Kroft: They’ll say you’re throwing in the towel–
President Barack Obama: No. Steve, we have an enormous presence in the Middle East. We have bases and we have aircraft carriers. And our pilots are flying through those skies. And we are currently supporting Iraq as it tries to continue to build up its forces. But the problem that I think a lot of these critics never answered is what’s in the interest of the United States of America and at what point do we say that, “Here are the things we can do well to protect America. But here are the things that we also have to do in order to make sure that America leads and America is strong and stays number one.” And if in fact the only measure is for us to send another 100,000 or 200,000 troops into Syria or back into Iraq, or perhaps into Libya, or perhaps into Yemen, and our goal somehow is that we are now going to be, not just the police, but the governors of this region. That would be a bad strategy Steve. And I think that if we make that mistake again, then shame on us.
Steve Kroft: Do you think the world’s a safer place?
President Barack Obama: America is a safer place. I think that there are places, obviously, like Syria that are not safer than when I came into office. But, in terms of us protecting ourselves against terrorism, in terms of us making sure that we are strengthening our alliances, in terms of our reputation around the world, absolutely we’re stronger.
On Friday, the Pentagon ended the program to train-and-equip Syrian rebels that the president told us did not work. In a moment, he talks about Donald Trump, Hillary Clinton’s emails and Joe Biden’s possible run for president.
Steve Kroft: OK. Mr. President, there are a lot of serious problems with the world right now, but I want to ask you a few questions about politics.
President Barack Obama: Yeah, go ahead.
Steve Kroft: What do you think of Donald Trump?
President Barack Obama: Well, I think that he is a great publicity-seeker and at a time when the Republican party hasn’t really figured out what it’s for, as opposed to what it’s against. I think that he is tapped into something that exists in the Republican party that’s real. I think there is genuine anti-immigrant sentiment in the large portion of at least Republican primary voters. I don’t think it’s uniform. He knows how to get attention. He is, you know, the classic reality TV character and, at this early stage, it’s not surprising that he’s gotten a lot of attention.
Steve Kroft: You think he’s running out of steam? I mean, you think he’s going to disappear?
President Barack Obama: You know, I’ll leave it up to the pundits to make that determination. I don’t think he’ll end up being president of the United States.
Steve Kroft: Did you know about Hillary Clinton’s use of private email server–
President Barack Obama: No.
Steve Kroft: –while she was Secretary of State?
President Barack Obama: No.
Steve Kroft: Do you think it posed a national security problem?
President Barack Obama: I don’t think it posed a national security problem. I think that it was a mistake that she has acknowledged and– you know, as a general proposition, when we’re in these offices, we have to be more sensitive and stay as far away from the line as possible when it comes to how we handle information, how we handle our own personal data. And, you know, she made a mistake. She has acknowledged it. I do think that the way it’s been ginned-up is in part because of– in part– because of politics. And I think she’d be the first to acknowledge that maybe she could have handled the original decision better and the disclosures more quickly. But–
Steve Kroft: What was your reaction when you found out about it?
President Barack Obama: This is one of those issues that I think is legitimate, but the fact that for the last three months this is all that’s been spoken about is an indication that we’re in presidential political season.
Steve Kroft: Do you agree with what President Clinton has said and Secretary Clinton has said, that this is not– not that big a deal. Do you agree with that?
President Barack Obama: Well, I’m not going to comment on–
Steve Kroft: You think it’s not that big a deal–
President Barack Obama: What I think is that it is important for her to answer these questions to the satisfaction of the American public. And they can make their own judgment. I can tell you that this is not a situation in which America’s national security was endangered.
Steve Kroft: This administration has prosecuted people for having classified material on their private computers.
President Barack Obama: Well, I– there’s no doubt that there had been breaches, and these are all a matter of degree. We don’t get an impression that here there was purposely efforts– on– in– to hide something or to squirrel away information. But again, I’m gonna leave it to–
Steve Kroft: If she had come to you.
President Barack Obama: I’m going to leave it to Hillary when she has an interview with you to address all these questions.
Steve Kroft: Right now, there’s nobody on either side of the aisle that is exactly running on your record. Do you want Joe Biden to get in the race and do it?
President Barack Obama: You know, I am going to let Joe make that decision. And I mean what I say. I think Joe will go down as one of the finest vice presidents in history, and one of the more consequential. I think he has done great work. I don’t think there’s any politician at a national level that has not thought about being the president. And if you’re sitting right next to the president in every meeting and, you know wrestling with these issues, I’m sure that for him he’s saying to himself, “I could do a really good job.”
Steve Kroft: I do want to talk a little bit about Congress. Are you going to miss John Boehner?
President Barack Obama: John Boehner and I disagreed on just about everything. But the one thing I’ll say about John Boehner is he did care about the institution. He recognized that nobody gets 100 percent in our democracy. I won’t say that he and I were ideal partners, but he and I could talk and we could get some things done. And so I am a little concerned that the reason he left was because there are a group of members of Congress who think having somebody who is willing to shut down the government or default on the U.S. debt is going to allow them to get their way 100 percent of the time.
Steve Kroft: Do you think you’re going to be able to get anything through Congress?
President Barack Obama: Well, given that– this Congress hasn’t been able to get much done at all over the last year and a half, two years, for that matter for the last four, it would be surprising if we were able to make huge strides on the things that are important. But I have a more modest goal, which is to make sure that Congress doesn’t do damage to the economy.
The president says that means avoiding another budget crisis and another round of threats to shut down the government, which could happen as early as December. Even with congressional Republicans in disarray, he’s hoping to reach a deal with Congress as he did two years ago, to lift some spending caps in defense and other areas while continuing to reduce the deficit.
President Barack Obama: Right now, our economy is much stronger relative to the rest of the world. China, Europe, emerging markets, they’re all having problems. And so, if we provide another shock to the system by shutting down the government, that could mean that the progress we have made starts going backwards instead of forwards. We have to make sure that we pass a transportation bill. It may not be everything that I want. We should be being much more aggressive in rebuilding America right now. Interest rates are low, construction workers need the work, and our economy would benefit from it. But if we can’t do a big multiyear plan, we have to at least do something that is robust enough– so that we are meeting the demands of a growing economy.
Steve Kroft: A few months back, at a fundraiser, you made a point of saying that the first lady was very pleased that you can’t run again.
President Barack Obama: Yeah, she is.
Steve Kroft: Do you feel the same way?
President Barack Obama: You know, it’s interesting. I– you go into your last year and I think it’s bittersweet. On the one hand, I am very proud of what we’ve accomplished and it makes me think, I’d love to do some more. But by the time I’m finished, I think it will be time for me to go. Because there’s a reason why we considered George Washington one of our greatest presidents. He set a precedent, saying that when you occupy this seat, it is an extraordinary privilege, but the way our democracy is designed, no one person is indispensable. And ultimately you are a citizen. And once you finish with your service, you go back to being a citizen. And I– and I think that– I think having a fresh set of legs in this seat, I think having a fresh perspective, new personnel and new ideas and a new conversation with the American people about issues that may be different a year from now than they were when I started eight years ago, I think that’s all good for our democracy. I think it’s healthy.
Steve Kroft: Do you think if you ran again, could run again, and did run again, you would be elected?
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President Obama is continuing his push for the Iran nuclear deal, giving a speech at American University. Here is a complete transcript of his remarks.
OBAMA: Thank you.
(APPLAUSE)
Thank you so much. Thank you. Everybody, please have a seat. Thank you very much.
I apologize for the slight delay; even presidents have a problem with toner.
(LAUGHTER)
It is a great honor to be back at American University, which has prepared generations of young people for service and public life.
I want to thank President Kerwin and the American University family for hosting us here today.
Fifty-two years ago, President Kennedy, at the height of the Cold War, addressed this same university on the subject of peace. The Berlin Wall had just been built. The Soviet Union had tested the most powerful weapons ever developed. China was on the verge of acquiring the nuclear bomb. Less than 20 years after the end of World War II, the prospect of nuclear war was all too real.
With all of the threats that we face today, it is hard to appreciate how much more dangerous the world was at that time. In light of these mounting threats, a number of strategists here in the United States argued we had to take military action against the Soviets, to hasten what they saw as inevitable confrontation. But the young president offered a different vision.
OBAMA: Strength, in his view, included powerful armed forces and a willingness to stand up for our values around the world. But he rejected the prevailing attitude among some foreign-policy circles that equated security with a perpetual war footing.
Instead, he promised strong, principled American leadership on behalf of what he called a practical and attainable peace, a peace based not on a sudden revolution in human nature, but on a gradual evolution in human institutions, on a series of concrete actions and effective agreements.
Such wisdom would help guide our ship of state through some of the most perilous moments in human history. With Kennedy at the helm, the Cuban Missile Crisis was resolved peacefully.
Under Democratic and Republican presidents, new agreements were forged: A nonproliferation treaty that prohibited nations from acquiring nuclear weapons, while allowing them to access peaceful nuclear energy, the SALT and START treaties, which bound the United States and the Soviet Union to cooperation on arms control.
Not every conflict was averted, but the world avoided nuclear catastrophe, and we created the time and the space to win the Cold War without firing a shot at the Soviets.
The agreement now reached between the international community and the Islamic Republic of Iran builds on this tradition of strong, principled policy diplomacy.
After two years of negotiations, we have achieved a detailed arrangement that permanently prohibits Iran from obtaining a nuclear weapon. It cuts off all of Iran’s pathways to a bomb. It contains the most comprehensive inspection and verification regime ever negotiated to monitor a nuclear program.
As was true in previous treaties, it does not resolve all problems. It certainly doesn’t resolve all our problems with Iran. It does not ensure a warming between our two countries. But it achieves one of our most critical security objectives. As such, it is a very good deal.
Today, I want to speak to you about this deal and the most consequential foreign-policy debate that our country has had since the invasion of Iraq, as Congress decides whether to support this historic diplomatic breakthrough or instead blocks it over the objection of the vast majority of the world. Between now and the congressional vote in September, you are going to hear a lot of arguments against this deal, backed by tens of millions of dollars in advertising. And if the rhetoric in these ads and the accompanying commentary sounds familiar, it should, for many of the same people who argued for the war in Iraq are now making the case against the Iran nuclear deal.
Now, when I ran for president eight years ago as a candidate who had opposed the decision to go to war in Iraq, I said that America didn’t just have to end that war. We had to end the mindset that got us there in the first place.
It was a mindset characterized by a preference for military action over diplomacy, a mindset that put a premium on unilateral U.S. action over the painstaking work of building international consensus, a mindset that exaggerated threats beyond what the intelligence supported.
Leaders did not level with the American people about the costs of war, insisting that we could easily impose our will on a part of the world with a profoundly different culture and history.
OBAMA: And, of course, those calling for war labeled themselves strong and decisive while dismissing those who disagreed as weak, even appeasers of a malevolent adversary.
More than a decade later, we still live with the consequences of the decision to invade Iraq. Our troops achieved every mission they were given, but thousands of lives were lost, tens of thousands wounded. That doesn’t count the lives lost among Iraqis. Nearly a trillion dollars was spent.
Today, Iraq remains gripped by sectarian conflict, and the emergence of al-Qaida in Iraq has now evolved into ISIL. And ironically, the single greatest beneficiary in the region of that war was the Islamic Republic of Iran, which saw its strategic position strengthened by the removal of its long-standing enemy, Saddam Hussein.
I raise this recent history because now more than ever, we need clear thinking in our foreign policy, and I raise this history because it bears directly on how we respond to the Iranian nuclear program. That program has been around for decades, dating back to the Shah’s efforts, with U.S. support, in the 1960s and ’70s to develop nuclear power. The theocracy that overthrew the Shah accelerated the program after the Iran-Iraq war in the 1980s, a war in which Saddam Hussein used chemical weapons to brutal effect, and Iran’s nuclear program advanced steadily through the 1990s despite unilateral U.S. sanctions.
When the Bush administration took office, Iran had no centrifuges, the machines necessary to produce material for a bomb, that were spinning to enrich uranium. But despite repeated warnings from the United States government, by the time I took office, Iran had installed several thousand centrifuges and showed no inclination to slow, much less halt, its program.
Among U.S. policymakers, there’s never been disagreement on the danger posed by an Iranian nuclear bomb. Democrats and Republicans alike have recognized that it would spark an arms race in the world’s most unstable region and turn every crisis into a potential nuclear showdown. It would embolden terrorist groups like Hezbollah and pose an unacceptable risk to Israel, which Iranian leaders have repeatedly threatened to destroy. More broadly, it could unravel the global commitment to nonproliferation that the world has done so much to defend.
The question then is not whether to prevent Iran from obtaining a nuclear weapon, but how. Even before taking office, I made clear that Iran would not be allowed to acquire a nuclear weapon on my watch, and it’s been my policy throughout my presidency to keep all options, including possible military options, on the table to achieve that objective.
But I have also made clear my preference for a peaceful diplomatic resolution of the issue, not just because of the costs of war, but also because a negotiated agreement offered a more effective, verifiable and durable resolution. And so in 2009, we let the Iranians know that a diplomatic path was available. Iran failed to take that path, and our intelligence community exposed the existence of a covert nuclear facility at Fordo.
Now some have argued that Iran’s intransigence showed the futility of negotiations. In fact, it was our very willingness to negotiate that helped America rally the world to our cause and secured international participation in an unprecedented framework of commercial and financial sanctions.
OBAMA: Keep in mind, unilateral U.S. sanctions against Iran had been in place for decades, but had failed to pressure Iran to the negotiating table. What made our new approach more effective was our ability to draw upon new U.N. Security Council resolutions, combining strong enforcement with voluntary agreements for nations like China and India, Japan and South Korea, to reduce their purchases of Iranian oil, as well as the imposition by our European allies of a total oil embargo.
Winning this global buy-in was not easy. I know; I was there. In some cases, our partners lost billions of dollars in trade because of their decision to cooperate. But we were able to convince them that, absent a diplomatic resolution, the result could be war with major disruptions to the global economy, and even greater instability in the Middle East.
In other words, it was diplomacy, hard, painstaking diplomacy, not saber rattling, not tough talk, that ratcheted up the pressure on Iran. With the world now unified beside us, Iran’s economy contracted severely, and remains about 20 percent smaller today than it would have otherwise been. No doubt this hardship played a role in Iran’s 2013 elections, when the Iranian people elected a new government, that promised to improve the economy through engagement to the world.
A window had cracked open. Iran came back to the nuclear talks. And after a series of negotiations, Iran agreed with the international community to an interim deal, a deal that rolled back Iran’s stockpile of near 20 percent enriched uranium, and froze the progress of its program so that the P5+1 — the United States, China, Russia, the United Kingdom, Germany, France, and the European Union, could negotiate a comprehensive deal without the fear that Iran might be stalling for time.
Now, let me pause here just to remind everybody that, when the interim deal was announced, critics, the same critics we are hearing from now, called it a historic mistake. They insisted Iran would ignore its obligations, they warned that the sanctions would unravel. They warned that Iran would receive a windfall to support terrorism.
The critics were wrong. The progress of Iran’s nuclear program was halted for the first time in a decade, its stockpile of dangerous materials was reduced, the deployment of its advanced centrifuges was stopped, inspections did increase. There was no flood of money into Iran. And the architecture of the international sanctions remained in place. In fact, the interim deal worked so well that the same people who criticized it so fiercely now cite it as an excuse not to support the broader accord. Think about that. What was once proclaimed as an historic mistake is now held up as a success and a reason to not sign the comprehensive of deal.
So keep that in mind when you assess the credibility of the arguments being made against diplomacy today. Despite the criticism, we moved ahead to negotiate a more lasting, comprehensive deal. Our diplomats, led by Secretary of State John Kerry kept our coalition united, our nuclear experts, including one of the best in the world, Secretary of Energy Ernie Moniz, work tirelessly on a technical details.
In July, we reached a comprehensive of plan of action that meets our objectives. Under its terms, Iran is never allowed to build a nuclear weapon. And while Iran, like any party to the nuclear non- proliferation treaty, is allowed to access peaceful nuclear energy, the agreement strictly defines the manner in which its nuclear program can proceed, ensuring that all pathways to a bomb are cut off.
OBAMA: Here is how.
Under this deal, Iran cannot acquire the plutonium needed for a bomb. The core of its heavy reactor at Arak will be pulled out, filled with concrete, replaced with one that will not produce plutonium for a weapon. The spent fuel from that reactor will be shipped out of the country, and Iran will not build any new heavy water reactors for at least 15 years.
Iran will also not be able to acquire the enriched uranium that could be used for a bomb. As soon as this deal is implemented, Iran will remove two-thirds of its centrifuges. For the next decade, Iran will not enrich uranium with its more advanced centrifuges. Iran will not enrich uranium at the previously undisclosed Fordo facility, which is very deep underground, for at least 15 years.
Iran will get rid of 98 percent of its stockpile of enriched uranium, which is currently enough for up to 10 nuclear bombs for the next 15 years. Even after those 15 years have passed, Iran will never have the right to use a peaceful program as cover to pursue a weapon, and in fact this deal shuts off the type of covert path Iran pursued in the past.
There will be 24/7 monitoring of Iran’s key nuclear facilities. For decades, inspectors will have access to Iran’s entire nuclear supply chain, from the uranium mines and mills where they get raw materials to the centrifuge production facilities where they make machines to enrich it. And understand why this is so important.
For Iran to cheat, it has to build a lot more than just one building or covert facility like Fordo. It would need a secret source for every single aspect of its program. No nation in history has been able to pull of such subterfuge when subjected to such rigorous inspections. And under the terms of the deal, inspectors will have the permanent ability to inspect any suspicious sites in Iran.
And finally, Iran has powerful incentives to keep its commitments. Before getting sanctions relief, Iran has to take significant concrete steps, like removing centrifuges and getting rid of its stock piles. If Iran violates the agreement over the next decade, all of the sanctions can snap back into place. We won’t need the support of other members of the U.N. Security Council, America can trigger snap back on our own.
On the other hand, if Iran abides by the deal, and its economy beings to reintegrate with the world, the incentive to avoid snap back will only grow.
So this deal is not just the best choice among alternatives, this is the strongest nonproliferation agreement ever negotiated, and because this is such a strong deal, every nation in the world that has commented publicly, with the exception of the Israeli government, has expressed support. The United Nations Security Council has unanimously supported it. The majority of arms control and nonproliferation experts support it. Over 100 former ambassadors who served under Republican and Democratic presidents support it.
I’ve had to make a lot of tough calls as president, but whether or not this deal is good for American security is not one of those calls, it’s not even close. Unfortunately, we’re living through a time in American politics where every foreign policy decision is viewed through a partisan prison, evaluated by headline-grabbing soundbites, and so before the ink was even dry on this deal, before Congress even read it, a majority of Republicans declared their virulent opposition. Lobbyists and pundits were suddenly transformed into armchair nuclear scientists…
(LAUGHTER)
… disputing the assessments of experts like Secretary Moniz, challenging his findings, offering multiple and sometimes contradictory arguments about why Congress should reject this deal.
OBAMA: But if you repeat these arguments long enough, they can get some traction. So, let me address just a few of the arguments that have been made so far in opposition to this deal.
First, there’re those who say the inspections are not strong enough, because inspectors can’t go anywhere in Iran at any time with no notice.
Well, here’s the truth. Inspectors will be allowed daily access to Iran’s key nuclear sites.
If there is a reason for inspecting a suspicious undeclared site anywhere in Iran, inspectors will get that access even if Iran objects. This access can be with as little as 24 hours notice.
And while the process for resolving a dispute about access can take up to 24 days, once we’ve identified a site that raises suspicion, we will be watching it continuously until inspectors get in.
And — and by the way, nuclear material isn’t something you hide in the closet.
(LAUGHTER)
It can leave a trace for years.
The bottom line is, if Iran cheats, we can catch them, and we will.
Second, there are those who argue that the deal isn’t strong enough, because some of the limitations on Iran’s civilian nuclear program expire in 15 years.
Let me repeat. The prohibition on Iran having a nuclear weapon is permanent. The ban on weapons-related research is permanent. Inspections are permanent.
It is true that some of the limitations regarding Iran’s peaceful program last only 15 years. But that’s how arms control agreements work. The first SALT treaty with the Soviet Union lasted five years. The first START treaty lasted 15 years.
And in our current situation, if 15 or 20 years from now, Iran tries to build a bomb, this deal ensures that the United States will have better tools to detect it, a stronger basis under international law to respond and the same options available to stop our weapons program as we have today, including, if necessary, military options.
On the other hand, without this deal, the scenarios that critics warn about happening in 15 years could happen six months from now. By killing this deal, Congress would not merely Iran’s pathway to a bomb, it would accelerate it.
Third, a number of critics say the deal isn’t worth it, because Iran will get billions of dollars in sanctions relief.
Now, let’s be clear. The international sanctions were put in place precisely to get Iran to agree to constraints on its program. That’s the point of sanctions. Any negotiated agreement with Iran would involve sanctions relief.
So an argument against sanctions relief is effectively an argument against any diplomatic resolution of this issue. It is true that if Iran lives up to its commitments, it will gain access to roughly $56 billion of its own money, revenue frozen overseas by other countries.
But the notion that this will be a game-changer with all this money funneled into Iran’s pernicious activities misses the reality of Iran’s current situation.
Partly because of our sanctions, the Iranian government has over half a trillion dollars in urgent requirements, from funding pensions and salaries to paying for crumbling infrastructure.
Iran’s leaders have raised expectations of their people, that sanctions relief will improve their lives. Even a repressive regime like Iran’s cannot completely ignore those expectations, and that’s why our best analysts expect the bulk of this revenue to go into spending that improves the economy and benefits the lives of the Iranian people.
Now, this is not to say that sanctions relief will provide no benefit to Iran’s military. Let’s stipulate that some of that money will flow to activities that we object to.
OBAMA: We have no illusions about the Iranian government or the significance of the Revolutionary Guard and the Quds Force. Iran supports terrorist organizations like Hezbollah. It supports proxy groups that threaten our interests and the interests of our allies, including proxy groups who killed our troops in Iraq.
They tried to destabilize our Gulf partners. But Iran has been engaged in these activities for decades. They engaged in them before sanctions and while sanctions were in place. In fact, Iran even engaged in these sanctions in the middle of the Iran-Iraq war, a war that cost them nearly a million lives and hundreds of billions of dollars. The truth is that Iran has always found a way to fund these efforts, and whatever benefit Iran may claim from sanctions relief pales in comparison to the danger it could pose with a nuclear weapon.
Moreover, there is no scenario where sanctions relief turns Iran into the region’s dominant power. Iran’s defense budget is eight times smaller than the combined budget of our Gulf allies. Their conventional capabilities will never compare to Israel’s, and our commitment to Israel’s qualitative military edge helps guarantee that.
Over the last several years, Iran has had to spend billions of dollars to support its only ally in the Arab world, Bashar al-Assad, even as he’s lost control of huge chunks of his country. And Hezbollah suffered significant blows on this same battlefield. And Iran, like the rest of the region, is being forced to respond to the threat of ISIL in Iraq.
So, contrary to the alarmists who claim Iran is on the brink of taking over the Middle East, or even the world, Iran will remain a regional power with its own set of challenges. The ruling regime is dangerous and it is repressive. We will continue to have sanctions in place on Iran’s support for terrorism and violation of human rights. We will continue to insist upon the release of Americans detained unjustly. We will have a lot of differences with the Iranian regime.
But if we are serious about confronting Iran’s destabilizing activities, it is hard to imagine a worse approach than blocking this deal. Instead, we need to check the behavior that we are concerned about directly, by helping our allies in the region strengthen their own capabilities to counter a cyber attack or a ballistic missile, by improving the interdiction of weapons’ shipments that go to groups like Hezbollah, by training our allies’ special forces so they can more effectively respond to situations like Yemen.
All these capabilities will make a difference. We will be in a stronger position to implement them with this deal.
And by the way, such a strategy also helps us effectively confront the immediate and lethal threat posed by ISIL.
Now, the final criticism, this is sort of catchall that you may hear, is the notion that there is a better deal to be had. We should get a better deal. That is repeated over and over again. It’s a bad deal — we need a better deal.
(LAUGHTER)
One that relies on vague promises of toughness and, more recently, the argument that we can apply a broader and indefinite set of sanctions to squeeze the Iranian regime harder. Those making this argument are either ignorant of Iranian society, or they are not being straight with the American people. Sanctions alone are not going to force Iran to completely dismantle all vestiges of its nuclear infrastructure, even aspects that are consistent with peaceful programs. That, is oftentimes, is what the critics are calling a better deal.
OBAMA: Neither the Iranian government, or the Iranian opposition, or the Iranian people would agree to what they would view as a total surrender of their sovereignty.
Moreover, our closest allies in Europe or in Asia, much less China or Russia, certainly are not going to enforce existing sanctions for another five, 10, 15 years according to the dictates of the U.S. Congress because their willingness to support sanctions in the first place was based on Iran ending its pursuit of nuclear weapons. It was not based on the belief that Iran cannot have peaceful nuclear power, and it certainly wasn’t based on a desire for regime change in Iran.
As a result, those who say we can just walk away from this deal and maintain sanctions are selling a fantasy. Instead of strengthening our position, as some have suggested, Congress’ rejection would almost certainly result in multi-lateral sanctions unraveling.
If, as has also been suggested, we tried to maintain unilateral sanctions, beefen them up, we would be standing alone. We cannot dictate the foreign, economic and energy policies of every major power in the world. In order to even try to do that, we would have to sanction, for example, some of the world’s largest banks. We’d have to cut off countries like China from the American financial system. And since they happen to be major purchasers of our debt, such actions could trigger severe disruptions in our own economy, and, by way, raise questions internationally about the dollar’s role as the world’s reserve currency. That’s part of the reason why many of the previous unilateral sanctions were waived.
What’s more likely to happen should Congress reject this deal is that Iran would end up with some form of sanctions relief without having to accept any of the constraints or inspections required by this deal. So in that sense, the critics are right. Walk away from this agreement, and you will get a better deal — for Iran.
(APPLAUSE)
Now because more sanctions won’t produce the results that the critics want, we have to be honest. Congressional rejection of this deal leaves any U.S. administration that is absolutely committed to preventing Iran from getting a nuclear weapon with one option, another war in the Middle East. I say this not to be provocative, I am stating a fact. Without this deal, Iran will be in a position, however tough our rhetoric may be, to steadily advance its capabilities. Its breakout time, which is already fairly small, could shrink to near zero. Does anyone really doubt that the same voices now raised against this deal will be demanding that whoever is president bomb those nuclear facilities? And as someone who does firmly believe that Iran must not get a nuclear weapon and who has wrestled with this issue since the beginning of my presidency, I can tell you that alternatives to military actions will have been exhausted once we reject a hard-won diplomatic solution that the world almost unanimously supports.
So let’s not mince words. The choice we face is ultimately between diplomacy or some form of war. Maybe not tomorrow, maybe not three months from now, but soon.
OBAMA: And here’s the irony. As I said before, military action would be far less effective than this deal in preventing Iran from obtaining a nuclear weapon. That’s not just my supposition. Every estimate, including those from Israeli analysts, suggest military action would only set back Iran’s program by a few years at best, which is a fraction of the limitations imposed by this deal.
It would likely guarantee that inspectors are kicked out of Iran. It is probable that it would drive Iran’s program deeper underground. It would certainly destroy the international unity that we have spent so many years building.
Now, there are some of opponents — I have to give them credit. They’re opponents of this deal who accept the choice of war. In fact, they argue that surgical strikes against Iran’s facilities will be quick and painless.
But if we’ve learned anything from the last decade, it’s that wars in general and wars in the Middle East in particular are anything but simple.
(APPLAUSE)
The only certainty in war is human suffering, uncertain costs, unintended consequences.
We can also be sure that the Americans who bear the heaviest burden are the less-than-1 percent of us, the outstanding men and women who serve in uniform, and not those of us who send them to war.
As commander-in-chief, I have not shied away from using force when necessary. I have ordered tens of thousands of young Americans into combat. I have sat by their bedside sometimes when they come home.
I’ve ordered military action in seven countries. There are times when force is necessary, and if Iran does not abide by this deal, it’s possible that we don’t have an alternative.
But how can we, in good conscience, justify war before we’ve tested a diplomatic agreement that achieves our objectives, that has been agreed to by Iran, that is supported by the rest of the world and that preserves our option if the deal falls short? How could we justify that to our troops? How could we justify that to the world or to future generations? In the end, that should be a lesson that we’ve learned from over a decade of war. On the front end, ask tough questions, subject our own assumptions to evidence and analysis, resist the conventional wisdom and the drumbeat of war, worry less about being labeled weak, worry more about getting it right.
I recognize that resorting to force may be tempting in the face of the rhetoric and behavior that emanates from parts of Iran. It is offensive. It is incendiary. We do take it seriously.
But superpowers should not act impulsively in response to taunts or even provocations that can be addressed short of war. Just because Iranian hardliners chant “Death to America” does not mean that that’s what all Iranians believe. In fact, it’s those…
(APPLAUSE)
In fact, it’s those hardliners who are most comfortable with the status quo. It’s those hardliners chanting “Death to America” who have been most opposed to the deal. They’re making common cause with the Republican Caucus.
(APPLAUSE)
The majority of the Iranian people have powerful incentives to urge their government to move in a different, less provocative direction, incentives that are strengthened by this deal. We should offer them that chance. We should give them the opportunity.
OBAMA: It’s not guaranteed to succeed. But if they take it, that would be good for Iran. It would be good for the United States. It would be good for a region that has known too much conflict. It would be good for the world.
And if Iran does not move in that direction, if Iran violates this deal, we will have ample ability to respond. You know, the agreements pursued by Kennedy and Reagan with the Soviet Union. Those agreements and treaties involved America accepting significant constraints on our arsenal. As such, they were riskier.
This agreement involves no such constraints. The defense budget of the United States is more than $600 billion. To repeat, Iran’s is about $15 billion. Our military remains the ultimate backstop to any security agreement that we make. I have stated that Iran will never be allowed to obtain a nuclear weapon, and have done what is necessary to make sure our military options are real. And I have no doubt that any president who follows me will take the same position.
So, let me sum up here. When we carefully examine the arguments against this deal, none stand up to scrutiny. That may be why the rhetoric on the other side is so strident. I suppose some of it can be ascribed to knee-jerk partisanship that has become all too familiar, rhetoric that renders every decision made to be a disaster, a surrender. You’re aiding terrorists; you’re endangering freedom.
On the other hand, I do think it is important to a knowledge another more understandable motivation behind the opposition to this deal, or at least skepticism to this deal. And that is a sincere affinity for our friend and ally Israel. An affinity that, as someone who has been a stalwart friend to Israel throughout my career, I deeply share.
When the Israeli government is opposed to something, people in the United States take notice; and they should. No one can blame Israelis for having a deep skepticism about any dealings with the government like Iran’s, which includes leaders who deny the Holocaust, embrace an ideology of anti-Semitism, facilitate the flow of rockets that are arrayed on Israel’s borders. Are pointed at Tel Aviv.
In such a dangerous neighbor Israel has to be vigilant, and it rightly insists it cannot depend on any other country, even it’s great friend the United States, for its own security.
So, we have to take seriously concerns in Israel. But the fact is, partly due to American military and intelligence assistance, which my administration has provided at unprecedented levels, Israel can defend itself against any conventional danger, whether from Iran directly or from its proxies. On the other hand, a nuclear-armed Iran changes that equation.
And that’s why this deal must be judged by what it achieves on the central goal of preventing Iran from obtaining a nuclear weapon. This deal does exactly that. I say this as someone who is done more than any other president to strengthen Israel’s security. And I have made clear to the Israeli government that we are prepared to discuss how we can deepen that cooperation even further. Already, we have held talks with Israel on concluding another 10-year plan for U.S. security assistance to Israel.
OBAMA: We can enhance support for areas like missile defense, information sharing, interdiction, all to help meet Israel’s pressing security needs. And to provide a hedge against any additional activities that Iran may engage in as a consequence of sanctions relief.
But I have also listened to the Israeli security establishment, which warned of the danger posed by a nuclear armed Iran for decades. In fact, they helped develop many of the ideas that ultimately led to this deal. So to friends of Israel and the Israeli people, I say this. A nuclear armed Iran is far more dangerous to Israel, to America, and to the world than an Iran that benefits from sanctions relief.
I recognize that prime minister Netanyahu disagrees, disagrees strongly. I do not doubt his sincerity, but I believe he is wrong. I believe the facts support this deal. I believe they are in America’s interests and Israel’s interests, and as president of the United States it would be an abrogation of my constitutional duty to act against my best judgment simply because it causes temporary friction with a dear friend and ally.
I do not believe that would be the right thing to do for the United States, I do not believe it would be the right thing to do for Israel.
(APPLAUSE)
For the last couple of weeks, I have repeatedly challenged anyone opposed to this deal to put forward a better, plausible alternative. I have yet to hear one. What I’ve heard instead are the same types of arguments that we heard in the run up to the Iraq war. “Iran cannot be dealt with diplomatically.” “We can take military strikes without significant consequences.” “We shouldn’t worry about what the rest of the world thinks, because once we act, everyone will fall in line.” “Tougher talk, more military threats will force Iran into submission.” “We can get a better deal.”
I know it’s easy to play in people’s fears, to magnify threats, to compare any attempt at diplomacy to Munich, but none of these arguments hold up. They didn’t back in 2002, in 2003, they shouldn’t now.
(APPLAUSE)
That same mind set in many cases offered by the same people, who seem to have no compunction with being repeatedly wrong…
(LAUGHTER)
… lead to a war that did more to strengthen Iran, more to isolate the United States than anything we have done in the decades before or since. It’s a mind set out of step with the traditions of American foreign policy where we exhaust diplomacy before war and debate matters of war and peace in the cold light of truth.
“Peace is not the absence of conflict,” President Reagan once said. It is the ability to cope with conflict by peaceful means. President Kennedy warned Americans not to see conflict as inevitable, accommodation as impossible, and communication as nothing more than the exchange of threats. It is time to apply such wisdom. The deal before us doesn’t bet on Iran changing, it doesn’t require trust, it verifies and requires Iran to forsake a nuclear weapon.
OBAMA: Just as we struck agreements with the Soviet Union at a time when they were threatening our allies, arming proxies against us, proclaiming their commitment to destroy our way of life, and had nuclear weapons pointed at all of our major cities, a genuine existential threat.
You know, we live in a complicated world, a world in which the forces unleashed by human innovation are creating for our children that were unimaginable for most of human history.
It is also a world of persistent threats, a world in which mass violence and cruelty is all too common and human innovation risks the destruction of all that we hold dear.
In this world, the United States of America remains the most powerful nation on Earth, and I believe that we will remain such for decades to come.
But we are one nation among many, and what separates us from the empires of old, what has made us exceptional, is not the mere fact of our military might.
Since World War II, the deadliest war in human history, we have used our power to try and bind nations together in a system of international law. We have led an evolution of those human institutions President Kennedy spoke about to prevent the spread of deadly weapons, to uphold peace and security and promote human progress.
We now have the opportunity to build on that progress. We built a coalition and held together through sanctions and negotiations, and now we have before us a solution that prevents Iran from obtaining a nuclear weapon without resorting to war.
As Americans, we should be proud of this achievement. And as members of Congress reflect on their pending decision, I urge them to set aside political concerns, shut out the noise, consider the stakes involved with the vote that you will cast.
If Congress kills this deal, we will lose more than just constraints on Iran’s nuclear deal or the sanctions we have painstakingly built. We will have lost something more precious: America’s credibility as a leader of diplomacy. America’s credibility is the anchor of the international system.
John F. Kennedy cautioned here more than 50 years ago at this university that the pursuit of peace is not as dramatic as the pursuit of war. But it’s so very important. It is surely the pursuit of peace that is most needed in this world so full of strife.
My fellow Americans, contact your representatives in Congress, remind them of who we are, remind them of what is best in us and what we stand for so that we can leave behind a world that is more secure and more peaceful for our children.
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He that is kind is free, though he is a slave; he that is evil is a slave, though he be a king.
~Saint Augustine
The only thing necessary for the triumph of evil is for good men to do nothing.
~Edmund Burke
There are a thousand hacking at the branches of evil to one who is striking at the root.
~Henry David Thoreau
The resolution to avoid an evil is seldom framed till the evil is so far advanced as to make avoidance impossible.
~Thomas Hardy
The Holocaust was the most evil crime ever committed.
~Stephen Ambrose
The sad truth is that most evil is done by people who never make up their minds to be good or evil.”
~Hannah Arendt
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The Silent Scream (Full Length)
FULL FOOTAGE: Planned Parenthood Uses Partial-Birth Abortions to Sell Baby Parts
Abby Johnson Exposes The Lie of Planned Parenthood
Planned Parenthood CEO Cecile Richards’ Attempt To Dismiss Viral Video Backfires!
Caught on Camera: Planned Parenthood Harvesting Babies Organs
Die Wannseekonferenz (1984)
A real time recreation of the 1942 Wannsee Conference, in which leading SS and Nazi Party officials led by SS-General Reinhard Heydrich gathered to discuss the “Final Solution to the Jewish Question”.
MAAFA 21 THE BLACK HOLOCAUST
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Planned Parenthood Banks on Fraud
Planned Parenthood’s New Image
Fit vs. UnFit, Eugenics, Planned Parenthood & Psychology, Mind Control Report
Sex Control Police State, Eugenics, Galton, Kantsaywhere, Mind Control Report
Mind Control Hate Propaganda, Hate Speech & Crime, Black PR
Mind Control, Psychology of Brainwashing, Sex & Hypnosis
Margaret Sanger: Eugenicist (1/3)
Margaret Sanger: Eugenicist (2/3)
Margaret Sanger: Eugenicist (3/3)
Eugenics Glenn Beck w/ Edwin Black author of “War Against the Weak” talk Al Gore & Margaret Sanger
Margaret Sanger, Planned Parenthood’s Racist Founder
Justice Antonin Scalia talks about Roe v. Wade
Auschwitz The Nazis and the Final Solution complete
Auschwitz: The Nazi and the Final Solution (1/5)
AUSHWITZ:THE FINAL SOLUTION CLIP 2/5
Auschwitz: The Nazi and the Final Solution (3/5)
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Auschwitz: The Nazi and the Final Solution (5/5)
Science and the Swastika: The Deadly Experiment
Sterilizing Undesirables: Did The USA Inspire The Nazis?
Keeping Dems Honest: CNN’s Anderson Cooper Puts Truth First and Challenges DNC Abortion Lies
Glenn Beck : Agenda 21 is not a fiction, it’s implemented right now in US and all over the World !
Glenn Beck – Ted Cruz Discusses the Evils of Agenda 21
Bill Whittle What We Believe Full Version
Brenda Lee – I’m Sorry (Live from Canada 1980)
Planned Parenthood head apologizes for ‘tone’ of doctor in covert video
The president of Planned Parenthood Federation of America on Thursday apologized for remarks captured on video that show Deborah Nucatola, an executive of the organization, casually discussing abortion techniques aimed at preserving the internal organs of fetuses for use in research.
In a video posted on Planned Parenthood’s Web site, Cecile Richards called the tenor of the remarks “unacceptable,” and said the organization strives as its top priority to provide compassionate care.
“In the video, one of our staff members speaks in a way that does not reflect that compassion,” she said. “This is unacceptable, and I personally apologize for the staff member’s tone and statements.”
But Richards also emphatically defended the organization’s tissue donation program, which she said is purely voluntary for the women and does not yield a profit for Planned Parenthood. And she condemned the group that covertly recorded Nucatola’s remarks, which she said heavily edited the video to make “outrageous claims.”
“We know the real agenda of organizations behind videos like this, and they have never been concerned with protecting the health and safety of women,” she said. “Their mission is to ban abortion completely and cut women off from care at Planned Parenthood and other health centers.”
Richards’s apology came a day after a little-known anti-abortion group called the Center for Medical Progress unveiled the video as part of what its leader said was a 30-month investigation into Planned Parenthood’s tissue donation program. The group alleges Planned Parenthood illegally sells fetal body parts to companies that use the tissue for research.
While the video did not prove this claim, it still painted Planned Parenthood in an unflattering light that reignited controversy over the women’s health organization, the nation’s largest abortion provider and a longtime target of anti-abortion activism. It showed Nucatola, the organization’s senior director of medical services, discussing graphically the ways in which abortions can be completed to preserve a fetus’s liver, lungs, heart and other materials for research.
“I’d say a lot of people want liver,” she says in the video, drinking wine and eating salad with anti-abortion activists posing as medical company representatives.
Later in the video, she continues: “We’ve been very good at getting heart, lung, liver, because we know that, so I’m not gonna crush that part, I’m gonna basically crush below, I’m gonna crush above, and I’m gonna see if I can get it all intact.”
The Center for Medical Research distilled the video into a nine-minute clip, but also posted a longer cut lasting more than two-and-a-half hours showing a fuller context of the discussion. It also posted some supporting documents on its site, and the group’s leader has promised more evidence in the coming weeks.
Planned Parenthood’s president apologized Thursday for a top official’s tone in a controversial video, but she also denied the clip’s allegation that her organization profits from tissue donation.
“Our top priority is the compassionate care that we provide. In the video, one of our staff members speaks in a way that does not reflect that compassion. This is unacceptable, and I personally apologize for the staff member’s tone and statements,” said Cecile Richards, the group’s president, in a video out Thursday. “As always, if there is any aspect of our work that can be strengthened, we want to know about it, and we take swift action to address it.”
Since the video’s release on Breitbart earlier this week, conservative elected officials have slammed its contents and called for congressional hearings on the incident, including House Speaker John Boehner and House Majority Leader Kevin McCarthy.
“I hope that everyone in the country watches it,” said Rep. Ann Wagner, R-Missouri, who called the video “the most horrifying and heartbreaking undercover video I have ever seen” during a Capitol Hill news conference on Wednesday.
But allegations that Planned Parenthood sells baby body organs and tissue are unfounded, she said.
“I want to be really clear: The allegation that Planned Parenthood profits in any way from tissue donation is not true. Our donation programs — like any other high-quality health care providers — follow all laws and ethical guidelines.”
On Wednesday, Richards used Twitter to criticize lawmakers and presidential candidates
“GOP leaders, including most of the ’16 field, are tripping over themselves to attack PP because they think that’s how to win elections,” organization president Cecile Richards said in a series of related tweets Wednesday. Her comments were her first addressing a video showing one of the organization’s top officials discussing the organs and tissue or aborted fetuses.
President of Planned Parenthood Federation of America Cecile Richards speaks during day two of the Democratic National Convention on September 5, 2012 in Charlotte, North Carolina.
Congressional leaders and Republican presidential hopefuls slammed Planned Parenthood on Wednesday and called for congressional hearings on the incident.
Richards said political attacks are nothing new for her organization, the country’s largest abortion provider.
“Spreading false information is an age-old strategy of people hell-bent on denying women care & shaming them for exercising their rights,” she tweeted.
Several Republican candidates have promised to defund federal dollars to Planned Parenthood if elected. Richards argued that would keep millions from breast exams, sexually transmitted infection exams and sex education.
“Reminder: 1 out of every 5 women has been to PP in her life. Threatening our patients’ care & rights will get politicians nowhere real fast,” she tweeted. “We’ve fought for our patients before, and we’ll fight for them again and again.”
Planned Parenthood exec, fetal body parts subject of controversial video
By Steve Almasy and Eliott C. McLaughlin, CNN
An anti-abortion group has released an online video that it says documents how Planned Parenthood is selling fetal organs for a profit, a felony, while violating medical ethics by altering normal abortion procedures so as to preserve the organs.
Planned Parenthood has countered that it donates the tissue for scientific research and receives only reimbursement for its expenses, which is legal. The group also says it helps people donate tissue “with full, appropriate consent from patients and under the highest ethical and legal standards,” according to a statement from spokesman Eric Ferrero.
Later, Ferrero issued another statement saying, “These outrageous claims are flat-out untrue, but that doesn’t matter to politicians with a longstanding political agenda to ban abortion and defund Planned Parenthood. Women and families who make the decision to donate fetal tissue for lifesaving scientific research should be honored, not attacked and demeaned.”
The group leveling the accusation, the Irvine, California-based Center for Medical Progress, says it shot the video a year ago at a California restaurant. On it, two people purporting to be with a human biologics company speak with a Planned Parenthood doctor over what appears to be a lunch meeting. The Center for Medical Progress says the pair, who are off-camera and never seen, are paid actors.
“Planned Parenthood’s criminal conspiracy to make money off of aborted baby parts reaches to the very highest levels of their organization,” said statement from David Daleiden, who led the undercover project.
The video has drawn the ire of GOP lawmakers in Washington, with House Speaker John Boehner calling for hearings on Planned Parenthood’s abortion practices.
“When anyone diminishes an unborn child, we are all hurt, irreversibly so. When an organization monetizes an unborn child — and with the cavalier attitude portrayed in this horrific video — we must all act,” he said.
On the video, Dr. Deborah Nucatola, the senior director of medical services at Planned Parenthood Federation of America, is seen talking matter-of-factly about the organization’s participation in tissue-donation programs.
Though Planned Parenthood has described the Center for Medical Progress footage as a hit piece by “a well-funded group established for the purpose of damaging Planned Parenthood’s mission and services,” Nucatola acknowledges in the video that Planned Parenthood’s national office sees the potential for controversy.
“So, we tried to do this, and at the national office we have a Litigation and Law Department that just really doesn’t want us to be the middle people for this issue right now,” she said. “And so we had a conversation, and we said, ‘What if we go out and find everyone who is doing this and present everybody with a menu?’ And at the end of the day they just decided that right now, it’s just too touchy an issue for us to be an official middleman.”
In another part of the video, the doctor tells the undercover actors that “behind closed doors,” Planned Parenthood’s affiliates are discussing how to handle the matter.
“Every provider has had patients who want to donate their tissue, and they absolutely want to accommodate them. They just want to do it in a way that is not perceived as ‘This clinic is selling tissue. This clinic is making money off of this,’ ” she said.
The edited version of the video appears to be missing important context that’s provided in the longer video. For instance, one of the actors asks Nucatola about prices for the organs.
“OK, so when you are, or the (Planned Parenthood) affiliate is determining what that monetary … so that it doesn’t raise any question of ‘This is what it’s about; this is the main,’ what price range would you …” the woman asks, her question trailing off.
Nucatola responds that the price would be between $30 and $100 per specimen, with consideration for what facility is used and “what’s involved.” It’s not clear if a specimen constitutes the entire organ or only samples of it.
Nucatola doesn’t specifically say that the price is for the purchase of the tissue, but the comment troubled bioethicist Art Caplan of New York University, who said after watching the edited version of the video it sounds like Planned Parenthood might be trying to make a profit.
But in the longer version of the video, Nucatola elaborates and appears to say the price is related to the cost of performing the procedure and shipping.
“It just has to do with space issues. Are you sending someone there who is going to be doing everything or is their staff going to be doing it? What exactly are they going to be doing? Is there shipping involved or is someone coming to pick it up?”
Selling fetal body parts — or any body parts — is against federal law, but Planned Parenthood said it makes no profit.
“In some instances, actual costs, such as the cost to transport tissue to leading research centers, are reimbursed, which is standard across the medical field,” the group said.
Another part of the video also raised concerns for Caplan. Nucatola talks about doctors performing abortions in which ultrasound is used to ascertain the best location to grab the fetus with forceps.
“We’ve been very good at getting heart, lung, liver because we know that, I’m not going to crush that part,” she says.
Altering procedures in order to get tissue in the best condition would be a “big no-no,” the bioethicist said, because the patient’s health is paramount and that should be the only concern for doctors. Caplan did not comment specifically on whether the ultrasound procedure would endanger the mother, but he made it clear that any deviation from normal procedures is unacceptable.
“In abortion the primary goal is to give the safest abortion possible,” Caplan said. “Your sole concern has to be the mother and her health.”
There’s a parallel in patient care, he said. When someone is dying, doctors shouldn’t change how they treat the patient in order to harvest good tissue for donation after death.
Doctors should treat the patient as they normally would, and then use whatever is available after death. If a provider is considering how to get the tissue that’s in the best shape, “that’s a huge conflict of interest. … If you modify how someone dies, that’s unethical.”
The Center for Medical Progress also alleges that Nucatola describes a method — using ultrasound to manipulate the fetus so it comes out feet first, or breech presentation, instead of head first, or vertex presentation — that “is the hallmark of the illegal partial-birth abortion procedure.”
Partial birth abortions are illegal, according to U.S. law, which defines them as procedures “in which the person performing the abortion deliberately and intentionally vaginally delivers a living fetus until, in the case of a head-first presentation, the entire fetal head is outside the body of the mother, or, in the case of breech presentation, any part of the fetal trunk past the navel is outside the body of the mother, for the purpose of performing an overt act that the person knows will kill the partially delivered living fetus.”
On the video, Nucatola describes the best strategy to extract calavarium, or skulls, intact, but it is not clear if she is speaking in general terms or if she is describing Planned Parenthood’s methods. And then, she says nothing about whether the fetus is still alive when it’s delivered.
“And with the calvarium, in general, some people will actually try to change the presentation so that it’s not vertex, because when it’s vertex presentation, you never have enough dilation at the beginning of the case, unless you have real, huge amount of dilation to deliver an intact calvarium. So if you do it starting from the breech presentation, there’s dilation that happens as the case goes on, and often, the last, you can evacuate an intact calvarium at the end.”
The Center for Medical Progress responded to Planned Parenthood’s written statement about the video and accused Planned Parenthood of lying about obtaining consent from patients and not making a profit on the tissue transactions. It did not offer any further evidence of either claim.
Planned Parenthood, meanwhile, said the anti-abortion group was the one that was lying.
“A well-funded group established for the purpose of damaging Planned Parenthood’s mission and services has promoted a heavily edited, secretly recorded videotape that falsely portrays Planned Parenthood’s participation in tissue donation programs that support lifesaving scientific research,” it said.
The statement continued, “Similar false accusations have been put forth by opponents of abortion services for decades. These groups have been widely discredited and their claims fall apart on closer examination, just as they do in this case.”
Planned Parenthood Federation of America (PPFA), commonly shortened to Planned Parenthood, is the U.S. affiliate of the International Planned Parenthood Federation (IPPF) and one of its larger members. PPFA is a non-profit organization providing reproductive health and maternal and child health services. The Planned Parenthood Action Fund, Inc. (PPAF) is a related organization which lobbies for pro-choice legislation, comprehensive sex education, and access to affordable health care in the United States. In recent years, Planned Parenthood has begun to move away from the pro-choice label to words and phrases that more accurately reflect the entire range of women’s health and economic issues.[3]
Planned Parenthood is the largest U.S. provider of reproductive health services, including cancer screening, HIV screening and counseling, contraception, and abortion.[4][5][6] Contraception accounts for 34% of PPFA’s total services and abortions account for 3%; PPFA conducts roughly 300,000 abortions each year, among 3 million people served.[7][8][9]
The organization has its roots in Brooklyn, New York, where Margaret Sanger opened the country’s first birth-control clinic. Sanger founded the American Birth Control League in 1921, which in 1942 became part of the Planned Parenthood Federation of America. Since then, Planned Parenthood has grown to have over 820 clinic locations in the U.S., with a total budget of US $1 billion. PPFA provides an array of services to over three million people in the United States, and supports services for over one million clients outside the United States.
Margaret Sanger (1922), the first president and founder of Planned Parenthood
The origins of Planned Parenthood date to October 16, 1916 when Margaret Sanger, her sister Ethel Byrne, and Fania Mindell opened the first birth control clinic in the U.S. in the Brownsville section of Brooklyn, New York.[10] All three women were immediately arrested and jailed for violating provisions of the Comstock Act– for distributing “obscene materials” at the clinic. The “Brownsville trials” brought national attention and support to their cause, and although Sanger and her co-defendants were convicted, their convictions were eventually overturned. Their campaign led to major changes in the laws governing birth control and sex education in the United States.[11]
In 1938, the clinic was organized into the American Birth Control League, which became part of the only national birth control organization in the US until the 1960s, but the title was found too offensive and “against families” so the League began discussions for a new name.[12] By 1941, the organization was operating 222 centers and had served 49,000 clients.[13] By 1942 the League had become part of what became the Planned Parenthood Federation of America.[12]
By 1960, the Federation’s grassroots volunteers had provided family planning counseling in hundreds of communities across the country.[13] Planned Parenthood was one of the founding members of the International Planned Parenthood Federation when it was launched at a conference in Bombay, India in 1952.[13][14]
After Sanger
Following Margaret Sanger, Alan Frank Guttmacher became president of Planned Parenthood and served from 1962 till 1974.[15] During his tenure, the Food and Drug Administration approved the sale of the original birth control pill, giving rise to new attitudes towards women’s reproductive freedom.[13] Also during his presidency, Planned Parenthood lobbied the federal government to support reproductive health, culminating with President Richard Nixon‘s signing of Title X to provide governmental subsidies for low-income women to access family planning services.[16] The Center for Family Planning Program Development was also founded as a semi-autonomous division during this time.[17] The center became an independent organization and was renamed the Guttmacher Institute in 1977.[17]
Faye Wattleton was the first woman named president of the Planned Parenthood Federation of America in 1978 and served till 1992.[18] She was the first African-American to serve as president, and the youngest president in Planned Parenthood’s history.[19] During her term, Planned Parenthood grew to become the seventh largest charity in the country, providing services to four million clients each year through its 170 affiliates whose activities were spread across 50 states.[20]
A Planned Parenthood supporter participates in a demonstration in support of the organization.
From 1996 to 2006, Planned Parenthood was led by Gloria Feldt.[21][22] Feldt activated the Planned Parenthood Action Fund, the organization’s political action committee, launching what was the most far reaching electoral advocacy effort in its history.[23] She also launched the Responsible Choices Action Agenda, a nationwide campaign to increase services to prevent unwanted pregnancies, improve quality of reproductive care and ensure access to safe and legal abortions.[13] Another initiative was the commencement of a “Global Partnership Program” with the aim of building a vibrant activist constituency in support of family planning.[13]
On February 15, 2006, Cecile Richards became president of the organization.[24]
PPFA is a federation of 85 independent Planned Parenthood affiliates around the U.S.[1] These affiliates together operate more than 820 health centers in all 50 states and the District of Columbia.[1][32] The largest of these facilities, a $26 million, 78,000-square-foot (7,200 m2) structure was completed in Houston, Texas in May 2010.[33] This serves as a headquarters for 12 clinics in Texas and Louisiana.[33] Together, they are the largest family planning services provider in the U.S. with over four million activists, supporters and donors.[34][35][36] Planned Parenthood is staffed by 27,000 staff members and volunteers.[37]
They serve over five million clients a year, 26% of which are teenagers under the age of 19.[38] According to Planned Parenthood, 75% of their clients have incomes at or below 150 percent of the federal poverty level.[37]
In 2009, Planned Parenthood provided 4,009,549 contraceptive services (35% of total), 3,955,926 sexually transmitted disease services (35% of total), 1,830,811 cancer related services (16% of total), 1,178,369 pregnancy/prenatal/midlife services (10% of total), 332,278 abortion services (3% of total), and 76,977 other services (1% of total), for a total of 11,383,900 services.[9][37][39][40][41][42] The organization also said its doctors and nurses annually conduct 1 million screenings for cervical cancer and 830,000 breast exams.
Planned Parenthood has received federal funding since 1970, when President Richard Nixon signed into law the Family Planning Services and Population Research Act, amending the Public Health Service Act. Title X of that law provides funding for family planning services, including contraception and family planning information. The law enjoyed bipartisan support from liberals who saw contraception access as increasing families’ control over their lives, and conservatives who saw it as a way to keep people off welfare. Nixon described Title X funding as based on the premise that “no American woman should be denied access to family planning assistance because of her economic condition.”[43]
In the fiscal year ending June 30, 2011, total (consolidated) revenue was $201 million: clinic revenue totaling $2 million, grants and donations of $190 million, investment income of $2 million, and $7 million other income.[44] Approximately two-thirds of the revenue is put towards the provision of health services, while non-medical services such as sex education and public policy work make up another 16%; management expenses, fundraising, and international family planning programs account for most of the rest.
Planned Parenthood receives about a third of its money in government grants and contracts (about $360 million in 2009).[45] By law, federal funding cannot be allocated for abortions,[46] but some opponents of abortion have argued that allocating money to Planned Parenthood for the provision of other medical services “frees up” funds to be re-allocated for abortion.[4][47]
A coalition of national and local pro-life groups have lobbied federal and state government to stop funding Planned Parenthood, and as a result, Republican federal and state legislators have proposed legislation to reduce the funding levels.[46][48] Some six states have gone ahead with such proposals.[4][49][50][51] In some cases, the courts have overturned such actions, citing conflict with federal or other state laws, and in others, the federal executive branch has provided funding in lieu of the states.[50][51][52] In other cases, complete or partial defunding of Planned Parenthood has gone through successfully.[53][54]
Planned Parenthood is also funded by private donors, with a membership base of over 700,000 active donors whose contributions account for approximately one quarter of the organization’s revenue.[55] Large donors also contribute a substantial portion of the organization’s budget; past donors have included the Bill & Melinda Gates Foundation, Buffett Foundation, Ford Foundation, Turner Foundation, the Cullmans and others.[56][57][58][59] The Bill & Melinda Gates Foundation’s contributions to the organization have been specifically marked to avoid funding abortions.[56] Some, such as the Buffett Foundation, have supported reproductive health that can include abortion services.[56] Pro-life groups have advocated the boycott of donors to Planned Parenthood.[60]
Stand on political and legal issues
Planned Parenthood and its predecessor organizations have provided and advocated for access to birth control. The modern organization of Planned Parenthood America is also an advocate for reproductive rights.[61] This advocacy includes contributing to sponsorship of abortion rights and women’s rights events[62] and assisting in the testing of new contraceptives.[63] The Federation opposes restrictions on women’s reproductive health services, including parental consent laws. Planned Parenthood has cited the case of Becky Bell, who died following a septic abortion after failing to seek parental consent, to justify their opposition.[64][65] Planned Parenthood also takes the position that laws requiring parental notification before an abortion is performed on a minor are unconstitutional on privacy grounds.[66] The organization also opposes laws requiring ultrasounds before abortions, stating that their only purpose is to make abortions more difficult to obtain.[67] Planned Parenthood has also opposed initiatives that require waiting periods before abortions,[68] and bans on late-term abortions including intact dilation and extraction, which has been illegal in the U.S. since 2003.[69]
Planned Parenthood argues for the wide availability of emergency contraception (EC) measures.[70] It opposes conscience clauses, which allow pharmacists to refuse to dispense drugs against their beliefs. In support of their position, they have cited cases where pharmacists have refused to fill life saving drugs under the laws.[71] Planned Parenthood has also been critical of hospitals that do not provide access to EC for rape victims.[72] Planned Parenthood supports and provides FDA-approved abortifacients such as mifepristone.[73]
Citing the need for medically accurate information in sex education, Planned Parenthood opposes abstinence-only education in public schools. Instead, Planned Parenthood is a provider of, and endorses, comprehensive sex education, which includes discussion of both abstinence and birth control.[74]
Planned Parenthood also has a political action committee called Planned Parenthood Action Fund. The committee was founded in 1996 by then new president Gloria Feldt for the purpose of maintaining reproductive health rights and supporting political candidates of the same mindset. In 2012 election cycle the committee gained prominence based on its effectiveness of spending on candidates.[75]
Before the U.S. Supreme Court
Former Planned Parenthood President Gloria Feldt with Congressman Albert Wynn in front of the U.S. Supreme Court
Planned Parenthood regional chapters have been active in the American courts. A number of cases in which Planned Parenthood has been a party have reached the U.S. Supreme Court. Notable among these cases is the 1992 case Planned Parenthood v. Casey, the case that sets forth the current constitutional abortion standard. In this case, “Planned Parenthood” was the Southeast Pennsylvania Chapter, and “Casey” was Robert Casey, the governor of Pennsylvania. The ultimate ruling was split, and Roe v. Wade was narrowed but upheld in an opinion written by Sandra Day O’Connor, Anthony Kennedy, and David Souter. Harry Blackmun and John Paul Stevens concurred with the main decision in separately written opinions. The Supreme Court struck down spousal consent requirements for married women to obtain abortions, but found no “undue burden”—an alternative to strict scrutiny which tests the allowable limitations on rights protected under the Constitution—from the other statutory requirements. Dissenting were William Rehnquist, Antonin Scalia, Clarence Thomas, and Byron White. Blackmun, Rehnquist, and White were the only justices who voted on the original Roe v. Wade decision in 1973 who were still on the Supreme Court to rule on this case, and their votes on this case were consistent with their votes on the original decision that legalized abortion.[76] Only Blackmun voted to maintain Roe v. Wade in its entirety.
Other related cases include:
Planned Parenthood of Central Missouri v. Danforth (1976). Planned Parenthood challenged the constitutionality of a Missouri law encompassing parental consent, spousal consent, clinic bookkeeping and allowed abortion methods. Portions of the challenged law were held to be constitutional, others not.[77]
Planned Parenthood Association of Kansas City v. Ashcroft (1983). Planned Parenthood challenged the constitutionality of a Missouri law encompassing parental consent, clinic record keeping, and hospitalization requirements. Most of the challenged law was held to be constitutional.[78]
Planned Parenthood v. ACLA (2001). The American Coalition of Life Activists (ACLA) released a flier and “Wanted” posters with complete personal information about doctors who performed abortions. A civil jury and the Ninth Circuit Court of Appeals both found that the material was indeed “true threats” and not protected speech.[79]
Gonzales v. Planned Parenthood (2003). Planned Parenthood sued Attorney General Gonzales for an injunction against the enforcement of the Partial-Birth Abortion Ban Act of 2003. Planned Parenthood argued the act was unconstitutional because it violated the Fifth Amendment, namely in that it was overly vague, violated women’s constitutional right to have access to abortion, and did not include language for exceptions for the health of the mother. Both the district court and the US Court of Appeals for the Ninth Circuit agreed,[80][81] but that decision was overturned in a 5–4 ruling by the Supreme Court.[82]
Ayotte v. Planned Parenthood of Northern New England (2006). Planned Parenthood et al. challenged the constitutionality of a New Hampshire parental notification law related to access to abortion.[83][84] In Sandra Day O’Connor’s final decision before retirement, the Supreme Court sent the case back to lower courts with instructions to seek a remedy short of wholesale invalidation of the statute. New Hampshire ended up repealing the statute via the legislative process.[85]
Controversy and criticism
Abortion
Planned Parenthood has occupied a central position in the abortion debate in the U.S., and has been among the most prominent targets of U.S. pro-life activists for decades. Congressional Republicans have attempted since the 1980s to defund the organization,[45] nearly leading to a government shutdown over the issue in 2011.[86] The federal money received by Planned Parenthood is not used to fund abortion services, but pro-life activists have argued that the funding frees up other resources which are, in turn, used to provide abortions.[45]
Planned Parenthood is the largest single provider of abortions in the U.S.[7] In 2009, Planned Parenthood performed 332,278 abortions (for comparison, 1.21 million abortions were performed in the US in 2008[87]), from which it derives about $164,154,000, or 15% of its annual revenue as of their 2008–2009 calculations.[88] According to PPFA’s own estimates, its contraceptive services prevent approximately 612,000 unintended pregnancies and 291,000 abortions annually.[37][89] Planned Parenthood president Cecile Richards has argued that the organization’s family planning services reduce the need for abortions.[90] Megan Crepeau of the Chicago Tribune said that, because of its birth control and family planning services, PPFA could be “characterized as America’s largest abortion preventer.”[91] Anti-abortion activists dispute the evidence that greater access to contraceptives reduces abortions.[92]
In the 1920s various theories of eugenics were popular among intellectuals in the United States. For example, 75% of colleges offered courses on eugenics.[93] Sanger, in her campaign to promote birth control, teamed with eugenics organizations such as the American Eugenics Society, although she argued against many of their positions.[94][95][96] Scholars describe Sanger as believing that birth control, sterilization and abortion should be voluntary and not based on race.[97] She advocated for “voluntary motherhood”—the right to choose when to be pregnant—for all women, as an important element of women’s rights.[98][99] Opponents of Planned Parenthood often refer to Sanger’s connection with supporters of eugenics to discredit the organization by associating it, and birth control, with the more negative modern view of eugenics.[100][101] Planned Parenthood has responded to this effort directly in a leaflet acknowledging that Sanger agreed with some of her contemporaries who advocated the voluntary hospitalization or sterilization of people with untreatable, disabling, hereditary conditions, and limits on the immigration of the diseased. The leaflet also states that Planned Parenthood “finds these views objectionable and outmoded” but says that it was compelled to discuss the topic because “anti-family planning activists continue to attack Sanger . . . because she is an easier target” than Planned Parenthood.[102]
Periodically pro-life activists have tried to demonstrate that Planned Parenthood does not follow applicable state or federal laws. The groups called or visited a Planned Parenthood health center posing as victims of statutory rape,[103] minors who would need parental notification for abortion,[104][105] racists seeking to earmark donations for abortions for black women to abort black babies,[106] or pimps who want abortions for child prostitutes.[107] Edited video and audio productions of these dialogues seem to capture employees being sympathetic to potentially criminal acts, leading to allegations that the health centers in question are violating the law. An official federal inspection in 2005 by the Bush administration‘s Department of Health and Human Services “yielded no evidence of clinics around the nation failing to comply with laws on reporting child abuse, child molestation, sexual abuse, rape or incest.”[104]
In 2011, the organization Live Action released a series of videos that they said showed Planned Parenthood employees at multiple affiliates actively assisting or being complicit in aiding the underage prostitution ring of actors posing as a pimp and a prostitute. Planned Parenthood conducted a frame-by-frame analysis of the recordings, and said they found instances of “editing that dramatically alter[ed] the meaning of the recorded conversations.”[108]
None of these stings have led to criminal conviction.[109] However, a small number of Planned Parenthood employees and volunteers were fired for not following procedure, and the organization committed to retraining its staff.[106][110]
State and local court cases against Planned Parenthood
In some states, anti-abortion Attorneys General have subpoenaed medical records of patients treated by Planned Parenthood. Planned Parenthood has gone to court to keep from turning over these records, citing medical privacy and concerns about the motivation for seeking the records.[111]
In 2006, Kansas Attorney General Phill Kline, a strongly anti-abortion Republican, released some sealed patient records obtained from Planned Parenthood to the public. His actions were described as “troubling” by the state Supreme Court, but ultimately Planned Parenthood was compelled to turn over the medical records, albeit with more stringent court-mandated privacy safeguards for the patients involved.[111] In 2007, Kline’s successor, Paul J. Morrison, notified the clinic that no criminal charges would be filed after a three-year investigation, as “an objective, unbiased and thorough examination” showed no wrongdoing. Morrison stated that he believed Kline had politicized the attorney general’s office.[112] In 2012, a Kansas district attorney dropped all of the remaining criminal charges against the Kansas City-area Planned Parenthood clinic accused of performing illegal abortions, citing a lack of evidence of wrongdoing.[113] In all, the Planned Parenthood clinic had faced 107 criminal charges from Kline and other Kansas prosecutors, all of which were ultimately dropped for lack of evidence.[113]
In Indiana, Planned Parenthood was not required to turn over its medical records in an investigation of possible child abuse.[114] In October 2005, Planned Parenthood Minnesota/North Dakota/South Dakota was fined $50,000 for violating a Minnesota state parental consent law.[115]
On December 31, 2012, Judge Gary Harger ruled Texas may exclude otherwise qualified doctors and clinics from receiving state funding if they advocate for abortion rights.[116]
In 1994, John Salvi entered a Brookline, Massachusetts Planned Parenthood clinic and opened fire, murdering receptionist Shannon Elizabeth Lowney and wounding three others. He fled to another Planned Parenthood clinic where he murdered Leane Nichols and wounded two others.[128]
Planned Parenthood “dates its beginnings to 1916” but a predecessor, the American Birth Control League, was not founded until 1921 and the organization did not adopt its name until 1942.
William Sanger (1902–1921)[note 1]
James Noah H. Slee (1922–1943).
Margaret Higgins Sanger (September 14, 1879 – September 6, 1966) was an American birth control activist, sex educator, and nurse. Sanger popularized the term birth control, opened the first birth control clinic in the United States, and established organizations that evolved into the Planned Parenthood Federation of America. Sanger was also a writer. She used this method to help promote her way of thinking. She was prosecuted for her book Family Limitation under the Comstock Act in 1914. She was afraid of what would happen, so she fled to Britain until she knew it was safe to return to the US.[citation needed] Sanger’s efforts contributed to several judicial cases that helped legalize contraception in the United States. Sanger is a frequent target of criticism by opponents of abortion and has also been criticized for supporting eugenics, but remains an iconic figure in the American reproductive rights movement.[2]
In 1916, Sanger opened the first birth control clinic in the United States, which led to her arrest for distributing information on contraception. Her subsequent trial and appeal generated controversy. Sanger felt that in order for women to have a more equal footing in society and to lead healthier lives, they needed to be able to determine when to bear children. She also wanted to prevent unsafe abortions, so-called back-alley abortions, which were common at the time because abortions were usually illegal. She believed that while abortion was sometimes justified it should generally be avoided, and she considered contraception the only practical way to avoid the use of abortions.[citation needed]
In 1921, Sanger founded the American Birth Control League, which later became the Planned Parenthood Federation of America. In New York City, she organized the first birth control clinic staffed by all-female doctors, as well as a clinic in Harlem with an entirely African-American staff. In 1929, she formed the National Committee on Federal Legislation for Birth Control, which served as the focal point of her lobbying efforts to legalize contraception in the United States. From 1952 to 1959, Sanger served as president of the International Planned Parenthood Federation. She died in 1966, and is widely regarded as a founder of the modern birth control movement.
Life
Early life
Sanger was born Margaret Louise Higgins in 1879 in Corning, New York,[3] to Michael Hennessey Higgins, an Irish-born stonemason and free-thinker, and Anne Purcell Higgins, a Catholic Irish-American. Michael Hennessey Higgins had emigrated to the USA at age 14 and joined the U.S. Army as a drummer at age 15, during the Civil War. After leaving the army, Michael studied medicine and phrenology, but ultimately became a stonecutter, making stone angels, saints, and tombstones.[4] Michael H. Higgins was a Catholic who became an atheist and an activist for women’s suffrage and free public education.[5] Anne Higgins went through 18 pregnancies (with 11 live births) in 22 years before dying at the age of 49. Sanger was the sixth of eleven surviving children,[6] and spent much of her youth assisting with household chores and caring for her younger siblings. Anne’s parents took their children and emigrated to Canada when she was a child, due to the Potato Famine.
Supported by her two older sisters, Margaret Higgins attended Claverack College and Hudson River Institute, before enrolling in 1900 at White Plains Hospital as a nurse probationer. In 1902, she married the dashing architect William Sanger and gave up her education.[7] Though she was plagued by a recurring active tubercular condition, Margaret Sanger bore three children, and the couple settled down to a quiet life in Westchester, New York.
Sanger with sons Grant and Stuart, c. 1919
Social activism
In 1911, after a fire destroyed their home in Hastings-on-Hudson, the Sangers abandoned the suburbs for a new life in New York City. Margaret Sanger worked as a visiting nurse in the slums of the East Side, while her husband worked as an architect and a house painter. Already imbued with her husband’s leftist politics, Margaret Sanger also threw herself into the radical politics and modernist values of pre-World War IGreenwich Village bohemia. She joined the Women’s Committee of the New York Socialist party, took part in the labor actions of the Industrial Workers of the World (including the notable 1912 Lawrence Textile Strike and the 1913 Paterson Silk Strike) and became involved with local intellectuals, left-wing artists, socialists and social activists, including John Reed, Upton Sinclair, Mabel Dodge and Emma Goldman.[8]
Sanger’s political interests, emerging feminism and nursing experience led her to write two series of columns on sex education entitled “What Every Mother Should Know” (1911–12) and “What Every Girl Should Know” (1912-13) for the socialist magazine New York Call. By the standards of the day, Sanger’s articles were extremely frank in their discussion of sexuality, and many New York Call readers were outraged by them. Other readers, however, praised the series for its candor, one stated that the series contained “a purer morality than whole libraries full of hypocritical cant about modesty.[9] Both were later published in book form in 1916.[10]
During her work among working class immigrant women, Sanger was exposed to graphic examples of women going through frequent childbirth, miscarriage and self-induced abortion for lack of information on how to avoid unwanted pregnancy. Access to contraceptive information was prohibited on grounds of obscenity by the 1873 federal Comstock law and a host of state laws. Searching for something that would help these women, Sanger visited public libraries, but was unable to find information on contraception.[11] These problems were epitomized in a (possibly fictional) story that Sanger would later recount in her speeches: while Sanger was working as a nurse, she was called to the apartment of a woman, “Sadie Sachs,” who had become extremely ill due to a self-induced abortion. Afterward, “Sadie” (whose marital status Sanger never mentioned) begged the attending doctor to tell her how she could prevent this from happening again, to which the doctor simply advised her to remain abstinent. A few months later, Sanger was called back to “Sadie’s” apartment — only this time, “Sadie” died shortly after Sanger arrived. She had attempted yet another self-induced abortion.[12][13] Sanger would sometimes end the story by saying, “I threw my nursing bag in the corner and announced … that I would never take another case until I had made it possible for working women in America to have the knowledge to control birth.” Although “Sadie Sachs” was possibly a fictional composite of several women Sanger had known, this story marks the time when Sanger began to devote her life to help desperate women before they were driven to pursue dangerous and illegal abortions.[13][14]
Accepting the connection proposed between contraception and working-class empowerment by radicals such as Emma Goldman, Sanger came to believe that only by liberating women from the risk of unwanted pregnancy would fundamental social change take place. She proceeded to launch a campaign to challenge governmental censorship of contraceptive information. She would set up a series of confrontational actions designed to challenge the law and force birth control to become a topic of public debate. Sanger’s trip to France in 1913 exposed her to what Goldman had been saying. Sanger’s experience during her trip to France directly influence The Women Rebel newsletter. The trip to France was also the beginning of the end of her marriage with William Sanger.[15]
In 1914, Sanger launched The Woman Rebel, an eight-page monthly newsletter which promoted contraception using the slogan “No Gods, No Masters“.[16][note 2][17] Sanger, collaborating with anarchist friends, popularized the term “birth control” as a more candid alternative to euphemisms such as “family limitation”[18] and proclaimed that each woman should be “the absolute mistress of her own body.”[19] In these early years of Sanger’s activism, she viewed birth control as a free-speech issue, and when she started publishing The Woman Rebel, one of her goals was to provoke a legal challenge to the federal anti-obscenity laws which banned dissemination of information about contraception.[20][21] Though postal authorities suppressed five of its seven issues, Sanger continuing publication, all the while preparing, Family Limitation, an even more blatant challenge to anti-birth control laws. This 16-page pamphlet contained detailed and precise information and graphic descriptions of various contraceptive methods. In August 1914 Margaret Sanger was indicted for violating postal obscenity laws by sending the The Woman Rebel through the postal system. Instead of standing trial, she jumped bail and fled to Canada. Then, under the alias “Bertha Watson”, sailed for England. En route she ordered her labor associates to release copies of the Family Limitation.[22]
Margaret Sanger spent much of her 1914 exile in England, where contact with British neo-Malthusianists helped refine her socioeconomic justifications for birth control. She was also profoundly influenced by the liberation theories of British sexual theorist Havelock Ellis. Under his tutelage she formulated a new rationale that would liberate women not just by making sexual intercourse safe, but also pleasurable. It would, in effect, free women from the inequality of sexual experience. Early in 1915, Margaret Sanger’s estranged husband, William Sanger, was entrapped into giving a copy of Family Limitation to a representative of anti-vice crusader Anthony Comstock. William Sanger was tried and convicted, he spent thirty days in jail, while also escalating interest in birth control as a civil liberties issue.[23][24][25]
This page from Sanger’s Family Limitation, 1917 edition, describes a cervical cap.
Some countries in northwestern Europe had more liberal policies towards contraception than the United States at the time, and when Sanger visited a Dutch birth control clinic in 1915, she learned about diaphragms and became convinced that they were a more effective means of contraception than the suppositories and douches that she had been distributing back in the United States. Diaphragms were generally unavailable in the United States, so Sanger and others began importing them from Europe, in defiance of United States law.[8]
On October 16, 1916, Sanger opened a family planning and birth control clinic at 46 Amboy St. in the Brownsville neighborhood of Brooklyn, the first of its kind in the United States.[26] Nine days after the clinic opened, Sanger was arrested. Sanger’s bail was set at $500 and she went back home. Sanger continued seeing some women in the clinic until the police came a second time. This time Sanger and her sister, Ethel Byrne, were arrested for breaking a New York state law that prohibited distribution of contraceptives, Sanger was also charged with running a public nuisance.[27] Sanger and Ethel went to trial in January 1917.[28] Byrne was convicted and sentenced to 30 days in a workhouse but went on hunger strike. She was the first woman in the US to be force fed.[29] Only when Sanger pledged that Byrne would never break the law, she was pardoned after ten days.[30] Sanger was convicted; the trial judge held that women did not have “the right to copulate with a feeling of security that there will be no resulting conception.”[31] Sanger was offered a more lenient sentence if she promised to not break the law again, but she replied: “I cannot respect the law as it exists today.”[32] For this, she was sentenced to 30 days in a workhouse.[32] An initial appeal was rejected, but in a subsequent court proceeding in 1918, the birth control movement won a victory when Judge Frederick E. Crane of the New York Court of Appeals issued a ruling which allowed doctors to prescribe contraception.[33] The publicity surrounding Sanger’s arrest, trial, and appeal sparked birth control activism across the United States, and earned the support of numerous donors, who would provide her with funding and support for future endeavors.[34]
Sanger became estranged from her husband in 1913, and the couple’s divorce was finalized in 1921.[35] Sanger’s second husband was Noah Slee. He followed Sanger around the world and provided much of Sanger’s financial assistance. The couple got married in September 1922, but the public did not know about it until February 1924. They supported each other with their pre-commitments.[36]
American Birth Control League
Sanger published the Birth Control Review from 1917 to 1929.[note 4]
After World War I, Sanger shifted away from radical politics, and she founded the American Birth Control League (ABCL) in 1921 to enlarge her base of supporters to include the middle class.[37] The founding principles of the ABCL were as follows:[38]
We hold that children should be (1) Conceived in love; (2) Born of the mother’s conscious desire; (3) And only begotten under conditions which render possible the heritage of health. Therefore we hold that every woman must possess the power and freedom to prevent conception except when these conditions can be satisfied.
Sanger’s appeal of her conviction for the Brownsville clinic secured a 1918 court ruling that exempted physicians from the law that prohibited the distribution of contraceptive information to women—provided it was prescribed for medical reasons—she established the Clinical Research Bureau (CRB) in 1923 to exploit this loophole.[8][39] The CRB was the first legal birth control clinic in the United States, and it was staffed entirely by female doctors and social workers.[40] The clinic received a large amount of funding from John D. Rockefeller Jr. and his family, which continued to make donations to Sanger’s causes in future decades, but generally made them anonymously to avoid public exposure of the family name,[41] and to protect family member Nelson Rockefeller‘s political career since openly advocating birth control could have led to the Catholic Church opposing him politically.[42] John D. Rockefeller Jr. donated five thousand dollars to her American Birth Control League in 1924 and a second time in 1925.[43] In 1922, she traveled to China, Korea, and Japan. In China she observed that the primary method of family planning was female infanticide, and she later worked with Pearl Buck to establish a family planning clinic in Shanghai.[44] Sanger visited Japan six times, working with Japanese feminist Kato Shidzue to promote birth control.[45] This was ironic since ten years earlier Sanger had accused Katō of murder and praised an attempt to kill her.[46]
In 1926, Sanger gave a lecture on birth control to the women’s auxiliary of the Ku Klux Klan in Silver Lake, New Jersey.[47] She described it as “one of the weirdest experiences I had in lecturing,” and added that she had to use only “the most elementary terms, as though I were trying to make children understand.”[47] Sanger’s talk was well received by the group, and as a result, “a dozen invitations to similar groups were proffered.”[47]
In 1928, conflict within the birth control movement leadership led Sanger to resign as the president of the ABCL and take full control of the CRB, renaming it the Birth Control Clinical Research Bureau (BCCRB), marking the beginning of a schism in the movement that would last until 1938.[48]
Sanger invested a great deal of effort communicating with the general public. From 1916 onward, she frequently lectured—in churches, women’s clubs, homes, and theaters—to workers, churchmen, liberals, socialists, scientists, and upper-class women.[49] She wrote several books in the 1920s which had a nationwide impact in promoting the cause of birth control. Between 1920 and 1926, 567,000 copies of Woman and the New Race and The Pivot of Civilization were sold.[50] She also wrote two autobiographies designed to promote the cause. The first, My Fight for Birth Control, was published in 1931 and the second, more promotional version, Margaret Sanger: An Autobiography, was published in 1938.
During the 1920s, Sanger received hundreds of thousands of letters, many of them written in desperation by women begging for information on how to prevent unwanted pregnancies.[51][52] Five hundred of these letters were compiled into the 1928 book, Motherhood in Bondage.[53][54]
Sanger’s Birth Control Clinical Research Bureau operated from this New York building from 1930 to 1973.
In 1929, Sanger formed the National Committee on Federal Legislation for Birth Control in order to lobby for legislation to overturn restrictions on contraception.[55] That effort failed to achieve success, so Sanger ordered a diaphragm from Japan in 1932, in order to provoke a decisive battle in the courts. The diaphragm was confiscated by the United States government, and Sanger’s subsequent legal challenge led to a 1936 court decision which overturned an important provision of the Comstock laws which prohibited physicians from obtaining contraceptives.[56] This court victory motivated the American Medical Association in 1937 to adopt contraception as a normal medical service and a key component of medical school curriculums.[57]
This 1936 contraception court victory was the culmination of Sanger’s birth control efforts, and she took the opportunity, now in her late 50s, to move to Tucson, Arizona, intending to play a less critical role in the birth control movement. In spite of her original intentions, she remained active in the movement through the 1950s.[57]
In 1937, Sanger became chairman of the newly formed Birth Control Council of America, and attempted to resolve the schism between the ABCL and the BCCRB.[58] Her efforts were successful, and the two organizations merged in 1939 as the Birth Control Federation of America.[59][note 5] Although Sanger continued in the role of president, she no longer wielded the same power as she had in the early years of the movement, and in 1942, more conservative forces within the organization changed the name to Planned Parenthood Federation of America, a name Sanger objected to because she considered it too euphemistic.[60]
In 1946, Sanger helped found the International Committee on Planned Parenthood, which evolved into the International Planned Parenthood Federation in 1952, and soon became the world’s largest non-governmental international family planning organization. Sanger was the organization’s first president and served in that role until she was 80 years old.[61] In the early 1950s, Sanger encouraged philanthropist Katharine McCormick to provide funding for biologist Gregory Pincus to develop the birth control pill which was eventually sold under the name Enovid.[62]
Long after her death, Sanger has continued to be regarded as a leading figure in the battle for American women’s rights. Sanger’s story has been the subject of several biographies, including an award-winning biography published in 1970 by David Kennedy, and is also the subject of several films, including Choices of the Heart: The Margaret Sanger Story.[65] Sanger’s writings are curated by two universities: New York University‘s history department maintains the Margaret Sanger Papers Project,[66] and Smith College‘s Sophia Smith Collection maintains the Margaret Sanger Papers collection.[67]
Sanger has been recognized with many important honors. In 1957, the American Humanist Association named her Humanist of the Year. Government authorities and other institutions have memorialized Sanger by dedicating several landmarks in her name, including a residential building on the Stony Brook University campus, a room in Wellesley College’s library,[68] and Margaret Sanger Square in New York City’s Greenwich Village.[69] In 1993, the Margaret Sanger Clinic—where she provided birth control services in New York in the mid twentieth century—was designated as a National Historic Landmark by the National Park Service.[70] In 1966, Planned Parenthood began issuing its Margaret Sanger Awards annually to honor “individuals of distinction in recognition of excellence and leadership in furthering reproductive health and reproductive rights.”[71]
While researching information on contraception Sanger read various treatises on sexuality in order to find information about birth control. She read The Psychology of Sex by the English psychologist Havelock Ellis and was heavily influenced by it.[74] While traveling in Europe in 1914, Sanger met Ellis.[75] Influenced by Ellis, Sanger adopted his view of sexuality as a powerful, liberating force.[76] This view provided another argument in favor of birth control, as it would enable women to fully enjoy sexual relations without the fear of an unwanted pregnancy.[77] Sanger also believed that sexuality, along with birth control, should be discussed with more candor.[76]
However, Sanger was opposed to excessive sexual indulgence. She stated “every normal man and woman has the power to control and direct his sexual impulse. Men and women who have it in control and constantly use their brain cells thinking deeply, are never sensual.”[78][79] Sanger said that birth control would elevate women away from a position of being an object of lust and elevate sex away from purely being for satisfying lust, saying that birth control “denies that sex should be reduced to the position of sensual lust, or that woman should permit herself to be the instrument of its satisfaction.”[80] Sanger wrote that masturbation was dangerous. She stated: “In my personal experience as a trained nurse while attending persons afflicted with various and often revolting diseases, no matter what their ailments, I never found any one so repulsive as the chronic masturbator. It would not be difficult to fill page upon page of heart-rending confessions made by young girls, whose lives were blighted by this pernicious habit, always begun so innocently.”[81] She believed that women had the ability to control their sexual impulses, and should utilize that control to avoid sex outside of relationships marked by “confidence and respect.” She believed that exercising such control would lead to the “strongest and most sacred passion.”[82] However, Sanger was not opposed to homosexuality and praised Ellis for clarifying “the question of homosexuals… making the thing a—not exactly a perverted thing, but a thing that a person is born with different kinds of eyes, different kinds of structures and so forth… that he didn’t make all homosexuals perverts—and I thought he helped clarify that to the medical profession and to the scientists of the world as perhaps one of the first ones to do that.”[83] Sanger believed sex should be discussed with more candor, and praised Ellis for his efforts in this direction. She also blamed the suppression of discussion about it on Christianity.[83]
Eugenics
Sanger’s 1920 book endorsed eugenics.
As part of her efforts to promote birth control, Sanger found common cause with proponents of eugenics, believing that they both sought to “assist the race toward the elimination of the unfit.”[84] Sanger was a proponent of negative eugenics, which aims to improve human hereditary traits through social intervention by reducing the reproduction of those who were considered unfit. In “The Morality of Birth Control,” a 1921 speech, she divided society into three groups: the educated and informed class that regulated the size of their families, the intelligent and responsible who desired to control their families however did not have the means or the knowledge and the irresponsible and reckless people whose religious scruples “prevent their exercising control over their numbers.” Sanger concludes “there is no doubt in the minds of all thinking people that the procreation of this group should be stopped.”[85] Sanger’s eugenic policies included an exclusionary immigration policy, free access to birth control methods and full family planning autonomy for the able-minded, and compulsory segregation or sterilization for the “profoundly retarded”.[86][87] In her book The Pivot of Civilization, she advocated coercion to prevent the “undeniably feeble-minded” from procreating.[88] Although Sanger supported negative eugenics, she asserted that eugenics alone was not sufficient, and that birth control was essential to achieve her goals.[89][90][91]
In contrast with eugenicist William Robinson, who advocated euthanasia for the unfit,[note 8] Sanger wrote, “we [do not] believe that the community could or should send to the lethal chamber the defective progeny resulting from irresponsible and unintelligent breeding.”[92] Similarly, Sanger denounced the aggressive and lethal Nazi eugenics program.[87] In addition, Sanger believed the responsibility for birth control should remain in the hands of able-minded individual parents rather than the state, and that self-determining motherhood was the only unshakable foundation for racial betterment.[89][93]
Sanger also supported restrictive immigration policies. In “A Plan for Peace”, a 1932 essay, she proposed a congressional department to address population problems. She also recommended that immigration exclude those “whose condition is known to be detrimental to the stamina of the race,” and that sterilization and segregation be applied to those with incurable, hereditary disabilities.[86][87][94]
Sanger’s writings echoed her ideas about inferiority and loose morals of particular races. In one “What Every Girl Should Know” commentary, she references popular opinion that Aboriginal Australians were “just a step higher than the chimpanzee” with “little sexual control,” as compared to the “normal man and Woman.”[78] Elsewhere she bemoaned that traditional sexual ethics “… have in the past revealed their woeful inability to prevent the sexual and racial chaos into which the world has today drifted.”[93]
Such attitudes did not keep her from collaborating with African-American leaders and professionals who saw a need for birth control in their communities. In 1929, James H. Hubert, a black social worker and leader of New York’s Urban League, asked Sanger to open a clinic in Harlem.[96] Sanger secured funding from the Julius Rosenwald Fund and opened the clinic, staffed with black doctors, in 1930. The clinic was directed by a 15-member advisory board consisting of black doctors, nurses, clergy, journalists, and social workers. The clinic was publicized in the African-American press and in black churches, and it received the approval of W. E. B. Du Bois, founder of the NAACP.[97] In 1939 Sanger wrote, “We should hire three or four colored ministers, preferably with social-service backgrounds, and with engaging personalities. The most successful educational approach to the Negro is through a religious appeal. We don’t want the word to go out that we want to exterminate the Negro population, and the minister is the man who can straighten out that idea if it ever occurs to any of their more rebellious members.” She did not tolerate bigotry among her staff, nor would she tolerate any refusal to work within interracial projects.[98] Sanger’s work with minorities earned praise from Martin Luther King, Jr., in his 1966 acceptance speech for the Margaret Sanger award.[99]
From 1939 to 1942 Sanger was an honorary delegate of the Birth Control Federation of America, which included a supervisory role—alongside Mary Lasker and Clarence Gamble—in the Negro Project, an effort to deliver birth control to poor black people.[100] Sanger wanted the Negro Project to include black ministers in leadership roles, but other supervisors did not. To emphasize the benefits of involving black community leaders, she wrote to Gamble “we do not want word to go out that we want to exterminate the Negro population and the minister is the man who can straighten out that idea if it ever occurs to any of their more rebellious members.” This quote has been cited by Angela Davis to support her claims that Sanger wanted to exterminate black people.[101] However, New York University’s Margaret Sanger Papers Project, argues that in writing that letter, “Sanger recognized that elements within the black community might mistakenly associate the Negro Project with racist sterilization campaigns in the Jim Crow South, unless clergy and other community leaders spread the word that the Project had a humanitarian aim.”[102]
Freedom of speech
Sanger opposed censorship throughout her career, with a zeal comparable to her support for birth control. Sanger grew up in a home where iconoclastic orator Robert Ingersoll was admired.[103] During the early years of her activism, Sanger viewed birth control primarily as a free-speech issue, rather than as a feminist issue, and when she started publishing The Woman Rebel in 1914, she did so with the express goal of provoking a legal challenge to the Comstock laws banning dissemination of information about contraception.[21] In New York, Emma Goldman introduced Sanger to members of the Free Speech League, such as Edward Bliss Foote and Theodore Schroeder, and subsequently the League provided funding and advice to help Sanger with legal battles.[104]
Over the course of her career, Sanger was arrested at least eight times for expressing her views during an era in which speaking publicly about contraception was illegal.[105] Numerous times in her career, local government officials prevented Sanger from speaking by shuttering a facility or threatening her hosts.[106] In Boston in 1929, city officials under the leadership of James Curley threatened to arrest her if she spoke—so she turned the threat to her advantage and stood on stage, silent, with a gag over her mouth, while her speech was read by Arthur M. Schlesinger, Sr.[107]
Abortion
Sanger’s family planning advocacy always focused on contraception, rather than abortion.[108][note 9] It was not until the mid-1960s, after Sanger’s death, that the reproductive rights movement expanded its scope to include abortion rights as well as contraception.[note 10] Sanger was opposed to abortions, both because she believed that life should not be terminated after conception, and because they were dangerous for the mother in the early 20th century. In her book Woman and the New Race, she wrote: “while there are cases where even the law recognizes an abortion as justifiable if recommended by a physician, I assert that the hundreds of thousands of abortions performed in America each year are a disgrace to civilization.”[111]
Historian Rodger Streitmatter concluded that Sanger’s opposition to abortion stemmed from concerns for the dangers to the mother, rather than moral concerns.[112] However, in her 1938 autobiography, Sanger noted that her opposition to abortion was based on the taking of life: “[In 1916] we explained what contraception was; that abortion was the wrong way no matter how early it was performed it was taking life; that contraception was the better way, the safer way—it took a little time, a little trouble, but was well worth while in the long run, because life had not yet begun.”[113] And in her book Family Limitation, Sanger wrote that “no one can doubt that there are times when an abortion is justifiable but they will become unnecessary when care is taken to prevent conception. This is the only cure for abortions.”[114]
Works
Books and pamphlets
What Every Mother Should Know – Originally published in 1911 or 1912, based on a series of articles Sanger published in 1911 in the New York Call, which were, in turn, based on a set of lectures Sanger gave to groups of Socialist party women in 1910–1911.[115] Multiple editions published through the 1920s, by Max N. Maisel and Sincere Publishing, with the title What Every Mother Should Know, or how six little children were taught the truth …Online(1921 edition, Michigan State University)
Family Limitation – Originally published 1914 as a 16-page pamphlet; also published in several later editions. Online (1917, 6th edition, Michigan State University)
What Every Girl Should Know – Originally published 1916 by Max N. Maisel; 91 pages; also published in several later editions. Online (1920 edition); Online (1922 ed., Michigan State University)
The Case for Birth Control: A Supplementary Brief and Statement of Facts – May 1917, published to provide information to the court in a legal proceeding. Online (Internet Archive)
Woman and the New Race, 1920, Truth Publishing, foreword by Havelock Ellis. Online (Harvard University); Online (Project Gutenberg); Online (Internet Archive); Audio on Archive.org
An Autobiography. New York, NY: Cooper Square Press. 1938. ISBN0-8154-1015-8.
Fight for Birth Control, 1916, New York] [1] (The Library of Congress)
Birth Control A Parent’s Problem or Women’s?” The Birth Control Review, Mar. 1919, 6-7.
Periodicals
The Woman Rebel – Seven issues published monthly from March 1914 to August 1914. Sanger was publisher and editor.
Birth Control Review – Published monthly from February 1917 to 1940. Sanger was Editor until 1929, when she resigned from the ABCL.[116] Not to be confused with Birth Control News, published by the London-based Society for Constructive Birth Control and Racial Progress.
Collections and anthologies
Sanger, Margaret, The Selected Papers of Margaret Sanger, Volume 1: The Woman Rebel, 1900–1928, Esther Katz, Cathy Moran Hajo, Peter Engelman (eds), University of Illinois Press, 2003
Sanger, Margaret, The Selected Papers of Margaret Sanger, Volume 2: Birth Control Comes of Age, 1928–1939, Esther Katz, Cathy Moran Hajo, Peter Engelman (eds), University of Illinois Press, 2007
Sanger, Margaret, The Selected Papers of Margaret Sanger, Volume 3: The Politics of Planned Parenthood, 1939–1966, Esther Katz, Cathy Moran Hajo, Peter Engelman (eds), University of Illinois Press, 2010
Story 1: Democrats and Progressives Support Planned Parenthood’s Big Business of Abortions, Baby Butchering and Selling Baby Body Parts For Money — Moral Bankruptcy of The Lying Lunatic Left — Killing Black, Hispanic and White Babies and Selling Their Baby Parts For Money — Progressive Eugenics Today –Stop Killing Babies! — Videos
SHOCK VIDEO: Planned Parenthood sells dead baby body parts
Planned Parenthood Uses Partial-Birth Abortions to Sell Baby Parts
BUSTED! Proof Planned Parenthood Sells Dead Babies to Anyone Willing to Buy! LEAKED FOOTAGE!
REP STANDS UP TO BABY PARTS BROKERS of PLANNED PARENTHOOD SATANISTS
Planned Parenthood Exposed
FULL FOOTAGE: Planned Parenthood Uses Partial-Birth Abortions to Sell Baby Parts
The Rolling Stones – You Can’t Always Get What You Want (lyrics)
Rolling Stones – You Can’t Always Get What You Want (The David Frost Show 1969)
The Silent Scream (Full Length)
The Silent Scream Complete Version – Abortion as Infanticide
Dr. Bernard Nathanson’s classic video that shocked the world. He explains the procedure of a suction abortion, followed by an actual first trimester abortion as seen through ultrasound. The viewer can see the child’s pathetic attempts to escape the suction curette as her heart rate doubles, and a “silent scream” as her body is torn apart. A great tool to help people see why abortion is murder. The most important video on abortion ever made. This video changed opinion on abortion to many people.
Introduction by Dr. Bernard Nathanson, host. Describes the technology of ultrasound and how, for the first time ever, we can actually see inside the womb. Dr. Nathanson further describes the ultrasound technique and shows examples of babies in the womb. Three-dimensional depiction of the developing fetus, from 4 weeks through 28 weeks. Display and usage of the abortionists’ tools, plus video of an abortionist performing a suction abortion.
Dr. Nathanson discusses the abortionist who agreed to allow this abortion to be filmed with ultrasound. The abortionist was quite skilled, having performed more than 10,000 abortions. We discover that the resulting ultrasound of his abortion so appalled him that he never again performed another abortion.
The clip begins with an ultrasound of the fetus (girl) who is about to be aborted. The girl is moving in the womb; displays a heartbeat of 140 per minute; and is at times sucking her thumb. As the abortionist’s suction tip begins to invade the womb, the child rears and moves violently in an attempt to avoid the instrument. Her mouth is visibly open in a “silent scream.” The child’s heart rate speeds up dramatically (to 200 beats per minute) as she senses aggression. She moves violently away in a pathetic attempt to escape the instrument. The abortionist’s suction tip begins to rip the baby’s limbs from its body, ultimately leaving only her head in the uterus (too large to be pulled from the uterus in one piece). The abortionist attempts to crush her head with his forceps, allowing it to be removed. In an effort to “dehumanize” the procedure, the abortionist and anesthesiologist refer to the baby’s head as “number 1.” The abortionist crushes “number 1” with the forceps and removes it from the uterus.
Abortion statistics are revealed, as well as who benefits from the enormously lucrative industry that has developed. Clinics are now franchised, and there is ample evidence that many are controlled by organized crime. Women are victims, too. They haven’t been told about the true nature of the unborn child or the facts about abortion procedures. Their wombs have been perforated, infected, destroyed, and sterilized. All as a result of an operation about which they they have had no true knowledge.
Films like this must be made part of “informed consent.” NARAL (National Abortion Rights Action League) and Planned Parenthood are accused of a conspiracy of silence, of keeping women in the dark about the reality of abortion. Finally, Dr. Nathanson discusses his credentials. He is a former abortionist, having been the director of the largest clinic in the Western world.
Margaret Sanger’s “Negro Project” & Barack Obama’s Planned Parenthood
Planned Parenthood Exposed
Obama Tells Planned Parenthood-God Bless You – YouTube
A message to Planned Parenthood Supporters from President Obama
Barack Obama Addresses Planned Parenthood
Obama In ’03: No On Banning Late Term Abortions
Obama’s Barbaric Views on Partial Birth Abortion and Infanticide
MAAFA 21 [A documentary on eugenics and genocide]
Hitler`s Biological Soldiers / Science and the Swastika (EUGENICS)
Eugenics Glenn Beck w/ Edwin Black author of “War Against the Weak” talk Al Gore & Margaret Sanger
OVERPOPULATION
What’s Wrong With Socialism?
Eugenics, Planned Parenthood & Psychology, Mind Control
Mind Control, Psychology of Brainwashing, Sex & Hypnosis
Sex Addiction, Restless Legs Syndrome, PMS & Drug, Mind Control Report
Margaret Sanger, Planned Parenthood’s Racist Founder
Margaret Sanger: Eugenicist (1/3)
Margaret Sanger: Eugenicist (2/3)
Margaret Sanger: Eugenicist (3/3)
Pro-Lifer Mark Crutcher & Alex Jones: Eugenics is The Heart of The Globalists Religion 1/3
Pro-Lifer Mark Crutcher & Alex Jones: Eugenics is The Heart of The Globalists Religion 2/3
Pro-Lifer Mark Crutcher & Alex Jones: Eugenics is The Heart of The Globalists Religion 3/3
Slow Kill Holocaust: Proof the Government is Killing You
War on the Weak: Eugenics in America
Eugenics: Science In History
Bill O’Reilly Calls Planned Parenthood An “Abortion Mill”
Eugenics: alive and well in the USA
Scientific Racism The Eugenics of Social Darwinism
Eugenics, Population Control, and the NWO
Agenda 21 & Eugenics – Bill Gates Depopulation Plans Exposed
The Depopulation Agenda For a New World Order Agenda 21 ☁☢☁☰☰☰☰☰✈
George Carlin – List of people who ought to be killed
The Rolling Stones – Angie – OFFICIAL PROMO (Version 1)
Undercover video shows Planned Parenthood official discussing fetal organs used for research
By Sandhya Somashekhar and Danielle Paquette
An antiabortion group on Tuesday released an undercover video of an official at Planned Parenthood discussing in graphic detail how to abort a fetus to preserve its organs for medical research — as well as the costs associated with sharing that tissue with scientists.
Over lunch at a Los Angeles restaurant, two antiabortion activists posing as employees from a biotech firm met with Deborah Nucatola, Planned Parenthood’s senior director of medical research. Armed with cameras, the activists recorded Nucatola talking about Planned Parenthood’s work donating fetal tissue to researchers and pressed her on whether the clinics were charging for the organs.
The Center for Medical Progress, which recorded and edited the video, says the footage proves that Planned Parenthood is breaking the law by selling fetal organs. But the video does not show Nucatola explicitly talking about selling organs. The Planned Parenthood official says the organization is “very, very sensitive” about being perceived as illegally profiting from organ sales and charges only for the cost, for instance, of shipping the tissue.
[Congressional and state investigations into the video have begun]
The video threatens to reignite a long-standing debate over the use of fetal tissue harvested through abortions and could add fuel to efforts seeking to ban abortions after 20 weeks of pregnancy.
In a statement, a spokesman for Planned Parenthood said the video misrepresents the organization’s work. Planned Parenthood clinics, with a patient’s permission, may sometimes donate fetal tissue for use in stem cell research, said the spokesman, who added that the group’s affiliates, which operate independently, do not profit from these donations.
“At several of our health centers, we help patients who want to donate tissue for scientific research, and we do this just like every other high-quality health-care provider does — with full, appropriate consent from patients and under the highest ethical and legal standards,” spokesman Eric Ferrero said. “In some instances, actual costs, such as the cost to transport tissue to leading research centers, are reimbursed, which is standard across the medical field.”
He accused the Center for Medical Progress of mounting a misleading attack similar to those by other groups that have tried to mount undercover “stings” targeting Planned Parenthood.
But antiabortion groups said the video shows that Planned Parenthood is essentially selling fetal organs and that Congress and other authorities should investigate.
Buying and selling human fetal tissue is illegal in the United States. Federal regulations also prohibit anyone from altering the timing or method of an abortion for the sole purpose of later using the tissue in research. Donating the tissue for research, however, is legal with a woman’s consent.
Antiabortion groups also said the callous nature of the discussion captured on film should tug at viewers’ consciences — particularly when Nucatola apparently describes “crushing” the fetus in ways that keep its internal organs intact and her remarks about researchers’ desire for lungs and livers.
“I’d say a lot of people want liver,” she says in the video posted on the Center for Medical Progress’s Web site, between bites of salad. “And for that reason, most providers will do this case under ultrasound guidance so they’ll know where they’re putting their forceps.”
She continues: “We’ve been very good at getting heart, lung, liver, because we know that, so I’m not gonna crush that part, I’m gonna basically crush below, I’m gonna crush above, and I’m gonna see if I can get it all intact.”
It’s hard to assess exactly what happened at the lunch with Nucatola. The antiabortion group had complete control over the filming and editing of the footage. The group also posted a nearly three-hour version of the video that it’s calling the “full footage,” though there is no way to verify that the video is truly complete.
Key moments from the undercover recording with Planned Parenthood executive(7:56)
The anti-abortion group Center for Medical Progress posted a long version of the conversation between a Planned Parenthood executive and undercover actors on YouTube along with an shorter version that has been shared widely. These are excerpts of the longer version. (CenterforMedicalProgress.org)
The unidentified activists, a man and a woman, told Nucatola they worked for a biotech firm that aimed to snare “a competitive advantage” by providing local samples for researchers who would like to avoid lengthy trips between clinic and lab. They said they worked in Norwalk, a suburb.
“Every provider has patients who want to donate their tissue, and they want to accommodate them,” says Nucatola. “They just want to do it in a way that is not perceived as: This clinic is selling tissue. This clinic is making money off this. In the Planned Parenthood world, they’re very, very sensitive to that. Some affiliates might do it for free. They want to come to a number that looks like a reasonable number for the effort that is allotted on their part . . . ”
One activist asks, “Okay, so, when you are — or when the affiliate is — determining what that monetary . . . So that it doesn’t raise the question of . . . ‘This is what it’s about’ — What price range would you . . . ?”
“You know, I would throw a number out, I would say it’s probably anywhere from $30 to $100, depending on the facility and what’s involved,” says Nucatola. “It just has to do with space issues, are you sending someone there that’s going to be doing everything . . . is there shipping involved? Is someone going to be there to pick it up?”
In order to film the footage, the activists wore “police-quality undercover cameras,” said David Daleiden, who ran the project for the Center of Medical Progress. (He refused to elaborate: “I don’t answer questions about our undercover costumes.”)
The “sting” unfolded over three years, Daleiden said, because it takes time to build up a front as a biotech company and gain access to Planned Parenthood executives. The lunch, he said, is just the beginning: The Center for Medical Progress plans to release a new video every week for the next few months.
Daleiden rejects Nucatola’s claim that costs associated with fetal tissue donation involve shipping and staff hours. “Literally the only thing the clinic is doing is carrying the fetus from the operation to the tech,” he said.
The Center for Medical Progress was established by Daleiden, a controversial antiabortion activist who previously worked with Live Action, another antiabortion group known for its “stings” of Planned Parenthood using actors and undercover videos.
The group is a non-profit organization that describes itself on its Web site as “a group of citizen journalists dedicated to monitoring and reporting on medical ethics and advances.”
“The promotional video mischaracterizing Planned Parenthood’s mission and services is made by a long time anti-abortion activist that has used deceptive and unethical video editing, and that has created a fake medical website as well as a fake human tissue website that purports to provide services to stem cell researchers,” Planned Parenthood said in a statement Tuesday.
Daleiden also alleges that the procedure described by Nucatola is similar to “intact dilation and extraction,” referred to by opponents as partial-birth abortion, which Congress outlawed in 2003. The Supreme Court upheld the law’s constitutionality four years later.
In the 1980s and 1990s, researchers considered fetal tissue transplants a budding treatment for Parkinson’s disease and diabetes. Some believed they held the potential to prevent autism.
As different kind of stem cells — embryonic stem cells — gain prominence in research, fetal tissue donations today are often used to gain deeper anatomical understanding of fetuses, said Arthur Caplan, director of New York University’s Division of Medical Ethics. The practice, however, is problematic if an abortion provider goes into a procedure with the primary intention of preserving a liver, he said. In the video, Nucatola appears to allude to methods for carefully extracting the organs.
“I think the only relevant goal of an abortion clinic is to provide a safe and least risky abortion to a woman,” Caplan said. “If you’re starting to play with how it’s done, and when it’s done, other things than women’s health are coming into play. You’re making a huge mountain of conflict of interest around a period for many people is morally difficult.”
A number of Republicans, including a few presidential candidates, reacted Tuesday to the video.
“This latest news is tragic and outrageous,” Carly Fiorina wrote on Facebook.
“This is a shocking and horrific reminder that we must do so much more to foster a culture of life in America,” said Jeb Bush on Twitter.
As politicians responded to the video, a bill to increase funding for breast cancer research was pulled from the House floor after abortion critics linked it to Planned Parenthood. The Breast Cancer Awareness Commemorative Coin Act would have raised as much as $4.75 million in research funds for Susan G. Komen for the Cure—an organization that has a longstanding alliance with Planned Parenthood to fund preventative cancer screenings. The bill was expected to pass easily, but House Republican leaders pulled it from consideration after the conservative group Heritage Action objected.
Whether the video Tuesday shows illegal activity could ultimately be irrelevant. For years, antiabortion groups promoted their cause by highlighting the sometimes disturbing details of abortion procedures and painting abortion providers as callous and unethical.
They have argued against allowing abortions later in pregnancy by suggesting that older fetuses can feel pain and they are pushing for a federal ban on the procedure at 20 weeks of pregnancy.
The accusation that Planned Parenthood is illegally selling the organs of fetuses is not new among antiabortion advocates. The controversy gained national attention in 2000, after the publication of an undercover investigation by a Texas-based antiabortion group, Life Dynamics, which was also involved in Tuesday’s video release.
The investigation’s conclusion, that a Kansas clinic affiliated with Planned Parenthood was participating in a scheme to profit from the sale of fetal tissues, prompted a 20/20 hidden camera investigation on the subject, and a hearing of the Subcommittee on Health and Environment in the House of Representatives.
The FBI also investigated the Kansas clinic for any wrongdoing, but later concluded that it did not break any laws.
Story 1: Supreme Court Obamacare Attack On American Consumer Sovereignty and Individual Freedom — Big Government Tyranny and Coercion — Videos
“The state is that great fiction by which everyone tries to live at the expense of everyone else.”
“Each of us has a natural right, from God, to defend his person, his liberty, and his property.”
~ Frederic Bastiat
“Liberty is always freedom from the government.”
“The fact is that, under a capitalistic system, the ultimate bosses are the consumers.
The sovereign is not the state, it is the people.”
“The common man is the sovereign consumer whose buying or abstention from buying ultimately determines what should be produced and in what quantity and quality.”
“It is important to remember that government interference always means either violent action or the threat of such action.
The funds that a government spends for whatever purposes are levied by taxation.
And taxes are paid because the taxpayers are afraid of offering resistance to the tax gatherers.
They know that any disobedience or resistance is hopeless.
As long as this is the state of affairs, the government is able to collect the money that it wants to spend.
Government is in the last resort the employment of armed men, of policemen, gendarmes, soldiers, prison guards, and hangmen.
The essential feature of government is the enforcement of its decrees by beating, killing, and imprisoning.
Those who are asking for more government interference are asking ultimately for more compulsion and less freedom.”
~Ludwig von Mises
“In a democracy, the power to make the law rests with those chosen by the people. Our role is more confined —’to say what the law is.’ … That is easier in some cases than in others. But in every case we must respect the role of the Legislature, and take care not to undo what it has done. A fair reading of legislation demands a fair understanding of the legislative plan. Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.”
~Chief Justice John Roberts
“Today’s interpretation is not merely unnatural; it is unheard of. Who would ever have dreamt that ‘Exchange established by the State’ means ‘Exchange established by the State or the Federal Government’? Little short of an express statutory definition could justify adopting this singular reading.”
“We should start calling this law SCOTUScare.”
~Justice Antonin Scalia
Watch: Stunned Judge Napolitano Reveals How Supreme Court Just Pulled The Wool Over America’s Eyes
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Cruz Slams ‘Lawless’ Supreme Court After Obamacare Ruling
Rand Paul Warns GOP Leadership: Don’t Give Us ‘Obamacare Lite’
Republicans Plot Next Steps After Supreme Court Upholds Obamacare Subsidies
US President Obama on Supreme Court decision on Obamacare | Affordable Care Act here to stay
Newsmax Now | Nick Tate discusses SCOTUS upholding the Obamacare Subsidies
The Hard Line | F.H. Buckley the Supreme Court’s ruling to uphold Obamacare subsidies
Supreme Court upholds Obamacare subsidies in 6-3 ruling
5 Takeaways From Today’s Supreme Court Ruling on Obamacare
How Americans are reacting to the Supreme Court’s ACA decision
G. Edward Griffin: The Collectivist Conspiracy
A Powerful Documentary: G Edward Griffin ‒ The Capitalist Conspiracy
The Truth About Obamacare
In Upholding Obamacare’s Subsidies, Justice Roberts Rewrites the Law—Again
Time to start calling the Affordable Care Act SCOTUScare.
By Peter Suderman
Supreme Court Chief Justice John Roberts has rewritten the law to save Obamacare—again.
Roberts’ majority opinion today in King v. Burwell, which ruled that the Obama administration’s decision to allow health insurance subsidies flow through the law’s federal exchanges, leaves no doubt that Roberts considers it his duty to keep the law afloat.
“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” he writes. “If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.”
And so Roberts decided that a law which explicitly and repeatedly states that subsidies are limited to exchanges “established by a State,” and which defines “State” as one of the 50 states or the District of Columbia, actually allows subsidies in exchanges established by a State or the federal government. Roberts’ decision does not interpret Obamacare; it adds to it and reworks it, and in the process transforms it into something that it is not.
Roberts has not merely tweaked the law; he has rewritten it to mean the opposite of what it clearly means. Why include the phrase “established by a State under Section 1311″—the section dealing with state-based exchanges—except to limit the subsidies to those particular exchanges? Roberts’ opinion reconceptualizes this limiting language as inclusive.
The Chief Justice frames his decision as a form of respectful deference to congressional intent. As my colleague Damon Root noted earlier, his opinion cautions that in “every case we must respect the role of the Legislature, and take care not to undo what it has done. A fair reading of legislation demands a fair understanding of the legislative plan.”
But Roberts’ opinion is far more than a fair reading of the legislative plan; it is a Court-imposed decision as to what that plan must be.
As Justice Antonin Scalia writes in a scathing dissent, Roberts presumes, with no definitive evidence, that his interpretation is the one that Congress intended. “What makes the Court so sure that Congress ‘meant’ tax credits to be available everywhere?” Scalia asks. “Our only evidence of what Congress meant comes from the terms of the law, and those terms show beyond all question that tax credits are available only on state Exchanges.”
Roberts’ opinion declares its intent to uphold the law’s basic policy scheme, arguing that there would be adverse insurance market effects to a decision in favor of the challengers. In other words, there would have been policy implications to a ruling for the plaintiffs. That is almost certainly true, but it is not an excuse to rewrite the clear language of the law.
As Scalia says in the dissent, “The Court protests that without the tax credits, the number of people covered by the individual mandate shrinks, and without a broadly applicable individual mandate the guaranteed-issue and community-rating requirements ‘would destabilize the individual insurance market.’ If true, these projections would show only that the statutory scheme contains a flaw; they would not show that the statute means the opposite of what it says.” The majority has decided how Obamacare’s policy scheme should work, and redrafted the statute accordingly.
If Roberts had truly wanted to defer to Congress, he could have ruled that the law means what says rather than what it does not, and effectively handed the issue back to the legislature, letting Congress decide whether and how to update the law in accordance with its own wishes. Instead, Roberts made the choice for Congress—taking its power to craft law for itself. As Scalia writes, “the Court’s insistence on making a choice that should be made by Congress both aggrandizes judicial power and encourages congressional lassitude.”
This is not the first time that Roberts has rewritten the law in order to uphold it. In 2012, he declared that the law’s individual mandate to purchase insurance was unconstitutional under the Constitution’s Commerce Clause—and yet upheld it by declaring that the law’s penalty was instead permissible as a tax. In the same decision, he also found that the law’s threat to revoke all federal Medicaid funding from states that decline to participate in Obamacare’s expansion of the program was unconstitutionally coercive. But rather than strike the whole thing down, Roberts rewrote it, allowing the Medicaid expansion, and the rest of the law, to continue but without the same threat to state budgets.
In his dissent, Scalia argues that there’s a pattern to these rulings. “Under all the usual rules of interpretation, in short, the Government should lose this case. But normal rules of interpretation seem always to yield to the overriding principle of the present Court: The Affordable Care Act must be saved.”
If anything, it’s even worse. What Roberts has saved is not the law so much as the Obama administration’s dubious, textually unsupported interpretation and implementation of Obamacare. This is not judicial restraint. It is judicial hubris.
And while it would be overstatement to say that this damages the legitimacy of the Court, it certainly reflects on the legacy and status of the law. As even Roberts admits in his opinion, the law “contains more than a few examples of inartful drafting” and generally “does not reflect the type of care and deliberation that one might expect of such significant legislation.” It is a shoddy, messy piece of legislation, held together, barely, by Supreme Court duct tape.
At this point, then, the law is as much a joint project between the administration and the Roberts court as it is a creation of Congress. As Scalia snarks at the end of his dissent, “we should start calling this law SCOTUScare.” Regardless of what we call it, that’s effectively what it has become.
The U.S. Supreme Court on Thursday handed the Obama administration a major victory on health care, ruling 6-3 that nationwide subsidies called for in the Affordable Care Act are legal.
“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” the court’s majority said in the opinion, which was written by Chief Justice John Roberts. But they acknowledged that “petitioners’ arguments about the plain meaning … are strong.”
The majority opinion cited the law’s “more than a few examples of inartful drafting,” but added, “the context and structure of the Act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase.”
Roberts was joined by the court’s liberal justices, Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan, as well as by Anthony Kennedy.
In his dissent, Justice Antonin Scalia said: “We should start calling this law SCOTUScare,” an apparent reference to the fact the Supreme Court has now saved the Affordable Care Act twice. Scalia called the majority’s reading of the text “quite absurd, and the court’s 21 pages of explanation make it no less so.”
As NPR’s Nina Totenberg reported in March, opponents of the law contended “that the text of the law does not authorize subsidies to make mandated insurance affordable in 34 states.”
At issue were six words in one section of the law. As Nina pointed out: “Those words stipulate that for people who cannot afford health coverage, subsidies are available through ‘an exchange established by the state.’ ” She added:
“The government [contended] that those words refer to any exchange, whether it is set up by the state itself or an exchange run for the state by the federal government in accordance with individual state insurance laws and regulations. The challengers [said] the statute means what it says and no more.”
The court agreed Thursday with the government’s position.
The decision comes three years after a bitterly divided high court upheld the Affordable Care Act as constitutional by a 5-4 vote.
President Obama made a statement on the ruling late Thursday morning, saying the Affordable Care Act “is here to stay.”
SCOTUS rules 6-3 in favor of administration in major defeat for critics of the health law.
Peter Suderman
Obamacare’s health insurance subsidies will live, thanks to the Supreme Court.
The High Court has ruled 6-3 in favor of the administration to uphold the subsidies in Obamacare’s federal exchanges. The case challenged the administration’s decision, through the Internal Revenue Service, to allow subsidies in the 36 exchanges run by the federal government under the law.
The challengers argued that the plain text of the law, which states that subsidies are only available in an exchange “established by a State,” defining “State” to mean the 50 states or the District of Columbia, prohibited subsidies in the federal exchanges. The administration argued that the IRS rule allowing those subsidies was consistent with the overall structure of the law, and with congressional intent.
Writing for the majority, Chief Justice John Roberts sided with the administration’s position, saying that although the health law contains “more than a few examples of inartful drafting,” the Court nevertheless believes that the relevant section of the law “can fairly be read consistent with what we see as Congress’s plan, and that is the reading we adopt.” The complete ruling can be read here.
Basically, the Supreme Court, decided they’d rather squint at the law and look at its general shape rather than bother too much with the plain meaning of the relevant text.
This is a major victory fo the administration and backers of the health law, whose decision to ignore the plain text of the law has been blessed by the Court. It’s also a big loss for critics of Obamacare, who hoped to see the law’s implementation restrained by its legislative text, and for straightforward interpretation of congressional statute.
What it means is that the crazy array of post-King scenarios that many had speculated about over the last few months will never come to pass. Obamacare stays the same, in terms of both policy and politics. It’s a ruling for the status quo.
Reason will have much more on this throughout the day.
Supreme Court Allows Nationwide Health Care Subsidies
The Supreme Courtruled on Thursday that President Obama’s health care law allows the federal government to provide nationwide tax subsidies to help poor and middle-class people buy health insurance, a sweeping vindication that endorsed the larger purpose of Mr. Obama’s signature legislative achievement.
The 6-to-3 ruling means that it is all but certain that the Affordable Care Act will survive after Mr. Obama leaves office in 2017. For the second time in three years, the law survived an encounter with the Supreme Court. But the court’s tone was different this time. The first decision, in 2012, was fractured and grudging, while Thursday’s ruling was more assertive.
“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Chief Justice John G. Roberts Jr. wrote for a united six-justice majority. In 2012’s closely divided decision, Chief Justice Roberts also wrote the controlling opinion, but that time no other justice joined it in full.
Photo
Demonstrators expressed their support for the Affordable Care Act outside of the Supreme Court on Thursday.CreditDoug Mills/The New York Times
In dissent on Thursday, Justice Antonin Scalia called the majority’s reasoning “quite absurd” and “interpretive jiggery-pokery.”
He announced his dissent from the bench, a sign of bitter disagreement. His summary was laced with notes of incredulity and sarcasm, sometimes drawing amused murmurs in the courtroom as he described the “interpretive somersaults” he said the majority had performed to reach the decision.
“We really should start calling this law Scotus-care,” Justice Scalia said, to laughter from the audience.
In a hastily arranged appearance in the Rose Garden on Thursday morning, a triumphant Mr. Obama praised the ruling. “After multiple challenges to this law before the Supreme Court, the Affordable Care Act is here to stay,” he said, adding: “What we’re not going to do is unravel what has now been woven into the fabric of America.”
The ruling was a blow to Republicans, who have been trying to gut the law since it was enacted. But House Speaker John A. Boehner vowed that the political fight against it would continue.
“The problem with Obamacare is still fundamentally the same: The law is broken,” Mr. Boehner said. “It’s raising costs for American families, it’s raising costs for small businesses and it’s just fundamentally broken. And we’re going to continue our efforts to do everything we can to put the American people back in charge of their health care and not the federal government.”
The case concerned a central part of the Affordable Care Act that created marketplaces, known as exchanges, to allow people who lack insurance to shop for individual health plans. Some states set up their own exchanges, but about three dozen allowed the federal government to step in to run them. Across the nation, about 85 percent of customers using the exchanges qualify for subsidies to help pay for coverage, based on their income.
The question in the case, King v. Burwell, No. 14-114, was what to make of a phrase in the law that seems to say the subsidies are available only to people buying insurance on “an exchange established by the state.”
A legal victory for the plaintiffs, lawyers for the administration said, would have affected more than six million people and created havoc in the insurance markets and undermined the law.
Chief Justice Roberts acknowledged that the plaintiffs had strong arguments about the plain meaning of the contested words. But he wrote that the words must be understood as part of a larger statutory plan. “In this instance,” he wrote, “the context and structure of the act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase.”
The court decided in King v. Burwell that tax subsidies are being provided lawfully in three dozen states that have decided not to run the marketplaces for insurance coverage. Full analysis »
6-3
MAJORITY
DISSENT
Sotomayor
Kagan
Ginsburg
Breyer
Kennedy
Roberts
Scalia
Alito
Thomas
This was challenging, he said, in light of the law’s “more than a few examples of inartful drafting,” a consequence of rushed work behind closed doors that “does not reflect the type of care and deliberation that one might expect of such significant legislation.”
But he said the law’s interlocking parts supported a ruling in favor of the subsidies, particularly given that a contrary decision could have given rise to chaos in the insurance markets. A ruling rejecting subsidies in most of the nation would have left in place other parts of the law, including its guarantee of coverage regardless of pre-existing conditions, its requirement that most Americans obtain insurance or pay a penalty, and its expansion of Medicaid.
Without the subsidies, many people would be unable to afford insurance, and healthier consumers would go without coverage, leaving insurers with a sicker, more expensive pool of customers. That would raise prices for everyone, leading to what supporters of the law called death spirals.
“The statutory scheme compels us to reject petitioners’ interpretation,” Chief Justice Roberts wrote, referring to the challengers, “because it would destabilize the individual insurance market in any state with a federal exchange, and likely create the very ‘death spirals’ that Congress designed the act to avoid.”
In dissent, Justice Scalia wrote that the majority had stretched the statutory text too far.
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Copies of the court’s ruling in favor of nationwide health insurance subsidies were rushed to television news reporters.CreditDoug Mills/The New York Times
“I wholeheartedly agree with the court that sound interpretation requires paying attention to the whole law, not homing in on isolated words or even isolated sections,” Justice Scalia wrote. “Context always matters. Let us not forget, however, why context matters: It is a tool for understanding the terms of the law, not an excuse for rewriting them.”
“Reading the act as a whole leaves no doubt about the matter,” he wrote. “ ‘Exchange established by the state’ means what it looks like it means.”
Justice Scalia said the decision had damaged the court’s reputation for “honest jurisprudence.”
The court, he said, had taken into its own hands a matter involving tens of billions of dollars that should have been left to Congress.
“It is up to Congress to design its laws with care,” he added, “and it is up to the people to hold them to account if they fail to carry out that responsibility.”
Justices Clarence Thomas and Samuel A. Alito Jr. joined Justice Scalia’s dissenting opinion.
Chief Justice Roberts rejected the argument that Congress had limited the availability of subsidies in order to encourage states to create their own exchanges, a notion that had occurred to almost no one at the time the law was enacted.
Sixteen states and the District of Columbia have established their own exchanges. Under the law, the federal government has stepped in to run exchanges in the rest of the states.
“The whole point of that provision,” Chief Justice Roberts wrote, “is to create a federal fallback in case a state chooses not to establish its own exchange. Contrary to petitioners’ argument, Congress did not believe it was offering states a deal they would not refuse — it expressly addressed what would happen if a state did refuse the deal.
The case started when four plaintiffs, all from Virginia, sued the Obama administration, saying the phrase meant that the law forbids the federal government to provide subsidies in states that do not have their own exchanges.
The plaintiffs challenged an Internal Revenue Service regulation that said subsidies were allowed whether the exchange was run by a state or by the federal government. They said the regulation was at odds with the Affordable Care Act.
In July, the United States Court of Appeals for the Fourth Circuit, in Richmond, Va., ruled against the challengers.
Judge Roger L. Gregory, writing for a three-judge panel of the court, said the contested phrase was “ambiguous and subject to multiple interpretations.” That meant, he said, that the I.R.S. interpretation was entitled to deference.
The Supreme Court’s ruling was more forceful. “This is not a case for the I.R.S.,” Chief Justice Roberts wrote. “It is instead our task to determine the correct reading.”
In a 6-3 ruling authored by Chief Justice Roberts, the Court held that subsidies are available on the federal exchanges. Those voting in the majority were Roberts, Kennedy, Ginsburg, Breyer, Sotomayor, and Kagan.
Had the court ruled otherwise, it would have put all of Obamacare in jeopardy, since 38 states do not have exchanges and Obamacare is too expensive for most people without a subsidy.
The issue was whether only state-established exchanges could issue tax credits, or whether the federal exchanges could also. Challengers to IRS regulations pointed to the words “established by the State” in the legislation as clear and unambiguous that subsidies were limited to state exchanges.
The Court rejected this assertion:
These provisions suggest that the Act may not always use the phrase “established by the State” in its most natural
sense. Thus, the meaning of that phrase may not be as clear as it appears when read out of context. [at 11.]
As he did in upholding an Obamacare constitutional challenge in 2012, Roberts found a way to read the law so as to save the law:
The upshot of all this is that the phrase “an Exchange established by the State under [42 U. S. C. §18031]” is properly viewed as ambiguous. The phrase may be limited in its reach to State Exchanges. But it is also possible that the phrase refers to all Exchanges—both State and Federal—at least for purposes of the tax credits. If a State chooses not to follow the directive in Section 18031 that it establish an Exchange, the Act tells the Secretary to establish “such Exchange.” §18041. And by using the words “such Exchange,” the Act indicates that State and Federal Exchanges should be the same. But State and Federal Exchanges would differ in a fundamental way if tax credits were available only on State Exchanges—one type of Exchange would help make insurance more affordable by providing billions of dollars to the States’ citizens; the other type of Exchange would not.2 [at 12-13]
The Court found Obamacare so “inartfully drafted” that the Court essentially wrote the law for Congress through “statutory interpretation.”
The Affordable Care Act contains more than a few examples of inartful drafting. (To cite just one, the Act creates three separate Section 1563s. See 124 Stat. 270, 911, 912.) Several features of the Act’s passage contributed to that unfortunate reality. Congress wrote key parts of the Act behind closed doors, rather than through “the traditional legislative process.” Cannan, A Legislative
History of the Affordable Care Act: How Legislative Procedure Shapes Legislative History, 105 L. Lib. J. 131, 163 (2013). And Congress passed much of the Act using a complicated budgetary procedure known as “reconciliation,” which limited opportunities for debate and amendment, and bypassed the Senate’s normal 60-vote filibuster requirement. Id., at 159–167. As a result, the Act does not reflect the type of care and deliberation that one mightexpect of such significant legislation….
Anyway, we “must do our best, bearing in mind the fundamental canon of statutory construction that the words of a statute must be read in their context and with a view to their place in the overall statutory scheme.” Utility Air Regulatory Group, 573 U. S., at ___ (slip op., at 15) (internal quotation marks omitted). After reading Section 36B along with other related provisions in the Act, we cannot conclude that the phrase “an Exchange established by the State under [Section 18031]” is unambiguous. [at 14-15]
Nowhere in any of the opinions is the term “Gruber” mentioned. Jonathan Gruber, one of the architects of the law, stated on numerous occasions that there was a specific purpose of the language to exclude the federal exchange, so as to pressure states to get subsidies for their citizens by establishing exchanges.
Architect of Obamacare: Only get tax credits if buy on state exchanges
The Court rejected the Gruber view of Congressional intent:
The whole point of that provision is to create a federal fallback in case a State chooses not to establish its own Exchange. Contrary to petitioners’ argument, Congress did not believe it was offering States a deal they would not refuse—it expressly addressed what
would happen if a State did refuse the deal.
Having found the term “established by the State” ambiguous, the Court read it in a way such as to save Obamacare and prevent a “death spiral” of the law:
Given that the text is ambiguous, we must turn to the broader structure of the Act to determine the meaning of Section 36B. “A provision that may seem ambiguous in isolation is often clarified by the remainder of the statutory scheme . . . because only one of the permissible meanings produces a substantive effect that is compatible with the rest of the law.” United Sav. Assn. of Tex. v. Timbers of Inwood Forest Associates, Ltd., 484 U. S. 365, 371 (1988). Here, the statutory scheme compels us to reject petitioners’ interpretation because it would destabilize the individual insurance market in any State with a Federal Exchange, and likely create the very “death spirals” that Congress designed the Act to avoid. [at 15]
Reliance on context and structure in statutory interpretation is a “subtle business, calling for great wariness lest
what professes to be mere rendering becomes creation and attempted interpretation of legislation becomes legislation itself.” Palmer v. Massachusetts, 308 U. S. 79, 83 (1939). For the reasons we have given, however, such reliance is appropriate in this case, and leads us to conclude that Section 36B allows tax credits for insurance purchased on any Exchange created under the Act. Those credits are necessary for the Federal Exchanges to function like their State Exchange counterparts, and to avoid the type of calamitous result that Congress plainly meant to avoid. [at 21]
Roberts and the majority did not want to be the ones to take down Obamacare, and that drove everything:
Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter. Section 36B can fairly be read consistent with what we see as Congress’s plan, and that is the reading we adopt. [at 21]
Scalia’s dissent, joined by Thomas and Alito, was stinging, and in my opinion correct as to the absurdity of the Court contorting itself to save the law (as Roberts did in the original Obamacare challenge):
The Court holds that when the Patient Protection and Affordable Care Act says “Exchange established by the State” it means “Exchange established by the State or the Federal Government.” That is of course quite absurd, and the Court’s 21 pages of explanation make it no less so. [at 1]
Scalia points out that the words have a plain meaning:
This case requires us to decide whether someone who buys insurance on an Exchange established by the Secretary gets tax credits. You would think the answer would be obvious—so obvious there would hardly be a need for the Supreme Court to hear a case about it. In order to receive any money under §36B, an individual must enroll in an insurance plan through an “Exchange established by the State.” The Secretary of Health and Human Services is not a State. So an Exchange established by the Secretary is not an Exchange established by the State—which means people who buy health insurance through such an Exchange get no money under §36B.
Words no longer have meaning if an Exchange that is not established by a State is “established by the State.” …. [at 2, italics in original]
Scalia argued — persuasively — that the overriding goal seems to be saving Obamacare, not exercising normal judicial interpretation of plain language:
“[T]he plain, obvious, and rational meaning of a statute is always to be preferred to any curious, narrow, hidden sense that nothing but the exigency of a hard case and the ingenuity and study of an acute and powerful intellect would discover.” Lynch v. Alworth-Stephens Co., 267 U. S. 364, 370 (1925) (internal quotation marks omitted). Under all the usual rules of interpretation, in short, the Government should lose this case. But normal rules of interpretation seem always to yield to the overriding principle of the present Court: The Affordable Care Act must be saved. [at 2-3]
Scalia wrote that the majority opinion rewrote the law “with no semblance of shame”:
The Court interprets §36B to award tax credits on both federal and state Exchanges. It accepts that the “most natural sense” of the phrase “Exchange established by the State” is an Exchange established by a State. Ante, at 11. (Understatement, thy name is an opinion on the Affordable Care Act!) Yet the opinion continues, with no semblance of shame, that “it is also possible that the phrase refers to all Exchanges—both State and Federal.” Ante, at 13. (Impossible possibility, thy name is an opinion on the Affordable Care Act!) [at 3]
Scalia then delivered the best line of the day. Looking back over multiple decisions from the Court to rewrite Obamacare in order to save it, Scalia insisted that the law now should be called SCOTUScare:
Today’s opinion changes the usual rules of statutory interpretation for the sake of the Affordable Care Act. That, alas, is not a novelty. In National Federation of Independent Business v. Sebelius, 567 U. S. ___, this Court revised major components of the statute in order to save them from unconstitutionality. The Act that Congress passed provides that every individual “shall” maintain insurance or else pay a “penalty.” 26 U. S. C. §5000A. This Court, however, saw that the Commerce Clause does not authorize a federal mandate to buy health insurance. So it rewrote the mandate-cum-penalty as a tax. 567 U. S., at ___–___ (principal opinion) (slip op., at 15–45).
The Act that Congress passed also requires every State to accept an expansion of its Medicaid program, or else risk losing all Medicaid funding. 42 U. S. C. §1396c. This Court, however, saw that the Spending Clause does not authorize this coercive condition. So it rewrote the law to withhold only the incremental funds associated with the Medicaid expansion. 567 U. S., at ___–___ (principal opinion) (slip op., at 45–58). Having transformed two major parts of the law, the Court today has turned its attention to a third. The Act that Congress passed makes tax credits available only on an “Exchange established by the State.” This Court, however, concludes that this limitation would prevent the rest of the Act from working as well as hoped. So it rewrites the law to make tax credits available everywhere.
We should start calling this law SCOTUScare. [at 20-21, emphasis and hard paragraph breaks added.]
The legacy of this Court, Scalia wrote, will live on just as Obamacare, but in infamy:
Perhaps the Patient Protection and Affordable Care Act will attain the enduring status of the Social Security Act or the Taft-Hartley Act; perhaps not. But this Court’s two decisions on the Act will surely be remembered through the years. The somersaults of statutory interpretation they have performed (“penalty” means tax, “further [Medicaid] payments to the State” means only incremental Medicaid payments to the State, “established by the State” means not established by the State) will be cited by litigants endlessly, to the confusion of honest jurisprudence. And the cases will publish forever the discouraging truth that the Supreme Court of the United States favors some laws over others, and is prepared to do whatever it takes to uphold and assist its favorites.
From ‘Jiggery-Pokery’ to ‘SCOTUScare,’ Read the Best Quotes From Today’s Obamacare Ruling
Justice Antonin Scalia’s flair for the dramatic shines through, while Chief Justice John Roberts plays it straight.
Supporters of the Affordable Care Act react with cheers as the opinion for health care is reported outside of the Supreme Court in Washington on Thursday .
By U.S. News Staff
Thursday’s 6-3 ruling by the Supreme Court upholding the validity of tax credits that help millions of people afford health insurance under the Affordable Care Act came down to a literal matter of interpretation.
At issue were words in the law that subsidies could be distributed for health coverage purchased through “an Exchange established by the State.” The plaintiffs argued the law should be read literally, nullifying subsidies provided through exchanges that relied on the federal government. The Obama administration countered that the law never intended to limit subsidies in such a way.
Chief Justice John Roberts authored the court’s majority opinion, and was countered by Justice Antonin Scalia’s dissent. Here are some select quotes from both.
Roberts:
Chief Justice John Roberts authored the court’s majority opinion.
“The upshot of all this is that the phrase ‘an Exchange established by the State under [42 U. S. C. §18031]’ is properly viewed as ambiguous. The phrase may be limited in its reach to State Exchanges. But it is also possible that the phrase refers to all Exchanges—both State and Federal—at least for purposes of the tax credits.”
“It would be odd indeed for Congress to write such detailed instructions about customers on a State Exchange, while having nothing to say about those on a Federal Exchange.”
“The Affordable Care Act contains more than a few examples of inartful drafting. Several features of the Act’s passage contributed to that unfortunate reality. Congress wrote key parts of the Act behind closed doors, rather than through ‘the traditional legislative process’ … As a result, the Act does not reflect the type of care and deliberation that one might expect of such significant legislation.”
“The statutory scheme compels us to reject petitioners’ interpretation because it would destabilize the individual insurance market in any State with a Federal Exchange, and likely create the very ‘death spirals’ that Congress designed the Act to avoid.”
“In petitioners’ view, Congress made the viability of the entire Affordable Care Act turn on the ultimate ancillary provision: a sub-sub-sub section of the Tax Code. We doubt that is what Congress meant to do.”
“In a democracy, the power to make the law rests with those chosen by the people. Our role is more confined —’to say what the law is.’ … That is easier in some cases than in others. But in every case we must respect the role of the Legislature, and take care not to undo what it has done. A fair reading of legislation demands a fair understanding of the legislative plan. Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.”
Scalia:
Justice Antonin Scalia authored the court’s dissenting opinion.
“Today’s interpretation is not merely unnatural; it is unheard of. Who would ever have dreamt that ‘Exchange established by the State’ means ‘Exchange established by the State or the Federal Government’? Little short of an express statutory definition could justify adopting this singular reading.”
“We should start calling this law SCOTUScare.”
“The Court holds that when the Patient Protection and Affordable Care Act says ‘Exchange established by the State’ it means ‘Exchange established by the State or the Federal Government.’ That is of course quite absurd, and the Court’s 21 pages of explanation make it no less so.”
“Yet the opinion continues, with no semblance of shame, that ‘it is also possible that the phrase refers to all Exchanges—both State and Federal.’ (Impossible possibility, thy name is an opinion on the Affordable Care Act!)”
“The Court’s next bit of interpretive jiggery-pokery involves other parts of the Act that purportedly presuppose the availability of tax credits on both federal and state Exchanges.”
“Much less is it our place to make everything come out right when Congress does not do its job properly. It is up to Congress to design its laws with care, and it is up to the people to hold them to account if they fail to carry out that responsibility.”
“Pure applesauce.”
“The somersaults of statutory interpretation they have performed (‘penalty’ means tax, ‘further [Medicaid] payments to the State’ means only incremental Medicaid payments to the State, ‘established by the State’ means not established by the State) will be cited by litigants endlessly, to the confusion of honest jurisprudence. And the cases will publish forever the discouraging truth that the Supreme Court of the United States favors some laws over others, and is prepared to do whatever it takes to uphold and assist its favorites.”
Decreasing the number of uninsured is a key goal of the Affordable Care Act (ACA), which provides Medicaid coverage to many low-income individuals in states that expand and Marketplace subsidies for individuals below 400% of the poverty line. Baseline estimates show that over 41 million individuals were uninsured in 2013, prior to the start of the major ACA coverage provisions, and early evidence suggests that the ACA has reduced this number. This brief describes trends in coverage leading up to the ACA, reviews early estimates of the impact of the ACA on the uninsured, examines the characteristics of the uninsured population, and summarizes the access and financial implications of not having coverage.
Summary: Key Facts about the Uninsured Population
What was happening to the uninsured leading up to the ACA?
Trends in the uninsured have historically tracked economic conditions, with the number of uninsured people increasing during recessionary periods when people lost their jobs. Public programs provided a safety net during the Great Recession and prevented many from going uninsured. On the eve of the ACA, as the economy stabilized, coverage losses slowed. However, over 41 million people were still without coverage in 2013.
What has been happening to the uninsured under the ACA?
As of 2014, the ACA helps expand coverage to millions of currently uninsured people through the expansion of Medicaid eligibility and establishment of Health Insurance Marketplaces. The ACA also includes reforms to help people maintain coverage and make private insurance affordable and accessible. Early evidence on coverage in the first few months of 2014 indicates that the number of uninsured has declined since the availability of these new provisions.
Why are so many Americans uninsured?
The high cost of insurance has been the main reason why people go without coverage. In 2013, 61% of uninsured adults said the main reason they were uninsured was because the cost was too high or because they had lost their job. Many people do not have access to coverage through a job, and gaps in eligibility for public coverage in the past have left many without an affordable option. Even after ACA coverage expansions, Medicaid eligibility for adults remains limited in states that did not expand their programs.
Who are the uninsured?
Most of the uninsured are in low-income working families. In 2013, nearly 8 in 10 were in a family with a worker, and nearly 6 in 10 have family income below 200% of poverty. Reflecting the more limited availability of public coverage, adults have been more likely to be uninsured than children. People of color are at higher risk of being uninsured than non-Hispanic Whites.
How does the lack of insurance affect access to health care?
People without insurance coverage have worse access to care than people who are insured. Almost a third of uninsured adults in 2013 (30%) went without needed medical care due to cost. Studies repeatedly demonstrate that the uninsured are less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases.
What are the financial implications of lack of coverage?
The uninsured often face unaffordable medical bills when they do seek care. In 2013, nearly 40% of uninsured adults said they had outstanding medical bills, and a fifth said they had medical bills that caused serious financial strain. These bills can quickly translate into medical debt since most of the uninsured have low or moderate incomes and have little, if any, savings.
What was happening to the uninsured leading up to the ACA?
The number of uninsured people steadily increased throughout most of the past decade due to decreasing employer sponsored insurance coverage and rising health care costs. The recent recession led to a steep increase in uninsured rates from 2008 to 2010 as a high jobless rate led millions to lose their employer sponsored coverage.1Medicaid and CHIP prevented steeper drops in insurance coverage, as many Americans became newly eligible for these programs when their income declined during the recession. From 2011 to 2013, uninsured rates dropped as the economy improved and early provisions expanding coverage under the ACA went into effect.
Key Details:
The share of the nonelderly population with employer-sponsored coverage declined steadily between 2000 and 2010, dropping nearly ten percentage points over the decade.2 In 2011, this trend ended as the share with employer-sponsored coverage held nearly constant at around 58% between 2011 and 2013. This break in trend was likely due to uptake of the ACA provision that allowed young adults to continue as dependents on parents’ private plans until age 26. It also reflects improving economic conditions. The unemployment rate peaked at 10.0 percent in October 2009. From 2010 on, the unemployment rate improved steadily, corresponding with a drop in the uninsured rate from 2010 to 2013 (Figure 1).
The share of people covered by Medicaid increased significantly during the recent recession due to the weak economy and loss of jobs, which led to declining family incomes and decreasing employer-sponsored coverage among families. Between 2007 and 2013, over 10 million people—primarily children—gained Medicaid coverage. These gains offset some of the loss of employer coverage over the period.
In 2013, the uninsured rate among nonelderly individuals was at 16.7%, a level comparable to pre-recession uninsured rates (Figure 1). Still, many uninsured individuals had been uninsured for long periods, often five years or more,3 indicating that their lack of coverage was related to forces outside the recession. With the major ACA coverage provisions going into effect in 2014, many are newly-insured.
What has been happening to the uninsured under the ACA?
Under the ACA, as of 2014, Medicaid coverage is expanded to nearly all adults with incomes at or below 138% of poverty in states that expand, and tax credits are available for people who purchase coverage through a health insurance Marketplace. Early data suggest that the ACA has helped expand coverage to millions of previously uninsured people, but some—particularly poor adults in states that do not expand Medicaid—are still left without affordable coverage.
Key Details:
As of mid-April 2014 (after the first open enrollment period), over 8 million people selected plans through the federal or state Marketplaces.4 The vast majority of Marketplace enrollees (85%) were eligible for premium tax credits. Many Marketplace enrollees are newly-insured. A survey of people with private non-group plans after open enrollment found that nearly six in ten (57 percent) of those with Marketplace coverage were uninsured prior to purchasing their current plan.5 Other data from insurers suggest a large increase in the individual market in the first quarter attributable to the ACA.6
Enrollment data also show that as of July 2014, Medicaid enrollment has grown by 8 million since the period before open enrollment (which started in October 2013).7 This growth is an increase of 14% in monthly Medicaid enrollment.8 Enrollment increases were higher (20%) among states that chose to expand Medicaid eligibility. These data suggest that Medicaid enrollment growth is related to ACA expansions.9
Early survey data suggest that the uninsured rate is falling. The early release of estimates from the first quarter (January through March) of the 2014 National Health Interview Survey indicates that the uninsured rate dropped for nonelderly individuals in the first quarter of 2014 by a full percentage point relative to the first quarter of the previous year.10 However, the NHIS early results were not likely to have captured most or all of the ACA’s effects, as many people enrolled in coverage after survey data were collected. NHIS early results also show that states that chose to expand Medicaid saw significant declines in uninsured rates among adults from 2013 to the first quarter of 2014 (Figure 2). States that did not choose to expand Medicaid did not see corresponding declines. Several private polls and surveys also indicate that the uninsured rate has been decreasing since the period prior to ACA open enrollment. While these surveys have different methodologies and often have high error margins that make point estimates unreliable, they are all in agreement that the uninsured rate has dropped in 2014.
Even with the availability of new coverage options, millions remain uninsured. Previous analyses show that many poor adults in states that do not expand Medicaid will continue to be at risk to be uninsured.11 People of color, people living in the South,12 and individuals living in rural areas are especially at risk to be left out of ACA coverage expansions.13
Why are so many Americans uninsured?
Insurance is expensive, and few people can afford to buy it on their own. Most Americans obtain health insurance coverage through an employer, but not all workers are offered employer-sponsored coverage. Also, not all who are offered coverage by an employer can afford their share of the premiums. Medicaid and the Children’s Health Insurance Program (CHIP) cover many low-income individuals, particularly children. However, Medicaid eligibility for adults remains limited in some states, and few people can afford to purchase coverage on their own without financial assistance.
Key Details:
Uninsured individuals report that cost poses a major barrier to purchasing coverage. In 2013, 61% of adults said that the main reason they are uninsured is either because the cost is too high or because they lost their job, compared to 1.7% who said they are uninsured because they do not need coverage (Figure 3). Under the ACA, financial assistance is available to help many uninsured people afford coverage.
Not all workers have access to coverage through their job. Most uninsured workers are self-employed or work for small firms where health benefits are less likely to be offered.14 Low-wage workers who are offered coverage often cannot afford their share of the premiums, especially for family coverage.15,16
Workers usually enroll in employer-sponsored health insurance if they are eligible.17 However, it has become increasingly difficult for many workers to afford coverage. In 2014, the average annual total cost of employer-sponsored family coverage was $16,834, and the worker’s share averaging $4,823 per year.18 Between 2004 and 2014, total premiums have increased by 69%, and the worker’s share has increased over 81%.19 Starting in 2015, under the ACA, employers with 50 or more workers will be penalized if they do not offer affordable coverage. As of 2014, the ACA provides Marketplace tax credits or Medicaid coverage for many employees without access to affordable employer-sponsored insurance.20
In 2013, over 51 million nonelderly individuals were covered by Medicaid and CHIP.21 Historically, Medicaid was only available to low-income children, parents, pregnant women, people with disabilities, and the elderly. While states have increasingly expanded eligibility for children over time, eligibility for parents remained much more limited before ACA coverage expansions.22
As of September 2014, 28 states are moving forward or will be moving forward with expanded Medicaid eligibility for most nonelderly individuals under 138% FPL.23 This expansion will fill in historical gaps in eligibility for public coverage. However, in states that do not expand their Medicaid programs, eligibility for adults remains limited: the median eligibility level for parents is just 47% of poverty, and adults without dependent children are ineligible in nearly all states not expanding.
Who are the Uninsured?
The majority of the uninsured are in low-income working families. Reflecting the more limited availability of public coverage, adults are more likely to be uninsured than children. People of color are at higher risk of being uninsured than non-Hispanic Whites.
Key Details:
Based on the most recent data that is available (which reflects coverage prior to the major ACA provisions), over six in ten of the uninsured have at least one full-time worker in their family, and 16% have a part-time worker in the family (Figure 4).
Individuals below poverty are at the highest risk of being uninsured, and this group accounted for 27% of all the uninsured in 2013 (the poverty level for a family of three was $19,530 in 2013). In total, almost nine in ten of the uninsured are in low- or moderate-income families, meaning they are below 400% of poverty (Figure 3).
While a plurality (46%) of the uninsured are White, non-Hispanic, people of color are at higher risk of being uninsured than White non-Hispanics. People of color make up 40% of the population but account for over half of the total uninsured population. The disparity in insurance coverage is especially high for Hispanics, who account for 19% of the total population but more than 30% of the uninsured population. Hispanics and non-Hispanic Blacks have significantly higher uninsured rates (25.6% and 17.3%, respectively) than Whites (11.7%).24
About eight in ten of the uninsured are U.S. citizens and 19.7% are non-citizens. Uninsured non-citizens include both lawfully present and undocumented immigrants. Undocumented immigrants and legal immigrants residing in the U.S. for less than five years are ineligible for federally funded health coverage.
Uninsured rates vary widely by state and by region, with individuals living in the South and West the most likely to be uninsured (Figure 5). This variation reflects different economic conditions, availability of employer-based coverage, demographics, and eligibility for public coverage.
How does the lack of insurance affect access to health care?
Almost a third of uninsured adults (30%) in 2013 went without needed care each year due to cost (Figure 5). Studies repeatedly demonstrate that the uninsured are less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases.25, 26, 27, 28 Research also has suggested that insurance can decrease likelihood of depression and stress.29
Key Details:
Health providers can choose to not provide care to the uninsured. Only emergency departments are required by federal law to screen and stabilize all individuals. However, the uninsured are not necessarily more likely to use the emergency room than those with insurance.30 If the uninsured are unable to pay for care in full, they are often turned away when they seek follow-up care for urgent medical conditions.31
The uninsured receive less preventive care and recommended screenings than the insured. In 2013, only 1 in 3 uninsured adults (33%) reported a preventive visit with a physician in the last year, compared to 74% of adults with employer coverage and 67% of adults with Medicaid.32 Uninsured older adults (ages 50-64) were far less likely than their insured counterparts to report having been screened for cancer in the past five years.33
Receiving needed care is especially important for the uninsured since they are generally not as healthy as those with private coverage. The uninsured are at higher risk for preventable hospitalizations and for missed diagnoses of serious health conditions.34 After a chronic condition is diagnosed, they are less likely to receive follow-up care and as a result are more likely to have their health decline.35 Lack of follow-up attributed to being uninsured can delay the detection of certain cancers, which can result in adverse outcomes.36 It follows that the uninsured also have significantly higher mortality rates than those with insurance.37,38
The uninsured report higher rates of postponing care and forgoing needed care or prescriptions due to cost compared to those enrolled in Medicaid and other public programs (Figure 6). A seminal study of health insurance in Oregon found that the uninsured were less likely to receive care from a hospital or doctor than newly insured Medicaid enrollees.39A follow-up study found that newly insured Medicaid enrollees were much less likely to delay care because of costs than the uninsured.40
What are the financial implications of lack of coverage?
The uninsured often face unaffordable medical bills when they do seek care. These bills can quickly translate into medical debt since most of the uninsured have low or moderate incomes and have little, if any, savings.
Key Details:
Those without insurance for an entire year pay for one-fifth of their care out-of-pocket.41 They are typically billed for any care they receive, often paying higher charges than the insured.42
Medical bills can put great strain on the uninsured and threaten their physical and financial well-being. The uninsured are significantly more likely than individuals covered by employer coverage, non-group insurance or Medicaid to have trouble paying medical bills (Figure 7). Almost 40% of uninsured adults have outstanding medical bills.
A study based on the Oregon Health Insurance Experiment found that the uninsured were more likely to experience financial strain from medical bills and out-of-pocket expenses than those with Medicaid coverage. The uninsured were also more likely than the insured to have to postpone care because of costs.43
The uninsured live with the knowledge that they may not be able to afford to pay for their family’s medical care, which can cause anxiety and potentially lead them to delay or forgo care. Almost three-quarters (70%) of the uninsured are not confident that they can pay for the health care services they think they need, compared to 13% of those with employer coverage and 37% with Medicaid.44
The average uninsured household has no net assets.45 Without sufficient income or assets to pay their medical bills, uninsured individuals often see their debts accumulate while their credit ratings are compromised. Medical debts contribute to almost half of all bankruptcies in the United States.46
Conclusion
Over 41 million nonelderly individuals were uninsured in 2013. This figure represents the baseline against which most changes in the ACA will be measured. While we do not yet know the full effect of the major coverage provisions of the ACA, early evidence indicates that it is working to expand insurance to those who need it.
Going without coverage can have serious health consequences for the uninsured because they receive less preventive care, and delayed care often results in more serious illness requiring advanced treatment. Being uninsured also can have serious financial consequences. The ACA holds promise for many people who will gain access to health insurance coverage, but monitoring how coverage changes and who is left out of coverage expansions is also important.
Story 1: Portrait of A Mass Murderer– Dylann Storm Roof — Racist, Drug User, Mentally Disturbed, Evil or Murderer? — It’s The Drugs — Feed Your Head — The House of the Rising Sun — Videos
SSRI Stories is a collection of over 6,000 stories that have appeared in the media (newspapers, TV, scientific journals) in which prescription drugs were mentioned and in which the drugs may be linked to a variety of adverse outcomes including violence.
This updated site includes the stories from the previous site and new ones from 2011 to date. We have used a new “category” classification system on the new stories. We are working back through previously SSRI Stories to bring them into the new classification system. In the meantime use the search box in the upper right column to search through both the old and the new stories.
SSRI Stories focuses primarily on problems caused by selective serotonin reuptake inhibitors (SSRIs), of which Prozac (fluoxetine) was the first. For more see About SSRIs. Other medications prescribed as antidepressants that fit the “nightmares” theme of the collected stories are sometimes included.
One pill makes you larger
And one pill makes you small
And the ones that mother gives you
Don’t do anything at all
Go ask Alice
When she’s ten feet tall
And if you go chasing rabbits
And you know you’re going to fall
Tell them a hookah-smoking caterpillar
Has given you the call
Call Alice when she was just small
When the men on the chess board
Get up and tell you where to go
And you just had some kind of mushroom
And your mind is moving slow
Go ask Alice
I think she’ll know
When logic and proportion
Have fallen sloppy dead
And the white knight is talking backwards
And the Red Queen’s lost her head
Remember what the dormouse said
Jefferson Airplane – White Rabbit (Grace Slick, Woodstock, aug 17 1969)
Jefferson Airplane – Somebody to love
Dylann Roof makes first South Carolina court appearance
Bond Hearing For Charleston Church Shooter Dylann Roof (Full Unedited): First Court Appearance
New video shows church group moments before shooting
Who is Dylann Roof?
Dylann Roof: Charleston Church Shooting | True News
Obama in 2004 on His Personal Drinking/Drug Use
‘I Got High’: Obama Talks About His Use of Drugs
Obama Says Legalizing Drugs is Worthy of Debate
The REAL Reason for the Mass Shooting Epidemic in America
The Marketing of Madness: The Truth About
Psychotropic Drugs
Is Depression a Mental Illness? No.
Psychotropic Drugs: The Hidden Dangers
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Medicated to Death: SSRIs and Mass Killings
SSRI’s Behind Mass Shootings – Psych Speaks Out!
Friend: Dyllan Storm Roof Took Gun from His Mom – She Didn’t Trust Him With It (VIDEO)
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Charleston Church Shootings: Special Report
Best 7 minutes on gun control I have ever seen!
In this segment of his Virtual State of the Union, the Virtual President talks about why politicians want to talk about gun control rather than crime control, and delivers the factual evidence and historical truths that make the case for the Second Amendment self-evident.
Dr Susan Gratia-Hupp – Survivor of the 1991 Kileen TX Lubys Shooting Massacre
Hupp and her parents were having lunch at the Luby’s Cafeteria in Killeen in 1991 when the Luby’s massacre commenced. The gunman shot 50 people and killed 23, including Hupp’s parents. Hupp later expressed regret about deciding to remove her gun from her purse and lock it in her car lest she risk possibly running afoul of the state’s concealed weapons laws; during the shootings, she reached for her weapon but then remembered that it was “a hundred feet away in my car.” Her father, Al Gratia, tried to rush the gunman and was shot in the chest. As the gunman reloaded, Hupp escaped through a broken window and believed that her mother, Ursula Gratia, was behind her. Actually however, her mother went to her mortally-wounded husband’s aid and was then shot in the head.
As a survivor of the Luby’s massacre, Hupp testified across the country in support of concealed-handgun laws. She said that if there had been a second chance to prevent the slaughter, she would have violated the Texas law and carried the handgun inside her purse into the restaurant. She testified across the country in support of concealed handgun laws, and was elected to the Texas House of Representatives in 1996. The law was signed by then-Governor George W. Bush.
The Animals – The House of the Rising Sun
“House Of The Rising Sun”
There is a house in New Orleans
They call the Rising Sun
And it’s been the ruin of many a poor boy
And God, I know I’m oneMy mother was a tailor
She sewed my new blue jeans
My father was a gamblin’ man
Down in New OrleansNow the only thing a gambler needs
Is a suitcase and trunk
And the only time he’s satisfied
Is when he’s on a drunk[Organ Solo]Oh mother, tell your children
Not to do what I have done
Spend your lives in sin and misery
In the House of the Rising SunWell, I got one foot on the platform
The other foot on the train
I’m goin’ back to New Orleans
To wear that ball and chainWell, there is a house in New Orleans
They call the Rising Sun
And it’s been the ruin of many a poor boy
And God, I know I’m one
The Moody Blues – Nights In White Satin
Charleston shooting: c’s stepmother defends ‘smart’ boy ‘drawn in by internet evil’
ALEX WARD
The stepmother of Dylann Roof, the 21-year-old charged with nine counts of murder for the shooting at a church in Charleston, has spoken out in his defence.
Paige Mann, who was married to Mr Roof’s father for 10 years and helped raise him, said that her stepson was so smart that he became bored in school and was a germophobe for some time.
“He went to catechism, he went to church,” Ms Mann said. “He was locked in his room looking up bad stuff on the computer.”
In an interview with the New York Daily News, she said: “Something on the computer drew him in – this is Internet evil. We just thought he was a lazy, this-generation kind of kid.”
Mr Roof’s manifesto, published online, shows how the 21-year-old’s views hardened after the shooting of Travyon Martin in Florida in 2012. Ms Paige claimed that it was only after her step-son began living with his mother over the past few years that he became a recluse.
Mr Roof sat with members of the Emanuel African Methodist Epsicopal Church for nearly an hour before he allegedly shot nine of them dead, including the pastor.
Divorce papers filed by Ms Paige in 2008 claim that Franklin Roof had hit her and that any hope Dylann had of a normal home left with her, it was reported by the Inquisitr.
According to the manifesto, which was updated just hours before the fatal attack, he believed that he had no choice but to carry out the attack on the church and “chose Charleston because it is the most historic city in my state”.
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Affidavits spell out chilling case against Dylann Roof
As a subdued Dylann Roof made his first official appearance Friday on charges of killing nine people at a historic black church, police affidavits offered grim details of the murder case, including an allegation that the gunman fired multiple shots into each victim and stood over them to issue “a racially inflammatory statement.”
The documents also said that Roof’s father and uncle contacted police to positively identify the 21-year-old as the suspect after authorities issued photos of the gunman within hours of the attack at the Emanuel AME Church in downtown Charleston Wednesday evening.
As those details trickled out, the suspect’s family issued a statement expressing sadness and offering condolences to the families of the victims:
Dylann Roof’s father, according to the court documents, told investigators that his son owned a .45-caliber handgun. The documents note that .45-caliber casings were found at the scene of the shootings.
The affidavits allege that Roof, wearing a fanny pack apparently to hide a weapon, spent an hour with the parishioners before opening fire on the group. Before leaving the scene of the carnage, he allegedly “uttered a racially inflammatory statement” over the bodies to a witness who was apparently allowed to survive to convey the message.
Roof was returned to South Carolina after waiving his extradition rights following his arrest Thursday near Shelby, N.C., about 245 miles northwest of Charleston.
He appeared at ease when he allegedly told investigators shortly after his capture that he had launched the attack that left nine dead, a federal law enforcement official said. The official, who is not authorized to comment publicly, said that the suspect expressed no remorse and appeared “comfortable” with what he had done.
Authorities have determined that Roof legally obtained a .45-caliber handgun earlier this year, using money likely provided as birthday gift from his family, the official said. The weapon was purchased at gun store near Columbia, S.C.
Statements made by some family members of victims were particularly powerful.
USA TODAY
Charleston shooting: What is a ‘hate crime’?
Appearing by video link from jail, the 21-year-old Roof, who was handcuffed and wore a striped jail jumpsuit, often pursed his lips, closed his eyes, or stared at the floor as the relatives of five victims spoke to the court at the bond hearing.
“You took something really precious away from me, I will never talk to her again, never hold her again, but I forgive you,” said the daughter of one of the victims, Ethel Lance. “You hurt me, you hurt a lot of people but God forgive you and I forgive you.”
Roof appeared wan and subdued, his distinctive bowl hair, shown in surveillance photos outside the church on the night of the killings, stringy and unkempt. He stood with his hands cuffed behind his back. Two heavily armed guards stood behind him.
Bethanee Middleton-Brown, sister of another victim, DePayne Middleton-Doctor, addressed the hearing amid sniffles and sobs in the tiny courtroom.
She said her sister “taught me me that we are the family that love built, we have no room for hate, so we have to forgive. And I pray to God for your soul and I also thank God that And I also thank God I won’t be around when your judgment day comes with him.”
Although the court legally could not issue any bond in on the murder charges, Magistrate James Gosnell Jr. set Roof’s bond on a related weapons possession charge at $1 million.
Roof, who often swallowed hard as the judge asked questions, spoke only three times, answering “yes, sir” and “no, sir” to questions about his employment status. Roof is unemployed.
At the opening of the emotional, 13-minute hearing, Gosnell addressed the court, saying Charleston is a strong, loving community with “big hearts.”
“We are going to reach out to everyone, all the victims, and we will touch them,” he said. “We have victims — nine of them — but we also have victims on the other side.
“There are victims on this young man’s side of the family. No one would have ever thrown them into the whirlwind of events that they have been thrown into … We must find it in their heart to also help his family as well.”
In Washington, meanwhile, Justice Department spokeswoman Emily Pierce said the federal inquiry into the church shooting is ongoing.
USA TODAY
What happens to mass killers: the data behind the crimes
Pierce said the investigation will not only consider possible hate crime violations, but prosecutors also will review the shooting as a possible “act of domestic terrorism.”
“This heartbreaking episode was undoubtedly designed to strike fear and terror into this community, and the department is looking at this crime from all angles,” Pierce said.
Charleston, South Carolina Mayor Joseph Riley said although he doesn’t condone the death penalty, he thinks prosecutors will seek it in the Emanuel AME church shooting. VPC
Gov. Nikki Haley, speaking on NBC’s Today show on Friday, said that “we will absolutely will want him to have the death penalty” for the fatal shooting of nine members of a Bible study group at the Emanuel AME Church on Wednesday evening.
Charleston Mayor Joseph P. Riley Jr., said at a news conference Friday that though he’s not a proponent of the death penalty, it’s the law in South Carolina and he expects it will be sought in the church shooting. “If you are going to have a death penalty, certainly this case would merit it,” Riley said.
Shelby police officials did not interview Roof formally, according to WBTV, a Charlotte TV station, which quotes an unidentified source as saying the suspect was videotaped during the entire time he was at the Shelby police department.
The source told WBTV that Roof spoke freely, told investigators he had been planning the attack for a period of time, had researched the Emanuel AME Church and targeted it because it was a historic African-American church.
According to WBTV’s source, Roof told investigators he had a Glock handgun hidden behind a pouch he was wearing around his waist. He also told investigators he thought he’d only shot a few people and when told he actually had killed nine people, he appeared to be somewhat remorseful, according to the source.
During the recorded conversation, Roof reportedly told investigators he actually thought he would be caught in Charleston before fleeing and was headed to Nashville when he was captured. When asked why he was going to Nashville, he reportedly told investigators “I’ve never been there before.”
Police alleged that Roof opened fire on worshipers after sitting with them for at least an hour. The victims included the pastor, Clementa Pinckney, 41, who was also a state senator.
The 21-year-old man accused of killing nine people as they worshiped at a Charleston, South Carolina church has a criminal past. Dylann Roof was arrested twice this year and images of him posted to social media seem to show a racist ideology. WCNC
Roof allegedly told police he “almost didn’t go through with (the shooting) because everyone was so nice to him,” other sources told NBC News’ Craig Melvin.
Police say they thought Roof was the lone gunman within hours of the bloody attack on the church, which was founded in 1816. Asked whether authorities believe Roof had acted alone, Mullen said: “We don’t have any reason to believe anyone else was involved.”
A one-time acquaintance of Roof’s told the Associated Press that he would rant that “blacks were taking over the world” as the pair got drunk on vodka.
Roof railed that “someone needed to do something about it for the white race,” said the former friend, Joseph Meek Jr., according to the AP.
Story 1: Lying Lunatic Left Gun Grabbers Blame Gun Violence (Nonexistent) and Not Human Violence (Real), Trump and Talk Radio on The Millennial Mass Murderer, Dylann Storm Roof, in Charleston, South Carolina Church Killing of Nine Instead of Drugs and Mental Illness — Videos
Charleston, S.C., shooting suspect Dylann Storm Roof, second from left, is escorted from the Shelby Police Department in Shelby, N.C., Thursday, June 18, 2015. Roof is a suspect in the shooting of several people Wednesday night at the historic The Emanuel African Methodist Episcopal Church in Charleston, S.C. (AP Photo/Chuck Burton)
Charleston, S.C., shooting suspect Dylann Storm Roof, center, is escorted from the Sheby Police Department in Shelby, N.C., Thursday, June 18, 2015. Roof is a suspect in the shooting of several people Wednesday night at the historic The Emanuel African Methodist Episcopal Church in Charleston, S.C. (AP Photo/Chuck Burton)
Dylann Roof: Charleston Church Shooting | True News
Nine people are dead after shooting which occurred 9pm on Wednesday at the Emanuel African Methodist Episcopal Church in Charleston, South Carolina. The congregation, established in 1816, is one of the oldest African American churches in the United States.
Gunman Dylann Roof was attending a bible study meeting at the church and told the worshipers, “I have to do it. You rape our women and you’re taking over our country and you have to go.”
One woman was specifically spared as Roof said, “I’m not going to shoot you because I want you to tell everyone what happened.”
Stefan Molyneux examines the news story, what is known about Dylann Roof, how this incident could have been prevented, incomprehensible parenting, false rape statistics, violence in Rhodesia/Zimbabwe, the call for gun control, the danger of SSRIs and a plea for an honest conversation about race in America.
Gun Control in 47 Seconds
Best 7 minutes on gun control I have ever seen!
In this segment of his Virtual State of the Union, the Virtual President talks about why politicians want to talk about gun control rather than crime control, and delivers the factual evidence and historical truths that make the case for the Second Amendment self-evident.
Dr Susan Gratia-Hupp – Survivor of the 1991 Kileen TX Lubys Shooting Massacre
Hupp and her parents were having lunch at the Luby’s Cafeteria in Killeen in 1991 when the Luby’s massacre commenced. The gunman shot 50 people and killed 23, including Hupp’s parents. Hupp later expressed regret about deciding to remove her gun from her purse and lock it in her car lest she risk possibly running afoul of the state’s concealed weapons laws; during the shootings, she reached for her weapon but then remembered that it was “a hundred feet away in my car.” Her father, Al Gratia, tried to rush the gunman and was shot in the chest. As the gunman reloaded, Hupp escaped through a broken window and believed that her mother, Ursula Gratia, was behind her. Actually however, her mother went to her mortally-wounded husband’s aid and was then shot in the head.
As a survivor of the Luby’s massacre, Hupp testified across the country in support of concealed-handgun laws. She said that if there had been a second chance to prevent the slaughter, she would have violated the Texas law and carried the handgun inside her purse into the restaurant. She testified across the country in support of concealed handgun laws, and was elected to the Texas House of Representatives in 1996. The law was signed by then-Governor George W. Bush.
The Truth About Gun Control
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Charleston shooting Suspect, Dylann Storm Roof, in police custody
Dylann Storm Roof, the 21-year-old white male allegedly behind the shooting of nine African-Americans at the Emanuel African Methodist Episcopal Church Wednesday night in Charleston, SC, was arrested by law enforcement on Thursday morning. Manila Chan has more on the details and what the authorities know at this time.
Dylann Storm Roof Captured by NC Police, Charleston Shooting Suspect Escorting VIDEO
Daily Show’s Jon Stewart on Charleston shooting: ‘This was a terrorist attack’
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Nine killed in South Carolina Charleston ‘hate crime’ shooting
Dylann Storm Roof Was ‘Wild,’ Not Violent, Took Drugs, Classmate of Charleston Shooting Suspect Says
President Obama makes statement on Charleston mass shooting
President Barack Obama expressed his sorrow about a mass shooting in Charleston, South Carolina that killed nine people during a news conference on Thursday. Speaking about the tragedy, the president also spoke about the need to take another look at gun violence in the nation.
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The Alex Jones Show (1st HOUR-VIDEO Commercial Free) Thursday June 18 2015: #CharlestonShooting
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CHARLESTON SHOOTER WAS ON DRUG LINKED TO VIOLENT OUTBURSTS
Dylann Storm Roof was taking habit-forming drug suboxone
by PAUL JOSEPH WATSON | JUNE 18, 2015
Charleston shooter Dylann Storm Roof was reportedly taking a drug that has been linked with sudden outbursts of violence, fitting the pattern of innumerable other mass shooters who were on or had recently come off pharmaceutical drugs linked to aggression.
According to aCBS News report, earlier this year when cops searched Roof after he was acting suspiciously inside a Bath and Body Works store, they found “orange strips” that Roof told officers was suboxone, a narcotic that is used to treat opiate addiction.
Suboxone is a habit-forming drug that has been connected with sudden outbursts of aggression.
Another poster on the Drugs.com website tells the story of how his personality completely changed as a result of taking suboxone.A user on theMD Junction websiterelates how her husband “became violent, smashing things and threatening me,” after just a few days of coming off suboxone.
The individual relates how he became “nasty” and “violent” just weeks into taking the drug, adding that he would “snap” and be mean to people for no reason.
Another poster reveals how his son-in-law “completely changed on suboxone,” and that the drug sent him into “self-destruct mode.”
A user named ‘Jhalloway’ also tells the story of how her husband’s addiction to suboxone was “ruining our life.”
Aposter on a separate forumwrites about how he became “horribly aggressive” towards his partner after taking 8mg of suboxone.
A website devoted to horror stories about the drug called SubSux.com also features a post by a woman whose husband obtained a gun and began violently beating his 15-year-old son after taking suboxone.
According to aCourier-Journal report, suboxone “is increasingly being abused, sold on the streets and inappropriately prescribed” by doctors. For some users, it is even more addictive than the drugs it’s supposed to help them quit.
As we previously highlighted, virtually every major mass shooter was taking some form of SSRI or other pharmaceutical drug at the time of their attack, including Columbine killer Eric Harris, ‘Batman’ shooter James Holmes and Sandy Hook gunman Adam Lanza.
As the websiteSSRI Stories profusely documents, there are literally hundreds of examples of mass shootings, murders and other violent episodes that have been committed by individuals on psychiatric drugs over the past three decades.
Pharmaceutical giants who produce drugs like Zoloft, Prozac and Paxilspend around $2.4 billion dollars a yearon direct-to-consumer television advertising every year. By running negative stories about prescription drugs, networks risk losing tens of millions of dollars in ad revenue, which is undoubtedly one of the primary reasons why the connection is habitually downplayed or ignored entirely.
White suspect in massacre at black South Carolina church charged, held in jail
CHARLESTON, S.C
Relatives of some of the nine black parishioners gunned down at a historic South Carolina church addressed on Friday the 21-year-old white man charged with murdering their loved ones, before a judge ordered him held without bail.
Dylann Roof, appearing in a video feed from the jail where he was brought after the end of a 14-hour manhunt on Thursday, stood quietly, looking down, as Judge James Gosnell ordered him held and victims’ family members spoke.
“May God have mercy on your soul,” said the mother of the youngest victim, 26-year-old Tywanza Sanders, while Roof looked on, expressionless.
The attack on Wednesday at Charleston’s nearly-200-year-old Emanuel African Methodist Episcopal Church came in a year that has seen waves of protest across the United States over police killings of unarmed black men in cities including New York, Baltimore and Ferguson, Missouri, which have sparked some of the largest race riots since the civil rights movement of the 1960s.
Roof spoke little during the hearing, providing brief answers to the judge’s questions, confirming his name and address and saying he was unemployed.
Judge Gosnell, who had no authority to release Roof on the nine murder charges he faces, set a bond of $1 million for the one gun charge he faces. Roof remains in custody.
From U.S. President Barack Obama, who has said the attack stirred memories of “a dark past,” to residents on the streets of Charleston, Americans have expressed outrage at an act intended to provoke a “race war” in the United States.
This latest in a series of mass shootings that have rocked the United States also illustrated some of the risks posed by the nation’s liberal gun laws, which gun-rights supporters say are protected by the Second Amendment of the U.S. Constitution.
Alana Simmons, whose grandfather Reverend Daniel Simmons, 74, died in the attack, also expressed forgiveness.
“Although my grandfather and the other victims died at the hands of hate, this is proof, everyone’s plea for your soul is proof, that they lived in love,” Simmons said. “Their legacies will live in love so hate won’t win. I just want to thank the court for making sure that hate doesn’t win.”
In addition to church leader and Democratic state Senator Clementa Pinckney, 41, other victims included pastors DePayne Middleton Doctor, 49, and Sharonda Coleman Singleton, 45.
Also killed were Cynthia Hurd, 54, a public library employee; Susie Jackson, 87; Ethel Lance, 70, and Myra Thompson 59, an associate pastor at the church, according to the county coroner.
(Additional reporting by Luciana Lopez and Brian Snyder in Charleston, South Carolina, and Suzannah Gonzales in Chicago; Writing by Scott Malone; Editing by James Dalgleish)
Dylann Storm Roof appears by closed-circuit televison at his bond hearing in Charleston, South Carolina June 19, 2015 in a still image from video.
Hours after delivering a statement on the shooting massacre of nine people at an historic church in Charleston, S.C., President Obama and a group of entertainment industry donors had a lengthy discussion about the roots of gun violence in the first of two Hollywood-centric fundraisers in Los Angeles on Thursday, according to an attendee who was present.
About 30 people attended the event at the Pacific Palisades home of Chuck Lorre, executive producerof “Two and a Half Men.” Tickets for what was billed as an intimate discussion with the president sold for up to $33,400 each, with proceeds going to the Democratic National Committee.
Among those attending were Kiefer Sutherland, Matthew Perry, Conan O’Brien, UTA’s Jay Sures, Bob Broder, Tennis Channel CEO Ken Solomon and writer-producer James Burrows.
The attendee described the meeting, which lasted an hour and 15 minutes, as different from other events in that it offered an opportunity for Obama to have a “long, thoughtful” and serious discussion about issues, including gun violence and his presidency, in a much more “macro” sense than in other forums. The discussion about gun violence touched on gun laws, mental health and race, among other factors, the attendee said. Obama talked about being an optimist, especially about the country’s place in history.
Next on Obama’s agenda was a larger, $2,500-per-person event at the home of Tyler Perry. Perry is a longtime supporter who also held a fundraiser for Obama’s re-election campaign in Atlanta.
He also addressed the Charleston shootings at the Perry event, before a crowd of about 250 people.
“To see such a horrific event unfold like that is particularly shocking and it’s a reminder that we’ve got a lot of work to do,” Obama said, according to a pool report.
Perry introduced Obama, saying that he was “one of the most incredible people I have ever met.” He joked that Obama volunteered to take over the Titanic after it had already struck the iceberg, according to the pool report.
Perry also told about going to the White House for dinner. On the Truman Balcony afterwards, Obama winked at Michelle who “turned into a 15 year old girl,” Perry said, per the pool report.
Among those also at the event were January Jones, Ted Sarandos, Jason Collins and Matthew Weiner.
The Lorre event was closed to the press, while the Perry event, held at his Tuscan-style home off of Mulholland Drive, was open to pool reporters.
“There is something particularly heartbreaking about a death happening in a place in which we seek solace and we seek peace,” Obama said at the White House earlier on Thursday. He said that he and first lady Michelle Obama knew Rev. Clementa Pinckney, pastor of Emanuel AME Church, who was one of the victims.
“We don’t have all the facts, but we do know that, once again, innocent people were killed in part because someone who wanted to inflict harm had no trouble getting their hands on a gun,” Obama said, adding that “at some point, we as a country have to reckon with the fact that this type of mass violence does not happen in other advanced countries.”
A White House spokesman told reporters that there had not been discussion of calling off the fundraisers in the wake of the shootings. While there was speculation earlier on Thursday as to whether the trips would proceed, in the past the administration has held to the president’s schedule in the face of major events. Obama also has fundraisers scheduled in San Francisco on Friday.
Obama’s trip will be followed on Friday by Hillary Clinton’s trek to Los Angeles to raise money for her presidential campaign. She is scheduled to fundraise at the home of Peter Lowy, co-CEO of Westfield Corp., at a lunchtime gathering. That will be followed by an early evening reception at the home of Michael Lombardo, president of programming at HBO, and his husband Sonny Ward, and then another event the home of actor Tobey Maguire and wife Jennifer Meyer.
“I’m not a gun owner and, as I think as is the case for the more than half the people in the country who also aren’t gun owners, that means that for me guns are alien. In the current rhetorical climate people seem not to want to say: I think guns are kind of scary and don’t want to be around them.” — Josh Marshall
“A fear of weapons is a sign of retarded sexual and emotional maturity.”
~ Sigmund Freud
Sorry, but your Second Amendment rights no longer apply because liberals like Josh Marshall tinkle on themselves every time they come within fifty feet of a gun. This is really what the debate on gun control in America comes down to in the end: people who lose nothing if guns are banned because they don’t use them demanding that everyone else be disarmed. Meanwhile, trying to reason with gun control advocates is like arguing with a four year old about whether her imaginary friend is real or not. It doesn’t matter how clearly you prove your case; she’ll be pouring her pal tea two minutes after you’ve left the room. Speaking of imaginary…
1) A “gun free zone” won’t keep bad people with guns away: The basic problem with a “gun free zone” is that anyone you can’t trust with a gun will bring it in anyway while it will cause the people you’d want armed in a dangerous situation to leave their weapons behind. If this concept actually worked, we’d just train all of our soldiers in Jiu-jitsu and then we’d declare everywhere we sent them to be a “gun free zone.” Admittedly, Mortal Kombat: Afghanistan sounds like it would be an amazing movie, but someone needs to inform Democrats that the world doesn’t really work this way.
2) Criminals and lunatics don’t obey gun laws: The belief that someone who’s planning to go on a killing spree is going to turn in a gun because it’s made illegal is almost as nuts as going on the killing spree. Yet, the gun grabbers in the Democrat Party operate on the assumption that nut jobs like Adam Lanza or a gangbanger who sells crack for a living is going to get rid of a high-capacity magazine if Congress says he can’t have it. That’s like a prohibitionist who gets upset about alcoholism and deals with the problem by demanding that all the people without drinking problems have to be kept away from booze.
3) We already have somewhere between 200-300 million guns in this country: Adding to the last point, ever heard this old joke?
A drunk loses the keys to his house and is looking for them under a lamppost. A policeman comes over and asks what he’s doing.“I’m looking for my keys” he says. “I lost them over there”.
The policeman looks puzzled. “Then why are you looking for them all the way over here?”
“Because the light is so much better”.
If there were no already existing guns in America, gun control could conceivably help keep weaponry out of the hands of criminals and mass murderers. However, in a nation that’s already armed to the teeth, the next Adam Lanza, Jared Loughner, Tookie Williams or Mumia Abu-Jamal has already got his gun and new laws will only disarm law abiding Americans.
4) Gun owners aren’t required to explain a “need” for our Second Amendment rights: Why do gun owners “need” their guns? The same reason that Rosa Parks “needed” her seat at the front of the bus. In other words, it’s our constitutional right; so kiss off! If you need more of an explanation than that, why does California “need” to have its votes counted in the next presidential election? Why do we “need” so many liberal newspapers? Why not close a few? Why do movie stars “need” to make so much money for their films? Why don’t we confiscate it? What was it that Ann Coulter said?
“Free people are not in the habit of providing reasons why they ‘need’ something simply because the government wants to ban it. That’s true of anything — but especially something the government is constitutionally prohibited from banning, like guns.”
5) You’re not fooling us: Liberals like to think they’re smarter than everyone else, but they’re as transparent as glass to anyone who’s paying attention. That’s why gun sales have blown up like a can of shaving cream in a microwave. If Barack Obama, Diane Feinstein, Nancy Pelosi, Joe Biden and the rest of the Democrat gun grabbers in Congress could get away with it, they would ban and confiscate every gun in America tomorrow — and people know it. Anything short of, “Nobody is allowed to own a firearm except the government,” is unacceptable to them and that’s why they always seem so ghoulishly pleased after tragedies like the Gabrielle Giffords shooting or the Newtown massacre. Everybody else is thinking of the victims, while they’re twirling their mustaches Snidely-Whiplash-style and repeating, “Never let a serious crisis go to waste,” to each other.
This section contains cases that could be considered non-public, which means mass murders perpetrated in a domestic environment. The section is divided into two sub-categories; the first encompasses the lists of familicides and contains those incidents where most of the victims were relatives of the perpetrator, while the second, paraphrased as home intruders, contains those cases where the targeted families were not related to the perpetrator.
This section contains those cases where only vehicles were used to attack people. Since it may be quite difficult to distinguish accidents, or cases of reckless driving from those incidents where the driver, or pilot, had the intention to harm others, only those cases are included where it is clear that the vehicle was applied as a weapon and crashed deliberately into people, other vehicles, or buildings. Also, those cases where a rampage killer used an armed vehicle, such as a tank, or a fighter aircraft, to shoot others are listed here.
This section lists incidents of “grenade amok”, which are mass murders where the perpetrator used only hand grenades or comparable explosive devices, like pipe bombs or dynamite sticks, for the attack. As it is sometimes difficult to distinguish cases of grenade amok from acts of terrorism or gang-related attacks, incidents are only included where there is at least some indication that it was neither committed in the context of a political, ethnic, or religious conflict, nor part of an assault with more than one participating offender.
This section lists mass murders by single perpetrators that do not fit into the upper categories, like arson fires, poisonings, and bombings.
Only cases with at least two people killed are included.
Story 1: Lying Lunatic Left Gun Grabbers Blame Gun Violence (Non-Existent) and Not Human Violence (Real), Trump and Talk Radio on The Millennial Mass Murderer, Dylann Storm Roof, in Charleston, South Carolina Church Killing of Nine Instead of Drugs and Mental Illness — Videos
Charleston, S.C., shooting suspect Dylann Storm Roof, second from left, is escorted from the Shelby Police Department in Shelby, N.C., Thursday, June 18, 2015. Roof is a suspect in the shooting of several people Wednesday night at the historic The Emanuel African Methodist Episcopal Church in Charleston, S.C. (AP Photo/Chuck Burton)
Charleston, S.C., shooting suspect Dylann Storm Roof, center, is escorted from the Sheby Police Department in Shelby, N.C., Thursday, June 18, 2015. Roof is a suspect in the shooting of several people Wednesday night at the historic The Emanuel African Methodist Episcopal Church in Charleston, S.C. (AP Photo/Chuck Burton)
Dylann Roof: Charleston Church Shooting | True News
Nine people are dead after shooting which occurred 9pm on Wednesday at the Emanuel African Methodist Episcopal Church in Charleston, South Carolina. The congregation, established in 1816, is one of the oldest African American churches in the United States.
Gunman Dylann Roof was attending a bible study meeting at the church and told the worshipers, “I have to do it. You rape our women and you’re taking over our country and you have to go.”
One woman was specifically spared as Roof said, “I’m not going to shoot you because I want you to tell everyone what happened.”
Stefan Molyneux examines the news story, what is known about Dylann Roof, how this incident could have been prevented, incomprehensible parenting, false rape statistics, violence in Rhodesia/Zimbabwe, the call for gun control, the danger of SSRIs and a plea for an honest conversation about race in America.
Gun Control in 47 Seconds
Best 7 minutes on gun control I have ever seen!
In this segment of his Virtual State of the Union, the Virtual President talks about why politicians want to talk about gun control rather than crime control, and delivers the factual evidence and historical truths that make the case for the Second Amendment self-evident.
Dr Susan Gratia-Hupp – Survivor of the 1991 Kileen TX Lubys Shooting Massacre
Hupp and her parents were having lunch at the Luby’s Cafeteria in Killeen in 1991 when the Luby’s massacre commenced. The gunman shot 50 people and killed 23, including Hupp’s parents. Hupp later expressed regret about deciding to remove her gun from her purse and lock it in her car lest she risk possibly running afoul of the state’s concealed weapons laws; during the shootings, she reached for her weapon but then remembered that it was “a hundred feet away in my car.” Her father, Al Gratia, tried to rush the gunman and was shot in the chest. As the gunman reloaded, Hupp escaped through a broken window and believed that her mother, Ursula Gratia, was behind her. Actually however, her mother went to her mortally-wounded husband’s aid and was then shot in the head.
As a survivor of the Luby’s massacre, Hupp testified across the country in support of concealed-handgun laws. She said that if there had been a second chance to prevent the slaughter, she would have violated the Texas law and carried the handgun inside her purse into the restaurant. She testified across the country in support of concealed handgun laws, and was elected to the Texas House of Representatives in 1996. The law was signed by then-Governor George W. Bush.
The Truth About Gun Control
Breaking News: Gov. Abbott sign Texas Open Carry Law June 2015
Texas ‘Open Carry’ Law Passes, Allowing Guns in Holsters on the Street
Charleston shooting Suspect, Dylann Storm Roof, in police custody
Dylann Storm Roof, the 21-year-old white male allegedly behind the shooting of nine African-Americans at the Emanuel African Methodist Episcopal Church Wednesday night in Charleston, SC, was arrested by law enforcement on Thursday morning. Manila Chan has more on the details and what the authorities know at this time.
Dylann Storm Roof Captured by NC Police, Charleston Shooting Suspect Escorting VIDEO
Daily Show’s Jon Stewart on Charleston shooting: ‘This was a terrorist attack’
Citizen With Concealed Weapons Permit Shoots and Kills Attacker
John Lott: More Guns, Less Crime
Gun Regulation: U.S Gun Homicides vs. Japan
John Lott: More Guns, Less Crime book interview on CSPAN
Nine killed in South Carolina Charleston ‘hate crime’ shooting
Dylann Storm Roof Was ‘Wild,’ Not Violent, Took Drugs, Classmate of Charleston Shooting Suspect Says
President Obama makes statement on Charleston mass shooting
President Barack Obama expressed his sorrow about a mass shooting in Charleston, South Carolina that killed nine people during a news conference on Thursday. Speaking about the tragedy, the president also spoke about the need to take another look at gun violence in the nation.
Carolina Church Shooting: Obama gets it wrong–Guns SAVE Lives!
PJTV: Wake Up Obama. Drugs Are the Problem, Not Guns
Fox News Host ‘Surprise’ as Obama ‘Quick’ Invoke Gun Control on Charleston Mass Shooting
Donald Trump rails against immigrants in presidential campaign launch
Hillary Clinton ATTACKS Donald Trump Connects Negative Remarks on Mexico to MURDERS in Charleston
Hillary Clinton Takes a Veiled Shot at Donald Trump
Donald Trump on his campaign speech comments that some Mexican immigrants are ‘rapists’
Donald Trump Presidential speech announcement 2016 – Donald Trump Bashes Mexico Obamacare
Charleston Shooting: What They’re Not Telling You
The Alex Jones Show (1st HOUR-VIDEO Commercial Free) Thursday June 18 2015: #CharlestonShooting
News Behind the News: John Lott on America’s Gun Laws
Top 10 Infamous Mass Shootings in the U.S.
Top 10 Infamous Mass Shootings Outside the U.S.
CHARLESTON SHOOTER WAS ON DRUG LINKED TO VIOLENT OUTBURSTS
Dylann Storm Roof was taking habit-forming drug suboxone
by PAUL JOSEPH WATSON | JUNE 18, 2015
Charleston shooter Dylann Storm Roof was reportedly taking a drug that has been linked with sudden outbursts of violence, fitting the pattern of innumerable other mass shooters who were on or had recently come off pharmaceutical drugs linked to aggression.
According to aCBS News report, earlier this year when cops searched Roof after he was acting suspiciously inside a Bath and Body Works store, they found “orange strips” that Roof told officers was suboxone, a narcotic that is used to treat opiate addiction.
Suboxone is a habit-forming drug that has been connected with sudden outbursts of aggression.
Another poster on the Drugs.com website tells the story of how his personality completely changed as a result of taking suboxone.A user on theMD Junction websiterelates how her husband “became violent, smashing things and threatening me,” after just a few days of coming off suboxone.
The individual relates how he became “nasty” and “violent” just weeks into taking the drug, adding that he would “snap” and be mean to people for no reason.
Another poster reveals how his son-in-law “completely changed on suboxone,” and that the drug sent him into “self-destruct mode.”
A user named ‘Jhalloway’ also tells the story of how her husband’s addiction to suboxone was “ruining our life.”
Aposter on a separate forumwrites about how he became “horribly aggressive” towards his partner after taking 8mg of suboxone.
A website devoted to horror stories about the drug called SubSux.com also features a post by a woman whose husband obtained a gun and began violently beating his 15-year-old son after taking suboxone.
According to aCourier-Journal report, suboxone “is increasingly being abused, sold on the streets and inappropriately prescribed” by doctors. For some users, it is even more addictive than the drugs it’s supposed to help them quit.
As we previously highlighted, virtually every major mass shooter was taking some form of SSRI or other pharmaceutical drug at the time of their attack, including Columbine killer Eric Harris, ‘Batman’ shooter James Holmes and Sandy Hook gunman Adam Lanza.
As the websiteSSRI Stories profusely documents, there are literally hundreds of examples of mass shootings, murders and other violent episodes that have been committed by individuals on psychiatric drugs over the past three decades.
Pharmaceutical giants who produce drugs like Zoloft, Prozac and Paxilspend around $2.4 billion dollars a yearon direct-to-consumer television advertising every year. By running negative stories about prescription drugs, networks risk losing tens of millions of dollars in ad revenue, which is undoubtedly one of the primary reasons why the connection is habitually downplayed or ignored entirely.
White suspect in massacre at black South Carolina church charged, held in jail
CHARLESTON, S.C
Relatives of some of the nine black parishioners gunned down at a historic South Carolina church addressed on Friday the 21-year-old white man charged with murdering their loved ones, before a judge ordered him held without bail.
Dylann Roof, appearing in a video feed from the jail where he was brought after the end of a 14-hour manhunt on Thursday, stood quietly, looking down, as Judge James Gosnell ordered him held and victims’ family members spoke.
“May God have mercy on your soul,” said the mother of the youngest victim, 26-year-old Tywanza Sanders, while Roof looked on, expressionless.
The attack on Wednesday at Charleston’s nearly-200-year-old Emanuel African Methodist Episcopal Church came in a year that has seen waves of protest across the United States over police killings of unarmed black men in cities including New York, Baltimore and Ferguson, Missouri, which have sparked some of the largest race riots since the civil rights movement of the 1960s.
Roof spoke little during the hearing, providing brief answers to the judge’s questions, confirming his name and address and saying he was unemployed.
Judge Gosnell, who had no authority to release Roof on the nine murder charges he faces, set a bond of $1 million for the one gun charge he faces. Roof remains in custody.
From U.S. President Barack Obama, who has said the attack stirred memories of “a dark past,” to residents on the streets of Charleston, Americans have expressed outrage at an act intended to provoke a “race war” in the United States.
This latest in a series of mass shootings that have rocked the United States also illustrated some of the risks posed by the nation’s liberal gun laws, which gun-rights supporters say are protected by the Second Amendment of the U.S. Constitution.
Alana Simmons, whose grandfather Reverend Daniel Simmons, 74, died in the attack, also expressed forgiveness.
“Although my grandfather and the other victims died at the hands of hate, this is proof, everyone’s plea for your soul is proof, that they lived in love,” Simmons said. “Their legacies will live in love so hate won’t win. I just want to thank the court for making sure that hate doesn’t win.”
In addition to church leader and Democratic state Senator Clementa Pinckney, 41, other victims included pastors DePayne Middleton Doctor, 49, and Sharonda Coleman Singleton, 45.
Also killed were Cynthia Hurd, 54, a public library employee; Susie Jackson, 87; Ethel Lance, 70, and Myra Thompson 59, an associate pastor at the church, according to the county coroner.
(Additional reporting by Luciana Lopez and Brian Snyder in Charleston, South Carolina, and Suzannah Gonzales in Chicago; Writing by Scott Malone; Editing by James Dalgleish)
Dylann Storm Roof appears by closed-circuit televison at his bond hearing in Charleston, South Carolina June 19, 2015 in a still image from video.
Hours after delivering a statement on the shooting massacre of nine people at an historic church in Charleston, S.C., President Obama and a group of entertainment industry donors had a lengthy discussion about the roots of gun violence in the first of two Hollywood-centric fundraisers in Los Angeles on Thursday, according to an attendee who was present.
About 30 people attended the event at the Pacific Palisades home of Chuck Lorre, executive producerof “Two and a Half Men.” Tickets for what was billed as an intimate discussion with the president sold for up to $33,400 each, with proceeds going to the Democratic National Committee.
Among those attending were Kiefer Sutherland, Matthew Perry, Conan O’Brien, UTA’s Jay Sures, Bob Broder, Tennis Channel CEO Ken Solomon and writer-producer James Burrows.
The attendee described the meeting, which lasted an hour and 15 minutes, as different from other events in that it offered an opportunity for Obama to have a “long, thoughtful” and serious discussion about issues, including gun violence and his presidency, in a much more “macro” sense than in other forums. The discussion about gun violence touched on gun laws, mental health and race, among other factors, the attendee said. Obama talked about being an optimist, especially about the country’s place in history.
Next on Obama’s agenda was a larger, $2,500-per-person event at the home of Tyler Perry. Perry is a longtime supporter who also held a fundraiser for Obama’s re-election campaign in Atlanta.
He also addressed the Charleston shootings at the Perry event, before a crowd of about 250 people.
“To see such a horrific event unfold like that is particularly shocking and it’s a reminder that we’ve got a lot of work to do,” Obama said, according to a pool report.
Perry introduced Obama, saying that he was “one of the most incredible people I have ever met.” He joked that Obama volunteered to take over the Titanic after it had already struck the iceberg, according to the pool report.
Perry also told about going to the White House for dinner. On the Truman Balcony afterwards, Obama winked at Michelle who “turned into a 15 year old girl,” Perry said, per the pool report.
Among those also at the event were January Jones, Ted Sarandos, Jason Collins and Matthew Weiner.
The Lorre event was closed to the press, while the Perry event, held at his Tuscan-style home off of Mulholland Drive, was open to pool reporters.
“There is something particularly heartbreaking about a death happening in a place in which we seek solace and we seek peace,” Obama said at the White House earlier on Thursday. He said that he and first lady Michelle Obama knew Rev. Clementa Pinckney, pastor of Emanuel AME Church, who was one of the victims.
“We don’t have all the facts, but we do know that, once again, innocent people were killed in part because someone who wanted to inflict harm had no trouble getting their hands on a gun,” Obama said, adding that “at some point, we as a country have to reckon with the fact that this type of mass violence does not happen in other advanced countries.”
A White House spokesman told reporters that there had not been discussion of calling off the fundraisers in the wake of the shootings. While there was speculation earlier on Thursday as to whether the trips would proceed, in the past the administration has held to the president’s schedule in the face of major events. Obama also has fundraisers scheduled in San Francisco on Friday.
Obama’s trip will be followed on Friday by Hillary Clinton’s trek to Los Angeles to raise money for her presidential campaign. She is scheduled to fundraise at the home of Peter Lowy, co-CEO of Westfield Corp., at a lunchtime gathering. That will be followed by an early evening reception at the home of Michael Lombardo, president of programming at HBO, and his husband Sonny Ward, and then another event the home of actor Tobey Maguire and wife Jennifer Meyer.
“I’m not a gun owner and, as I think as is the case for the more than half the people in the country who also aren’t gun owners, that means that for me guns are alien. In the current rhetorical climate people seem not to want to say: I think guns are kind of scary and don’t want to be around them.” — Josh Marshall
“A fear of weapons is a sign of retarded sexual and emotional maturity.”
~ Sigmund Freud
Sorry, but your Second Amendment rights no longer apply because liberals like Josh Marshall tinkle on themselves every time they come within fifty feet of a gun. This is really what the debate on gun control in America comes down to in the end: people who lose nothing if guns are banned because they don’t use them demanding that everyone else be disarmed. Meanwhile, trying to reason with gun control advocates is like arguing with a four year old about whether her imaginary friend is real or not. It doesn’t matter how clearly you prove your case; she’ll be pouring her pal tea two minutes after you’ve left the room. Speaking of imaginary…
1) A “gun free zone” won’t keep bad people with guns away: The basic problem with a “gun free zone” is that anyone you can’t trust with a gun will bring it in anyway while it will cause the people you’d want armed in a dangerous situation to leave their weapons behind. If this concept actually worked, we’d just train all of our soldiers in Jiu-jitsu and then we’d declare everywhere we sent them to be a “gun free zone.” Admittedly, Mortal Kombat: Afghanistan sounds like it would be an amazing movie, but someone needs to inform Democrats that the world doesn’t really work this way.
2) Criminals and lunatics don’t obey gun laws: The belief that someone who’s planning to go on a killing spree is going to turn in a gun because it’s made illegal is almost as nuts as going on the killing spree. Yet, the gun grabbers in the Democrat Party operate on the assumption that nut jobs like Adam Lanza or a gangbanger who sells crack for a living is going to get rid of a high-capacity magazine if Congress says he can’t have it. That’s like a prohibitionist who gets upset about alcoholism and deals with the problem by demanding that all the people without drinking problems have to be kept away from booze.
3) We already have somewhere between 200-300 million guns in this country: Adding to the last point, ever heard this old joke?
A drunk loses the keys to his house and is looking for them under a lamppost. A policeman comes over and asks what he’s doing.“I’m looking for my keys” he says. “I lost them over there”.
The policeman looks puzzled. “Then why are you looking for them all the way over here?”
“Because the light is so much better”.
If there were no already existing guns in America, gun control could conceivably help keep weaponry out of the hands of criminals and mass murderers. However, in a nation that’s already armed to the teeth, the next Adam Lanza, Jared Loughner, Tookie Williams or Mumia Abu-Jamal has already got his gun and new laws will only disarm law abiding Americans.
4) Gun owners aren’t required to explain a “need” for our Second Amendment rights: Why do gun owners “need” their guns? The same reason that Rosa Parks “needed” her seat at the front of the bus. In other words, it’s our constitutional right; so kiss off! If you need more of an explanation than that, why does California “need” to have its votes counted in the next presidential election? Why do we “need” so many liberal newspapers? Why not close a few? Why do movie stars “need” to make so much money for their films? Why don’t we confiscate it? What was it that Ann Coulter said?
“Free people are not in the habit of providing reasons why they ‘need’ something simply because the government wants to ban it. That’s true of anything — but especially something the government is constitutionally prohibited from banning, like guns.”
5) You’re not fooling us: Liberals like to think they’re smarter than everyone else, but they’re as transparent as glass to anyone who’s paying attention. That’s why gun sales have blown up like a can of shaving cream in a microwave. If Barack Obama, Diane Feinstein, Nancy Pelosi, Joe Biden and the rest of the Democrat gun grabbers in Congress could get away with it, they would ban and confiscate every gun in America tomorrow — and people know it. Anything short of, “Nobody is allowed to own a firearm except the government,” is unacceptable to them and that’s why they always seem so ghoulishly pleased after tragedies like the Gabrielle Giffords shooting or the Newtown massacre. Everybody else is thinking of the victims, while they’re twirling their mustaches Snidely-Whiplash-style and repeating, “Never let a serious crisis go to waste,” to each other.
This section contains cases that could be considered non-public, which means mass murders perpetrated in a domestic environment. The section is divided into two sub-categories; the first encompasses the lists of familicides and contains those incidents where most of the victims were relatives of the perpetrator, while the second, paraphrased as home intruders, contains those cases where the targeted families were not related to the perpetrator.
This section contains those cases where only vehicles were used to attack people. Since it may be quite difficult to distinguish accidents, or cases of reckless driving from those incidents where the driver, or pilot, had the intention to harm others, only those cases are included where it is clear that the vehicle was applied as a weapon and crashed deliberately into people, other vehicles, or buildings. Also, those cases where a rampage killer used an armed vehicle, such as a tank, or a fighter aircraft, to shoot others are listed here.
This section lists incidents of “grenade amok”, which are mass murders where the perpetrator used only hand grenades or comparable explosive devices, like pipe bombs or dynamite sticks, for the attack. As it is sometimes difficult to distinguish cases of grenade amok from acts of terrorism or gang-related attacks, incidents are only included where there is at least some indication that it was neither committed in the context of a political, ethnic, or religious conflict, nor part of an assault with more than one participating offender.
This section lists mass murders by single perpetrators that do not fit into the upper categories, like arson fires, poisonings, and bombings.
Only cases with at least two people killed are included.
Story 1: Historic Winter Blizzard Snow Storm Named Juno Hits Northeast — What is New? — Progressive Global Warming Alarmists Panicking! — Shrinking Balls — So What? — Memory — The Coming Ice Age — Videos
NYC braces for “historic” snowstorm
Massive blizzard hits the United States’ East Coast on Monday
Potentially crippling snowstorm begins to hit Northeast
Snow Emergency In New York City
NYC mayor: Snowstorm could be worst ever | Northeast Braces for ‘Catastrophic,’ ‘Historic’ Storm
NEW YORK BLIZZARD 2015 – Drone Footage Biggest Snow storm Hit NYC [RAW FOOTAGE]
Weather History: The Great Blizzard of 1888
Patriots Press Conference Cold Open – Saturday Night Live
Grumpy Old Men Having a Heat Wave
grumpy old men fence stand off / the great Ice war.
Dean Martin – Baby It’s Cold Outside
The Global Warming Hoax Explained for Dummies
Man Made Climate Change in 7 Minutes
Climate Change in 12 Minutes – The Skeptic’s Case
MAJOR REDUCTIONS IN CARBON EMISSIONS ARE NOT WORTH THE MONEY 4 /14- Intelligence Squared U.S.
Co-Founder of The Weather Channel: GLOBAL WARMING IS A COMPLETE HOAX
Professor Bob Carter torpedoes the “scientific consensus” on the climate HOAX
Professor Bob Carter on Global Warming Science
Global Warming or a New Ice Age: Documentary Film
Global cooling was a conjecture during the 1970s of imminent cooling of the Earth’s surface and atmosphere along with a posited commencement of glaciation. This hypothesis had little support in the scientific community, but gained temporary popular attention due to a combination of a slight downward trend of temperatures from the 1940s to the early 1970s and press reports that did not accurately reflect the scientific understanding of ice age cycles. In contrast to the global cooling conjecture, the current scientific opinion on climate change is that the Earth has not durably cooled, but undergone global warming throughout the twentieth century.
Concerns about nuclear winter arose in the early 1980s from several reports. Similar speculations have appeared over effects due to catastrophes such as asteroid impacts and massive volcanic eruptions. A prediction that massive oil well fires in Kuwait would cause significant effects on climate was quite incorrect.
The idea of a global cooling as the result of global warming was already proposed in the 1990s. In 2003, the Office of Net Assessment at the United States Department of Defense was commissioned to produce a study on the likely and potential effects of a modern climate change, especially of a shutdown of thermohaline circulation. The study, conducted under ONA head Andrew Marshall, modelled its prospective climate change on the 8.2 kiloyear event, precisely because it was the middle alternative between the Younger Dryas and the Little Ice Age. The study caused controversy in the media when it was made public in 2004. However, scientists acknowledge that “abrupt climate change initiated by Greenland ice sheet melting is not a realistic scenario for the 21st century”.
Currently, the concern that cooler temperatures would continue, and perhaps at a faster rate, has been observed to be incorrect by the IPCC. More has to be learned about climate, but the growing records have shown that the cooling concerns of 1975 have not been borne out.
As for the prospects of the end of the current interglacial (again, valid only in the absence of human perturbations): it isn’t true that interglacials have previously only lasted about 10,000 years; and Milankovitch-type calculations indicate that the present interglacial would probably continue for tens of thousands of years naturally. Other estimates (Loutre and Berger, based on orbital calculations) put the unperturbed length of the present interglacial at 50,000 years. Berger (EGU 2005 presentation) believes that the present CO2 perturbation will last long enough to suppress the next glacial cycle entirely.
As the NAS report indicates, scientific knowledge regarding climate change was more uncertain than it is today. At the time that Rasool and Schneider wrote their 1971 paper, climatologists had not yet recognized the significance of greenhouse gases other than water vapor and carbon dioxide, such as methane, nitrous oxide, and chlorofluorocarbons. Early in that decade, carbon dioxide was the only widely studied human-influenced greenhouse gas. The attention drawn to atmospheric gases in the 1970s stimulated many discoveries in future decades. As the temperature pattern changed, global cooling was of waning interest by 1979
The Great Global Warming Swindle Full Movie
Milankovitch Cycles
Milankovitch Cycles Precession and Obliquity
Milankovitch Cycles
How Milankovicth cycles can theoretically change Earth’s current orbit and result in cycles of glaciation and warmer periods.
ManBearPig, Climategate and Watermelons: A conversation with author James Delingpole
James Delingpole is a bestselling British author and blogger who helped expose the Climategate scandal back in 2009. Reason.tv caught up with Delingpole in Los Angeles recently to learn more about his entertaining and provocative new book Watermelons: The Green Movement’s True Colors. At its very roots, argues Delingpole, climate change is an ideological battle, not a scientific one. In other words, it’s green on the outside and red on the inside. At the end of the day, according to Delingpole, the “watermelons” of the modern environmental movement do not want to save the world. They want to rule it.
George Carlin on Global Warming
Rush Limbaugh Podcast January 26 2015 Full Podcast
RUSH: We all here at the EIB Network are experiencing a huge void in all of our hearts here today because of a death, one of our staff members, the very first staff member to join me 27 years ago in New York. Christopher Carson, “Kit,” my trusted chief of staff, aide-de-camp, passed away today at 8 a.m. at his home in New Jersey after what really was a four-year battle, really valiant, never-seen-anything-like-it battle with essentially brain cancer.
Barbra Streisand – HD STEREO – Memory – CC for lyrics
“Memory”
Midnight
Not a sound from the pavement
Has the moon lost her memory
She is smiling alone
In the lamplight
The withered leaves collect at my feet
And the wind begins to moan
Memory, all alone in the moonlight
I can dream of the old days
Life was beautiful then
I remember the time I knew what happiness was
Let the memory live again
Every street lamp seems to beat
A fatalistic warning
Someone mutters and the street lamp sputters
Soon it will be morning
Daylight
I must wait for the sunrise
I must think of a new life and
I mustn’t give in
When the dawn comes
Tonight will be a memory too
And a new day will begin
Burnt out ends of smoky days
The stale court smell of morning
A street lamp dies
Another night is over
Another day is dawning
Touch me,
It is so easy to leave me
All alone with the memory
Of my days in the sun
If you’ll touch me,
You’ll understand what happiness is
Look, a new day has begun…
Cuomo On Blizzard 2015: Subways To Shut Down At 11 P.M., Travel Ban On Local, State Roads
De Blasio Warns: Non-Essential Drivers Caught On Streets Could Face Arrest, Stiff Fines
As a potentially historic blizzard swept through the Tri-State Area on Monday night, New York Gov. Andrew Cuomo announced that the entire New York City subway system and other Metropolitan Transportation Authority transportation would shut down at 11 p.m.
In addition, local, state and city roads would be shut down to all but emergency vehicles.
New estimates indicate that wind speeds will gust up to 70 mph, and thus, the state decided to shut down all MTA and Port Authority of New York and New Jersey facilities.
“Getting the subways and the railroad cars in a safe position is key, so that when the weather does leave, we’re in a position for the system to start back up,” Cuomo said.
The shutdown of the system began rolling into effect at around 5 p.m., and was to be completed by 11 p.m.
“A lot of people think of the subways as being completely underground. In fact, a huge proportion of it, probably about 40 percent, of the subway is above ground and is prone to getting icing and snow,” MTA Spokesman Aaron Donovan told WCBS 880.
“We’re going to be spending the whole night monitoring the conditions throughout our service area, monitoring the area. It really depends on what we see the conditions are but we can’t guarantee there will be service tomorrow morning,” he added.
Travel will also be restricted on all roads – whether interstate, state, county, city or town – in 13 counties from Ulster and Sullivan in the northern suburbs to New York City and Long Island, Cuomo said. Only emergency vehicles would be allowed on the roads, and those caught not complying would face penalties, he said.
“This is a serious situation,” Cuomo said. “If you violate this state order, it’s a possible misdemeanor, with fines up to $300, and that will go into effect at 11 o’clock also,” Cuomo said.
A blizzard warning is in effect for the metropolitan area through midnight Wednesday morning. CBS2’s Lonnie Quinn expects snow to fall at a rate of 2 to 4 inches an hour between late Monday night and midday Tuesday, with winds gusting 40 to 60 mph.
The storm could bury some communities in 4 or more feet of snow. Coastal flooding and erosion is also a major threat.
One forecasting model anticipates a grand total of 34.4 inches of snow falling in New York City. More modest models anticipate 17.1 inches.
Northeast Residents Preparing For ‘Crippling’ Blizzard That Could Dump Up To 2 Feet Of Snow Over 250-Mile Stretch
The Philadelphia-to-Boston corridor of more than 35 million people began shutting down and bundling up Monday against a potentially history-making storm that could unload a paralyzing 1 to 3 feet of snow.
More than 5,000 flights in and out of the Northeast were canceled, and many of them may not take off again until Wednesday. Schools and businesses let out early. And cities mobilized snowplows and salt spreaders to deal with a dangerously windy blast that could instantly make up for what has been a largely snow-free winter in the urban Northeast.
Snow was already falling during the morning commute in several cities, including Philadelphia and New York, with Boston up next in the afternoon. Forecasters said the brunt of the storm would hit Monday evening and into Tuesday.
The Weather Channel reports that 28 million people are under blizzard warnings and an additional 11 million are under winter storm warnings.
All too aware that big snowstorms can make or break politicians, governors and mayors moved quickly to declare emergencies and order the shutdown of highways, streets and mass transit systems to prevent travelers from getting stranded and to enable plows and emergency vehicles to get through.
“You cannot underestimate this storm. It is not a regular storm,” New York Mayor Bill de Blasio warned in ordering city streets closed to all but emergency vehicles beginning at 11 p.m. “What you are going to see in a few hours is something that hits very hard and very fast.”
Boston is expected to get 2 to 3 feet, New York 1½ to 2 feet, and Philadelphia more than a foot. The National Weather Service issued a blizzard warning for a 250-mile swath of the region, meaning heavy, blowing snow and potential whiteout conditions.
In Hartford, Connecticut, Frank Kurzatkowski stopped for gas and said he also filled several five-gallon buckets of water at his home in case the power went out and his well pump failed.
“I’ve got gas cans filled for my snowblowers,” he said. “I have four-wheel-drive.”
Supermarkets and hardware stores did a brisk trade as light snow fell in New Jersey.
Nicole Coelho, 29, a nanny from Lyndhurst, New Jersey, was preparing to pick up her charges early from school and stocking up on macaroni and cheese, frozen pizzas and milk at a supermarket. She also was ready in case of a power outage.
“I’m going to make sure to charge up my cellphone, and I have a good book I haven’t gotten around to reading yet,” she said.
New Jersey Gov. Chris Christie issued a state of emergency and asked commuters to stay off the roads.
“From the reports I’ve seen, you’ve all been to the supermarket. I don’t know why the rush on bread, but what the heck,” Christie joked.
About half of all flights out of New York’s LaGuardia Airport were called off Monday, and about 60 percent of flights heading into the airport were scratched. Boston’s Logan Airport said there would be no flights after 7 p.m. Monday.
The storm posed one of the biggest tests yet for Massachusetts Gov. Charlie Baker, who has been in office for less than three weeks. He warned residents to prepare for power outages and roads that are “very hard, if not impossible, to navigate.”
Wind gusts of 75 mph or more were possible for coastal areas of Massachusetts, and up to 50 mph farther inland, forecasters said.
New York Gov. Andrew Cuomo declared a state of emergency and urged commuters to stay home on Monday, warning that roads could be closed before the evening rush hour, even major highways such as the New York Thruway and the Long Island Expressway.
Similarly, Connecticut Gov. Dannel P. Malloy ordered a travel ban on his state’s highways, while officials in other states asked residents to avoid going anywhere unless it is necessary.
The Washington area was expecting only a couple of inches of snow. But the House postponed votes scheduled for Monday night because lawmakers were having difficulty flying back to the nation’s capital after the weekend.
On Wall Street, the New York Stock Exchange said it will stay open and operate normally on Monday and Tuesday.
A tractor-trailer jackknifed, and a beer truck crashed into the median on Interstate 81 near Harrisburg, Pennsylvania, during the morning commute. No injuries were reported.
Some schools were planning to close early or not open at all Monday in Pennsylvania, New Jersey, New York and Connecticut.
The Super Bowl-bound New England Patriots expected to be out of town by the time the storm arrived in Boston. The team planned to leave Logan Airport at 12:30 p.m. Monday for Phoenix, where the temperature will reach the high 60s.
This has been an “active” winter, climatologists say, but snowfall totals haven’t set a record for Long Island yet.
Here are monthly snowfall totals recorded by Brookhaven National Laboratory since the winter of 1947-48. The chart shows amount of snowfall for December through February. For 2014, the February total is as of Feb. 20.
A History of New York City Snowstorms (1970 – 2014)
Since 1970 New York has experienced fifteen snowstorms of one-foot or more (more than half of them in the past ten winters). An additional seven storms have dumped between 10 and 12 inches. The summary of storms that follows lists not only these big ones but others in the five to ten-inch range, since even these can be debilitating, especially in Manhattan (these smaller storms often produced greater accumulations in the suburbs). The storms, 56 in total, are arranged by calendar date. If you’d like to see a list arranged by each winter, double click here.
JANUARY
Jan. 1, 1971 – Old Man Winter waited until New Year’s Eve revelers returned home before dumping the largest snowfall of the winter. 6.4″ of snow accumulated between 4AM-4PM, with much of it falling in the storm’s initial three hours. This was the century’s largest New Year’s Day snowfall (and second all-time after a nine-inch snowstorm way back in 1869).
Jan. 2-3, 2014 – A sprawling winter storm moved into the area during the evening with snow beginning in NYC at 6:30 and continuing into the overnight hours. In total 6.4″ fell. Besides snow and gusty winds, there was Arctic cold to contend with as the mercury fell from the upper 20s when the snow started to 18 degrees by midnight and down to 11 by daybreak.
Jan. 4, 1988 – The City woke up to 5.8″ of snow that fell overnight. It was the winter’s biggest snowfall. Four days later a steady light snow fell throughout the day, accumulating an additional5.4″.
Jan. 7-8, 1996 – A crippling blizzard began Sunday afternoon and continued until early afternoon thenext day. It immobilized an area from West Virgina through Massachusetts and dumped 20.2″ on Central Park, the third greatest snow total in NYC history (13.6″ fell on Jan. 7 and 6.6″ on Jan. 8, records for the dates). At one point five inches of snow fell between 5-7PM. Wind gusts of 40-50 mph whipped the snow into three and four-foot drifts on many side streets.
Areas west of NYC reported considerably more snow than Central Park: 32″ in Staten Island; 28″ in Newark; 26″ in Allentown, PA; and 31″ in Philadelphia. Temperatures were also very cold with a high/low of just 22/12 on the 7th and 23/16 on the 8th.
Looking west on Greenwich Ave.
Jan. 11, 1991 – 5.7″ of snow accumulated during the afternoon and evening before changing to rain overnight as temps rose into the mid-30s (close to one inch of rain fell). Despite the changeover it was a record amount of snow for the date.
Jan. 11-12, 2011 – Snow began the night of the 11th (three inches fell by midnight) and was over by daybreak, totaling 9.1″. The 6.1″ that fell during the morning of the 12th was a record for the date.
Photo was napped shortly after midnight in Greenwich Village on 7th Ave. South near Sheridan Square.
Jan. 13, 1982 – A late afternoon/nighttime snowstorm that dumped 5.8″ on NYC was the same winter system that affected Washington, DC earlier in the afternoon when an Air Florida jet crashedinto the Potomac River minutes after takeoff, killing 78. The following day an additional 3.5″ of snow fell from an “Alberta clipper” that moved through in the evening hours.
Jan. 20, 1978 – Snow that began yesterday evening fell at a rate of an inch per hour between 2-7AM, and by 2PM 13.6″ had fallen. This was NYC’s biggest snowfall since the “Lindsay snowstorm” of February 1969. (However, in less than three weeks this storm would be largely forgotten, overshadowed by the great blizzard of February 1978.)
Jan. 20, 2000 – The largest snowfall of the winter, 5.5″, caught forecasters by surprise. The accumulation was held down when sleet and freezing rain mixed in. The same storm buried Raleigh, NC with 20.3″ of snow, the largest snowfall in that city’s history.
Jan. 21, 2001 – A quick-moving snowstorm dumped six inches of snow on Sunday morning, a record for the date. The flakes stopped flying by 8AM.
Jan. 21, 2014 – A wind-driven snow began at around 9AM and fell throughout the day and evening, with 11″ on the ground by midnight – a record for the date (an additional 0.5″ fell after midnight). Besides wind and snow, the storm was made more fierce by Arctic cold, with temperatures in the teens all day. The storm extended from DC to Boston. Its timing couldn’t have been worse for commuters, who had to contend with getting home in the teeth of the storm. Accumulations were even greater on Long Island.
Jan. 22, 1987 – A daytime snowstorm dumped 8.1″ of snow on the City while much of Long Island picked up a foot or more. (Virginia, DC, Maryland, Delaware and South Jersey bore the brunt of the storm.) The City’s accumulation was held down when sleet mixed in. This was NYC’s biggest snowfall in four years and would be the biggest until the March 1993 Superstorm.
Jan. 22-23, 2005 – A weekend snowstorm began early Saturday afternoon and by daybreak Sunday13.8″ had fallen (8.5″ fell on Saturday, 5.3″ on Sunday). After a very cold a.m. low of 9 degrees on the 22nd, the high of 25 was reached at midnight. This was the biggest January snowstorm since the blizzard of 1996.
Jan. 26-27, 2011 – Snow began falling heavily by late afternoon and blizzard conditions developed after nightfall. By midnight close to 13 inches had fallen, and by the time the snow wound down at daybreak on the 27th 19 inches had piled up. (This was just one month after the post-Christmas blizzard socked NYC with 20 inches.) Shortly after midnight I ventured outside to snap photos and found traffic mostly at a standstill on the streets of the West Village, with taxis on Seventh Ave. pointed every which way. The quiet usually associated with a snowfall was broken by the sound of spinning tires. This furious spinning produced an odor of burning rubber that pervaded the air.
The 6.7″ of snow that fell before daybreak on the 27th was a record for the date and brought the month’s snow total to 36.0″ – the most ever in January. (Just one year earlier 36.9″ of snow fell in February.) In the past thirty-three days, beginning with the Christmas blizzard, an incredible 52″ of snow fell. And for the first time NYC had two snowstorms of 19″ or more in one winter.
Jan. 27-28, 2004 – Snow moved in after 8PM and by the time it ended early the next morning 10.3″inches of powdery snow had accumulated (six inches of it fell tonight). January 27 was the fifth day in a row in which high temperatures were colder than 25 degrees.
FEBRUARY
Feb. 3, 1996 – 7.5″ of snow, which was over by daybreak, fell in advance of the coldest air of the winter. This was the the third snowfall of six+ inches this winter (with one more of that magnitude two weeks later). I had flown down to Key West for vacation the day before thinking I had escaped, but a few days later the Arctic cold penetrated all the way down to the Keys and it felt like more like fall.
Feb. 3, 2014 – One day after the high temperature was 56 degrees, eight inches of heavy, wet snow fell during the morning and afternoon as the temperature hovered around the freezing mark. Today’s snowfall was a record for the date and was the third accumulation of six inches or more this winter (just the eighth winter since 1960 in which this has occurred). Snow began falling less than nine hours after the Super Bowl, played in northern NJ, had ended.
Feb. 4, 1995 – Only 11.8″ of snow fell during the winter of 1994-95 and almost all of it fell today as10.8″ of heavy, wet snow fell furiously on a Saturday morning (close to three inches fell between 6-7AM) before changing over to rain at around 9AM. Then the coldest air of the winter moved in overnight.
Feb. 6-7, 1978 – Less than three weeks after 13.6″ of snow buried the City, an even bigger snowstorm struck. Snow began before dawn and by midnight 15.5″ had fallen in Central Park. An additional 2.2″ fell the next morning. Snow, drifted by wind gusts of 30-40 mph, fell heaviest between 7PM-1AM, when it fell at a rate of more than an inch per hour.
The storm’s 17.7″ accumulation made this NYC’s biggest snowstorm since December 26-27, 1947, when 26.4″ buried the City (later broken in February 2006). This was the first winter in 17 years to have two snowstorms of one foot or more. Snow would be on the ground in Central Park for the next five weeks.
Feb. 8-9, 2013 – An intense winter storm developed off the Delmarva peninsula during the day and by nightfall near-blizzard conditions were common in NYC and points north and east. An icy mix of light snow and wind blown sleet began at daybreak and fell throughout the day, becoming steadier and heavier after dark. By midnight, 6.3″ had fallen in Central Park; by the time the snow ended shortly before daybreak on Feb. 9, 11.4″ had piled up. This was the City’s 15th biggest snowfall since 1970. However, this amount was manageable compared to Suffolk County and New England, where accumulations of two to three feet were common.
Feb. 8-9, 1994 – After January saw a large amount of sleet and freezing rain NYC finally got a storm that brought snow as nine inches fell. It came down especially heavy between 9AM-1PM, but the snow predicted for the rest of the day didn’t materialize as it came down as sleet. Snow resumed after midnight and an additional 1.8″ fell.
Feb. 10, 2010 – Four days after a monster snowstorm stopped short of NYC’s doorstep, another one made its presence known today and dumped 10″ of heavy, wet snow. Because the daytime temperature was just above freezing (the high was 34) it prevented main streets from getting much in the way of accumulation.
Feb. 11, 1983 – A monster snowstorm moved in Friday afternoon and continued until the wee hours of the morning on Saturday. The storm really cranked up between 8-11PM when six inches of snow came down. When the last flakes had fallen 17.6″ had piled up. It was the biggest snowfall in NYC since 1978 (when 17.7″ fell on Feb. 5-7) and at the time was the sixth biggest snowstorm in NYC history (it’s now ranked twelfth).
Feb. 11, 1994 – 12.8″ of snow fell during a snowstorm that began shortly before daybreak and continued into Friday evening. This was just three days after a nine-inch snowstorm and was NYC’s biggest snowfall since 1983, which happened to occur on this date as well.
A nearly deserted 5th Ave. near St. Patrick’s Cathedral on the afternoon of Feb. 11, 1994.
Feb. 11-12, 2006 – New York was the bulls-eye for a record-setting amount of snow over the weekend. Beginning the night of the 11th as light snow (2.8″ fell by midnight), it turned heavier after midnight and between 4-10AM Sunday morning the snow was falling at a rate of two inches/hour (between 8:25-9:25 nearly four inches piled up).
When it was over 26.9″ had fallen, a half-inch more than the City’s previous record on Dec. 26-27, 1947. Snowfall totals outside of NYC were also impressive but not nearly as much as what Central Park picked up. This storm accounted for two-thirds of the winter’s total snowfall. Only 1.3″ of snow fell for the rest of the winter.
Snow-buried benches in Washington Square Park.
Feb. 12, 1975 – A quick-moving winter storm delivered the biggest snowfall of the winter, with 7.8″piling up between 8AM-3PM. Snow fell at the rate of one-inch per hour for five consecutive hours. This was the biggest snowfall of the eight winters from 1970 thru 1977.
Feb. 13-14, 2014 – An intense storm system moved up the East Coast and brought with it high winds, heavy snow in the morning (9.5″), rain in the evening (accompanied by thunder & lightning) and more snow after midnight (3.0″). This was the winter’s fourth snowfall of 6 inches or more, something that’s happened in just one other winter since 1950 (in 1958). This snowstorm brought the season’s snowfall to 54.0″, moving it up to 7th on the all-time list.
Feb. 16-17, 1996 – Snow fell throughout the day and by the time it came to and end shortly after 1AM 10.7″ had piled up (9.9″ of it fell on the 16th; the rest after midnight), the third snowstorm this winter of eight-inches or more. It was a fluffy snow with just 0.52″ of water content.
Feb. 16-17, 2003 – After beginning Sunday night (when 3.5″ fell), the brunt of the Presidents’ Day blizzard kicked in and dumped an additional 16.3″ on Monday, making this NYC’s fourth biggest snowfall on record. (Since then three snowstorms during the winters of 2005/06, 2009/10 and 2010/11 have surpassed it.) Ferocious winds gusting over 40 mph created snow drifts of 3-5 feet. And although Monday’s temperatures were quite cold (high/low of 26/14), they were a warm-up from Sunday’s frigid 15/8.
Feb. 19, 1972– A nor’easter packing 40 mph winds brought the biggest snowfall of the winter, 5.7″, but it was part of a sloppy mix of snow, sleet and rain so there was never more than two to three inches of snow on the ground at any given time. Temperatures didn’t go below freezing until evening. In total 1.64″ of precipitation was measured.
Feb. 19, 1979 – A fast-moving snowstorm buried the City on Presidents’ Day with 12.7″ of snow between 4:00AM-noon. However, the storm’s deepest snows, of 18-24″, fell in Virginia, DC, Maryland and Delaware. The storm came in the midst of a deep freeze that saw fifteen of the past nineteen days with high temperatures at the freezing mark or below, averaging 14 degrees below average. Including today’s snowfall, 20.1″ of snow fell during these nineteen days. Another President’s Day storm with even more snow would strike NYC 24 years later.
February 22, 2008 – Six inches of slushy snow fell during the morning into the early afternoon, the biggest snowfall of the winter – and the largest accumulation since NYC’s all-time snowstorm two Februarys ago. Today’s snow was also a record for the date.
February 24, 2005 – Snow moved in during the evening and by 3AM six inches had accumulated.
February 25-26 2010 – After beginning in the morning as steady rain a changeover to snow occurred in the afternoon and developed into NYC’s third major snowstorm of the winter. 9.4″ fell by midnight and an additional 11.5″ of snow fell on the 26th, ending in the early afternoon, bringing the storm’s two-day total to 20.9″. This was the fourth largest accumulation in NYC history – and just 0.1″ shy of the total from the great blizzard of March 1888.
With this storm February’s total snowfall reached 36.9″, the most ever measured in any month. (And this was without getting any snow from the big Mid-Atlantic blizzard of Feb. 4-5 that stopped at our doorstep.) This turned out to be the last snowfall of the winter.
February 26, 1991 – A surprise snowstorm dumped 8.9″ of wet snow, the biggest accumulation in eight years (since 17.6″ buried the City in on Feb. 11-12, 1983 ). Because the temperature was just above freezing for much of the day the snow didn’t accumulate much on the streets or sidewalks. This was the winter’s third snowfall of five inches or more.
February 28-March 1, 2005 – March came in a like a lion camouflaged as a lamb by all of the snow covering him. 7.7″ of snow fell from a storm that began the afternoon of Feb. 28 and ended at daybreak on March 1. It wasn’t a cold storm as the temperature rose into the low 40s after the snow ended. This was the third accumulation of five inches+ in the past ten days. Combined, 18.7″ fell from these snow events.
MARCH
March 1-2, 2009 – 8.3″ of snow fell from a quick-moving storm that began the night of the 1st (when 1.8″ fell), making this the largest accumulation of the winter (and the most to fall in three years). 12-15″ fell out on Long Island.
March 5, 1981 – A heavy, wet snowfall of 8.6″ was the biggest snow of the winter and a record amount for the date. It also has the distinction of being the second largest accumulation in the month of March in the 1970-2014 period.
March 5-6, 2001 – Call this the storm that couldn’t. The City was put on high alert after 15-24″ of snow was predicted during the weekend. City schools and some businesses were closed on Monday and we waited, but it was in vain as the storm never lived up to its billing. The storm strengthened later and further north than predicted. New York received 3.5″ as a consolation prize. However, Long Island received significant accumulations.
March 8-9, 1984 – Snow moved in the night of the 8th and by daybreak 6.9″ had accumulated (5.1″ of it on the 9th), making this the biggest snow of the winter. It was a powdery snow with just 0.38″ of water content.
March 13, 1993 – The great March Superstorm (also called “Storm of the Century”) paralyzed the Eastern third of the nation and dumped 10.6″ of snow on NYC. The heavy snow changed to sleet and rain later in the afternoon, a Saturday, reducing the predicted snow total by about six inches. The sound of the sleet lashing against my windows, propelled by 40-60 mph wind gusts, was deafening. All told, 2.37″ of precipitation fell. To read a first-person account of the storm double click here.
Plowing down 7th Ave. South, approaching Bleecker St.
March 16, 2007 – An all-day onslaught of sleet and snow dumped 5.5″ of icy precipitation, the biggest snow of the winter. This storm somewhat resembled last month’s severe sleet storm onValentine’s Day, but this one had considerably more snow. The total amount of precipitation was 2.07″, a record for the date. This was the last snowfall of the winter, a winter in which just 12.4″ fell, quite a contrast from the previous four winters, all of which had at least forty inches of snow.
March 19, 1992 – The biggest snowfall of the winter occurred today, a sloppy 6.2″. This tripled the winter’s relatively snowless snow total to 9.4″. Just two degrees separated the day’s high and low (33/31).
APRIL
April 6, 1982 – Just 1.1″ of snow had fallen in February and March when a blizzard dumped 9.6″ of snow on the City today, less than a week before Easter. More than a foot fell in New Jersey and Westchester County. The storm started as rain in the pre-dawn hours and changed over to snow mid-morning and lasted through late afternoon. By midnight the temperature had fallen to a record low 21 degrees. This was the most snow to fall so late in the season since ten inches fell on April 3, 1915. To read a first-person account click here.
April 7, 2003 – Four inches of snow fell, the biggest April snowfall in twenty-one years. This brought the season’s snowfall close to 50 inches.
OCTOBER/NOVEMBER
October 29, 2011 – An intense nor’easter lashed the area with high winds and outrageously early snowfall. The 2.9″ of heavy, wet snow that was measured in Central Park was the most ever to fall in October (5.2″ fell in Newark and over a foot buried northern NJ, parts of NY state, Connecticut, western Massachusetts and New Hampshire).
Since the temperature never fell below freezing there was no serious accumulation on City streets (except for slush). However, the day’s low of 33, which occurred in the early afternoon, was the coldest reading in October since 1988. Total liquid precipitation from the storm was two inches. Remarkably, twelve weeks would pass before the next measurable snow (4.3″ on Jan. 21, 2012).
November 7, 2012 – Just nine days after the region was raked by hurricane Sandy’s high winds and record storm surge, a nor’easter lashed the area. It moved far enough off the coast to pull cold air into the area, changing the rain to snow by 2PM. This was just the fifth snowfall of one-inch+ to occur in November in the past 40 years – and the first since 1997. 4.7″ fell (4.3″ of it today), making it the earliest 4-inch snowfall on record (the previous record was in 1989 when 4.7″ fell on Nov. 22-23). It was also the largest accumulation of the calendar year, topping the 4.3″ that fell on Jan 21.
November 22-23, 1989 – A Thanksgiving Day snowstorm along the Mid-Atlantic (which began late the previous night) dumped 4.7″ of snow on NYC; however, it was over by the time the Macy’sparade began. Although this wasn’t officially a wintertime snowfall it was larger than any accumulation during the 1989/90 season. The day’s high topped out at just 31, twenty degrees below average.
DECEMBER
December 5, 2002 – One year after record warmth occurred on this date (high of 70 degrees) six inches of snow fell, the biggest snow so early in the season since 1938.
December 5-6, 2003 – Snow fell during the afternoon and lasted into early evening, accumulatingeight inches (more than was predicted). This snowfall came one year to the date after six inches fell. It was part of a two-stage storm that brought more significant snowfall the following day. That day, a Saturday, the City was under a blizzard warning for much of the day and an additional six inches of snow fell. The high temperature rose to only 28 after a morning low of 23. Just a week into the month and this was already the snowiest December since 1960, when 19.8 inches fell.
Waverly Place, on the North side of Washington Square Park.
December 9, 2005 – 9.3″ of snow fell in the past six days. The 5.8″ of wet snow that fell on this Friday morning was a record for the date.
December 19-20, 1995 – Beginning today and continuing into tomorrow NYC experienced its biggest December snowstorm since 1960 as 7.7″ fell (10-12″ had been predicted). Less than 10 miles away, La Guardia Airport was buried by 15″.
December 19-20, 2009 – This first snow of the winter was a snowstorm that moved in late in the afternoon on a Saturday. By the time it ended at around 4AM on Sunday 10.9″ had fallen. Long Island received considerably more with parts of Suffolk County buried by more than 20″.
December 26-27, 2010 – Snow began falling during the afternoon and by evening blizzard conditions had developed. When the flakes stopped flying the following morning 20 inches had piled up. The City was largely unprepared for a storm of such intensity (and mayor Bloomberg was on vacation at an undisclosed location).
This was the sixth biggest snowstorm in NYC’s history (and it shared its dates with New York’s landmark 1947 snowstorm that dumped 26.4″). It was the second 20-inch accumulation of the year – the only year to have two storms of such magnitude (the first was on Feb. 25-26 when 20.9″ fell). The blizzard’s bulls-eye was west of NYC where most towns in New Jersey were buried by more than two feet of snow (e.g., Newark measured 24.2 inches).
December 28, 1990 – Today’s 7.2″ snowfall (which began late last night) was the largest accumulation in nearly four years (since January 1987) and the biggest December snowfall since 1960. Snow ended shortly before 11AM.
December 30, 2000 – A foot of snow fell as the year was winding down. It was a record for the date, the most snow since the blizzard of January ’96 and the biggest December snowstorm since 1960. This Saturday snowstorm was a fast mover, lasting just eight hours (5AM-1PM).
Is Mitt Romney becoming a climate change crusader?
During his 2012 presidential bid, Romney was dismissive about Democratic efforts to combat the effects of climate change, and he pushed for an expanded commitment to fossil fuels. But in a speech in California on Monday, Romney, who is considering a third run for president in 2016, signaled a shift on the issue. According to the Palm Springs Desert Sun, the former Massachusetts governor “said that while he hopes the skeptics about global climate change are right, he believes it’s real and a major problem,” and he lamented that Washington had done “almost nothing” to stop it.
For Romney, this is his second about-face on climate change. In his 2010 book, No Apology, he called human activity a “contributing factor” to melting ice caps. And in the run-up to the 2012 Republican primaries, Romney backed a reduction in emissions to curb anthropogenic global warming. “I believe based on what I read that the world is getting warmer,” he told the Manchester Union-Leader in 2011. “And…I believe that humans contribute to that. I don’t know how much our contribution is to that, because I know there have been periods of greater heat and warmth in the past, but I believe that we contribute to that. So I think it’s important for us to reduce our emissions of pollutants and greenhouse gases that may well be significant contributors to the climate change and the global warming that you’re seeing.”
But as the 2012 campaign evolved, Romney reversed course. He said that heopposed curbing carbon dioxide emissions. He declared, “We don’t know what’s causing climate change on this planet.” Instead, he pledged to increase coal production and ramp up oil exploration. At the Republican convention in Tampa, he turned climate change into a punch line. “I’m not in this race to slow the rise of the oceans or to heal the planet,” he remarked during his nomination speech—a jab at President Obama’s 2008 campaign promise that his victory would mark “the moment when the rise of the oceans began to slow and our planet began to heal.”
A Romney spokesman says the former governor’s remarks on Monday are”consistent with what he said on the trail in 2012 about climate change.” Perhaps. It just depends which 2012 comments he’s referring to.
‘I never once doubted his instincts. I had total trust’
JOE KOVACS
An emotional Rush Limbaugh remembers his chief of staff, Kit Carson, who died of brain cancer Monday, Jan. 26. 2015.
Christopher “Kit” Carson, the chief of staff for America’s top-rated radio host Rush Limbaugh, died Monday morning in New Jersey after a four-year battle with brain cancer. He was 58.
“It’s such a void because he loved this job,” Limbaugh said Monday with a heavy heart as he paid tribute for nearly an hour to Carson, who was the first staffer he hired for his show 27 years ago. “He’s just going to be really missed … Even though we knew this was coming for a while … It’s a huge void in everybody’s heart.”
“You knew you were talking to somebody who actively loved being alive and had active respect for being alive,” he continued. “It’s the one bad thing about getting old, because your friends start [getting] old, too.”
“He was such an integral part of this program every day, even though you never heard him. …
“He was irreplaceable and it’s just a very, very, sad, unfortunate thing that happens to everybody, and the way he dealt with it is a lesson in and of itself.”
Kit Carson (courtesy RushLimbaugh.com)
Kit Carson
Carson was originally from the Milwaukee, Wisconsin, area, and his initial career goals led toward Hollywood, Limbaugh explained.
“He wanted to be an actor, and he ended up enjoying what he did here so much, he became 100-percent totally devoted to the program.”
Limbaugh said Kit “became the resident expert on me and the program. He became its number-one champion, defender, evangelist.”
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As far as his presence around the broadcast office, “Kit Carson honest to God never ever had a bad word to say about anybody,” Limbaugh said. “He did not engage in backstabbing.”
Rush recalled the first time Carson showed up for work, saying, “He walked in the room wearing those cargo shorts and the short white socks and the black Keds. He didn’t care if you were laughing at him. It didn’t matter. And everyone laughed.”
Limbaugh noted he had complete trust in Carson.
“He is the one guy … I never once doubted his instincts. I had total trust. … The only thing he cared about was doing whatever to make sure I looked the best I could be.
“He had this innocent exuberance about everybody. … You really had to earn his distrust.”
Limbaugh even admitted, “I stole his opinions sometimes. Sometimes I gave him credit.”
Listen to Rush Limbaugh remembering Kit Carson:
“He did not allow me to be pessimistic or negative. He didn’t allow me to get down in the dumps about anything. And if he sensed that I was, he would do anything that he could that enabled me to get the best out of myself.”
Limbaugh recalled the happiest he ever saw Carson was when Kit first met his future spouse.
“When he met his soon-to-be wife Theresa, he was like a kid in a candy store forever.”
Once married, “He could not believe that he actually convinced this woman to marry him,” Limbaugh said. “It was exactly like a fairy tale.”
“I grabbed his hand and held his hand and said, ‘There’s nobody who can replace you. There’s no one who can do what you do.’”
Limbaugh says Carson had a head that was full of red hair, and even after undergoing cancer treatments, he still retained much of it.
“He loved to go walking down 6th Avenue and Japanese tourists thought he was Conan O’Brien,” Limbaugh said.
Carson had many friends among the news media.
WND Editor and CEO Joseph Farah was among them.
“I’ve known Kit Carson for more than 20 years,” Farah said. “I worked with him on the development of a daily column for Rush at the Sacramento Union. I worked with him again during my collaboration with Rush on his mega-bestselling ‘See I Told You So.’ And, over the years, he has always been a gracious help to me – a real gentleman. He will be greatly missed by all – especially Rush, whom he served as chief of staff for so long.”
James Grisham, producer of Sean Hannity’s radio program, told WND: “Kit Carson always took time from a very busy schedule to kid around with us or help if needed. He was a man of faith lived, never talked about much, the kind that I think matter most.”
Carson leaves behind his wife, Theresa, and two sons, Jack and Jesse.
Limbaugh says his own wife, Kathryn, has been spending time with Carson’s family in recent days.
“She thinks we ought to put a chair in [the Palm Beach, Florida, studio] and up in New York, called the Kit Chair, the honorary Kit Chair,” Limbaugh said. “It’s always gonna be there. That chair is always gonna be where he sat. So we’re gonna do that.” http://www.wnd.com/2015/01/rush-limbaughs-right-hand-man-dies/
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36 Times Obama Said You Could Keep Your Health Care Plan | SuperCuts #18
ACA Architect Confession: Created Lies For Obama
Obamacare – Concerns “Cadillac Tax” Forcing Employers To Cut Back Health Plans
What is the “cadillac tax?”
Obamacare’s Cadillac Tax Pushing People To Plans With High Deductible- Union You Got What You Wanted
Obamacare – Concerns “Cadillac Tax” Forcing Employers To Cut Back Health Plans
The Five: Large Employers Cite ObamaCare “Cadillac” Tax In Reducing Benefits
SMOKING GUN! Gruber Admits Obama Was in Room During Planning of Cadillac Lie
GRUBER: “Lack of transparency is a huge political advantage.”
GRUBER; Deceive Americans Critical to Pass Obamacare-Calls us ‘Stupid Americans’; Part 1 of 3
Gruber Remarks Puts Obama Administration on Scramble; Part 2 of 3
Jonathan Gruber: States Which Do Not Set Up an Exchange Do Not Get Tax Subsidies
BookTV: Jonathan Gruber, “Health Care Reform: What It Is, Why It’s Necessary, How It Works”
Jonathan Gruber admits Obamacare is inherently unaffordable
Obamacare – Concerns “Cadillac Tax” Forcing Employers To Cut Back Health Plans
Krauthammer rips Jonathan Gruber: “We’re hearing the true voice of liberal arrogance”
Megyn Slams ObamaCare Architect Who Declined to Appear on ‘Kelly File’
Democrats Loved Jonathan Gruber Before They Forgot Who He Was
Sen. Harry Reid, 2009: Gruber Is One Of The ‘Most Respected Economists’ Out There
Sen. Harry Reid (D-NV) in a December 2009 floor speech on Capitol Hill lauded Jonathan Gruber as one of the most “respected economists in the world” as Reid cited facts defending the Senate’s Obamacare bill.
Nancy Pelosi In 2009: Americans Should Read Jonathan Gruber’s ObamaCare Analysis
Nancy Pelosi In 2009: Americans Should Read Jonathan Gruber’s ObamaCare Analysis (November 5, 2009)
AHEC 2013 Conference
As part of the 24th Annual Health Economics Conference hosted by PennLDI, Mark Pauly and Jonathan Gruber were featured in the Plenary Panel discussing the role of economics in shaping (and possibly reshaping) the ACA. See below for the conference agenda with links to working papers. See the full AHEC agenda: http://ldi.upenn.edu/ahec2013/agenda
Jonathan Gruber at Noblis – January 18, 2012
The Noblis Technology Tuesday speaker series covers a broad spectrum of political, technical and innovative ideas. Noblis is a nonprofit science, technology, and strategy organization that brings the best of scientific thought, management, and engineering expertise with a reputation for independence and objectivity. The opinions expressed in this video are those of the speaker and do not necessarily reflect the views or opinions of Noblis.
Jonathan Gruber spoke to a Noblis audience on January 18, 2012 Few experts know more about America’s dire need of health care reform than Gruber. And of that short list, he is the only one prepared to enter the pages of a comic book to make the case. To be clear: Gruber is not an expert; he is “the” expert. An award-winning MIT economist and the director of the Health Care Program at the National Bureau of Economic Research, he was a key architect of the ambitious health care reform effort in Massachusetts and is a member of the Health Connector Board now implementing it; in 2006 he was named by “Modern Healthcare” as the nineteenth most powerful person in health care in the United States. In 2008 he was a consultant to the Clinton, Edwards, and Obama presidential campaigns. The national legislation passed by Congress in 2009 derives directly from Gruber’s insights learned during the Massachusetts health care debate.
Honors Colloquium 2012 – Jonathan Gruber
Dr. Jonathan Gruber is a Professor of Economics at the Massachusetts Institute of Technology, where he has taught since 1992. He is also the Director of the Health Care Program at the National Bureau of Economic Research, where he is a Research Associate. He is an Associate Editor of both the Journal of Public Economics and the Journal of Health Economics. In 2009 he was elected to the Executive Committee of the American Economic Association. He is also a member of the Institute of Medicine, the American Academy of Arts and Sciences, and the National Academy of Social Insurance.
Dr. Gruber received his B.S. in Economics from MIT, and his Ph.D. in Economics from Harvard University. Dr. Gruber’s research focuses on the areas of public finance and health economics. He has published more than 140 research articles, has edited six research volumes, and is the author of Public Finance and Public Policy, a leading undergraduate text, and Health Care Reform, a graphic novel. In 2006 he received the American Society of Health Economists Inaugural Medal for the best health economist in the nation aged 40 and under. During the 1997-1998 academic year, Dr. Gruber was on leave as Deputy Assistant Secretary for Economic Policy at the Treasury Department. From 2003-2006 he was a key architect of Massachusetts’ ambitious health reform effort, and in 2006 became an inaugural member of the Health Connector Board, the main implementing body for that effort. In that year, he was named the 19th most powerful person in health care in the United States by Modern Healthcare Magazine.
BookTV: Jonathan Gruber, “Health Care Reform: What It Is, Why It’s Necessary, How It Works
Jonathan Gruber, economics professor at the Massachusetts Institute of Technology and director of the health care program at the National Bureau of Economic Research, presents his thoughts on health care. Mr. Gruber a leading architect of Massachusetts’ health care reform also consulted with Congress and President Obama on the creation of the Affordable Care Act, signed into law by the President in 2010.
Obamacare architect Jonathan Gruber suddenly recast as bit player after uproar
Nancy Pelosi, fellow Democrats scramble to distance themselves from MIT professor, economist
For years, Massachusetts Institute of Technology professor Jonathan Gruber was deemed an architect of Obamacare and his economic modeling was cited regularly by the health care law’s defenders on Capitol Hill and in legal briefs defending the Affordable Care Act in federal courts.
But after tapes surfaced of the economist saying “stupid” voters needed to be bamboozled and the books cooked to get the legislation passed in 2010, Democrats are scrambling to reduce Mr. Gruber to a bit player — and raising questions about whether he needs to be expunged from their defense strategy as they face yet another Supreme Court review.
House Minority Leader Nancy Pelosi, who as speaker in 2009 posted an Obamacare “myth buster” citing Mr. Gruber, vehemently distanced herself from him Thursday.
“I don’t who he is. He didn’t help write our bill,” she said, but added that Mr. Gruber’s comments were a year old and he had recanted them.
In the comments that have just come to light, Mr. Gruber said the health care bill was written in a “tortured” way to ensure the Congressional Budget Office didn’t score the individual mandate as a tax, even though the U.S. Supreme Court ultimately upheld the mandate as constitutional under Congress’ taxing power.
“Lack of transparency is a huge political advantage,” Mr. Gruber said at the time. “And basically, call it the stupidity of the American voter or whatever, but basically that was really, really critical to get the thing to pass.”
Mr. Gruber said this week that he regretted the remarks. But House Speaker John A. Boehner, Ohio Republican, said Thursday that American voters are “anything but stupid” and oppose the health care system’s overhaul for valid reasons.
Mitch McConnell, the Kentucky Republican selected as the next Senate majority leader, said Mr. Gruber made a classic “Washington gaffe — when a politician mistakenly tells you what he really thinks.”
However, Mr. Gruber’s explanation in 2012 of how Obamacare’s subsidies should be paid put the Justice Department in a tough spot.
In legal briefs submitted last year to a federal district court in Virginia, Obama administration attorneys cited Mr. Gruber in a case defending their ability to pay subsidies to enrollees regardless of whether they are part of state-run or federally run health care exchanges.
“According to the calculations of one health care economist, without the minimum coverage provision and subsidized insurance coverage, premiums for single individuals would be double the amount anticipated under the ACA,” the Justice Department wrote in a legal brief last November, citing Mr. Gruber’s work in a footnote.
The Supreme Court decided this month to take up the case, King v. Burwell, after the challengers lost to the administration in the 4th U.S. Circuit Court of Appeals.
Neither the Justice Department nor the White House responded to questions about Mr. Gruber — who declined to comment for this story — and his role in their legal strategy.
But Sam Kazman, general counsel for the Competitive Enterprise Institute, which is funding the administration’s opponents in the King case, said Mr. Gruber’s 2012 remarks about subsidies bolster their own arguments.
Mr. Gruber at the time said subsidies would flow only to states that set up their own exchanges.
“What’s important to remember politically about this is if you’re a state and you don’t set up an exchange, that means your citizens don’t get their tax credits — but your citizens still pay the taxes that support this bill,” the economist told an audience.
That would mean consumers in most states wouldn’t be eligible for subsidies, which would puncture a big hole in Obamacare. The Obama administration has argued that even though the law says subsidies go to state exchanges, they also should include states that have opted for the federal exchange.
Mr. Kazman said the Gruber comments create a major problem for Mr. Obama.
“He’s not toxic to us,” Mr. Kazman said in an interview Thursday. “We may give him an award for public service.”
In a parallel case before the D.C. Circuit, the administration tried to downplay Mr. Gruber in its latest court filings. On Nov. 3, the Justice Department said in a footnote that “post-enactment statements by a non-legislator are entitled to no weight.”
“In any event, Professor Gruber has since clarified that the remarks on which plaintiffs rely were mistaken,” the attorneys told the D.C. Circuit, which has suspended its proceedings until the Supreme Court weighs in.
“Tellingly,” Mr. Carvin said in a reply brief, “the government also ignores that Jonathan Gruber — the ACA architect whose work it cited in every brief below but is nowhere mentioned now — articulated the incentive purpose of [subsidies] as early as 2012.”
Mr. Gruber has made hundreds of thousands of dollars off Obamacare, serving as a consultant to the Department of Health and Human Services and to states that used health care grant money to pay him for his services.
Timothy Jost, a law professor at Washington and Lee University who closely tracks the health care law, said the controversy has been overblown.
“This whole thing just puzzles me,” he said. “He wasn’t a legislator. He didn’t write the bill. He didn’t vote on the bill.”
Transcending Obamacare: An Introduction To Patient-Centered, Consumer-Driven Health Reform
Avik Roy
Today, the Manhattan Institute is publishing my 20,000-word, 68-page health reform proposal entitled “Transcending Obamacare: A Patient-Centered Plan for Near-Universal Coverage and Permanent Fiscal Solvency.” It represents a novel approach to health reform: neither accepting Obamacare as is, nor requiring the law’s repeal to move forward. And yet its ambition is to permanently solve our health care entitlement problem, while also expanding coverage for the uninsured.
As most Apothecary readers know, I’ve long been critical of Obamacare, the so-called Affordable Care Act. The law expands Medicaid, the worst health insurance program in the developed world. It significantly drives up the underlying cost of health insurance for those who shop for coverage on their own. And regardless of what John Roberts has to say about it, Obamacare’s individual mandate—forcing most Americans to buy government-certified health coverage—is an injury to the Constitution.
But I’ve also long supported the principle of universal coverage. Universal coverage, done right, is a core part of a conservative worldview that values equality of opportunity for the sick and the poor. If 10 of the 11 freest economies in the world can establish universal coverage, it’s not impossible for the United States to do so in a way that is consonant with economic freedom.
Switzerland and Singapore: Market-based health reform models
The most market-oriented health care systems in the developed world—those ofSwitzerland and Singapore—have much to teach us about how to achieve universal coverage in a way that spends far less than what the U.S. does. In 2012, U.S. government entities spent $4,160 per capita on health care. That’s more than twice as much as Switzerland, and nearly five times as much as Singapore.
And that brings us right back to Obamacare. The vast majority of the law is misguided and misconceived. But a handful of its provisions can provide the basis of constructive health care reform: in particular, its use of Swiss-style means-tested tax credits to subsidize private health insurance premiums. Most importantly, those tax credits are applied to insurance plans that people shop for on their own, substantially expanding the market for individually purchased health coverage.
The Swiss system is far from perfect, as I have discussed on many occasions. But the basic idea in Switzerland is to offer premium subsidies to the people who really need them. In Switzerland, one-fifth of the population gets subsidized health coverage. In the U.S., around four-fifths do. That’s the difference between a safety net and an entitlement leviathan.
Conservative health reform after Obamacare
One of the fundamental flaws in the conservative approach to health care policy is that few—if any—Republican leaders have articulated a vision of what a market-oriented health care system would look like. Hence, Republican proposals on health reform have often been tactical and political—in opposition to whatever Democrats were pitching—instead of strategic and serious.
Those days must come to an end. The problems with our health care system are too great. Health care is too expensive for the government, and too expensive for average Americans.
In 2012, as the Romney campaign came to a close, Rich Lowry, the editor ofNational Review, asked me to write an article with my thoughts about the best path forward for conservative health care reform. I outlined a four-step plan to take the entire gamish of government health care programs and reform them into something consumer-driven and fiscally sustainable: (1) deregulate Obamacare’s insurance exchanges, including repeal of the individual mandate, while preserving guaranteed issue for individuals with pre-existing conditions; (2) migrate future retirees onto the reformed exchanges; (3) repeal Obamacare’s employer mandate; (4) migrate Medicaid acute-care and dual-eligible enrollees onto the exchanges.
“After these four relatively simple steps,” I wrote, “we would be left with a health-care system that would look a lot like Switzerland’s. Rises in premium subsidies could be held to a sustainable growth rate to ensure their long-term fiscal stability. And Americans might finally have the opportunity to purchase insurance for themselves, gain control of their own health-care dollars, and enjoy a wide range of low-cost, high-quality coverage options.”
A few months later, former Congressional Budget Office director Douglas Holtz-Eakin and I wrote a similar piece for Reuters, which elicited a broad range of responses from both the left and the right.
It became clear that I had to do more than write op-eds, that I had to develop this idea in detail, with credible fiscal and economic modeling.
Modeling market-based health reform
So, over the last 18 months, I’ve done just that. Stephen Parente, a health economist at the University of Minnesota, and his team modeled the fiscal and coverage impact of the bulk of my proposed set of reforms. (I then modeled the remainder, using analyses from the Congressional Budget Office, the Centers for Medicare and Medicaid Services, and the like.)
The Manhattan Institute for Policy Research, where I am a Senior Fellow, raised money to fund Parente’s work on this project. Steve and his team and I went back and forth for months, refining and tweaking the proposal until it met five non-negotiable goals. The end result had to:
Reduce the deficit without raising taxes
Expand coverage meaningfully above ACA levels
Repeal the individual mandate
Reduce the cost of private health insurance
Improve health outcomes for the poor
Based on our modeling, the plan, over a thirty-year period, reduces federal spending by $10.5 trillion and federal revenue by $2.5 trillion, for a net deficit reduction of $8 trillion. We project that it will expand coverage by more than 12 million individuals over its first decade, despite the fact that it repeals the individual mandate. It reduces the cost of private-sector insurance policies by 17 percent for single policies and 4 percent for family policies.
But the most dramatic improvement, we estimate, is in the Medicaid population. A group that today receives substandard care and substandard access to care will see a dramatic increase in provider access and health outcomes, based on Parente-developed indices that measure these things.
Breaking free of the repeal-or-reform debate
Importantly, while this plan is compatible with “repealing and replacing” Obamacare, it does not require the repeal of Obamacare. To achieve the former, you would repeal Obamacare and replace it with a universal system of state-based health insurance exchanges. To achieve the latter, you’d reform the pre-existing ACA exchanges, and gradually migrate future retirees and Medicaid enrollees onto the reformed exchanges.
In this way, perhaps the plan can attract interest from both the right and the center.
Both clips reveal a gleefully dismissive attitude toward public concerns about the law, and offer a telling reminder of the attitude that played a crucial role in shaping and selling the law to the public.
In the first video, recorded in March of 2010, just a few days before the law would pass the House, Gruber argues that the public does not really care about the uninsured. What it cares about is cost control. Therefore, he says, the law had to be sold on the basis of its cost control.
Yet as Gruber admits in the video, the bill was not primarily focused on cost control—the bill “is 90% health insurance coverage and 10% about cost control.” Indeed, the problem with cost control, he says, is that “we don’t know how” to do it.
“Barack Obama’s not a stupid man, okay?” Gruber said in his remarks at the College of the Holy Cross on March 11, 2010. “He knew when he was running for president that quite frankly the American public doesn’t actually care that much about the uninsured….What the American public cares about is costs. And that’s why even though the bill that they made is 90% health insurance coverage and 10% about cost control, all you ever hear people talk about is cost control. How it’s going to lower the cost of health care, that’s all they talk about. Why? Because that’s what people want to hear about because a majority of American care about health care costs.”
Elsewhere in the same speech, Gruber says:
“The only way we’re going to stop our country from being a latter day Roman Empire and falling under its own weight is getting control of the growth rate of health care costs. The problem is we don’t know how.”
Remember, this is what Gruber was saying as the law was still being debated. It didn’tpass in the House, the critical step before hitting President Obama’s desk, until more than a week later. And what Gruber was saying, even before the bill was law, was that supporters had intentionally emphasized parts of the bill that were relatively minor, and that were not certain to even produce their intended effects.
This is not lying, exactly; the bill did in fact include some attempts at cost control, although as Gruber said, it was unclear at the time if or how well they would work. And Gruber may well have been right that the public was more concerned with cost control than expanding coverage. But, especially in combination with the other video released this week, it indicates that Gruber believed that the law’s advocates were not being completely straight with the public, that supporters of Obamacare were telling the public what they believed the public wanted to hear instead of giving them the full story, and that they were doing so on the understanding that telling the full story would make the bill impossible to pass.
What it shows, in other words, is Gruber openly embracing a strategy of messaging manipulation and misleading emphasis even while the bill was still being debated. If the public understood the bill clearly, he believed, they would reject it. It was more important to pass the bill.
Another video, posted today by The Daily Signal, shows Gruber taking a similarly dismissive attitude toward public concerns about the bill. At a meeting with the Vermont House Health Care Committee, Gruber is presented with a question about whether systems like those described in a report by Gruber and Harvard health economist William Hsiao, might result in “ballooning costs, increased taxes and bureaucratic outrages” as well “shabby facilities, disgruntled providers” and destructive price controls.
Gruber’s response begin with: “Was this written by my adolescent children by any chance?” The Signal quotes two-term Vermont state senator and Reagan-adviser John McClaughry as saying that the question had been submitted “by a former senior policy adviser in the White House who knew something about health care systems.”
Gruber’s response is intended as a joke, and it reveals little about the health care law (the reforms in question are specific to Vermont). But it says plenty about Gruber, and the flippant, arrogant way he treats concerns and criticism.
This is the person whom the White House relied on to help craft the bill; he was paid handsomely to model its effects (a fact he did not disclose, even when asked), and he was in the room when important decisions were made about how it would work. He claims to have helped write specific portions of the law himself. Gruber was not the sole architect of the law, but he was one of its biggest single influences on both its design and on how the media, which quoted him repeatedly, reported and understood the law.
The White House and its allies are desperately trying to distance themselves from Gruber right now by downplaying his role in the law’s creation. But the record of his involvement is clear enough: At The Washington Post, Ezra Klein has variously described Gruber as “one of the key architects behind the structure of the Affordable Care Act” and “the most aggressive academic economist supporting the reform effort.” The New York Times in 2012 described his role as helping to design the overall structure as well as being “dispatched” by the White House to Congress to write the legislative text. Gruber’s work was cited repeatedly by the White House, Democratic leadership, and the media.
So when he describes the thinking about how the law was crafted and sold to the public, it’s worth taking note. This is the posture of one of the law’s authors and chief backers. It’s part of the spirit in which the law was created and passed. Gruber’s ideas were embedded in the law’s structure and language, and so was his attitude.
The White House is denouncing comments from key Obamacare architect Jonathan Gruber that a lack of transparency and the stupidity of voters helped in the passage of the health care law and is instead pointing a finger at Republicans.
“The fact of the matter is, the process associated with the writing and passing and implementing of the Affordable Care Act has been extraordinarily transparent,” White House press secretary Josh Earnest said during a news briefing in Myanmar, according to a transcript provided by the White House.
Story Continued Below
“I disagree vigorously with that assessment,” Earnest responded when asked about Gruber’s claim that Obamacare wouldn’t have passed if the administration was more transparent and voters more intelligent.
He added, “It is Republicans who have been less than forthright and transparent about what their proposed changes to the Affordable Care Act would do in terms of the choices are available to middle class families.”
Earnest said the president “is proud of the transparent process that was undertaken to pass that bill into law.”
The response from the White House comes as a third video of Gruber criticizing the intelligence of American voters has surfaced.
“We just tax the insurance companies, they pass on higher prices that offsets the tax break we get, it ends up being the same thing. It’s a very clever, you know, basic exploitation of the lack of economic understanding of the American voter,” Gruber said in remarks from 2012 that aired Wednesday evening on “On the Record with Greta Van Susteren.”
Gruber has been causing headaches for the White House as conservatives have had a field day that began with comments the MIT professor made in 2013.
“Lack of transparency is a huge political advantage. And basically, call it the stupidity of the American voter, or whatever, but basically that was really, really critical for the thing to pass,” Gruber said at the time, according to one of the videos that has recently come to light.
In another video clip of a separate event, while talking about tax credits in the Affordable Care Act, he said, “American voters are too stupid to understand the difference.”
Gruber apologized for the comments during an appearance earlier this week on MSNBC’s “Ronan Farrow Daily”:
(Also on POLITICO: Ted Cruz out on a limb on Obamacare repeal)
“I was speaking off the cuff, and I was basically speaking inappropriately, and I regret having made those comments.”
Meanwhile, House Minority Leader Nancy Pelosi dismissed Gruber’s role in Obamacare on Thursday, telling the press, “I don’t know who he is. He didn’t help write our bill.”
Many outlets were quick to point out that Pelosi cited Gruber in a “Health Insurance Reform Mythbuster” on her official website in 2009.
House Speaker John Boehner released a statement Thursday, slamming Gruber for his comments.
“If there was ever any doubt that ObamaCare was rammed through Congress with a heavy dose of arrogance, duplicity, and contempt for the will of the American people, recent comments by one of the law’s chief architects, Jonathan Gruber, put that to rest,” the top Republican said.
The statement continues, “The American people are anything but ‘stupid.’ They’re the ones bearing the consequences of the president’s health care law and, unsurprisingly, they continue to oppose it.” http://www.politico.com/story/2014/11/jonathan-gruber-obamacare-voters-white-house-response-112856.html
Informally, a Cadillac plan is any unusually expensive health insurance plan, usually arising in discussions of medical-cost control measures in the United States.[1][2][3][4] The term derives from the Cadillac automobile, which has represented American luxury since its introduction in 1902,[1] and as a health care metaphor dates to the 1970s.[1] The term gained popularity in the early 1990s during the debate over the Clinton health care plan of 1993,[1] and was also widespread during debate over possible excise taxes on “Cadillac” plans during the health care reforms proposed during the Obama administration.[1] (Bills proposed by Clinton and Obama did not use the term “Cadillac”.)
Criticisms of these plans generally center on the small or nonexistent co-pays, deductibles, or caps that encourage the overuse of medical care, driving the cost up for the uninsured or those on other plans, which some say necessitates aCadillac tax.[citation needed]
A study published in Health Affairs in December 2009 found that high-cost health plans do not provide unusually rich benefits to enrollees. The researchers found that only 3.7% of the variation in the cost of family coverage in employer-sponsored health plans is attributable to differences in the actuarial value of benefits. Only 6.1% of the variation is attributable to the combination of benefit design and plan type (e.g., PPO, HMO, etc.). The employer’s industry and regional variations in health care costs explain part of the variation, but most is unexplained. The researchers conclude “…that analysts should not equate high-cost plans with Cadillac plans, but that in fact other factors—industry and cost of medical inputs—are as important in predicting whether a plan is a high-cost plan. Without appropriate adjustments, a simple cap may exacerbate rather than ameliorate current inequities.”[5]
How ObamaCare Taxes Affect You: New Taxes, Hikes, Breaks, Credits, and Other Changes
Here’s a full list of ObamaCare Taxes. The 21 new ObamaCare tax hikes and breaks impact us all, but which ObamaCare taxes will you actually pay? Find out how the tax related provisions in the Affordable Care Act (ObamaCare) will affect you, your family, your business, and your tax returns for 2013 and beyond.
The Bottom Line on the ObamaCare Tax Plan
The new tax related provisions in theAffordable Care Act(ObamaCare) include tax hikes, limits to deductions, tax credits, tax breaks, and other changes. While a few of the changes directly affect the average American, tax increases primarily affect high earners (those making over $200,000 as an individual or $250,000 as a family), large businesses (those making over $250,000), and the health care industry, while tax credits primarily affect low-to-middle income Americans and small businesses.
Here are some quick facts to help you understand how ObamaCare affects taxes:
• For the majority of the 85% of Americans with health insurance the percentage of income paid in taxes won’t change much, if at all. However, some of the changes may directly or indirectly affect specific groups.
• The majority of the 15% of Americans without health insurance will primarily be affected by the Individual Mandate (the requirement to buy health insurance), the Employer Mandate (the requirement for large employers to insure full-time employees), and Tax Credits (tax credits reduce premium costs for individuals, families, and small businesses).
• Many Americans will be affected by changes to new limits on medical tax deduction thresholds MSAs, FSAs, and HSAs.
• Small businesses will not be required to provide health insurance, but will gettax credits to reduce premium costs if they choose to offer group plans.
• Even if you won’t see higher taxes under the Affordable Care Act, it doesn’t mean there aren’t costs associated with the law. You’ll still need to buy health insurance, unless you qualify for Medicaid or an exemption, and that will cost you money.
• As a rule of thumb those who make less pay less and those who make more pay more, both in regard to health insurance costs and taxes under theAffordable Care Act.
• The Congressional Budget Office has shown that the revenue generated from the new taxes, along with cuts to spending, will help to pay for the Affordable Care Act’s many provisions, fund tax credits and lower the deficit by 2023.Learn More.
Why Does ObamaCare Create New Taxes?
ObamaCare includes many new benefits, rights, and protections including the requirement for health insurers to cover people with pre-existing conditions. It also expands access to affordable health insurance to almost 50 million low-to-middle income men, women, and children across the country by offering reduced premiums via tax credits and expanding Medicaid and CHIP. Expanding the quality, affordability and availability of health insurance (along with other aspects of the law) come at a high cost. Assuming all tax provisions remain in place, the revenue generated from these new taxes help to cover the costs of the program and reduces the deficit. Learn more about the new benefits, rights, protections offered by the Affordable Care Act.
A Quick Overview of Key Taxes in the Affordable Care Act
Before we get to the full list of taxes here is a quick overview of the key tax related provisions that may affect those without insurance, those who plan to go without insurance, and those who are struggling to afford insurance now.
Individual Mandate (new tax): Americans who can afford to must obtain minimum essential health coverage for 2014, get an exemption or pay a per month fee.
Employer Mandate (new tax): Come 2015 large employers must insure full time employees or pay a per employee fee. Over half of Americans get their insurance through work and the largest group of uninsured is currently the working poor.
Taking all the tax provisions in the ACA into account ObamaCare technically provides the greatest middle class tax cut to healthcare in history.
Full List of All Taxes in ObamaCare / All Taxes in the Affordable Care Act
The following list of new ObamaCare taxes collectively raise over $800 billion by 2022. Here is a complete list of new fees and taxes contained withinObamaCare:
ObamaCare Taxes That Most Likely Won’t Directly Affect the Average American
• 2.3% Tax on Medical Device Manufacturers 2014
• 10% Tax on Indoor Tanning Services 2014
• Blue Cross/Blue Shield Tax Hike
• Excise Tax on Charitable Hospitals which fail to comply with the requirements of ObamaCare
• Tax on Brand Name Drugs
• Tax on Health Insurers
• $500,000 Annual Executive Compensation Limit for Health Insurance Executives
• Elimination of tax deduction for employer-provided retirement Rx drug coverage in coordination with Medicare Part D
• Employer Mandate on business with over 50 full-time equivalent employees to provide health insurance to full-time employees. $2000 per employee $3000 if employee uses tax credits to buy insurance on the exchange (marketplace). (pushed back to 2015)
• Medicare Tax on Investment Income 3.8% over $200k/$250k
• Medicare Part A Tax increase of .9% over $200k/$250k
• Employer Reporting of Insurance on W-2 (not a tax)
• Corporate 1099-MISC Information Reporting (repealed)
• Codification of the “economic substance doctrine” (not a tax)
ObamaCare Taxes That (may) Directly Affect the Average American
• 40% Excise Tax “Cadillac” on high-end Premium Health Insurance Plans 2018
• An annual $63 fee levied by ObamaCare on all plans (decreased each year until 2017 when pre-existing conditions are eliminated) to help pay for insurance companies covering the costs of high-risk pools.
• Medicine Cabinet Tax
Over the counter medicines no longer qualified as medical expenses for flexible spending accounts (FSAs), health reimbursement arrangements (HRAs), health savings accounts (HSAs), and Archer Medical Saving accounts (MSAs).
• Additional Tax on HSA/MSA Distributions
Health savings account or an Archer medical savings account, penalties for spending money on non-qualified medical expenses. 10% to 20% in the case of a HSA and from 15% to 20% in the case of a MSA.
• Flexible Spending Account Cap 2013
Contributions to FSAs are reduced to $2,500 from $5,000.
• Medical Deduction Threshold tax increase 2013
Threshold to deduct medical expenses as an itemized deduction increases to 10% from 7.5%.
• Individual Mandate (the tax for not purchasing insurance if you can afford it) 2014
Starting in 2014, anyone not buying “qualifying” health insurance must pay an income tax surtax at a rate of 1% or $95 in 2014 to 2.5% in 2016 on profitable income above the tax threshold. The total penalty amount cannot exceed the national average of the annual premiums of a “bronze level” health insurance plan on ObamaCare exchanges.
• Premium Tax Credits for Small Businesses 2014 (not a tax)
• Advanced Premium Tax Credits for Individuals and Families 2014 (not a tax)
• Medical Loss Ratio (MRL): Premium rebates (not a tax)
The link below provides a full list of ObamaCare Taxes by the IRS.
Let’s take a look at how ObamaCare’s taxes affect certain income groups.
ObamaCare Taxes for High Earners and Large Businesses
Most of the new taxes are on high-earners (individuals making over $200,000 and families making over $250,000), large businesses (over 50 full-time equivalent employees making over $250,000), and industries that profit from healthcare. Essentially those who will see gains under ObamaCare are required to put money back in the program via taxes.
FACT: Tax increases generally affect single filers with an adjusted gross income (AGI) above $200,000 and married couples filing jointly above $250,000. Some of the tax increases don’t kick in until single AGI hits $400,000 and married filing jointly AGI hits $450,000.
ObamaCare Taxes for the Average American With Health insurance
For most of the 85% of Americans with health insurance, making less than $250,000, most of the new taxes won’t mean much of anything although certain taxes below will affect specific individuals and families.
ObamaCare Taxes for the Average American Without Health insurance
The 15% of Americans without health insurance will be required to obtain health insurance (Individual Mandate) or will face a “tax penalty”.
The good news is that many uninsured will be exempt from the Individual mandate due to income, offered cost assistance through the marketplaceincluding Tax Credits (also available to small businesses), qualify for Medicaid, or will get insurance through work (the Employer Mandaterequires large employers to insure full-time employees by 2015). Adults who are under 26 will be able to stay on their parents plan as well, this will help to limit the number of young people who will pay the fee. Both the employer and individual mandates are part of our “shared responsibility” to expand the quality and affordability of health insurance in the United States as a trade for our new benefits, rights and protections.
ObamaCare Taxes for Small Businesses
Small businesses with less than 25 full-time equivalent employees will have access to tax credits to reduce premium costs of group plans.
ObamaCare Taxes for Specific Groups With Health Insurance
Here are a few changes that my affect specific groups of Americans with health insurance:
• Other tax provisions such as changes medical deduction thresholds, HSAs, MSAs, and FSAs may impact some Americans by limiting tax deductions.
• The Medical Loss Ratio (MLR or 80/20 rule) will mean that some Americans may get rebates if health insurance companies spend on non-healthcare related expenses.
• Tax provisions like the 10% tanning bed tax, taxes on drug companies, taxes on medical devices and taxes on health insurance companies selling insurance on and off the exchange may affect the amount of money we pay for some health care related goods and services, but will not have a significant impact on our daily lives.
• The employer mandate has caused some companies to cut down full-time workers to part-time to avoid providing benefits, however major employers like Disney and Walmart have actually increased their full-time workforce in response to the looming 2015 deadline.
• Overall the benefits tend to outweigh the costs for the average American as even those who pay a little more, get a lot more in return due to the increased quality of their health insurance.
Will I pay More Taxes and High Premiums Because of ObamaCare?
As mentioned above premium rates and the taxes you will have to pay are primarily based on income. Aside from income premium prices are based on which plan you choose, family size, age, smoking status and geography. Subsidies reduce the overall rate of your premiums (however smoking is calculated after subsidies). Come 2018 there will be a 40% excise tax on high end health insurance plans.
Aside from the tax provisions that require Americans to obtain insurance and subsidize it’s costs, ObamaCare also includes a few tax related provisions that work as consumer protections including requirements for better reporting and the Medical Loss Ratio.
ObamaCare Tax Rebates
Some consumers in both individual and group markets will see tax rebates due to ObamaCare’s Medical Loss Ratio (MLR). Health insurance companies will have to provide rebates to consumers if they spend less than 80 to 85% of premium dollars on medical care.
Medical Loss Ratio (MLR)
The Medical Loss Ratio (MLR) means that Insurance companies are now required to spend at least 80% of premium dollars (85% in large group markets) on medical care and quality improvement activities. Insurance companies that are not meeting this standard will be required to provide rebates to their consumers. The MLR isn’t a tax, but it does have implications in regards to filing taxes and rebates can be given in the form of reduced premiums. See our page on ObamaCare Health Insurance Regulations for more details.
ObamaCare Income Tax Penalty For Not Having Insurance “Individual Mandate”
Starting in 2014, most people will have to have insurance or pay a “penalty deducted from your taxable income”. For individuals, penalty starts at $95 a year, or up to 1% of income, whichever is greater, and rise to $695, or 2.5% of income, by 2016.
For families the tax will be $2,085 or 2.5% percent of household income, whichever is greater. The requirement can be waived for several reasons, including financial hardship or religious beliefs. If the tax would exceed 8% of your income you are exempt, also some religious groups are exempt. That tax cannot exceed the cost of a “bronze plan” bought on the exchange.
Many individuals who are exempt from the mandate to buy insurance will still be eligible for free or low-cost insurance through the health insurance marketplace.
While some states, including Alabama, Wyoming and Montana, have passed laws to block the requirement to carry health insurance, those provisions do not override federal law. Get more information on the ObamaCare Individual Mandate.
The Individual Mandate is officially called the “individual shared responsibility provision”.
What Are ObamaCare Tax Credits?: Advanced Premium Tax Credits
Premium tax credits are a form of cost assistance that reduce premium costs for coverage purchased onyour State’s “health insurance marketplace” for individuals, families, and small businesses.
Advanced Premium Tax Credits for Individuals and Families
Individuals and families will have access to Advanced premium tax credits on the marketplace. Tax Credits are deducted from your premium cost by your health insurance provider and are adjusted on your Modified Adjusted Gross Income (MAGI). You can choose how much advance credit payments to apply to your premiums each month, up to a maximum amount. If the amount of advance credit payments you get for the year is less than the tax credit you’re due, you’ll get the difference as a refundable credit when you file your federal income tax return. If your advance payments for the year are more than the amount of your credit, you must repay the excess advance payments with your tax return.
Aside from premium tax credits individuals and families can also get lower cost sharing on out-of-pocket expenses like coinsurance, copays, deductibles and out-of-pocket maximums through the marketplace.
Eligibility for Tax Credits
In general, you may be eligible for the credit if you meet all of the following:
buy health insurance through the Marketplace;
are ineligible for coverage through an employer or government plan;
are within certain income limits;
file a joint return, if married; and
cannot be claimed as a dependent by another person.
If you are eligible for the credit, you can choose to:
Get It Now: have some or all of the estimated credit paid in advance directly to your insurance company to lower what you pay out-of-pocket for your monthly premiums during 2014; or
Get It Later: wait to get all of the credit when you file your 2014 tax return in 2015.
How Will Advanced Premium Tax Credits Affect My Health Insurance Costs?
Under the Affordable Care Act health insurance that costs less than 8% of your MAGI is considered affordable. Although the law doesn’t guarantee lower costs, premium tax credits help to ensure that more Americans will have access to affordable insurance.
s a rule of thumb most Americans will pay between 1.5% and 9.5% on their Modified Adjusted Gross Income (MAGI) when using tax credits to buy a basic Silver Plan on the marketplace.
If the lowest-priced coverage available to you would cost more than 8% of your household income are exempt from the individual mandate.
The amount you pay is on a sliding scale based on your income. Use the chart below to get an idea of what you and your family may pay for insurance purchased through the Health Insurance Marketplace. Make sure to check outObamaCare Subsidies for more detailed information on Premium Tax Credits.
The 2013 Federal Poverty Level Guidelines below are used to Determine if your percentage of the poverty level for both taxes and cost-assistance.
Household Size
100%
133%
150%
200%
300%
400%
1
$11,170
$14,856
$16,755
$22,340
$33,510
$44,680
2
15,130
20,123
22,695
30,260
45,390
60,520
3
19,090
25,390
28,635
38,180
57,270
76,360
4
23,050
30,657
34,575
46,100
69,150
92,200
5
27,010
35,923
40,515
54,020
81,030
108,040
6
30,970
41,190
46,455
61,940
92,910
123,880
7
34,930
46,457
52,395
69,860
104,790
139,720
8
38,890
51,724
58,335
77,780
116,670
155,560
For each additional person, add
$3,960
$5,267
$5,940
$7,920
$11,880
$15,840
This following table is an example of how premium tax credits work. Please note that the numbers below are purely for example and don’t reflect your personal rates.
Health Insurance Premiums and Cost Sharing under PPACA for Average Family of 4
For “Silver Plan”
Income % of federal poverty level
Premium Cap as a Share of Income
Income $ (family of 4)
Max Annual Out-of-Pocket Premium
Premium Savings
Additional Cost-Sharing Subsidy
133%
3% of income
$31,900
$992
$10,345
$5,040
150%
4% of income
$33,075
$1,323
$9,918
$5,040
200%
6.3% of income
$44,100
$2,778
$8,366
$4,000
250%
8.05% of income
$55,125
$4,438
$6,597
$1,930
300%
9.5% of income
$66,150
$6,284
$4,628
$1,480
350%
9.5% of income
$77,175
$7,332
$3,512
$1,480
400%
9.5% of income
$88,200
$8,379
$2,395
$1,480
In 2016, the FPL is projected to equal about $11,800 for a single person and about $24,000 for family of four. Use the Kaiser ObamaCare Cost Calculator for more information. DHHS and CBO estimate the average annual premium cost in 2014 to be $11,328 for family of 4 without the reform. Source: Wikipedia
ObamaCare Employer / Employee Taxes
ObamaCare’s taxes mean large employers will have to provide health insurance to their employees and will see a raised Medicare part A tax, small businesses may be eligible for tax breaks.
Medicare part A Tax Hike for Employers and Employees
The Medicare part A tax is paid by both employees and employers who earn over a certain amount. ObamaCare’s Medicare tax hike is a .9% increase (from 2.9% to 3.8%) on the current total Medicare part A tax. This tax is split between the employer and employee meaning that they will both see a .45% raise. Small businesses making under $250,000 are exempt from the tax. Employees making less than $200,000 as an individual or ($250,000) as a family are also exempt. Employers must withhold and report an additional 0.9 percent total on employee wages or compensation that exceed $200,000.
Tax Penalty for Not Providing Full-time Workers with Health Insurance the “Employer Mandate”
Employers with over 50 full-time equivalent employees must either insure their full-time employees or pay a penalty or “employer shared responsibility fee”. The penalty is $2000 per employee. If however, at least one full-time employee receives a premium tax credit because coverage is either unaffordable or does not cover 60 percent of total costs, the employer must pay the lesser of $3,000 for each of those employees receiving a credit or $750 for each of their full-time employees total.
Employers with under 25 full time employees, whose average income doesn’t exceed $50,000, can apply for tax credits of up to 50% for insuring their employees.
Tax Credits for Small Businesses
Small businesses with under 25 full-time equivalent employees with average annual wages of less than $50,000 can apply for tax breaks of up to 50% of their share of employee premium costs via ObamaCare’s Small Business Health Options Program (accessible through your State’s Health Insurance Marketplace). The credit can be as much as 50% of employer premiums (35% for not-for-profits in 2014). The credit is only available if the employer is paying at least 50% of the total premiums.
Small Business Health Options Program
Employers with 50 or fewer employees, you can purchase affordable insurance through the Small Business Health Options Program (SHOP) even if they don’t qualify for tax credits.
Reporting
Along with the new law there are new requirements for reporting.
Effective for calendar year 2015, you must file an annual return reporting whether and what health insurance you offered your employees. This rule is optional for 2014. Learn more.
Effective for calendar year 2015, if you provide self-insured health coverage to your employees, you must file an annual return reporting certain information for each employee you cover. This rule is optional for 2014. Learn more.
Beginning Jan. 1, 2013, you must withhold and report an additional 0.9 percent on employee wages or compensation that exceed $200,000. Learn more.
Aside from having to adhere to the “employer mandate” ObamaCare also imposes taxes and fees that are unique to big business. ObamaCare taxes some medical device manufactures, drug companies and health insurance companies. Beginning in 2013, medical device manufacturers and importers must pay a 2.3% tax on the sale of a taxable medical device. This raises $29 billion over a 10 years. However, many states are asking to delay the medical device excise tax to protect jobs in states that produce the devices. An annual fee for health insurers is expected to raise more than $100 billion over 10 years, while a fee for brand name drugs will bring in another $34 billion.
Employers that have employees who earn more than $200,000 will have to look at the potential for additional Medicare withholding due to the Medicare part A tax.
Employers that issued 250 or more W-2 forms in 2012 must report the cost of employer-sponsored health coverage for 2013 on the 2013 W-2 forms.
Medical Device Excise Tax
There is a 2.3% medical excise tax on medical device manufacturers and importers on the sale of taxable medical devices. Section 4191 of the Internal Revenue Code imposes an excise tax on the sale of certain medical devices by the manufacturer or importer of the device. The tax applies to sales of taxable medical devices after Dec. 31, 2012. You can learn more from the official IRS page on the Medical Device Tax.
What Increases Do the ObamaCare Taxes Include for The $200k/$250k Earners?
ObamaCare Medicare Part A Payroll Tax
Starting in 2013, individuals with earnings above $200,000 and married couples making more than $250,000 will see an increase in the Medicare part A payroll tax. It’s an increase of 2.35%, up from the current 1.45% ( a .9% Medicare part A payroll tax hike), on adjusted income over the threshold.
ObamaCare Unearned Income Tax
This group will also pay a 3.8% unearned income (capital gains) tax on interest, dividends, annuities, royalties, rents, and gains on the sale of investments over the threshold.
Taxable income under the $200,000 for individuals and $250,000 threshold for families is subject to the same benefits and tax cuts as those who make under the threshold.
ObamaCare Home Sales Tax / ObamaCare Real Estate Tax Increase
ObamaCare increases taxes on unearned income by 3.8% and this can add additional taxes to the sales of some homes, but many limitations apply which means it won’t affect most sellers. The 3.8% capital gains tax typically doesn’t apply to your primary residence. It also doesn’t usually apply to homes you have owned for over 5 years or on profits of less than $250,000 for individuals and $500,000 for couples due to a capital gains tax exclusion rule for sales of a primary home.
In short the ObamaCare home sales tax isn’t something that most of us will pay, it is a tax is aimed at those selling non-primary residences in short term periods for profit and not at the average American buying and selling their primary residence.
ObamaCare Medical Expense Deductions
ObamaCare increases the medical expense deduction threshold. Unreimbursed medical expense deductions will now be available only for those medical expenses in excess of 10% of AGI, which has been raised from 7.5%. There is a temporary exemption for individuals ages 65 and older and their spouses from 2013 through 2016.
ObamaCare “Cadillac” Tax
Starting in 2018, the new health care law imposes a 40% excise tax on the portion of most employer-sponsored health coverage (this excludes dental and vision) that exceed $10,200 a year and $27,500 for families. The tax has been dubbed a “Cadillac” tax because it hits only high-end “gold”, “platinum” and high-end health care plans not purchased on the exchange. The tax raises over $150 billion over the next 10 years.
New ObamaCare Taxes Summary
Going through the new ObamaCare taxes line by line is, in itself, taxing. The bottom line is that a majority of Americans will find themselves paying less for better healthcare, while higher-earners will pay tax rates closer to what they did in the Clinton years. ObamaCare pays for most of itself via the above taxes, reforms to Medicare, and health care as a whole, as well as cutting out billions in wasteful spending.
ObamaCare Taxes Moving Forward into 2014
We hope this helps you to understand the new ObamaCare taxes and how they work. Many of the ObamaCare’s taxes won’t be fully implemented until 2022, but most will be in effect by 2014. ObamaCare helps all Americans get access to quality affordable healthcare, and new benefits, rights and protections. Make sure to look out for ObamaCare tax breaks, credits, subsidies and breaks on up front costs moving forward into 2014. As we learn more we will update our full ObamaCare tax list.
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You Decide
Frank Sinatra-New York,New York
Frank Sinatra-New York,New York-Lyrics
Start spreadin’ the news, I’m leavin’ today
I want to be a part of it
New York, New York
These vagabond shoes, are longing to stray
Right through the very heart of it
New York, New YorkI want to wake up, in a city that never sleeps
And find I’m king of the hill
Top of the heapThese little town blues, are melting away
I’ll make a brand new start of it
In old New York
If I can make it there, I’ll make it anywhere
It’s up to you, New York..New YorkNew York…New York
I want to wake up, in a city that never sleeps
And find I’m A number one, top of the list
King of the hill, A number one….These little town blues, are melting away
I’ll make a brand new start of it
In old New York
If I can make it there, I’ll make it anywhere
It’s up to you, New York..New York New York!!!
Frank Sinatra – New York New York Song **Lyrics** [HD]
My Kind of Town (Chicago) – Frank Sinatra
“My Kind Of Town”
Now this could only happen to a guy like me
And only happen in a town like this
So may I say to each of you most gratef’lly
As I throw each one of you a kissThis is my kind of town, Chicago is
My kind of town, Chicago is
My kind of people, too
People who smile at youAnd each time I roam, Chicago is
Calling me home, Chicago is
Why I just grin like a clown
It’s my kind of town[brief instrumental]My kind of town, Chicago is
My kind of town, Chicago is
My kind of razzmatazz
And it has all that jazzAnd each time I leave, Chicago is
Tuggin’ my sleeve, Chicago is
The Wrigley Building, Chicago is
The Union Stockyard, Chicago is
One town that won’t let you down
It’s my kind of town
New York, New Jersey Set Up Mandatory Quarantine Requirement Amid Ebola Threat Christie: New Policy Has Already Been Used At Newark Liberty International Airport
As CBS 2’s Alice Gainer reported, no other states have yet set up increased screening procedures for Ebola.
“We believe it’s appropriate to increase the current screening procedures from people coming from affected countries from the current (Centers for Disease Control and Prevention screening procedures),” Gov. Andrew Cuomo said Friday afternoon. “We believe it within the State of New York and the State of New Jersey’s legal rights.”
Under the new rules, state officials will establish a risk level by considering the countries that people have visited and their level of possible exposure to Ebola.
The patients with the highest level of possible exposure will be automatically quarantined for 21 days at a government-regulated facility. Those with a lower risk will be monitored for temperature and symptoms, Cuomo explained.
The New York and New Jersey health departments will determine their own specific procedures for hospitalization and quarantine, and will provide a daily recap to state officials on the status of screening, New York State Health Commissioner Dr. Howard Zucker said at the news conference.
The new procedures already have been put into use at Newark Liberty International Airport.
On Friday, a health care worker landed at Newark after treating Ebola patients in West Africa, New Jersey Gov. Chris Christie said at the news conference. A legal quarantine was issued for the woman, who was not a New Jersey resident and was set to go on to New York afterward.
“This woman, while her home residence is outside the area, said her next stop was going to be here in New York,” Christie said. “Governor Cuomo and I discussed it before we came out here, and a quarantine order will be issued.”
The woman will be quarantined in either New York or New Jersey, Christie said.
In discussing the new plan, Cuomo and Christie said a policy of voluntary quarantine simply does not go far enough.
“Voluntary quarantine – you know it’s almost an oxymoron. This is a very serious situation.” Cuomo said. “Voluntary quarantine – raise your right hand and promise you’re going to stay home for 21 days. We’ve seen what happens.”
The new rules were announced a day after Dr. Craig Spencer, a member of Doctors Without Borders, became New York City’s first Ebola patient.
He reported Thursday morning coming down with a fever and diarrhea and is being treated in an isolation ward at Bellevue Hospital, a designated Ebola center.
Spencer returned from West Africa last Friday after treating Ebola patients in Guinea with Doctors Without Borders. He arrived at John F. Kennedy International Airport, passing the extensive CDC screening process.
“When he arrived in the United States, he was also well with no symptoms,” said New York City Health Commissioner Mary Travis Bassett.
Doctors Without Borders said per the guidelines it provides its staff members on their return from Ebola assignments, “the individual engaged in regular health monitoring and reported this development immediately.” But Spencer also took the subway, walked the High Line, and went bowling in Williamsburg, Brooklyn the day before he became sick.
“He was a doctor, and even he didn’t follow the guidelines,” Cuomo said.
With that in mind, the states have to lay down the law, the governors said.
“It’s too serious a situation to leave it to the honor system,” Cuomo said.
The CDC is reviewing its policy for health care workers returning from West Africa, but anyone flying into a Port Authority of New York and New Jersey airport will need to abide by the new procedures.
Ebola Arrives in New York. How Prepared Is the City to Handle It?
Dr. Craig Spencer, the health care worker who recently returned from Guinea and tested positivefor the Ebola virus, is now the first patient to be treated at New York’s Bellevue Hospital.
But the hospital, as well as city, state and federal officials, have been working for weeks or more to ensure the city is ready to identify and treat Ebola cases.
This preparation reflects the now-proven fact that the longer the outbreak rages on in West Africa, the more likely it was that a patient would wind up in Western cities, including New York.
On Oct. 15, the state designated Bellevue Hospital Center as the facility to receive Ebola patients from among the city’s 11 public hospitals, and to receive transferred patients from other hospitals as well, in the event that any Ebola cases occur in the city.
According to a statement from the New York City Health and Hospitals Corporation, the hospital has four single-bed rooms in its infectious disease ward to treat “high probability or confirmed Ebola cases.” This part of the hospital also has a new laboratory that can test for Ebola, separate from the rest of the hospital’s labs, to handle Ebola blood samples.
Because the virus can be spread through contact with an infected person’s bodily fluids, careful handling of blood and other samples is necessary.
The hospital is particularly well suited due to its long history of being on the front lines of epidemics and emerging public health threats, and managing an isolation unit for diseases, such as TB, for many years with support from and collaboration with the City Health Department.
Three other hospitals in New York City have also been designated by the state to treat suspected and confirmed Ebola cases, including Mt. Sinai and New York Presbyterian in Manhattan and Montefiore in the Bronx, according to Governor Cuomo’s Ebola preparedness plan.
None of these hospitals, including Bellevue, has an isolated biocontainment unit like those that have treated patients at Emory University Hospital in Atlanta, Georgia, and Nebraska Medical Center in Omaha, Nebraska.
The American public may not have much faith in ordinary hospitals to treat Ebola, considering that the only non-specialized hospital to treat Ebola patients, Texas Health Presbyterian Hospital Dallas, allowed the virus to spread to two nurses who worked on the original patient, Thomas Eric Duncan, who died of Ebola on Oct. 8. Both of the nurses are now being treated in a biocontainment unit.
The probability of an Ebola case in New York was always considerably higher than it was for many other cities in the U.S., given that two of the city’s international airports — JFK and Newark — are key gateways for travelers to and from West Africa, via stops in Europe or elsewhere in Africa.
“New York City is a frequent port of entry for travelers from West Africa, a home to communities of West African immigrants who travel back to their home countries, and a home to health care workers who travel to West Africa to treat Ebola patients,” The Centers for Disease Control and Prevention (CDC) said in a report on Oct. 17.
“Ongoing transmission of Ebola virus in West Africa could result in an infected person arriving in NYC,” the report said. However, the chance that a New Yorker who has not traveled to an Ebola hotspot would come down with the virus is “extremely slim,” since the disease is only spread through direct contact with an infectious person’s bodily fluids.
Ultimately, it was a doctor who lived in the city who would bring the virus home.
In recent weeks, the New York Health Commissioner issued a “Commissioner’s Order” to all hospitals and ambulance services in the state, “requiring that they follow protocols for identification, isolation and medical evaluation of patients requiring care.”
The state has been conducting “unannounced drills” at hospitals and health care facilities to test preparedness for handling possible Ebola cases. The state has also involved the Metropalitan Transit Authority, which operates the city’s subways and buses, in training for encountering possible Ebola patients.
And a mass Ebola training for health care workers, which included demonstrations for putting on and taking off protective equipment, took place in the city on Oct. 21.
According to new guidelines the CDC issued on Monday, there are now 30 steps health care workers have to take every time they treat a patient with Ebola or Ebola-like symptoms.
At hospitals like Bellevue, actors have played the role of patients with Ebola symptoms have been part of the drills, and the city’s 911 operators have been told to ask people who call in with Ebola-like symptoms if they have recently traveled to West Africa, according to the Guardian.
As of Thursday, there have been nearly 10,000 cases of Ebola in West Africa, along with about 4,900 deaths. However, these figures are likely to be underestimates, since the lack of treatment facilities and other circumstances are causing many patients to go uncounted.
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Immigration Professor, Unlawful Presence and Unlawful Presence Waivers, Part 2 of 3
Immigration Professor, Unlawful Presence and Unlawful Presence Waivers, Part 3 of 3
EXCLUSIVE: OBAMA ADMINISTRATION QUIETLY PREPARES ‘SURGE’ OF MILLIONS OF NEW IMMIGRANT IDS
Despite no official action from the president ahead of the election, the Obama administration has quietly begun preparing to issue millions of work authorization permits, suggesting the implementation of a large-scale executive amnesty may have already begun.
Unnoticed until now, a draft solicitation for bids issued by U.S. Citizenship and Immigration Services (USCIS) Oct. 6 says potential vendors must be capable of handling a “surge” scenario of 9 million id cards in one year “to support possible future immigration reform initiative requirements.”
The request for proposals says the agency will need a minimum of four million cards per year. In the “surge,” scenario in 2016, the agency would need an additional five million cards – more than double the baseline annual amount for a total of 9 million.
“The guaranteed minimum for each ordering period is 4,000,000 cards. The estimated maximum for the entire contract is 34,000,000 cards,” the document says.
The agency is buying the materials need to construct both Permanent Residency Cards (PRC), commonly known as green cards, as well as Employment Authorization Documentation (EAD) cards which have been used to implement President Obama’s “Deferred Action for Childhood Arrivals” (DACA) program. The RFP does not specify how many of each type of card would be issued.
Jessica Vaughan, an immigration expert at the Center for Immigration Studies and former State Department official, said the document suggests a new program of remarkable breadth.
The RFP “seems to indicate that the president is contemplating an enormous executive action that is even more expansive than the plan that Congress rejected in the ‘Gang of Eight’ bill,” Vaughan said.
Last year, Vaughan reviewed the Gang of Eight’s provisions to estimate that it would have roughly doubled legal immigration. In the “surge” scenario of this RFP, even the relatively high four million cards per year would be more than doubled, meaning that even on its own terms, the agency is preparing for a huge uptick of 125 percent its normal annual output.
It’s not unheard of for federal agencies to plan for contingencies, but the request specifically explains that the surge is related to potential changes in immigration policy.
“The Contractor shall demonstrate the capability to support potential ‘surge’ in PRC and EAD card demand for up to 9M cards during the initial period of performance to support possible future immigration reform initiative requirements,” the document says.
A year ago, such a plan might have been attributed to a forthcoming immigration bill. Now, following the summer’s border crisis, the chances of such a new law are extremely low, giving additional credence to the possibility the move is in preparation for an executive amnesty by Obama.
Even four million combined green cards and EADs is a significant number, let alone the “surge” contemplated by USCIS. For instance, in the first two years after Obama unilaterally enacted DACA, about 600,000 people were approved by USCIS under the program. Statistics provided by USCIS on its website show that the entire agency had processed 862,000 total EADs in 2014 as of June.
Vaughan said EADs are increasingly coming under scrutiny as a tool used by the Obama administration to provide legalization for groups of illegal aliens short of full green card status.
In addition to providing government approval to work for illegal aliens, EADs also cost significantly less in fees to acquire, about $450 compared to more than $1000. In many states, EADs give aliens rights to social services and the ability to obtain drivers’ licenses.
Vaughan noted there are currently about 4.5 million individuals waiting for approval for the green cards having followed immigration law and obtained sponsorships from relatives in the U.S. or otherwise, less than the number of id cards contemplated by the USCIS “surge.”
USCIS officials did not provide additional information about the RFP by press time.
Card Consumables
Solicitation Number: HSSCCG-14-R-00028
Agency: Department of Homeland Security
Office: Citizenship & Immigration Services
Location: USCIS Contracting Office
Note:
There have been modifications to this notice. You are currently viewing the original synopsis. To view the most recent modification/amendment, click here
USCIS Contracting will be posting a solicitation for the requirement of Card Stock used by the USCIS Document Management Division. The objective of this procurement is to provide card consumables for the Document Management Division (DMD) that will be used to produce Permanent Resident Cards (PRC) and Employment Authorization Documentation (EAD) cards. The requirement is for an estimated 4 million cards annually with the potential to buy as many as 34 million cards total.The ordering periods for this requirement shall be for a total of five (5) years. This is a Firm Fixed Price (FFP) supply purchase for commercial items, utilizing North American Industry Classification System (NAICS) code 325211 and Product / Service Code (PSC) 9330. This requirement is for the acquisition of 100% polycarbonate solid body card stock with Radio Frequency Identification (RFID) and holographic images embedded within the card construction substrate layers, card design service, and storage.
The solicitation will be posted at this FedBidOpps webpage.
United States Citizenship and Immigration Services
United States Citizenship and Immigration Services (USCIS) is a component of the United StatesDepartment of Homeland Security (DHS). It performs many administrative functions formerly carried out by the former United States Immigration and Naturalization Service (INS), which was part of the Department of Justice. The stated priorities of the USCIS are to promote national security, to eliminate immigration case backlogs, and to improve customer services. USCIS is headed by a director, currently Leon Rodriguez, who reports directly to the Deputy Secretary for Homeland Security.[1]
Functions
Atlanta, Georgia
USCIS is charged with processing immigrant visa petitions, naturalization petitions, and asylum and refugeeapplications, as well as making adjudicative decisions performed at the service centers, and managing all other immigration benefits functions (i.e., not immigration enforcement) performed by the former INS. Other responsibilities include:
Administration of immigration services and benefits
Adjudicating asylum claims
Issuing employment authorization documents (EAD)
Adjudicating petitions for non-immigrant temporary workers (H-1B, O-1, etc.)
While core immigration benefits functions remain the same as under the INS, a new goal is to process applications efficiently and effectively. Improvement efforts have included attempts to reduce the applicant backlog, as well as providing customer service through different channels, including the National Customer Service Center (NCSC) with information in English and Spanish, Application Support Centers (ASCs), the Internet and other channels. The enforcement of immigration laws remain under CBP and ICE.
USCIS focuses on two key points on the immigrant’s journey towards civic integration: when they first become permanent residents and when they are ready to begin the formal naturalization process. A lawful permanent resident is eligible to become a citizen of the United States after holding the Permanent Resident Card for at least five continuous years, with no trips out of the United States that last for 180 days or more. If, however, the lawful permanent resident marries a U.S. citizen, eligibility for U.S. citizenship is shortened to three years so long as the resident has been living with the spouse continuously for at least three years and the spouse has been a citizen for at least three years.
Forms
USCIS handles all forms and processing materials related to immigration and naturalization. This is evident from USCIS’s predecessor, the INS, (Immigration and Naturalization Service) which is defunct as of May 9, 2003.
USCIS currently handles two kinds of forms: those relating to immigration, and those related to naturalization. Forms are designated by a specific name, and an alphanumeric sequence consisting of one letter, followed by two or three digits. Forms related to immigration are designated with an I (for example, I-551, Permanent Resident Card) and forms related to naturalization are designated by an N (for example, N-400, Application for Naturalization).
Also, USCIS runs an online appointment scheduling service known as INFOPASS. This system allows people with questions about immigration to come into their local USCIS office and speak directly with a government employee about their case and so on. This is an important way in which USCIS serves the public. USCIS maintains a blog entitled “The Beacon” as well as the “@uscis” Twitter account.
Funding
Unlike most other federal agencies, USCIS is funded almost entirely by user fees.[3] Under President George W. Bush’s FY2008 budget request, direct congressional appropriations made about 1% of the USCIS budget and about 99% of the budget was funded through fees. The total USCIS FY2008 budget was projected to be $2.6 billion.[4]
Staffing
USCIS consists of 18,000 federal employees and contractors working at 250 offices around the world.[5]
On March 1, 2003, the INS ceased to exist and services provided by that organization transitioned into USCIS. Eduardo Aguirre was appointed the first USCIS Director by President Bush. In December 2005, Emilio T. Gonzalez, Ph. D., was confirmed by the U.S. Senate as the Director of USCIS, and he held this position until April 2008.[8] Nominated by President Barack Obama on April 24 and unanimously confirmed on August 7 by the U.S. Senate, Alejandro Mayorkas was sworn in as USCIS Director on August 12, 2009.
USCIS History: Major milestones of USCIS and other immigration agencies, from the 19th century to 2003
Employment authorization document
From Wikipedia, the free encyclopedia
This article includes a list of references, but its sources remain unclear because it has insufficient inline citations.Please help to improve this article by introducing more precise citations.(November 2010)
An employment authorization document (EAD, Form I-766), EAD card, known popularly as a “work permit”, is a document issued by United States Citizenship and Immigration Services (USCIS) that provides its holder a legal right to work in the US. It is similar to, but should not be confused with the green card.
Certain ‘aliens’ (non-residents) who are temporarily in the United States may file a Form I-765, application for employment authorization, to request an EAD. An EAD is issued for a specific period of time based on alien’s immigration situation. Foreign nationals with an EAD can lawfully work in the United States for any employer.
Aliens who are sponsored by US employers and issued temporary work visas for such as H, I, L-1 or O-1 visas are authorized to work for the sponsoring employer, through the duration of the visa . This is known as ’employment incident to status’. Aliens on such work visas do not qualify for an EAD according to the US Citizenship and Immigration Service regulations (8 CFR Part 274a).[1]
Currently the EAD is issued in the form of a standard credit card-size plastic card enhanced with multiple security features. The EAD card contains some basic information about alien: name, birth date, sex, immigrant category, country of birth, photo, alien registration number (also called “A-number”), card number, restrictive terms and conditions, and dates of validity.
Restriction
The eligibility for employment authorizations are detailed in the Federal Regulations at 8 C.F.R. §274a.12.[2] Only aliens who fall under the enumerated categories are eligible for an employment authorization document.
There are more than 40 types of immigration status that make their holders eligible to apply for an EAD.[3] Some are nationality-based and apply to a very small number of people. Others are much broader, such as those covering the spouses of E-1, E-2, E-3 or L-1 visa holders.
USCIS issues EADs in the following categories:
Renewal EAD: Renewal cannot be filed more than 120 days before the current employment authorization expires.
Replacement EAD: Replaces a lost, stolen, or mutilated EAD. A replacement EAD also replaces an EAD that was issued with incorrect information, such as a misspelled name.
Obtaining an EAD
Applicants would file Form I-765 (application for employment authorization) by mail with the USCIS Regional Service Center that serves the area where they live. They may also be eligible to file Form I-765 electronically (seeUSCIS Electronic Filing). For employment based green card applicants, your priority date needs to be current to apply for Adjustment of Status (I485) at which time you can apply for EAD. Typically, it is recommended to apply for Advance Parole (AP) at the same time so that you do not have to get a visa stamping when re-entering US from a foreign country.
Interim EAD
An interim EAD is an EAD issued to an eligible applicant when USCIS has failed to adjudicate an application within 90 days of receipt of a properly filed EAD application or within 30 days of a properly filed initial EAD application based on an asylum application filed on or after January 4, 1995. The interim EAD will be granted for a period not to exceed 240 days and is subject to the conditions noted on the document.
An interim EAD is no longer issued by local service centers. One can however take an INFOPASS appointment and place a service request at local centers, explicitly asking for it if the application exceeds 90 days and 30 days for asylum applicants without an adjudication .
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Americans want flight restrictions from Ebola countries. And it’s not close.
By Aaron Blake
Nearly two-thirds of Americans say they are concerned about an Ebola outbreak in the United States, and about the same amount say they want flight restrictions from the countries in West Africa where the disease has quickly spread.
A new poll from the Washington Post and ABC News shows 67 percent of people say they would support restricting entry to the United States from countries struggling with Ebola. Another 91 percent would like to see stricter screening procedures at U.S. airports in response to the disease’s spread.
Thus far, some countries in Europe have restricted flights from these countries in West Africa, and an increasing number of U.S. lawmakers are calling for similar bans. The White House has yet to increase restrictions, with federal officials saying such a move could actually increase the spread of the disease by hampering the movement of aid workers and supplies.
Concern about Ebola, at this point, is real but not pervasive. About two-thirds (65 percent) say they are concerned about an Ebola outbreak in the United States. But while people are broadly concerned about an outbreak, they are not necessarily worried about that potential outbreak directly affecting them. Just 43 percent of people are worried about themselves or someone in their family becoming infected – including 20 percent who are “very worried.”
That finding echoes a Pew poll from last week which showed just 11 percent were “very worried” about themselves or their families becoming infected. Since that survey, Dallas Ebola patient Thomas Eric Duncan died, and news that a nurse who provided care for him became infected broke on the final day of the Post-ABC poll.
By comparison, slightly more Americans said they were worried about the H1N1 virus – a.k.a. the swine flu – in October 2009 (52 percent). Concern about Ebola is about on-par with concern about Avian influenza – a.k.a. the bird flu – in 2006 (41 percent) and slightly higher than concern about Sudden Acute Respiratory Syndrome (SARS) in 2003 (as high as 38 percent).
The support for increasing restrictions puts the White House in a tough spot. Given the moves by other countries and the American public’s stance, there is increasing pressure to act. And given the very real — but still somewhat muted — concerns about the disease, that’s significant, especially if the disease continues to expand.
The Department of Homeland Security announced Tuesday that all travelers from Ebola outbreak countries in West Africa will be funneled through one of five U.S. airports with enhanced screening starting Wednesday.
Customs and Border Protection within the department began enhanced screening — checking the traveler’s temperature and asking about possible exposure to Ebola — at New York’s John F. Kennedy International Airport on Oct. 11.
Enhanced screening for travelers from Liberia, Sierra Leone and Guinea was expanded Oct. 16 to Washington Dulles, Chicago O’Hare, New Jersey’s Newark and Hartsfield-Jackson Atlanta international airports.
Those airports were supposed to screen 94% of the average 150 people per day arriving from the three countries. Lawmakers from other states asked for enhanced screening at their airports, too.
Some lawmakers have called for more restrictions, such as suspending visas or denying entry at ports for citizens from the three countries.
Jeh Johnson, secretary of Homeland Security, announced that travelers from West Africa must arrive at one of the five airports starting Wednesday.
“We are working closely with the airlines to implement these restrictions with minimal travel disruption,” Johnson said. “If not already handled by the airlines, the few impacted travelers should contact the airlines for rebooking as needed.”
The enhanced screening will apply to anyone who traveled recently to, from or through the three outbreak countries, according to the department’s announcement to be published Thursday in the Federal Register. Customs and Border Protection will work with airlines to identify potential travelers before they board, but airlines will be obligated to comply with the rule for carrying to the USA any passengers who recently traveled through the region, according to the filing.
The restrictions should affect only about nine travelers per day who would have arrived at other airports. Katie Cody, a spokeswoman for American Airlines, which serves Europe from hubs such as Philadelphia and Charlotte, said the airline has no concerns about the change.
“We have been tracking that, and we don’t have any concerns because the numbers are so small,” Cody said.
British Airways, which serves a variety of U.S. destinations other than the five targeted airports, said it would comply with the measures.
“Customers affected will be offered a refund or will be rerouted if there is availability,” spokeswoman Michele Kropf said.
Republican lawmakers offered muted praise but pressed for stricter travel restrictions.
“In addition to requiring all travelers from at-risk countries to fly through airports with enhanced screening measures in place, I continue to call on the administration to suspend all visas from Liberia, Sierra Leone and Guinea,” said Rep. Michael McCaul, R-Texas, the head of the House Homeland Security Committee.
The head of the House Judiciary Committee, Rep. Bob Goodlatte, R-Va., said a “real solution” is to deny entry to anyone from the three countries under a provision of the 1952 Immigration and Nationality Act.
“President Obama has a real solution at his disposal under current law and can use it at any time to temporarily ban foreign nationals from entering the United States from Ebola-ravaged countries,” Goodlatte said. “The vast majority of Americans strongly support such a travel moratorium, and I urge the president to take every step possible to protect the American people from danger.”
Rep. John Conyers of Michigan, the top Democrat on the House Judiciary Committee, said steering travelers through the five airports is a sensible precaution.
“As agreed upon by experts in both the public health and transportation communities, issuing a blanket travel ban would not only be counterproductive, but it would also irresponsibly impede getting much-needed supplies and relief to the countries that need it most,” Conyers said.
Roger Dow, CEO of the U.S. Travel Association, a trade group for all aspects of travel, praised the move to calm travel concerns while avoiding a travel ban.
“The Obama administration continues to heed the counsel of an overwhelming consensus of health and security experts and resist calls for any sort of travel ban on the grounds that it will be counterproductive to efforts to contain Ebola,” Dow said.
A Liberian national, Thomas Eric Duncan, who became the first person diagnosed with the disease in the USA after arriving in Dallas on Sept. 20, had a temperature of 97.3 degrees but didn’t tell airport officials in Monrovia, Liberia, that he had cared for a pregnant woman suffering from Ebola. He died Oct. 8, and two nurses who treated him have become infected.
Sen. Charles Schumer, D-N.Y., said the enhanced screening adds a layer of protection against Ebola entering the country.
“The Department of Homeland Security’s policy to funnel all passengers arriving from Ebola hot spots to one of these five equipped airports is a good and effective step towards tightening the net and further protecting our citizens,” Schumer said.
Obama and Johnson have said they will continue to monitor travel restrictions for possible changes.
“We are continually evaluating whether additional restrictions or added screening and precautionary measures are necessary to protect the American people and will act accordingly,” Johnson said.
Gabbard Calls On CDC To Increase Incubation Period To Prevent Ebola Spread
By Chad Blair
Rep. Tulsi Gabbard (D-HI) has called on the Center for Disease Control to implement stricter incubation guidelines for people who have been in contact with patients “confirmed or suspected” to have the Ebola virus.
According to a press release from her office, Gabbard is calling on the CDC to increase the quarantine and restriction period from the 21-day standard to 42 days, “based on the latest scientific studies and the World Health Organization report that the incubation period for the deadly Ebola virus can extend as long as 42 days.”
On Friday, Gabbard called for the “immediate suspension” of visas for citizens of Ebola-stricken West African nations as well as flights from those countries into the United States.
“Recent mistakes have revealed that the U.S. public health system is clearly not fully prepared to combat Ebola and prevent its spread in the United States,” she said in a statement.
Democrats like Gabbard are among a growing number who are “beginning to sound more like Republicans when they talk about Ebola. And Republicans are moving into overdrive with their criticism of the government’s handling of the deadly virus,” according to The Washington Post.
“The sharpened rhetoric, strategists say, suggests Democrats fear President Obama’s response to Ebola in the United States could become a political liability in the midterm election and Republicans see an opportunity to tie increasing concerns about the disease to the public’s broader worries about Obama’s leadership.”
The Washington Post notes, however, that Gabbard is “a liberal Democrat who is not in any danger of losing reelection.” It also reports that a Washington Post-ABC News poll showed that “67 percent of Americans would support restricting entry to the United States from countries fighting dealing with an Ebola crisis.”
How is the end of an Ebola outbreak decided and declared?
Information note – October 2014
Who decides the date?
The WHO Ebola outbreak response team is responsible for establishing the date of the end of the outbreak in collaboration with the affected country’s subcommittee for surveillance, epidemiology and laboratory.
How is the date determined?
An Ebola virus disease outbreak in a country can be declared over once 42 days have passed and no new cases have been detected. The 42 days represents twice the maximum incubation period for Ebola (21 days). This 42-day period starts from the last day that any person in the country had contact with a confirmed or probable Ebola case.
This includes health care workers who have been exposed to patients with Ebola virus disease, even if the health worker was wearing personal protective equipment and followed infection control procedures since such a person could be exposed accidentally without realizing it. In the setting of an Ebola treatment centre, the date of the last infectious contact is defined as the day when the last patient in the treatment centre tested negative for Ebola virus disease, using a real-time reverse-transcriptase polymerase chain reaction (RT-PCR) test.
If no new case has been detected at the end of this 42-day period, the risk of a further case is very low, and the outbreak is declared over.
Why 42 days?
The maximum incubation period for Ebola virus disease is 21 days. The 42-day period set by WHO (twice the maximum incubation period) provides a margin of security to cover any possible missed cases, uncertainty in reporting dates or hidden chains of transmission. (*)
During the 42-day period, the surveillance system should be fully functional, so that all contacts of the last patient are followed to detect possible chains of transmission.
What is the procedure to make the declaration?
The WHO Ebola outbreak response team in collaboration with the affected country’s subcommittee for surveillance, epidemiology and laboratory determines the date of the end of the epidemic. The government of the affected country, in collaboration with WHO and international partners, makes an official declaration of the end of the epidemic.
The Obama administration has reversed course on putting travel restrictions on those coming from three West African nations tainted with Ebola and is putting in place demands that they enter only through five U.S. airports prepared to screen for the virus.
Homeland Security Secretary Jeh Johnson said in a statement that the new rules will take effect Wednesday, bowing to demands from both parties that the U.S. do a better job so secure the border from Ebola.
“Today, as part of the Department of Homeland Security’s ongoing response to prevent the spread of Ebola to the United States, we are announcing travel restrictions in the form of additional screening and protective measures at our ports of entry for travelers from the three West African Ebola-affected countries,” said Johnson.
He said the rules require that anyone coming from Liberia, Sierra Leone or Guinea enter the U.S. only through the five airports where special Ebola screenings have been set up: New York’s John F. Kennedy, Newark Liberty, Washington Dulles, Atlanta’s Hartsfield-Jackson and Chicago’s O’Hare.
“All passengers arriving in the United States whose travel originates in Liberia, Sierra Leone or Guinea will be required to fly into one of the five airports that have the enhanced screening and additional resources in place. We are working closely with the airlines to implement these restrictions with minimal travel disruption. If not already handled by the airlines, the few impacted travelers should contact the airlines for rebooking, as needed,” said the statement.
He said that passengers flying into those airports on flights originating in Liberia, Sierra Leone and Guinea “are subject to secondary screening and added protocols, including having their temperature taken, before they can be admitted into the United States. These airports account for about 94 percent of travelers flying to the United States from these countries.”
There are no direct, non-stop commercial flights from Liberia, Sierra Leone or Guinea to the U.S.
NIH unit treating Dallas nurse for Ebola is one of 4 special isolation facilities in U.S.
By Lena H. Sun
It has a specially designed air-flow system to prevent contaminated air from leaving the patient room. It requires anyone who enters to be buzzed in. Personnel who work there receive special training in infection control to prevent the spread of bioterror agents, natural or man-made. It also has a tiny gym.
Welcome to the Special Clinical Studies Unit at the National Institutes of Health in Bethesda, Md. It is a 4,000-square-foot unit inside the NIH Clinical Center, the nation’s only hospital dedicated to research, which provides free state-of-the-art care to very sick patients from all over the world.
Now it’s home to its first confirmed Ebola patient, Nina Pham.
Pham is the first patient with a confirmed infectious disease to be cared for in the special seven-bed unit, center director John Gallin said in an interview Friday. Opened in 2010 for patients who need advanced isolation and extended stays, the unit was initially designed to take care of personnel working at the U.S. Army Medical Research Institute of Infectious Diseases in case they were exposed to infectious agents. In more recent years, it has been used to house healthy volunteers participating in live vaccine trials. The volunteers need to be monitored in a place where they can be safely quarantined, Gallin said. To accommodate those healthy volunteers, the unit has a dining room and a “tiny fitness area,” he said.
Pham, the first nurse diagnosed with Ebola after caring for a patient in Dallas, is in fair and stable condition, officials said Friday morning.
What does an Ebola isolation ward look like?
“We are giving her the best possible care on a symptomatic and systemic basis,” Anthony Fauci, director of NIH’s National Institute of Allergy and Infectious Diseases, said during a news conference.
Pham, 26, was transferred to the facility, one of four in the country with a special biocontainment unit, late Thursday. She was diagnosed with Ebola on Sunday, becoming the first person to contract the disease on U.S. soil. Pham had been part of the team that treated Thomas Eric Duncan, a Liberian man who flew to Dallas last month before being diagnosed with Ebola. Duncan died last week, four days before it was announced that Pham had contracted the disease.
“There is no specific therapy that has been proven to be effective against Ebola, and that’s why excellent medical care is critical,” Fauci said. He said Pham was “very, very tired” from her trip.
Patients infected with the Ebola virus require a large number of staffers to provide care around-the-clock. At NIH, that comes out to about 27 people a week — doctors, nurses, support staff — for one patient, Gallin said. With about 50 to 60 such personnel specially trained for infectious disease and critical care, NIH can only care for two Ebola patients at a time, he said.
The four facilities that provide such care were designed in the aftermath of the Sept. 11, 2001, terrorist attacks to protect against bioterrorism. Two of them, Emory University Hospital in Atlanta and the Nebraska Medical Center, are each treating one Ebola patient. The other facility is St. Patrick Hospital in Missoula, Mont.
They require staff to undergo more rigorous training in infection control, and staff must follow strict protocol for putting on and taking off personal protective equipment in a separate anteroom. Officials say meticulous attention to detail in following protocols is what sets them apart from other facilities.
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Emory has treated three Ebola patients, all of whom have recovered. The University of Nebraska treated one patient who recovered and is now caring for a freelance NBC cameraman. St. Patrick has not yet treated an Ebola patient. The hospital has received so many inquiries that it has set up a special hotline where they are transcribed and forwarded to the appropriate departments.
Bruce Ribner gives a tour of the Emory University Hospital isolation unit which has been used for treatment of patients infected with the Ebola virus. (Emory University via YouTube)
Unlike the Dallas hospital where Pham and another nurse were infected, which officials said most likely occurred because of a breach of protocol involving personal protective equipment, no health workers taking care of the Ebola patients at the special facilities have become infected.
“There is a step-by-step, checklisted procedure to putting on your personal protective equipment for when you go in to the patient’s room to perform your duties and when you come out,” said Mark Rupp, medical director of Nebraska Medical Center’s infection control department, which includes the special unit. “That’s the big difference with what goes on in our unit and what goes on in a regular intensive-care unit.”
The facilities have one person whose only job is to make sure health-care workers put on and take off their protective equipment correctly. At NIH, this person is dubbed “the Watson,” Gallin said, for the sidekick to Sherlock Holmes.
The Watson “has the authority to stop everything at any moment if someone looks like they’re breaking protocol,” Gallin said. The Watson has a checklist, like a pilot’s preflight checklist, and everything has to be done in that order. If not, the Watson can “scream at them and tell them to stop,” Gallin said, which apparently happened at least once Thursday night when doctors and staff were admitting Pham.
The protective gear that health-care workers take off is autoclaved (sanitized via pressurized steam) and then incinerated. Equipment that is not disposable is disinfected according to the manufacturer’s directions. The units also have negative air pressure to prevent germs from spreading beyond patient rooms. For Ebola patients, contaminated air is not such a concern because the disease is not transmitted through the air, but through contact with bodily fluids.
The seven-bed, 4,000-square-foot biocontainment unit at the National Institutes of Health Clinical Center in Bethesda, Md., is a state-of-the-art facility built to keep the world’s scariest pathogens from escaping. The four U.S. facilities are all different — NIH’s even has a gym — but they contain many of the same things. This layout is based on the unit at Emory University in Atlanta.
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President Obama Speaks on Ebola
Fast Facts on US Hospitals
The American Hospital Association conducts an annual survey of hospitals in the United States. The data below, from the 2012 AHA Annual Survey, are a sample of what you will find in AHA Hospital Statistics, 2014 edition. The definitive source for aggregate hospital data and trend analysis, AHA Hospital Statistics includes current and historical data on utilization, personnel, revenue, expenses, managed care contracts, community health indicators, physician models, and much more.
AHA Hospital Statistics is published annually by Health Forum, an affiliate of the American Hospital Association. Additional details on AHA Hospital Statistics and other Health Forum data products are available at www.ahadataviewer.com. To order AHA Hospital Statistics, call (800) AHA-2626 or click on www.ahaonlinestore.com.
For further information or customized data and research, contact the AHA Resource Center at (312) 422-2050 or rc@aha.org.
*Registered hospitals are those hospitals that meet AHA’s criteria for registration as a hospital facility. Registered hospitals include AHA member hospitals as well as nonmember hospitals. For a complete listing of the criteria used for registration, please see Registration Requirements for Hospitals.
**Community hospitals are defined as all nonfederal, short-term general, and other special hospitals. Other special hospitals include obstetrics and gynecology; eye, ear, nose, and throat; rehabilitation; orthopedic; and other individually described specialty services. Community hospitals include academic medical centers or other teaching hospitals if they are nonfederal short-term hospitals. Excluded are hospitals not accessible by the general public, such as prison hospitals or college infirmaries.
***System is defined by AHA as either a multihospital or a diversified single hospital system. A multihospital system is two or more hospitals owned, leased, sponsored, or contract managed by a central organization. Single, freestanding hospitals may be categorized as a system by bringing into membership three or more, and at least 25 percent, of their owned or leased non-hospital preacute or postacute health care organizations. System affiliation does not preclude network participation.
**** Network is a group of hospitals, physicians, other providers, insurers and/or community agencies that work together to coordinate and deliver a broad spectrum of services to their community. Network participation does not preclude system affiliation.
Ebola has officially made it to the US, but there is absolutely no reason to freak out. That’s in large part thanks to Emory University Hospital’s state-of-the-art isolation ward, which is better-equipped to field Ebola cases than any ordinary hospital in the country. Here’s a look at the tech that keeps doctors and nurses safe.
Emory is one of four high-level biocontainment patient care units in the US; the others are located at the National Institutes of Health in Maryland, Rocky Mountain Laboratories in Montana, and the University of Nebraska Medical Center. We spoke with Dr. Angela Hewlett, associate medical director at the Nebraska Biocontainment Patient Care Unit — the largest of the four facilities — about biocontainment suits, wearing three pairs of gloves, and custom air pressure systems.
Perhaps the most comfort Hewlett was able to provide is that none of the super-fancy tech that these four high-level isolation wards have at their disposal is even necessary for Ebola. “There’s a big fear factor with this illness but really, these types of patients can taken care of at any good healthcare facility,” says Dr. Hewlett.
That’s because the Ebola virus easily dies outside of the human body, so unless you’ve been handling a sick person’s blood or feces, you are almost certainly A-OK. Ebola is pretty darn hard to get compared to an airborne disease like SARS or even the regular old flu. But with a mortality rate of up to 90 per cent — and over 50 per cent with the strain in the current outbreak — we still need to keep doctors and nurses as safe as we can. Here’s how Nebraska Biocontainment Unit keeps diseases like Ebola — and much, much worse — from spreading in the hospital.
Negative air pressure. As with Emory in Atlanta, the isolation unit in Nebraska is isolated from the rest of the general hospital. It runs on its own air circulation system, and the air is passed through a high-efficiency particulate air (HEPA) filter before it is vented outside of the building. That’s the same kind of precautions that you would see in a biosafety level 4 lab (the highest) that works with deadly or highly contagious diseases.
In addition, the biocontainment unit has negative air pressure, which means that air pressure inside the isolation rooms is slightly lower than that outside. Essentially, air is gently sucked into the room, so particles from inside the room can’t float out when you open a door. As another line of protection, ultraviolet lights zap any viruses or bacteria in the air or on surfaces.
Full-body suits and THREE pairs of gloves. The Biocontainment Unit is equipped with gear that covers you head to toe, in some places three times over. That includes personal respirators, headgear, full-body suits and gloves. Healthcare workers wear three pairs, including one thick pair that protects against needle accidents, and then two pairs of ordinary gloves so they have an extra pair to work with patients.
Entering and exiting the room becomes an elaborate production because putting on and taking off all the gear can take more than 10 minutes each way. A second person assists to make sure every piece of equipment is put on right and there are no rips or tears in any of the protective gear. Afterwards, every piece of equipment is wiped down to kill the pathogen; in the case of Ebola, simple bleach is enough to do the trick. The full-body suit is discarded after each use.
Training and training and training. Having fancy technology is great but not if you don’t know how to use it properly. “They have to go through really extensive training,” says Hewlett of the the 30-person team that works in the unit. They get 80 hours of training before they can begin, followed by monthly meetings and quarterly drills, where the photos in this post were taken.
It’s worth reiterating that most of this equipment and these procedures go above and beyond protecting for Ebola. The air systems and full-body suits are really there to guard against possible airborne diseases, like smallpox or SARS or some highly contagious avian flu viruses that may emerge in the future.
In fact, the CDC’s current guidelines for treating Ebola in U.S. hospitals require only gloves, goggles, a facemask, and a gown in most situations. Even if someone inadvertently brings Ebola to other hospitals, it’s highly unlikely to spread in the U.S. The situation is different in Africa, where inadequate equipment and fear of healthcare workers has contributed to the worsening situation.
A State Department official did visit Nebraska to see whether the unit would be ready to accept any Ebola patients in the future, though the facility hasn’t yet been used despite being open for nine years. There hasn’t been a disease serious enough to merit it. “This is good thing,” says Dr. Hewlett, “However with world travel the way it is, it is inevitable these things are going to come eventually.” If and when Ebola does come to the U.S. again, we are definitely prepared, which is not something we can say about what else may be coming down the line.
Pictures: University of Nebraska Medical Center
Obama names Ron Klain as Ebola ‘czar’
David Jackson
President Obama tapped veteran government insider Ron Klain to coordinate his administration’s efforts to contain the Ebola virus Friday.
Klain, a former chief of staff to Vice Presidents Joe Biden and Al Gore, is well-known by Obama and White House aides. He was selected for his management experience and contacts throughout the government, White House spokesman Josh Earnest said.
“He is the right person for the job,” Earnest said, particularly the challenge of “integrating the interagency response.”
Klain’s appointment marks a swift turnabout for Obama, who until Thursday had resisted calls to appoint a single official to run the government’s response to Ebola.
Asked Thursday about the prospect of an “Ebola czar,” Obama said, “It may make sense for us to have one person, in part just so that after this initial surge of activity, we can have a more regular process just to make sure that we’re crossing all the t’s and dotting all the i’s going forward.”
USA TODAY
From recounts to stimulus to Ebola: Ron Klain’s resume
Obama did not mention Klain’s appointment during a speech Friday to the Consumer Financial Protection Bureau, but he said his administration is taking an “all-hands-on-deck” approach to fighting Ebola.
The administration has come under increased pressure to name an anti-Ebola coordinator in the wake of news that two nurses in Dallas contracted the deadly virus. Both had treated a man who died of Ebola.
Klain played a high-profile file in Gore’s 2000 presidential campaign. Oscar-winning actor Kevin Spacey portrayed him in an HBO movie on that year’s Florida recount.
The Ebola response includes efforts to screen travelers from West African nations where Ebola has reached epidemic proportions and killed more than 4,500 people. Klain will help coordinate the assistance the U.S. military provides in West Africa.
Some Republican lawmakers criticized Obama for entrusting the job to a former government manager rather than a professional.
Rep. Andy Harris, R-Md., tweeted, “Worst ebola epidemic in world history and Pres. Obama puts a government bureaucrat with no healthcare experience in charge. Is he serious?”
Members of the public health community expressed surprise.
“When are they going to stop making mistakes?” said Robert Murphy, the director of the Center for Global Health at Northwestern University’s Feinberg School of Medicine. “We need a czar, but optimally a strong public health expert. I am so disappointed. This is not what we need.”
Physician Amesh Adalja, a spokesman for the Infectious Diseases Society of America, said, “It’s clear that there’s a desperate desire for an organized approach to dealing with this outbreak. I don’t necessarily think we need a disease-specific czar — we have one for HIV — but more of an emerging infectious diseases/biosecurity coordinator who reports to the president.”
The Ebola position is designed to be more managerial in nature, involving an array of government agencies ranging from the Pentagon to Health and Human Services.
“This is much broader than a medical response,” Earnest said.
As for Republican criticism, Earnest joked, “That’s a shocking development.” He noted that national elections are less than three weeks away.
Klain may weigh in on another question facing the administration: the prospect of a U.S. travel ban from West African nations where there have been Ebola outbreaks.
Obama and aides have disputed the need for a travel ban, questioning whether it would work and arguing that it might create unintended problems.
Thursday, Obama said experts in infectious diseases have told him “a travel ban is less effective than the measures that we are currently instituting that involve screening passengers who are coming from West Africa.”
Klain is likely to take a low key role publicly.
Earnest said Obama wasn’t looking for an Ebola expert but “an implementation expert.”
He confirmed Klain’s title: “Ebola response coordinator.”
Klain will report to two officials involved in the anti-Ebola effort: homeland security adviser Lisa Monaco and national security adviser Susan Rice.
Obama is pleased with the work of Monaco and Rice, but “given their management of other national and homeland security priorities, additional bandwidth will further enhance the government’s Ebola response,” a White House official said, speaking on condition of anonymity.
The president has long known Klain, who helped prepare him for debates with Mitt Romney during the 2012 presidential campaign.
Klain has been out of government since leaving Biden’s staff during Obama’s first term.
The administration’s Ebola evasions reveal its disdain for the American people.
The administration’s handling of the Ebola crisis continues to be marked by double talk, runaround and gobbledygook. And its logic is worse than its language. In many of its actions, especially its public pronouncements, the government is functioning not as a soother of public anxiety but the cause of it.
An example this week came in the dialogue between Megyn Kelly of Fox News andThomas Frieden, director of the Centers for Disease Control.
Their conversation focused largely on the government’s refusal to stop travel into the United States by citizens of plague nations. “Why not put a travel ban in place,” Ms. Kelly asked, while we shore up the U.S. public-health system?
Dr. Frieden replied that we now have screening at airports, and “we’ve already recommended that all nonessential travel to these countries be stopped for Americans.” He added: “We’re always looking at ways that we can better protect Americans.”
“But this is one,” Ms. Kelly responded.
Dr. Frieden implied a travel ban would be harmful: “If we do things that are going to make it harder to stop the epidemic there, it’s going to spread to other parts of—”
Ms. Kelly interjected, asking how keeping citizens from the affected regions out of America would make it harder to stop Ebola in Africa.
“Because you can’t get people in and out.”
“Why can’t we have charter flights?”
“You know, charter flights don’t do the same thing commercial airliners do.”
“What do you mean? They fly in and fly out.”
Dr. Frieden replied that limiting travel between African nations would slow relief efforts. “If we isolate these countries, what’s not going to happen is disease staying there. It’s going to spread more all over Africa and we’ll be at higher risk.”
Later in the interview, Ms. Kelly noted that we still have airplanes coming into the U.S. from Liberia, with passengers expected to self-report Ebola exposure.
Dr. Frieden responded: “Ultimately the only way—and you may not like this—but the only way we will get our risk to zero here is to stop the outbreak in Africa.”
Ms. Kelly said yes, that’s why we’re sending troops. But why can’t we do that and have a travel ban?
“If it spreads more in Africa, it’s going to be more of a risk to us here. Our only goal is protecting Americans—that’s our mission. We do that by protecting people here and by stopping threats abroad. That protects Americans.”
Dr. Frieden’s logic was a bit of a heart-stopper. In fact his responses were more non sequiturs than answers. We cannot ban people at high risk of Ebola from entering the U.S. because people in West Africa have Ebola, and we don’t want it to spread. Huh?
In testimony before Congress Thursday, Dr. Frieden was not much more straightforward. His answers often sound like filibusters: long, rolling paragraphs of benign assertion, advertising slogans—“We know how to stop Ebola,” “Our focus is protecting people”—occasionally extraneous data, and testimony to the excellence of our health-care professionals.
It is my impression that everyone who speaks for the government on this issue has been instructed to imagine his audience as anxious children. It feels like how the pediatrician talks to the child, not the parents. It’s as if they’ve been told: “Talk, talk, talk, but don’t say anything. Clarity is the enemy.”
The language of government now is word-spew.
Dr. Frieden did not explain his or the government’s thinking on the reasons for opposition to a travel ban. On the other hand, he noted that the government will consider all options in stopping the virus from spreading here, so perhaps that marks the beginning of a possible concession.
It is one thing that Dr. Frieden, and those who are presumably making the big decisions, have been so far incapable of making a believable and compelling case for not instituting a ban. A separate issue is how poor a decision it is. To call it childish would be unfair to children. In fact, if you had a group of 11-year-olds, they would surely have a superior answer to the question: “Sick people are coming through the door of the house, and we are not sure how to make them well. Meanwhile they are starting to make us sick, too. What is the first thing to do?”
The children would reply: “Close the door.” One would add: “Just for a while, while you figure out how to treat everyone getting sick.” Another might say: “And keep going outside the door in protective clothing with medical help.” Eleven-year-olds would get this one right without a lot of struggle.
If we don’t momentarily close the door to citizens of the affected nations, it is certain that more cases will come into the U.S. It is hard to see how that helps anyone. Closing the door would be no guarantee of safety—nothing is guaranteed, and the world is porous. But it would reduce risk and likelihood, which itself is worthwhile.
Africa, by the way, seems to understand this. The Associated Press on Thursday reported the continent’s health-care officials had limited the threat to only five countries with the help of border controls, travel restrictions, and aggressive and sophisticated tracking.
All of which returns me to my thoughts the past few weeks. Back then I’d hear the official wordage that doesn’t amount to a logical thought, and the unspoken air of “We don’t want to panic you savages,” and I’d look at various public officials and muse: “Who do you think you are?”
Now I think, “Who do they think we are?”
Does the government think if America is made to feel safer, she will forget the needs of the Ebola nations? But Americans, more than anyone else, are the volunteers, altruists and in a few cases saints who go to the Ebola nations to help. And they were doing it long before the Western media was talking about the disease, and long before America was experiencing it.
At the Ebola hearings Thursday, Rep. Henry Waxman (D., Calif.) said, I guess to the American people: “Don’t panic.” No one’s panicking—except perhaps the administration, which might explain its decisions.
Is it always the most frightened people who run around telling others to calm down?
This week the president canceled a fundraiser and returned to the White House to deal with the crisis. He made a statement and came across as about three days behind the story—“rapid response teams” and so forth. It reminded some people of the statement in July, during another crisis, of the president’s communications director, who said that when a president rushes back to Washington, it “can have the unintended consequence of unduly alarming the American people.” Yes, we’re such sissies. Actually, when Mr. Obama eschews a fundraiser to go to his office to deal with a public problem we are not scared, only surprised.
But again, who do they think we are? You gather they see us as poor, panic-stricken people who want a travel ban because we’re beside ourselves with fear and loathing. Instead of practical, realistic people who are way ahead of our government.
Klain’s early experience on Capitol Hill included serving as Legislative Director for U.S. RepresentativeEd Markey. From 1989 to 1992, he served as Chief Counsel to the U.S. Senate Committee on the Judiciary, overseeing the legal staff’s work on matters of constitutional law, criminal law, antitrust law, and Supreme Court nominations. In 1995, Senator Tom Daschle appointed him the Staff Director of the Senate Democratic Leadership Committee.
Clinton administration
Klain joined the Clinton-Gore campaign in 1992. He ultimately was involved in both of Bill Clinton‘s campaigns, oversaw Clinton’s judicial nominations, and was General Counsel to Al Gore’s recount committee in the 2000 election aftermath. Some published reports have given him credit for Clinton’s “100,000 cops” proposal during the 1992 campaign; at a minimum, he worked closely with Clinton aide Bruce Reed in formulating it. In the White House, he was Associate Counsel to the President, directing judicial selection efforts, and led the team that won confirmation of Supreme Court Associate Justice Ruth Bader Ginsburg. Klain left the judicial selection role in 1994 to become Chief of Staff and Counselor to Attorney General Janet Reno. In 1995, he became Assistant to the President, and Chief of Staff and Counselor to Al Gore.
Gore campaign
During Klain’s tenure as Gore’s Chief of Staff, Gore consolidated his position as the likely Democratic nominee in 2000. Still, Klain was seen as too loyal to Clinton by some longtime Gore advisors. Feuding broke out between Clinton and Gore loyalists in the White House in 1999, and Klain was ousted by Gore campaign chairmanTony Coelho in August of that year. In October 1999, he joined the Washington, D.C. office of the law firm of O’Melveny & Myers. A year later, Klain returned to the Gore campaign, once Coelho was replaced by William M. Daley. Daley hired Klain for a senior position in the Gore campaign and then named him General Counsel of Gore’s Recount Committee.
Legal career
In 1994, Time named Klain one of the “50 most promising leaders in America” under the age of 40. In 1999, Washingtonian magazine named him the top lawyer in Washington under the age of 40, and the American Bar Association’s Barrister magazine named him one of the top 20 young lawyers nationwide. The National Law Journal named him one of its Lawyers of the Year for 2000.
Lobbying
Klain helped Fannie Mae overcome “regulatory issues”.[8]Lobbying on “regulatory issues concerning Fannie Mae” in 2004, as disclosure forms indicate Klain did, involved convincing Congress and Fannie Mae’s regulators that Fannie Mae wasn’t doing anything dangerous, and wasn’t exposing taxpayers to risk. In other words, Ron Klain got paid to help fuel the housing bubble up until a couple of years before it popped.
2004-2008
During the 2004 Presidential campaign, Klain worked as an adviser to Wesley Clark in the early primaries. Later, during the General Election, Klain was heavily involved behind the scenes in John Kerry‘s campaign and is widely credited for his role in preparing Senator Kerry for a strong performance in the debates against President George W. Bush, which gave Kerry a significant boost in the polls.[9] He then acted as an informal adviser to Evan Bayh, who is from Klain’s home state of Indiana. Klain has also commented on matters of law and policy on televised programs such as the Today Show, Good Morning America, Nightline, Capital Report,NewsHour with Jim Lehrer, and Crossfire.
In 2005, Klain left his partnership at O’Melveny & Myers to serve as Executive Vice President and General Counsel of a new investment firm, Revolution LLC, launched by AOL co-founder Steve Case.[citation needed]
Klain was mentioned as a possible replacement for White House Chief of Staff Rahm Emanuel,[12] but opted to leave the White House for a position in the private sector in January 2011.[2]
Klain apparently signed off on President Obama’s support of a $535 million loan guarantee for now-defunct solar-panel company Solyndra. Despite concerns about whether the company was viable, Klain approved an Obama visit, stating, “The reality is that if POTUS visited 10 such places over the next 10 months, probably a few will be belly-up by election day 2012.”[13]
Dr. Lurie is the Assistant Secretary for Preparedness and Response (ASPR) at the US Department of Health and Human Services (HHS).
The mission of her office is to lead the nation in preventing, responding to and recovering from the adverse health effects of public health emergencies and disasters, ranging from hurricanes to bioterrorism.
Dr. Lurie was previously Senior Natural Scientist and the Paul O’ Neill Alcoa Professor of Health Policy at the RAND Corporation. There she directed RAND’s public health and preparedness work as well as RAND’s Center for Population Health and Health Disparities. She also served as Principal Deputy Assistant Secretary of Health in the US Department of Health and Human Services; in state government, as Medical Advisor to the Commissioner at the Minnesota Department of Health; and in academia, as Professor in the University of Minnesota Schools of Medicine and Public Health. Dr. Lurie has a long history in the health services research field, primarily in the areas of access to and quality of care, mental health, prevention, public health infrastructure and preparedness and health disparities.
Dr. Lurie attended college and medical school at the University of Pennsylvania, and completed her residency and MSPH at UCLA, where she was also a Robert Wood Johnson Foundation Clinical Scholar. She is the recipient of numerous awards, and is a member of the Institute of Medicine.
Finally, Dr. Lurie continues to practice clinical medicine in the health care safety net in Washington, DC. She has three sons.
Nicole Lurie
From Wikipedia, the free encyclopedia
[hide]This article has multiple issues. Please help improve it or discuss these issues on the talk page.
The Assistant Secretary for Preparedness and Response serves as the Secretary’s principal advisor on matters related to bioterrorism and other public health emergencies. The ASPR also coordinates interagency activities between HHS, other Federal departments, agencies, and offices, and State and local officials responsible for emergency preparedness and the protection of the civilian population from acts of bioterrorism and other public health emergencies.[2] The mission of her office is to lead the nation in preventing, responding to and recovering from the adverse health effects of public health emergencies and disasters. Dr. Lurie was nominated to the position by President Obama on May 12, 2009[3] and her confirmation by the U.S. Senate[4] was announced by HHS Secretary Kathleen Sebelius on July 10, 2009.[5]
Dr. Lurie has served as the Senior Natural Scientist and the Paul O’ Neill Alcoa Professor of Health Policy at the RAND Corporation.[7] There she directed RAND’s public health and preparedness work as well as RAND’s Center for Population Health and Health Disparities. She has previously served in federal government, as Principal Deputy Assistant Secretary of Health in the US Department of Health and Human Services; in state government, as Medical Advisor to the Commissioner at the Minnesota Department of Health; and in academia, as Professor in the University of Minnesota School of Medicine and the University of Minnesota School of Public Health. Dr. Lurie has a long history in the health services research field, primarily in the areas of access to and quality of care, managed care, mental health, prevention, public health infrastructure and preparedness and health disparities.
Lurie has served as the Senior Editor for Health Services Research and has served on editorial boards and as a reviewer for numerous journals. She has served on the council and was President of the Society of General Internal Medicine,[8] and on the board of directors for Academy Health, and has served on multiple other national committees.
Story 1: Breaking News — Third Confirmed Case of Ebola in Dallas, Texas, Airborne Ebola Spreading Through Tiny Aerosolized Droplets in Sneezes and Coughs — Time To Send Ebola Patients to A Biosafety Level 4 Safety Hospitals with A Total of 19 Beds — Videos
“We shall not grow wiser before we learn that much that we have done was very foolish.”
Friedrich August von Hayek
Obama Calls for CDC ‘SWAT’ Team for Ebola Virus
Response Team to Be Sent for Any Ebola Case: Obama
Experts: Ebola Could Go Airborne, Kill Millions
Expert Doctor says CDC is lying about Ebola virus
Ebola strain appears to be different
Second Health Care Worker Tests Positive For Ebola In Texas
Dallas Mayor: ‘It May Get Worse Before it Gets Better’
Texas officials confirm second healthcare worker has Ebola
CDC: Ebola patient flew on plane before diagnosis
CDC Set To Slow Large Ebola Outbreak by Placing Doctors At Risk
BioContainment Unit at The Nebraska Medical Center
USAMRIID The US Army Medical Research Institute of Infectious Disease
USAMRIID Overview
Activation- A Nebraska Medical Center Biocontainment Unit Story
US Army: Ebola like FLU needs Winter Weather to go AIRBORNE
Max Alert! EBOLA Bodily Fluids Readily Airborne Weaponizable
Aerosolizing ONE DROP of EBOLA = 1/2 MILLION DEAD
Ebola – The Truth About the Outbreak (Documentary)
Why Do Viruses Kill
MicroKillers: Super Flu
The Influenza Pandemic of 1918
We Heard the Bells: The Influenza of 1918 (full documentary)
In 1918-1919, the worst flu in recorded history killed an estimated 50 million people worldwide. The U.S. death toll was 675,000 – five times the number of U.S. soldiers killed in World War I. Where did the 1918 flu come from? Why was it so lethal? What did we learn?
RED ALERT: TOP GENERAL WARNS EBOLA WILL NOT STAY IN WEST AFRICA!!!!
Dallas Mayor: ‘It May Get Worse Before it Gets Better’
“There are two things that I harken back to this. The only way that we are going to beat this is person by person, moment by moment, detail by detail. We have those protocols in place, the city and county, working closely with the CDC and the hospital. The second is we want to minimize rumors and maximize facts. We want to deal with facts, not fear. And I continue to believe that while Dallas is anxious about this and with this news this morning, the anxiety level goes up a level, we are not fearful and I’m pleased and proud of the citizens that I talk to day in and day out knowing that there is hope if we take care and do what is right in these details. It may get worse before it gets better. But it will get better.”
The comments were given at a news conference in Dallas this morning announcing that another hospital worker in Dallas has been diagnosed with Ebola.
Nurses’ Union: Ebola Patient Left In Open Area Of ER For Hours
A Liberian Ebola patient was left in an open area of a Dallas emergency room for hours, and nurses treating him worked without proper protective gear and faced constantly changing protocols, according to a statement released by the nation’s largest nurses’ union.
Among those nurses was Nina Pham, 26, who has been hospitalized since Friday after catching Ebola while caring for Thomas Eric Duncan, the first person diagnosed with the virus in the U.S. He died last week.
Public-health authorities announced Wednesday that a second Texas Health Presbyterian Hospital health care worker had tested positive for Ebola, raising more questions about whether American hospitals and their staffs are adequately prepared to contain the virus.
The CDC has said some breach of protocol probably sickened Pham, but National Nurses United contends the protocols were either non-existent or changed constantly after Duncan arrived in the emergency room by ambulance on Sept. 28.
Medical records provided to The Associated Press by Duncan’s family show that Pham helped care for him throughout his hospital stay, including the day he arrived in intensive care with diarrhea, abdominal pain, nausea and vomiting, and the day before he died.
When Pham’s mother learned she was caring for Duncan, she tried to reassure her that she would be safe.
Pham told her: “Mom, no. Don’t worry about me,” family friend Christina Tran told The Associated Press.
Duncan’s medical records make numerous mentions of protective gear worn by hospital staff, and Pham herself notes wearing the gear in visits to Duncan’s room. But there is no indication in the records of her first encounter with Duncan, on Sept. 29, that Pham donned any protective gear.
Deborah Burger of National Nurses United, who convened a conference call with reporters to relay what she said were concerns of nurses at the hospital, said they were forced to use medical tape to secure openings in their flimsy garments and worried that their necks and heads were exposed as they cared for Duncan.
RoseAnn DeMoro, executive director of Nurses United, said the statement came from “several” and “a few” nurses, but she refused repeated inquiries to state how many. She said the organization had vetted the claims, and that the nurses cited were in a position to know what had occurred at the hospital. She did not specify whether they were among the nurses caring for Duncan.
The nurses allege that his lab samples were allowed to travel through the hospital’s pneumatic tubes, possibly risking contaminating of the specimen-delivery system. They also said that hazardous waste was allowed to pile up to the ceiling.
Wendell Watson, a Presbyterian spokesman, did not respond to specific claims by the nurses but said the hospital has not received similar complaints.
“Patient and employee safety is our greatest priority, and we take compliance very seriously,” he said in a statement. He said the hospital would “review and respond to any concerns raised by our nurses and all employees.”
The nurses’ statement said they had to “interact with Mr. Duncan with whatever protective equipment was available,” even as he produced “a lot of contagious fluids.” Duncan’s medical records underscore that concern. They also say nurses treating Duncan were also caring for other patients in the hospital and that, in the face of constantly shifting guidelines, they were allowed to follow whichever ones they chose.
When Ebola was suspected but unconfirmed, a doctor wrote that use of disposable shoe covers should also be considered. At that point, by all protocols, shoe covers should have been mandatory to prevent anyone from tracking contagious body fluids around the hospital.
A few days later, however, entries in the hospital charts suggest that protection was improving.
“RN entered room in Tyvek suits, triple gloves, triple boots, and respirator cap in place,” a nurse wrote.
The Presbyterian nurses are not represented by Nurses United or any other union. DeMoro and Burger said the nurses claimed they had been warned by the hospital not to speak to reporters or they would be fired.
The AP has attempted since last week to contact dozens of individuals involved in Duncan’s care. Those who responded to reporters’ inquiries have so far been unwilling to speak.
David R. Wright, deputy regional administrator for the U.S. Centers for Medicare & Medicaid Services, which monitors patient safety and has the authority to withhold federal funding, said his agency is going to want to get all of the information the nurses provided.
“We can’t talk about whether we’re going to investigate or not, but we’d be interested in hearing that information,” he said.
CDC officials did not immediately respond to requests for comment.
Duncan first sought care at the hospital’s ER late on Sept. 25 and was sent home the next morning. He was rushed by ambulance back to the hospital on Sept. 28. Unlike his first visit, mention of his recent arrival from Liberia immediately roused suspicion of an Ebola risk, records show.
The CDC said 76 staff members at the hospital could have been exposed to Duncan after his second ER visit. Another 48 people who may have had contact with him before he was isolated are being monitored. Pham remained hospitalized Tuesday in good condition and said in a statement that she was doing well.
The Rev. Jim Khoi, pastor at Our Lady of Fatima Church in Fort Worth, which Pham’s family attends, said the 2010 Texas Christian University nursing school graduate appeared to be in good spirits when she spoke to her mother via video chat.
Pham’s mother, Ngoc Pham, is “calm,” Khoi said. “She trusts in God. And she asks for prayers.”
CDC: Ebola Patient Traveled By Air With “Low-Grade” Fever
The CDC has announced that the second healthcare worker diagnosed with Ebola — now identified as Amber Joy Vinson of Dallas — traveled by air Oct. 13, with a low-grade fever, a day before she showed up at the hospital reporting symptoms.
The CDC is now reaching out to all passengers who flew on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth. The flight landed at 8:16 p.m. CT.
All 132 passengers on the flight are being asked to call 1 800-CDC INFO (1 800 232-4636). Public health professionals will begin interviewing passengers about the flight Wednesday afternoon.
“Although she (Vinson) did not report any symptoms and she did not meet the fever threshold of 100.4, she did report at that time she took her temperature and found it to be 99.5,” said CDC Director Tom Frieden. Her temperature coupled with the fact that she had been exposed to the virus should have prevented her from getting on the plane, he said. “I don’t think that changes the level of risk of people around her. She did not vomit, she was not bleeding, so the level of risk of people around her would be extremely low.”
Vinson first reported a fever to the hospital on Tuesday (Oct. 14) and was isolated within 90 minutes, according to officials. She did not exhibit symptoms while on the Monday flight, according to crew members. However, the CDC says passenger notification is needed as an “extra level of safety” due to the proximity in time between the flight and the first reported symptoms.
“Those who have exposures to Ebola, she should not have traveled on a commercial airline,” said Dr. Frieden. “The CDC guidance in this setting outlines the need for controlled movement. That can include a charter plane; that can include a car; but it does not include public transport. We will from this moment forward ensure that no other individual who is being monitored for exposure undergoes travel in any way other than controlled movement.”
Frieden specifically noted that the remaining 75 healthcare workers who treated Thomas Duncan at Texas Health Presbyterian Hospital will not be allowed to fly. The CDC will work with local and state officials to accomplish this.
Frontier Airlines is working closely with the CDC to identify and notify all passengers on the flight. The airline also says the plane has been thoroughly cleaned and was removed from service following CDC notification early Wednesday morning.
However, according to Flighttracker, the plane was used for five additional flights on Tuesday before it was removed from service. Those flights include a return flight to Cleveland, Cleveland to Fort Lauderdale–Hollywood International Airport (FLL), FLL to Cleveland, Cleveland to Hartsfield–Jackson Atlanta International Airport (ATL), and ATL to Cleveland.
While in Ohio, Vinson visited relatives, who are employees at Kent State University. The university is now asking Vinson’s three relatives stay off campus and self-monitor per CDC protocol for the next 21 days out of an “abundance of caution.”
“It’s important to note that the patient was not on the Kent State campus,” said Kent State President Beverly Warren. “She stayed with her family at their home in Summit County and did not step foot on our campus. We want to assure our university community that we are taking this information seriously, taking steps to communicate what we know,” said Dr. Angela DeJulius, director of University Health Services at Kent State.
Vinson is a Kent State graduate. She received degrees from there in 2006 and 2008.
Cleveland’s Public Health Director, Toinette Parrilla, said Vinson was visiting in preparation for her wedding. While there, she visited her mother and her fiance.
The latest Ebola diagnosis was announced by the Texas Department of State Health Services early Wednesday morning.
Vinson is the second worker at Presbyterian Hospital to be diagnosed after providing health care to Duncan, the first person to be diagnosed with Ebola in the United States. He died last week.
Medical records provided to The Associated Press by Thomas Eric Duncan’s family show Amber Joy Vinson was actively engaged in caring for Duncan in the days before his death. The records show she inserted catheters, drew blood, and dealt with Duncan’s body fluids.
Dallas Mayor Mike Rawlings addressed the media on Wednesday, saying the patient lives alone and has no pets.
“It may get worse before it gets better,” Rawlings said, “but it will get better.”
Crews worked to decontaminate the common areas of Vinson’s Dallas apartment building Tuesday morning. The apartment unit will be decontaminated by contractors starting early Wednesday afternoon.
The CDC announced that Vinson will be transported to Emory Hospital in Atlanta for further treatment. Two previous American Ebola patients, Dr. Kent Brantly and Nancy Writebol, were treated at Emory and were the first Ebola patients to be treated in the United States. They were released in August.
Nina Pham was diagnosed with the virus over the weekend and remains isolated in good condition. Pham’s dog — a Cavalier King Charles Spaniel named Bentley — has been taken into custody and is being cared for at an undisclosed location.
Frontier Airlines released the following statement:
“At approximately 1:00 a.m. MT on October 15, Frontier was notified by the CDC that a customer traveling on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth on Oct. 13 has since tested positive for the Ebola virus. The flight landed in Dallas/Fort Worth at 8:16 p.m. local and remained overnight at the airport having completed its flying for the day at which point the aircraft received a thorough cleaning per our normal procedures which is consistent with CDC guidelines prior to returning to service the next day. It was also cleaned again in Cleveland last night. Previously the customer had traveled from Dallas Fort Worth to Cleveland on Frontier flight 1142 on October 10.
Customer exhibited no symptoms or sign of illness while on flight 1143, according to the crew. Frontier responded immediately upon notification from the CDC by removing the aircraft from service and is working closely with CDC to identify and contact customers who may traveled on flight 1143.
Customers who may have traveled on either flight should contact CDC at 1 800 CDC-INFO.
The safety and security of our customers and employees is our primary concern. Frontier will continue to work closely with CDC and other governmental agencies to ensure proper protocols and procedures are being followed.”
Frontier jet made 5 flights before taken out of service in Ebola scare
The Frontier Airlines jet that carried a Dallas healthcare worker diagnosed with Ebola made five additional flights after her trip before it was taken out of service, according to a flight-monitoring website.
Denver-based Frontier said in a statement that it grounded the plane immediately after the carrier was notified late Tuesday night by the Centers for Disease Control and Prevention about the Ebola patient.
Ebola patient flew day before symptoms surfaced
Amber Joy Vinson of Dallas, traveled by air on Oct. 13, the day before she first reported symptoms.
Flight 1143, on which the woman flew from Cleveland to Dallas/Fort Worth, was the last trip of the day Monday for the Airbus A320. But Tuesday morning the plane was flown back to Cleveland and then to Fort Lauderdale, Fla., back to Cleveland and then to Atlanta and finally back to Cleveland again, according to Daniel Baker, chief executive of the flight-monitoring site Flightaware.com.
He said his data did not include any passenger manifests, so he could not tell how many total passengers flew on the plane Tuesday.
The airline said it is working with the CDC to contact all 132 passengers on the Monday flight that carried the Ebola patient.
Frontier could not be reached to confirm the FlightAware data, and it was unclear if passengers on the additional flights were being contacted.
The passenger “exhibited no symptoms or sign of illness while on Flight 1143, according to the crew,” Frontier said.
The plane went through a routine but “thorough” cleaning Monday night, Frontier said. Airline industry experts said routine overnight cleaning includes wiping down tray tables, vacuuming carpet and disinfecting restrooms.
The healthcare worker also had flown to Cleveland from Dallas three days earlier on Frontier Flight 1142, the airline reported.
In response to the news that another Ebola patient flew on a commercial flight, the union that represents 60,000 flight attendants on 19 airlines is asking the CDC to monitor and care for the four flight attendants who were on flight from Cleveland to Dallas/Fort Worth.
cComments
whats it going to take to close the border to people from africa? 10 dead? 100 dead? 1000 dead? we know obumma doesnt give a flying fluke about the american citizens, but isn’t there someone in the government with an ounce of brains? or is this part of obumma’s scheme to declare martial law?…
The Assn. of Flight Attendants “will continue to press that crew members are regularly monitored and provided with any additional resources that may be required,” the group said.
The Ebola scare prompted the union last week to call for better measures to protect flight attendants from exposure to the deadly virus.
The group’s international president, Sara Nelson, suggested that flight attendants are being asked to do too much in the fight against Ebola.
“We are not, however, professional healthcare providers and our members have neither the extensive training nor the specialized personal protective equipment required for handling an Ebola patient,” she said in a statement.
Earlier this month, United Airlines was rushing to contact passengers who flew on two flights that carried a Liberian man infected with Ebola from Brussels to Washington, D.C., and then to Dallas.
The Ebola-stricken healthcare worker who flew on Frontier had been treating the Liberian man, Thomas Eric Duncan, who has since died.
Airline-industry stock prices have taken a beating in recent weeks, with some analysts blaming the Ebola scare.
On Wednesday, stocks of Delta Air Lines and American Airlines fell more than 6% in early trading before partially recovering. With less than 90 minutes remaining in the regular trading session, the two stocks were each down about 2% from Tuesday’s closes. Frontier is privately held.
There are only 19 level 4 bio-containment beds in the whole of the United States…and four in the UK
Liz Bennett
The UK is well set for an Ebola outbreak (sarcasm alert) We have TWO isolation units, but one is getting ‘redeveloped’ so it’s not available right now. Called High Security Infectious Diseases Units there are two in the country, each capable of taking two patients. One is at The Royal Free Hospital in Hampstead North London, the other, the one getting a bit of a make-over, is at The Royal Victoria Infirmary in Newcastle, up in the north-east of England.
Four level 4 bio-containment beds between 69,000,000 people
In the US there are 4 units geared up to handle Ebola. The National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, has 3 beds. Nebraska Medical Center, Omaha, has 10 beds. Emory Hospital, Atlanta has 3 beds and St Patricks Hospital, Missoula has 3 beds (source)
19 level four biocontainment beds for 317,000,000 people
I think we just found out why the government(s) are under-playing the situation. They simply do not have the facilities to cope with even a small outbreak. They are, in fact in exactly the same position as the dirt-poor hospitals in West Africa…there are not enough facilities to stop the spread of the disease if it gets out. The quality of care is better, but the availability of containment most likely isn’t.
I am sure ‘regular’ isolation units will be pressed into use but they are not designed to handle level 4 biohazards, they are nowhere near as secure medically speaking, as biocontainment units.
A couple of days ago I explained how exponential spread works. You can read that article here if you like. As a quick recap. Once a disease is at the point where every carrier infects 2 more people,(exponential spread) it will continue until it:
A) runs out of hosts
B) is stopped by medical science or
C) mutates into something less harmful.
What follows will show you how woefully inadequately our governments have prepared for something as lethal as Ebola.
In the flu pandemic of 1918-1920 28% of Americans were infected with the disease…try to remember I am talking numbers here not HOW disease spreads or any medical similarities between diseases, 625,000 Americans lost their lives out of some 29,400,000 infections. The population of the United States at that time was 105,000,000 people. (source)
Fast forward to today. If that flu pandemic had hit the United States in 2014, when the population stands at 317,000,000 people 88,760,000 people would have been infected and 2,130,240 of them would have died.
Now, let’s try this with Ebola. I have picked Liberia just because it is in the news due to the Thomas Duncan case.
Liberia has a population of 4,290,000 people, as of the latest figures there have been 3692 cases of Ebola, this represents 0.0086% of the population.Of those infections, 1998 people have died that’s a fatality rate of 54%. (source)
If that same infection and death rate were applied to the United States Ebola would infect 269,000 people and of those 156,281 would die.
Now, if as doctors and scientists fear the basic reproduction rate rises to 2 in Liberia the numbers change very quickly. Using the mean average incubation time of 9 days it would take around 13 weeks for the entire population of Liberia to become infected. (10 doublings starting with 3692 = just under the population of Liberia. This multiplied by 9 days gives us 90 days which divided by 7 gives 12.85 weeks.) Of the 4,290,000 people infected 2,316,000 would lose their lives.
This is just Liberia, not the other affected countries in West Africa.
Translated to an equivalent outbreak in the United States, where the basic reproduction rate is also 2, the numbers are horrifying. Starting with patient zero it would take around 245 days, 35 weeks for every person in the United States to become infected. Of those 17,118,000 people would die. (27.17 doublings x 9 days = 245 days =35 weeks)
Please remember the figures for Liberia are pulled from the CDC website, the percentages are correct.
United States was based on exactly the same parameters as for Liberia…a like for like comparison.
The CDC could be spending their time educating people, advising people to stock up, get ready for the possibility of staying in their homes. Self imposed isolation, or if need be state imposed isolation, that may last for an extended time period may become a reality. They’re not doing it though are they? They are sprouting figures and applying them to West Africa, and they can’t even get that right. They are saying that there could be 1.4 deaths in West Africa in a worst case scenario. When actually applying the figures they supplied with some simple mathematics we can see that 1.4 million deaths is a gross understatement.
Even a basic reproduction rate of 1.7, the latest figure for Liberia it will only take around 30 weeks to get to the same point as the above scenario, over 2,000,000 dead.
Don’t get me wrong, I am not saying that the UK government is any better, if anything they are worse, they don’t even try to do the maths. Most of them went to Eton (a very expensive school that churns out politicians) so it’s unlikely they would be capable of it even if they wanted to. You only have to look at our national finances to see they are no good at sums. They send out press briefings that there will be an emergency COBRA meeting, do you have any clue what that stands for? Let me enlighten you, Cabinet Office Briefing Room A. COBRA is not an emergency planning group, it’s an effing office.
Although I am loathed to say it, it’s time that our governments started worrying about the facilities at home rather than worrying about the facilities abroad. Stopping the disease in Africa does not mean we are out of the woods. There are so many unreported cases, people turned away from medica facilities in West Africa that nobody has the slightest idea how many cases of Ebola are actually out there. The porous borders of the region mean that people move around without the controls that are usually exercised in the west. There has to be a travel ban on non-US citizens entering the United States from these areas, the same applies from the UK.
Border control has to be improved in both countries if we have any hope of halting the spread of this terrible disease. The west is going to be the destination for anyone from Ebola hit areas that can afford to make their way from Africa. Many West Africans have contacts in the west who will help them get out, and shelter them when they arrive. As harsh as it seems this has to be stopped, it’s time for governments to put their own citizens first. Repatriation of your own is one thing, risking millions of lives at home because you won’t man up and prevent foreigners entering is quite another.
Guinea, Liberia and Sierra Leone have been struggling since March to stop what has become the largest Ebola outbreak ever recorded. The disease is causing widespread fear and disruption in West Africa, and shows no signs of being brought under control.
CHRONOLOGY OF COVERAGE
OCT. 15, 2014
Spain’s ad hoc, improvisational response to citizens infected by Ebola virus and brought back to the country underscores holes in West’s readiness to confront wider outbreak; cases of Ebola in Spain have raised urgent questions about risks of disease spreading even in developed countries, particularly among health care workers. MORE
OCT. 15, 2014
Doctors Without Borders criticizes lack of reliable evacuation systems from West Africa, saying that more would volunteer to fight Ebola in region if it were not so difficult to leave in case of emergency; cites fact that it took 50 hours to evacuate French nurse to Paris after she tested positive for virus. MORE
OCT. 15, 2014
Bellevue Hospital is designated as center for treatment of the Ebola virus should it emerge in New York City; announcement comes amid widespread concerns that disease may not be so easily contained by every hospital that has an isolation unit. MORE
OCT. 15, 2014
World Health Organization warns new cases of Ebola virus could reach 10,000 a week in West Africa by December, nearly 10 times the current rate; reports none of the three most heavily affected countries, Liberia, Sierra Leone and Guinea, are adequately prepared for epidemic; comments come in report before the United Nations Security Council, which voices fear that epidemic could renew the risk of political instability in a region barely recovering from civil war.MORE
OCT. 15, 2014
Dr Thomas R Frieden, Centers for Disease Control and Prevention director, acknowledges for first time that quicker and more concerted action on agency’s part might have kept Dallas nurse from contracting Ebola virus; says agency plans a more robust response to any future Ebola cases in American hospitals. MORE
OCT. 15, 2014
Frank Bruni Op-Ed column contends other, more common ailments deserve more concern and attention in United States than Ebola; points out influenza kills between 3,000 and 50,000 Americans per year, and skin cancer kills 10,000 per year; lists other common, and much-researched, illnesses that Americans should vaccinate and protect themselves against. MORE
OCT. 15, 2014
Jere Longman On Soccer column examines plight of SIerra Leone’s national soccer team, caught amid self-destructive feud between nation’s soccer federation and sports ministry; observes that team was already exhausted from playing road-only games due to Ebola outbreak. MORE
OCT. 14, 2014
Transmission of Ebola virus to Dallas nurse Nina Pham forces Centers for Disease Control and Prevention to reconsider its approach to containing the disease; state and federal officials are re-examining whether equipment and procedures are adequate or too loosely followed, and whether more decontamination steps are necessary when health workers leave isolation units. MORE
OCT. 14, 2014
Experience of Emory University Hospital in Atlanta in caring for three Ebola patients calls into question oft repeated assurances from federal health officials that most American hospitals can safely treat disease; transmission of virus to Dallas nurse Nina Pham has also raised questions about general level of preparedness in hospitals around the country; medical experts have begun to suggest it may be better to transfer patients to designated centers with expertise in treating Ebola. MORE
OCT. 14, 2014
Public health concerns about Ebola virus have spread to both political parties, which are engaged in finger-pointing debate that could jar midterm elections; Republicans blame the Obama administration for failing to protect the United States, and Democrats are saying it is GOP budget cutting that has put Americans at risk. MORE
OCT. 14, 2014
Experts rule out notion that Ebola virus has become a super-pathogen and raise doubts that it will evolve into one; say virus is not fundamentally different from those in previous outbreaks dating back to 1976, and it is highly unlikely that natural selection will give it ability to spread more easily, particularly by becoming airborne. MORE
OCT. 14, 2014
Friends of Dallas nurse Nina Pham describe the 26-year-old, part of the team that treated Thomas Eric Duncan, as conscientious and caring, and from a very private family. MORE
OCT. 14, 2014
Editorial warns effort to combat the Ebola virus in Western Africa is lagging dangerously behind; contends the international community must dramatically step up aid if epidemic is to be controlled; holds obligation is particularly strong for the United Sates as it faces first case of patient who contracted the virus domestically. MORE
OCT. 14, 2014
Sierra Leone’s national soccer team is enduring a series of demeaning and discouraging indignities since outbreak of Ebola in West Africa; team is barred from playing in its own stricken country and it must play every match on the road as it struggles to qualify for the 2015 Africa Cup of Nations, continent’s biennial championship. MORE
OCT. 14, 2014
World Bank president Dr Jim Yong Kim, frustrated with slow global response to Ebola outbreak, has made fighting epidemic his mission, driving bank to act on Ebola with uncharacteristic speed; bank has committed $400 million to fighting disease. MORE
OCT. 13, 2014
The topic everyone on Wall Street is discussing urgently but quietly isn’t the volatile stock market. It is Ebola. MORE
OCT. 13, 2014
News that a nurse at Texas Health Presbyterian Hospital has contracted Ebola virus transforms part of Dallas into scene of concern and contamination; residents in victim’s neighborhood are filled with anxiety, while hazardous-materials crews scramble to clean her apartment building. MORE
OCT. 13, 2014
Nurse at Texas Presbyterian Hospital in Dallas becomes first person to contract Ebola within United States; development prompts local, state and federal officials to scramble to determine how she became infected, despite wearing protective gear, and to monitor others potentially at risk; news further stokes fears among health care workers across country. MORE
OCT. 13, 2014
Centers for Disease Control and Prevention say agency will take new steps to help hospital workers protect themselves, providing more training and urging hospitals to practice dealing with potential Ebola patients. MORE
OCT. 13, 2014
Op-Ed article by Prof Siddhartha Mukherjee contends Ebola case of Thomas Eric Duncan in Dallas shows that medical community must rethink concept of quarantine, in light of the absence of any established anti-viral treatment; calls for development of pilot program for rapid-testing quarantine. MORE
OCT. 12, 2014
Liberian Army has suddenly become linchpin in fight against Ebola virus rampaging the country; for decades, Liberians viewed the armed forces with fear due to atrocities committed during civil war. MORE
OCT. 11, 2014
Doctors Without Borders, first to respond to Ebola crisis in West Africa, remains primary international medical aid group battling disease there; strained and overworked charity has erected six treatment centers in West Africa, with plans for more, and has treated the majority of patients, just as they have in previous Ebola outbreaks and some other epidemics in the developing world. MORE
OCT. 10, 2014
Health workers at International Medical Corps treatment center in Liberia face dilemma of how to care for newborn whose mother may have died of Ebola; many health workers have contracted Ebola while attending to births and being exposed to blood and other body fluids, provoking fears of providing maternity care; doctors speculate that Ebola can be transmitted from mother to baby (Series: The Ebola Ward). MORE
OCT. 10, 2014
Britain says it will introduce measures at airports and rail terminals to screen passengers from affected countries as concerns over Ebola grow in Europe. MORE
OCT. 10, 2014
Presidents of Guinea, Liberia and Sierra Leone, nations most affected by the Ebola outbreak, implore world leaders to increase their support to fight the disease; speak at meeting of the World Bank and the International Monetary Fund in Washington. MORE
OCT. 10, 2014
Nebraska Biocontainment Patient Care Unit in Omaha, with arrival of two Ebola patients in last six weeks, is at forefront of the nation’s response to the disease; unit’s 10 beds sat empty for years. MORE
OCT. 10, 2014
Dallas officials say Sgt Michael Monnig, local shefiff’s deputy examined for possible infection with Ebola virus, has tested negative and is sent home from hospital; many in city remain uneasy. MORE
OCT. 9, 2014
Thomas Eric Duncan dies of Ebola in Dallas, renewing questions about whether delay in receiving treatment could have played a role in his death and what role it played in the possibility of his spreading the disease to others; it remains unclear why, and how, Texas Health Presbyterian Hospital did not initially view the Liberian man as a potential Ebola case; nearly 50 people who came into contact with Duncan when he was experiencing active symptoms are being monitored. MORE
OCT. 9, 2014
Federal health officials will require temperature checks for the first time at five major American airports for people arriving from three West African countries hardest hit by Ebola epidemic; however, health experts say measures are more likely to calm worried public than to prevent people with Ebola from entering country; move comes after death of Thomas Eric Duncan, Liberian man who was the first person diagnosed with Ebola in the United States. MORE
OCT. 9, 2014
Bellevue Hospital Center in Manhattan shows off its isolation rooms and its leave-no-skin-cell-uncovered precautions in an attempt to reassure New Yorkers that should the Ebola virus arrive in the city, its premier public hospital could handle it. MORE
OCT. 9, 2014
European leaders are scrambling to upgrade their response to Ebola crisis after Pres Obama’s announcement that he will send 3,000 troops to West Africa to build hospitals and otherwise help in fight against the disease. MORE
OCT. 9, 2014
Spanish health officials explain how auxiliary nurse Maria Teresa Romero Ramos became the first Ebola case in Western Europe, saying that it was likely she became infected when she touched her face with the gloves she had worn while tending to a Spanish missionary with Ebola at a Madrid hospital. MORE
OCT. 9, 2014
Dog named Excalibur who belonged to Ebola-infected nurse Maria Teresa Romero Ramos is destroyed by Spanish health officials, even as protesters and animal rights activists surround Madrid home of the nurse and her husband; online petition calling for dog’s life to be spared drew hundreds of thousands of signatures. MORE
OCT. 9, 2014
Editorial notes new screening procedures directed at travelers entering United States from Guinea, Liberia or Sierra Leone, center of the Ebola epidemic in West Africa; holds screenings, while burdensome and possibly of little practical value, may ease public anxieties about keeping virus out of country and assure people that risks are being minimized. MORE
OCT. 8, 2014
Schedule for a single day at newly opened Ebola treatment center in Suakoko, Liberia, run by International Medical Corps charity, offers portrait of efforts to halt spread of virus; center is both ordinary and otherwordly, where health workers tend to those infected and those quarantined while awaiting test results (Series: The Ebola Ward).MORE
OCT. 8, 2014
Spain’s government comes under heavy criticism for its handling of Western Europe’s first Ebola case, as health care workers argue that they have not been given proper training or equipment to handle the disease; government quarantines three more people and monitors dozens who had come into contact with infected nurse. MORE
OCT. 8, 2014
Centers for Disease Control and Prevention scrambles to address concerns from health workers nationwide as anxiety mounts over Ebola virus; agency has scheduled two nationwide conference calls, but has so far not changed its recommendations on protective gear.MORE
OCT. 8, 2014
Doctors report first positive signs in recovery of Thomas Eric Duncan, Liberian man battling Ebola virus in Dallas hospital; Duncan’s temperature and blood pressure have normalized, though he remains on a ventilator and is still receiving kidney dialysis. MORE
OCT. 8, 2014
Centers for Disease Control and Prevention officials promise additional measures to screen airline passengers arriving in United States for Ebola virus; remain opposed to draconian travel restrictions such as outright bans, saying that they would cause more problems than they would solve. MORE
OCT. 7, 2014
Nurse in Spain becomes first health worker to be infected with Ebola virus outside West Africa, raising serious concerns about how prepared Western nations are to safely treat people with the deadly illness; nurse contracted the illness while treating a Spanish missionary who was infected in Sierra Leone and flown to Madrid, where he died; infection exposes weak spots in Spain’s highly praised health care defense systems. MORE
OCT. 7, 2014
Adel Faqih, Saudi Arabia’s acting health minister, says this year’s hajj has been free of Ebola and other contagious diseases like Middle East Respiratory Syndrome because of measures taken to protect more than two million Muslim pilgrims. MORE
OCT. 7, 2014
Pres Obama says screening for Ebola virus at airports both in the United States and West Africa will increase, but does not offer specifics; Dallas residents remain on edge as they await to learn if those who came into contact with Ebola patient Thomas Eric Duncan became infected. MORE
Story 1: Stop The Ebola Illegal Alien Invasion/Pandemic — Secure The U.S./Mexican Border — Videos
USA Invaded by Central America….
RED ALERT: TOP GENERAL WARNS EBOLA WILL NOT STAY IN WEST AFRICA!!!!
Why Do Viruses Kill
MicroKillers: Super Flu
The Influenza Pandemic of 1918
We Heard the Bells: The Influenza of 1918 (full documentary)
In 1918-1919, the worst flu in recorded history killed an estimated 50 million people worldwide. The U.S. death toll was 675,000 – five times the number of U.S. soldiers killed in World War I. Where did the 1918 flu come from? Why was it so lethal? What did we learn?
After Armageddon (when deadly virus strikes)
SOMETHING ‘NEVER SEEN BEFORE’ IS COMING TO AMERICA (GLOBAL PANDEMIC)
Video: Ebola patient escapes quarantine, spreads panic in Monrovia (Liberia)
Judge Jeanine Pirro – Hidden Danger? – Could Illegal Immigrant Kids Bring Diseases To U.S.?
Obama Triggers a Massive Surge of Illegal Immigrant Children(90,000!)
Reporters Confront U.S. Border Patrol Over Illegal Immigration Stand-Down
Pestilence : Illegal Aliens bringing serious diseases across the U.S. Border (Aug 01, 2014)
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immigrants bring in serious, contagious diseases
PJTV – Illegal Immigrants Being Illegally Dumped in Arizona…Illegally
Story 1: Breaking News: Second Confirmed Ebola Case of Health Care Worker in Dallas Texas Health Presbyterian Hospital — Ebola Is Airborne and Spreading — Center for Disease Control (CDC) Blames It on Breach of Protocol — CDC’s Deep Denial Delusions — World Health Organization (WHO): Aerosolised Ebola Virus droplets produced from coughing or sneezing. –Videos
I beseech you, in the bowels of Christ, think it possible you may be mistaken.
Oliver Cromwell
What Happens When You Are Infected With The Ebola Virus? Common Cold,Bleeding Out The Ears And Eyes
Ebola Outrage as Outbreak Officially Begins In U.S.
Dallas Dog Raises Questions About Animals And Ebola
Ebola: The Undocumented Pandemic
#Ebola outbreak: Texas nurse tests positive & Suspected Case in Boston
CDC investigating Ebola protocol, as second U.S. patient confirmed
SouthCom Issues Stark Ebola Warning: “Katie Bar the Door”
Marine Corps general who leads America’s Southern Command warned Tuesday that the U.S. could face an unprecedented flood of immigrants from the south if the Ebola virus epidemic hits Central America.
‘If it breaks out, it’s literally, “Katie bar the door”,’ Gen John Kelly told said during a public discussion at the National Defense University. ‘And there will be mass migration into the United States.’
US Army: Ebola like FLU needs Winter Weather to go AIRBORNE
CDC Warns On AIRBORNE EBOLA
Max Alert! EBOLA Bodily Fluids Readily Airborne Weaponizable
Second CONFIRMED Case Of Ebola In The U.S. Texas hospital worker tests positive for Ebola
Pestilence : Health Care worker at Dallas Texas Hospital tests positive for Ebola (Oct 12, 2014)
Ebola Health care worker tests positive at Texas hospital
Pestilence : Press Conference of Second Confirmed Diagnosed Case in Texas (Oct 12, 2014)
Ebola – The Truth About the Outbreak (Documentary)
What Pisses Me Off About Ebola
Science Today: Virus Mutation | California Academy of Sciences
Antigenic Shift
Influenza: Get the (Antigenic) Drift
Flu Shift and Drift
Virus Basics
Introduction to Viruses and Viral Replication
Antigenic Shift – the Spread of a New, Mutated Virus
Ebola: The world’s most dangerous Virus (full documentary)
Texas nurse fighting Ebola receives blood transfusion from survivor Dr Kent Brantly – who also matched blood types with two others struck by the deadly virus in the U.S.
Nina Pham, 26, has received blood transfusion from Dr Kent Brantly
Survivor Brantly also donated to Dr Nick Sacra and NBC’s Ashoka Mukpo
Antibodies in his blood could help the patients fight the disease
Pham caught the Ebola virus while treating Thomas Eric Duncan in Dallas
Second person who some identified as Miss Pham’s boyfriend is being monitored for symptoms
Miss Pham raised in Vietnamese family in Fort Worth and graduated from Texas Christian University in 2010 with Bachelor of Science in Nursing
HazChem teams spent the weekend fumigating her Dallas apartment
Authorities have blamed a ‘breach of protocol’ – but nursing leaders have criticized the CDC for making her a scapegoat
About 70 staff members at Texas hospital were involved in the care of first Ebola patient Thomas Eric Duncan after he was hospitalized
By NICK FAGGE IN DALLAS, TEXAS FOR MAILONLINE and MIA DE GRAAF FOR MAILONLINE
The Texan nurse diagnosed with Ebola has received a blood transfusion from survivor Dr Kent Brantly.
It is the third time Dr Brantly has donated blood to an Ebola victim after medics discovered he had the same blood type as previous patient Dr Nick Sacra and NBC cameraman Ashoka Mukpo, who is still being treated.
Incredibly, nurse Nina Pham, 26, has also matched with Dr Brantly and on Monday received a transfusion of his blood in a move that doctors believe could save her life.
Lifeline: Dr Kent Brantly (left), who has been cleared of Ebola, has match blood types with Nina Pham (right) and donated so she can receive a blood transfusion to battle the deadly virus she caught treating a patient
Miss Pham has been in quarantine since Friday after catching the disease from ‘patient zero’ Thomas Eric Duncan – the man who brought the deadly virus to America.
About 70 staff members at Texas Health Presbyterian Hospital were involved in the care of Mr Duncan after he was hospitalized, including the 26-year-old.
Brantly is believed to have traveled to Texas Health Presbyterian Hospital, where Pham worked, to make the donation on Sunday night.
Miss Pham’s condition was described as ‘clinically stable’ on Tuesday morning. She is believed to be in good spirits and had spoken to her mother via Skype.
A second person who came in contact with the nurse is being monitored for Ebola symptoms in an isolation unit at Texas Presbyterian. He is reportedly Miss Pham’s boyfriend according to Dallas News.
The individual works at Alcon in Fort Worth, according to a staff email seen by CBS. MailOnline was awaiting confirmation from the global eye care products company.
Those who have survived Ebola have antibodies in their blood which can help new sufferers beat the disease.
Dr Kent Brantly was flown back from Liberia to the U.S. after contracting Ebola during his missionary work for Samaritan’s Purse.
He survived after receiving a dose of the experimental serum Z-Mapp and round-the-clock care at Emory University Hospital in Atlanta, Georgia.
On September 10, Dr Brantly donated blood to a fellow doctor, Dr Rick Sacra, who also contracted Ebola during his work in West Africa and survived the disease.
Last Tuesday, he was on a road trip from Indiana to Texas when he received a call from Ashoka Mukpo’s medical center in Nebraska telling him his blood type matched Mukpo’s.
He also offered his blood to Thomas Eric Duncan but their blood types didn’t match.
Cured: Dr Nick Sacra was cleared of Ebola after receiving a blood transfusion from Dr Kent Brantly
Being treated: On Tuesday, Dr Brantly pulled over during a road trip to give blood to NBC’s Ashoka Mukpo
Within minutes, he stopped off at the Community Blood Center in Kansas City, Missouri, and his donation was flown to Omaha.
Pham was diagnosed after admitting herself to hospital on Friday when her temperature spiked – one of the first symptoms of the deadly virus.
HOW COMMON IS IT FOR TWO PEOPLE TO MATCH BLOOD TYPE?
There are four major blood types: A, B, AB, and O. They divide into positive and negative categories.
It is not known what blood type the four Ebola patients have in common.
The most common blood type in the US is O positive, although ethnic groups normally differ.
The majority of African Americans and Hispanics have O positive.
Around 37 per cent of Caucasians do too, but 33 per cent have A positive.
There is more variety among Asian people. A quarter are listed as B positive, according to the Red Cross, but many also have a high number of Os and As.
A blood test confirmed she had the disease and she is now being treated in an isolation ward.
The Emergency Room where she was admitted was cleared and decontaminated.
Nina Pham’s uncle confirmed to MailOnline that she is the nurse who has contracted Ebola while treating patient zero Thomas Eric Duncan.
Jason Nguyen told MailOnline: ‘Nina has contracted Ebola, she is my niece. Her mother called me on Saturday and told me; ‘Nina has caught Ebola.’
‘My sister is very upset, we all are. She said she was going up to the hospital in Dallas and I haven’t heard from her since. I’ve tried to call but I can’t get through. It’s very shocking. I don’t know any of the details, only what I hear on the news. It’s frightening.’
He added: ‘Nina is very hard working. She is always up at the hospital in Dallas.’
A friend added: ‘You always hear it on the news, but you don’t expect someone you know so well to have it.’
HazChem teams spent the weekend fumigating her apartment in Dallas while health officials have ordered an investigation into how she contracted the disease.
Texas nurse with Ebola identified as 26-yr-old Nina Pham
Tragic: Nina Pham, 26, is fighting for her life after contracting Ebola from Thomas Eric Duncan. Here she is pictured with her beloved King Charles Spaniel clled Bentley who is not expected to be destroyed
+10
Kind-hearted: Raised in Vietnamese family in Fort Worth, Miss Pham graduated from Texas Christian University in 2010 with a Bachelor of Science in Nursing
Her beloved King Charles Spaniel Bentley will not be destroyed and is being quarantined, Dallas mayor Mike Rawlings has assured.
Director of the Centers for Disease Control and Protection (CDC) Dr Thomas Frieden has blamed a ‘breach in protocol’ of infection control lead Miss Pham to catch Ebola.
Mr Duncan arrived in Texas from Liberia on September 20. He began showing symptoms of Ebola three days after his arrival and was admitted to Texas Presbyterian Hospital on Sunday 28. He died on Wednesday October 8.
Presbyterian’s chief clinical officer, Dr Dan Varga, said all staff had followed CDC recommended precautions – ‘gown, glove, mask and shield’ – while treating Mr Duncan.
CDC chief backtracks after blaming nurse who got Ebola
And on Monday the CDC said that a critical moment may have come when Miss Pham took off her equipment.
Ebola victims suffer chronic diarrhea and bleeding. But blood and feces from an Ebola patient are considered the most infectious bodily fluids.
Mr Duncan also underwent two surgical procedures in a bid to keep him alive but which are particularly high-risk for transmitting the virus – kidney dialysis and intubation to help him to breathe – due to the spread of blood and saliva.
Nurses’ leader Bonnie Castillo has criticized the CDC for blaming the nurse for the spread of the disease.
Ms Castillo, of the National Nurses United, said: ‘You don’t scapegoat and blame when you have a disease outbreak. We have a system failure. That is what we have to correct.’
In response to the criticism, Frieden clarified his comments to say that he did not mean it was an error on Miss Pham’s part that led to the ‘breach of protocol.’
Hazard: Protect Environmental workers move disposal barrels to a staging area outside the Dallas apartment of Miss Pham
Clean up: A man in full hazmat clothing walks in front of Pham’s home after disinfecting the front porch
Compassion: Tom Ha, who taught Miss Pham bible class said: ‘I expect, with the big heart she has, she went beyond what she was supposed to do to help anyone in need’
The CDC said on Monday it has launched a wholesale review of the procedures and equipment used by healthcare workers.
Dr Frieden added that the case ‘substantially’ changes how medical staff approach the control of the virus, adding that: ‘We have to rethink how we address Ebola control, because even a single infection is unacceptable.’
When she got accepted into nursing school she was really excited. Her mom would tell how it’s really hard and a bunch of her friends quit doing it because it was so stressful. But she was like, “This is what I want to do”
– Friend of Miss Pham
Friends and well-wishers have paid tribute to Miss Pham and praised her as a big-hearted, compassionate nurse dedicated to caring for other.
Raised in Vietnamese family in Fort Worth, she graduated from Texas Christian University in 2010 with a Bachelor of Science in Nursing.
She obtained her nursing license in August 2010 and recently qualified as a critical care nurse.
A friend told the Dallas Morning News: ‘When she got accepted into nursing school she was really excited. Her mom would tell how it’s really hard and a bunch of her friends quit doing it because it was so stressful. But she was like, “This is what I want to do”.’
A devout Christian she regularly attends mass at the Lady of Fatima Church.
Tom Ha, who taught her bible class, told the paper: ‘The family is very dedicated and go out of their way to help people. I expect, with the big heart she has, she went beyond what she was supposed to do to help anyone in need.’
Aid: Miss Pham had treated Mr Duncan multiple times after he was diagnosed with the disease and the CDC has claimed that a ‘breach of protocol’ meant the nurse contracted Ebola. However, nursing leaders attacked the authorities for apparently making Miss Pham a scapegoat
Hung Le, who is president and counselor at Our Lady of Fatima, said parishioners are uniting in prayer for Miss Pham.
He said: ‘Our most important concern as a church is to help the family as they are coping with this. As a parish, we are praying for them.’
Ha, who taught the woman in Bible classes, said he and others are translating health information into Vietnamese to help others learn about the illness.
‘People are more worried for the family than for themselves, but some have questions because they don’t really understand what it is or how it is transmitted.’
SPREAD OF A DEADLY PLAGUE: HOW WILL AMERICA CONTAIN EBOLA?
WHEN IS EBOLA CONTAGIOUS?
Only when someone is showing symptoms, which can start with vague symptoms including a fever, flu-like body aches and abdominal pain, and then vomiting and diarrhea.
HOW DOES EBOLA SPREAD?
Through close contact with a symptomatic person’s bodily fluids, such as blood, sweat, vomit, feces, urine, saliva or semen. Those fluids must have an entry point, like a cut or scrape or someone touching the nose, mouth or eyes with contaminated hands, or being splashed. That’s why health care workers wear protective gloves and other equipment.
The World Health Organization says blood, feces and vomit are the most infectious fluids, while the virus is found in saliva mostly once patients are severely ill and the whole live virus has never been culled from sweat.
WHAT ABOUT MORE CASUAL CONTACT?
Ebola isn’t airborne. Dr. Tom Frieden, director of the Centers for Disease Control and Prevention, has said people don’t get exposed by sitting next to someone on the bus.
‘This is not like flu. It’s not like measles, not like the common cold. It’s not as spreadable, it’s not as infectious as those conditions,’ he added.
WHO GETS TESTED WHEN EBOLA IS SUSPECTED?
Hospitals with a suspected case call their health department or the CDC to go through a checklist to determine the person’s level of risk. Among the questions are whether the person reports a risky contact with a known Ebola patient, how sick they are and whether an alternative diagnosis is more likely. Most initially suspicious cases in the U.S. haven’t met the criteria for testing.
HOW IS IT CLEANED UP?
The CDC says bleach and other hospital disinfectants kill Ebola. Dried virus on surfaces survives only for several hours.
The World Health Organization on Monday called the Ebola outbreak ‘the most severe, acute health emergency seen in modern times’.
It added that economic disruption can be curbed if people are educated so they don’t make any irrational moves to dodge infection.
WHO Director-General Margaret Chan, citing World Bank figures, said 90 per cent of economic costs of any outbreak ‘come from irrational and disorganised efforts of the public to avoid infection.’
‘We are seeing, right now, how this virus can disrupt economies and societies around the world,’ she said, but added that adequately educating the public was a ‘good defense strategy’ and would allow governments to prevent economic disruptions.
Ebola screening of passengers arriving from three West African countries began at New York’s JFK airport on Saturday.
Medical teams equipped with temperature guns and questionnaires are monitoring arrivals from Guinea, Liberia and Sierra Leone – countries at the centre of the Ebola outbreak.
Screening at Newark Liberty, Washington Dulles, Chicago O’Hare and Hartsfield-Jackson Atlanta will begin later this week.
These are professionals and this is the United States, where the best conditions and protective gear are available, unlike in West Africa, where the Ebola epidemic is raging in much poorer conditions.
The health worker wore protective gear while having extensive contact with Thomas Eric Duncan, the Liberian man who died Wednesday of Ebola at Texas Health Presbyterian Hospital.
Officials say she has not been able to pinpoint any breach in infection control protocols, although there apparently was a breach, they say.
Experience shows that health workers can safely care for Ebola patients, “but we also know that it’s hard and that even a single breach can result in contamination,” Dr. Thomas Frieden, director of the federal Centers for Disease Control and Prevention, said Sunday on CBS’ “Face the Nation.”
The situation also raises fresh concerns about whether any U.S. hospital can safely handle Ebola patients, as health officials have insisted is possible.
“A breach in protocol could be anything from not taking your gloves off the right way to taking a dialysis catheter out of a dialysis patient and not disposing of it the right way,” explains Dr. Darrin D’Agostino, Chair of Internal Medicine UNT.
According to Dr. D’Agostino those are just some of the multitude of scenarios.
He says these incidents don’t happen often, but accidents do occur.
“We can be as diligent and meticulous as we want to be but occasionally things happen that expose to risk,” said Dr. D’Agostino.
While the fight to eradicate Ebola in Dallas and internationality Dr. D’Agostino is reminding us the battle will be long.
“The fact of the matter is that we do have a lot to learn about this virus and all the viruses that are in this family…this one is particularly infectious.”
Despite the uncertainty Dr. D’Agostino says he is confident that we have the proper infrastructure and resources to handle these cases.
Some questions and answers about the new case.
Q: What protection do health workers have?
A: The exact gear can vary. A hazardous material type suit usually includes a gown, two sets of gloves, a face mask, and an eye shield. There are strict protocols for how to use it correctly.
“When you put on your garb and you take off your garb, it’s a buddy system,” with another health worker watching to make sure it’s done right, said Dr. Dennis Maki, University of Wisconsin-Madison infectious disease specialist and former head of hospital infection control.
Q: How might infection have occurred?
A: Officials are focusing on two areas: How the garb was removed, and the intensive medical procedures Duncan received, which included kidney dialysis and a breathing machine. Both involve inserting tubes — into blood vessels or an airway. That raises the risk a health worker will have contact with the patient’s bodily fluids, which is how Ebola spreads.
“Removing the equipment can really be the highest risk. You have to be extremely careful and have somebody watching you to make sure you remember all the steps,” said Dr. Eileen Farnon, a Temple University doctor who formerly worked at the CDC and led teams investigating past Ebola outbreaks in Africa.
“After every step you usually would do hand hygiene,” washing your hands with antiseptic or being sprayed with a chlorine spray, she said.
Q: How else could infection have happened?
A: Some of the garb the health worker takes off might brush against a surface and contaminate it. New data suggest that even tiny droplets of a patient’s body fluids can contain the virus, Maki said.
“I can have on the suit and be very careful, but I can pick up some secretions or body fluids on a surface” and spread it that way, he said.
Q: Can any U.S. hospital safely treat Ebola patients?
A: Frieden and other health officials say yes, but others say the new case shows the risks.
“We can’t control where the Ebola patient appears,” so every hospital’s emergency room needs to be prepared to isolate and take infection control precautions, Maki said.
That said, “I don’t think we should expect that small hospitals take care of Ebola patients. The challenge is formidable,” and only large hospitals like those affiliated with major universities truly have enough equipment and manpower to do it right, Maki said.
“If we allow it to be taken care of in hospitals that have less than optimal resources, we will promote the spread,” he warned.
The case heightens concern for health workers’ safety, and nurses at many hospitals “are alarmed at the inadequate preparation they see,” says a statement from Rose Ann DeMoro, executive director of the trade union, National Nurses United.
Q: Should Ebola patients be transferred to one of the specialized centers that have treated others in the U.S.?
A: Specialized units are the ideal, but there are fewer than half a dozen in the nation and they don’t have unlimited beds. “It is also a high-risk activity to transfer patients,” potentially exposing more people to the virus, Farnon said.
Q. What is CDC recommending that a hospital do?
A. Training has been ramped up, and the CDC now recommends that a hospital minimize the number of people caring for an Ebola patient, perform only procedures essential to support the patient’s care, and name a fulltime infection control supervisor while any Ebola patient is being cared for. Frieden also said the agency was taking a new look at personal protective equipment, “understanding that there is a balance and putting more on isn’t always safer — it may make it harder to provide effective care.”
A Texas Health Presbyterian Hospital health care worker in Dallas who had “extensive contact” with the first Ebola patient to die in the United States has contracted the disease.
The Centers for Disease Control and Prevention in Atlanta confirmed the news Sunday afternoon after an official test.
The infected person detected a fever Friday night and drove herself to the Presbyterian emergency room, where she was placed in isolation 90 minutes later. A blood sample sent to the state health lab in Austin confirmed Saturday night that she had Ebola — the first person to contract the disease in the United States.
The director for the Centers for Disease Control and Prevention said Sunday that the infection in the health care worker, who was not on the organization’s watch list for people who had contact with Ebola patient Thomas Eric Duncan, resulted from a “breach in protocol.”
“We have spoken with the health care worker,” who cannot “identify the specific breach” that allowed the infection to spread, said CDC director Dr. Tom Frieden. The CDC has sent additional staff members to Dallas to “assist with the response,” he said.
Frieden said exposure can result from a “single inadvertent slip.” He cautioned: “Unfortunately it is possible in the coming days we will see additional cases of Ebola” in health care workers.
Texas health commissioner David Lakey said the health care worker had “extensive contact” with Duncan. The nurse, who missed two days of work before going to the emergency room, is believed to have had contact with one person while symptomatic. Ebola, which is spread through direct contact with bodily fluids of a sick person, can only be transmitted from infected people showing symptoms.
“We have been preparing for an event like this,” Lakey said.
Presbyterian chief clinical officer Daniel Varga said the exposure occurred during Duncan’s second visit to the hospital. Duncan, the first person to die of Ebola in the United States, went to the Presbyterian emergency room Sept. 25 and was sent home with antibiotics only to return to the hospital on Sept. 28. He was diagnosed with Ebola and died Oct. 8.
It is not clear how the health care provider contracted Ebola. According to Duncan’s patient records released by the family to The Associated Press, this is what happened at Presbyterian:
— On Sept. 28, an ambulance with Duncan arrived at the hospital’s emergency bay shortly after 10 a.m.
— Doctors performed tests on Duncan, who told them he had recently arrived from Africa, and determined he had sinusitis.
— Now in isolation, Duncan was projectile vomiting, having explosive diarrhea and his temperature was 103.1 degrees.
— On Sept. 29, as his condition worsened, Duncan asked the nurse to put him in a diaper.
— On Sept. 30, tests results confirmed Duncan had Ebola. Only then did staff treating Duncan trade their gowns and scrubs for hazmat suits, and the room was cleaned with bleach.
Varga at Presbyterian said the worker was wearing protective gear, including a gown, glove, mask and shield, when she came into contact with Duncan. “This individual was following full CDC precautions,” Varga said
Officials haven’t released the name of the health care worker or her job description. Dallas County Judge Clay Jenkins said he has spoken to the health care worker’s parents, who have asked for privacy.
“Let’s remember that this is a real person who is going through a great ordeal. So is that person’s family,” Jenkins said.
The second Ebola patient lives in the 5700 block of Marquita Avenue in East Dallas, where the person’s apartment was going to be decontaminated Sunday. While the CDC didn’t consider the person to be at “high risk” of contracting Ebola, the health care worker had been monitoring for signs of the disease, including checking for fever twice daily.
The person’s car was decontaminated and the common area of an apartment complex was going to be cleaned by a hazardous-material team Sunday.
A crew of 15 people from the Cleaning Guys was going to decontaminate the person’s apartment Sunday afternoon, said company owner Erick McCallum. “Our main objective is for this to go away and to be eradicated,” he said.
Staff writers Melissa Repko, Sherry Jacobson, Claire Cardona, Eva-Marie Ayala and Matthew Haag contributed to this report.
=====
Update at 2:59 p.m.
Brad Smith, Vice President of CG Environmental-Cleaning Guys, a hazardous material company, was hired to clean the apartment unit of the ill health care worker.
He said the hazmat crew will begin cleaning in the next hour or two. They are not sure how long it will take. The crew will include up to 15 people.
He said he’s not concerned about the safety of the crew. He heard the health care worker contracted Ebola after “there was something that went wrong in her PPE” or “personal protective equipment.”
“I’m not sure how it happened,” he said. “But we will not let that happen to our guys.”Smith said the company was hoping not to get any more calls about an Ebola case.
“I was speechless. I don’t know what my thoughts were,” he said. “I just knew we had to react and gear up and do it again.”
Smith said the crew plans to clean the exterior today and clean the interior tomorrow. It will be similar to the cleanup of the apartment where Thomas Eric Duncan stayed.
“We won’t do anything different,” he said. “We think the last time we went out we were successful in cleaning it up. We will continue to so the same thing.”
Update at 12:21 p.m.
At the end of Marquita, morning services were underway at Skillman Church of Christ. The congregation first became aware of the deadly disease when medical missionary Dr. Kent Brantly, who many congregants know, contracted the illness.
Then many became close to the son of Thomas Eric Duncan, who died of the disease. Now pastor Joel Sanchez was telling the church that a healthcare worker just a few blocks away has Ebola.
“As much as we are connected to the world, it’s easy to see something on the television and think of it as happening over yonder, over there,” he said. “But when it hits close to home, it becomes real.”
The congregation prayed for the healthcare worker who Sanchez said put another in front of herself because he had a need. They prayed for the family of Duncan. But then Sanchez asked his congregation not to forget the thousands suffering in West Africa, an area with limited medical resources where nearly 4,000 people have died from Ebola.
“We can’t forget those people whose only course of action is to pray that they don’t get it,” Sanchez said.
Dallas County Judge Clay Jenkins, Mayor Mike Rawlings and Dr. Daniel Varga held a news conference Sundaymorning to inform the public that a health care worker at Texas Health Presbyterian Hospital in Dallas test positive for the Ebola virus after coming in close contact with Ebola patient Thomas Eric Duncan.
Health care worker at Presbyterian Hospital in Dallas tests positive for Ebola
Louis DeLuca/Staff Photographer
Police guard the residence at 5700 block of Marquita, where reportedly a person diagnosed with Ebola lived, photographed in Dallas on Sunday, October 12, 2014. (Louis DeLuca/The Dallas Morning News)
A Texas Health Presbyterian Hospital health care worker in Dallas who had “extensive contact” with the first Ebola patient to die in the United States has contracted the disease
The infected person detected a fever Friday night and drove herself to the Presbyterian emergency room, where she was placed in isolation 90 minutes later. A blood sample sent to the state health lab in Austin confirmedSaturday night that she had Ebola — the first person to contract the disease in the United States.
The director for the Centers for Disease Control and Prevention said Sunday that the infection in the health care worker, who was not on the organization’s watch list for people who had contact with Ebola patient Thomas Eric Duncan, resulted from a “breach in protocol.”
“We have spoken with the health care worker,” who cannot “identify the specific breach” that allowed the infection to spread, said CDC director Dr. Tom Frieden. The CDC has sent additional staff members to Dallas to “assist with the response,” he said.
Frieden said exposure can result from a “single inadvertent slip.” He cautioned: “Unfortunately it is possible in the coming days we will see additional cases of Ebola” in health care workers.
Texas health commissioner David Lakey said the health care worker had “extensive contact” with Duncan. The nurse, who missed two days of work before going to the emergency room, is believed to have had contact with one person while symptomatic. Ebola, which is spread through direct contact with bodily fluids of a sick person, can only be transmitted from infected people showing symptoms.
“We have been preparing for an event like this,” Lakey said.
Presbyterian chief clinical officer Daniel Varga said the exposure occurred during Duncan’s second visit to the hospital. Duncan, the first person to die of Ebola in the United States, went to the Presbyterian emergency room Sept. 26 and was sent home with antibiotics only to return to the hospital on Sept. 28. He was diagnosed with Ebola and died Oct. 8
Officials haven’t released the name of the health care worker or her job description. Dallas County Judge Clay Jenkins said he has spoken to the health care worker’s parents, who have asked for privacy.
“Let’s remember that this is a real person who is going through a great ordeal. So is that person’s family,” Jenkins said.
The second Ebola patient lives in the 5700 block of Marquita Avenue in East Dallas, where the person’s apartment was decontaminated Sunday. While the CDC didn’t consider the person to be at “high risk” of contracting Ebola, the health care worker had been monitoring for signs of the disease, including checking for fever twice daily.
The person’s car was decontaminated and the common area of an apartment complex was cleaned by a hazardous-material team Sunday. A pet also lived in the person’s apartment.
Dallas police have cordoned off the East Dallas apartment, where a frenzy of news media and helicopters circling above have drawn neighbors outside. Police officers and a CDC representative talked to residents Sundaymorning and distributing papers about Ebola symptoms. Dallas Mayor Mike Rawlings also visited with residents.
“It just breaks my heart. … She was just an innocent woman who took care of someone who was sick,” said neighbor Colleen Watson said. “She did her job, and probably with full empathy and kindness, and for this to happen to her is so much sadder than any other case.”
Dina Smith was holding her 3-year-old daughter, still in disbelief that the first contracted case was just a block away. She said Mayor Mike Rawlings and staff members from the mayor’s office visited Sunday morning and talked to residents.
“I’m not particularly concerned because from everything I heard, she was a nurse and took every precaution,” Smith said. “But you hear the helicopters overhead and see the news, and it makes you pay more attention.”
Lindsey Carpenter, 33, said her roommate had searched on the Internet to find out why news helicopters were flying over their neighborhood. He barged into her room at 9:30 a.m. when he found an answer: “There’s an Ebola patient in the neighborhood.”
Carpenter, who works in a hospital in Lewisville, said she hopes Presbyterian investigates how the nurse contracted Ebola — especially because she was exposed to Duncan during his second visit to the hospital.
“They were prepared with hazmat suits and everything,” she said. “I wonder how she got it. It’s really puzzling. There’s probably more to the story that we don’t know.”
Texas Health says “the Emergency Department at Texas Health Dallas is diverting ambulance traffic with the exception of patients showing symptoms of Ebola Virus Disease. The ED is open and seeing patients arriving by any other means.”
Staff writers Melissa Repko, Sherry Jacobson, Claire Cardona, Eva-Marie Ayala and Matthew Haag contributed to this report.
Update at 12:21 p.m.
At the end of Marquita, morning services were underway at Skillman Church of Christ. The congregation first became aware of the deadly disease when medical missionary Dr. Kent Brantly, who many congregants know, contracted the illness.
Then many became close to the son of Thomas Eric Duncan, who died of the disease. Now pastor Joel Sanchez was telling the church that a healthcare worker just a few blocks away has Ebola.
“As much as we are connected to the world, it’s easy to see something on the television and think of it as happening over yonder, over there,” he said. “But when it hits close to home, it becomes real.”
The congregation prayed for the healthcare worker who Sanchez said put another in front of herself because he had a need. They prayed for the family of Duncan. But then Sanchez asked his congregation not to forget the thousands suffering in West Africa, an area with limited medical resources where nearly 4,000 people have died from Ebola.
“We can’t forget those people whose only course of action is to pray that they don’t get it,” Sanchez said.
WATCH: Dallas mayor, hospital doctors give details on Ebola patient No. 2
Dallas County Judge Clay Jenkins, Mayor Mike Rawlings and Dr. Daniel Varga held a news conference Sundaymorning to inform the public that a health care worker at Texas Health Presbyterian Hospital in Dallas test positive for the Ebola virus after coming in close contact with Ebola patient Thomas Eric Duncan.
The cafeteria, where employees and patients at Texas Health Presbyterian Hospital normally take a meal break, is looking more like a ghost town since the outbreak of Ebola. A cafeteria worker said their business had taken a major hit in the wake of Nina Pham’s becoming symptomatic after treating Thomas Eric Duncan while he was ill at this hospital.
Breitbart Texas visited Texas Health Presbyterian Hospital on Monday to check out the mood of workers in the hospital. While visiting the various café’s throughout the hospital, there was a severe shortage of customers. A worker in “Café Presby” said their business is down by 25 percent over the past two weeks.
“I am concerned for our workers,” the employee said. “I hope we don’t have to lay anyone off or cut their hours because of this.”
A nurse who spoke with Breitbart Texas said they are very concerned for Nina Pham. “We aren’t as concerned for ourselves as we are for her. Exposure is one of the risks that comes with our job. We take all the precautions we can but there is always a risk of exposure.”
Another nurse who works for a different hospital but was visiting Texas Health Presbyterian said Nina Pham is a friend of one of her friends. “We are all praying for Nina,” she said. “She is a very sweet and caring nurse. We know she is strong and will recover from this.”
Breitbart Texas spoke with a doctor in the hospital about employee morale. “We are doing fine,” the doctor said. “The real enemy here is the media.” He expressed concern about some outlets sensationalized coverage of the Texas Ebola cases.
While exiting the hospital’s parking lot, the parking toll attendant wore protective gloves while handling the cash handed to her by people leaving the hospital.\
The World Health Organization called the Ebola outbreak “the most severe, acute health emergency seen in modern times” on Monday but also said that economic disruptions can be curbed if people are adequately informed to prevent irrational moves to dodge infection.
WHO Director-General Margaret Chan, citing World Bank figures, said 90 percent of economic costs of any outbreak “come from irrational and disorganized efforts of the public to avoid infection.”
Staffers of the global health organization “are very well aware that fear of infection has spread around the world much faster than the virus,” Chan said in a statement read out to a regional health conference in the Philippine capital, Manila.
“We are seeing, right now, how this virus can disrupt economies and societies around the world,” she said, but added that adequately educating the public was a “good defense strategy” and would allow governments to prevent economic disruptions.
The Ebola epidemic has killed more than 4,000 people, mostly in the West African countries of Liberia, Sierra Leone and Guinea, according to WHO figures published last week.
Chan did not specify those steps but praised the Philippines for holding an anti-Ebola summit last week which was joined by government health officials and private sector representatives, warning that the Southeast Asian country was vulnerable due to the large number of Filipinos working abroad.
While bracing for Ebola, health officials should continue to focus on major health threats, including non-communicable diseases, she said.
Philippine Health Secretary Enrique Ona said authorities will ask more than 1,700 Filipinos working in Liberia, Sierra Leone and Guinea to observe themselves for at least 21 days for Ebola symptoms in those countries first if they plan to return home.
Once home, they should observe themselves for another 21 days and then report the result of their self-screening to health authorities to be doubly sure they have not been infected, he said, adding that hospitals which would deal with any Ebola patients have already been identified in the Philippines.
Last month, U.N. Secretary-General Ban Ki-moon urged leaders in the most affected countries to establish special centers that aim to isolate infected people from non-infected relatives in an effort to stem the spread of Ebola.
Ban has also appealed for airlines and shipping companies not to suspend services to countries affected by Ebola. Doing so, he said, hinders delivery of humanitarian and medical assistance.
As Thomas Eric Duncan’s family mourns the USA’s first Ebola death in Dallas, one question reverberates over a series of apparent missteps in the case: Who is in charge of the response to Ebola?
The answer seems to be — there really isn’t one person or agency. There is not a single national response.
The Atlanta-based Centers for Disease Control and Prevention has emerged as the standard-bearer — and sometimes the scapegoat — on Ebola.
Public health is the purview of the states, and as the nation anticipates more Ebola cases, some experts say the way the United States handles public health is not up to the challenge.
“One of the things we have to understand is the federal, state and local public health relationships,” says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “Public health is inherently a state issue. The state really is in charge of public health at the state and local level. It’s a constitutional issue. The CDC can’t just walk in on these cases. They have to be invited in.”
USA TODAY
Texas health care worker tests positive for Ebola
The CDC deployed a team of 10 — three senior epidemiologists, a communication officer, a public health adviser and five epidemic intelligence officers, or “disease detectives” — to Dallas on the night of Sept. 30, hours after the agency announced that Duncan, a Liberian national who traveled to Dallas, had the Ebola virus. The next afternoon, Dallas County Judge Clay Jenkins, head of the Dallas County Office of Homeland Security and Emergency Management; CDC director Tom Frieden; and David Lakey, commissioner of the Texas Department of State Health Services, agreed during a conference call to set up an Emergency Operations Center in Dallas County with Jenkins in charge.
The EOC was staffed by officials from Dallas County, the city of Dallas, the CDC, the county and state health departments and the Dallas County Sheriff’s Department, among others.
This was the team that made decisions on matters such as isolating people who had been in direct contact with Duncan, including his fiancée, Louise Troh, her teenage son and two other male relatives. Because they were not sick, they couldn’t technically be quarantined, Jenkins said Friday. Instead, Lakey issued a “control order” to keep them at home, where they could be monitored for signs of Ebola. Jenkins and Texas Gov. Rick Perry agreed to the order.
Texas officials were criticized for keeping the family inside the apartment where Duncan first showed signs of the disease, potentially exposing them to the virus. The family worried about Duncan’s soiled sheets and other waste in the apartment. The response team located a private home where the family could move and got permits to clean the apartment and truck 140 55-gallon barrels of waste to an incinerator 400 miles away.
Jenkins says he has a working model for how to respond to Ebola cases. Others aren’t so confident.
“In Texas, they really were slow to the plate,” said Robert Murphy, director of the Center for Global Health at Northwestern University Feinberg School of Medicine. “Texas is going to be the example of what not to do.”
Duncan, who arrived in Dallas on Sept. 20, somehow slipped through a Liberian airport screening process that allowed him into the country. He became ill several days later and went to the emergency room at Texas Health Presbyterian hospital Sept. 25; he was prescribed antibiotics, told to take Tylenol and sent home early on the morning of Sept. 26..
According to medical records provided to the Associated Press by Duncan’s family, his temperature spiked at 103 degrees during that visit. Duncan told a nurse that he had recently been in Africa, and he showed symptoms that can indicate Ebola: fever, sharp headache and abdominal pain. He was given a battery of tests and sent to his sister’s apartment with antibiotics. He returned by ambulance Sept. 28, was admitted to the hospital and placed in isolation. On Sept. 30, the CDC confirmed that he had Ebola.
In a statement Friday, the hospital said it had made procedural changes and continues to “review and evaluate” decisions surrounding Duncan’s case.
Murphy says some of the issues in Texas stem from a “system problem” in the way public health care is managed in the USA. The Centers for Disease Control provides only guidance for infection prevention and management. “What they do in Texas, what they do in Illinois, it’s up to the state,” he says.
“The question is, who’s in charge?” Murphy says. “The states can follow all the guidelines and take the advice, which they usually do, but they don’t have to. It’s not a legal requirement. So there really is no one entity that’s controlling things.”
Though the CDC is tasked with readying the nation for an Ebola outbreak, then leading the national response, the Department of Homeland Security is responsible for protecting the borders, according to Thomas Skinner, a spokesman for the CDC, which is under the auspices of the Department of Health and Human Services.
The CDC collaborates with health departments and laboratories around the USA to make sure they are able to test for Ebola and respond rapidly if there is a case in their state, CDC spokeswoman Kirsten Nordlund said.
The agency is working to educate U.S. health care workers on how to isolate patients and protect themselves from infection; it developed a Web-based document that identifies rapidly emerging CDC guidelines for Ebola applicable to public health preparedness national standards for state and local planning.
The agency developed an introductory training course for licensed clinicians who intend to work in Ebola treatment units in Africa, and at any given time, it has 300-500 people working at CDC headquarters to support its Ebola response, Nordlund said.
Homeland Security “is focused on protecting the air traveling public and is taking steps to ensure that passengers with communicable diseases like Ebola are screened, isolated and quickly and safely referred to medical personnel,” deputy secretary Alejandro Mayorkas said Thursday.
That includes issuing “do not board” orders to airlines if the CDC and State Department determine a passenger is a risk to the traveling public; providing information and guidance about Ebola to the airlines; posting notices at airports to raise awareness about Ebola; and providing a health notice called a care sheet to travelers entering the USA that have traveled from or through affected countries.
In addition, Health and Human Services has the authority to suspend the entry of persons into the USA based on outbreaks of disease in other countries and when necessary to protect public health.
Screening started Saturday at New York’s John F. Kennedy airport. Medical workers will take the temperature of airline passengers originating from Guinea, Liberia and Sierra Leone, and Customs and Border Protection staffers will ask questions about their health and possible exposure to Ebola. Those suspected of possible Ebola exposure will be referred to a CDC public health officer for additional screening.
The testing will expand in the next few days to four more airports: Washington Dulles, Newark, Chicago’s O’Hare and Atlanta’s Hartsfield-Jackson airports.
Osterholm and Murphy say the nation’s public health system leaves room for a broad array of Ebola responses from state to state.
“We have to have more clarity,” Osterholm says. “We have to have a level of excellence. If that means putting the CDC in charge of these departments of public health, that means we have to find a way to do that. We can have agreements (between the states and the CDC). … We can’t leave it up to the whims of the state to do it right or not do it right.”
He acknowledges that no one has called for such a change.
“Not yet,” he says. “But we need it, though. Texas was an example of how not to do it.”
Contributing: Rick Jervis in Dallas, Gregory Korte
W.H.O. contradicts CDC, admits Ebola can spread via coughing, sneezing and by touching contaminated surfaces
The World Health Organization has issued a bulletin which confirms what Natural News has been asserting for weeks: that Ebola can spread via indirect contact with contaminated surfaces and aerosolized droplets produced from coughing or sneezing.
“…wet and bigger droplets from a heavily infected individual, who has respiratory symptoms caused by other conditions or who vomits violently, could transmit the virus — over a short distance — to another nearby person,” says a W.H.O. bulletin released this week. [1] “This could happen when virus-laden heavy droplets are directly propelled, by coughing or sneezing…”
That same bulletin also says, “The Ebola virus can also be transmitted indirectly, by contact with previously contaminated surfaces and objects.”
In other words, the WHO just confirmed what the CDC says is impossible — that Ebola can be acquired by touching a contaminated surface.
CDC remains in total denial, spreading dangerous disinformation about Ebola transmission vectors
This information published by the WHO directly contradicts the ridiculous claims of the CDC which continues to insist Ebola cannot spread through “indirect” means.
According to the CDC, Ebola can only spread via “direct contact,” but the CDC is basing this assumption on the behavior of the Ebola outbreak from 1976 — nearly four decades ago.
The CDC, in fact, continues to push five deadly assumptions about Ebola, endangering the lives of Americans in the process by failing to communicate accurate safety information to health professionals and the public.
Because of the CDC’s lackadaisical attitude about Ebola transmission, the Dallas Ebola outbreak may have been made far worse by people walking in and out of the Ebola-contaminated Duncan apartment while wearing no protective gear whatsoever.
Because the CDC sets the standards for dealing with infectious disease in the United States, when the CDC claims Ebola can only spread via “direct contact,” that causes emergency responders, Red Cross volunteers and even family members to conclude, “Then we don’t even need to wear latex gloves as long as we’re not touching the patient!”
Not “airborne” but can spread through the air
Both the CDC and the WHO continue to aggressively insist that Ebola is not an “airborne” disease. “Ebola virus disease is not an airborne infection,” says the WHO bulletin. But that same bulletin describes the ability of Ebola to spread through the air via aerosolized droplets.
The medical definition of “airborne,” it turns out, is a specific, narrow definition that defies the common understanding of the term. To most people, “airborne” means it can spread through the air, and Ebola most certainly can spread through the air when it is attached to aerosolized particles of spit, saliva, mucus, blood or other body fluids.
The CDC has now admitted there is a slight possibility of Ebola mutating to become “airborne” but says that chance is very small. [2] However, all honest virologists agree that the longer Ebola remains in circulation in West Africa, replicating among human hosts, the more chances it has to mutate into an airborne strain.
But the virus doesn’t need to mutate to continue to spread. It has already proven quite capable of spreading via indirect contact in a way that all the governments of the world have been utterly unable to stop. Despite the best efforts of the CDC and WHO, Ebola continues to replicate out of control across West African nations. Even in the United States, the Dallas “patient zero” incident has reportedly caused 100 people to be monitored for possible Ebola infections.
This is why government claims that “we have this under control” are just as much hogwash as the claim that Ebola can only spread via “direct contact.”
But that seems to be the default response of government to all legitimate threats: first, deny reality and misinform the public. Keep people in the dark and maybe the whole thing can be swept under the rug… at least until the mid-term elections.
When the experts describe the Ebola disaster, they do so with numbers. The statistics include not just the obvious ones, such as caseloads, deaths and the rate of infection, but also the ones that describe the speed of the global response.
Right now, the math still favors the virus.
Global health officials are looking closely at the “reproduction number,” which estimates how many people, on average, will catch the virus from each person stricken with Ebola. The epidemic will begin to decline when that number falls below one. A recent analysis estimated the number at 1.5 to 2.
The number of Ebola cases in West Africa has been doubling about every three weeks. There is little evidence so far that the epidemic is losing momentum.
“The speed at which things are moving on the ground, it’s hard for people to get their minds around. People don’t understand the concept of exponential growth,” said Tom Frieden, director of the U.S. Centers for Disease Control and Prevention. “Exponential growth in the context of three weeks means: ‘If I know that X needs to be done, and I work my butt off and get it done in three weeks, it’s now half as good as it needs to be.’ ”
Frieden warned Thursday that without immediate, concerted, bold action, the Ebola virus could become a global calamity on the scale of HIV. He spoke at a gathering of global health officials and government leaders at the World Bank headquarters in Washington. The president of Guinea was at the table, and the presidents of Liberia and Sierra Leone joined by video link. Amid much bureaucratic talk and table-thumping was an emerging theme: The virus is still outpacing the efforts to contain it.
“The situation is worse than it was 12 days ago. It’s entrenched in the capitals. Seventy percent of the people [who become infected] are definitely dying from this disease, and it is accelerating in almost all settings,” Bruce Aylward, assistant director general of the World Health Organization, told the group.
Aylward had come from West Africa only hours earlier. He offered three numbers: 70, 70 and 60. To bring the epidemic under control, officials should ensure that at least 70 percent of Ebola-victim burials are conducted safely, and that at least 70 percent of infected people are in treatment, within 60 days, he said.
More numbers came from Ernest Bai Koroma, president of Sierra Leone: The country desperately needs 750 doctors, 3,000 nurses, 1,500 hygienists, counselors and nutritionists.
The numbers in this crisis are notoriously squishy, however. Epidemiological data is sketchy at best. No one really knows exactly how big the epidemic is, in part because there are areas in Liberia, Sierra Leone and Guinea where disease detectives cannot venture because of safety concerns.
The current assumption is that for every four known Ebola cases, about six more go unreported.
The latest World Health Organization statistics, published Wednesday, show 8,033 cases of suspected or confirmed Ebola in the West Africa outbreak, with 3,865 deaths. That figure does not include Thomas Eric Duncan, a Liberian man who died Wednesday in Dallas.
How quickly Ebola spreads compared to other diseases VIEW GRAPHIC
“This has been a particularly difficult outbreak because of the difficulty getting a lot of data quickly out of the countries,” said Martin Meltzer, a CDC researcher who models epidemics. “My crystal ball is painted a deep black. It’s like tracking a hurricane.”
Meltzer helped produce a report in late September that said that at current rates of infection, as many as 1.4 million people would become infected by January. That number, officials stressed, was a straight extrapolation of the explosive spread of Ebola at a time when the world had managed to mount only a feeble response. The more vigorous response underway is designed to bend that curve.
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The U.S. military is building 17 treatment centers that can hold 100 people each, but the top military commander in Africa said Tuesday that they won’t be ready until mid-November. Liberia and Sierra Leone have a particularly keen need for more hospital beds. The two countries currently have 924 beds between them, but they need 4,078, according to the WHO.
“The virus is moving on virus time; we’re moving on bureaucracy or program time,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “The virus is actually picking up the pace. Even as we add resources, we get farther behind.”
Aylward, the WHO official, pointed to some bright spots in the response in recent weeks. Liberia has gone from just six burial teams to 54. Officials are working with religious leaders to enable safe burials while respecting cultural traditions. “There’s a way to observe most of the ritual while keeping safe,” Aylward said in an interview.
But he said that overall, the countries in West Africa still lack a coordinated response.
“What is needed in every country is a list, an Excel spreadsheet. It’s not complicated. Here is every district, every county, here is burials and who is going to lead them, here is case finding and contact tracing, here is behavioral change,” Aylward said. In effect, the countries need better numbers.
The latest data from the WHO show hints of progress in bringing Ebola under control in certain rural areas stricken by the disease earlier this year. Seven provinces in Guinea that previously reported Ebola cases saw no new infections in the most recent three-week period covered in Wednesday’s WHO update. Two districts in Sierra Leone and one in Liberia showed a decline in infections.
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But experts caution against reading too much into small fluctuations that may simply reflect an increase or decrease in surveillance or a reappraisal of older data. This cautious attitude toward lower numbers particularly applies to a reported drop in new cases in Liberia in the past three weeks, which the WHO said is “unlikely to be genuine” and more likely reflects “a deterioration in the ability of overwhelmed responders to record accurate epidemiological data.”
Gerardo Chowell, a mathematical epidemiologist at Arizona State University, used data compiled through the end of August to estimate the reproduction number of 1.5 to 2 for this Ebola epidemic. Chowell said that even modest gains in lowering that number could give health officials and the military a better chance of controlling the epidemic.
“Maybe we can bring it from two to 1.2 or 1.3, which would indicate that the number of new cases will be dramatically reduced, and that will give you time,” he said.
Another key number: how many days elapse between the time symptoms occur (which is when a person becomes contagious) and when health officials diagnose the disease in that person. Driving that number down is critical to containing the virus.
The incubation period for Ebola is usually about a week to 10 days, although it can last as long as 21 days. That creates obvious challenges for health workers who have to do contact tracing — they have to repeatedly knock on doors and take the temperatures of people who weeks earlier were potentially exposed to the virus. But it also gives those same workers a decent interval of time to track down people who may be infected before they start shedding the virus and potentially spreading the disease.
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There are several scenarios for how this plays out. One is that the conventional methods of containing Ebola — isolating patients and doing contact tracing of people who might be exposed — lower the rate of new infections until finally the epidemic burns itself out. That has been the case in all previous outbreaks of Ebola, although no outbreak has ever been nearly as extensive as this one.
A second scenario is more dire: The conventional methods come too late, the epidemic keeps spreading, and the virus is beaten back only when vaccines can be developed and scaled up to the point where they can be widely distributed.
As the number of infections increases, so does the possibility that a person with Ebola will carry it to another country. This is known as an export.
“So we had two exports in the first 2,000 patients,” Frieden said in a recent interview. “Now we’re going to have 20,000 cases, how many exports are we going to have?”
The UK is well set for an Ebola outbreak (sarcasm alert) We have TWO isolation units, but one is getting ‘redeveloped’ so it’s not available right now. Called High Security Infectious Diseases Units there are two in the country, each capable of taking two patients. One is at The Royal Free Hospital in Hampstead North London, the other, the one getting a bit of a make-over, is at The Royal Victoria Infirmary in Newcastle, up in the north-east of England.
Four level 4 bio-containment beds between 69,000,000 people
In the US there are 4 units geared up to handle Ebola. The National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, has 3 beds. Nebraska Medical Center, Omaha, has 10 beds. Emory Hospital, Atlanta has 3 beds and St Patricks Hospital, Missoula has 3 beds (source)
19 level four biocontainment beds for 317,000,000 people
I think we just found out why the government(s) are under-playing the situation. They simply do not have the facilities to cope with even a small outbreak. They are, in fact in exactly the same position as the dirt-poor hospitals in West Africa…there are not enough facilities to stop the spread of the disease if it gets out. The quality of care is better, but the availability of containment most likely isn’t.
I am sure ‘regular’ isolation units will be pressed into use but they are not designed to handle level 4 biohazards, they are nowhere near as secure medically speaking, as biocontainment units.
A couple of days ago I explained how exponential spread works. You can read that article here if you like. As a quick recap. Once a disease is at the point where every carrier infects 2 more people,(exponential spread) it will continue until it:
A) runs out of hosts
B) is stopped by medical science or
C) mutates into something less harmful.
What follows will show you how woefully inadequately our governments have prepared for something as lethal as Ebola.
In the flu pandemic of 1918-1920 28% of Americans were infected with the disease…try to remember I am talking numbers here not HOW disease spreads or any medical similarities between diseases, 625,000 Americans lost their lives out of some 29,400,000 infections. The population of the United States at that time was 105,000,000 people. (source)
Fast forward to today. If that flu pandemic had hit the United States in 2014, when the population stands at 317,000,000 people 88,760,000 people would have been infected and 2,130,240 of them would have died.
Now, let’s try this with Ebola. I have picked Liberia just because it is in the news due to the Thomas Duncan case.
Liberia has a population of 4,290,000 people, as of the latest figures there have been 3692 cases of Ebola, this represents 0.0086% of the population.Of those infections, 1998 people have died that’s a fatality rate of 54%. (source)
If that same infection and death rate were applied to the United States Ebola would infect 269,000 people and of those 156,281 would die.
Now, if as doctors and scientists fear the basic reproduction rate rises to 2 in Liberia the numbers change very quickly. Using the mean average incubation time of 9 days it would take around 13 weeks for the entire population of Liberia to become infected. (10 doublings starting with 3692 = just under the population of Liberia. This multiplied by 9 days gives us 90 days which divided by 7 gives 12.85 weeks.) Of the 4,290,000 people infected 2,316,000 would lose their lives.
This is just Liberia, not the other affected countries in West Africa.
Translated to an equivalent outbreak in the United States, where the basic reproduction rate is also 2, the numbers are horrifying. Starting with patient zero it would take around 245 days, 35 weeks for every person in the United States to become infected. Of those 17,118,000 people would die. (27.17 doublings x 9 days = 245 days =35 weeks)
Please remember the figures for Liberia are pulled from the CDC website, the percentages are correct. The scenario for the United States was based on exactly the same parameters as for Liberia…a like for like comparison.
The CDC could be spending their time educating people, advising people to stock up, get ready for the possibility of staying in their homes. Self imposed isolation, or if need be state imposed isolation, that may last for an extended time period may become a reality. They’re not doing it though are they? They are sprouting figures and applying them to West Africa, and they can’t even get that right. They are saying that there could be 1.4 deaths in West Africa in a worst case scenario. When actually applying the figures they supplied with some simple mathematics we can see that 1.4 million deaths is a gross understatement.
Even a basic reproduction rate of 1.7, the latest figure for Liberia it will only take around 30 weeks to get to the same point as the above scenario, over 2,000,000 dead.
Don’t get me wrong, I am not saying that the UK government is any better, if anything they are worse, they don’t even try to do the maths. Most of them went to Eton (a very expensive school that churns out politicians) so it’s unlikely they would be capable of it even if they wanted to. You only have to look at our national finances to see they are no good at sums. They send out press briefings that there will be an emergency COBRA meeting, do you have any clue what that stands for? Let me enlighten you, Cabinet Office Briefing Room A. COBRA is not an emergency planning group, it’s an effing office.
Although I am loathed to say it, it’s time that our governments started worrying about the facilities at home rather than worrying about the facilities abroad. Stopping the disease in Africa does not mean we are out of the woods. There are so many unreported cases, people turned away from medica facilities in West Africa that nobody has the slightest idea how many cases of Ebola are actually out there. The porous borders of the region mean that people move around without the controls that are usually exercised in the west. There has to be a travel ban on non-US citizens entering the United States from these areas, the same applies from the UK.
Border control has to be improved in both countries if we have any hope of halting the spread of this terrible disease. The west is going to be the destination for anyone from Ebola hit areas that can afford to make their way from Africa. Many West Africans have contacts in the west who will help them get out, and shelter them when they arrive. As harsh as it seems this has to be stopped, it’s time for governments to put their own citizens first. Repatriation of your own is one thing, risking millions of lives at home because you won’t man up and prevent foreigners entering is quite another.
In February 2002, consultations between the National Institute of Allergy and Infectious Diseases (NIAID) and its Blue Ribbon Panel on Bioterrorism produced several recommendations for NIAID to better protect people from the threat of bioterrorism. Fulfilling some of those recommendations required more laboratory space for working with dangerous pathogens than was previously available in the United States. In September 2003 and September 2005, NIAID announced the recipients of grants partially funding the construction of two National Biocontainment Laboratories (NBLs) and thirteen Regional Biocontainment Laboratories (RBLs), increasing Biosafety Level-4 (BSL-4) and BSL-3 lab space nationwide.
The NBLs and RBLs are operated by the grant recipients, research institutions across the country. These labs support biodefense and emerging infectious diseases research as resources that provide lab space for basic research of dangerous pathogens and development of new vaccines and treatments. The NBLs are required to have BSL-4, BSL-3, and BSL-2 labs, animal facilities, insectary facilities, clinical facilities, and research support space. The RBLs are required to have BSL-3 and BSL-2 labs, animal facilities, and research support space. While fulfilling the need of researchers occupying the facility, the NBLs and RBLs can be used by other biodefense researchers within the region, particularly those within the Regional Centers of Excellence in Biodefense and Emerging Infectious Diseases. In addition, these labs are available to provide assistance to national, state, and local public health efforts during a biological attack.
The Regional Centers of Excellence for Biodefense and Emerging Infectious Diseases (RCEs) are consortia of universities and research institutions that pursue research with the intentions of producing therapeutics, vaccines, and diagnostics for pathogens that could be used in a bioterrorist attack or could become more widespread. Activities within the RCEs include developing and conducting research programs, training new scientists in research activities, and developing and maintaining facilities and services supportive of activities of the RCEs and other regional biodefense investigators. The RCEs also develop effective treatments and treatment strategies from basic research findings and provide first-line responders with facilities and support during a biological attack.
The National Institute of Allergy and Infectious Diseases (NIAID) created the RCE program in response to a recommendation from meetings between the NIAID and its Blue Ribbon Panel on Bioterrorism in February 2002. By June 2005, NIAID had established a total of ten RCEs in ten geographical regions across the country. Each RCE is composed of the investigators from the lead institution that submitted the application and collaborating investigators at universities and research institutions within the consortium. The consortia have access to resources such as facilities and services within the RCE and the National Biocontainment Laboratories and the Regional Biocontainment Laboratories.
Regional Centers of Excellence for Biodefense and Emerging Infectious Diseases
This map displays major Biosafety Level 4 (BSL-4) facilities around the world according to data collected by FAS in 2010 and 2011. These high-containment facilities are used to conduct beneficial research on dangerous and emerging pathogens.
Required for work with dangerous and exotic agents which pose a high individual risk of life-threatening disease. The facility is either in a separate building or in a controlled area within a building, which is completely isolated from all other areas of the building. Walls, floors, and ceilings of the facility are constructed to form a sealed internal shell which facilitates fumigation and is animal and insect proof. A dedicated non-recirculating ventilation system is provided. The supply and exhaust components of the system are balanced to assure directional airflow from the area of least hazard to the area(s) of greatest potential hazard. Within work areas of the facility, all activities are confined to Class III biological safety cabinets, or Class II biological safety cabinets used with one-piece positive pressure personnel suits ventilated by a life support system. The Biosafety Level 4 laboratory has special engineering and design features to prevent microorganisms from being disseminated into the environment. Personnel enter and leave the facility only through the clothing change and shower rooms, and shower each time they leave the facility. Personal clothing is removed in the outer clothing change room and kept there. A specially designed suit area may be provided in the facility to provide personnel protection equivalent to that provided by Class III cabinets. The exhaust air from the suit area is filtered by two sets of HEPA filters installed in series. Supplies and materials needed in the facility are brought in by way of double-doored autoclave, fumigation chamber, or airlock, which is appropriately decontaminated between each use. Viruses assigned to Biosafety Level 4 include Crimean-Congo hemorrhagic fever, Ebola, Junin, Lassa fever, Machupo, Marburg, and tick-borne encephalitis virus complex (including Absettarov, Hanzalova, Hypr, Kumlinge, Kyasanur Forest disease, Omsk hemorrhagic fever, and Russian Spring-Summer encephalitis).
BSL-3, Biosafety Level 3
Applicable to clinical, diagnostic, teaching, and research or production facilities involving indigenous or exotic strains of agents which may cause serious or potentially lethal disease as a result of exposure by inhalation. All procedures involving the manipulation of infectious material are conducted within biological safety cabinets or other physical containment devices, or by personnel wearing appropriate personal protective clothing and equipment. The laboratory has special engineering and design features. A ducted exhaust air ventilation system is provided. This system creates directional airflow that draws air from “clean” areas toward “contaminated” areas. The High Efficiency Particulate Air (HEPA)-filtered exhaust air from Class II or Class III biological safety cabinets is discharged directly to outside or through the building exhaust system. The typical HEPA filter removes 99.97% of all particles that are 0.3 micron or larger in size, which means that all microbial agents will be trapped in the filter. Biosafety Level 3 practices, containment equipment, and facilities are recommended for manipulations of cultures or work involving production volumes or concentrations of cultures associated with most biological warfare agents.
BSL-2, Biosafety Level 2
Suitable for work involving agents of moderate potential hazard to personnel and the environment. Agents which may produce disease of varying degrees of severity from exposure by injection, ingestion, absorption, and inhalation, but which are contained by good laboratory techniques are included in this level. Biosafety Level 2 practices, containment equipment, and facilities are recommended for activities using clinical materials and diagnostic quantities of infectious cultures associated with most biological warfare agents.
BSL-1, Biosafety Level 1
Suitable for work involving well-characterized agents of no known or of minimal potential hazard to laboratory personnel and the environment. The laboratory is not necessarily separated from the general traffic patterns in the building. Work is generally conducted on open bench tops using standard microbiological practices. Special containment equipment is not required or generally used. This is the type of laboratory found in municipal water- ing laboratories, in high schools, and in some community colleges.
Biosafety Level Information
For more information about BSL facilities in the United States and worldwide, please see the links below.
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CDC: Airborne Ebola possible but unlikely
By Elise Viebeck
The Ebola virus becoming airborne is a possible but unlikely outcome in the current epidemic, Centers for Disease Control and Prevention (CDC) Director Tom Frieden said Tuesday.
The outbreak involves Ebola Zaire, a strain that is passed through bodily fluids, not the air. But some experts have expressed fear about viral mutations due to the unprecedented — and rising — number of Ebola cases.
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Frieden sought to allay those fears during a call with reporters.
“The rate of change [with Ebola] is slower than most viruses, and most viruses don’t change how they spread,” he said. Frieden is unofficially spearheading the U.S. response to Ebola.
“That is not to say it’s impossible that it could change [to become airborne],” he continued. “That would be the worst-case scenario. We would know that by looking at … what is happening in Africa. That is why we have scientists from the CDC on the ground tracking that.”
A change in the way Ebola spreads would make the virus significantly more dangerous. The disease kills roughly half the people it infects, and lacking a vaccine or cure, its traceable chain of transmission through bodily fluids is one reason officials believe they can contain it.
Still, there is almost no precedent for a human virus mutating to become transmissible in a different way, a key piece of evidence in weighing whether that kind of shift is likely for Ebola.
“We have so many problems with Ebola, let’s not make another one that, of course, is theoretically possible but is pretty way down on the list of likely issues,” infectious diseases expert William Schaffner of Vanderbilt University told Scientific American.
Frieden touted new progress against Ebola in West Africa and Dallas, where a Liberian man remains in critical condition, but warned that “globally, this is going to be a long, hard fight.”
The Dallas patient interacted with 10 definite and 38 possible interlocturos who are now being monitored, he said. None have shown symptoms.
Some Ebola experts worry virus may spread more easily than assumed
Ebola could be spread through air in tight quarters, some scientists fear
Some Ebola experts worry that the virus may spread more easily than thought — through the air in small spaces, for example.
By DAVID WILLMAN contact the reporter NationMedical ResearchAfricaScientific ResearchDiseases and IllnessesEbolaU.S. Centers for Disease Control and Prevention
Ebola researcher says he would not rule out possibility that the virus spreads through air in tight quarters
‘There are too many unknowns here,’ a virologist says of how Ebola may spread
Ebola researcher says he thinks there is a chance asymptomatic people could spread the virus
U.S. officials leading the fight against history’s worst outbreak of Ebola have said they know the ways the virus is spread and how to stop it. They say that unless an air traveler from disease-ravaged West Africa has a fever of at least 101.5 degrees or other symptoms, co-passengers are not at risk.
“At this point there is zero risk of transmission on the flight,” Dr. Thomas Frieden, director of the federal Centers for Disease Control and Prevention, said after a Liberian man who flew through airports in Brussels and Washington was diagnosed with the disease last week in Dallas.
First Ebola infection outside West Africa
Three more people have been hospitalized in Madrid for possible exposure to the Ebola virus after a Spanish nurse tested positive for the virus.
Other public health officials have voiced similar assurances, saying Ebola is spread only through physical contact with a symptomatic individual or their bodily fluids. “Ebola is not transmitted by the air. It is not an airborne infection,” said Dr. Edward Goodman of Texas Health Presbyterian Hospital in Dallas, where the Liberian patient remains in critical condition.
Yet some scientists who have long studied Ebola say such assurances are premature — and they are concerned about what is not known about the strain now on the loose. It is an Ebola outbreak like none seen before, jumping from the bush to urban areas, giving the virus more opportunities to evolve as it passes through multiple human hosts.
Dr. C.J. Peters, who battled a 1989 outbreak of the virus among research monkeys housed in Virginia and who later led the CDC’s most far-reaching study of Ebola’s transmissibility in humans, said he would not rule out the possibility that it spreads through the air in tight quarters.
“We just don’t have the data to exclude it,” said Peters, who continues to research viral diseases at the University of Texas in Galveston.
Dr. Philip K. Russell, a virologist who oversaw Ebola research while heading the U.S. Army’s Medical Research and Development Command, and who later led the government’s massive stockpiling of smallpox vaccine after the Sept. 11 terrorist attacks, also said much was still to be learned. “Being dogmatic is, I think, ill-advised, because there are too many unknowns here.”
If Ebola were to mutate on its path from human to human, said Russell and other scientists, its virulence might wane — or it might spread in ways not observed during past outbreaks, which were stopped after transmission among just two to three people, before the virus had a greater chance to evolve. The present outbreak in West Africa has killed approximately 3,400 people, and there is no medical cure for Ebola.
“I see the reasons to dampen down public fears,” Russell said. “But scientifically, we’re in the middle of the first experiment of multiple, serial passages of Ebola virus in man…. God knows what this virus is going to look like. I don’t.”
A resident looks from behind a gate during the Liberian government’s 11-day Ebola quarantine in the West Point district of Monrovia.
Tom Skinner, a spokesman for the CDC in Atlanta, said health officials were basing their response to Ebola on what has been learned from battling the virus since its discovery in central Africa in 1976. The CDC remains confident, he said, that Ebola is transmitted principally by direct physical contact with an ill person or their bodily fluids.
Skinner also said the CDC is conducting ongoing lab analyses to assess whether the present strain of Ebola is mutating in ways that would require the government to change its policies on responding to it. The results so far have not provided cause for concern, he said.
The researchers reached in recent days for this article cited grounds to question U.S. officials’ assumptions in three categories.
One issue is whether airport screenings of prospective travelers to the U.S. from West Africa can reliably detect those who might have Ebola. Frieden has said the CDC protocols used at West African airports can be relied on to prevent more infected passengers from coming to the U.S.
“One hundred percent of the individuals getting on planes are screened for fever before they get on the plane,” Frieden said Sept. 30. “And if they have a fever, they are pulled out of the line, assessed for Ebola, and don’t fly unless Ebola is ruled out.”
Individuals who have flown recently from one or more of the affected countries suggested that travelers could easily subvert the screening procedures — and might have incentive to do so: Compared with the depleted medical resources in the West African countries of Liberia, Sierra Leone and Guinea, the prospect of hospital care in the U.S. may offer an Ebola-exposed person the only chance to survive.
U.S. To Increase Airport Screening For Ebola
The deteriorating conditions in Africa make it more likely additional cases of Ebola will appear in the United States and officials are pushing for increased screenings at airports.
A person could pass body temperature checks performed at the airports by taking ibuprofen or any common analgesic. And prospective passengers have much to fear from identifying themselves as sick, said Kim Beer, a resident of Freetown, the capital of Sierra Leone, who is working to get medical supplies into the country to cope with Ebola.
“It is highly unlikely that someone would acknowledge having a fever, or simply feeling unwell,” Beer said via email. “Not only will they probably not get on the flight — they may even be taken to/required to go to a ‘holding facility’ where they would have to stay for days until it is confirmed that it is not caused by Ebola. That is just about the last place one would want to go.”
Liberian officials said last week that the patient hospitalized in Dallas, Thomas Eric Duncan, did not report to airport screeners that he had had previous contact with an Ebola-stricken woman. It is not known whether Duncan knew she suffered from Ebola; her family told neighbors it was malaria.
The potential disincentive for passengers to reveal their own symptoms was echoed by Sheka Forna, a dual citizen of Sierra Leone and Britain who manages a communications firm in Freetown. Forna said he considered it “very possible” that people with fever would medicate themselves to appear asymptomatic.
It would be perilous to admit even nonspecific symptoms at the airport, Forna said in a telephone interview. “You’d be confined to wards with people with full-blown disease.”
On Monday, the White House announced that a review was underway of existing airport procedures. Frieden and President Obama’s assistant for homeland security and counter-terrorism, Lisa Monaco, said Friday that closing the U.S. to passengers from the Ebola-affected countries would risk obstructing relief efforts.
CDC officials also say that asymptomatic patients cannot spread Ebola. This assumption is crucial for assessing how many people are at risk of getting the disease. Yet diagnosing a symptom can depend on subjective understandings of what constitutes a symptom, and some may not be easily recognizable. Is a person mildly fatigued because of short sleep the night before a flight — or because of the early onset of disease?
Moreover, said some public health specialists, there is no proof that a person infected — but who lacks symptoms — could not spread the virus to others.
“It’s really unclear,” said Michael Osterholm, a public health scientist at the University of Minnesota who recently served on the U.S. government’s National Science Advisory Board for Biosecurity. “None of us know.”
Russell, who oversaw the Army’s research on Ebola, said he found the epidemiological data unconvincing.
“The definition of ‘symptomatic’ is a little difficult to deal with,” he said. “It may be generally true that patients aren’t excreting very much virus until they become ill, but to say that we know the course of [the virus’ entry into the bloodstream] and the course of when a virus appears in the various secretions, I think, is premature.”
The CDC’s Skinner said that while officials remained confident that Ebola can be spread only by the overtly sick, the ongoing studies would assess whether mutations that might occur could increase the potential for asymptomatic patients to spread it.
Finally, some also question the official assertion that Ebola cannot be transmitted through the air. In late 1989, virus researcher Charles L. Bailey supervised the government’s response to an outbreak of Ebola among several dozen rhesus monkeys housed for research in Reston, Va., a suburb of Washington.
What Bailey learned from the episode informs his suspicion that the current strain of Ebola afflicting humans might be spread through tiny liquid droplets propelled into the air by coughing or sneezing.
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“We know for a fact that the virus occurs in sputum and no one has ever done a study [disproving that] coughing or sneezing is a viable means of transmitting,” he said. Unqualified assurances that Ebola is not spread through the air, Bailey said, are “misleading.”
Peters, whose CDC team studied cases from 27 households that emerged during a 1995 Ebola outbreak in Democratic Republic of Congo, said that while most could be attributed to contact with infected late-stage patients or their bodily fluids, “some” infections may have occurred via “aerosol transmission.”
Ailing in Monrovia, Liberia
Relatives pray over a weak Siata Johnson, 23, outside the Ebola treatment center at a hospital on the outskirts of Monrovia, Liberia. (John Moore / Getty Images)
Skinner of the CDC, who cited the Peters-led study as the most extensive of Ebola’s transmissibility, said that while the evidence “is really overwhelming” that people are most at risk when they touch either those who are sick or such a person’s vomit, blood or diarrhea, “we can never say never” about spread through close-range coughing or sneezing.
“I’m not going to sit here and say that if a person who is highly viremic … were to sneeze or cough right in the face of somebody who wasn’t protected, that we wouldn’t have a transmission,” Skinner said.
Peters, Russell and Bailey, who in 1989 was deputy commander for research of the Army’s Medical Research Institute of Infectious Diseases, in Frederick, Md., said the primates in Reston had appeared to spread Ebola to other monkeys through their breath.
The Ebola strain found in the monkeys did not infect their human handlers. Bailey, who now directs a biocontainment lab at George Mason University in Virginia, said he was seeking to research the genetic differences between the Ebola found in the Reston monkeys and the strain currently circulating in West Africa.
Though he acknowledged that the means of disease transmission among the animals would not guarantee the same result among humans, Bailey said the outcome may hold lessons for the present Ebola epidemic.
“Those monkeys were dying in a pattern that was certainly suggestive of coughing and sneezing — some sort of aerosol movement,” Bailey said. “They were dying and spreading it so quickly from cage to cage. We finally came to the conclusion that the best action was to euthanize them all.”
Dallas County Judge Clay Jenkins pulled into the Ivy Apartments community late in the evening Friday wearing suit pants and a lavender dress shirt.
There were hazardous materials trucks all around, as cleaning crews had arrived to remove materials that might have been touched by Thomas Duncan, a Liberian man who is hospitalized in Texas with Ebola. The hazmat workers were covered from head to toe in bright yellow body suits, green gloves and breathing masks.
Jenkins walked into the apartment in building No. 6 to greet Louise Troh, her family and others who live with her and had been court-ordered to stay in their home because they were considered high risk after coming into contact with Duncan.
It was time to move, and Troh, her 13-year old son, a relative of Duncan’s and another man — all of whom lived in the apartment — got into the judge’s car for the 45-minute drive to their new, temporary home, in an undisclosed part of Dallas.
Jenkins, the judge, never covered up.
“I’m a married man with a little girl,” Jenkins told reporters later that night. “I’m wearing the same shirt I was when I was in the car with that family.
“I was in their house next to those materials, meeting with them, listening to them, and assuring them last night and again of course today. If there were any risk, I would not expose myself or my family to that risk.”
He added: “There is zero risk.”
In the face of widespread fear — and in some cases misinformation — about Ebola following the first diagnosis of the virus in the United States, Dallas officials have taken a notable visual approach to make the point that, at least right now, the city is safe.
The Ebola outbreak in West Africa has reached the United States, as officials confirm one case in Dallas. Here’s how U.S. health officials plan to stop the virus. (Gillian Brockell and Jorge Ribas/The Washington Post)
On a daily basis, workers monitoring the temperatures and health of as many as nine individuals who they believe might have had direct contact with Duncan have entered those people’s homes with no gloves, no masks and no personal protective equipment whatsoever.
And city officials including Jenkins, Dallas Mayor Mike Rawlings and Dallas County Health and Human Services Director Zachary Thompson have interacted with the family no differently that they might have if the four people who are in a state of semi-isolation had been suspected of having come into contact with somebody sick with the flu.
“Based on our assessment, they were asymptomatic; therefore, I didn’t feel they posed any threat to me,” Thompson said in an interview with The Washington Post on Monday. “There is a standard procedure for when they should be using the PPE’s (personal protective equipment). In this case we knew our nurses, our staff, had assessed that they were asymptomatic.”
So far, none of the people who have potentially had contact with Duncan are showing any symptoms, Thompson said.
Yet concern and stigma are widespread in Dallas.
Photographs from Liberia, Sierra Leone and Guinea — where the epidemic is spiraling out of control — frequently show fully masked health workers carrying infected people to hospitals or burial sites. Those images have become closely associated with the virus and the outbreak in the public’s mind.
And for one day, similar images briefly appeared in Dallas as cleaning crews removed materials from Troh’s apartment that might have come into contact with the virus.
A hazmat team arrives on Oct. 3 to clean a unit at the Dallas apartment complex where the confirmed Ebola patient was staying. (Joe Raedle/Getty Images)
The decision for the crew to wear personal protective equipment was made by the company, the “Cleaning Guys,” according to Dallas officials.
“We train for this type of thing,” company executive Brad Smith told ABC News. “Obviously, we haven’t trained for Ebola because there hasn’t been a situation in Texas until now.”
The Ebola virus is not very hearty outside of the human body.
Still, touching and destroying potentially infected materials is far different from speaking to or being in the same room with people who might have been exposed to the virus.
And public health expert Gavin Macgregor-Skinner, who worked in Nigeria to end that country’s outbreak, said that treating people with a sense of humanity and not feeding hysteria is critical to managing the Dallas Ebola case and others that might occur around the world.
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“Even in West Africa when we do contact tracing, we don’t put on personal protective equipment,” said Macgregor-Skinner, an assistant professor in the Department of Public Health Sciences at the Penn State Milton S. Hershey Medical Center. “We have the six-feet rule: We stay about six feet away from people and I can interview them and I can make them feel like people.
“If they have no symptoms, we need to make them feel normal, like they’re part of the community, like they are still loved.”
Dallas officials have also urged residents to go about their normal activities and attend community gatherings and fairs without fear.
“The broader perspective is that we had done immediate disease tracking and contact tracing and the family had been identified who had had close contact and they had not shown any symptoms,” said Thompson. “Other than that one case, basically, his virus has been contained.”
‘In 1976 I discovered Ebola – now I fear an unimaginable tragedy’
Peter Piot was a researcher at a lab in Antwerp when a pilot brought him a blood sample from a Belgian nun who had fallen mysteriously ill in Zaire
Professor Peter Piot, the Director of the London School of Hygiene and Tropical Medicine: ‘Around June it became clear to me there was something different about this outbreak. I began to get really worried’ Photograph: Leon Neal/AFP
Professor Piot, as a young scientist in Antwerp, you were part of the team that discovered the Ebola virus in 1976. How did it happen?
I still remember exactly. One day in September, a pilot from Sabena Airlines brought us a shiny blue Thermos and a letter from a doctor in Kinshasa in what was then Zaire. In the Thermos, he wrote, there was a blood sample from a Belgian nun who had recently fallen ill from a mysterious sickness in Yambuku, a remote village in the northern part of the country. He asked us to test the sample for yellow fever.
These days, Ebola may only be researched in high-security laboratories. How did you protect yourself back then?
We had no idea how dangerous the virus was. And there were no high-security labs in Belgium. We just wore our white lab coats and protective gloves. When we opened the Thermos, the ice inside had largely melted and one of the vials had broken. Blood and glass shards were floating in the ice water. We fished the other, intact, test tube out of the slop and began examining the blood for pathogens, using the methods that were standard at the time.
But the yellow fever virus apparently had nothing to do with the nun’s illness.
No. And the tests for Lassa fever and typhoid were also negative. What, then, could it be? Our hopes were dependent on being able to isolate the virus from the sample. To do so, we injected it into mice and other lab animals. At first nothing happened for several days. We thought that perhaps the pathogen had been damaged from insufficient refrigeration in the Thermos. But then one animal after the next began to die. We began to realise that the sample contained something quite deadly.
But you continued?
Other samples from the nun, who had since died, arrived from Kinshasa. When we were just about able to begin examining the virus under an electron microscope, the World Health Organisation instructed us to send all of our samples to a high-security lab in England. But my boss at the time wanted to bring our work to conclusion no matter what. He grabbed a vial containing virus material to examine it, but his hand was shaking and he dropped it on a colleague’s foot. The vial shattered. My only thought was: “Oh, shit!” We immediately disinfected everything, and luckily our colleague was wearing thick leather shoes. Nothing happened to any of us.
In the end, you were finally able to create an image of the virus using the electron microscope.
Yes, and our first thought was: “What the hell is that?” The virus that we had spent so much time searching for was very big, very long and worm-like. It had no similarities with yellow fever. Rather, it looked like the extremely dangerous Marburg virus which, like ebola, causes a haemorrhagic fever. In the 1960s the virus killed several laboratory workers in Marburg, Germany.
Were you afraid at that point?
I knew almost nothing about the Marburg virus at the time. When I tell my students about it today, they think I must come from the stone age. But I actually had to go the library and look it up in an atlas of virology. It was the American Centres for Disease Control which determined a short time later that it wasn’t the Marburg virus, but a related, unknown virus. We had also learned in the meantime that hundreds of people had already succumbed to the virus in Yambuku and the area around it.
A few days later, you became one of the first scientists to fly to Zaire.
Yes. The nun who had died and her fellow sisters were all from Belgium. In Yambuku, which had been part of the Belgian Congo, they operated a small mission hospital. When the Belgian government decided to send someone, I volunteered immediately. I was 27 and felt a bit like my childhood hero, Tintin. And, I have to admit, I was intoxicated by the chance to track down something totally new.
A girl is led to an ambulance after showing signs of Ebola infection in the village of Freeman Reserve, 30 miles north of the Liberian capital, Monrovia. Photograph: Jerome Delay/APWas there any room for fear, or at least worry?
Of course it was clear to us that we were dealing with one of the deadliest infectious diseases the world had ever seen – and we had no idea that it was transmitted via bodily fluids! It could also have been mosquitoes. We wore protective suits and latex gloves and I even borrowed a pair of motorcycle goggles to cover my eyes. But in the jungle heat it was impossible to use the gas masks that we bought in Kinshasa. Even so, the Ebola patients I treated were probably just as shocked by my appearance as they were about their intense suffering. I took blood from around 10 of these patients. I was most worried about accidentally poking myself with the needle and infecting myself that way.
But you apparently managed to avoid becoming infected.
Well, at some point I did actually develop a high fever, a headache and diarrhoea …
… similar to Ebola symptoms?
Exactly. I immediately thought: “Damn, this is it!” But then I tried to keep my cool. I knew the symptoms I had could be from something completely different and harmless. And it really would have been stupid to spend two weeks in the horrible isolation tent that had been set up for us scientists for the worst case. So I just stayed alone in my room and waited. Of course, I didn’t get a wink of sleep, but luckily I began feeling better by the next day. It was just a gastrointestinal infection. Actually, that is the best thing that can happen in your life: you look death in the eye but survive. It changed my whole approach, my whole outlook on life at the time.
You were also the one who gave the virus its name. Why Ebola?
On that day our team sat together late into the night – we had also had a couple of drinks – discussing the question. We definitely didn’t want to name the new pathogen “Yambuku virus”, because that would have stigmatised the place forever. There was a map hanging on the wall and our American team leader suggested looking for the nearest river and giving the virus its name. It was the Ebola river. So by around three or four in the morning we had found a name. But the map was small and inexact. We only learned later that the nearest river was actually a different one. But Ebola is a nice name, isn’t it?
In the end, you discovered that the Belgian nuns had unwittingly spread the virus. How did that happen?
In their hospital they regularly gave pregnant women vitamin injections using unsterilised needles. By doing so, they infected many young women in Yambuku with the virus. We told the nuns about the terrible mistake they had made, but looking back I would say that we were much too careful in our choice of words. Clinics that failed to observe this and other rules of hygiene functioned as catalysts in all additional Ebola outbreaks. They drastically sped up the spread of the virus or made the spread possible in the first place. Even in the current Ebola outbreak in westAfrica, hospitals unfortunately played this ignominious role in the beginning.
After Yambuku, you spent the next 30 years of your professional life devoted to combating Aids. But now Ebola has caught up to you again. American scientists fear that hundreds of thousands of people could ultimately become infected. Was such an epidemic to be expected?
No, not at all. On the contrary, I always thought that Ebola, in comparison to Aids or malaria, didn’t present much of a problem because the outbreaks were always brief and local. Around June it became clear to me that there was something fundamentally different about this outbreak. At about the same time, the aid organisation Médecins Sans Frontières sounded the alarm. We Flemish tend to be rather unemotional, but it was at that point that I began to get really worried.
Why did WHO react so late?
On the one hand, it was because their African regional office isn’t staffed with the most capable people but with political appointees. And the headquarters in Geneva suffered large budget cuts that had been agreed to by member states. The department for haemorrhagic fever and the one responsible for the management of epidemic emergencies were hit hard. But since August WHO has regained a leadership role.
There is actually a well-established procedure for curtailing Ebola outbreaks: isolating those infected and closely monitoring those who had contact with them. How could a catastrophe such as the one we are now seeing even happen?
I think it is what people call a perfect storm: when every individual circumstance is a bit worse than normal and they then combine to create a disaster. And with this epidemic there were many factors that were disadvantageous from the very beginning. Some of the countries involved were just emerging from terrible civil wars, many of their doctors had fled and their healthcare systems had collapsed. In all of Liberia, for example, there were only 51 doctors in 2010, and many of them have since died of Ebola.
The fact that the outbreak began in the densely populated border region between Guinea, Sierra Leone and Liberia …
… also contributed to the catastrophe. Because the people there are extremely mobile, it was much more difficult than usual to track down those who had had contact with the infected people. Because the dead in this region are traditionally buried in the towns and villages they were born in, there were highly contagious Ebola corpses travelling back and forth across the borders in pickups and taxis. The result was that the epidemic kept flaring up in different places.
For the first time in its history, the virus also reached metropolises such as Monrovia and Freetown. Is that the worst thing that can happen?
In large cities – particularly in chaotic slums – it is virtually impossible to find those who had contact with patients, no matter how great the effort. That is why I am so worried about Nigeria as well. The country is home to mega-cities like Lagos and Port Harcourt, and if the Ebola virus lodges there and begins to spread, it would be an unimaginable catastrophe.
Have we completely lost control of the epidemic?
I have always been an optimist and I think that we now have no other choice than to try everything, really everything. It’s good that the United States and some other countries are finally beginning to help. But Germany or even Belgium, for example, must do a lot more. And it should be clear to all of us: This isn’t just an epidemic any more. This is a humanitarian catastrophe. We don’t just need care personnel, but also logistics experts, trucks, jeeps and foodstuffs. Such an epidemic can destabilise entire regions. I can only hope that we will be able to get it under control. I really never thought that it could get this bad.
What can really be done in a situation when anyone can become infected on the streets and, like in Monrovia, even the taxis are contaminated?
We urgently need to come up with new strategies. Currently, helpers are no longer able to care for all the patients in treatment centres. So caregivers need to teach family members who are providing care to patients how to protect themselves from infection to the extent possible. This on-site educational work is currently the greatest challenge. Sierra Leone experimented with a three-day curfew in an attempt to at least flatten out the infection curve a bit. At first I thought: “That is totally crazy.” But now I wonder, “why not?” At least, as long as these measures aren’t imposed with military power.
A three-day curfew sounds a bit desperate.
Yes, it is rather medieval. But what can you do? Even in 2014, we hardly have any way to combat this virus.
Do you think we might be facing the beginnings of a pandemic?
There will certainly be Ebola patients from Africa who come to us in the hopes of receiving treatment. And they might even infect a few people here who may then die. But an outbreak in Europe or North America would quickly be brought under control. I am more worried about the many people from India who work in trade or industry in west Africa. It would only take one of them to become infected, travel to India to visit relatives during the virus’s incubation period, and then, once he becomes sick, go to a public hospital there. Doctors and nurses in India, too, often don’t wear protective gloves. They would immediately become infected and spread the virus.
The virus is continually changing its genetic makeup. The more people who become infected, the greater the chance becomes that it will mutate …
… which might speed its spread. Yes, that really is the apocalyptic scenario. Humans are actually just an accidental host for the virus, and not a good one. From the perspective of a virus, it isn’t desirable for its host, within which the pathogen hopes to multiply, to die so quickly. It would be much better for the virus to allow us to stay alive longer.
Could the virus suddenly change itself such that it could be spread through the air?
Like measles, you mean? Luckily that is extremely unlikely. But a mutation that would allow Ebola patients to live a couple of weeks longer is certainly possible and would be advantageous for the virus. But that would allow Ebola patients to infect many, many more people than is currently the case.
But that is just speculation, isn’t it?
Certainly. But it is just one of many possible ways the virus could change to spread itself more easily. And it is clear that the virus is mutating.
You and two colleagues wrote a piece for the Wall Street Journalsupporting the testing of experimental drugs. Do you think that could be the solution?
Patients could probably be treated most quickly with blood serum from Ebola survivors, even if that would likely be extremely difficult given the chaotic local conditions. We need to find out now if these methods, or if experimental drugs like ZMapp, really help. But we should definitely not rely entirely on new treatments. For most people, they will come too late in this epidemic. But if they help, they should be made available for the next outbreak.
Testing of two vaccines is also beginning. It will take a while, of course, but could it be that only a vaccine can stop the epidemic?
I hope that’s not the case. But who knows? Maybe.
In Zaire during that first outbreak, a hospital with poor hygiene was responsible for spreading the illness. Today almost the same thing is happening. Was Louis Pasteur right when he said: “It is the microbes who will have the last word”?
Of course, we are a long way away from declaring victory over bacteria and viruses. HIV is still here; in London alone, five gay men become infected daily. An increasing number of bacteria are becoming resistant to antibiotics. And I can still see the Ebola patients in Yambuku, how they died in their shacks and we couldn’t do anything except let them die. In principle, it’s still the same today. That is very depressing. But it also provides me with a strong motivation to do something. I love life. That is why I am doing everything I can to convince the powerful in this world to finally send sufficient help to west Africa. Now!
A 1976 photograph of two nurses standing in front of Mayinga N., a person with Ebola virus disease; she died only a few days later due to severe internal hemorrhaging.
Ebola virus disease (EVD), Ebola hemorrhagic fever (EHF), or simply Ebola is a disease of humans and other primates caused by an ebolavirus. Symptoms start two days to three weeks after contracting the virus, with afever, sore throat, muscle pain, and headaches. Typically, vomiting, diarrhea, and rash follow, along with decreased function of the liver and kidneys. Around this time, affected people may begin to bleed both within the bodyand externally.[1]
The virus may be acquired upon contact with blood or bodily fluids of an infected human or other animal.[1] Spreading through the air has not been documented in the natural environment.[2]Fruit bats are believed to be a carrier and may spread the virus without being affected. Once human infection occurs, the disease may spread between people, as well. Male survivors may be able to transmit the disease via semen for nearly two months. To make the diagnosis, typically other diseases with similar symptoms such as malaria, cholera and other viral hemorrhagic fevers are first excluded. To confirm the diagnosis, blood samples are tested for viral antibodies, viralRNA, or the virus itself.[1]
Outbreak control require community engagement, case management, surveillance and contact tracing, a good laboratory service, and safe burials.[1] Prevention includes decreasing the spread of disease from infected animals to humans. This may be done by checking such animals for infection and killing and properly disposing of the bodies if the disease is discovered. Properly cooking meat and wearing protective clothing when handling meat may also be helpful, as are wearing protective clothing and washing hands when around a person with the disease. Samples of bodily fluids and tissues from people with the disease should be handled with special caution.[1]
No specific treatment for the disease is yet available.[1] Efforts to help those who are infected are supportive and include giving either oral rehydration therapy (slightly sweet and salty water to drink) or intravenous fluids.[1] This supportive care improves outcomes.[1] The disease has a high risk of death, killing between 50% and 90% of those infected with the virus.[1][3] EVD was first identified in an area of Sudan that is now part of South Sudan, as well as in Zaire (now the Democratic Republic of the Congo). The disease typically occurs in outbreaks in tropical regions of sub-Saharan Africa.[1] From 1976 (when it was first identified) through 2013, the World Health Organization reported a total of 1,716 cases.[1][4] The largest outbreak to date is the ongoing 2014 West African Ebola outbreak, which is affecting Guinea, Sierra Leone, Liberia, and Nigeria.[5][6] As of 28 September 2014, 7,157 suspected cases resulting in the deaths of 3,330 have been reported.[7] Efforts are under way to develop a vaccine; however, none yet exists.[1]
Signs and symptoms of Ebola usually begin suddenly with an influenza-like stage characterized by fatigue, fever, headaches, joint, muscle, and abdominal pain.[9][10] Vomiting, diarrhea, and loss of appetite are also common.[10]Less common symptoms include the following: sore throat, chest pain, hiccups, shortness of breath, and trouble swallowing.[10] The average time between contracting the infection and the start of symptoms (incubation period) is 8 to 10 days, but it can vary between 2 and 21 days.[10][11] Skin manifestations may include a maculopapular rash (in about 50% of cases).[12] Early symptoms of EVD may be similar to those of malaria, dengue fever, or other tropical fevers, before the disease progresses to the bleeding phase.[9]
Heavy bleeding is rare and is usually confined to the gastrointestinal tract.[12][15] In general, the development of bleeding symptoms often indicates a worse prognosis and this blood loss can result in death.[9] All people infected show some signs of circulatory system involvement, including impaired blood clotting.[12] If the infected person does not recover, death due to multiple organ dysfunction syndrome occurs within 7 to 16 days (usually between days 8 and 9) after first symptoms.[14]
EVD is caused by four of five viruses classified in the genus Ebolavirus, family Filoviridae, order Mononegavirales. The four disease-causing viruses are Bundibugyo virus (BDBV), Sudan virus (SUDV), Taï Forest virus (TAFV), and one called, simply, Ebola virus (EBOV, formerly Zaire Ebola virus)). Ebola virus is the sole member of the Zaire ebolavirus species and the most dangerous of the known Ebola disease-causing viruses, as well as being responsible for the largest number of outbreaks.[16] The fifth virus, Reston virus (RESTV), is not thought to be disease-causing in humans. These five viruses are closely related to the Marburg viruses.
Transmission
Human-to-human transmission can occur via direct contact with blood or bodily fluids from an infected person (including embalming of an infected dead person) or by contact with objects contaminated by the virus, particularly needles and syringes.[17] Other body fluids with ebola virus include saliva, mucus, vomit, feces, sweat, tears, breast milk, urine, and semen. Entry points include the nose, mouth, eyes, or open wounds, cuts and abrasions.[18] The potential for widespread EVD infections is considered low as the disease is only spread by direct contact with the secretions from someone who is showing signs of infection.[17] The symptoms limit a person’s ability to spread the disease as they are often too sick to travel.[19] Because dead bodies are still infectious, traditional burial rituals may spread the disease. Nearly two thirds of the cases of Ebola in Guinea during the 2014 outbreak are believed to be due to burial practices.[20][21] Semen may be infectious in survivors for up to 7 weeks.[1] It is not entirely clear how an outbreak is initially started.[22] The initial infection is believed to occur after ebola virus is transmitted to a human by contact with an infected animal’s body fluids.
One of the primary reasons for spread is that the health systems in the part of Africa where the disease occurs function poorly.[23] Medical workers who do not wear appropriate protective clothing may contract the disease.[24]Hospital-acquired transmission has occurred in African countries due to the reuse of needles and lack of universal precautions.[25][26] Some healthcare centers caring for people with the disease do not have running water.[27]
Airborne transmission has not been documented during EVD outbreaks.[2] They are, however, infectious as breathable 0.8– to 1.2-μm laboratory-generated droplets.[28] The virus has been shown to travel, without contact, from pigs to primates, although the same study failed to demonstrate similar transmission between non-human primates.[29]
Bats drop partially eaten fruits and pulp, then land mammals such as gorillas and duikers feed on these fallen fruits. This chain of events forms a possible indirect means of transmission from the natural host to animal populations, which has led to research towards viral shedding in the saliva of bats. Fruit production, animal behavior, and other factors vary at different times and places that may trigger outbreaks among animal populations.[30]
Reservoir
Bushmeat being prepared for cooking in Ghana, 2013. Human consumption of equatorial animals in Africa in the form of bushmeat has been linked to the transmission of diseases to people, including Ebola.[31]
Bats are considered the most likely natural reservoir of the EBOV. Plants, arthropods, and birds were also considered.[1][32] Bats were known to reside in the cotton factory in which the first cases for the 1976 and 1979 outbreaks were observed, and they have also been implicated in Marburg virus infections in 1975 and 1980.[33] Of 24 plant species and 19 vertebrate species experimentally inoculated with EBOV, only bats became infected.[34] The absence of clinical signs in these bats is characteristic of a reservoir species. In a 2002–2003 survey of 1,030 animals including 679 bats from Gabon and the Republic of the Congo, 13 fruit bats were found to contain EBOV RNA fragments.[35] As of 2005, three types of fruit bats (Hypsignathus monstrosus, Epomops franqueti, and Myonycteris torquata) have been identified as being in contact with EBOV. They are now suspected to represent the EBOV reservoir hosts.[36][37] Antibodies against Zaire and Reston viruses have been found in fruit bats in Bangladesh, thus identifying potential virus hosts and signs of the filoviruses in Asia.[38]
Between 1976 and 1998, in 30,000 mammals, birds, reptiles, amphibians and arthropods sampled from outbreak regions, no ebolavirus was detected apart from some genetic traces found in six rodents (Mus setulosus andPraomys) and one shrew (Sylvisorex ollula) collected from the Central African Republic.[33][39] Traces of EBOV were detected in the carcasses of gorillas and chimpanzees during outbreaks in 2001 and 2003, which later became the source of human infections. However, the high lethality from infection in these species makes them unlikely as a natural reservoir.[33]
Transmission between natural reservoir and humans is rare, and outbreaks are usually traceable to a single case where an individual has handled the carcass of gorilla, chimpanzee or duiker.[40] Fruit bats are also eaten by people in parts of West Africa where they are smoked, grilled or made into a spicy soup.[37][41]
Like all mononegaviruses, ebolavirions contain linear nonsegmented, single-strand, non-infectious RNAgenomes of negative polarity that possesses inverse-complementary 3′ and 5′ termini, do not possess a 5′ cap, are notpolyadenylated, and are not covalently linked to a protein.[42] Ebolavirus genomes are approximately 19 kilobase pairs long and contain seven genes in the order 3′-UTR–NP–VP35–VP40–GP–VP30–VP24–L–5′-UTR.[43] The genomes of the five different ebolaviruses (BDBV, EBOV, RESTV, SUDV, and TAFV) differ in sequence and the number and location of gene overlaps.
Structure
Like all filoviruses, ebolavirions are filamentous particles that may appear in the shape of a shepherd’s crook or in the shape of a “U” or a “6”, and they may be coiled, toroid, or branched.[43] In general, ebolavirions are 80 nm in width, but vary somewhat in length. In general, the median particle length of ebolaviruses ranges from 974 to 1,086 nm (in contrast to marburgvirions, whose median particle length was measured at 795–828 nm), but particles as long as 14,000 nm have been detected in tissue culture.[44]
Replication
The ebolavirus life cycle begins with virion attachment to specific cell-surface receptors, followed by fusion of the virion envelope with cellular membranes and the concomitant release of the virus nucleocapsid into the cytosol. The viral RNA polymerase, encoded by the L gene, partially uncoats the nucleocapsid and transcribes the genes into positive-strand mRNAs, which are then translated into structural and nonstructural proteins. Ebolavirus RNA polymerase (L) binds to a single promoter located at the 3′ end of the genome. Transcription either terminates after a gene or continues to the next gene downstream. This means that genes close to the 3′ end of the genome are transcribed in the greatest abundance, whereas those toward the 5′ end are least likely to be transcribed. The gene order is, therefore, a simple but effective form of transcriptional regulation. The most abundant protein produced is the nucleoprotein, whose concentration in the cell determines when L switches from gene transcription to genome replication. Replication results in full-length, positive-strand antigenomes that are, in turn, transcribed into negative-strand virus progeny genome copy. Newly synthesized structural proteins and genomes self-assemble and accumulate near the inside of the cell membrane. Virions bud off from the cell, gaining their envelopes from the cellular membrane they bud from. The mature progeny particles then infect other cells to repeat the cycle. The Ebola virus genetics are difficult to study due to its virulent nature.[45]
Pathophysiology
Pathogenesis schematic
Endothelial cells, macrophages, monocytes, and liver cells are the main targets of infection. After infection, a secreted glycoprotein (sGP) known as the Ebola virus glycoprotein (GP) is synthesized. Ebola replication overwhelms protein synthesis of infected cells and host immune defenses. The GP forms a trimeric complex, which binds the virus to the endothelial cells lining the interior surface of blood vessels. The sGP forms a dimeric protein that interferes with the signaling of neutrophils, a type of white blood cell, which allows the virus to evade the immune system by inhibiting early steps of neutrophil activation. These white blood cells also serve as carriers to transport the virus throughout the entire body to places such as the lymph nodes, liver, lungs, and spleen.[46]
The presence of viral particles and cell damage resulting from budding causes the release of chemical signals (to be specific, TNF-α, IL-6, IL-8, etc.), which are the signaling molecules for fever and inflammation. The cytopathic effect, from infection in the endothelial cells, results in a loss of vascular integrity. This loss in vascular integrity is furthered with synthesis of GP, which reduces specific integrins responsible for cell adhesion to the inter-cellular structure, and damage to the liver, which leads to improper clotting.[47]
Diagnosis
The travel and work history along with exposure to wildlife are important to consider when the diagnosis of EVD is suspected. The diagnosis is confirmed by isolating the virus, detecting its RNA or proteins, or detecting antibodiesagainst the virus in a person’s blood. Isolating the virus by cell culture, detecting the viral RNA by polymerase chain reaction (PCR) and detecting proteins by enzyme-linked immunosorbent assay (ELISA) works best early and in those who have died from the disease. Detecting antibodies against the virus works best late in the disease and in those who recover.[48]
During an outbreak, virus isolation is often not feasible. The most common diagnostic methods are therefore real-time PCR and ELISA detection of proteins, which can be performed in field or mobile hospitals.[49] Filovirions can be seen and identified in cell culture by electron microscopy due to their unique filamentous shapes, but electron microscopy cannot tell the difference between the various filoviruses despite there being some length differences.[44]
Phylogenetic tree comparing the Ebolavirus and Marburgvirus. Numbers indicate percent confidence of branches.
Classification
The genera Ebolavirus and Marburgvirus were originally classified as the species of the now-obsolete Filovirus genus. In March 1998, the Vertebrate Virus Subcommittee proposed in the International Committee on Taxonomy of Viruses (ICTV) to change the Filovirus genus to the Filoviridae family with two specific genera: Ebola-like viruses andMarburg-like viruses. This proposal was implemented in Washington, DC, on April 2001 and in Paris on July 2002. In 2000, another proposal was made in Washington, D.C., to change the “-like viruses” to “-virus” resulting in today’s Ebolavirus and Marburgvirus.[50]
Rates of genetic change are 100 times slower than influenza A in humans, but on the same magnitude as those of hepatitis B. Extrapolating backwards using these rates indicates that Ebolavirus and Marburgvirus diverged several thousand years ago.[51] However, paleoviruses (genomic fossils) of filoviruses (Filoviridae) found in mammals indicate that the family itself is at least tens of millions of years old.[52]Fossilized viruses that are closely related to ebolaviruses have been found in the genome of the Chinese hamster.[53]
The risk of transmission is increased among those caring for people infected. Recommended measures when caring for those who are infected include isolating them, sterilizing equipment and surfaces, and wearing protective clothing including masks, gloves, gowns, and goggles.[22] If a person with Ebola dies, direct contact with the body of the deceased patient should be avoided.[22]
In order to reduce the spread, the World Health Organization recommends raising community awareness of the risk factors for Ebola infection and the protective measures individuals can take.[60] These include avoiding contact with infected people and regular hand washing using soap and water.[61] Traditional burial rituals, especially those requiring washing or embalming of bodies, should be discouraged or modified.[62][63] Social anthropologists may help find alternatives to traditional rules for burials.[64] Airline crews are instructed to isolate anyone who has symptoms resembling Ebola virus.[65]
The Ebola virus can be eliminated with heat (heating for 30 to 60 minutes at 60 °C or boiling for 5 minutes). On surfaces, some lipid solvents such as some alcohol-based products, detergents, sodium hypochlorite (bleach) or calcium hypochlorite (bleaching powder), and other suitable disinfectants at appropriate concentrations can be used as disinfectants.[66][67]
In laboratories where diagnostic testing is carried out, biosafety level 4-equivalent containment is required, since Ebola viruses are World Health Organization Risk Group 4 pathogens. Laboratory researchers must be properly trained in BSL-4 practices and wear proper personal protective equipment.
Quarantine
Quarantine, also known as enforced isolation, is usually effective in decreasing spread.[68][69] Governments often quarantine areas where the disease is occurring or individuals who may be infected.[70] In the United States, the law allows quarantine of those infected with Ebola.[71] During the 2014 outbreak, Liberia closed schools.[72]
Contact tracing
Contact tracing is regarded as important to contain an outbreak. It involves finding everyone who had close contact with infected individuals and watching for signs of illness for 21 days. If any of these contacts comes down with the disease, they should be isolated, tested, and treated. Then repeat the process by tracing the contacts’ contacts.[73][74]
Treatment
Standard support
A hospital isolation ward in Gulu, Uganda, during the October 2000 outbreak
Intensive care is often used in the developed world.[77] This may include maintaining blood volume and electrolytes (salts) balance as well as treating any bacterial infections that may develop.[77] Dialysis may be needed for kidney failure while extracorporeal membrane oxygenation may be used for lung dysfunction.[77]
Prognosis
The disease has a high mortality rate: often between 25 percent and 90 percent.[1][3] As of September 2014, information from WHO across all occurrences to date puts the overall fatality rate at 50%.[1] There are indications based on variations in death rate between countries that early and effective treatment of symptoms (e.g., supportive care to prevent dehydration) may reduce the fatality rate significantly.[78] If an infected person survives, recovery may be quick and complete. Prolonged cases are often complicated by the occurrence of long-term problems, such as inflammation of the testicles, joint pains, muscle pains, skin peeling, or hair loss. Eye symptoms, such as light sensitivity, excess tearing, iritis, iridocyclitis, choroiditis, and blindness have also been described. EBOV and SUDV may be able to persist in the semen of some survivors for up to seven weeks, which could give rise to infections and disease via sexual intercourse.[1]
CDC worker incinerates medical waste from Ebola patients in Zaire in 1976
The disease typically occurs in outbreaks in tropical regions of Sub-Saharan Africa.[1] From 1976 (when it was first identified) through 2013, the World Health Organization reported 1,716 confirmed cases.[1][4] The largest outbreak to date is the ongoing 2014 West Africa Ebola virus outbreak, which is affecting Guinea, Sierra Leone, Liberia and Nigeria.[5][6] As of 13 August, 2,127 cases have been identified, with 1,145 deaths.[5]
1976
The first identified case of Ebola was on 26 August 1976, in Yambuku, a small rural village in Mongala District in northern Democratic Republic of the Congo (then known as Zaire).[79] The first victim, and the index case for the disease, was village school headmaster Mabalo Lokela, who had toured an area near the Central African Republic border along the Ebola river between 12–22 August. On 8 September he died of what would become known as the Ebola virus species of the ebolavirus.[80] Subsequently a number of other cases were reported, almost all centered on the Yambuku mission hospital or having close contact with another case.[80] 318 cases and 280 deaths (a 88% fatality rate) occurred in the DRC.[81] The Ebola outbreak was contained with the help of the World Health Organization and transport from the Congolese air force, by quarantining villagers, sterilizing medical equipment, and providing protective clothing. The virus responsible for the initial outbreak, first thought to be Marburg virus, was later identified as a new type of virus related to Marburg, and named after the nearby Ebola river. Another ebolavirus, the Sudan virus species, was also identified that same year when an outbreak occurred in Sudan, affecting 284 people and killing 151.[82]
1995 to 2013
The second major outbreak occurred in 1995 in the Democratic Republic of Congo, affecting 315 and killing 254. The next major outbreak occurred in Uganda in 2000, affecting 425 and killing 224; in this case the Sudan virus was found to be the ebolavirus species responsible for the outbreak.[83] In 2003 there was an outbreak in the Republic of Congo that affected 143 and killed 128, a death rate of 90%, the highest to date.[84]
In August 2007, 103 people were infected by a suspected hemorrhagic fever outbreak in the village of Kampungu, Democratic Republic of the Congo. The outbreak started after the funerals of two village chiefs, and 217 people in four villages fell ill.[83][85][86] The 2007 outbreak eventually affected 264 individuals and resulted in the deaths of 187.[1]
On 30 November 2007, the Uganda Ministry of Health confirmed an outbreak of Ebola in the Bundibugyo District in Western Uganda. After confirmation of samples tested by the United States National Reference Laboratories and the Centers for Disease Control, the World Health Organization confirmed the presence of a new species of Ebolavirus, which was tentatively named Bundibugyo.[87] The WHO reported 149 cases of this new strain and 37 of those led to deaths.[1]
The WHO confirmed two small outbreaks in Uganda in 2012. The first outbreak affected 7 people and resulted in the death of 4 and the second affected 24, resulting in the death of 17. The Sudan variant was responsible for both outbreaks.[1]
On 17 August 2012, the Ministry of Health of the Democratic Republic of the Congo reported an outbreak of the Ebola-Bundibugyo variant[88] in the eastern region.[89][90] Other than its discovery in 2007, this was the only time that this variant has been identified as the ebolavirus responsible for an outbreak. The WHO revealed that the virus had sickened 57 people and claimed 29 lives. The probable cause of the outbreak was tainted bush meat hunted by local villagers around the towns of Isiro and Viadana.[1][91]
Increase over time in the cases and deaths during the 2014 outbreak
In March 2014, the World Health Organization (WHO) reported a major Ebola outbreak in Guinea, a western African nation.[92] Researchers traced the outbreak to a two-year old child who died on 28 December 2013.[93][94] The disease then rapidly spread to the neighboring countries of Liberia and Sierra Leone. It is the largest Ebola outbreak ever documented, and the first recorded in the region.[92]
On 8 August 2014, the WHO declared the epidemic to be an international public health emergency. Urging the world to offer aid to the affected regions, the Director-General said, “Countries affected to date simply do not have the capacity to manage an outbreak of this size and complexity on their own. I urge the international community to provide this support on the most urgent basis possible.”[95] By mid-August 2014, Doctors Without Borders reported the situation in Liberia’s capital Monrovia as “catastrophic” and “deteriorating daily”. They reported that fears of Ebola among staff members and patients had shut down much of the city’s health system, leaving many people without treatment for other conditions.[96] By late August 2014, the disease had spread to Nigeria, and one case was reported in Senegal.[97][98][99][100] On 30 September 2014, the first confirmed case of Ebola was diagnosed in the United States at Texas Health Presbyterian Hospital in Dallas, Texas.[101]
Aside from the human cost, the outbreak has severely eroded the economies of the affected countries. A Financial Times report suggested the economic impact of the outbreak could kill more people than the virus itself. As of 23 September, in the three hardest hit countries, Liberia, Sierra Leone, and Guinea, there were only 893 treatment beds available while the current need was 2122. In a 26 September statement, the WHO said, “The Ebola epidemic ravaging parts of West Africa is the most severe acute public health emergency seen in modern times. Never before in recorded history has a biosafety level four pathogen infected so many people so quickly, over such a broad geographical area, for so long.”[102]
By 29 September 2014, 7,192 suspected cases and 3,286 deaths had been reported, however the World Health Organization has said that these numbers may be vastly underestimated.[103] The WHO reports that more than 216 healthcare workers are among the dead, partly due to the lack of equipment and long hours.[104][105]
History
For more about the outbreak in Virginia, US, see Reston virus.
Cases of ebola fever in Africa from 1979 to 2008.
The first recorded outbreak of EBD occurred in Southern Sudan in June 1976. A second outbreak soon followed in the Democratic Republic of the Congo (then Zaire).[106] Virus isolated from both outbreaks was named “Ebola virus” by Belgian researchers[107] after the Ebola River, located near the Zaire outbreak.[108] Although it was assumed that the two outbreaks were connected, scientists later realized that they were caused by distinct species of filoviruses, Sudan virus and Ebola virus.[106]
In late 1989, Hazelton Research Products’ Reston Quarantine Unit in Reston, Virginia suffered a mysterious outbreak of fatal illness (initially diagnosed as Simian hemorrhagic fever virus (SHFV)) among a shipment of crab-eating macaque monkeys imported from the Philippines. Hazelton’s veterinary pathologist sent tissue samples from dead animals to the United States Army Medical Research Institute of Infectious Diseases (USAMRIID) at Fort Detrick, Maryland, where a laboratory test known as an ELISA assay showed antibodies to Ebola virus.[109] An electron microscopist from USAMRIID discoveredfiloviruses similar in appearance to Ebola in the tissue samples sent from Hazelton Research Products’ Reston Quarantine Unit.[110]
Shortly afterward, a US Army team headquartered at USAMRIID went into action to euthanize the monkeys which had not yet died, bringing those monkeys and those which had already died of the disease toFt. Detrick for study by the Army’s veterinary pathologists and virologists, and eventual disposal under safe conditions.[109]
Blood samples were taken from 178 animal handlers during the incident.[111] Of those, six animal handlers eventually seroconverted, including one who had cut himself with a bloody scalpel.[46][112] When the handlers did not become ill, the CDC concluded that the virus had a very low pathogenicity to humans.[112]
The Philippines and the United States had no previous cases of Ebola infection, and upon further isolation, researchers concluded it was another strain of Ebola, or a new filovirus of Asian origin, which they named Reston ebolavirus (REBOV) after the location of the incident.[109]
William Close‘s 1995 Ebola: A Documentary Novel of Its First Explosion and 2002 Ebola: Through the Eyes of the People focused on individuals’ reactions to the 1976 Ebola outbreak in Zaire.[117]
It is widely believed that outbreaks of EVD among human populations result from handling infected wild animal carcasses. Some research suggests that an outbreak in the wild animals used for consumption, bushmeat, may result in a corresponding human outbreak. Since 2003, such outbreaks have been monitored through surveillance of animal populations with the aim of predicting and preventing Ebola outbreaks in humans.[119]
Recovered carcasses from gorillas contain multiple Ebola virus strains, which suggest multiple introductions of the virus. Bodies decompose quickly and carcasses are not infectious after three to four days. Contact between gorilla groups is rare, suggesting transmission among gorilla groups is unlikely, and that outbreaks result from transmission between viral reservoir and animal populations.[120]
Ebola has a high mortality among primates.[121] Frequent outbreaks of Ebola may have resulted in the deaths of 5,000 gorillas.[122] Outbreaks of Ebola may have been responsible for an 88% decline in tracking indices of observed chimpanzee populations in 420 square kilometer Lossi Sanctuary between 2002 and 2003.[120] Transmission among chimpanzees through meat consumption constitutes a significant risk factor, while contact between individuals, such as touching dead bodies and grooming, is not.[123]
Domesticated animals
Reston ebolavirus (REBOV) can be transmitted to pigs.[124] This virus was discovered during an outbreak of what at the time was thought to be simian hemorrhagic fever virus (SHFV) in crab-eating macaques in Reston, Virginia (hence the name Reston elabavirus) in 1989. Since the initial outbreak it has since been found in nonhuman primates in Pennsylvania, Texas, and Italy. In each case, the affected animals had been imported from a facility in the Philippines,[70] where the virus had infected pigs.[125] Despite its status as a Level‑4organism and its apparent pathogenicity in monkeys, REBOV has not caused disease in exposed human laboratory workers.[126] In 2012 it was demonstrated that the virus can travel without contact from pigs to nonhuman primates, although the same study failed to achieve transmission in that manner between primates.[124] According to the WHO, routine cleaning and disinfection of pig (or monkey) farms with sodium hypochlorite or other detergents should be effective in inactivating the Reston ebolavirus. If an outbreak is suspected, the area must be immediately quarantined.[82]
While pigs that have been infected with REBOV tend to show symptoms of the disease, it has been shown that dogs may become infected with EBOV and remain asymptomatic. Dogs in some parts of Africa scavenge for their food and it is known that they sometimes eat infected animals and the corpses of humans. Although they remain asymptomatic, a 2005 survey of dogs during an EBOV outbreak found that over 31.8% showed a seroprevalence for EBOV closest to an outbreak versus 9% a farther distance away.[127]
Research
A number of experimental treatments are being studied.[128] In the United States, the Food and Drug Administration (FDA)’s animal efficacy rule is being used to demonstrate reasonable safety to obtain permission to treat people who are infected with Ebola. It is being used as the normal path for testing drugs is not possible for diseases caused by dangerous pathogens or toxins. Experimental drugs are made available for use with the approval of regulatory agencies under named patient programs, known in the US as “expanded access”.[129] On 12 August 2014 the WHO released a statement that the use of not yet proven treatments is ethical in certain situations in an effort to treat or prevent the disease.[130]
Medications
Researchers looking at slides of cultures of cells that make monoclonal antibodies. These are grown in a lab and the researchers are analyzing the products to select the most promising of them.
As of August 14, 2014, the United States Food and Drug Administration (FDA) has not approved any drugs to treat or prevent Ebola and advises people to watch out for fraudulent products.[131] The unavailability of experimental treatments in the most affected regions during the 2014 outbreak spurred controversy, with some calling for experimental drugs to be made more widely available in Africa on a humanitarian basis, and others warning that making unproven experimental drugs widely available would be unethical, especially in light of past experimentation conducted in developing countries by Western drug companies.[132][133]
ZMapp is a monoclonal antibody vaccine. The limited supply of the drug has been used to treat a small number of individuals infected with the Ebola virus. Although some of these have recovered the outcome is not consideredstatistically significant.[138] ZMapp has proved effective in a trial involving Rhesus macaque monkeys.[139]
Antivirals
A number of antiviral medications are being studied. Favipiravir, an anti-viral drug approved in Japan for stockpiling against influenza pandemics, appears to be useful in a mouse model of Ebola.[9][140] On 4 October 2014, it was reported that a French nun who contracted Ebola while volunteering in Liberia was cured with Favipiravir treatment.[141]BCX4430 is a broad-spectrum antiviral drug developed by BioCryst Pharmaceuticals and currently being researched as a potential treatment for Ebola by USAMRIID.[142] The drug has been approved to progress to Phase 1 trials, expected late in 2014.[143]Brincidofovir, another broad-spectrum antiviral drug, has been granted an emergency FDA approval as an investigational new drug for the treatment of Ebola, after it was found to be effective against Ebolavirus in in vitro tests.[144] It has subsequently been used to treat the first patient diagnosed with Ebola in the USA, after he had recently returned from Liberia.[145] The antiviral drug lamivudine, which is usually used to treat HIV / AIDS, was reported in September 2014 to have been used successfully to treat 13 out of 15 Ebola-infected patients by a doctor in Liberia, as part of a combination therapy also involving intravenous fluids and antibiotics to combat opportunistic bacterial infection of Ebola-compromised internal organs.[146] Western virologists have however expressed caution about the results, due to the small number of patients treated and confounding factors present. Researchers at the NIH stated that lamivudine had so far failed to demonstrate anti-Ebola activity in preliminary in vitro tests, but that they would continue to test it under different conditions and would progress it to trials if even slight evidence for efficacy is found.[147]
Two selective estrogen receptor modulators used to treat infertility and breast cancer (clomiphene and toremifene) have been found to inhibit the progress of Ebola virus in infected mice. Ninety percent of the mice treated with clomiphene and fifty percent of those treated with toremifene survived the tests.[152]
A 2014 study found that three ion channel blockers used in the treatment of heart arrhythmias, amiodarone, dronedarone and verapamil, block the entry of Ebolavirus into cells in vitro.[153] Given their oral availability and history of human use, these drugs would be candidates for treating Ebola virus infection in remote geographical locations, either on their own or together with other antiviral drugs.
Melatonin has also been suggested as a potential treatment for Ebola based on promising in vitro results.[154]
Blood products
The WHO has stated that transfusion of whole blood or purified serum from Ebola survivors is the therapy with the greatest potential to be implemented immediately, although there is little information as to its efficacy.[155] At the end of September, WHO issued an interim guideline for this therapy.[156] The blood serum from those who have survived an infection is currently being studied to see if it is an effective treatment.[157] During a meeting arranged by WHO this research was deemed to be a top priority.[157] Seven of eight people with Ebola survived after receiving a transfusion of blood donated by individuals who had previously survived the infection in an 1999 outbreak in the Democratic Republic of the Congo.[76][158] This treatment, however, was started late in the disease meaning they may have already been recovering on their own and the rest of their care was better than usual.[76] Thus this potential treatment remains controversial.[77]Intravenous antibodies appear to be protective in non-human primates who have been exposed to large doses of Ebola.[159]The World Health Organisation has approved the use of convalescent serum and whole blood products to treat people with Ebola.[160]
Vaccines have protected nonhuman primates. Immunization takes six months, which impedes the counter-epidemic use of the vaccines. Searching for a quicker onset of effectiveness, in 2003, a vaccine using an adenoviral (ADV) vector carrying the Ebola spike protein was tested on crab-eating macaques. Twenty-eight days later, they were challenged with the virus and remained resistant.[162] A vaccine based on attenuated recombinant vesicular stomatitis virus (VSV) vector carrying either the Ebola glycoprotein or the Marburg glycoprotein in 2005 protected nonhuman primates,[171] opening clinical trials in humans.[167] The study by October completed the first human trial, over three months giving three vaccinations safely inducing an immune response. Individuals for a year were followed, and, in 2006, a study testing a faster-acting, single-shot vaccine began; this new study was completed in 2008.[168] Trying the vaccine on a strain of Ebola that more resembles one that infects humans is the next step.[172] On 6 December 2011, the development of a successfulvaccine against Ebola for mice was reported. Unlike the predecessors, it can be freeze-dried and thus stored for long periods in wait for an outbreak.[173] An experimental vaccine made by researchers at Canada’s national laboratory in Winnipeg was used, in 2009, to pre-emptively treat a German scientist who might have been infected during a lab accident.[174] However, actual EBOV infection was never demonstrated beyond doubt.[175] Experimentally, recombinant vesicular stomatitis Indiana virus (VSIV) expressing the glycoprotein of EBOV or SUDV has been used successfully in nonhuman primate models as post-exposure prophylaxis.[176][177] The CDC’s recommendations are currently under review.[citation needed]
Simultaneous phase 1 trials of an experimental vaccine known as the NIAID/GSK vaccine commenced in September 2014.[178]GlaxoSmithKline and the NIH jointly developed the vaccine,[178] based on a modified chimpanzee adenovirus, and contains parts of the Zaireand Sudan ebola strains.[178] If this phase is completed successfully, the vaccine will be fast tracked for use in West Africa. In preparation for this, GSK is preparing a stockpile of 10,000 doses.[179][180]
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Jump up^Pringle, C. R. (2005). “Order Mononegavirales”. In Fauquet, C. M.; Mayo, M. A.; Maniloff, J.; Desselberger, U.; Ball, L. A. Virus Taxonomy – Eighth Report of the International Committee on Taxonomy of Viruses. San Diego, US: Elsevier/Academic Press. pp. 609–614. ISBN0-12-370200-3
^ Jump up to:abKiley MP, Bowen ET, Eddy GA, Isaäcson M, Johnson KM, McCormick JB, Murphy FA, Pattyn SR, Peters D, Prozesky OW, Regnery RL, Simpson DI, Slenczka W, Sureau P, van der Groen G, Webb PA, Wulff H (1982). “Filoviridae: A taxonomic home for Marburg and Ebola viruses?”. Intervirology18 (1–2): 24–32.doi:10.1159/000149300. PMID7118520.
Jump up^Feldmann, H.; Geisbert, T. W.; Jahrling, P. B.; Klenk, H.-D.; Netesov, S. V.; Peters, C. J.; Sanchez, A.; Swanepoel, R.; Volchkov, V. E. (2005). “Family Filoviridae”. In Fauquet, C. M.; Mayo, M. A.; Maniloff, J.; Desselberger, U.; Ball, L. A. Virus Taxonomy – Eighth Report of the International Committee on Taxonomy of Viruses. San Diego, US: Elsevier/Academic Press. pp. 645–653. ISBN0-12-370200-3
^ Jump up to:abSmith, Tara (2005). Ebola (Deadly Diseases and Epidemics). Chelsea House Publications. ISBN0-7910-8505-8.
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Jump up^Gear JH, Ryan J, Rossouw E (1978). “A consideration of the diagnosis of dangerous infectious fevers in South Africa”. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde53 (7): 235–237. PMID565951.
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Jump up^“Ebolavirus – Pathogen Safety Data Sheets”. Laboratory Biosafety and Biosecurity > Biosafety Programs and Resources > Pathogen Safety Data Sheets and Risk Assessment. Public Health Agency of Canada.
Jump up^Alazard-Dany N, Ottmann Terrangle M, Volchkov V (2006). “[Ebola and Marburg viruses: the humans strike back]”. Med Sci (Paris) (in French) 22 (4): 405–10.doi:10.1051/medsci/2006224405. PMID16597410.
Jump up^Formenty P, Libama F, Epelboin A, Allarangar Y, Leroy E, Moudzeo H, Tarangonia P, Molamou A, Lenzi M, Ait-Ikhlef K, Hewlett B, Roth C, Grein T (2003). “[Outbreak of Ebola hemorrhagic fever in the Republic of the Congo, 2003: a new strategy?]”. Med Trop (Mars) (in French) 63 (3): 291–5.PMID14579469.
Jump up^Borio L, Inglesby T, Peters CJ, Schmaljohn AL, Hughes JM, Jahrling PB, Ksiazek T, Johnson KM, Meyerhoff A, O’Toole T, Ascher MS, Bartlett J, Breman JG, Eitzen EM, Hamburg M, Hauer J, Henderson DA, Johnson RT, Kwik G, Layton M, Lillibridge S, Nabel GJ, Osterholm MT, Perl TM, Russell P, Tonat K (2002). “Hemorrhagic fever viruses as biological weapons: medical and public health management”. Journal of the American Medical Association287 (18): 2391–405.doi:10.1001/jama.287.18.2391. PMID11988060.
Jump up^Formenty P, Boesch C, Wyers M, Steiner C, Donati F, Dind F, Walker F, Le Guenno B (1999). “Ebola virus outbreak among wild chimpanzees living in a rain forest of Côte d’Ivoire”. The Journal of infectious diseases. 179. Suppl 1 (s1): S120–S126.doi:10.1086/514296. PMID9988175.
Jump up^Oestereich L, Lüdtke A, Wurr S, Rieger T, Muñoz-Fontela C, Günther S (2014). “Successful treatment of advanced Ebola virus infection with T-705 (favipiravir) in a small animal model”. Antiviral Res.105: 17–21. doi:10.1016/j.antiviral.2014.02.014.PMID24583123.
Jump up^Geisbert TW, Lee AC, Robbins M, Geisbert JB, Honko AN, Sood V, Johnson JC, de Jong S, Tavakoli I, Judge A, Hensley LE, Maclachlan I (29 May 2010). “Postexposure protection of non-human primates against a lethal Ebola virus challenge with RNA interference: A proof-of-concept study”. The Lancet375 (9729): 1896–1905. doi:10.1016/S0140-6736(10)60357-1.PMID20511019.
Jump up^Warren TK, Warfield KL, Wells J, Swenson DL, Donner KS, Van Tongeren SA, Garza NL, Dong L, Mourich DV, Crumley S, Nichols DK, Iversen PL, Bavari S (September 2010). “Advanced antisense therapies for postexposure protection against lethal filovirus infections”. Nature Medicine16 (9): 991–994.doi:10.1038/nm.2202. PMID20729866.
Jump up^Gehring G, Rohrmann K, Atenchong N, Mittler E, Becker S, Dahlmann F, Pöhlmann S, Vondran FW, David S, Manns MP, Ciesek S, von Hahn T (2014). “The clinically approved drugs amiodarone, dronedarone and verapamil inhibit filovirus cell entry”. J. Antimicrob. Chemother.69 (8): 2123–31.doi:10.1093/jac/dku091. PMID24710028.
Jump up^Tan, DX; Reiter, RJ; Manchester, LC (2014 Sep 27). “Ebola virus disease: Potential use of melatonin as a treatment.”. Journal of pineal research. PMID25262626.
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External links
Find more about Ebola virus diseaseat Wikipedia’s sister projects
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Employment Situation Summary
Transmission of material in this release is embargoed until USDL-14-1796
8:30 a.m. (EDT) Friday, October 3, 2014
Technical information:
Household data: (202) 691-6378 • cpsinfo@bls.gov • www.bls.gov/cps
Establishment data: (202) 691-6555 • cesinfo@bls.gov • www.bls.gov/ces
Media contact: (202) 691-5902 • PressOffice@bls.gov
THE EMPLOYMENT SITUATION -- SEPTEMBER 2014
Total nonfarm payroll employment increased by 248,000 in September, and the
unemployment rate declined to 5.9 percent, the U.S. Bureau of Labor Statistics
reported today. Employment increased in professional and business services,
retail trade, and health care.
Household Survey Data
In September, the unemployment rate declined by 0.2 percentage point to 5.9
percent. The number of unemployed persons decreased by 329,000 to 9.3 million.
Over the year, the unemployment rate and the number of unemployed persons were
down by 1.3 percentage points and 1.9 million, respectively. (See table A-1.)
Among the major worker groups, unemployment rates declined in September for
adult men (5.3 percent), whites (5.1 percent), and Hispanics (6.9 percent). The
rates for adult women (5.5 percent), teenagers (20.0 percent), and blacks (11.0
percent) showed little change over the month. The jobless rate for Asians was
4.3 percent (not seasonally adjusted), little changed from a year earlier.
(See tables A-1, A-2, and A-3.)
Among the unemployed, the number of job losers and persons who completed temporary
jobs decreased by 306,000 in September to 4.5 million. The number of long-term
unemployed (those jobless for 27 weeks or more) was essentially unchanged at 3.0
million in September. These individuals accounted for 31.9 percent of the unemployed.
Over the past 12 months, the number of long-term unemployed is down by 1.2 million.
(See tables A-11 and A-12.)
The civilian labor force participation rate, at 62.7 percent, changed little in
September. The employment-population ratio was 59.0 percent for the fourth
consecutive month. (See table A-1.)
The number of persons employed part time for economic reasons (sometimes referred
to as involuntary part-time workers) was little changed in September at 7.1 million.
These individuals, who would have preferred full-time employment, were working part
time because their hours had been cut back or because they were unable to find a
full-time job. (See table A-8.)
In September, 2.2 million persons were marginally attached to the labor force,
essentially unchanged from a year earlier. (The data are not seasonally adjusted.)
These individuals were not in the labor force, wanted and were available for work,
and had looked for a job sometime in the prior 12 months. They were not counted as
unemployed because they had not searched for work in the 4 weeks preceding the survey.
(See table A-16.)
Among the marginally attached, there were 698,000 discouraged workers in September,
down by 154,000 from a year earlier. (The data are not seasonally adjusted.) Discouraged
workers are persons not currently looking for work because they believe no jobs are
available for them. The remaining 1.5 million persons marginally attached to the labor
force in September had not searched for work for reasons such as school attendance or
family responsibilities. (See table A-16.)
Establishment Survey Data
Total nonfarm payroll employment rose by 248,000 in September, compared with an
average monthly gain of 213,000 over the prior 12 months. In September, job growth
occurred in professional and business services, retail trade, and health care.
(See table B-1.)
Professional and business services added 81,000 jobs in September, compared with an
average gain of 56,000 per month over the prior 12 months. In September, job gains
occurred in employment services (+34,000), management and technical consulting
services (+12,000), and architectural and engineering services (+6,000). Employment
in legal services declined by 5,000 over the month.
Employment in retail trade rose by 35,000 in September. Food and beverage stores
added 20,000 jobs, largely reflecting the return of workers who had been off payrolls
in August due to employment disruptions at a grocery store chain in New England.
Employment in retail trade has increased by 264,000 over the past 12 months.
Health care added 23,000 jobs in September, in line with the prior 12-month average
gain of 20,000 jobs per month. In September, employment rose in home health care
services (+7,000) and hospitals (+6,000).
Employment in information increased by 12,000 in September, with a gain of 5,000
in telecommunications. Over the year, employment in information has shown little net
change.
Mining employment rose by 9,000 in September, with the majority of the increase
occurring in support activities for mining (+7,000). Over the year, mining has added
50,000 jobs.
Within leisure and hospitality, employment in food services and drinking places
continued to trend up in September (+20,000) and is up by 290,000 over the year.
In September, construction employment continued on an upward trend (+16,000).
Within the industry, employment in residential building increased by 6,000. Over
the year, construction has added 230,000 jobs.
Employment in financial activities continued to trend up in September (+12,000) and
has added 89,000 jobs over the year. In September, job growth occurred in insurance
carriers and related activities (+6,000) and in securities, commodity contracts,
and investments (+5,000).
Employment in other major industries, including manufacturing, wholesale trade,
transportation and warehousing, and government, showed little change over the month.
In September, the average workweek for all employees on private nonfarm payrolls
edged up by 0.1 hour to 34.6 hours. The manufacturing workweek was unchanged at
40.9 hours, and factory overtime edged up by 0.1 hour to 3.5 hours. The average
workweek for production and nonsupervisory employees on private nonfarm payrolls
edged down by 0.1 hour to 33.7 hours. (See tables B-2 and B-7.)
Average hourly earnings for all employees on private nonfarm payrolls, at $24.53,
changed little in September (-1 cent). Over the year, average hourly earnings
have risen by 2.0 percent. In September, average hourly earnings of private-sector
production and nonsupervisory employees were unchanged at $20.67.
(See tables B-3 and B-8.)
The change in total nonfarm payroll employment for July was revised from +212,000
to +243,000, and the change for August was revised from +142,000 to +180,000.
With these revisions, employment gains in July and August combined were 69,000 more
than previously reported.
_____________
The Employment Situation for October is scheduled to be released on Friday,
November 7, 2014, at 8:30 a.m. (EST).
Employment Situation Summary Table A. Household data, seasonally adjusted
HOUSEHOLD DATA
Summary table A. Household data, seasonally adjusted
[Numbers in thousands]
Category
Sept.
2013
July
2014
Aug.
2014
Sept.
2014
Change from:
Aug.
2014-
Sept.
2014
Employment status
Civilian noninstitutional population
246,168
248,023
248,229
248,446
217
Civilian labor force
155,473
156,023
155,959
155,862
-97
Participation rate
63.2
62.9
62.8
62.7
-0.1
Employed
144,270
146,352
146,368
146,600
232
Employment-population ratio
58.6
59.0
59.0
59.0
0.0
Unemployed
11,203
9,671
9,591
9,262
-329
Unemployment rate
7.2
6.2
6.1
5.9
-0.2
Not in labor force
90,695
92,001
92,269
92,584
315
Unemployment rates
Total, 16 years and over
7.2
6.2
6.1
5.9
-0.2
Adult men (20 years and over)
7.0
5.7
5.7
5.3
-0.4
Adult women (20 years and over)
6.2
5.7
5.7
5.5
-0.2
Teenagers (16 to 19 years)
21.3
20.2
19.6
20.0
0.4
White
6.3
5.3
5.3
5.1
-0.2
Black or African American
13.0
11.4
11.4
11.0
-0.4
Asian (not seasonally adjusted)
5.3
4.5
4.5
4.3
–
Hispanic or Latino ethnicity
8.9
7.8
7.5
6.9
-0.6
Total, 25 years and over
5.9
5.0
5.1
4.7
-0.4
Less than a high school diploma
10.4
9.6
9.1
8.4
-0.7
High school graduates, no college
7.5
6.1
6.2
5.3
-0.9
Some college or associate degree
6.1
5.3
5.4
5.4
0.0
Bachelor’s degree and higher
3.7
3.1
3.2
2.9
-0.3
Reason for unemployment
Job losers and persons who completed temporary jobs
5,803
4,859
4,836
4,530
-306
Job leavers
984
862
860
829
-31
Reentrants
3,165
2,848
2,845
2,809
-36
New entrants
1,211
1,087
1,066
1,105
39
Duration of unemployment
Less than 5 weeks
2,571
2,587
2,609
2,383
-226
5 to 14 weeks
2,685
2,431
2,449
2,508
59
15 to 26 weeks
1,802
1,412
1,486
1,416
-70
27 weeks and over
4,125
3,155
2,963
2,954
-9
Employed persons at work part time
Part time for economic reasons
7,914
7,511
7,277
7,103
-174
Slack work or business conditions
4,955
4,609
4,261
4,162
-99
Could only find part-time work
2,548
2,519
2,587
2,562
-25
Part time for noneconomic reasons
18,919
19,662
19,526
19,561
35
Persons not in the labor force (not seasonally adjusted)
Marginally attached to the labor force
2,302
2,178
2,141
2,226
–
Discouraged workers
852
741
775
698
–
– Over-the-month changes are not displayed for not seasonally adjusted data.
NOTE: Persons whose ethnicity is identified as Hispanic or Latino may be of any race. Detail for the seasonally adjusted data shown in this table will not necessarily add to totals because of the independent seasonal adjustment of the various series. Updated population controls are introduced annually with the release of January data.
Employment Situation Summary Table B. Establishment data, seasonally adjusted
ESTABLISHMENT DATA
Summary table B. Establishment data, seasonally adjusted
Footnotes (1) Includes other industries, not shown separately. (2) Data relate to production employees in mining and logging and manufacturing, construction employees in construction, and nonsupervisory employees in the service-providing industries. (3) The indexes of aggregate weekly hours are calculated by dividing the current month’s estimates of aggregate hours by the corresponding annual average aggregate hours. (4) The indexes of aggregate weekly payrolls are calculated by dividing the current month’s estimates of aggregate weekly payrolls by the corresponding annual average aggregate weekly payrolls. (5) Figures are the percent of industries with employment increasing plus one-half of the industries with unchanged employment, where 50 percent indicates an equal balance between industries with increasing and decreasing employment. (p) Preliminary
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Watch experts analyze the economic effects of pandemic influenza including on the labor force and trade.
This session was part of a CFR symposium, Pandemic Influenza: Science, Economics, and Foreign Policy, which was cosponsored with Science Magazine.
SPEAKERS:
Yanzhong Huang, Director, Center for Global Health Studies, Seton Hall University
Andrew Jack, Pharmaceutical Correspondent, Financial Times
Michael T. Osterholm, Director, Center for Infectious Disease Research and Policy (CIDRAP), University of Minnesota (via teleconference)
PRESIDER:
Robert E. Rubin, Co-Chair, Council on Foreign Relations; Former U.S. Secretary of the Treasury
Saudi Arabia bans Ebola-stricken countries from hajj pilgrimage
With the arrival of approximately two million people from around the world in Saudi Arabia for the annual hajj pilgrimage, there are a group of pilgrims who were not welcomed.
The Saudi government has banned the entry of travelers from three countries currently dealing with the Ebola epidemic: Liberia, Guinea and Sierra Leone. The decision to reject visa requests from these countries has affected 7,400 people, according to the Associated Press.
Hospitals in Saudi Arabia are also preparing in the event of an outbreak by setting up isolation and surgery units as well as dispatching medical staff to airports.
Despite banning pilgrim seekers from West Africa, Saudi officials are granting visas to pilgrims travelling from Nigeria. Saudi Arabia’s King Abdulaziz International Airport has provided them with two exclusive lounges as a precaution.
“So far 118,000 pilgrims have arrived by air from Nigeria. There was not a single suspected case of the deadly virus among anyone of them,” said Abdul Ghani Al-Malki, supervisor of hajj affairs at the airport.
Saudi officials have also been closely monitoring incoming flights from Kenya, Congo and other countries with reported cases of Ebola. Al-Malki told the local Saudi Gazettethat airport’s health inspection center ensured that planes and their passengers were not only free of Ebola, but other contagious diseases as well. “We have double-checked the papers that prove the airplanes had been sprayed twice before taking off to their destinations.”
The current death toll from Ebola in West Africa rose to 3,338, according to the World Health Organization report released Wednesday.
Saudi Arabia plays down Ebola concern for Hajj pilgrimage
Some in the crowd wore face masks – a possible precaution over Ebola fears
Two million Muslims have begun the annual Hajj pilgrimage, a five-day ritual central to Islam.
This year there have been concerns pilgrims may spread the contagious diseases Ebola and MERS.
Saudi Arabia, where the Hajj takes place, played down fears on Ebola, having banned pilgrims from Sierra Leone, Guinea and Liberia.
Their decision has excluded 7,400 Muslims, though it is estimated that 1.4m of the pilgrims are international.
Some of the numbers involved in 2014’s Hajj – in 60 seconds
Saudi Arabia has claimed this year’s Hajj is Ebola free as pilgrims flooded into Mina, 5km (three miles) from the holy city of Mecca, for the start of the pilgrimage.
As well as refusing visas to those from the three countries worst hit by Ebola, Saudi authorities asked all visitors to fill out medical screening cards and detail their travels over the past three weeks.
But Ebola is not the only disease concerning the Saudi government.
MERS, or Middle East Respiratory Syndrome, hit Saudi Arabia badly in the spring of this year.
Since 2012, there have been more than 750 cases of MERS in the country. Of this total 319 people died, some of whom were health workers.
The meaning of Hajj
Pilgrims walk around the Kaaba in Mecca, the building is the most sacred place in Islam and the direction of prayer for Muslims
Hajj is an annual five-day pilgrimage which all able-bodied Muslims are required to perform at least once in their lives, if they can afford it
It is the fifth and final pillar of Islam and is supposed to cleanse Muslims of sin and bring them closer to each other and God
The pilgrims, or Hajjis, wear simple white garments called “ihram” which give them all equal status
Those going on the hajj are required to abstain from sex, not to argue, kill anything or hunt and to avoid shaving and cutting their nails
Pilgrims perform several rituals during the hajj including walking counter-clockwise seven times around the Kaaba in Mecca, drinking from the Zam Zam Well and performing a symbolic stoning of the devil.
Will Airborne Ebola Become A Modern Global Plague?
The last several months have led to much confusion about the spread of the Ebola virus. Health officials and governments first denied that a serious threat existed and took no significant action to prevent its spread outside of West Africa. Then, after it had made it’s way to six different countries in the region, officials at the World Health Organization and the U.S. Centers for Disease Control started to panic. Apathy gave way to the real fear that we were facing a virus on a whole different scale than ever before.
At its current rate, some mathematical models show that the virus could infect anywhere from 20,000 to 100,000 by the end of the year, with over 4,000 people worldwide having been infected thus far. About 2,300 people, over 50% of those who have contracted it, have died.
Fired Up Obama to Immigration Activists: ‘No Force On Earth Can Stop Us’
‘Si se puede, si votamos! Yes, we can, if we vote!’
BY DANIEL HALPER
A fired up President Barack Obama had a message to immigration activists at a dinner this evening in Washington, D.C.: “no force on earth can stop us.”
“The clearest path to change is to change [the voter turnout] number,” said Obama “Si se puede, si votamos! Yes, we can, if we vote!”
“You know, earlier this year, I had a chance to host a screening of the film Cesar Chavez at the White House, and I was reminded that Cesar organized for nearly 20 years before his first major victory. He never saw that time as a failure. Looking back, he said, I remember the families who joined our movement and paid dues long before there was any hope of winning contracts. I remember thinking then that with spirit like that, no force on earth could stop us.
“That’s the promise of America then and that’s the promise of America now. People who love this country can change it. America isn’t Congress. America isn’t Washington. America is the striving immigrant who starts a business or the mom who works two low-wage jobs to give her kids a better life. America is the union leader and the CEO who put aside their differences to make the economy stronger. America is the student who defies the odds to become the first in the family to go to college. The citizen who defies the cynics and goes out there and votes. The young person who comes out of the shadows to demand the right to dream. That’s what America is about.
“And six years ago, I asked you to believe, and tonight, I ask you to keep believing, not just in my ability to bring about change, but in your ability to bring about change. Because in the end, DREAMer is more than just a title, it’s a pretty good description of what it means to be an American.
Patient Being Evaluated for Possible Ebola at D.C.’s Howard University Hospital
A patient with Ebola-like symptoms who had recently traveled to Nigeria is being treated at Howard University Hospital in Washington, D.C., a hospital spokesperson confirmed late Friday morning.
That person has been admitted to the hospital in stable condition and is isolated. The medical team is working with the CDC and other authorities to monitor the patient’s condition.
“In an abundance of caution, we have activated the appropriate infection control protocols, including isolating the patient,” said hospital spokesperson Kerry-Ann Hamilton in a statement. “Our medical team continues to evaluate and monitor progress in close collaboration with the CDC and the Department of Health.”
Hamilton did not share further details about the patient, citing privacy reasons, but said the hospital will provide updates as warranted.
The D.C. Department of Health released a statement shortly before 1 p.m. Wednesday, saying that the department has been working with the CDC and Howard University Hospital to monitor “any patients displaying symptoms associated with the Ebola virus.”
There are no confirmed cases of Ebola in D.C., said the statement.
At Shady Grove Adventist Hospital in Rockville, Maryland, a patient is in isolation with “flu-like symptoms and a travel history that matches criteria for possible Ebola,” according to a statement from the hospital. Lab results indicate the patient has another illness.
“We are working closely with the Montgomery County Health Department and State Department of Health and Mental Hygiene (DHMH) as well as the CDC to manage this case and to ensure we continue to be prepared to care for patients with Ebola symptoms,” the statement said.
“We will only be making an announcement if and when there is a laboratory confirmed case, and that announcement would be made in conjunction with the Maryland Department of Health and Mental Hygiene and the CDC,” Montgomery County Department of Health and Human Services spokesperson Mary Anderson said.
The White House announced Friday that senior administration officials will hold a briefing on the U.S. government’s response to the Ebola pandemic at 4:30 p.m., NBC News reported.
As public health advocates had warned, the raging Ebola outbreak in West Africa has begun to affect Westerners, though the disease is difficult to spread casually.
The cameraman, Ashoka Mukpo, had been working with chief medical correspondent Dr. Nancy Snyderman. NBC News is flying Mukpo and the entire team back to the U.S. so Mukpo can be treated and the team can be quarantined for 21 days.
Snyderman told MSNBC’s Rachel Maddow that she and the rest of her crew have shown no signs of the disease and have taken precautions while covering the outbreak, including washing their hands with bleach.
The crew are quarantining themselves as a precaution.
“There is no risk to people who have been in contact with those who have been sick with Ebola and recovered, or people who have been exposed and have not yet shown symptoms,” said Dr. Thomas Frieden of the CDC.
Duncan, a Liberian man with family in the United States, first went to Texas Health Presbyterian Hospital Sept. 25 but was sent home. He returned to the hospital via ambulance Sunday.
On Friday, he was listed in serious but stable condition.
Officials Say About 100 Individuals Will Be Monitored for Potential Exposure
By ANA CAMPOY, DREW HINSHAW and DAN FROSCH
The number of people in Texas who are being screened for potential exposure to Ebola expanded to approximately 100, and four members of a family close to the U.S. patient were ordered to remain in their Dallas home. (Photo: AP)
The number of people in Texas who are being screened for potential exposure to Ebola expanded Thursday to roughly 100, as health officials cast a wide net to try to prevent the one confirmed case of the disease from sparking an outbreak.
Four members of a family close to Thomas Eric Duncan, the Liberian man diagnosed with the virus, were ordered to remain in their Dallas home and not receive any visitors until at least Oct. 19, to pass the 21-day maximum incubation period for the often-deadly disease.
The 100 people being screened represent a “very wide net,” including some who possibly had brief encounters with Mr. Duncan, Texas health officials said. They added that the number is likely to drop as they narrow the list to those actually at potential risk of infection.
Thursday, an American freelance journalist in Liberia tested positive for the disease, his father and his employer, NBC News, said. The 33-year-old man is tentatively scheduled to be transported back to the U.S. on Sunday.
In Mr. Duncan’s case, Tom Frieden, director of the Centers for Disease Control and Prevention, said officials so far have identified only “a handful” of individuals who may have had close contact with him.
The public health search comes as authorities in Liberia grapple with how Mr. Duncan managed to leave their country and bring Ebola to the U.S. despite government efforts to stop transmission of the virus, a journey that took him from a neighborhood of tin-roof houses in a West African capital to an isolation ward at a Dallas hospital.
Before traveling to Texas via Belgium, Mr. Duncan escorted a woman to a treatment ward in Liberia’s capital, Monrovia, where she was turned away and died of the virus within hours, said Irene Seyou, Mr. Duncan’s next-door neighbor.
In a community near where U.S. victim Thomas Eric Duncan lived in Monrovia, many have died and children are worried they will be taken away. Glenna Gordon for The Wall Street Journal
On Sept. 16, several health workers arrived in Mr. Duncan’s neighborhood in Monrovia to investigate a report that a pregnant 18-year-old woman, recently sent home from a nearby clinic, had shown Ebola symptoms that included vomiting, diarrhea and bleeding, said Prince Toe and other members of the Ebola Response Team in the capital’s 72nd community.
But when the team arrived in the neighborhood, residents insisted the pregnant teenager had been in a car accident, said Mr. Toe, the unit’s supervisor. When the neighbors grew rowdy at being pressed for information, the team turned back, he said.
At Liberia’s airport, the temperatures of arriving and departing passengers are checked three times by security guards—at the entrance, before the check-in desk and at the metal detectors—to screen out those who display Ebola’s hallmark early symptom, a fever.
Passengers are asked to fill out questionnaires about whether they had been in contact with any Ebola victims. Mr. Duncan lied on those forms—and would be prosecuted for doing so if he returns to Liberia—the Associated Press reported Liberia’s government as saying Thursday.
Mr. Duncan is in an isolation unit at Texas Health Presbyterian Hospital in Dallas, which initially sent him home with antibiotics after he complained of illness, only to accept him on Sunday after he returned in an ambulance. Hospital officials have since conceded that they erred by not taking him in initially after he mentioned his symptoms and country of origin.
Hospital officials said Thursday that Mr. Duncan’s condition continued to be serious. Dr. Frieden of the CDC said Mr. Duncan’s physicians were discussing the possible use of experimental treatments with his family.
Edward Goodman, Texas Health Presbyterian Hospital’s epidemiologist, said the team of doctors treating Mr. Duncan has received guidelines from the CDC but that there is no specific treatment for Ebola other than supportive measures, such as keeping the patient well hydrated to avoid organ damage and supplying oxygen.
Most of the 100 people Texas is tracking for potential Ebola exposure haven’t been ordered to stay home. Officials said they ordered four of Mr. Duncan’s family members to remain in their home because the family disobeyed their request to stay there. They said the family, which was examined Thursday, hadn’t developed any symptoms. A law enforcement official is stationed outside their apartment to make sure they don’t leave.
Ebola is a highly contagious virus, but only if you come into contact with certain bodily fluids of those infected. What do scientists know about how it’s transmitted? WSJ’s Jason Bellini has #TheShortAnswer.
Judge Clay Jenkins, the highest elected official in Dallas County, said there were no plans to issue similar orders for other people. Local and state health officials said they had delivered groceries to the family and were arranging for a contractor to clean the apartment. Mr. Jenkins said it appeared that sealed bags filled with Mr. Duncan’s belongings, including his clothes and sheets, were still inside, and that the family had pushed mattresses against the wall.
Dallas Mayor Mike Rawlings sought to assure the public that the risk of contagion was minimal. “We’re getting the word out and people are starting to understand what has happened,” he said.
Still, at schools attended by five children who came into contact with Mr. Duncan, attendance was down to 86% from the 95% level that is normal, said Mike Miles, superintendent of the Dallas Independent School District, who added that custodians were doing extra cleaning.
While officials sought to control the panic over Ebola in Texas, some people who had come into contact with Mr. Duncan wondered why he hadn’t received treatment sooner.
Joe Joe Jallah said he met Mr. Duncan last week when visiting Mr. Jallah’s former wife, Louise Troh, the same woman Mr. Duncan had come to see in the U.S.
Ms. Troh declined to speak about the situation when reached by phone.
Mr. Jallah, who has a daughter with Ms. Troh, said he listened as Mr. Duncan described how dire things had become in Liberia, and how rigorous the health screenings were during his trip to the U.S.
Several days later, on Saturday, Mr. Jallah said he heard that Mr. Duncan had fallen ill at Ms. Troh’s apartment. Concerned, Mr. Jallah went back.
“He was lying down on the floor with a comforter. He said he was sick and that he had no appetite,” Mr. Jallah said.
“I said, ‘Did you go to the hospital?’ He said, ‘Yes, but they did nothing for me,’” Mr. Jallah recalled. “I said, ‘You should eat so you can gain strength.’”
The next day, Mr. Jallah said he returned after his daughter, Youngor Jallah, a nurse’s aide who visits her mother frequently, called, sounding frantic and saying that Mr. Duncan was still sick.
Ms. Jallah said Mr. Duncan had been up all night with diarrhea. His eyes were red, he seemed exhausted and had no appetite for the breakfast she made. He tried to drink some tea. Ms. Jallah took his temperature and it was 104, she said.
Ms. Jallah decided to call an ambulance. When emergency workers came, she informed them that Mr. Duncan was sick and had traveled to Dallas from a virus stricken-region in Africa. The workers put masks over their faces.
Ms. Jallah said she has since been told she and her family must stay in their home for 17 more days.
“I am concerned for myself. When I took his blood pressure, I never had no protection. I worry about my kids. My kids were over there with my mom,” she said.
This biographical articleneeds additional citations for verification. Please help by adding reliable sources. Contentious material about living persons that is unsourced or poorly sourced must be removed immediately, especially if potentially libelous or harmful.(March 2013)
From 1975 to 1999, Osterholm served in various roles at the Minnesota Department of Health (MDH), including as state epidemiologist and Chief of the Acute Disease Epidemiology Section from 1984 to 1999. While at the MDH, Osterholm strengthened the departments role in infectious diseaseepidemiology, notably including numerous foodborne disease outbreaks, the association between tampons and toxic shock syndrome (TSS), and the transmission of hepatitis B and human immunodeficiency virus (HIV) in healthcare workers. Other work included studies regarding the epidemiology of infectious diseases in child-care settings, vaccine-preventable diseases (particularly Haemophilus influenzae type b and hepatitis B), Lyme disease, and other emerging and re-emerging infections.
From 2001 through early 2005, Osterholm, in addition to his role at CIDRAP, served as a Special Advisor to then–HHS Secretary Tommy G. Thompson on issues related to bioterrorism and public health preparedness. In April 2002, Osterholm was appointed to the interim management team to lead the Centers for Disease Control and Prevention (CDC), until the eventual appointment of Julie Gerberding as director.
Osterholm has been particularly outspoken on the lack of international prepardness for an influenzapandemic.[3][4] Osterholm has also been an international leader against the use of biological agents as weapons targeted toward civilians.
Other
Osterholm serves on the editorial boards of five journals, and is a reviewer for another two dozen. He is a past president of the Council of State and Territorial Epidemiologists (CSTE) and has served on the CDC National Center for Infectious Diseases Board of Scientific Counselors from 1992 to 1997.
Osterholm serves on the IOM Forum on Emerging Infections. He has served on the IOM Committee on Emerging Microbial Threats to Health in the 21st Century and the IOM Committee on Food Safety, Production to Consumption, and he was a reviewer for the IOM Report on Chemical and Biological Terrorism. He is a frequent consultant to the World Health Organization (WHO), the National Institutes of Health (NIH), the Food and Drug Administration (FDA), the Department of Defense, and the CDC.
Story 1: Obama Spreading Communicable Diseases Across United States With Illegal Aliens in Schools and Communities– TB, Virus, Ebola — What’s Next? — Pandemic! — Videos
Story 1: When Will Obama Close United States Airports and Borders To Flights and Travelers From Ebola Virus Disease Infected Countries Such As Liberia, Guinea, Sierra Leone and Nigeria? Time To Follow Saudi Arabia’s Stringent Ebola Checks! — Videos
Obama Just Endangered 250 Million Americans, UNBELIEVABLE!
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Suspected Ebola victim dies in Saudi Arabia.
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SOMETHING ‘NEVER SEEN BEFORE’ IS COMING TO AMERICA (GLOBAL PANDEMIC)
Michael Osterholm on the Bird Flu in China
Pandemic Influenza: Science, Economics, and Foreign Policy: Session Two: The Economics
Watch experts analyze the economic effects of pandemic influenza including on the labor force and trade.
This session was part of a CFR symposium, Pandemic Influenza: Science, Economics, and Foreign Policy, which was cosponsored with Science Magazine.
SPEAKERS:
Yanzhong Huang, Director, Center for Global Health Studies, Seton Hall University
Andrew Jack, Pharmaceutical Correspondent, Financial Times
Michael T. Osterholm, Director, Center for Infectious Disease Research and Policy (CIDRAP), University of Minnesota (via teleconference)
PRESIDER:
Robert E. Rubin, Co-Chair, Council on Foreign Relations; Former U.S. Secretary of the Treasury
Saudi Arabia bans Ebola-stricken countries from hajj pilgrimage
With the arrival of approximately two million people from around the world in Saudi Arabia for the annual hajj pilgrimage, there are a group of pilgrims who were not welcomed.
The Saudi government has banned the entry of travelers from three countries currently dealing with the Ebola epidemic: Liberia, Guinea and Sierra Leone. The decision to reject visa requests from these countries has affected 7,400 people, according to the Associated Press.
Hospitals in Saudi Arabia are also preparing in the event of an outbreak by setting up isolation and surgery units as well as dispatching medical staff to airports.
Despite banning pilgrim seekers from West Africa, Saudi officials are granting visas to pilgrims travelling from Nigeria. Saudi Arabia’s King Abdulaziz International Airport has provided them with two exclusive lounges as a precaution.
“So far 118,000 pilgrims have arrived by air from Nigeria. There was not a single suspected case of the deadly virus among anyone of them,” said Abdul Ghani Al-Malki, supervisor of hajj affairs at the airport.
Saudi officials have also been closely monitoring incoming flights from Kenya, Congo and other countries with reported cases of Ebola. Al-Malki told the local Saudi Gazettethat airport’s health inspection center ensured that planes and their passengers were not only free of Ebola, but other contagious diseases as well. “We have double-checked the papers that prove the airplanes had been sprayed twice before taking off to their destinations.”
The current death toll from Ebola in West Africa rose to 3,338, according to the World Health Organization report released Wednesday.
Saudi Arabia plays down Ebola concern for Hajj pilgrimage
Some in the crowd wore face masks – a possible precaution over Ebola fears
Two million Muslims have begun the annual Hajj pilgrimage, a five-day ritual central to Islam.
This year there have been concerns pilgrims may spread the contagious diseases Ebola and MERS.
Saudi Arabia, where the Hajj takes place, played down fears on Ebola, having banned pilgrims from Sierra Leone, Guinea and Liberia.
Their decision has excluded 7,400 Muslims, though it is estimated that 1.4m of the pilgrims are international.
Some of the numbers involved in 2014’s Hajj – in 60 seconds
Saudi Arabia has claimed this year’s Hajj is Ebola free as pilgrims flooded into Mina, 5km (three miles) from the holy city of Mecca, for the start of the pilgrimage.
As well as refusing visas to those from the three countries worst hit by Ebola, Saudi authorities asked all visitors to fill out medical screening cards and detail their travels over the past three weeks.
But Ebola is not the only disease concerning the Saudi government.
MERS, or Middle East Respiratory Syndrome, hit Saudi Arabia badly in the spring of this year.
Since 2012, there have been more than 750 cases of MERS in the country. Of this total 319 people died, some of whom were health workers.
The meaning of Hajj
Pilgrims walk around the Kaaba in Mecca, the building is the most sacred place in Islam and the direction of prayer for Muslims
Hajj is an annual five-day pilgrimage which all able-bodied Muslims are required to perform at least once in their lives, if they can afford it
It is the fifth and final pillar of Islam and is supposed to cleanse Muslims of sin and bring them closer to each other and God
The pilgrims, or Hajjis, wear simple white garments called “ihram” which give them all equal status
Those going on the hajj are required to abstain from sex, not to argue, kill anything or hunt and to avoid shaving and cutting their nails
Pilgrims perform several rituals during the hajj including walking counter-clockwise seven times around the Kaaba in Mecca, drinking from the Zam Zam Well and performing a symbolic stoning of the devil.
Will Airborne Ebola Become A Modern Global Plague?
The last several months have led to much confusion about the spread of the Ebola virus. Health officials and governments first denied that a serious threat existed and took no significant action to prevent its spread outside of West Africa. Then, after it had made it’s way to six different countries in the region, officials at the World Health Organization and the U.S. Centers for Disease Control started to panic. Apathy gave way to the real fear that we were facing a virus on a whole different scale than ever before.
At its current rate, some mathematical models show that the virus could infect anywhere from 20,000 to 100,000 by the end of the year, with over 4,000 people worldwide having been infected thus far. About 2,300 people, over 50% of those who have contracted it, have died.
Fired Up Obama to Immigration Activists: ‘No Force On Earth Can Stop Us’
‘Si se puede, si votamos! Yes, we can, if we vote!’
BY DANIEL HALPER
A fired up President Barack Obama had a message to immigration activists at a dinner this evening in Washington, D.C.: “no force on earth can stop us.”
“The clearest path to change is to change [the voter turnout] number,” said Obama “Si se puede, si votamos! Yes, we can, if we vote!”
“You know, earlier this year, I had a chance to host a screening of the film Cesar Chavez at the White House, and I was reminded that Cesar organized for nearly 20 years before his first major victory. He never saw that time as a failure. Looking back, he said, I remember the families who joined our movement and paid dues long before there was any hope of winning contracts. I remember thinking then that with spirit like that, no force on earth could stop us.
“That’s the promise of America then and that’s the promise of America now. People who love this country can change it. America isn’t Congress. America isn’t Washington. America is the striving immigrant who starts a business or the mom who works two low-wage jobs to give her kids a better life. America is the union leader and the CEO who put aside their differences to make the economy stronger. America is the student who defies the odds to become the first in the family to go to college. The citizen who defies the cynics and goes out there and votes. The young person who comes out of the shadows to demand the right to dream. That’s what America is about.
“And six years ago, I asked you to believe, and tonight, I ask you to keep believing, not just in my ability to bring about change, but in your ability to bring about change. Because in the end, DREAMer is more than just a title, it’s a pretty good description of what it means to be an American.
Patient Being Evaluated for Possible Ebola at D.C.’s Howard University Hospital
A patient with Ebola-like symptoms who had recently traveled to Nigeria is being treated at Howard University Hospital in Washington, D.C., a hospital spokesperson confirmed late Friday morning.
That person has been admitted to the hospital in stable condition and is isolated. The medical team is working with the CDC and other authorities to monitor the patient’s condition.
“In an abundance of caution, we have activated the appropriate infection control protocols, including isolating the patient,” said hospital spokesperson Kerry-Ann Hamilton in a statement. “Our medical team continues to evaluate and monitor progress in close collaboration with the CDC and the Department of Health.”
Hamilton did not share further details about the patient, citing privacy reasons, but said the hospital will provide updates as warranted.
The D.C. Department of Health released a statement shortly before 1 p.m. Wednesday, saying that the department has been working with the CDC and Howard University Hospital to monitor “any patients displaying symptoms associated with the Ebola virus.”
There are no confirmed cases of Ebola in D.C., said the statement.
At Shady Grove Adventist Hospital in Rockville, Maryland, a patient is in isolation with “flu-like symptoms and a travel history that matches criteria for possible Ebola,” according to a statement from the hospital. Lab results indicate the patient has another illness.
“We are working closely with the Montgomery County Health Department and State Department of Health and Mental Hygiene (DHMH) as well as the CDC to manage this case and to ensure we continue to be prepared to care for patients with Ebola symptoms,” the statement said.
“We will only be making an announcement if and when there is a laboratory confirmed case, and that announcement would be made in conjunction with the Maryland Department of Health and Mental Hygiene and the CDC,” Montgomery County Department of Health and Human Services spokesperson Mary Anderson said.
The White House announced Friday that senior administration officials will hold a briefing on the U.S. government’s response to the Ebola pandemic at 4:30 p.m., NBC News reported.
As public health advocates had warned, the raging Ebola outbreak in West Africa has begun to affect Westerners, though the disease is difficult to spread casually.
The cameraman, Ashoka Mukpo, had been working with chief medical correspondent Dr. Nancy Snyderman. NBC News is flying Mukpo and the entire team back to the U.S. so Mukpo can be treated and the team can be quarantined for 21 days.
Snyderman told MSNBC’s Rachel Maddow that she and the rest of her crew have shown no signs of the disease and have taken precautions while covering the outbreak, including washing their hands with bleach.
The crew are quarantining themselves as a precaution.
“There is no risk to people who have been in contact with those who have been sick with Ebola and recovered, or people who have been exposed and have not yet shown symptoms,” said Dr. Thomas Frieden of the CDC.
Duncan, a Liberian man with family in the United States, first went to Texas Health Presbyterian Hospital Sept. 25 but was sent home. He returned to the hospital via ambulance Sunday.
On Friday, he was listed in serious but stable condition.
Officials Say About 100 Individuals Will Be Monitored for Potential Exposure
By ANA CAMPOY, DREW HINSHAW and DAN FROSCH
The number of people in Texas who are being screened for potential exposure to Ebola expanded to approximately 100, and four members of a family close to the U.S. patient were ordered to remain in their Dallas home. (Photo: AP)
The number of people in Texas who are being screened for potential exposure to Ebola expanded Thursday to roughly 100, as health officials cast a wide net to try to prevent the one confirmed case of the disease from sparking an outbreak.
Four members of a family close to Thomas Eric Duncan, the Liberian man diagnosed with the virus, were ordered to remain in their Dallas home and not receive any visitors until at least Oct. 19, to pass the 21-day maximum incubation period for the often-deadly disease.
The 100 people being screened represent a “very wide net,” including some who possibly had brief encounters with Mr. Duncan, Texas health officials said. They added that the number is likely to drop as they narrow the list to those actually at potential risk of infection.
Thursday, an American freelance journalist in Liberia tested positive for the disease, his father and his employer, NBC News, said. The 33-year-old man is tentatively scheduled to be transported back to the U.S. on Sunday.
In Mr. Duncan’s case, Tom Frieden, director of the Centers for Disease Control and Prevention, said officials so far have identified only “a handful” of individuals who may have had close contact with him.
The public health search comes as authorities in Liberia grapple with how Mr. Duncan managed to leave their country and bring Ebola to the U.S. despite government efforts to stop transmission of the virus, a journey that took him from a neighborhood of tin-roof houses in a West African capital to an isolation ward at a Dallas hospital.
Before traveling to Texas via Belgium, Mr. Duncan escorted a woman to a treatment ward in Liberia’s capital, Monrovia, where she was turned away and died of the virus within hours, said Irene Seyou, Mr. Duncan’s next-door neighbor.
In a community near where U.S. victim Thomas Eric Duncan lived in Monrovia, many have died and children are worried they will be taken away. Glenna Gordon for The Wall Street Journal
On Sept. 16, several health workers arrived in Mr. Duncan’s neighborhood in Monrovia to investigate a report that a pregnant 18-year-old woman, recently sent home from a nearby clinic, had shown Ebola symptoms that included vomiting, diarrhea and bleeding, said Prince Toe and other members of the Ebola Response Team in the capital’s 72nd community.
But when the team arrived in the neighborhood, residents insisted the pregnant teenager had been in a car accident, said Mr. Toe, the unit’s supervisor. When the neighbors grew rowdy at being pressed for information, the team turned back, he said.
At Liberia’s airport, the temperatures of arriving and departing passengers are checked three times by security guards—at the entrance, before the check-in desk and at the metal detectors—to screen out those who display Ebola’s hallmark early symptom, a fever.
Passengers are asked to fill out questionnaires about whether they had been in contact with any Ebola victims. Mr. Duncan lied on those forms—and would be prosecuted for doing so if he returns to Liberia—the Associated Press reported Liberia’s government as saying Thursday.
Mr. Duncan is in an isolation unit at Texas Health Presbyterian Hospital in Dallas, which initially sent him home with antibiotics after he complained of illness, only to accept him on Sunday after he returned in an ambulance. Hospital officials have since conceded that they erred by not taking him in initially after he mentioned his symptoms and country of origin.
Hospital officials said Thursday that Mr. Duncan’s condition continued to be serious. Dr. Frieden of the CDC said Mr. Duncan’s physicians were discussing the possible use of experimental treatments with his family.
Edward Goodman, Texas Health Presbyterian Hospital’s epidemiologist, said the team of doctors treating Mr. Duncan has received guidelines from the CDC but that there is no specific treatment for Ebola other than supportive measures, such as keeping the patient well hydrated to avoid organ damage and supplying oxygen.
Most of the 100 people Texas is tracking for potential Ebola exposure haven’t been ordered to stay home. Officials said they ordered four of Mr. Duncan’s family members to remain in their home because the family disobeyed their request to stay there. They said the family, which was examined Thursday, hadn’t developed any symptoms. A law enforcement official is stationed outside their apartment to make sure they don’t leave.
Ebola is a highly contagious virus, but only if you come into contact with certain bodily fluids of those infected. What do scientists know about how it’s transmitted? WSJ’s Jason Bellini has #TheShortAnswer.
Judge Clay Jenkins, the highest elected official in Dallas County, said there were no plans to issue similar orders for other people. Local and state health officials said they had delivered groceries to the family and were arranging for a contractor to clean the apartment. Mr. Jenkins said it appeared that sealed bags filled with Mr. Duncan’s belongings, including his clothes and sheets, were still inside, and that the family had pushed mattresses against the wall.
Dallas Mayor Mike Rawlings sought to assure the public that the risk of contagion was minimal. “We’re getting the word out and people are starting to understand what has happened,” he said.
Still, at schools attended by five children who came into contact with Mr. Duncan, attendance was down to 86% from the 95% level that is normal, said Mike Miles, superintendent of the Dallas Independent School District, who added that custodians were doing extra cleaning.
While officials sought to control the panic over Ebola in Texas, some people who had come into contact with Mr. Duncan wondered why he hadn’t received treatment sooner.
Joe Joe Jallah said he met Mr. Duncan last week when visiting Mr. Jallah’s former wife, Louise Troh, the same woman Mr. Duncan had come to see in the U.S.
Ms. Troh declined to speak about the situation when reached by phone.
Mr. Jallah, who has a daughter with Ms. Troh, said he listened as Mr. Duncan described how dire things had become in Liberia, and how rigorous the health screenings were during his trip to the U.S.
Several days later, on Saturday, Mr. Jallah said he heard that Mr. Duncan had fallen ill at Ms. Troh’s apartment. Concerned, Mr. Jallah went back.
“He was lying down on the floor with a comforter. He said he was sick and that he had no appetite,” Mr. Jallah said.
“I said, ‘Did you go to the hospital?’ He said, ‘Yes, but they did nothing for me,’” Mr. Jallah recalled. “I said, ‘You should eat so you can gain strength.’”
The next day, Mr. Jallah said he returned after his daughter, Youngor Jallah, a nurse’s aide who visits her mother frequently, called, sounding frantic and saying that Mr. Duncan was still sick.
Ms. Jallah said Mr. Duncan had been up all night with diarrhea. His eyes were red, he seemed exhausted and had no appetite for the breakfast she made. He tried to drink some tea. Ms. Jallah took his temperature and it was 104, she said.
Ms. Jallah decided to call an ambulance. When emergency workers came, she informed them that Mr. Duncan was sick and had traveled to Dallas from a virus stricken-region in Africa. The workers put masks over their faces.
Ms. Jallah said she has since been told she and her family must stay in their home for 17 more days.
“I am concerned for myself. When I took his blood pressure, I never had no protection. I worry about my kids. My kids were over there with my mom,” she said.
This biographical articleneeds additional citations for verification. Please help by adding reliable sources. Contentious material about living persons that is unsourced or poorly sourced must be removed immediately, especially if potentially libelous or harmful.(March 2013)
From 1975 to 1999, Osterholm served in various roles at the Minnesota Department of Health (MDH), including as state epidemiologist and Chief of the Acute Disease Epidemiology Section from 1984 to 1999. While at the MDH, Osterholm strengthened the departments role in infectious diseaseepidemiology, notably including numerous foodborne disease outbreaks, the association between tampons and toxic shock syndrome (TSS), and the transmission of hepatitis B and human immunodeficiency virus (HIV) in healthcare workers. Other work included studies regarding the epidemiology of infectious diseases in child-care settings, vaccine-preventable diseases (particularly Haemophilus influenzae type b and hepatitis B), Lyme disease, and other emerging and re-emerging infections.
From 2001 through early 2005, Osterholm, in addition to his role at CIDRAP, served as a Special Advisor to then–HHS Secretary Tommy G. Thompson on issues related to bioterrorism and public health preparedness. In April 2002, Osterholm was appointed to the interim management team to lead the Centers for Disease Control and Prevention (CDC), until the eventual appointment of Julie Gerberding as director.
Osterholm has been particularly outspoken on the lack of international prepardness for an influenzapandemic.[3][4] Osterholm has also been an international leader against the use of biological agents as weapons targeted toward civilians.
Other
Osterholm serves on the editorial boards of five journals, and is a reviewer for another two dozen. He is a past president of the Council of State and Territorial Epidemiologists (CSTE) and has served on the CDC National Center for Infectious Diseases Board of Scientific Counselors from 1992 to 1997.
Osterholm serves on the IOM Forum on Emerging Infections. He has served on the IOM Committee on Emerging Microbial Threats to Health in the 21st Century and the IOM Committee on Food Safety, Production to Consumption, and he was a reviewer for the IOM Report on Chemical and Biological Terrorism. He is a frequent consultant to the World Health Organization (WHO), the National Institutes of Health (NIH), the Food and Drug Administration (FDA), the Department of Defense, and the CDC.
California SUPERVOLCANO Earthquake Swarm — Mono Lake / Mammoth Mountain
Top 10 Most Dangerous Volcanoes in the USA
Top 10 Highest Cascade Volcanoes! “Perfect Harmony,” Music by MrPerfectHarmony
Mount Rainier Volcano is a Ticking Time Bomb
Yellowstone Caldera : The Biggest Volcanic Eruption Ever Awaits Mankind
Mount Rainier Volcano is a Ticking Time Bomb
Supervolcano.The Truth About Yellowstone.
Supervolcano (full movie)
Mammoth earthquake swarm is the largest in nearly a decade
Morre than 600 small earthquakes have rattled the Mammoth Lakes region in less than 36 hours as ripple effects continued across one of the most seismically active volcanic regions in California, according to the U.S. Geological Survey.
The swarm of quakes — ranging from magnitude 1.0 to 3.8 — began just before 5 a.m. Thursday, according to the USGS.
“This is one of the largest earthquake swarms we’ve seen in the past decade or so,” said David Shelly, a USGS research seismologist who has been studying the volcanic system near Mammoth Lakes. “We’ll be tracking it closely.”
Residents reported periodic rattles through the day but said they were used to the shaking given that Mammoth is a seismically active area.
Earthquake swarms are not uncommon to this region in California’s Eastern Sierra. Countless small faults crisscross the area known as the Long Valley Caldera, Shelly said. This roughly 20-mile-wide crater-like depression, adjacent to Mammoth Mountain, was formed from ash and pumice deposits during a volcanic “super eruption” about 760,000 years ago.
At 11,053 feet, Mammoth Mountain is a lava dome complex on the southwest rim of the caldera and last erupted about 57,000 years ago. The volcanic region is one of the most seismically active in a mostly quiet network of 17 volcanoes throughout California.
The central part of the caldera has been uplifting slowly in recent decades, and these earthquake swarms happen episodically as part of the volcanic and tectonic interactions in the area, Shelly said.
It doesn’t mean that the volcano is any more active. It’s an ongoing process in an volcanic system.
– David Shelly, USGS research seismologist
Deep down in the earth, there is magma, but the magma is not what’s moving, Shelly said. The earthquakes are usually triggered when water and carbon dioxide above the magma move up into higher layers of the earth’s crust and into the cracks of the small faults. The increase in fluid pressure sets off the movements.
“It doesn’t mean that the volcano is any more active,” he said. “It’s an ongoing process in an volcanic system.”
The latest earthquakes seem to be occurring in the same location as a swarm in July, when about 200 quakes of magnitude 2.7 or smaller rocked the area.
The size of the most recent swarm was notable, but was not nearly the size of some swarms in the 1980s and 1990s.
In the 1980s, the area was hit with multiple 6.0-magnitude temblors, which were likely overshadowed by the Mount St. Helens eruption in Washington state, Shelly said.
The last larger swarm occurred in 1997, when temblors as high as magnitude 4.9 shook the region. Thousands of earthquakes were part of that sequence, which lasted several months, Shelly said.
Mammoth quake swarm
Mammoth Mountain is one of the most seismically active volcanoes in California. (Brian van der Brug / Los Angeles Times)
There has been no indication that this week’s earthquakes will turn into anything like what happened in 1997. About 109 quakes of magnitude 2.0 or greater have been recorded since Thursday morning, while hundreds of smaller 1.0-magnitude quakes made up a bulk of the activity. At least six were greater than 3.0 magnitude.
By midday Friday, the swarm seemed to be slowing down, but Shelly said scientists would continue to monitor the area closely.
“At this point, we don’t know if it would continue to die down, or if there’d be another stage to this swarm,” Shelly said. “This is certainly an interesting scientific opportunity to better understand the processes that are driving this activity.”
Story 1: Record Low Temperatures in United States As Mother Nature Changes Weather and Climate To Global Cooling — The Coming Ice Age — Need Nuclear Power To Keep Warm and Cool — Videos
North America set for record low temperatures as cold snap stretches
Arctic freeze hits US Midwest with record low temperatures
What is an Ice Age?
Climate Change in 12 Minutes – The Skeptic’s Case
The Next Ice Age and The Gulf Stream – Future Focus
In Search Of… The Coming Ice Age (1978) [Global Cooling]
Global Cooling: The Coming Ice Age
Dr Matthew J Penn suggests global cooling – new Little Ice Age
Global Cooling || UN Climate Report Reveals Rate Of Global Warming About Half Average Rate – Dobbs
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Supreme Court Chief Justice John Roberts has rewritten the law to save Obamacare—again.
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This article incorporates 
Pilgrims walk around the Kaaba in Mecca, the building is the most sacred place in Islam and the direction of prayer for Muslims
Pronk Palisades 
Planned Parenthood’s Evil of Killing, Butchering and Selling Baby Parts Regrets Their Tone Not Their Actions– Reminds Me of The Nazis (National Socialist German Workers’ Party) Discussing The Final Solution for The Jewish Question — The Killing of Babies Supported By Barack Obama, Democratic Party, Progressives and Ruling Political Elites — Stop Killing Babies And Lying To The American People — Videos
Posted on July 18, 2015. Filed under: American History, Articles, Babies, Biology, Blogroll, Books, British History, Business, Catholic Church, Chemistry, College, Communications, Congress, Constitution, Corruption, Crime, Crisis, Cult, Culture, Demographics, Diasters, Documentary, Economics, Education, Employment, European History, Faith, Family, Federal Government Budget, Fiscal Policy, Friends, Genocide, government, government spending, Health Care, history, Homicide, Illegal, Immigration, Investments, IRS, Language, Law, Legal, liberty, Life, Links, media, Medical, Money, Music, Non-Fiction, Obamacare, People, Philosophy, Photos, Political Correctness, Politics, Press, Programming, Psychology, Quotations, Radio, Radio, Rants, Regulations, Religion, Science, Security, Strategy, Supreme Court, Talk Radio, Tax Policy, Taxation, Taxes, Television, Terrorism, Torture, Video, War, Wealth, Weapons, Welfare, Wisdom, Writing | Tags: 17 July 2015, Abby Johnson, Abortion Statistics, Abortions, America, articles, Audio, Auschwitz The Nazis and the Final Solution, Breaking News, Brenda Lee, Broadcasting, Butchering Babies, capitalism, Cartoons, Cecile Richards, Charity, Citizenship, Clarity, Classical Liberalism, Collectivism, Commentary, Commitment, Communicate, Communication, Concise, Convincing, Courage, Culture, Current Affairs, Current Events, Die Wannseekonferenz (1984), Discussing The Final Solution for The Jewish Question, economic growth, economic policy, Economics, Edmund Burke, Education, eugenics, Eugenics Movement, Evil, Evils of Agenda 21, Experience, Faith, Family, First, fiscal policy, Fit vs. UnFit, free enterprise, freedom, freedom of speech, Friends, Give It A Listen, God, Good, Goodwill, Growth, Hanna Arendt, Harvesting Babies Organs, Henry David Thoreau, Hope, I'm Sorry, Individualism, Jr, Justice Antonin Scalia, Killing Babies, Knowledge, liberty, Life, Love, Lovers of Liberty, MAAFA 21 THE BLACK HOLOCAUST, Margaret Sanger, Martin Luther King, monetary policy, MPEG3, Music, Nazis (National Socialist German Workers' Party), News, Number One Killer of Blacks -- Abortions, Opinions, Partial-Birth Abortions, Peace, Photos, Planned Parenthood, Podcasts, Political Philosophy, Politics, Progressives, Promoting Black Genocide in US, prosperity, Racism, Radio, Raymond Thomas Pronk, Representative Republic, Republic, Resources, Respect, rule of law, Rule of Men, Saint Augustine, Selling Baby Parts, Senator Lankford, Show Notes, Songs, Stephen Ambrose, Sterilizing Undesirables, Talk Radio, Targeting Blacks, The Final Solution, The Pronk Pops Show, The Pronk Pops Show 507, The Silent Scream, Thomas Hardy, Tone, Truth, Tyranny, U.S. Constitution, Undercover Video Exposes Planned Parenthood, United States of America, Videos, Virtue, War, Wisdom |
The Pronk Pops Show Podcasts
Pronk Pops Show 507: July 17, 2015
Pronk Pops Show 506: July 16, 2015
Pronk Pops Show 505: July 15, 2015
Pronk Pops Show 504: July 14, 2015
Pronk Pops Show 503: July 13, 2015
Pronk Pops Show 502: July 10, 2015
Pronk Pops Show 501: July 9, 2015
Pronk Pops Show 500: July 8, 2015
Pronk Pops Show 499: July 6, 2015
Pronk Pops Show 498: July 2, 2015
Pronk Pops Show 497: July 1, 2015
Pronk Pops Show 496: June 30, 2015
Pronk Pops Show 495: June 29, 2015
Pronk Pops Show 494: June 26, 2015
Pronk Pops Show 493: June 25, 2015
Pronk Pops Show 492: June 24, 2015
Pronk Pops Show 491: June 23, 2015
Pronk Pops Show 490: June 22, 2015
Pronk Pops Show 489: June 19, 2015
Pronk Pops Show 488: June 18, 2015
Pronk Pops Show 487: June 17, 2015
Pronk Pops Show 486; June 16, 2015
Pronk Pops Show 485: June 15, 2015
Pronk Pops Show 484: June 12, 2015
Pronk Pops Show 483: June 11, 2015
Pronk Pops Show 482; June 10, 2015
Pronk Pops Show 481: June 9, 2015
Pronk Pops Show 480: June 8, 2015
Pronk Pops Show 479: June 5, 2015
Pronk Pops Show 478: June 4, 2015
Pronk Pops Show 477: June 3, 2015
Pronk Pops Show 476: June 2, 2015
Pronk Pops Show 475: June 1, 2015
Pronk Pops Show 474; May 29, 2015
Pronk Pops Show 473: May 28, 2015
Pronk Pops Show 472: May 27, 2015
Pronk Pops Show 471: May 26, 2015
Pronk Pops Show 470: May 22, 2015
Pronk Pops Show 469: May 21, 2015
Pronk Pops Show 468: May 20, 2015
Pronk Pops Show 467: May 19, 2015
Pronk Pops Show 466: May 18, 2015
Pronk Pops Show 465: May 15, 2015
Pronk Pops Show 464; May 14, 2015
Pronk Pops Show 463; May 13, 2015
Pronk Pops Show 462: May 8, 2015
Pronk Pops Show 461: May 7, 2015
Pronk Pops Show 460; May 6, 2015
Pronk Pops Show 459: May 4, 2015
Pronk Pops Show 458: May 1, 2015
Pronk Pops Show 457: April 30, 2015
Pronk Pops Show 456: April 29, 2015
Pronk Pops Show 455: April 28, 2015
Pronk Pops Show 454: April 27, 2015
Pronk Pops Show 453: April 24, 2015
Pronk Pops Show 452: April 23, 2015
Pronk Pops Show 451: April 22, 2015
Pronk Pops Show 450: April 21, 2015
Pronk Pops Show 449: April 20, 2015
Pronk Pops Show 448: April 17, 2015
Pronk Pops Show 447: April 16, 2015
Pronk Pops Show 446: April 15, 2015
Pronk Pops Show 445: April 14, 2015
Pronk Pops Show 444: April 13, 2015
Pronk Pops Show 443: April 9, 2015
Pronk Pops Show 442: April 8, 2015
Pronk Pops Show 441: April 6, 2015
Pronk Pops Show 440: April 2, 2015
Pronk Pops Show 439: April 1, 2015
Story 1: Planned Parenthood’s Evil of Killing, Butchering and Selling Baby Parts Regrets Their Tone Not Their Actions– Reminds Me of The Nazis (National Socialist German Workers’ Party) Discussing The Final Solution for The Jewish Question — The Killing of Babies Supported By Barack Obama, Democratic Party, Progressives and Ruling Political Elites — Stop Killing Babies And Lying To The American People — Videos
He that is kind is free, though he is a slave; he that is evil is a slave, though he be a king.
The only thing necessary for the triumph of evil is for good men to do nothing.
There are a thousand hacking at the branches of evil to one who is striking at the root.
The resolution to avoid an evil is seldom framed till the evil is so far advanced as to make avoidance impossible.
The sad truth is that most evil is done by people who never make up their minds to be good or evil.”
~Hannah Arendt
Planned Parenthood: Cecile Richards’ Official Video Response
Brenda Lee – I’m Sorry
Senator Lankford Speaks about the Planned Parenthood Video on the Senate Floor
Planned Parenthood Uses Partial-Birth Abortions to Sell Baby Parts
What So-Called Pro-Choicers Cannot Watch From Start To Finish
The Silent Scream (Full Length)
FULL FOOTAGE: Planned Parenthood Uses Partial-Birth Abortions to Sell Baby Parts
Abby Johnson Exposes The Lie of Planned Parenthood
Planned Parenthood CEO Cecile Richards’ Attempt To Dismiss Viral Video Backfires!
Caught on Camera: Planned Parenthood Harvesting Babies Organs
Die Wannseekonferenz (1984)
A real time recreation of the 1942 Wannsee Conference, in which leading SS and Nazi Party officials led by SS-General Reinhard Heydrich gathered to discuss the “Final Solution to the Jewish Question”.
MAAFA 21 THE BLACK HOLOCAUST
Abortion Inc: Promoting Black Genocide in US?
Planned Parenthood Banks on Fraud
Planned Parenthood’s New Image
Fit vs. UnFit, Eugenics, Planned Parenthood & Psychology, Mind Control Report
Sex Control Police State, Eugenics, Galton, Kantsaywhere, Mind Control Report
Mind Control Hate Propaganda, Hate Speech & Crime, Black PR
Mind Control, Psychology of Brainwashing, Sex & Hypnosis
Margaret Sanger: Eugenicist (1/3)
Margaret Sanger: Eugenicist (2/3)
Margaret Sanger: Eugenicist (3/3)
Eugenics Glenn Beck w/ Edwin Black author of “War Against the Weak” talk Al Gore & Margaret Sanger
Margaret Sanger, Planned Parenthood’s Racist Founder
Justice Antonin Scalia talks about Roe v. Wade
Auschwitz The Nazis and the Final Solution complete
Auschwitz: The Nazi and the Final Solution (1/5)
AUSHWITZ:THE FINAL SOLUTION CLIP 2/5
Auschwitz: The Nazi and the Final Solution (3/5)
Auschwitz: The Nazi and the Final Solution (4/5)
Auschwitz: The Nazi and the Final Solution (5/5)
Science and the Swastika: The Deadly Experiment
Sterilizing Undesirables: Did The USA Inspire The Nazis?
Keeping Dems Honest: CNN’s Anderson Cooper Puts Truth First and Challenges DNC Abortion Lies
Glenn Beck : Agenda 21 is not a fiction, it’s implemented right now in US and all over the World !
Glenn Beck – Ted Cruz Discusses the Evils of Agenda 21
Bill Whittle What We Believe Full Version
Brenda Lee – I’m Sorry (Live from Canada 1980)
Planned Parenthood head apologizes for ‘tone’ of doctor in covert video
The president of Planned Parenthood Federation of America on Thursday apologized for remarks captured on video that show Deborah Nucatola, an executive of the organization, casually discussing abortion techniques aimed at preserving the internal organs of fetuses for use in research.
In a video posted on Planned Parenthood’s Web site, Cecile Richards called the tenor of the remarks “unacceptable,” and said the organization strives as its top priority to provide compassionate care.
“In the video, one of our staff members speaks in a way that does not reflect that compassion,” she said. “This is unacceptable, and I personally apologize for the staff member’s tone and statements.”
[Undercover video shows Planned Parenthood official discussing fetal organs used for research]
But Richards also emphatically defended the organization’s tissue donation program, which she said is purely voluntary for the women and does not yield a profit for Planned Parenthood. And she condemned the group that covertly recorded Nucatola’s remarks, which she said heavily edited the video to make “outrageous claims.”
“We know the real agenda of organizations behind videos like this, and they have never been concerned with protecting the health and safety of women,” she said. “Their mission is to ban abortion completely and cut women off from care at Planned Parenthood and other health centers.”
Richards’s apology came a day after a little-known anti-abortion group called the Center for Medical Progress unveiled the video as part of what its leader said was a 30-month investigation into Planned Parenthood’s tissue donation program. The group alleges Planned Parenthood illegally sells fetal body parts to companies that use the tissue for research.
While the video did not prove this claim, it still painted Planned Parenthood in an unflattering light that reignited controversy over the women’s health organization, the nation’s largest abortion provider and a longtime target of anti-abortion activism. It showed Nucatola, the organization’s senior director of medical services, discussing graphically the ways in which abortions can be completed to preserve a fetus’s liver, lungs, heart and other materials for research.
“I’d say a lot of people want liver,” she says in the video, drinking wine and eating salad with anti-abortion activists posing as medical company representatives.
Later in the video, she continues: “We’ve been very good at getting heart, lung, liver, because we know that, so I’m not gonna crush that part, I’m gonna basically crush below, I’m gonna crush above, and I’m gonna see if I can get it all intact.”
The Center for Medical Research distilled the video into a nine-minute clip, but also posted a longer cut lasting more than two-and-a-half hours showing a fuller context of the discussion. It also posted some supporting documents on its site, and the group’s leader has promised more evidence in the coming weeks.
http://www.washingtonpost.com/news/post-nation/wp/2015/07/16/planned-parenthood-head-apologizes-for-tone-of-doctor-in-covert-video/
Planned Parenthood chief apologizes after video
By Eugene Scott, CNN
Planned Parenthood’s president apologized Thursday for a top official’s tone in a controversial video, but she also denied the clip’s allegation that her organization profits from tissue donation.
“Our top priority is the compassionate care that we provide. In the video, one of our staff members speaks in a way that does not reflect that compassion. This is unacceptable, and I personally apologize for the staff member’s tone and statements,” said Cecile Richards, the group’s president, in a video out Thursday. “As always, if there is any aspect of our work that can be strengthened, we want to know about it, and we take swift action to address it.”
Since the video’s release on Breitbart earlier this week, conservative elected officials have slammed its contents and called for congressional hearings on the incident, including House Speaker John Boehner and House Majority Leader Kevin McCarthy.
“I hope that everyone in the country watches it,” said Rep. Ann Wagner, R-Missouri, who called the video “the most horrifying and heartbreaking undercover video I have ever seen” during a Capitol Hill news conference on Wednesday.
But allegations that Planned Parenthood sells baby body organs and tissue are unfounded, she said.
“I want to be really clear: The allegation that Planned Parenthood profits in any way from tissue donation is not true. Our donation programs — like any other high-quality health care providers — follow all laws and ethical guidelines.”
On Wednesday, Richards used Twitter to criticize lawmakers and presidential candidates
“GOP leaders, including most of the ’16 field, are tripping over themselves to attack PP because they think that’s how to win elections,” organization president Cecile Richards said in a series of related tweets Wednesday. Her comments were her first addressing a video showing one of the organization’s top officials discussing the organs and tissue or aborted fetuses.
Congressional leaders and Republican presidential hopefuls slammed Planned Parenthood on Wednesday and called for congressional hearings on the incident.
RELATED: Lawmakers call for Hill hearings on Planned Parenthood
Richards said political attacks are nothing new for her organization, the country’s largest abortion provider.
“Spreading false information is an age-old strategy of people hell-bent on denying women care & shaming them for exercising their rights,” she tweeted.
Several Republican candidates have promised to defund federal dollars to Planned Parenthood if elected. Richards argued that would keep millions from breast exams, sexually transmitted infection exams and sex education.
“Reminder: 1 out of every 5 women has been to PP in her life. Threatening our patients’ care & rights will get politicians nowhere real fast,” she tweeted. “We’ve fought for our patients before, and we’ll fight for them again and again.”
http://www.cnn.com/2015/07/16/politics/planned-parenthood-president-criticizes-gop-candidates/
Planned Parenthood exec, fetal body parts subject of controversial video
By Steve Almasy and Eliott C. McLaughlin, CNN
An anti-abortion group has released an online video that it says documents how Planned Parenthood is selling fetal organs for a profit, a felony, while violating medical ethics by altering normal abortion procedures so as to preserve the organs.
Planned Parenthood has countered that it donates the tissue for scientific research and receives only reimbursement for its expenses, which is legal. The group also says it helps people donate tissue “with full, appropriate consent from patients and under the highest ethical and legal standards,” according to a statement from spokesman Eric Ferrero.
Later, Ferrero issued another statement saying, “These outrageous claims are flat-out untrue, but that doesn’t matter to politicians with a longstanding political agenda to ban abortion and defund Planned Parenthood. Women and families who make the decision to donate fetal tissue for lifesaving scientific research should be honored, not attacked and demeaned.”
The group leveling the accusation, the Irvine, California-based Center for Medical Progress, says it shot the video a year ago at a California restaurant. On it, two people purporting to be with a human biologics company speak with a Planned Parenthood doctor over what appears to be a lunch meeting. The Center for Medical Progress says the pair, who are off-camera and never seen, are paid actors.
The video, which is almost three hours long, was released Tuesday along with a heavily edited eight-minute version, which has drawn more than 1 million views on YouTube, as opposed to about 40,000 for the the full-length footage. The group has also released a transcript of the longer video.
“Planned Parenthood’s criminal conspiracy to make money off of aborted baby parts reaches to the very highest levels of their organization,” said statement from David Daleiden, who led the undercover project.
The video has drawn the ire of GOP lawmakers in Washington, with House Speaker John Boehner calling for hearings on Planned Parenthood’s abortion practices.
“When anyone diminishes an unborn child, we are all hurt, irreversibly so. When an organization monetizes an unborn child — and with the cavalier attitude portrayed in this horrific video — we must all act,” he said.
On the video, Dr. Deborah Nucatola, the senior director of medical services at Planned Parenthood Federation of America, is seen talking matter-of-factly about the organization’s participation in tissue-donation programs.
Though Planned Parenthood has described the Center for Medical Progress footage as a hit piece by “a well-funded group established for the purpose of damaging Planned Parenthood’s mission and services,” Nucatola acknowledges in the video that Planned Parenthood’s national office sees the potential for controversy.
“So, we tried to do this, and at the national office we have a Litigation and Law Department that just really doesn’t want us to be the middle people for this issue right now,” she said. “And so we had a conversation, and we said, ‘What if we go out and find everyone who is doing this and present everybody with a menu?’ And at the end of the day they just decided that right now, it’s just too touchy an issue for us to be an official middleman.”
In another part of the video, the doctor tells the undercover actors that “behind closed doors,” Planned Parenthood’s affiliates are discussing how to handle the matter.
“Every provider has had patients who want to donate their tissue, and they absolutely want to accommodate them. They just want to do it in a way that is not perceived as ‘This clinic is selling tissue. This clinic is making money off of this,’ ” she said.
The edited version of the video appears to be missing important context that’s provided in the longer video. For instance, one of the actors asks Nucatola about prices for the organs.
“OK, so when you are, or the (Planned Parenthood) affiliate is determining what that monetary … so that it doesn’t raise any question of ‘This is what it’s about; this is the main,’ what price range would you …” the woman asks, her question trailing off.
Nucatola responds that the price would be between $30 and $100 per specimen, with consideration for what facility is used and “what’s involved.” It’s not clear if a specimen constitutes the entire organ or only samples of it.
Nucatola doesn’t specifically say that the price is for the purchase of the tissue, but the comment troubled bioethicist Art Caplan of New York University, who said after watching the edited version of the video it sounds like Planned Parenthood might be trying to make a profit.
But in the longer version of the video, Nucatola elaborates and appears to say the price is related to the cost of performing the procedure and shipping.
“It just has to do with space issues. Are you sending someone there who is going to be doing everything or is their staff going to be doing it? What exactly are they going to be doing? Is there shipping involved or is someone coming to pick it up?”
Selling fetal body parts — or any body parts — is against federal law, but Planned Parenthood said it makes no profit.
“In some instances, actual costs, such as the cost to transport tissue to leading research centers, are reimbursed, which is standard across the medical field,” the group said.
Another part of the video also raised concerns for Caplan. Nucatola talks about doctors performing abortions in which ultrasound is used to ascertain the best location to grab the fetus with forceps.
“We’ve been very good at getting heart, lung, liver because we know that, I’m not going to crush that part,” she says.
Altering procedures in order to get tissue in the best condition would be a “big no-no,” the bioethicist said, because the patient’s health is paramount and that should be the only concern for doctors. Caplan did not comment specifically on whether the ultrasound procedure would endanger the mother, but he made it clear that any deviation from normal procedures is unacceptable.
“In abortion the primary goal is to give the safest abortion possible,” Caplan said. “Your sole concern has to be the mother and her health.”
There’s a parallel in patient care, he said. When someone is dying, doctors shouldn’t change how they treat the patient in order to harvest good tissue for donation after death.
Doctors should treat the patient as they normally would, and then use whatever is available after death. If a provider is considering how to get the tissue that’s in the best shape, “that’s a huge conflict of interest. … If you modify how someone dies, that’s unethical.”
The Center for Medical Progress also alleges that Nucatola describes a method — using ultrasound to manipulate the fetus so it comes out feet first, or breech presentation, instead of head first, or vertex presentation — that “is the hallmark of the illegal partial-birth abortion procedure.”
Partial birth abortions are illegal, according to U.S. law, which defines them as procedures “in which the person performing the abortion deliberately and intentionally vaginally delivers a living fetus until, in the case of a head-first presentation, the entire fetal head is outside the body of the mother, or, in the case of breech presentation, any part of the fetal trunk past the navel is outside the body of the mother, for the purpose of performing an overt act that the person knows will kill the partially delivered living fetus.”
On the video, Nucatola describes the best strategy to extract calavarium, or skulls, intact, but it is not clear if she is speaking in general terms or if she is describing Planned Parenthood’s methods. And then, she says nothing about whether the fetus is still alive when it’s delivered.
“And with the calvarium, in general, some people will actually try to change the presentation so that it’s not vertex, because when it’s vertex presentation, you never have enough dilation at the beginning of the case, unless you have real, huge amount of dilation to deliver an intact calvarium. So if you do it starting from the breech presentation, there’s dilation that happens as the case goes on, and often, the last, you can evacuate an intact calvarium at the end.”
The Center for Medical Progress responded to Planned Parenthood’s written statement about the video and accused Planned Parenthood of lying about obtaining consent from patients and not making a profit on the tissue transactions. It did not offer any further evidence of either claim.
GOP calls for Hill hearings on Planned Parenthood video
Planned Parenthood, meanwhile, said the anti-abortion group was the one that was lying.
“A well-funded group established for the purpose of damaging Planned Parenthood’s mission and services has promoted a heavily edited, secretly recorded videotape that falsely portrays Planned Parenthood’s participation in tissue donation programs that support lifesaving scientific research,” it said.
The statement continued, “Similar false accusations have been put forth by opponents of abortion services for decades. These groups have been widely discredited and their claims fall apart on closer examination, just as they do in this case.”
http://www.cnn.com/2015/07/15/health/planned-parenthood-undercover-video/
Cecile Richards
Austin, Texas, U.S.
Cecile Richards (born 1958)[1] is an American activist and has been the president of the Planned Parenthood Federation of America since 2006.[2] She is a member of the Democratic Party.[3] In 2010, Richards was elected to the Ford Foundation board of trustees.
Contents
Political involvement
Richards previously founded and served as president of America Votes, a coalition of national Democratic Party-affiliated organizations.[4] Before that, she was deputy chief of staff to the U.S. Rep. Nancy Pelosi, the Democratic Leader in the U.S. House of Representatives.[5] She has also worked at the Turner Foundation.[6] In 1996, she founded the Texas Freedom Network, a Texas organization formed to counter the Christian right.[7]
Personal life
Richards is the daughter of former Texas governor Ann Richards (née Dorothy Ann Willis) and David Richards.[3] She attended St. Stephen’s Episcopal School for high school, and graduated from Brown University in 1980.[8] She is married to Kirk Adams, a labor organizer with the Service Employees International Union, and has three children.[9] She currently lives in New York City.[10]
Awards and honors
References
External links
Gloria Feldt
2006–present
https://en.wikipedia.org/wiki/Cecile_Richards
Planned Parenthood
Planned Parenthood Federation of America (PPFA), commonly shortened to Planned Parenthood, is the U.S. affiliate of the International Planned Parenthood Federation (IPPF) and one of its larger members. PPFA is a non-profit organization providing reproductive health and maternal and child health services. The Planned Parenthood Action Fund, Inc. (PPAF) is a related organization which lobbies for pro-choice legislation, comprehensive sex education, and access to affordable health care in the United States. In recent years, Planned Parenthood has begun to move away from the pro-choice label to words and phrases that more accurately reflect the entire range of women’s health and economic issues.[3]
Planned Parenthood is the largest U.S. provider of reproductive health services, including cancer screening, HIV screening and counseling, contraception, and abortion.[4][5][6] Contraception accounts for 34% of PPFA’s total services and abortions account for 3%; PPFA conducts roughly 300,000 abortions each year, among 3 million people served.[7][8][9]
The organization has its roots in Brooklyn, New York, where Margaret Sanger opened the country’s first birth-control clinic. Sanger founded the American Birth Control League in 1921, which in 1942 became part of the Planned Parenthood Federation of America. Since then, Planned Parenthood has grown to have over 820 clinic locations in the U.S., with a total budget of US $1 billion. PPFA provides an array of services to over three million people in the United States, and supports services for over one million clients outside the United States.
History
Early history
Margaret Sanger (1922), the first president and founder of Planned Parenthood
The origins of Planned Parenthood date to October 16, 1916 when Margaret Sanger, her sister Ethel Byrne, and Fania Mindell opened the first birth control clinic in the U.S. in the Brownsville section of Brooklyn, New York.[10] All three women were immediately arrested and jailed for violating provisions of the Comstock Act– for distributing “obscene materials” at the clinic. The “Brownsville trials” brought national attention and support to their cause, and although Sanger and her co-defendants were convicted, their convictions were eventually overturned. Their campaign led to major changes in the laws governing birth control and sex education in the United States.[11]
In 1938, the clinic was organized into the American Birth Control League, which became part of the only national birth control organization in the US until the 1960s, but the title was found too offensive and “against families” so the League began discussions for a new name.[12] By 1941, the organization was operating 222 centers and had served 49,000 clients.[13] By 1942 the League had become part of what became the Planned Parenthood Federation of America.[12]
By 1960, the Federation’s grassroots volunteers had provided family planning counseling in hundreds of communities across the country.[13] Planned Parenthood was one of the founding members of the International Planned Parenthood Federation when it was launched at a conference in Bombay, India in 1952.[13][14]
After Sanger
Following Margaret Sanger, Alan Frank Guttmacher became president of Planned Parenthood and served from 1962 till 1974.[15] During his tenure, the Food and Drug Administration approved the sale of the original birth control pill, giving rise to new attitudes towards women’s reproductive freedom.[13] Also during his presidency, Planned Parenthood lobbied the federal government to support reproductive health, culminating with President Richard Nixon‘s signing of Title X to provide governmental subsidies for low-income women to access family planning services.[16] The Center for Family Planning Program Development was also founded as a semi-autonomous division during this time.[17] The center became an independent organization and was renamed the Guttmacher Institute in 1977.[17]
Faye Wattleton was the first woman named president of the Planned Parenthood Federation of America in 1978 and served till 1992.[18] She was the first African-American to serve as president, and the youngest president in Planned Parenthood’s history.[19] During her term, Planned Parenthood grew to become the seventh largest charity in the country, providing services to four million clients each year through its 170 affiliates whose activities were spread across 50 states.[20]
A Planned Parenthood supporter participates in a demonstration in support of the organization.
From 1996 to 2006, Planned Parenthood was led by Gloria Feldt.[21][22] Feldt activated the Planned Parenthood Action Fund, the organization’s political action committee, launching what was the most far reaching electoral advocacy effort in its history.[23] She also launched the Responsible Choices Action Agenda, a nationwide campaign to increase services to prevent unwanted pregnancies, improve quality of reproductive care and ensure access to safe and legal abortions.[13] Another initiative was the commencement of a “Global Partnership Program” with the aim of building a vibrant activist constituency in support of family planning.[13]
On February 15, 2006, Cecile Richards became president of the organization.[24]
Margaret Sanger Awards
In 1966, PPFA began awarding the Margaret Sanger Award annually to honor, in their words, “individuals of distinction in recognition of excellence and leadership in furthering reproductive health and reproductive rights.” In the first year, it was awarded to four men, Carl G. Hartman, William H. Draper, Lyndon Baines Johnson, and Martin Luther King.[25][26][27][28] Later recipients have included John D. Rockefeller III, Katharine Hepburn, Jane Fonda, Hillary Rodham Clinton, and Ted Turner.[29][30][31]
Services and facilities
Location in Houston, Texas
PPFA is a federation of 85 independent Planned Parenthood affiliates around the U.S.[1] These affiliates together operate more than 820 health centers in all 50 states and the District of Columbia.[1][32] The largest of these facilities, a $26 million, 78,000-square-foot (7,200 m2) structure was completed in Houston, Texas in May 2010.[33] This serves as a headquarters for 12 clinics in Texas and Louisiana.[33] Together, they are the largest family planning services provider in the U.S. with over four million activists, supporters and donors.[34][35][36] Planned Parenthood is staffed by 27,000 staff members and volunteers.[37]
They serve over five million clients a year, 26% of which are teenagers under the age of 19.[38] According to Planned Parenthood, 75% of their clients have incomes at or below 150 percent of the federal poverty level.[37]
Services provided at locations include contraceptives (birth control); emergency contraception; screening for breast, cervical and testicular cancers; pregnancy testing and pregnancy options counseling; testing and treatment for sexually transmitted diseases; comprehensive sexuality education, menopause treatments; vasectomies, tubal ligations, and abortion.
In 2009, Planned Parenthood provided 4,009,549 contraceptive services (35% of total), 3,955,926 sexually transmitted disease services (35% of total), 1,830,811 cancer related services (16% of total), 1,178,369 pregnancy/prenatal/midlife services (10% of total), 332,278 abortion services (3% of total), and 76,977 other services (1% of total), for a total of 11,383,900 services.[9][37][39][40][41][42] The organization also said its doctors and nurses annually conduct 1 million screenings for cervical cancer and 830,000 breast exams.
Funding
Planned Parenthood headquarters on Massachusetts Avenue in Washington, D.C.
Planned Parenthood has received federal funding since 1970, when President Richard Nixon signed into law the Family Planning Services and Population Research Act, amending the Public Health Service Act. Title X of that law provides funding for family planning services, including contraception and family planning information. The law enjoyed bipartisan support from liberals who saw contraception access as increasing families’ control over their lives, and conservatives who saw it as a way to keep people off welfare. Nixon described Title X funding as based on the premise that “no American woman should be denied access to family planning assistance because of her economic condition.”[43]
In the fiscal year ending June 30, 2011, total (consolidated) revenue was $201 million: clinic revenue totaling $2 million, grants and donations of $190 million, investment income of $2 million, and $7 million other income.[44] Approximately two-thirds of the revenue is put towards the provision of health services, while non-medical services such as sex education and public policy work make up another 16%; management expenses, fundraising, and international family planning programs account for most of the rest.
Planned Parenthood receives about a third of its money in government grants and contracts (about $360 million in 2009).[45] By law, federal funding cannot be allocated for abortions,[46] but some opponents of abortion have argued that allocating money to Planned Parenthood for the provision of other medical services “frees up” funds to be re-allocated for abortion.[4][47]
A coalition of national and local pro-life groups have lobbied federal and state government to stop funding Planned Parenthood, and as a result, Republican federal and state legislators have proposed legislation to reduce the funding levels.[46][48] Some six states have gone ahead with such proposals.[4][49][50][51] In some cases, the courts have overturned such actions, citing conflict with federal or other state laws, and in others, the federal executive branch has provided funding in lieu of the states.[50][51][52] In other cases, complete or partial defunding of Planned Parenthood has gone through successfully.[53][54]
Planned Parenthood is also funded by private donors, with a membership base of over 700,000 active donors whose contributions account for approximately one quarter of the organization’s revenue.[55] Large donors also contribute a substantial portion of the organization’s budget; past donors have included the Bill & Melinda Gates Foundation, Buffett Foundation, Ford Foundation, Turner Foundation, the Cullmans and others.[56][57][58][59] The Bill & Melinda Gates Foundation’s contributions to the organization have been specifically marked to avoid funding abortions.[56] Some, such as the Buffett Foundation, have supported reproductive health that can include abortion services.[56] Pro-life groups have advocated the boycott of donors to Planned Parenthood.[60]
Stand on political and legal issues
Planned Parenthood and its predecessor organizations have provided and advocated for access to birth control. The modern organization of Planned Parenthood America is also an advocate for reproductive rights.[61] This advocacy includes contributing to sponsorship of abortion rights and women’s rights events[62] and assisting in the testing of new contraceptives.[63] The Federation opposes restrictions on women’s reproductive health services, including parental consent laws. Planned Parenthood has cited the case of Becky Bell, who died following a septic abortion after failing to seek parental consent, to justify their opposition.[64][65] Planned Parenthood also takes the position that laws requiring parental notification before an abortion is performed on a minor are unconstitutional on privacy grounds.[66] The organization also opposes laws requiring ultrasounds before abortions, stating that their only purpose is to make abortions more difficult to obtain.[67] Planned Parenthood has also opposed initiatives that require waiting periods before abortions,[68] and bans on late-term abortions including intact dilation and extraction, which has been illegal in the U.S. since 2003.[69]
Planned Parenthood argues for the wide availability of emergency contraception (EC) measures.[70] It opposes conscience clauses, which allow pharmacists to refuse to dispense drugs against their beliefs. In support of their position, they have cited cases where pharmacists have refused to fill life saving drugs under the laws.[71] Planned Parenthood has also been critical of hospitals that do not provide access to EC for rape victims.[72] Planned Parenthood supports and provides FDA-approved abortifacients such as mifepristone.[73]
Citing the need for medically accurate information in sex education, Planned Parenthood opposes abstinence-only education in public schools. Instead, Planned Parenthood is a provider of, and endorses, comprehensive sex education, which includes discussion of both abstinence and birth control.[74]
Political Action Committee
Planned Parenthood also has a political action committee called Planned Parenthood Action Fund. The committee was founded in 1996 by then new president Gloria Feldt for the purpose of maintaining reproductive health rights and supporting political candidates of the same mindset. In 2012 election cycle the committee gained prominence based on its effectiveness of spending on candidates.[75]
Before the U.S. Supreme Court
Former Planned Parenthood President Gloria Feldt with Congressman Albert Wynn in front of the U.S. Supreme Court
Planned Parenthood regional chapters have been active in the American courts. A number of cases in which Planned Parenthood has been a party have reached the U.S. Supreme Court. Notable among these cases is the 1992 case Planned Parenthood v. Casey, the case that sets forth the current constitutional abortion standard. In this case, “Planned Parenthood” was the Southeast Pennsylvania Chapter, and “Casey” was Robert Casey, the governor of Pennsylvania. The ultimate ruling was split, and Roe v. Wade was narrowed but upheld in an opinion written by Sandra Day O’Connor, Anthony Kennedy, and David Souter. Harry Blackmun and John Paul Stevens concurred with the main decision in separately written opinions. The Supreme Court struck down spousal consent requirements for married women to obtain abortions, but found no “undue burden”—an alternative to strict scrutiny which tests the allowable limitations on rights protected under the Constitution—from the other statutory requirements. Dissenting were William Rehnquist, Antonin Scalia, Clarence Thomas, and Byron White. Blackmun, Rehnquist, and White were the only justices who voted on the original Roe v. Wade decision in 1973 who were still on the Supreme Court to rule on this case, and their votes on this case were consistent with their votes on the original decision that legalized abortion.[76] Only Blackmun voted to maintain Roe v. Wade in its entirety.
Other related cases include:
Controversy and criticism
Abortion
Planned Parenthood has occupied a central position in the abortion debate in the U.S., and has been among the most prominent targets of U.S. pro-life activists for decades. Congressional Republicans have attempted since the 1980s to defund the organization,[45] nearly leading to a government shutdown over the issue in 2011.[86] The federal money received by Planned Parenthood is not used to fund abortion services, but pro-life activists have argued that the funding frees up other resources which are, in turn, used to provide abortions.[45]
Planned Parenthood is the largest single provider of abortions in the U.S.[7] In 2009, Planned Parenthood performed 332,278 abortions (for comparison, 1.21 million abortions were performed in the US in 2008[87]), from which it derives about $164,154,000, or 15% of its annual revenue as of their 2008–2009 calculations.[88] According to PPFA’s own estimates, its contraceptive services prevent approximately 612,000 unintended pregnancies and 291,000 abortions annually.[37][89] Planned Parenthood president Cecile Richards has argued that the organization’s family planning services reduce the need for abortions.[90] Megan Crepeau of the Chicago Tribune said that, because of its birth control and family planning services, PPFA could be “characterized as America’s largest abortion preventer.”[91] Anti-abortion activists dispute the evidence that greater access to contraceptives reduces abortions.[92]
Margaret Sanger and eugenics
In the 1920s various theories of eugenics were popular among intellectuals in the United States. For example, 75% of colleges offered courses on eugenics.[93] Sanger, in her campaign to promote birth control, teamed with eugenics organizations such as the American Eugenics Society, although she argued against many of their positions.[94][95][96] Scholars describe Sanger as believing that birth control, sterilization and abortion should be voluntary and not based on race.[97] She advocated for “voluntary motherhood”—the right to choose when to be pregnant—for all women, as an important element of women’s rights.[98][99] Opponents of Planned Parenthood often refer to Sanger’s connection with supporters of eugenics to discredit the organization by associating it, and birth control, with the more negative modern view of eugenics.[100][101] Planned Parenthood has responded to this effort directly in a leaflet acknowledging that Sanger agreed with some of her contemporaries who advocated the voluntary hospitalization or sterilization of people with untreatable, disabling, hereditary conditions, and limits on the immigration of the diseased. The leaflet also states that Planned Parenthood “finds these views objectionable and outmoded” but says that it was compelled to discuss the topic because “anti-family planning activists continue to attack Sanger . . . because she is an easier target” than Planned Parenthood.[102]
Recorded stings by pro-life activists
Planned Parenthood supporters in Columbus, OH
Periodically pro-life activists have tried to demonstrate that Planned Parenthood does not follow applicable state or federal laws. The groups called or visited a Planned Parenthood health center posing as victims of statutory rape,[103] minors who would need parental notification for abortion,[104][105] racists seeking to earmark donations for abortions for black women to abort black babies,[106] or pimps who want abortions for child prostitutes.[107] Edited video and audio productions of these dialogues seem to capture employees being sympathetic to potentially criminal acts, leading to allegations that the health centers in question are violating the law. An official federal inspection in 2005 by the Bush administration‘s Department of Health and Human Services “yielded no evidence of clinics around the nation failing to comply with laws on reporting child abuse, child molestation, sexual abuse, rape or incest.”[104]
In 2011, the organization Live Action released a series of videos that they said showed Planned Parenthood employees at multiple affiliates actively assisting or being complicit in aiding the underage prostitution ring of actors posing as a pimp and a prostitute. Planned Parenthood conducted a frame-by-frame analysis of the recordings, and said they found instances of “editing that dramatically alter[ed] the meaning of the recorded conversations.”[108]
None of these stings have led to criminal conviction.[109] However, a small number of Planned Parenthood employees and volunteers were fired for not following procedure, and the organization committed to retraining its staff.[106][110]
State and local court cases against Planned Parenthood
In some states, anti-abortion Attorneys General have subpoenaed medical records of patients treated by Planned Parenthood. Planned Parenthood has gone to court to keep from turning over these records, citing medical privacy and concerns about the motivation for seeking the records.[111]
In 2006, Kansas Attorney General Phill Kline, a strongly anti-abortion Republican, released some sealed patient records obtained from Planned Parenthood to the public. His actions were described as “troubling” by the state Supreme Court, but ultimately Planned Parenthood was compelled to turn over the medical records, albeit with more stringent court-mandated privacy safeguards for the patients involved.[111] In 2007, Kline’s successor, Paul J. Morrison, notified the clinic that no criminal charges would be filed after a three-year investigation, as “an objective, unbiased and thorough examination” showed no wrongdoing. Morrison stated that he believed Kline had politicized the attorney general’s office.[112] In 2012, a Kansas district attorney dropped all of the remaining criminal charges against the Kansas City-area Planned Parenthood clinic accused of performing illegal abortions, citing a lack of evidence of wrongdoing.[113] In all, the Planned Parenthood clinic had faced 107 criminal charges from Kline and other Kansas prosecutors, all of which were ultimately dropped for lack of evidence.[113]
In Indiana, Planned Parenthood was not required to turn over its medical records in an investigation of possible child abuse.[114] In October 2005, Planned Parenthood Minnesota/North Dakota/South Dakota was fined $50,000 for violating a Minnesota state parental consent law.[115]
On December 31, 2012, Judge Gary Harger ruled Texas may exclude otherwise qualified doctors and clinics from receiving state funding if they advocate for abortion rights.[116]
Anti-abortion violence
Planned Parenthood clinics have been the target of many instances of anti-abortion violence, including (but not limited to) bombing, arson, and attacks with chemical weaponry.[117][118][119][120][121][122][123][124][125][126][127]
1994 Brookline shootings
In 1994, John Salvi entered a Brookline, Massachusetts Planned Parenthood clinic and opened fire, murdering receptionist Shannon Elizabeth Lowney and wounding three others. He fled to another Planned Parenthood clinic where he murdered Leane Nichols and wounded two others.[128]
See also
Notes
https://en.wikipedia.org/wiki/Planned_Parenthood
Margaret Sanger
September 14, 1879
Corning, New York,
United States
Tucson, Arizona,
United States
James Noah H. Slee (1922–1943).
Margaret Higgins Sanger (September 14, 1879 – September 6, 1966) was an American birth control activist, sex educator, and nurse. Sanger popularized the term birth control, opened the first birth control clinic in the United States, and established organizations that evolved into the Planned Parenthood Federation of America. Sanger was also a writer. She used this method to help promote her way of thinking. She was prosecuted for her book Family Limitation under the Comstock Act in 1914. She was afraid of what would happen, so she fled to Britain until she knew it was safe to return to the US.[citation needed] Sanger’s efforts contributed to several judicial cases that helped legalize contraception in the United States. Sanger is a frequent target of criticism by opponents of abortion and has also been criticized for supporting eugenics, but remains an iconic figure in the American reproductive rights movement.[2]
In 1916, Sanger opened the first birth control clinic in the United States, which led to her arrest for distributing information on contraception. Her subsequent trial and appeal generated controversy. Sanger felt that in order for women to have a more equal footing in society and to lead healthier lives, they needed to be able to determine when to bear children. She also wanted to prevent unsafe abortions, so-called back-alley abortions, which were common at the time because abortions were usually illegal. She believed that while abortion was sometimes justified it should generally be avoided, and she considered contraception the only practical way to avoid the use of abortions.[citation needed]
In 1921, Sanger founded the American Birth Control League, which later became the Planned Parenthood Federation of America. In New York City, she organized the first birth control clinic staffed by all-female doctors, as well as a clinic in Harlem with an entirely African-American staff. In 1929, she formed the National Committee on Federal Legislation for Birth Control, which served as the focal point of her lobbying efforts to legalize contraception in the United States. From 1952 to 1959, Sanger served as president of the International Planned Parenthood Federation. She died in 1966, and is widely regarded as a founder of the modern birth control movement.
Life
Early life
Sanger was born Margaret Louise Higgins in 1879 in Corning, New York,[3] to Michael Hennessey Higgins, an Irish-born stonemason and free-thinker, and Anne Purcell Higgins, a Catholic Irish-American. Michael Hennessey Higgins had emigrated to the USA at age 14 and joined the U.S. Army as a drummer at age 15, during the Civil War. After leaving the army, Michael studied medicine and phrenology, but ultimately became a stonecutter, making stone angels, saints, and tombstones.[4] Michael H. Higgins was a Catholic who became an atheist and an activist for women’s suffrage and free public education.[5] Anne Higgins went through 18 pregnancies (with 11 live births) in 22 years before dying at the age of 49. Sanger was the sixth of eleven surviving children,[6] and spent much of her youth assisting with household chores and caring for her younger siblings. Anne’s parents took their children and emigrated to Canada when she was a child, due to the Potato Famine.
Supported by her two older sisters, Margaret Higgins attended Claverack College and Hudson River Institute, before enrolling in 1900 at White Plains Hospital as a nurse probationer. In 1902, she married the dashing architect William Sanger and gave up her education.[7] Though she was plagued by a recurring active tubercular condition, Margaret Sanger bore three children, and the couple settled down to a quiet life in Westchester, New York.
Sanger with sons Grant and Stuart, c. 1919
Social activism
In 1911, after a fire destroyed their home in Hastings-on-Hudson, the Sangers abandoned the suburbs for a new life in New York City. Margaret Sanger worked as a visiting nurse in the slums of the East Side, while her husband worked as an architect and a house painter. Already imbued with her husband’s leftist politics, Margaret Sanger also threw herself into the radical politics and modernist values of pre-World War I Greenwich Village bohemia. She joined the Women’s Committee of the New York Socialist party, took part in the labor actions of the Industrial Workers of the World (including the notable 1912 Lawrence Textile Strike and the 1913 Paterson Silk Strike) and became involved with local intellectuals, left-wing artists, socialists and social activists, including John Reed, Upton Sinclair, Mabel Dodge and Emma Goldman.[8]
Sanger’s political interests, emerging feminism and nursing experience led her to write two series of columns on sex education entitled “What Every Mother Should Know” (1911–12) and “What Every Girl Should Know” (1912-13) for the socialist magazine New York Call. By the standards of the day, Sanger’s articles were extremely frank in their discussion of sexuality, and many New York Call readers were outraged by them. Other readers, however, praised the series for its candor, one stated that the series contained “a purer morality than whole libraries full of hypocritical cant about modesty.[9] Both were later published in book form in 1916.[10]
During her work among working class immigrant women, Sanger was exposed to graphic examples of women going through frequent childbirth, miscarriage and self-induced abortion for lack of information on how to avoid unwanted pregnancy. Access to contraceptive information was prohibited on grounds of obscenity by the 1873 federal Comstock law and a host of state laws. Searching for something that would help these women, Sanger visited public libraries, but was unable to find information on contraception.[11] These problems were epitomized in a (possibly fictional) story that Sanger would later recount in her speeches: while Sanger was working as a nurse, she was called to the apartment of a woman, “Sadie Sachs,” who had become extremely ill due to a self-induced abortion. Afterward, “Sadie” (whose marital status Sanger never mentioned) begged the attending doctor to tell her how she could prevent this from happening again, to which the doctor simply advised her to remain abstinent. A few months later, Sanger was called back to “Sadie’s” apartment — only this time, “Sadie” died shortly after Sanger arrived. She had attempted yet another self-induced abortion.[12][13] Sanger would sometimes end the story by saying, “I threw my nursing bag in the corner and announced … that I would never take another case until I had made it possible for working women in America to have the knowledge to control birth.” Although “Sadie Sachs” was possibly a fictional composite of several women Sanger had known, this story marks the time when Sanger began to devote her life to help desperate women before they were driven to pursue dangerous and illegal abortions.[13][14]
Accepting the connection proposed between contraception and working-class empowerment by radicals such as Emma Goldman, Sanger came to believe that only by liberating women from the risk of unwanted pregnancy would fundamental social change take place. She proceeded to launch a campaign to challenge governmental censorship of contraceptive information. She would set up a series of confrontational actions designed to challenge the law and force birth control to become a topic of public debate. Sanger’s trip to France in 1913 exposed her to what Goldman had been saying. Sanger’s experience during her trip to France directly influence The Women Rebel newsletter. The trip to France was also the beginning of the end of her marriage with William Sanger.[15]
In 1914, Sanger launched The Woman Rebel, an eight-page monthly newsletter which promoted contraception using the slogan “No Gods, No Masters“.[16][note 2][17] Sanger, collaborating with anarchist friends, popularized the term “birth control” as a more candid alternative to euphemisms such as “family limitation”[18] and proclaimed that each woman should be “the absolute mistress of her own body.”[19] In these early years of Sanger’s activism, she viewed birth control as a free-speech issue, and when she started publishing The Woman Rebel, one of her goals was to provoke a legal challenge to the federal anti-obscenity laws which banned dissemination of information about contraception.[20][21] Though postal authorities suppressed five of its seven issues, Sanger continuing publication, all the while preparing, Family Limitation, an even more blatant challenge to anti-birth control laws. This 16-page pamphlet contained detailed and precise information and graphic descriptions of various contraceptive methods. In August 1914 Margaret Sanger was indicted for violating postal obscenity laws by sending the The Woman Rebel through the postal system. Instead of standing trial, she jumped bail and fled to Canada. Then, under the alias “Bertha Watson”, sailed for England. En route she ordered her labor associates to release copies of the Family Limitation.[22]
Margaret Sanger spent much of her 1914 exile in England, where contact with British neo-Malthusianists helped refine her socioeconomic justifications for birth control. She was also profoundly influenced by the liberation theories of British sexual theorist Havelock Ellis. Under his tutelage she formulated a new rationale that would liberate women not just by making sexual intercourse safe, but also pleasurable. It would, in effect, free women from the inequality of sexual experience. Early in 1915, Margaret Sanger’s estranged husband, William Sanger, was entrapped into giving a copy of Family Limitation to a representative of anti-vice crusader Anthony Comstock. William Sanger was tried and convicted, he spent thirty days in jail, while also escalating interest in birth control as a civil liberties issue.[23][24][25]
Birth control movement
This page from Sanger’s Family Limitation, 1917 edition, describes a cervical cap.
Some countries in northwestern Europe had more liberal policies towards contraception than the United States at the time, and when Sanger visited a Dutch birth control clinic in 1915, she learned about diaphragms and became convinced that they were a more effective means of contraception than the suppositories and douches that she had been distributing back in the United States. Diaphragms were generally unavailable in the United States, so Sanger and others began importing them from Europe, in defiance of United States law.[8]
In 1917, she started publishing the monthly periodical Birth Control Review.[note 3]
On October 16, 1916, Sanger opened a family planning and birth control clinic at 46 Amboy St. in the Brownsville neighborhood of Brooklyn, the first of its kind in the United States.[26] Nine days after the clinic opened, Sanger was arrested. Sanger’s bail was set at $500 and she went back home. Sanger continued seeing some women in the clinic until the police came a second time. This time Sanger and her sister, Ethel Byrne, were arrested for breaking a New York state law that prohibited distribution of contraceptives, Sanger was also charged with running a public nuisance.[27] Sanger and Ethel went to trial in January 1917.[28] Byrne was convicted and sentenced to 30 days in a workhouse but went on hunger strike. She was the first woman in the US to be force fed.[29] Only when Sanger pledged that Byrne would never break the law, she was pardoned after ten days.[30] Sanger was convicted; the trial judge held that women did not have “the right to copulate with a feeling of security that there will be no resulting conception.”[31] Sanger was offered a more lenient sentence if she promised to not break the law again, but she replied: “I cannot respect the law as it exists today.”[32] For this, she was sentenced to 30 days in a workhouse.[32] An initial appeal was rejected, but in a subsequent court proceeding in 1918, the birth control movement won a victory when Judge Frederick E. Crane of the New York Court of Appeals issued a ruling which allowed doctors to prescribe contraception.[33] The publicity surrounding Sanger’s arrest, trial, and appeal sparked birth control activism across the United States, and earned the support of numerous donors, who would provide her with funding and support for future endeavors.[34]
Sanger became estranged from her husband in 1913, and the couple’s divorce was finalized in 1921.[35] Sanger’s second husband was Noah Slee. He followed Sanger around the world and provided much of Sanger’s financial assistance. The couple got married in September 1922, but the public did not know about it until February 1924. They supported each other with their pre-commitments.[36]
American Birth Control League
Sanger published the Birth Control Review from 1917 to 1929.[note 4]
After World War I, Sanger shifted away from radical politics, and she founded the American Birth Control League (ABCL) in 1921 to enlarge her base of supporters to include the middle class.[37] The founding principles of the ABCL were as follows:[38]
Sanger’s appeal of her conviction for the Brownsville clinic secured a 1918 court ruling that exempted physicians from the law that prohibited the distribution of contraceptive information to women—provided it was prescribed for medical reasons—she established the Clinical Research Bureau (CRB) in 1923 to exploit this loophole.[8][39] The CRB was the first legal birth control clinic in the United States, and it was staffed entirely by female doctors and social workers.[40] The clinic received a large amount of funding from John D. Rockefeller Jr. and his family, which continued to make donations to Sanger’s causes in future decades, but generally made them anonymously to avoid public exposure of the family name,[41] and to protect family member Nelson Rockefeller‘s political career since openly advocating birth control could have led to the Catholic Church opposing him politically.[42] John D. Rockefeller Jr. donated five thousand dollars to her American Birth Control League in 1924 and a second time in 1925.[43] In 1922, she traveled to China, Korea, and Japan. In China she observed that the primary method of family planning was female infanticide, and she later worked with Pearl Buck to establish a family planning clinic in Shanghai.[44] Sanger visited Japan six times, working with Japanese feminist Kato Shidzue to promote birth control.[45] This was ironic since ten years earlier Sanger had accused Katō of murder and praised an attempt to kill her.[46]
In 1926, Sanger gave a lecture on birth control to the women’s auxiliary of the Ku Klux Klan in Silver Lake, New Jersey.[47] She described it as “one of the weirdest experiences I had in lecturing,” and added that she had to use only “the most elementary terms, as though I were trying to make children understand.”[47] Sanger’s talk was well received by the group, and as a result, “a dozen invitations to similar groups were proffered.”[47]
In 1928, conflict within the birth control movement leadership led Sanger to resign as the president of the ABCL and take full control of the CRB, renaming it the Birth Control Clinical Research Bureau (BCCRB), marking the beginning of a schism in the movement that would last until 1938.[48]
Sanger invested a great deal of effort communicating with the general public. From 1916 onward, she frequently lectured—in churches, women’s clubs, homes, and theaters—to workers, churchmen, liberals, socialists, scientists, and upper-class women.[49] She wrote several books in the 1920s which had a nationwide impact in promoting the cause of birth control. Between 1920 and 1926, 567,000 copies of Woman and the New Race and The Pivot of Civilization were sold.[50] She also wrote two autobiographies designed to promote the cause. The first, My Fight for Birth Control, was published in 1931 and the second, more promotional version, Margaret Sanger: An Autobiography, was published in 1938.
During the 1920s, Sanger received hundreds of thousands of letters, many of them written in desperation by women begging for information on how to prevent unwanted pregnancies.[51][52] Five hundred of these letters were compiled into the 1928 book, Motherhood in Bondage.[53][54]
Planned Parenthood era
Sanger’s Birth Control Clinical Research Bureau operated from this New York building from 1930 to 1973.
In 1929, Sanger formed the National Committee on Federal Legislation for Birth Control in order to lobby for legislation to overturn restrictions on contraception.[55] That effort failed to achieve success, so Sanger ordered a diaphragm from Japan in 1932, in order to provoke a decisive battle in the courts. The diaphragm was confiscated by the United States government, and Sanger’s subsequent legal challenge led to a 1936 court decision which overturned an important provision of the Comstock laws which prohibited physicians from obtaining contraceptives.[56] This court victory motivated the American Medical Association in 1937 to adopt contraception as a normal medical service and a key component of medical school curriculums.[57]
This 1936 contraception court victory was the culmination of Sanger’s birth control efforts, and she took the opportunity, now in her late 50s, to move to Tucson, Arizona, intending to play a less critical role in the birth control movement. In spite of her original intentions, she remained active in the movement through the 1950s.[57]
In 1937, Sanger became chairman of the newly formed Birth Control Council of America, and attempted to resolve the schism between the ABCL and the BCCRB.[58] Her efforts were successful, and the two organizations merged in 1939 as the Birth Control Federation of America.[59][note 5] Although Sanger continued in the role of president, she no longer wielded the same power as she had in the early years of the movement, and in 1942, more conservative forces within the organization changed the name to Planned Parenthood Federation of America, a name Sanger objected to because she considered it too euphemistic.[60]
In 1946, Sanger helped found the International Committee on Planned Parenthood, which evolved into the International Planned Parenthood Federation in 1952, and soon became the world’s largest non-governmental international family planning organization. Sanger was the organization’s first president and served in that role until she was 80 years old.[61] In the early 1950s, Sanger encouraged philanthropist Katharine McCormick to provide funding for biologist Gregory Pincus to develop the birth control pill which was eventually sold under the name Enovid.[62]
Death
Margaret Sanger Square, at the intersection of Mott Street and Bleecker Street in Manhattan
Sanger died of congestive heart failure in 1966 in Tucson, Arizona, aged 86, about a year after the event that marked the climax of her 50-year career: the landmark U.S. Supreme Court case Griswold v. Connecticut, which legalized birth control in the United States.[note 6] Sanger is buried in Fishkill, New York, next to her sister, Nan Higgins, and her second husband, Noah Slee.[63] One of her surviving brothers was College Football Hall of Fame player and coach Bob Higgins.[64]
Legacy
Long after her death, Sanger has continued to be regarded as a leading figure in the battle for American women’s rights. Sanger’s story has been the subject of several biographies, including an award-winning biography published in 1970 by David Kennedy, and is also the subject of several films, including Choices of the Heart: The Margaret Sanger Story.[65] Sanger’s writings are curated by two universities: New York University‘s history department maintains the Margaret Sanger Papers Project,[66] and Smith College‘s Sophia Smith Collection maintains the Margaret Sanger Papers collection.[67]
Sanger has been recognized with many important honors. In 1957, the American Humanist Association named her Humanist of the Year. Government authorities and other institutions have memorialized Sanger by dedicating several landmarks in her name, including a residential building on the Stony Brook University campus, a room in Wellesley College’s library,[68] and Margaret Sanger Square in New York City’s Greenwich Village.[69] In 1993, the Margaret Sanger Clinic—where she provided birth control services in New York in the mid twentieth century—was designated as a National Historic Landmark by the National Park Service.[70] In 1966, Planned Parenthood began issuing its Margaret Sanger Awards annually to honor “individuals of distinction in recognition of excellence and leadership in furthering reproductive health and reproductive rights.”[71]
Due to her connection with Planned Parenthood, many who are opposed to abortion frequently condemn Sanger by criticizing her views on racial supremacy, birth control, and eugenics.[72][73][note 7] In spite of such controversies, Sanger continues to be regarded as an icon for the American reproductive rights movement and woman’s rights movement.
Controversies
Sexuality
While researching information on contraception Sanger read various treatises on sexuality in order to find information about birth control. She read The Psychology of Sex by the English psychologist Havelock Ellis and was heavily influenced by it.[74] While traveling in Europe in 1914, Sanger met Ellis.[75] Influenced by Ellis, Sanger adopted his view of sexuality as a powerful, liberating force.[76] This view provided another argument in favor of birth control, as it would enable women to fully enjoy sexual relations without the fear of an unwanted pregnancy.[77] Sanger also believed that sexuality, along with birth control, should be discussed with more candor.[76]
However, Sanger was opposed to excessive sexual indulgence. She stated “every normal man and woman has the power to control and direct his sexual impulse. Men and women who have it in control and constantly use their brain cells thinking deeply, are never sensual.”[78][79] Sanger said that birth control would elevate women away from a position of being an object of lust and elevate sex away from purely being for satisfying lust, saying that birth control “denies that sex should be reduced to the position of sensual lust, or that woman should permit herself to be the instrument of its satisfaction.”[80] Sanger wrote that masturbation was dangerous. She stated: “In my personal experience as a trained nurse while attending persons afflicted with various and often revolting diseases, no matter what their ailments, I never found any one so repulsive as the chronic masturbator. It would not be difficult to fill page upon page of heart-rending confessions made by young girls, whose lives were blighted by this pernicious habit, always begun so innocently.”[81] She believed that women had the ability to control their sexual impulses, and should utilize that control to avoid sex outside of relationships marked by “confidence and respect.” She believed that exercising such control would lead to the “strongest and most sacred passion.”[82] However, Sanger was not opposed to homosexuality and praised Ellis for clarifying “the question of homosexuals… making the thing a—not exactly a perverted thing, but a thing that a person is born with different kinds of eyes, different kinds of structures and so forth… that he didn’t make all homosexuals perverts—and I thought he helped clarify that to the medical profession and to the scientists of the world as perhaps one of the first ones to do that.”[83] Sanger believed sex should be discussed with more candor, and praised Ellis for his efforts in this direction. She also blamed the suppression of discussion about it on Christianity.[83]
Eugenics
Sanger’s 1920 book endorsed eugenics.
As part of her efforts to promote birth control, Sanger found common cause with proponents of eugenics, believing that they both sought to “assist the race toward the elimination of the unfit.”[84] Sanger was a proponent of negative eugenics, which aims to improve human hereditary traits through social intervention by reducing the reproduction of those who were considered unfit. In “The Morality of Birth Control,” a 1921 speech, she divided society into three groups: the educated and informed class that regulated the size of their families, the intelligent and responsible who desired to control their families however did not have the means or the knowledge and the irresponsible and reckless people whose religious scruples “prevent their exercising control over their numbers.” Sanger concludes “there is no doubt in the minds of all thinking people that the procreation of this group should be stopped.”[85] Sanger’s eugenic policies included an exclusionary immigration policy, free access to birth control methods and full family planning autonomy for the able-minded, and compulsory segregation or sterilization for the “profoundly retarded”.[86][87] In her book The Pivot of Civilization, she advocated coercion to prevent the “undeniably feeble-minded” from procreating.[88] Although Sanger supported negative eugenics, she asserted that eugenics alone was not sufficient, and that birth control was essential to achieve her goals.[89][90][91]
In contrast with eugenicist William Robinson, who advocated euthanasia for the unfit,[note 8] Sanger wrote, “we [do not] believe that the community could or should send to the lethal chamber the defective progeny resulting from irresponsible and unintelligent breeding.”[92] Similarly, Sanger denounced the aggressive and lethal Nazi eugenics program.[87] In addition, Sanger believed the responsibility for birth control should remain in the hands of able-minded individual parents rather than the state, and that self-determining motherhood was the only unshakable foundation for racial betterment.[89][93]
Sanger also supported restrictive immigration policies. In “A Plan for Peace”, a 1932 essay, she proposed a congressional department to address population problems. She also recommended that immigration exclude those “whose condition is known to be detrimental to the stamina of the race,” and that sterilization and segregation be applied to those with incurable, hereditary disabilities.[86][87][94]
Race
W. E. B. Du Bois served on the board of Sanger’s Harlem clinic.[95]
Sanger’s writings echoed her ideas about inferiority and loose morals of particular races. In one “What Every Girl Should Know” commentary, she references popular opinion that Aboriginal Australians were “just a step higher than the chimpanzee” with “little sexual control,” as compared to the “normal man and Woman.”[78] Elsewhere she bemoaned that traditional sexual ethics “… have in the past revealed their woeful inability to prevent the sexual and racial chaos into which the world has today drifted.”[93]
Such attitudes did not keep her from collaborating with African-American leaders and professionals who saw a need for birth control in their communities. In 1929, James H. Hubert, a black social worker and leader of New York’s Urban League, asked Sanger to open a clinic in Harlem.[96] Sanger secured funding from the Julius Rosenwald Fund and opened the clinic, staffed with black doctors, in 1930. The clinic was directed by a 15-member advisory board consisting of black doctors, nurses, clergy, journalists, and social workers. The clinic was publicized in the African-American press and in black churches, and it received the approval of W. E. B. Du Bois, founder of the NAACP.[97] In 1939 Sanger wrote, “We should hire three or four colored ministers, preferably with social-service backgrounds, and with engaging personalities. The most successful educational approach to the Negro is through a religious appeal. We don’t want the word to go out that we want to exterminate the Negro population, and the minister is the man who can straighten out that idea if it ever occurs to any of their more rebellious members.” She did not tolerate bigotry among her staff, nor would she tolerate any refusal to work within interracial projects.[98] Sanger’s work with minorities earned praise from Martin Luther King, Jr., in his 1966 acceptance speech for the Margaret Sanger award.[99]
From 1939 to 1942 Sanger was an honorary delegate of the Birth Control Federation of America, which included a supervisory role—alongside Mary Lasker and Clarence Gamble—in the Negro Project, an effort to deliver birth control to poor black people.[100] Sanger wanted the Negro Project to include black ministers in leadership roles, but other supervisors did not. To emphasize the benefits of involving black community leaders, she wrote to Gamble “we do not want word to go out that we want to exterminate the Negro population and the minister is the man who can straighten out that idea if it ever occurs to any of their more rebellious members.” This quote has been cited by Angela Davis to support her claims that Sanger wanted to exterminate black people.[101] However, New York University’s Margaret Sanger Papers Project, argues that in writing that letter, “Sanger recognized that elements within the black community might mistakenly associate the Negro Project with racist sterilization campaigns in the Jim Crow South, unless clergy and other community leaders spread the word that the Project had a humanitarian aim.”[102]
Freedom of speech
Sanger opposed censorship throughout her career, with a zeal comparable to her support for birth control. Sanger grew up in a home where iconoclastic orator Robert Ingersoll was admired.[103] During the early years of her activism, Sanger viewed birth control primarily as a free-speech issue, rather than as a feminist issue, and when she started publishing The Woman Rebel in 1914, she did so with the express goal of provoking a legal challenge to the Comstock laws banning dissemination of information about contraception.[21] In New York, Emma Goldman introduced Sanger to members of the Free Speech League, such as Edward Bliss Foote and Theodore Schroeder, and subsequently the League provided funding and advice to help Sanger with legal battles.[104]
Over the course of her career, Sanger was arrested at least eight times for expressing her views during an era in which speaking publicly about contraception was illegal.[105] Numerous times in her career, local government officials prevented Sanger from speaking by shuttering a facility or threatening her hosts.[106] In Boston in 1929, city officials under the leadership of James Curley threatened to arrest her if she spoke—so she turned the threat to her advantage and stood on stage, silent, with a gag over her mouth, while her speech was read by Arthur M. Schlesinger, Sr.[107]
Abortion
Sanger’s family planning advocacy always focused on contraception, rather than abortion.[108][note 9] It was not until the mid-1960s, after Sanger’s death, that the reproductive rights movement expanded its scope to include abortion rights as well as contraception.[note 10] Sanger was opposed to abortions, both because she believed that life should not be terminated after conception, and because they were dangerous for the mother in the early 20th century. In her book Woman and the New Race, she wrote: “while there are cases where even the law recognizes an abortion as justifiable if recommended by a physician, I assert that the hundreds of thousands of abortions performed in America each year are a disgrace to civilization.”[111]
Historian Rodger Streitmatter concluded that Sanger’s opposition to abortion stemmed from concerns for the dangers to the mother, rather than moral concerns.[112] However, in her 1938 autobiography, Sanger noted that her opposition to abortion was based on the taking of life: “[In 1916] we explained what contraception was; that abortion was the wrong way no matter how early it was performed it was taking life; that contraception was the better way, the safer way—it took a little time, a little trouble, but was well worth while in the long run, because life had not yet begun.”[113] And in her book Family Limitation, Sanger wrote that “no one can doubt that there are times when an abortion is justifiable but they will become unnecessary when care is taken to prevent conception. This is the only cure for abortions.”[114]
Works
See also
https://en.wikipedia.org/wiki/Margaret_Sanger
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