WASHINGTON, D.C. – Co-Chairs of the Childhood Cancer Caucus, Reps. Michael McCaul (R-TX), Jackie Speier (D-CA), Mike Kelly (R-PA), and G. K. Butterfield (D-NC), applaud the passage of the Senate companion to their bill – S. 292, the Childhood Cancer STAR Act.

The STAR Act passed the House today by a unanimous vote.  It addresses the four major concerns facing the pediatric cancer community: Survivorship, Treatment, Access, and Research, and will elevate and prioritize the fight against childhood cancer at the National Institute of Health (NIH).

The members released the following joint statement:

"Today was a long anticipated day for the pediatric cancer community, and one to be celebrated.  This bill is the most comprehensive childhood cancer bill to ever pass Congress and will finally head to the president’s desk to be signed into law. Childhood cancer remains one of the deadliest killers of our kids and we as a Congress, and a nation, must say, ‘Enough is enough.’  As co-chairs of the Childhood Cancer Caucus, we would like to thank all those who made this possible, including the Alliance for Childhood Cancer and the entire childhood cancer advocacy community.”

Click here to watch McCaul’s floor remarks ahead of the House passage of the STAR Act.

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On February 21 I published a piece on LinkedIn – Communications Considerations for Medical Manufacturers as the COVID-19 Epidemic Emerges – that provided an overview of some of the communications considerations for pharma, biotech and device manufacturers related to the … Continue reading →

Posted by Roger Bate A Star Newspaper investigation of drug quality in Canada (see here) demonstrates the risks patients in rich nations like Canada run from receiving poor quality medicines, especially imported from India. What is most worrying is the lack of transparency at some western health agencies. What the investigation shows is that Health Canada has hidden information about problems with medications. While it is true that educated people occasionally make bad medicine choices (think [...]

by Adriana Gallardo, ProPublica, and Ariel Goodman for ProPublica

They’ve gotten to know New York City in a way many have not, through the low-wage work of cleaning its skyscrapers, serving its restaurants and crisscrossing its streets on bicycles, through long subway rides very early in the morning and very late at night. The saying goes: You’re not a true New Yorker unless you’ve lived here for a decade. They’ve done their time and felt a deep sense of belonging in this city of immigrants.

But, in the epicenter of a pandemic, the undocumented have never felt more alone.

They are losing loved ones but do not qualify for city funding to help bury them. They are getting sick but hesitating to get tested or go to the hospital, balancing their fear of the virus with their fear of exposure to immigration authorities. They are worried about supporting their families abroad as well as those who live with them, weighing whether to keep working perilous jobs or to stay home and somehow keep food on the table.

They’ve experienced separation, but not like this — out in the world, in a skeleton crew, wearing a mask to deliver food to closed doors; in cramped apartments, sectioned off, in an attempt to quarantine. They are divided across national borders as family members die, praying novenas on Google Hangouts. Their bodies cannot be buried, intact, where they were born; they move from hospital bed, to refrigerated truck, to incinerator.

ProPublica interviewed two dozen undocumented Latino immigrants and their families about their experiences with death, illness and survival. Some spoke on the condition of anonymity, afraid of being targeted. Others allowed us to use their first names or the full names of their family members who died.

One kitchen worker from the Bronx worked in the World Trade Center two decades ago. “We used to fill the back elevators of those towers,” he said. He lost friends on Sept. 11, 2001, who were not identified or acknowledged among the dead because their names did not match those on record or their families were unable to claim the bodies.

He and others spoke to ProPublica because this time they wanted their experiences to be counted as part of the story of their city, overtaken by a virus.

Barriers to a Proper Burial

Adrian Hernandez Lopez, 38, never planned to stay in New York City. His 15 year stint here was dotted with visits to his family in Mexico, for the baptism of his son, who is now almost a teen, and to check on the house he had been sending his paychecks to build.

He and brother worked at an Italian restaurant in Times Square. “We were always together,” his brother said. They crossed the border together and, years later, commuted together from Queens to midtown Manhattan.

The last time they spoke by phone, Lopez waited in agony in a hard chair at Elmhurst Hospital, breathing in oxygen from a machine. He was transferred to Woodhull Hospital in Brooklyn. One day later, the father of two wound up in a vegetative state.

He died on April 2. His mother, who lives in Allende, a small village in the state of Puebla, wants him buried there, alongside two babies she lost just after birth.

He can’t be traditionally buried, despite the strong Mexican custom. More than 400 Mexican migrants are known to have died of COVID-19 in the New York area, but for health reasons, Mexico will only accept their bodies if they are cremated.

In place of seeing the body one last time, Lopez’s brother was sent photos by the funeral home, which will hold the cremains while the family figures out how to get them to Mexico.

The Mexican Consulate pledged financial aid to the families of nationals who died of COVID-19 complications, but it has been slow to materialize. According to Lopez’s brother, they’ve been asked to follow guidelines to receive a reimbursement. The Consulate General’s office in New York said it was not authorized by the Mexican government to give interviews at the time of our request for comment.

The city of New York provides burial assistance, but it requires a Social Security number for both the deceased and the person requesting funds. City officials say they are limited by federal and state law in the help they can offer. “We are exploring every possible option to ensure that all New Yorkers, regardless of immigration status, are able to bury their loved ones in the way they feel is most fitting,” city spokesperson Avery Cohen said.

Two members of the City Council have called for an emergency fund to provide assistance to all low-income families, including the undocumented.

“One of the most devastating calls I’m regularly getting is from people who can’t afford to bury their loved ones and aren’t eligible for any assistance,” Council Member Francisco Moya said in a release. “That’s simply not acceptable.”

Lopez’s family is one of several raising money for the transport and burial of their loved one who died in the United States.

As he tries to figure out how to send Lopez home, his brother sits in the small apartment they shared in Queens, with his wife and 6-year-old daughter, listening to the sirens that have become a constant reminder of their loss. He and his wife have been out of work for a month. They don’t know how they will pay the rent.

Deterred From Seeking Care

More than a dozen undocumented people told ProPublica that when they got sick, they stayed home, deterred from seeking care by the worry that they would not get it if they tried. They faced the same obstacles as everyone else in New York, where hospitals were crowded and unsafe, and feared additional ones involving their immigration status.

Fani lives in East Harlem. Over the last 18 years, she’s worked at a laundromat and a factory, a restaurant and as a babysitter. When she and her husband got sick they called 311. She said the voice on the other end confirmed their COVID-19 symptoms and told them to stay home unless they couldn’t breathe.

“They said there were no beds, no respirators. We healed each other as best we could with soups, teas and Tylenol,” she said.

Sonia, who became ill with COVID-19 symptoms almost three weeks ago, was afraid to go to the hospital. “I knew several people who went into the hospital with symptoms and they never came back,” she said. “That was my fear and why I decided to not go in. I preferred to isolate myself at home, with a lot of home remedies and hot teas.”

Multiple people said they knew hospitals had limited resources and worried they would be placed last in line for care because they were undocumented. “They’re going to let us die,” one man told his brother. A woman named Yogi in the Bronx said, “It might not be that they don’t want to treat us, maybe there weren’t enough supplies.”

Stories rippled through the Latino community about those who had difficulty getting care and those who could not be saved. According to a recent poll of voters in New York City, more than half of Latinos there said they know someone who died, the highest percentage of any group asked.

They hear stories about people like Juan Leonardo Torres, a 65-year-old retired doorman who knew someone on every corner of Corona, Queens. Unlike the others, Torres, from the Dominican Republic, was a citizen. Even so, he grew discouraged when he tried to get care.

Within one week at the end of March, Torres had gone from feeling slightly ill to experiencing difficulty breathing and fevers that his wife Mindy tried to manage using herbs and other “remedios caseros,” or home remedies. She and her five sons who lived with them finally persuaded him to go to Long Island Jewish Medical Center Forest Hills, just a five-minute drive from the house.

When Torres arrived, he told his family there were not enough seats in the crowded emergency room. He gave his chair up to an older woman and stood for hours as staff connected and disconnected him to an oxygen tank.

Fifteen hours later, on a drizzly night, Torres appeared at the door of the family home. It was 2:30 a.m. He had made the walk alone and declared in Spanish, “For no reason do I want to go to the hospital to die like a dog.”

He spent the next three days quarantined in his son’s room, where he died.

As the family waited six hours for his body to be retrieved, his wife sat in the living room “like a statue.”

Calculating Survival

Unable to qualify for relief programs like unemployment and stimulus cash, undocumented people are faced with the difficult choice of working dangerous jobs or running out of the money they need for essentials like food and housing.

“The little we have goes to food,” said Berenice, who suffers from kidney problems and whose son struggles with asthma. She’s been home for weeks along with her husband Luis, who before the pandemic worked at a cab company.

“Yes, we need money, but there is also our health,” Berenice said. “We have family who are sick and friends who died. We are trying to survive.”

Luis has lived in New York for 18 years, working his way up from delivering pizza on a bicycle to owning a cab. He worries about exposing his wife and son. “I just want this to pass and we’ll see about starting over again,” he said.

Adan lives in the Bronx with his two teenage sons, who were born in New York City, and his wife. She cleaned homes. He worked in a restaurant in East Harlem. Neither are working and both overcame COVID-19. “The little money we had went to pay last month’s rent,” he said. “I don’t know what to do, we just want to work.”

He said his landlord always comes looking for the rent in person. He told “el señor” that he’s spending all his money on food. The man gave him flyers about unemployment, but Adan knows he won’t qualify. “Me las voy a ver duras,” he said. He’s going to see hard times. He said he has lived in the same building for 11 years and has never missed a payment. Even though he can’t be evicted now, he said, “the debt will be there.”

Adding to the pressure, for some, is that they also work to support family members in their home countries, who count on the money they send.

One delivery worker in Queens sends $400 to Mexico every two weeks to help his son, who studies biomedicine at a university in Puebla; that helps him cover what he needs for school, including rent and transportation. He sends another $300 each month to his elderly mother.

He said he remains one of only a few bicycle delivery workers at his diner who are still on the job, and he is seeing more orders than usual. He’s always worked six days a week, but this past month was so busy, he couldn’t stop to eat lunch or take breaks.

He would much rather be outside than at home, but the streets feel tense. “I feel strange not seeing anyone or saying hi anymore, but I think it’s much better this way,” he said. “I understand why people are afraid.”

Even though he doesn’t see them in the buildings he visits, customers have been conscious about leaving tips in envelopes. He feels grateful as he passes the long lines in Queens of those waiting for free food. It makes him sad to know how many need it now.

He rents a room in an apartment he shares with three other men who have all lost their jobs. One was in construction, the other two in restaurants. He takes precautions to keep them safe when he comes home, including changing his clothes before coming in. “It would be irresponsible not to,” he said.

He hopes the rules of social distancing, and his mask and gloves, will protect him. “I’m not scared,” he said. “If you are afraid all the time, you will get sick faster.”

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by Wendi C. Thomas, MLK50: Justice Through Journalism

MEMPHIS, Tenn. — On her first day at her new warehouse job, Daria Meeks assumed the business would provide face coverings. It didn’t.

She assumed her fellow workers would be spread out to account for the new coronavirus. They weren’t.

There wasn’t even soap in the bathroom.

Instead, on March 28, her first day at PFS, which packages and ships makeup and jewelry, Meeks found herself standing alongside four other new workers at a station the size of a card table as a trainer showed them how to properly tuck tissue paper into gift boxes.

The following day, Meeks, 29, was just two hours into her shift when she heard that a worker had thrown up.

“They said her blood pressure had went up and she was just nauseated, but when we turned around, everybody who was permanent that worked for PFS had on gloves and masks,” Meeks said.

Temporary workers like her weren’t offered either.

Since then, workers have been told twice that coworkers have tested positive for the coronavirus. The first time was April 10 at a warehouse just across the state line in Southaven, Mississippi. The next was April 16 at the warehouse in southeast Memphis where Meeks worked, several temporary and permanent workers told MLK50: Justice Through Journalism and ProPublica.

In interviews, the workers complained of a crowded environment where they shared devices and weren’t provided personal protective equipment. The company has about 500 employees at its four Memphis-area locations, according to the Memphis Business Journal.

In right-to-work states such as Tennessee and Mississippi, where union membership is low, manual laborers have long said they are vulnerable, and workers’ rights advocates say the global pandemic has underscored just how few protections they have.

A spokesman for Tennessee’s Occupational Safety and Health Administration confirmed that the department received an anonymous complaint about PFS in April.

“A few of (sic) people have tested positive for Covid-19 and the company has not taken precaution to prevent employees from contracting the coronavirus,” the complainant wrote. “As of today (04/13/2020) no one have (sic) come to clean or sanitize the building.”

In response, the spokesman said TOSHA sent the company a letter “informing them of measures they may take to help prevent the spread of COVID-19.”

PFS did not answer specific questions about the number of workers infected at its facilities or about specific precautions it takes. Instead the company released a short statement that said PFS “is committed to the safety and well-being of its employees.” It also said it performs temperature checks at the door and supplies workers with masks, gloves and face shields.

But workers said none of these measures were in effect as late as the middle of April, when Shelby County, Tennessee, and DeSoto County, Mississippi, each home to two PFS facilities, were reporting more than 1,600 coronavirus infections and 30 deaths. (As of Friday, there are more than 2,750 infections and 50 deaths in the two counties.) A current employee said the company now provides gloves and masks, but they’re optional, as are the temperature checks.

When Meeks started at PFS, cases in the county were still at a trickle. But she didn’t stick around long.

On her third day at work, workers were split into two groups for lunch, but the break room was still full. “You could barely pull out a chair, that’s how crowded it was,” she said. “Everybody was shoulder to shoulder.”

Meeks said she asked the security guard at the front desk if she could eat her lunch in the empty lobby but was told no.

“I said, this is just not going to work,” said Meeks, who was paid $9 an hour. “You got different people coughing, sneezing, allergies — you never know what’s going on with a person.”

She left during her break and didn’t come back.

Economy Dominated by Low-Wage Industry, Jobs

In cities across the country, workers at Amazon facilities and other warehouses have been infected with COVID-19, as have workers at meatpacking plants nationwide.

What makes Memphis different is the outsized share of the workforce in the logistics industry, which includes warehouses and distribution centers.

The Greater Memphis Chamber of Commerce boasts on its website that the logistics industry employs 1 in 6 workers in the Memphis metro area, a higher share than anywhere else in the country.

The high concentration of these low-wage jobs is a testament to the city’s decades-old campaign to brand itself as “America’s Distribution Center.” Memphis is home to FedEx’s headquarters and its world distribution hub, which is undergoing a $1.5 billion expansion, as well as to Nike’s largest global distribution center, a sprawling 2.8 million-square-foot facility.

According to 2019 data from the U.S. Bureau of Labor Statistics, more than 58,000 workers in the Memphis metro area fill and stock orders, package materials and move materials by hand.

In Memphis, workers at distribution centers for FedEx, Nike and Kroger have tested positive for the coronavirus. The Shelby County Health Department received 64 complaints about businesses between April 1 and April 29, but could not say how many were about warehouses.

Interim guidance from the Centers for Disease Control and Prevention calls for employers to notify workers of positive cases. But it is voluntary. The federal OSHA has no such requirement, and neither does Tennessee’s OSHA.

Although Congress passed the Families First Coronavirus Response Act, which provides two weeks paid sick leave for coronavirus-affected or infected workers, it doesn’t apply to many warehouse and temporary employees, said Laura Padin, senior staff attorney at the Washington-based National Employment Law Project, which advocates for better public policy for workers, particularly low-wage workers.

“The big issue is that it exempts so many employers, especially employers with over 500 employees,” Padin said. “And the vast majority of temp workers and many warehouse workers work for employers with more than 500 employees.”

The coronavirus has disproportionately affected people of color, the very group that makes up the bulk of the warehouse and temporary workforce.

“Black workers make up 12% of the workforce but 26% of temp workers, and Latino workers make up 16% of the workforce but 25% of temp workers,” said Padin, citing Bureau of Labor Statistics data released in 2018.

Add to that the yawning racial wealth gap and low-wage workers like Meeks are in an untenable situation, Padin said.

“They either stay home and they risk their financial security,” Padin said, “or they go to work and risk their lives.”

“You Can Always Go Back”

With 1.45 million square feet of warehouse space among its four area locations, PFS is the ninth-largest third-party distribution operation in the metro area, according to the Memphis Business Journal’s 2020 Book of Lists. PFS doesn’t sell products under its own name but rather fulfills orders for better-known companies.

Pandora, which is perhaps best known for its charm bracelets, is one of PFS’s clients. “Each item shipped for PANDORA is wrapped in customized, branded, and sometimes seasonal packing materials, making every purchase a gift,” PFS’s website says.

Meeks’ favorite part of her job was taking each customer’s personal message, tucking it into a tiny envelope and then into the gift package.

“When we were sending out these Pandora bracelets and these Chanel gifts, I sat there and read all my cards,” said Meeks, who like all of the workers interviewed for this story, is black. “They were so cute.”

One Pandora customer sent a note to “beloved mother,” Meeks said, and another seemed to be from someone in a long-distance relationship.

“He was like: Even though I’m miles and miles away, I always think about you,” Meeks said. He wrote that he hoped the jewelry would “glitter in your eyes, or something like that.”

The day Meeks quit PFS, she said she called Prestigious Placement, the temporary agency that sent her there, asking for another job.

The temporary agency representative “was like, ‘Well, you can always go back to PFS until we get something else,’ and I was like, ‘No.’”

“She said, ‘Well, we haven’t had anyone to get sick,’” Meeks recalled.

Meeks said she tried to explain that regardless of whether some workers had tested positive, the company wasn’t taking enough steps, in her opinion, to keep current workers safe.

The representative said she’d ask the agency’s on-site manager about Meeks’ concerns, but Meeks said that there was no on-site manager present on her second or third day.

Prestigious Placement did not respond to multiple requests for comment for this story.

A local labor leader said Meeks’ experience illustrates the tough situation for temporary workers at warehouses.

“They tend not to have benefits, sick time and insurance and all the things that allow us to keep our whole community safe during a pandemic,” said Jeffrey Lichtenstein, executive secretary of the Memphis Labor Council, a federation of around 40 union locals.

Unlike companies such as Nike and FedEx, which have reputations to protect, the general public doesn’t know who PFS is or what it does, he said. “They have no brand vulnerability,” he said.

With little leverage to exert on businesses, these workers are up against a regional business model that mires them in dead-end, low-wage jobs, Lichtenstein said.

The city’s power brokers, he said, “have a couple of main tenets of their economic philosophy. One, logistics is really, really important, and two, cheap labor is very, very important.”

“Nothing Essential About It”

Memphis Mayor Jim Strickland issued a “Safer At Home” executive order on March 23, mirroring those put in place elsewhere. But the order specifically exempted warehouses and distribution centers from COVID-19 restrictions.

PFS gave workers a letter that cited Strickland’s order and the U.S. Department of Homeland Security’s guidance that “transportation and logistics are deemed a critical infrastructure that must be maintained during the COVID-19 crisis,” according to a copy reviewed by MLK50.

If they were stopped by authorities on the way to work, employees were told, this letter would ease their passage.

Some workers questioned whether the distribution center should be open at all.

“I don’t see nothing essential about it,” said one employee who asked to remain anonymous for fear she’d be fired for talking to a journalist. “It don’t got nothing to do with nurses or health.”

When a worker tested positive at a PFS distribution center in southeast Memphis, the employee, who worked at a Southaven, Mississippi, location about eight miles away, worried that the virus could spread if workers were shuffled between sites.

A manager assured her that workers would stay put, the employee said. But on April 16, a supervisor told workers that two Memphis workers, who had been brought in to the employee’s Southaven facility, had tested positive for the coronavirus.

“I said, ‘Well, since y’all got everybody in here messed up, can’t you call and get everyone in there a COVID-19 test?’” she remembered. “They said if you don’t feel safe, you can go home.”

She can’t risk taking the virus home to a relative, who has chronic illnesses, and she can’t afford not to work. “I’m concerned for my health,” she said. “I don’t want to die.”

Padin, who works with workers’ rights centers across the country, said she’s not aware of much being done by advocates to narrow the list of businesses considered essential. “I do think some of these essential worker orders are quite broad,” she said. “Our sense is that it’s a little arbitrary and just seems to be a result of lobbying.”

She pointed to the success of meat processing plants, which were declared “critical infrastructure” by President Donald Trump despite coronavirus outbreaks that sickened thousands and killed dozens.

Days before Trump’s declaration, meatpacking giant Tyson ran a full-page ad in The New York Times saying “The food supply chain is breaking.”

In Memphis, an amended executive order, signed by the mayor April 21, clarified which distribution centers and warehouses could remain in operation, including ones that handle medical supplies, food and hygiene products.

The order would seem to exclude facilities such as PFS. “Products and services for and in industries that are not otherwise identified in this provision constitute non-essential goods and services,” reads the order, which is set to expire at midnight Tuesday. On Monday, Memphis will move into the first phase of its “Back to Business” plan, which means nonessential businesses can operate with face masks, social distancing in the workplace, and symptom checks.

“No Social Distancing”

Because the turnover in warehouses like PFS is high, the need for a steady flow of labor is paramount. And temp agencies are a major source of employees.

One Memphis mother saw a job posting on Facebook for PFS. A family member’s workplace had closed because of the coronavirus, so the woman rushed to find work to make up for the lost household income. She was hired in late March by Paramount Staffing and sent to a warehouse in Southaven, Mississippi. She wanted to remain anonymous for fear of job retaliation.

From the moment workers entered the building, she said, they were close together. A single-file line funneled workers past several time clocks, one for PFS’s permanent workers and one for each staffing agency with temporary workers there.

“Some people have masks on, some don’t,” said the worker, who earned $9 an hour. Workers weren’t provided any personal protective equipment.

She opted to be a packer, a mostly stationary job, but she had to use a shared tape dispenser to seal boxes and her co-workers were within arm’s reach.

Her other job option was as a picker, but they’re in motion most of the shift, selecting products for individual orders from totes and using a shared scan gun. Pickers send the completed orders to packers.

“It’s basically no social distancing at that warehouse,” she said. “They’re gonna have to work on that.”

About two hours before her shift ended April 10, a manager huddled workers in her area together for an announcement.

“He said, ‘Well, we’re just letting y’all know that we have an employee here who tested positive and we are asking everyone here to leave the building immediately and we will clock y’all out,’” the worker recalled.

The manager instructed them not to touch anything as they left, “just go straight out the door and we will let y’all know when to return,” she recalled.

The warehouse was closed for the next day and reopened the following day.

“It makes me nervous because my health is important to me, but at the same time, it’s like that’s the only thing I can do right now,” she said.

She’s grateful for the job but insists she won’t be there long. “I’m going to try to get in a couple more checks and then I’m going to quit.”

She left about a week ago, but hasn’t found another job yet.

Paramount Staffing, which sent the worker to PFS, relies on the client to provide personal protective equipment to workers, said company president Matthew Schubert.

“My understanding is that they’ve been taking temperatures as employees walk in,” Schubert said, plus performing more frequent cleanings and coaching the workers on social distancing, but he acknowledged he didn’t know when any of those measures began.

“What we want to make sure is that they’re doing everything in their power to follow the CDC guidelines,” said Schubert, who estimates Paramount has 75 to 80 workers at PFS’s area warehouses.

“We’re limited as to what we can and cannot do, because it’s not our facility.”

Both Lichtenstein and Padin say it’s the worksite employer’s responsibility to provide personal protective equipment.

A Perfect Combination: Higher Pay and Less Risk

Just days after Meeks quit PFS, she turned to a different agency and was sent to a Memphis warehouse that labels and ships cleaning products.

Her first day was April 17, and she was impressed by the precautions the employer takes.

Before workers enter the building, Meeks said, their temperatures are taken in a white tent outside. If they don’t have a fever, they get a wristband that is a different color each day.

The company provides masks, gloves and goggles, she said, and there are even kickstands on the bathroom doors, so they can be opened by foot.

Working the third shift means fewer people, Meeks said. “We’re not working close to each other.”

Meeks said she wouldn’t put a price on her health, but at her new job, the risks are lower and the pay higher — up from $9 to $11.50 an hour.

Wendi C. Thomas is the editor of MLK50: Justice Through Journalism. Email her at wendicthomas@mlk50.com and follow her on Twitter at @wendi_c_thomas.

Do you work at a warehouse or distribution center in the Memphis area? MLK50 and ProPublica want to hear from you.

• Call or text us: (901) 633-3638
• Email us: memphis@propublica.org

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by Nina Martin and Bernice Yeung

When Alfredo Pabatao told his family that he had helped move a suspected coronavirus patient through the hospital where he’d worked as an orderly for nearly 20 years, he didn’t make a big deal out of it. “My parents are the type of parents who don’t like to make us worry,” his youngest daughter, Sheryl, recalled. But Sheryl was concerned that her father’s vulnerabilities weren’t being given more consideration as he toiled on the pandemic’s front lines in hard-hit northern New Jersey. “Why would they let a 68-year-old man with an underlying heart condition … transport a suspected COVID patient when there’s younger transporters in the hospital who could do it?”

Sheryl’s mother, Susana, was an assistant nurse in a long-term care facility where she often pulled double shifts, saving money for her annual trips back to the Philippines. At 64, she wasn’t much younger than the elderly patients she helped bathe and feed, and she had diabetes, which increased her risk of severe complications if she got sick. The nursing home wasn’t providing adequate personal protection equipment, Susana reported, so Sheryl brought home a stash of surgical masks for her mother to wear on the job. That didn’t go over well with Susana’s managers, Sheryl said: “They gave her a warning, saying she shouldn’t be wearing that. … She was really mad.”

Alfredo fell ill first, his symptoms flaring on March 17. Susana soon developed a fever. The couple had grown up on the same street in Manila and shared a romance that reminded their daughter of a telenovela; after 44 years of marriage and five children, they were all but inseparable. “Where mom goes, my dad goes. Where my dad goes, my mom goes. That’s the way they are,” Sheryl said. The day Alfredo was admitted to the ICU, his heart failing, Susana checked into the same hospital. They died four days apart.

Filipino American medical workers have suffered some of the most staggering losses in the coronavirus pandemic. In the New York-New Jersey region alone, ProPublica learned of at least 30 deaths of Filipino health care workers since the end of March and many more deaths in those peoples’ extended families. The virus has struck hardest where a huge concentration of the community lives and works. They are at “the epicenter of the epicenter,” said Bernadette Ellorin, a community organizer.

Some of the largest Filipino enclaves on the East Coast are in the New York City borough of Queens and northern New Jersey — the very places now being ravaged by COVID-19.

Filipinos are on the front lines there and across the country, four times more likely to be nurses than any other ethnic group in the U.S., experts say. In the New York-New Jersey region, nearly a quarter of adults with Filipino ancestry work in hospitals or other medical fields, a ProPublica analysis of 2017 U.S. census data found. The statistic bears repeating: Of every man and woman in the Filipino community there, one in four works in the health care industry.

“So many people can rattle off five, 10 relations that are working in the medical field,” said filmmaker Marissa Aroy, whose most recent documentary is about Filipino nurses. Her parents were registered nurses in California, and various relatives are in health care professions, including a cousin who works in a rehab center in the Bronx and recently recovered from COVID-19. “Think about all of those family members who are going to be affected,” Aroy said. “We’re talking about huge family structures here.”

The scale of the trauma and the way it is unfolding are “similar to times of war,” said Kevin Nadal, a professor of psychology at John Jay College of Criminal Justice and The Graduate Center of the City University of New York who has written extensively about Filipino American psychology and culture.

The majority of the reported deaths have involved nurses, including Susan Sisgundo and Ernesto “Audie” DeLeon, who worked at Bellevue Hospital in New York City, and Marlino Cagas, who spent 40 years as a pharmacy tech at Harlem Hospital before embarking on a nursing career at the age of 60. A handful, including Jessie Ariel Ferreras, a family practitioner in Bergen County, were doctors. Others worked in support roles, like Louis Torres, 47, the director of food services at a nursing home in Woodside, Queens, and his 73-year-old mother, Lolita, or Lely, a clerk at a nearby hospital. They lived together and fell sick around the same time, both developing pneumonia. Lolita died on April 7, her son, the following day.

Don Ryan Batayola, a 40-year-old occupational therapist, was from a big, tight-knit family and lived in Springfield Township, New Jersey. He is believed to have caught the virus from a patient and was rushed to the hospital on March 31. By April 4, he had improved enough to FaceTime with his wife, also an occupational therapist who was sick and self-isolating at home, their children sheltering with relatives. Then, an hour later, he went into cardiac arrest.

One of the most wrenching aspects of the epidemic is the sense of disconnection and helplessness in a community that stakes its economic well-being on providing care and comfort and cherishes its closeness. So many members of Batayola’s extended family are health care workers, “we could almost open our own hospital,” said his oldest sister Aimee Canton, an oncology nurse in Northern California. But to protect each other, they’ve had to remain apart, with no idea when they’ll be able to come together again. “It’s so sad when you’re a nurse,” Canton said, “and you can’t even help your own family.”

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Almost all the deaths of Filipino American health care workers that ProPublica found involve people, like the Batayolas, who immigrated during the 1970s to 2000s, when critical shortages created opportunities for medical personnel with the right training.

But the story of Filipino nurses in the U.S. goes back much further, to the end of the Spanish-American War in 1898, when the Philippines became a U.S. territory, said Catherine Ceniza Choy, a professor of ethnic studies at the University of California, Berkeley, and author of “Empire of Care: Nursing and Migration in Filipino American History.” One legacy of the colonial era is a network of hundreds of Americanized nursing schools that eventually produced tens of thousands of caregivers a year, making the country “the leading exporter of nurses in the world,” Choy said.

Nursing offered an escape route from economic and political instability and a path to the middle class for those who had few other options. It also appealed to deeply held cultural values: “kapwa,” Tagalog for “a feeling of interconnectedness to all people, putting others before yourself and taking care of the community,” Nadal said, and “utang ng loob,” the idea that people owe a debt to each other and to those who came before.

Most nurses trained in the Philippines who sought work abroad hoped to end up in the U.S. (They also migrated in large numbers to the Middle East and the U.K.) American immigration policies ebbed and flowed depending on labor shortages and political expediency. In the first third of the 20th century, the numbers of Filipino nurses were small; most workers from the islands were sent to the fields of California and the plantations of Hawaii. Then, in the wake of the Great Depression, Filipino immigrants were capped at just 50 per year, rising to 100 after World War II.

After the war, U.S. nursing shortages grew acute. Even as the passage of Medicare and Medicaid made health care more accessible to the elderly and poor, the rise of the feminist movement, which opened up professional opportunities for American women, made caregiver work less appealing, Choy said. The Immigration Act of 1965 swept aside the long-standing system of country-based quotas, instead giving preference to immigrants with professional degrees. Tens of thousands of Filipino nurses answered the call.

Caregivers on the Front Lines

The scale of losses among Filipino Americans from COVID-19 is only beginning to sink in. Clockwise from top left: Don Ryan Batayola, an occupational therapist; Alfredo Pabatao, a hospital orderly; Susan Sisgundo, a neonatal ICU nurse; Ernesto “Audie” DeLeon, a hospital nurse; Susana Pabatao, a long-term care nurse; Daisy Doronila, a correctional facility nurse.

Many ended up at inner-city and rural hospitals that had the greatest difficulty recruiting staff, often working the least desirable jobs and shifts, including, in the 1980s and ’90s, on the front lines of the AIDS epidemic. It was part of a historical pattern, said Nadal, of “immigrants doing a lot of the dirty work that people don’t want to do... being painted as heroes, when in reality they are only put in these positions because their lives are viewed as disposable.”

Yet it was a template for economic security that many of their American-born children and grandchildren embraced. “It’s like any kind of family dynamic,” Aroy said. “You see your parents do the job. And so then you know that that’s accessible to you. As a second- generation kid, I always knew that was a path for me if I wanted it.”

Today, people of Filipino ancestry comprise about 1% of the U.S. population but more than 7% of the hospital and health care workforce in the United States — nearly 500,000 workers, according to census data. They find themselves fighting not just a potentially lethal illness, but the scapegoating stoked by President Donald Trump and supporters who have taken to calling COVID-19 the “Chinese virus.” Since late March, civil rights organizations have received nearly 1,500 reports of anti-Asian hate incidents, mostly from California and New York, including against Filipino Americans.

“This anti-Asian racism that’s happening right now,” Aroy said, “what it makes me want to do is scream out: ‘How dare you treat us like the carriers? We are your caregivers.’”

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A host of factors, from medical to cultural, have put large numbers of Filipinos in harm’s way and made them vulnerable to the types of severe complications that often turn deadly. They begin with the specific type of health care work they do.

A survey by the Philippine Nurses Association of America published in 2018 found that a large proportion of respondents were concentrated in bedside and critical care — “the opposite of social distancing,” said executive director Leo-Felix Jurado, who teaches nursing at William Paterson University in Wayne, New Jersey. Many of the organization’s members have contracted the virus, he said, including the current president, New Jersey-based registered nurse Madelyn Yu; she is recovering, but her husband died.

For Daisy Doronila, employed at the Hudson County Correctional Facility in northern New Jersey for more than two decades, the profession was almost a religious calling. “My mom had a very, very humble beginning,” said her only child, Denise Rendor. “She really wanted to take care of people that no one wanted to take care of.”

Doronila saw her responsibilities to her colleagues no less seriously. The single mother and devout Catholic “was always the most reliable person at the job,” Rendor said. “If there was a snowstorm, people called out, nope, not her: ‘I’ll be there.’” As a kid, Rendor sometimes resented the missed volleyball games and dance recitals. Looking back now, “I don’t think I would have the life that I had had my mom not worked so hard.”

It’s not clear how Doronila contracted the virus, though the Hudson County jail has had at least four deaths. Once she fell ill in mid-March, she was turned away for testing by clinics and doctors on three occasions because her symptoms didn’t meet the criteria at the time, Rendor said. On March 21, Doronila started feeling breathless and drove herself to urgent care, which sent her by ambulance to the hospital. She died on April 5 at the age of 60.

If she hadn’t gotten sick, Rendor is sure she would have been volunteering for extra shifts. “That’s just who my mother was. She was just always willing to help.”

That selflessness is common among Filipino immigrants, said Zenei Cortez, a registered nurse in the San Francisco Bay Area who is the president of the California Nurses Association/National Nurses United. “They have such a profound willingness to work that they would forget their own well-being,” she said. “They would think of their loved ones in the Philippines — if they don’t work, then they can’t send money back home.”

In 2019, Filipinos abroad sent $35 billion back to the Philippines, making it the fourth-largest recipient of overseas remittances in the world; many are also helping to support networks of relatives in the U.S. “That’s the economic factor that is on the minds of a lot of Filipino nurses,” Cortez said. “If we miss work, there will be no income.”

It’s a worry that keeps many Filipinos doing sometimes-grueling labor well into their 70s. Doronila’s colleague at the Hudson County jail, nurse Edwin Montanano, was 73 when he died in early April. Jesus Villaluz, a much-beloved patient transporter at Holy Name Medical Center in Teaneck, one of the worst-hit hospitals in northern New Jersey, was 75. “They cannot in their conscience walk away from patients who need them,” said Maria Castaneda, a registered nurse and the secretary-treasurer of 1199SEIU United Healthcare Workers East, who immigrated from the Philippines in 1984. “At the same time, they are there in solidarity with other co-workers. If they are not there, it adds to the burden of those who are working.”

COVID-19 risks are magnified in people who are older or suffer underlying chronic conditions. Filipinos have very high rates of Type II diabetes and cardiovascular disease, both of which render the virus more dangerous. “They’re doing amazing things and helping others to survive,” Nadal said. “But they’re putting themselves at risk because they have immuno-compromised traits that make them susceptible to severe sickness and death.”

And in many situations, they’ve been forced to do that work without proper PPE and other safeguards, said Ellorin, the Queens-based community organizer and executive director of the advocacy group Mission to End Modern-Day Slavery. They are “being infected and not being protected, and then their families, or whoever they live with, are getting infected.”

Sheryl Pabatao thinks of the many people she knows who are working in hospitals and other medical settings and feel unable to speak out. “Even though they don’t want to do things, they still do it because they don’t want to lose their jobs.”

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When they first applied to immigrate to the U.S. in the 1980s, Alfredo Pabatao was in the car business; Susana was a former nursing student turned housewife and mother of two. By the time their petition was approved about 14 years later, their two eldest children were too old to qualify to come to the U.S. with their parents, so the Pabataos were forced to leave them behind, bringing only their youngest two daughters and son. “To this day, that was one of the hardest things — being separated from everyone,” Sheryl said.

They arrived in the U.S. a few weeks after 9/11. One of Alfredo’s sisters, a registered nurse, helped him get a job transporting patients at her hospital, now known as Hackensack Meridian Health Palisades Medical Center, in North Bergen, New Jersey. “My father grew up with wealth, and when he came here, he had to be modest and humble,” Sheryl said. Susana earned her assistant nursing certification while working as a grocery store cashier, then went to work at what is now called Bergen New Bridge Medical Center in Paramus, the largest hospital and licensed nursing home in the state. Taking care of elderly people helped ease the sadness and guilt at what she had left behind. “She was not able to take care of her own mother,” Sheryl said. “So when she does her job here, she cares for them like her own.”

America proved to be both generous and hard. The couple prospered enough to buy a house, then lost it in the Great Recession. They managed to rebuild their lives and gained their U.S. citizenship, the kids choosing careers in the pharmaceutical side of health care. After 18 years in the same job, Alfredo was waiting for Susana to retire so he could, too.

Then came the pandemic.

Sheryl had been following the news reports from China since early February and was concerned enough about her family to procure a small supply of masks before vendors ran out; “I’d put my parents in a bubble if I can,” she said. Her father was more easygoing: “He has survived so many things in his life. His attitude is: ‘If I get it, I get it. I’ll be OK with it.’”

Sheryl doesn’t know how the responsibility fell to him to transport a patient suspected of having COVID-19 during the second week in March. “But knowing my dad, he agrees to anything. He has that work ethic: ‘This is my job. If I can do it, l do it.’ Knowing him, if one of the other [orderlies] didn’t want to transfer the patient, they asked him and he said yes.”

When Susana found out her husband had been exposed to the virus that way, she was not happy, Sheryl said. Susana was having her own issues at the nursing home. In mid-March, she received an email from her bosses that warned in boldface, “Facemasks are to be used only by staff who have an authorized or clinical reason to use them. Do not wear non-hospital issued facemasks.” It was a policy Susana complained was being made by people who weren’t doing bedside care and didn’t understand the real risks. She was also told the masks would scare patients. She pretended to obey the directive when her managers were around, Sheryl said, “but my mom was stubborn, so when they left, she put [her mask] back on.”

Bergen New Bridge called Susana a “valued” employee who is “greatly missed.” The hospital denied that it has experienced any PPE shortages, but it noted that “guidance from federal and state health officials regarding the use of PPE has been evolving.” Early on, “it was recommended that masks were to be worn only by those individuals who were sick or those who were caring for COVID-19 patients.” Once the virus began spreading within the community, “we quickly moved to universal masking of all employees,” the hospital said. “Like all healthcare facilities, our Medical Center has stressed the importance of using hospital-issued PPE, as guided by the CDC.”

As of April 29, New Bridge’s long-term care facility had recorded 120 confirmed COVID-19 cases and 26 deaths. Hackensack Meridian Health didn’t respond to ProPublica’s requests for comment about Alfredo’s case.

It wasn’t just Alfredo and Susana who fell ill. Sheryl and her brother, both living at home, caught the virus, too. The weekend before Alfredo’s symptoms emerged, he and the rest of the family attended a gathering in honor of a relative who had died in January from cancer. Alfredo spent much of the party talking to his younger brother; later, the brother ended up with COVID-19 and on a ventilator for nearly three weeks. An aunt of Sheryl’s who is a housekeeper in the same hospital system as Alfredo wasn’t at the gathering but fell ill anyway and was out sick for two weeks. Her symptoms weren’t as severe as those of some of the others; she’s already back at work.

The spread of the virus has been unrelenting for Sheryl. When she returned to her own job as a pharmacy tech this past week, a month after her parents died, she learned that someone who worked at her company — who was also Filipino — had died during her absence. “You have no idea about the extent of this,” she said, “until it hits you.”

Sophie Chou contributed reporting.

Correction, May 5, 2020: This story originally misspelled the first name of the president of the California Nurses Association/National Nurses United. She is Zenei Cortez, not Zeine.

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by J. David McSwane

The Transportation Security Administration ignored guidance from the Department of Homeland Security and internal pushback from two agency officials when it stockpiled more than 1.3 million N95 respirator masks instead of donating them to hospitals, internal records and interviews show.

Internal concerns were raised in early April, when COVID-19 cases were growing by the thousands and hospitals in some parts of the country were overrun and desperate for supplies. The agency held on to the cache of life-saving masks even as the number of people coming through U.S. airports dropped by 95% and the TSA instructed many employees to stay home to avoid being infected. Meanwhile, other federal agencies, including the Department of Veterans Affairs’ vast network of hospitals, scrounged for the personal protective equipment that doctors and nurses are dying without.

“We don’t need them. People who are in an infectious environment need them. Nobody is flying,” Charles Kielkopf, a TSA attorney based in Columbus, Ohio, told ProPublica. “You don’t take things for yourself. It’s the wrong thing to do.”

Kielkopf shared a copy of an official whistleblower complaint he filed Monday. In it, he alleges the agency had engaged in gross mismanagement that represented a “substantial and specific danger to public health.”

TSA has not required its screeners to wear N95s, which require fitting and training to use properly, and internal memos show most are using surgical masks, which are more widely available but are less effective and lack the same filtering ability.

Kielkopf raised a red flag last month about the TSA’s plan to store N95 respirators it had been given by Customs and Border Protection, which found more than a million old but usable masks in an Indiana warehouse. Both agencies are overseen by DHS. That shipment added to 116,000 N95s the TSA had left over from the swine flu pandemic of 2009, a TSA memo shows. While both stockpiles were older than the manufacturer’s recommended shelf life, the Centers for Disease Control and Prevention said that expired masks remain effective against spreading the virus.

Kielkopf and another TSA official in Minnesota suggested that the agency send its N95 masks to hospitals in early April, records show. Instead, TSA quietly stored many of them in its warehouse near the Dallas-Fort Worth airport and dispersed the rest to empty airports across the nation.

“We need to reserve medical masks for health care workers,” Kielkopf said, “not TSA workers who are behind an X-ray machine.”

The Number of Travelers Passing TSA Checkpoints Has Dropped to Historic Lows

The TSA didn’t provide answers to several detailed questions sent by ProPublica, but spokesman Mark Howell said in an email that the agency’s “highest priority is to ensure the health, safety and security of our workforce and the American people.”

“With the support of CBP and DHS, in April, TSA was able to ensure a sufficient supply of N95 masks would be available for any officer who chose to wear one and completed the requisite training,” the statement read.

“We are continuing to acquire additional personal protective equipment for our employees to ensure both their and the traveling public’s health and safety based on our current staffing needs, and as supplies become available,” TSA said.

A review of federal contracting data shows the agency has mostly made modest purchases such as a $231,000 purchase for gallons of disinfectant, but has not reported any new purchases of N95s.

An internal TSA memo last month said the surplus of N95s was expected to last the agency about 30 days, but the same memo noted that estimate did not account for the drastic decline in security officers working at airports. ProPublica asked how long the masks were actually going to last, accounting for the decreased staffing levels.

“While we cannot provide details on staffing, passenger throughput and corresponding operations have certainly decreased,” the TSA statement said.

The trade journal Government Executive reported this week that internal TSA records showed most employee schedules have been “sharply abbreviated,” while an additional 8,000 security screeners are on paid leave over concerns that they could be exposed to the virus.

More than 500 TSA employees have tested positive for COVID-19, the agency reported, and five have died.

The CDC has not recommended the use of N95s by TSA staff, records show, but that doesn’t mean workers who have or want to wear them can’t.

In one April 7 email, DHS Deputy Under Secretary for Management Randolph D. Alles sent guidance to TSA officials, urging them to wear homemade cloth face coverings and maintain social distancing. But the N95s, which block 95% of particles that can transmit the virus, were in notoriously short supply and should be “reserved” for health care workers.

“The CDC has given us very good information about how to make masks that are suitable, so that we can continue to reserve medical masks and PPE for healthcare workers battling the COVID-19 pandemic,” Alles wrote.

But two days later, on April 9, Cliff Van Leuven, TSA’s federal security director in Minnesota, followed up and asked why he had been sent thousands of masks despite that guidance.

“I just received 9,000 N-95 masks that I have very little to no need for,” he said in the email, which was first reported by Government Executive. “We’ve made N95s available to our staff and, of the officers who wear masks, they overwhelmingly prefer the surgical masks we just received after a couple months on back order.”

Minnesota Gov. Tim Walz had publicly asked that anyone who had PPE donate their surplus to the state’s Department of Health, Van Leuven said in the email to senior TSA staff.

“I’d like to donate the bulk of our current stock of N-95s in support of that need and keep a small supply on hand,” he wrote, adding the Minneapolis-St. Paul International Airport had screened fewer than 1,500 people the previous day, about a third of which were airport staff.

Van Leuven declined to comment, referring questions to a TSA spokesperson.

Later that day, Kielkopf forwarded the concerns to TSA attorneys in other field offices, trying to get some attention to the stockpile he felt would be better used at hospitals.

“I am sharing with you some issues we are having with n95 masks in Minnesota,” he wrote. “And the tension between our increasing supply of n95 masks at our TSA airport locations and the dire need for them in the medical community.”

Weeks went by, and finally, on May 1, Kielkopf wrote: “I have been very disappointed in our position to keep tens of thousands of n95 masks while healthcare workers who have a medical requirement for the masks — because of their contact with infected people — still go without.”

DHS did not respond to ProPublica’s questions about why it transferred N95 masks to TSA despite a top official saying they should be reserved for healthcare workers.

“So now the TSA position is that we desperately need these masks for the protection of our people,” Kielkopf said. “At the same time, most of our people aren’t even working. It’s a complete 180 that doesn’t make any sense.”

Do you have access to information about federal contracts that should be public? Email david.mcswane@propublica.org. Here’s how to send tips and documents to ProPublica securely.

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by Robert Faturechi and Derek Willis

Sen. Richard Burr was not the only member of his family to sell off a significant portion of his stock holdings in February, ahead of the market crash spurred by coronavirus fears. On the same day Burr sold, his brother-in-law also dumped tens of thousands of dollars worth of shares. The market fell by more than 30% in the subsequent month.

Burr’s brother-in-law, Gerald Fauth, who has a post on the National Mediation Board, sold between $97,000 and $280,000 worth of shares in six companies — including several that have been hit particularly hard in the market swoon and economic downturn.

A person who picked up Fauth’s phone on Wednesday hung up when asked if Fauth and Burr had discussed the sales in advance.

In 2017, President Donald Trump appointed Fauth to the three-person board of the National Mediation Board, a federal agency that facilitates labor-management relations within the nation’s railroad and airline industries. He was previously a lobbyist and president of his own transportation economic consulting firm, G.W. Fauth & Associates.

Burr came under scrutiny after ProPublica reported that he sold off a significant percentage of his stocks shortly before the market tanked, unloading between $628,000 and $1.72 million of his holdings on Feb. 13 in 33 separate transactions. As chairman of the Senate Intelligence Committee and a member of the health committee, Burr had access to the government’s most highly classified information about threats to America’s security and public health concerns.

Before his sell-off, Burr had assured the public that the federal government was well-prepared to handle the virus. In a Feb. 7 op-ed that he co-authored with another senator, he said “the United States today is better prepared than ever before to face emerging public health threats, like the coronavirus.”

That month however, according to a recording obtained by NPR, Burr had given a VIP group at an exclusive social club a much more dire preview of the economic impact of the the coronavirus, warning it could curtail business travel, cause schools to be closed and result in the military mobilizing to compensate for overwhelmed hospitals.

The timing of Burr’s stock sales drew widespread outrage, allegations of insider trading, calls for his resignation and an FBI investigation.

Burr defended his actions, saying he relied solely on public information, including CNBC reports, to inform his trades and did not rely on information he obtained as a senator.

Fauth avoided between $37,000 and $118,000 in losses by selling off when he did, considering how steeply the companies’ shares fell in recent weeks, according to an analysis by Luke Brindle-Khym, a partner and general counsel of Manhattan-based investigative firm QRI. Brindle-Khym obtained Fauth’s financial disclosure from the Office of Government Ethics and shared it with ProPublica. Government forms only require that the value of stock trades be disclosed in ranges. After the February sales, the total value of Fauth’s individual stock holdings appears to be between $680,000 and $2 million.

Alice Fisher, Burr’s attorney, told ProPublica that “Sen. Burr participated in the stock market based on public information and he did not coordinate his decision to trade on Feb. 13 with Mr. Fauth.”

She did not respond to a question about whether Burr discussed anything he learned as a senator with Fauth or any other relatives.

A review of Fauth’s financial disclosure forms since 2017 show that he is not a frequent stock trader, but that he also had a major day of sales in August 2019.

On Feb. 13, Fauth or his spouse sold between $15,001 and $50,000 of Altria, the tobacco company; between $50,001 and $100,000 of snack food maker Mondelez International; and between $1,001 and $15,000 of home furnishings retailer Williams-Sonoma. He also sold stakes in several oil companies, which have been hit particularly hard, including between $15,001 and $50,000 of Chevron; between $1,001 and $15,000 of BP and between $15,001 and $50,000 of Royal Dutch Shell.

The finances of the Burrs and Fauths have intersected before. Federal Election Commission records show that Burr’s leadership PAC, Next Century Fund, has paid $120,348 since 2002 to his sister-in-law, Mary Fauth, Gerald’s wife, who serves as treasurer. The PAC has also paid $104,850 in rent and utilities over the same period to 116 S. Royal St. Partners, in which Gerald Fauth is a partner.

Do you have access to information about stock trading by Trump administration officials or members of Congress that should be public? Email robert.faturechi@propublica.org or reach him on Signal/WhatsApp at 213-271-7217. Here’s how to send tips and documents to ProPublica securely.

Update, May 6, 2020: This story was updated with new comment from Sen. Richard Burr’s attorney.

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by Abrahm Lustgarten

The scientists who study how diseases emerge in a changing environment knew this moment was coming. Climate change is making outbreaks of disease more common and more dangerous.

Over the past few decades, the number of emerging infectious diseases that spread to people — especially coronaviruses and other respiratory illnesses believed to have come from bats and birds — has skyrocketed. A new emerging disease surfaces five times a year. One study estimates that more than 3,200 strains of coronaviruses already exist among bats, awaiting an opportunity to jump to people.

The diseases may have always been there, buried deep in wild and remote places out of reach of people. But until now, the planet’s natural defense systems were better at fighting them off.

Today, climate warming is demolishing those defense systems, driving a catastrophic loss in biodiversity that, when coupled with reckless deforestation and aggressive conversion of wildland for economic development, pushes farms and people closer to the wild and opens the gates for the spread of disease.

Aaron Bernstein, the interim director for the C-Change Center for Climate, Health and the Global Environment at Harvard University’s T.H. Chan School of Public Health, said that ignoring how climate and rapid land development were putting disease-carrying animals in a squeeze was akin to playing Russian roulette.

“Nature is trying to tell us something,” Bernstein said.

Scientists have not suggested that climate played any direct role in causing the current COVID-19 outbreak. Though the virus is believed to have originated with the horseshoe bat, part of a genus that’s been roaming the forests of the planet for 40 million years and thrives in the remote jungles of south China, even that remains uncertain.

Scientists have, however, been studying the coronaviruses of southern China for years and warning that swift climate and environmental change there — in both loss of biodiversity and encroachment by civilization — was going to help new viruses jump to people.

There are three ways climate influences emerging diseases. Roughly 60% of new pathogens come from animals — including those pressured by diversity loss — and roughly one-third of those can be directly attributed to changes in human land use, meaning deforestation, the introduction of farming, development or resource extraction in otherwise natural settings. Vector-borne diseases — those carried by insects like mosquitoes and ticks and transferred in the blood of infected people — are also on the rise as warming weather and erratic precipitation vastly expand the geographic regions vulnerable to contagion. Climate is even bringing old viruses back from the dead, thawing zombie contagions like the anthrax released from a frozen reindeer in 2016, which can come down from the arctic and haunt us from the past.

Thus the COVID-19 pandemic, even as it unfolds in the form of an urgent crisis, is offering a larger lesson. It is demonstrating in real time the enormous and undeniable power that nature has over civilization and even over its politics. That alone may make the pandemic prologue for more far-reaching and disruptive changes to come. But it also makes clear that climate policy today is indivisible from efforts to prevent new infectious outbreaks, or, as Bernstein put it, the notion that climate and health and environmental policy might not be related is “a ​dangerous delusion.”

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The warming of the climate is one of the principal drivers of the greatest — and fastest — loss of species diversity in the history of the planet, as shifting climate patterns force species to change habitats, push them into new regions or threaten their food and water supplies. What’s known as biodiversity is critical because the natural variety of plants and animals lends each species greater resiliency against threat and together offers a delicately balanced safety net for natural systems. As diversity wanes, the balance is upset, and remaining species are both more vulnerable to human influences and, according to a landmark 2010 study in the journal Nature, more likely to pass along powerful pathogens.

The casualties are amplified by civilization’s relentless push into forests and wild areas on the hunt for timber, cropland and other natural resources. Epidemiologists tracking the root of disease in South Asia have learned that even incremental and seemingly manageable injuries to local environments — say, the construction of a livestock farm adjacent to stressed natural forest — can add up to outsized consequences.

Around the world, according to the World Resources Institute, only 15% of the planet’s forests remain intact. The rest have been cut down, degraded or fragmented to the point that they disrupt the natural ecosystems that depend on them. As the forests die, and grasslands and wetlands are also destroyed, biodiversity sharply decreases further. The United Nations warns that the number of species on the planet has already dropped by 20% and that more than a million animal and plant species now face extinction.

Losing species has, in certain cases, translated directly to a rise in infectious disease.

Americans have been experiencing this phenomenon directly in recent years as migratory birds have become less diverse and the threat posed by West Nile encephalitis has spread. It turns out that the birds that host the disease happen to also be the tough ones that prevail amid a thinned population. Those survivors have supported higher infection rates in mosquitoes and more spread to people.

Similarly, a study published last month in the journal Proceedings of the Royal Society B found that as larger mammals suffer declines at the hands of hunters or loggers or shifting climate patterns, smaller species, including bats, rats and other rodents, are thriving, either because they are more resilient to the degraded environment or they are able to live better among people.

It is these small animals, the ones that manage to find food in garbage cans or build nests in the eaves of buildings, that are proving most adaptable to human interference and also happen to spread disease. Rodents alone accounted for more than 60% of all the diseases transmitted from animals to people, the researchers found.

Warmer temperatures and higher rainfall associated with climate change — coupled with the loss of predators — are bound to make the rodent problem worse, with calamitous implications. In 1999, for example, parts of Panama saw three times as much rainfall as usual. The rat population exploded, researchers found. And so did the viruses rats carry, along with the chances those viruses would jump to people. That same year, a fatal lung disease transmitted through the saliva, feces and urine of rats and mice called hantavirus pulmonary syndrome emerged in Panama for the first time, according to a report in the journal Emerging Infectious Diseases.

As much as weather changes can drive changes in species, so does altering the landscape for new farms and new cities. In fact, researchers attribute a full 30% of emerging contagion to what they call “land use change.” Nothing drives land use shifts more than conversion for farmland and feedstock — a result of the push to feed the planet’s 7.8 billion people. As the global population surges to 10 billion over the next 35 years, and the capacity to farm food is stressed further again by the warming climate, the demand for land will only get more intense. Already, more than one-third of the planet’s land surface, and three-quarters of all of its fresh water, go toward the cultivation of crops and raising of livestock. These are the places where infectious diseases spread most often.

Take, for example, the 1999 Nipah outbreak in Malaysia — the true-life subject matter adapted for the film “Contagion.” Rapid clearcutting of the forests there to make way for palm plantations drove fruit bats to the edge of the trees. (Separate research also suggests that climate changes are shifting fruit bats’ food supply.) They found places to roost, as it happens, alongside a hog farm. As the bats gorged themselves on fruit, they dropped pieces of food from the branches, along with their urine, into the pigsties, where at least one pig is believed to have eaten some. When the pig was slaughtered and brought to market, an outbreak is believed to have been spread by the man who handled the meat. More than 100 people died.

The U.S. Centers for Disease Control and Prevention says that fully three-quarters of all new viruses have emerged from animals. Even the 2014 Ebola outbreak in West Africa is believed to have begun when a boy dug into a tree stump that happened to be the roost of bats carrying the virus.

As Christine Johnson, the associate director of the One Health Institute, an interdisciplinary epidemiological program at the University of California, Davis, puts it, global health policymakers have a responsibility to understand how climate, habitat and land use changes lead to disease. Almost every major epidemic we know of over the past couple of decades — SARS, COVID-19, Ebola and Nipah virus — jumped to people from wildlife enduring extreme climate and habitat strain, and still, “we’re naive to them,” she said. “That puts us in a dangerous place.”

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Once new diseases are let loose in our environment, changing temperatures and precipitation are also changing how those diseases spread — and not for the better. Warming climates increase the range within which a disease can find a home, especially those transmitted by “vectors,” mosquitoes and ticks that carry a pathogen from its primary host to its new victim.

A 2008 study in the journal Nature found nearly one-third of emerging infectious diseases over the past 10 years were vector-borne, and that the jumps matched unusual changes in the climate. Especially in cases where insects like infection-bearing mosquitoes are chasing warmer temperatures, the study said, “climate change may drive the emergence of diseases.”

Ticks and mosquitoes now thrive in places they’d never ventured before. As tropical species move northward, they are bringing dangerous pathogens with them. The Zika virus or Chikungunya, a mosquito-spread virus that manifests in intense joint pain, were once unseen in the United States, but both were transmitted locally, not brought home by travelers, in southern Texas and Florida in recent years.

Soon, they’ll be spreading further northward. According to a 2019 study in the journal PLOS Neglected Tropical Diseases, by 2050, disease-carrying mosquitoes will ultimately reach 500 million more people than they do today, including some 55 million more Americans. In 2013, dengue fever — an affliction affecting nearly 400 million people a year, but normally associated with the poorest regions of Africa — was transmitted locally in New York for the first time.

“The long-term risk from dengue may be much higher than COVID,” said Scott Weaver, the director of the Institute for Human Infections and Immunity at the University of Texas Medical Branch in Galveston. “It’s a disease of poor countries, so it doesn’t get the attention it deserves.”

The chain of events that ultimately leads to a pandemic can be long and subtle, steered by shifts in the ecosystem. The 1999 West Nile outbreak in the U.S., for example, came after climate-driven droughts dried up streams and rivers, leaving pools of stagnant water where mosquitoes bred unhindered. It turns out the loss of water also killed off their predators — dragonflies and frogs that depend on large watering holes were gone.

Coronaviruses like COVID-19 aren’t likely to be carried by insects — they don’t leave enough infected virus cells in the blood. But one in five other viruses transmitted from animals to people are vector-borne, said U.C. Davis’ Johnson, meaning it’s only a matter of time before other exotic animal-driven pathogens are driven from the forests of the global tropics to the United States or Canada or Europe because of the warming climate. “Climate is going to shift vulnerability to that,” Johnson said, “and I think some of these regions are not prepared.”

The changing climate won’t just affect how the diseases move about the planet, it will also shape how easily we get sick. According to a 2013 study in the journal PLOS Currents Influenza, warm winters were predictors of the most severe flu seasons in the following year. The brief respite in year one, it turns out, relaxed people’s natural defenses and reduced “herd immunity,” setting conditions for the virus to rage back with a vengeance.

Even harsh swings from hot to cold, or sudden storms — exactly the kinds of climate-induced patterns we’re already seeing — make people more likely to get sick. A study in the journal Environmental Research Letters linked the brutal 2017-18 flu season — which killed 79,000 people — to erratic temperature swings and extreme weather that winter, the same period in which a spate of floods and hurricanes devastated much of the country. If the climate crisis continues on its current trajectory, the authors wrote, respiratory infections like the flu will sharply increase. The chance of a flu epidemic in America’s most populated cities will increase by as much as 50% this century, and flu-related deaths in Europe could also jump by 50%.

“We’re on a very dangerous path right now,” said the University of Texas’ Weaver. Slow action on climate has made dramatic warming and large-scale environmental changes inevitable, he said, “and I think that increases in disease are going to come along with it.”

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Twelve months before the first COVID-19 case was diagnosed, a group of epidemiologists working with a U.S. Agency for International Development project called PREDICT, or Pandemic Influenza and other Emerging Threats, was deep in the remote leafy jungle of southern China’s Yunnan province hunting for what it believed to be one of the greatest dangers to civilization: a wellspring of emerging viruses.

A decade of study there had identified a pattern of obscure illnesses affecting remote villagers who used bat guano as fertilizer and sometimes for medicine. Scientists traced dozens of unnamed, emerging viruses to caves inhabited by horseshoe bats. Any one of them might have triggered a global pandemic killing a million people. But luck — and mostly luck alone — had so far kept the viruses from leaping out of those remote communities and into the mainstream population.

The luck is likely to run out, as Yunnan is undergoing enormous change. Quaint subsistence farm plots were overtaken by hastily erected apartment towers and high-speed rail lines, as the province endured dizzying development fueled by decades of Chinese economic expansion. Cities’ footprints swelled, pushing back the forests. More people moved into rural places and the wildlife trade, common to such frontier regions, thrived. With every new person and every felled tree, the bats’ habitat shrank, putting the viruses they carried on a collision course with humanity. By late 2018, epidemiologists there were bracing for what they call “spillover,” or the failure to keep a virus locally contained as it jumped from the bats and villages of Yunnan into the wider world.

In late 2018, the Trump administration, as part of a sweeping effort to bring U.S. programs in China to a halt, abruptly shut down the research — and its efforts to intercept the spread of a new novel coronavirus along with it. “We got a cease and desist,” said Dennis Carroll, who founded the PREDICT program and has been instrumental in global work to address the risks from emerging viruses. By late 2019, USAID had cut the program’s global funding.

USAID did not respond to a detailed list of questions from ProPublica.

The loss is immense. The researchers believed they were on the cusp of a breakthrough, racing to sequence the genes of the coronaviruses they’d extracted from the horseshoe bat and to begin work on vaccines. They’d campaigned for years for policymakers to fully consider what they’d learned about how land development and climate changes were driving the spread of disease, and they thought their research could literally provide governments a map to the hot spots most likely to spawn the next pandemic. They also hoped the genetic material they’d collected could lead to a vaccine not just for one lethal variation of COVID, but perhaps — like a missile defense shield for the biosphere — to address a whole family of viruses at once. (In fact, the gene work they were able to complete was used to test the efficacy of remdesivir, an experimental drug that early clinical trial data shows can help COVID-19 patients.)

Carroll said knowledge of the virus genomes had the potential “to totally transform how we think about future biomedical interventions before there’s an emergence.” His goal was to not just react to a pandemic, but to change the very definition of preparedness.

If PREDICT’s efforts in China had the remote potential to fend off the current COVID pandemic, though, it also offered an opportunity to study how climate and land development were driving disease.

But there has been little appetite for that inquiry among policymakers. PREDICT’s staff and advisers have pushed the U.S. government to consider how welding public health policy with environmental and climate science could help stem the spread of contagions. Climate change was featured in presentations that PREDICT staff made to Congress, according to U.C. Davis’ Johnson, who is now also the director of PREDICT, which received a temporary funding extension this spring. And until 2016, leadership of New York-based EcoHealth Alliance, the research group working under PREDICT funding in Yunnan, was invited several times to the White House to advise on global health policy.

Since Donald Trump was elected, the group hasn’t been invited back.

“It’s falling on deaf ears,” said Peter Daszak, EcoHealth Alliance’s president.

A White House spokesperson did not respond to an emailed request for comment.

What Daszak really wants — in addition to restored funding to continue his work — is the public and leaders to understand that it’s human behavior driving the rise in disease, just as it drives the climate crisis. In China’s forests, he looks past the destruction of trees and asks why they are being cut in the first place, and who is paying the cost. Metals for iPhones and palm oil for processed foods are among the products that come straight out of South Asian and African emerging disease hot spots.

“We turn a blind eye to the fact that our behavior is driving this,” he said. “We get cheap goods through Walmart, and then we pay for it forever through the rise in pandemics. It’s upside down.”

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by Michael Grabell

On Tuesday, March 31, an emergency room doctor at the main hospital in Grand Island, Nebraska, sent an urgent email to the regional health department: “Numerous patients” from the JBS beef packing plant had tested positive for COVID-19. The plant, he feared, was becoming a coronavirus “hot spot.”

The town’s medical clinics were also reporting a rapid increase in cases among JBS workers. The next day, Dr. Rebecca Steinke, a family medicine doctor at one of the clinics, wrote to the department’s director: “Our message is really that JBS should shut down for 2 weeks and have a solid screening plan before re-opening.”

Teresa Anderson, the regional health director, immediately drafted a letter to the governor.

But during a conference call that Sunday, Gov. Pete Ricketts made it clear that the plant, which produces nearly 1 billion pounds of beef a year and is the town’s largest employer, would not be shut down.

Since then, Nebraska has become one of the fastest-growing hot spots for the novel coronavirus in the United States, and Grand Island has led the way. Cases in the city of 50,000 people have skyrocketed from a few dozen when local health officials first reported their concerns to more than 1,200 this week as the virus spread to workers, their families and the community.

The dismissed warnings in Grand Island, documented in emails that ProPublica obtained under the state’s public records law, show how quickly the virus can spread when politicians overrule local health officials. But on a broader scale, the events unfolding in Nebraska provide an alarming case study of what may come now that President Donald Trump has used the Defense Production Act to try to ensure meat processing plants remain open, severely weakening public health officials’ leverage to stop the spread of the virus in their communities.

Ricketts spokesman Taylor Gage said the governor explained on the call with local officials that the plant would stay open because it was declared an essential industry by the federal government. Two and a half weeks later, as cases were rising among the state’s meatpacking workers, Ricketts, a Republican businessman whose father founded the brokerage TD Ameritrade, held a news conference and said he couldn’t foresee a scenario where he would tell the meatpacking plants to close because of their importance to the nation’s food supply.

“Can you imagine what would happen if people could not go to the store and get food?” he asked. “Think about how mad people were when they couldn’t get paper products.”

“Trust me,” he added, “this would cause civil unrest.”

In the last two weeks, small meatpacking towns across Nebraska have experienced outbreaks, including at a Tyson Foods beef plant in Dakota City, a Costco chicken plant in Fremont and a Smithfield Foods pork plant in Crete. With the governor vowing to keep plants open, the companies have only in recent days decided to close for deep cleanings as cases have grown to staggering levels.

In Grand Island, two hours west of Omaha, the consequences of the governor’s decision came quickly. The CHI Health St. Francis hospital, which has 16 intensive care beds, was soon overwhelmed. At one point in April, it had so many critical patients that it had to call in three different helicopter companies to airlift patients to larger hospitals in Lincoln and Omaha, said Beth Bartlett, the hospital’s vice president for patient care.

JBS workers felt the strain, too. Under pressure to keep the food supply chain flowing, some of the plant’s 3,500 workers, many hailing from Latin America, Somalia and Sudan, said they were told to report for work regardless. In a letter to the governor last week, Nebraska Appleseed, a nonprofit advocacy group, said a JBS worker had been told by his supervisor that if he tested positive, he should come to work anyway and “keep it on the DL” or he’d be fired. Some workers who’d been told to quarantine after being exposed told ProPublica this week that they were called back to work before the 14-day window recommended by the Centers for Disease Control and Prevention — even if they felt sick. One worker in the offal, or entrails, section recently fainted in the plant, they said, but was told he couldn’t go home.

Cameron Bruett, head of corporate affairs for JBS, said the company has worked in partnership with local officials to prevent the spread of the coronavirus and did not influence the governor’s decision to keep the plant open. He pointed to comments made recently by University of Nebraska Medical Center officials who toured the plant, who said JBS has put in place some “best practices,” including installing barriers on the meat cutting line, communicating new precautions in multiple languages and ensuring the proper use of masks.

Bruett said no one is forced to come to work or punished for calling in sick. “Such actions, if true, would be grotesque and a clear violation of our culture,” he said.

The emails obtained by ProPublica show that local health officials have traced 260 cases to the JBS plant. But that was nearly two weeks ago and almost certainly underestimates the total. Anderson, who directs the Central District Health Department, said she hasn’t had enough tests to do targeted testing of JBS employees and is only testing people when they’re symptomatic. In Grand Island and its surrounding county, 32 people have died from the virus. According to workers, at least one of those was a JBS employee.

Across the country, more than 10,000 COVID-19 cases have been linked to meatpacking plants, and at least three dozen workers are known to have died, a ProPublica review of news reports and government health data shows.

While cases in the worst hit urban areas like New York appear to have plateaued, the nation’s meatpacking towns have continued to see spikes. A few large outbreaks have dominated public attention, but COVID-19 cases have popped up in well over 100 plants in mostly rural communities. There the virus’s impact is magnified by the workers’ sometimes cramped living conditions, with multiple generations of immigrant and refugee families often residing together in apartments, houses and trailers.

Before Trump’s order, more than 30 plants had shut down at least briefly to increase cleaning and control the spread among their workforces. The various closures have cut beef and pork production by more than a third compared with last year, causing supply chain disruptions for some supermarkets and fast-food chains.

Some of those closures show the role public health officials have had in the actions of large meatpacking companies like JBS, which has beef, pork and poultry plants in 27 states.

In Colorado, Dr. Mark Wallace of the Weld County Department of Public Health and Environment and state health director Jill Hunsaker Ryan grew worried that that if the coronavirus spread at JBS’ Greeley plant, it would have a “devastating” effect on the community that “would quickly overwhelm the medical resources available in the hospitals.”

Unlike Nebraska, Colorado’s health officials eventually ordered the JBS plant to close. But documents obtained by ProPublica show the protracted debate that came before that decision, with JBS invoking the governor to question the formal closure order. By the time the order was issued, some public officials felt the virus had been given too big a head start.

Like Grand Island, Greeley officials were already hearing by the end of March that hospital emergency rooms were seeing a “high number of JBS employees,” according to an email Wallace sent April 1 to the plant’s occupational health director.

“Their concern, and mine, is far too many employees must be working when sick and spreading infection to others,” Wallace wrote, urging the plant to take additional safety measures.

Three days later, Wallace wrote a more detailed letter to JBS’ human resources director, Chris Gaddis, documenting the virus’s spread and threatening to shut the plant down if it didn’t screen employees and ensure they could work 6 feet apart.

But as days passed, the situation in Greeley didn’t improve.

“Want you to know my colleagues are not reassured by what I’m sharing about measures being implemented,” Wallace wrote to Gaddis. “‘The cat’s out of the bag’ is what all health care providers are saying — too many sick people already, too much spread already, etc.”

After nine days of back-and-forth, JBS agreed to close the plant and Hunsaker Ryan and Wallace issued a formal shutdown order. But negotiations seemed to stretch until the last minute, emails show.

After Hunsaker Ryan sent JBS the order on the afternoon of April 10, Gaddis appeared confused. “It is our understanding from the telephone conversation that the governor did not want this letter sent,” Gaddis wrote. “Please confirm it was properly sent.”

Bruett said the company’s impression was that the governor didn’t feel a formal order “was necessary given our voluntary decision to shut down.” But Conor Cahill, a spokesman for Gov. Jared Polis, said: “Of course the governor wanted the health order sent. The governor has been clear that JBS needs to be more transparent with their staff and the public about the situation at their plant.”

Notified of the shutdown by his staff, Greeley Mayor John Gates wrote in an email, “In my opinion, that should have happened a week ago for the health and safety of their employees.”

On Wednesday, the state announced the latest numbers on the JBS outbreak: 280 employees had tested positive for COVID-19, and seven of them had died.

The Grand Island beef plant opened in 1965 in a sugar beet farming area. In recent decades, the plant has drawn immigrants from Mexico and Central America, and more recently refugees from Somalia and Sudan. In a sign of the area’s shifting workforce, Somali residents have opened a mosque in the old El Diamante nightclub and a community center in the former Lucky 7 Saloon next to a Salvadoran restaurant named El Tazumal.

Members of those communities became among the first to hit the area’s medical clinics as the virus began to spread. By the last week in March, the Family Practice of Grand Island, where Steinke works, had opened a special respiratory clinic to handle COVID-19 patients. That week, six of the patients had come from JBS. But over three days from March 30 to April 1, the clinic saw 25 patients that carried JBS insurance, indicating they were either employees or their dependents.

Danny Lemos’ father was one of the first JBS workers to get sick from the virus in late March. The 62-year-old, who’d worked at the plant for a year, had developed a fever and a cough.

“One day, he was laying in the living room on a chair, wrapped up in a blanket, shivering,” Lemos said. “My mom takes his temperature, and he had a temperature of 105 and he was really having trouble breathing.”

His father was rushed to the hospital and put on a ventilator.

Within days, Lemos said he also started having trouble breathing and joined his father in the ICU. Lemos, 39, was put in a medically induced coma and given a 20% chance of living, he said.

Surprisingly, he said, he eventually recovered and was released from the hospital in late April. His father, Danny Lemos Sr., has been in the hospital for more than a month, most of the time on a ventilator, and is only now starting to recover.

Lemos said JBS should have taken better precautions.

“Shutting down right away, I think, probably would have helped a ton,” he said. “Do I think it would have kept everybody from getting sick? No, because those same people are still going to be out and about in the community. But just being so many people in one building, it was like a ticking time bomb.”

In an interview this week, Steinke said that it was hard to get the message across to JBS that more needed to be done.

“Even if they did not stop or shut down, if they would have put in better protections right from the start,” she said, “we would not have seen such a rapid rise in cases.”

At one point before the governor’s decision, the emails ProPublica obtained show, officials found language on the U.S. Department of Agriculture’s website that said local authorities could close a plant and the USDA would follow those decisions, potentially giving the health district some leverage.

“I guess I will send it to … HR there and maybe he will take us more seriously,” Anderson, the local health director, wrote in an email to the city administrator.

Under Trump’s executive order, that guidance has been reversed: The USDA could try to overrule local decisions if federal officials disagree.

That could pose a risk to the USDA’s own workforce of federal food inspectors, who work inside the plants to ensure the meat is safe to eat. According to the emails, some inspectors at the JBS plant also tested positive. Because inspectors sometimes monitor multiple sites, one inspector noted that she had recently worked in two other plants that have also had outbreaks, potentially spreading the virus within other plants.

“From my perspective,” temporarily closing the JBS plant “would have reduced the transmission,” Anderson said in an interview this week. “But if you shut down a plant and your 3,700 employees have nowhere to go, where are they going to go and how far is the spread going to be outside the plant vs. inside the plant? And if you end up going a month, what happens to their ability to feed their families?”

Anderson said that the “general feeling” she got from the call with the governor was that they needed to do more testing. So after the governor blocked the effort to close the plant, she continued to try to work collaboratively with JBS to encourage more testing of their employees.

In the emails, JBS officials said they were open to testing but repeatedly expressed concern about public disclosure of the results. “We want to make sure that testing is conducted in a way that does not foment fear or panic among our employees or the community,” JBS chief ethics and compliance officer Nicholas White wrote in an email to Anderson on April 15.

A week later, after the number of JBS cases was released by Anderson, Tim Schellpeper, president of the company’s U.S. beef processing operations, emailed her that he was worried about the amount of national attention it was attracting. “Have you given more thought to adding clarity/correction around this in your comments today?” he asked.

As JBS officials fretted about the optics of testing their employees, tensions within the families of the workers mounted. As the number of sick workers grew, the daughter of one worker, Miriam, said she was panicking about what would happen to her mother, who worked on the plant’s kill floor. At the end of every shift, she said, she called her mother to make sure she was okay.

“It was dreadful,” said Miriam, who asked that her last name not be used to protect her mother from retaliation. “It was just kind of living in fear waiting for the day she would have a fever. We knew it was going to happen because she’s a JBS employee. We didn’t think it was preventable anymore.”

Then, one day, she got a call from her mother, telling her that she had developed a fever and was being sent home.

“As she was changing in the locker room, she calls me and you can just hear the fear in her voice,” Miriam said.

Shortly after, her father tested positive for the virus too. Thankfully, she said, both her parents had only mild symptoms and have since recovered. But JBS and the governor should have done more, Miriam said.

“It just seemed like they were kind of careless,” she said. “I think it would have been a smart idea if not to close down the plant, to take more action to help the employees. They’re essential, but they need protection. They need to be kept safe.”

In the meantime, Ricketts has said that his approach of keeping the state “open for business” worked. And at a news conference Friday, he underscored the importance of the meatpacking industry to the state’s economy, proclaiming May as “Beef Month” in Nebraska.

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by Joshua Kaplan and Benjamin Hardy

On April 17 in Toledo, Ohio, a 19-year-old black man was arrested for violating the state stay-at-home order. In court filings, police say he took a bus from Detroit to Toledo “without a valid reason.” Six young black men were arrested in Toledo last Saturday while hanging out on a front lawn; police allege they were “seen standing within 6 feet of each other.” In Cincinnati, a black man was charged with violating stay-at-home orders after he was shot in the ankle on April 7; according to a police affidavit, he was talking to a friend in the street when he was shot and was “clearly not engaged in essential activities.”

Ohio’s health director, Dr. Amy Acton, issued the state’s stay-at-home order on March 22, prohibiting people from leaving their home except for essential activities and requiring them to maintain social distancing “at all times.” A violation of the order is a misdemeanor, punishable by up to 90 days in jail and a $750 fine. Since the order, hundreds of people have been charged with violations across Ohio.

The state has also seen some of the most prominent protests against state stay-at-home orders, as large crowds gather on the statehouse steps to flout the directives. But the protesters, most of them white, have not faced arrest. Rather, in three large Ohio jurisdictions ProPublica examined, charges of violating the order appear to have fallen disproportionately on black people.

ProPublica analyzed court records for the city of Toledo and for the counties that include Columbus and Cincinnati, three of the most populous jurisdictions in Ohio. In all of them, ProPublica found, black people were at least four times as likely to be charged with violating the stay-at-home order as white people.

As states across the country attempt to curb the spread of COVID-19, stay-at-home orders have proven instrumental in the fight against the novel coronavirus; experts credit aggressive restrictions with flattening the curve in the nation’s hotbeds. Many states’ orders carry criminal penalties for violations of the stay-at-home mandates. But as the weather warms up and people spend more time outside, defense lawyers and criminal justice reform advocates fear that black communities long subjected to overly aggressive policing will face similarly aggressive enforcement of stay-at-home mandates.

In Ohio, ProPublica found, the disparities are already pronounced.

As of Thursday night in Hamilton County, which is 27% black and home to Cincinnati, there were 107 charges for violating the order; 61% of defendants are black. The majority of arrests came from towns surrounding Cincinnati, which is 43% black. Of the 29 people charged by the city’s Police Department, 79% were black, according to data provided to ProPublica by the Hamilton County Public Defender.

In Toledo, where black people make up 27% of the population, 18 of the 23 people charged thus far were black.

Lt. Kellie Lenhardt, a spokeswoman for the Toledo Police Department, said that in enforcing the stay-at-home order, the department’s goal is not to arrest people and that officers are primarily responding to calls from people complaining about violations of the order. She told ProPublica that if the police arrested someone, the officers believed they had probable cause, and that while biased policing would be “wrong,” it would also be wrong to arrest more white people simply “to balance the numbers.”

In Franklin County, which is 23.5% black, 129 people were arrested between the beginning of the stay-at-home order and May 4; 57% of the people arrested were black.

In Cleveland, which is 50% black and is the state’s second-largest city, the Municipal Court’s public records do not include race data. The court and the Cleveland Police Department were unable to readily provide demographic information about arrests to ProPublica, though on Friday, the police said they have issued eight charges so far.

In the three jurisdictions, about half of those charged with violating the order were also charged with other offenses, such as drug possession and disorderly conduct. The rest were charged only with violating the order; among that group, the percentage of defendants who were black was even higher.

Franklin Country is home to Columbus, where enforcement of the stay-at-home order has made national headlines for a very different reason. Columbus is the state capital and Ohio’s largest city with a population of almost 900,000. In recent weeks, groups of mostly white protesters have campaigned against the stay-at-home order on the Statehouse steps and outside the health director’s home. Some protesters have come armed, and images have circulated of crowds of demonstrators huddled close, chanting, many without masks.

No protesters have been arrested for violating the stay-at-home order, a spokesperson for the Columbus mayor’s office told ProPublica. Thomas Hach, an organizer of a group called Free Ohio Now, said in an email that he was not aware of any arrests associated with protests in the entire state. The Columbus Division of Police did not respond to ProPublica’s request for comment.

Ohio legislators are contemplating reducing the criminal penalties for violating the order. On Wednesday, the state House passed legislation that would eliminate the possibility of jail time for stay-at-home violators. A first offense would result in a warning, and further violations would result in a small fine. The bill is pending in the state Senate.

Penalties for violating stay-at-home orders vary across the country. In many states, including California, Florida, Michigan and Washington, violations can land someone behind bars. In New York state, violations can only result in fines. In Baltimore, police told local media they had only charged two people with violations; police have reportedly relied on a recording played over the loudspeakers of squad cars: “Even if you aren’t showing symptoms, you could still have coronavirus and accidentally spread it to a relative or neighbor. Being home is being safe. We are all in this together.”

Enforcement has often resulted in controversy. In New York City, a viral video showed police pull out a Taser and punch a black man after they approached a group of people who weren’t wearing masks. Police say the man who was punched took a “fighting stance” when ordered to disperse. In Orlando, police arrested a homeless man walking a bicycle because he was not obeying curfew. In Hawaii, charges against a man accused of stealing a car battery, normally a misdemeanor punishable by up to 30 days in jail, were enhanced to a felony, which can result in 10 years in prison, because police and prosecutors said he was in violation of the state order.

The orders are generally broad, and decisions about which violations to treat as acceptable and which ones to penalize have largely been left to local police departments’ discretion.

Kristen Clarke, president of the Lawyers’ Committee for Civil Rights Under Law, a legal organization focused on racial justice, said such discretion has opened the door to police abuse, and she said the U.S. Department of Justice or state governments should issue detailed guidelines about when to make arrests. That discretion “is what’s given rise to these rogue practices,” she told ProPublica, “that are putting black communities and communities of color with a target on their backs.”

In jails and prisons around the country, inmates have fallen ill or died from COVID-19 as the virus spreads rapidly through the facilities. Many local governments have released some inmates from jail and ordered police to reduce arrests for minor crimes. But in Hamilton County, some people charged with failing to maintain social distancing have been kept in jail for at least one night, even without any other charges. Recently, two sheriff’s deputies who work in the jail tested positive for COVID-19. “The cops put their hands on them, they cram them in the car, they take them to the [jail], which has 800 to 1400 people, depending on the night,” said Sean Vicente, director of the Hamilton County Public Defender’s misdemeanor division. “It’s often so crowded everyone’s just sitting on the floor.”

Clarke said the enforcement push is sometimes undercutting the public health effort: “Protecting people’s health is in direct conflict with putting people in overcrowded jails and prisons that have been hotbeds for the virus.”

Court records show that the Cincinnati Police Department has adopted some surprising applications of the law.

Six people were charged with violations of the order after they were shot. Only one was charged with another crime as well, but police affidavits state that when they were shot, they were or likely were in violation of the order. One man was shot in the ankle while talking to a friend, according to court filings, and “was clearly not engaged in essential activities.” Another was arrested with the same explanation; police wrote that he had gone to the hospital with a gunshot wound. The Cincinnati Police Department did not respond to ProPublica’s requests for comment.

In Springfield Township, a small, mostly white Cincinnati suburb, nine people have been arrested for violating the order thus far. All of them are black.

Springfield Township Police Chief Robert Browder told ProPublica in an email that the department is “an internationally accredited law enforcement organization” and has “strict policies ... to ensure that our zero tolerance policy prohibiting bias-based profiling is adhered to.”

Browder said race had not played a role in his department’s enforcement of the order and that he was “appalled if that is the insinuation.”

Several of the black people arrested in Springfield Township were working for a company that sells books and magazine subscriptions door to door. One of the workers, Carl Brown, 50, said he and five colleagues were working in Springfield Township when two members of the team were arrested while going door to door. Police called the other sales people, and when they arrived at the scene, they too were arrested. Five of them, including Brown, were charged only with violating the stay-at-home order; the sixth sales person had an arrest warrant in another state, according to Browder, and police also charged her for giving them false identification.

Brown said one of the officers had left the group with a warning: They should never come back, and if they do, it’s “going to be worse.”

Browder denied that the officers made such a threat, and he said the police had received calls from residents about the sales people and their tactics and that the sales people had failed to register with the Police Department, as required for door-to-door solicitation.

Other violations in Hamilton County have been more egregious, but even in some of those cases, the law enforcement response has stirred controversy. On April 4, a man who had streamed a party on Facebook Live, saying, “We don’t give a fuck about this coronavirus,” was arrested in Cincinnati’s Over-the-Rhine neighborhood, the setting of a 2001 riot after police fatally shot an unarmed black man.

The man who streamed the party, Rashaan Davis, was charged with violating the stay-at-home order and inciting violence, and his bond was set at $350,000.

After Judge Alan Triggs said he would release Davis from jail pretrial because the offense charged was nonviolent, local media reported, prosecutors dropped the misdemeanor and said they would focus on the charge of inciting violence, a felony.

The Hamilton County prosecutor’s office declined to comment on Davis’ case.

In Toledo, there’s been public controversy around perceived differences in the application of the law. On April 21, debate at the Toledo City Council meeting centered around a food truck. Local politicians discussed recent arrests of young black people at house parties, some contrasting them with a large, white crowd standing close together in line outside a BBQ stand, undisturbed by police. Councilmember Gary Johnson told ProPublica he’s asked the police chief to investigate why no one was arrested at a party he’d heard about, where white people were congregating on docks. “I don’t know the circumstances of the arrests,” he said. But “if you feel you need to go into poor neighborhoods and African American neighborhoods, you better be going into white neighborhoods too. … You have to say we’re going to be heavy-handed with the stay-at-home order or we’re going to be light with it. It has to be one or the other.”

Toledo police enforcement has not been confined to partygoers. Armani Thomas, 20, is one of the six young men arrested for not social distancing on a lawn. He told ProPublica he was sitting there with nine friends “doing nothing” when the police pulled up. Two kids ran off, and the police made the rest stay, eventually arresting “all the dudes” and letting the girls go. He was taken to the county jail, where several inmates have tested positive, for booking and released after several hours. The men’s cases are pending.

“When police see black people gathered in public, I think there’s this looming belief that they must be doing something illegal,” RaShya Ghee, a criminal defense attorney and lecturer at the University of Toledo, told ProPublica. “They’re hanging out in a yard — something illegal must have happened. Or, something illegal is about to happen.”

Lenhardt, the police lieutenant, said the six men were arrested after police received 911 calls reporting “a group gathering and flashing guns.” None of the six men were arrested on gun charges. As for the 19-year-old charged for taking the bus without reason, she said police asked him on consecutive days to not loiter at a bus station.

With more than 70,000 Americans dead from the coronavirus, government officials have not figured out how to balance the threat of COVID-19 with the harms of over policing, Clarke said. “On the one hand, we want to beat back the pandemic. That’s critical. That’s the end goal,” she told ProPublica. “On the other hand, we’re seeing social distancing being used as a pretext to arrest the very communities that have been hit hardest by the virus.”

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by Marshall Allen

The links to the viral video “Plandemic” started showing up in my Facebook feed Wednesday. “Very interesting,” one of my friends wrote about it. I saw several subsequent posts about it, and then my brother texted me, “Got a sec?”

My brother is a pastor in Colorado and had someone he respects urge him to watch “Plandemic,” a 26-minute video that promises to reveal the “hidden agenda” behind the COVID-19 pandemic. I called him and he shared his concern: People seem to be taking the conspiracy theories presented in “Plandemic” seriously. He wondered if I could write something up that he could pass along to them, to help people distinguish between sound reporting and conspiracy thinking or propaganda.

So I watched “Plandemic.” I did not find it credible, as I will explain below. YouTube, Facebook and Vimeo have since removed it from their platforms for violating their guidelines. Now it’s available on its own site.

Sensational videos, memes, rants and more about COVID-19 are likely to keep coming. With society polarized and deep distrust of the media, the government and other institutions, such content is a way for bad actors to sow discord, mostly via social media. We saw it with Russia in the 2016 election and we should expect it to continue.

But what surprised me is how easily “Plandemic” sank its hooks into some of my friends. My brother also felt alarmed that his own church members and leaders in other churches might be tempted to buy into it.

The purpose of this column is not to skewer “Plandemic.” My goal is to offer some criteria for sifting through all the content we see every day, so we can tell the difference between fair reporting and something so biased it should not be taken seriously.

Here’s a checklist, some of which I shared with my friends on Facebook, to help interrogate any content — and that includes what we publish at ProPublica.

Is the Presentation One-Sided?

There’s never just one side to a story. I mentioned this point in 2018 when I wrote about my faith and the biblical basis for investigative reporting. One of my favorite Proverbs says, “The first to state his case seems right until another comes and cross-examines him.” So a fair presentation should at least acknowledge opposing points of view.

I didn’t see this in “Plandemic,” so I called the filmmaker, Mikki Willis, who is also the film’s narrator, to ask him whether I had somehow missed the other side of the argument. I had not. “The other side of the argument plays 24/7 on every screen in every airport and on every phone and in every home,” Willis said. “The people are only seeing one side of the story all the time. This is the other side of the story. This is not a piece that’s intended to be perfectly balanced.”

I asked Willis if it was fair to call his film “propaganda,” which the Oxford dictionary defines as “information, especially of a biased or misleading nature, used to promote or publicize a particular political cause or point of view.”

He said he doesn’t feel there’s anything misleading in his film, but otherwise the definition fits. And based on that definition he feels 100% of news reporting is propaganda. “What isn’t propaganda these days?” he asked. “In that sense, what we’re doing is fighting fire with fire.”

Is There an Independent Pursuit of the Truth?

The star of “Plandemic,” medical researcher Judy Mikovits, is controversial. The magazine Science reports that it published and then retracted one of her papers in 2011. A search warrant provided to ProPublica by one of her former attorneys shows she was fired from her position at Whittemore Peterson Institute, a research center in Nevada, in September 2011. Then she allegedly stole notebooks and a laptop computer from the Institute, the search warrant said, leading to an arrest warrant for alleged possession of stolen property and unlawful taking of computer data. She was arrested on Nov. 18, 2011, but denied wrongdoing. The charges were dropped.

But “Plandemic” ignores or brushes past these facts and portrays her as an embattled whistleblower. “So you made a discovery that conflicted with the agreed-upon narrative?” Willis says to Mikovits, introducing her as a victim. “And for that, they did everything in their powers to destroy your life.”

A typical viewer is not going to know the details about Mikovits’ background. But as the primary source of controversial information being presented as fact, it’s worth an online search. The fact-checking site PolitiFact details her arrest and criminal charges. Clearly, there’s more to her story than what’s presented in “Plandemic.” That should give us pause when we assess its credibility.

Is There a Careful Adherence to the Facts?

In “Plandemic,” Willis asks Mikovits about her arrest: “What did they charge you with?”

“Nothing,” she replies. “I was held in jail, with no charges.”

Being charged with a crime is one of those concrete facts that we can check out. Science magazine reported Mikovits’ arrest and felony charge. I also found a civil lawsuit she filed against the Whittemore Peterson Institute in 2014 in the U.S. District Court for the Southern District of California. “Mikovits was arrested on criminal charges…” her complaint says in the case, which was eventually dismissed.

I asked Willis about the apparent discrepancy, where she said in his film that she wasn’t charged, when court documents show that she was charged. After my inquiry, he said he spoke to Mikovits and now feels it is clear that she meant that the charges were dropped.

I tracked down Mikovits and she said what she meant in the film is that there were no charges of any type of wrongdoing that would have led to her being charged with being a fugitive from justice. She admitted that all the controversy has been hard for her to sort out. “I’ve been confused for a decade,” she told me. She said she would try to be more clear in the future when she talks about the criminal charge: “I’ll try to learn to say it differently,” she said.

This underscores the importance of careful verification, and it distinguishes the craft of journalism from other forms of information sharing. People often speak imprecisely when they’re telling their stories. It’s our duty to nail down precisely what they do and do not mean, and verify it independently. If we don’t, we risk undermining their credibility and ours. That’s in part why we at ProPublica and many other journalists often link directly to our underlying source documents, so you can verify the information yourself.

Are Those Accused Allowed to Respond?

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, is one of the nation’s leaders in the response to the coronavirus. In “Plandemic,” Mikovits accuses Fauci of a cover-up and of paying off people who perpetrate fraud, among other things. PolitiFact found no evidence to support the allegations against Fauci.

Every time I write a story that accuses someone of wrongdoing I call them and urge them to explain the situation from their perspective. This is standard in mainstream journalism. Sometimes I’ve gone to extreme lengths to get comments from someone who will be portrayed unfavorably in my story — traveling to another state and showing up at their office and their home and leaving a note if they are not there to meet me. “Plandemic” doesn’t indicate whether the filmmakers reached out to Fauci for his version of the story. So I asked Willis about it. “We did not,” he told me.

Are All Sources Named and Cited, and if Not, Is the Reason Explained?

All sources should be identified, with their credentials, so viewers can verify their expertise or possible biases. If they can’t be for some reason, then that should be explained. “Plandemic” features unnamed people in medical scrubs, presented as doctors, saying they’re being wrongly pressured to add COVID-19 on people’s death certificates or are not being allowed to use the drug hydroxychloroquine to treat patients. But the speakers are not named, so we can’t really tell who they are, or even if they are doctors at all. That makes it impossible to tell if they are credible.

I asked Willis why he didn’t name those people. He told me he was in a hurry to release the 26-minute version of “Plandemic,” but the doctors will be named in the final version. “We should have done that,” he said.

Does the Work Claim Some Secret Knowledge?

“Plandemic” calls itself a documentary that reveals “the hidden agenda behind COVID-19.” We are in the midst of a global pandemic where few people in the world can figure out what is happening or the right way to respond, let alone agendas. We have almost every journalist in the country writing about this. And if the truth about a conspiracy is out there, many people have an incentive to share it. But “Plandemic” would like us to think it’s presenting some exclusive bit of secret knowledge that is going to get at the real story. That’s not likely.

Plus, to be honest, there were so many conspiratorial details stacked on top of each other in the film I couldn’t keep them straight. When I spoke to Willis I told him I was having a hard time understanding his point. Then I took a stab at what I thought was the main thrust of his argument. “Are you saying that powerful people planned the pandemic and made it happen so they could get rich by making everyone get vaccines?” I asked.

It turns out Willis isn’t sure either. “We’re in the exploratory phase,” he told me. “I don’t know, to be clear, if it’s an intentional or naturally occurring situation. I have no idea.”

Then he went on to say that the pandemic is being politicized and used to take away our civil liberties and leverage other political policies. “Certain forces” have latched onto the situation, he said. “It’s too fishy.”

He had me at, “I have no idea.” That sums it up. This is a vast pandemic and massive catastrophe. Our country wasn’t prepared for it, and the response by our top leaders has been disjointed. We’re restricted to our homes. Many people have lost their jobs and some are afraid or sick or dying. That makes us vulnerable to exploitation by people who will present inaccurate or intellectually dishonest information that promises to tell us the truth.

Perhaps “Plandemic” is guilty of sloppy storytelling, or maybe people really do believe the things they’re saying in the video. Or perhaps they’re being intentionally dishonest, or it’s a biased connecting of the dots rooted in personal and professional grievances. I don’t know because I can’t get inside their heads to judge their motives.

Ultimately, we’re all going to need to be more savvy consumers when it comes to information, no matter how slickly it’s presented. This may be but a signal of what’s to come in the run-up to the 2020 presidential election, when memes and ads of unknown origin come across our social media feeds. There are standards for judging the credibility of the media we take in every day, so let’s apply them.

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by Duaa Eldeib, Adriana Gallardo, Akilah Johnson, Annie Waldman, Nina Martin, Talia Buford and Tony Briscoe

ProPublica Illinois is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.

Larry Arnold lived less than a mile from a hospital but, stepping out of his South Side apartment with a 103-degree fever, he told the Uber driver to take him to another 30 minutes away.

Charles Miles’ breathing was so labored when a friend called to check on him that the friend called an ambulance. Still, Miles, a retired respiratory therapist, was reluctant to leave his home.

Close family support had helped Rosa Lynn Franklin recover from a stroke several years ago, but when she was admitted to the hospital in late March, her daughter could do little more than pat her on the back and say goodbye.

All three were among the first people to die of COVID-19 in Chicago, and all three were African American. Their deaths reflect the stunning racial disparity in the initial toll of the virus. Of the city’s first 100 recorded victims, 70 were black.

As the pandemic has spread, that gap has narrowed, and Latinos now make up the largest portion of any reported demographic of confirmed cases across Illinois, state data shows. But the disparity in black deaths persists. As of early May, African Americans, who make up just 30% of Chicago’s population, are about half of its more than 1,000 coronavirus deaths.

It has been well established that African Americans are dying of COVID-19 at a disproportionate rate in cities across America. ProPublica sought to explore the problem by examining the first 100 recorded deaths in Chicago, a city with a rich and often troubled history on issues of race.

Using a database obtained from the Cook County Medical Examiner’s Office that listed the names, health and location information of all COVID-19-related deaths, reporters reached out to the families and friends of each person who died. Reporters ultimately spoke with those who knew 22 of the victims; gleaned details about the lives of many others from obituaries and social media posts; and interviewed experts, medical professionals and government officials to understand how and why those first 100 died.

The racial disparities in coronavirus deaths have largely been attributed to endemic and entrenched inequalities in Chicago — decades of disinvestment in the predominantly black neighborhoods on the South and West sides that have left residents with fewer jobs, poorer health and diminished opportunities. Those forces often are portrayed as intractable and, during a pandemic, nearly impossible to fix.

Chicago Mayor Lori Lightfoot acknowledged the challenge when she spoke publicly about the disparities last month and announced a plan to address them.

“We’re not going to reverse this in a moment, overnight, but we have to say it for what it is and move forward decisively as a city, and that’s what we will do,” she said. “This is about health care accessibility, life expectancy, joblessness and hunger.”

While all this is true, ProPublica’s reporting also revealed other patterns, factors that could — and should — have been addressed and which almost certainly exist in other communities experiencing similar disparities. Even though many of these victims had medical conditions that made them particularly susceptible to the virus, they didn’t always get clear or appropriate guidance about seeking treatment. They lived near hospitals that they didn’t trust and that weren’t adequately prepared to treat COVID-19 cases. And perhaps most poignantly, the social connections that gave their lives richness and meaning — and that played a vital role in helping them to navigate this segregated city that can at times feel hostile to black residents — made them more likely to be exposed to the virus before its deadly power became apparent.

Many of the first 100 recorded Chicago COVID-19 victims led lives threaded through with community and civic involvement, powerfully connected to their city, to friends and family. Some had led careers of service, like Patricia Frieson, a retired nurse, and Rhoda Hatch, a former teacher, and Carl Redd, a U.S. Army veteran. Their small businesses helped shape their corners of the city; Hardwell Smith, 85, arrived in Chicago as part of the Great Migration from the Jim Crow South and established gas stations and auto repair shops on the South Side. They were church deacons and musicians; doting uncles like 32-year-old Carl White and nurturing mothers like Juliet Davis, who, despite her limited means, fed the homeless who lived under a neighborhood viaduct.

Most of the first 100 lived in majority-black neighborhoods, according to an analysis of medical examiner data; hardest hit were South Shore, Auburn Gresham and Austin, where the median income for 40% or more of the residents in each community is less than $25,000.

Many were already sick, with underlying health conditions. Seventy-eight of them had hypertension and 53 had diabetes. Just 12 had one health condition, and only five people had no comorbidities. James Brooks, a 27-year-old black man, was the youngest to die.

“I’m not surprised because every natural disaster will peel back the day-to-day covers over society and reveal the social fault lines that decide in some ways who gets to live and who gets to die,” said Dr. David Ansell, senior vice president for community health equity at Rush University Medical Center. “And in the United States, those vulnerabilities are often at the intersection of race and health.”

Ansell, who wrote “The Death Gap: How Inequality Kills,” has spent decades documenting the life expectancy gap between black and white Chicagoans, which is the largest in the country. Structural racism, concentrated poverty, economic exploitation and chronic stress cause what’s known as biological weathering, Ansell said, where the body ages prematurely and results in earlier death.

Who dies first is different for each pandemic, said Dr. Howard Markel, director of the Center for the History of Medicine at the University of Michigan. The coronavirus’s earliest victims, he said, were the most vulnerable.

“They’re not quite forgotten, but we don’t pay close enough attention to the health and well-being of this segment of the population,” he said. “Then a microscopic organism comes and topples them over.”

They were vulnerable, but their deaths cannot be dismissed as inevitable.

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One-Size-Fits-All Guidance

Phillip Thomas, 48, started to feel sick while working a day shift at the Walmart in Evergreen Park. A diabetic, he was cautious about his health, and he reached out to a doctor, who told him to stay home and self-quarantine in case he had the coronavirus.

About a week into his bedrest, Thomas told his sister Angela McMiller that he was having a hard time standing up and was vomiting, no longer able to keep anything down. She encouraged him to go to the emergency room, but he didn’t immediately go, citing the doctor’s advice to stay home.

Within a couple of days, he called an ambulance, which took him to Jackson Park Hospital, where he was intubated. Two days later, on March 29, he died, in the hospital where he was born.

When McMiller next saw her brother, it was at his funeral, which only 10 people could attend because of social distancing requirements. “It was devastating,” said McMiller. “My mother fell down, my brothers cried.”

McMiller is upset that her brother was told to stay home when he was sick, particularly considering the additional risks posed by his health history.

“It shocked me,” she said. “He was diabetic.”

Since the earliest days of the pandemic, the Centers for Disease Control and Prevention’s guidelines have emphasized staying home when symptoms are mild. “Most people with COVID-19 have mild illness and can recover at home without medical care,” the CDC says on its website. It recommends people call a doctor before going to get care in person, unless experiencing emergency signs like trouble breathing, blue lips or chest pain.

But experts told ProPublica that this one-size-fits-all advice does not account for the fact that African Americans are not only more likely to have preexisting conditions that increase their chances of bad outcomes, but also have a long-standing wariness of the health care system.

“There is this distrust between black communities and health care systems based on this fraught history of how health care systems have exploited and abused black people,” said Dr. Uché Blackstock, an emergency medicine physician in Brooklyn and the founder and CEO of Advancing Health Equity. “What happens as a result of that is that patients don’t want to interface with the health care system.”

In addition, doctors said patients may delay seeking care out of a fear of the medical bills, lack of insurance or transportation barriers — all of which underscores the need for targeted guidance. So instead of encouraging staying at home, these doctors want guidance to encourage African American patients to proactively seek care before symptoms get out of hand.

Dr. Mira Iliescu-Levine, a pulmonary critical care doctor at The Loretto Hospital on Chicago’s West Side, is concerned that African American and Latino patients are waiting to come to the hospital after their symptoms become too severe.

“You end up with an overwhelming clinical picture, almost like a tornado, that’s very hard to stop,” she said.

She said she wants patients, especially her African American patients with diabetes, obesity and other comorbidities, to seek care when they have “innocent symptoms” like a cough, runny nose, itchy eyes or low-grade fever.

Earlier treatment does not guarantee a better outcome, she said, but it can give the patient a fighting chance.

“Reach out,” she said. “Don’t wait.”

Asked whether the CDC would consider tailoring its recommendations to reflect the underlying health conditions and barriers to care in African American communities, a spokesperson said the “CDC is collecting data to monitor and track disparities among racial and ethnic groups … to help inform decisions on how to effectively address observed disparities. … We will continue to update our recommendations as we learn more.”

The CDC spokesperson said the agency has increased “engagement with organizations and other partners representing and serving racial and ethnic minority groups to identify gaps in the current response efforts,” and that people should “never avoid emergency rooms or wait to see a doctor if you feel your symptoms are serious.”

On the first day, Willie Flake, a 72-year-old mechanic, lost his ability to taste. Then, he lost his appetite. With each new coronavirus symptom he experienced, his sister Betty and her daughter Yolanda pushed him to go to the hospital.

But Flake, who had diabetes, stayed home because he thought his symptoms were not severe enough to go to the emergency room. He soon developed a fever. By the fourth day, he had trouble breathing.

Flake took an ambulance to Rush University Medical Center on March 27, where his condition appeared to stabilize before worsening again.

“They say, ‘Don’t come in until your fever is high and you can’t breathe,’” Yolanda Flake said. “That’s the part where I feel like they failed him. He waited until he couldn’t breathe and it was too late.”

In the early hours of April 1, his sister and niece put on masks and gloves and looked through the glass window of his hospital room. He had been like a father to Yolanda, attended every graduation, from kindergarten through college, and had recently accompanied her to buy a car for her daughter, his 23-year-old grandniece, LaSeanda.

Yolanda said she wished she could have been with him inside the room, regardless of the risks.

“I wanted to touch him,” she said. “I wanted to talk to him before he took his last breath. I couldn’t say it through the glass door.”

And then, his heart stopped.

“He waited at home,” Yolanda said, “and he was dying already.”

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Struggling Hospitals

Larry Arnold also waited, not because he was instructed to, but because he didn’t trust his neighborhood hospitals.

Two — Jackson Park Hospital and South Shore Hospital — sit within five minutes of his home. Both are century-old nonprofit facilities that serve majority low-income and uninsured patients on the South Side. When Arnold started to feel sick in mid-March, he worried that if he called an ambulance, it would take him to one or the other. He didn’t want to go to either.

“What upsets me is that we don’t have adequate medical facilities where we can go to and feel like we’ll be cared for,” his niece Angelyn Vanderbilt said. “I’m sure they’re very good people … but the consensus in the community is that those hospitals are inadequate and they have been for years.”

After his fever didn’t subside for a few days, Arnold, who was 70 and had chronic obstructive pulmonary disease, or COPD, knew he couldn’t wait any longer, his family said. He got into an Uber with a temperature of 103 and told the driver to take him to Advocate Christ Medical Center in Oak Lawn, some 30 minutes away.

On March 31, 16 days after he was admitted, the nurse put the phone to Arnold’s ear one last time.

“We told him to be strong and to continue to fight,” Vanderbilt said.

He died about an hour later.

People who live on Chicago’s South and West sides are often at a geographic disadvantage during medical crises because the hospitals that are closest to them frequently are those with fewer resources.

Illinois Gov. J.B. Pritzker acknowledged the hardships at a press briefing last month. “The safety-net hospitals are challenged in our state, and the availability of health care in communities of color has been at a lower quality or lower availability than in other communities,” he said.

The city’s safety-net hospitals, facilities that serve a large portion of low-income and uninsured patients regardless of their ability to pay, don’t have the private-insurance patient base or the cash reserves to fall back on during a pandemic that many larger hospitals have, said Larry Singer, associate professor at the Beazley Institute for Health Law and Policy at Loyola University Chicago School of Law. Some are millions of dollars in the red and housed in aging buildings. And while their mission is a valiant one, he said, they have not been able to respond to the coronavirus as quickly or with the same equipment and staffing.

“They’re trying to fight the same fight as everybody else with one arm tied behind their back,” Singer said. “They deserve the resources to do an even better job. I’m truly impressed by what they are trying to achieve during a time of crisis.”

Tim Caveney, president and CEO of South Shore Hospital, said that limited resources is one reason safety-net hospitals have struggled to earn the trust of the communities they serve. “Safety net [hospitals] have gotten a bad beat because we don’t have much money. It’s a funding issue,” he said, adding that the pandemic has aggravated South Shore’s financial issues. Not only have lucrative elective surgeries been postponed, but COVID-19 patients often require complex and lengthy care, which can be expensive.

Dr. Khalilah Gates, an African American pulmonary and critical care specialist at Northwestern Memorial Hospital who has family on the South Side, said she is painfully aware that some black patients may prefer to “wait it out” or travel to distant hospitals.

“Both of those are very common phenomenons,” she said. “Not all community hospitals, but many of the community hospitals in those communities lack the resources that offer security to the residents in those areas.”

ProPublica spoke with several families who said their loved ones either delayed care because they didn’t want to go to neighborhood hospitals or ultimately wound up in those hospitals as a last resort.

Miles, the retired respiratory therapist, had worked for about 40 years at Northwestern Memorial Hospital providing breathing treatments for patients there. When he started feeling sick in mid-March, he knew what resources he might need.

A friend called him on March 22 and heard his labored breathing. He told Miles that he was calling an ambulance, but Miles resisted, in part, because he didn’t want to be taken to Jackson Park, the nearest hospital.

“He should’ve been in there a week before that,” said his sister Roselle Jones. “But he was insistent on not going.”

The paramedics said that they had to take him to Jackson Park because it was the closest hospital. Miles’ family asked that he be transferred to another hospital, but once he tested positive for the coronavirus, a doctor told the family that Miles couldn’t be moved, Jones said.

By the end of the week, Miles had been sedated and placed on a ventilator. He died on April 3.

“We wanted him out of there. We wanted him somewhere he could get some good care,” Jones said. “The doors should be closed, and the building torn down.”

Philman Williams’ family also said they tried in vain to get him transferred out of Jackson Park after an ambulance took him there. Williams, 70, worked as a doorman at a luxury high-rise where residents dubbed him the “Mayor of Michigan Avenue” for his charm and good humor. Not only was his doctor at another hospital, but the family worried about the quality of care he would receive.

A day after he was admitted, their concerns were amplified by a news story detailing reports from employees that the hospital did not have enough personal protective equipment, prompting nurses to avoid entering patient rooms.

Nurses who were sick and those afraid to come to work because they had elderly relatives at home have led to staffing shortages, said Kindra Perkins, a representative with National Nurses United, the union that represents nurses at Jackson Park. One day, an ambulance couldn’t drop off a patient because there were only two nurses working in the emergency room, she said.

“The nurses deserve to have the resources that they need to provide the quality care in that community, and the people in that community are just as important as the folks on the North Side of Chicago,” Perkins said.

Margo Brooks-Pugh, a vice president of development at Jackson Park Hospital, did not answer specific questions, but she wrote in an email that the hospital takes patient and staff safety seriously.

“Jackson Park Hospital follows all guidelines and standards as related to patient care and safety,” she wrote.

Austin, on the West Side, is one of the city’s largest and most chronically underserved areas. It has become a hot spot for COVID-19 cases. The Loretto Hospital, a small nonprofit that has been an anchor in the community for more than 90 years, is the primary provider in the area. Like many of the safety-net hospitals in Chicago, it has struggled financially for years.

When Asberry Stoudemire Jr., a 54-year-old diabetic, got a runny nose, then felt his blood sugar levels begin to fall, his family knew he needed to get care quickly. He also had a history of congestive heart failure, which had forced the avid stepper and musician to retire early from his job as a certified nursing assistant. The Loretto Hospital wasn’t their first choice — or their second. But it was the closest. Within hours of arriving at Loretto, his condition deteriorated so rapidly that he was sedated and intubated.

His daughter Miranda Stoudemire said she had trouble getting a clear sense of what was going on in the 10 days her father spent in the hospital’s recently reopened 15-bed ICU. Loretto couldn’t afford to keep the unit up and running before the pandemic, a fate hospital administrators said they fear could be repeated without an infusion of cash as the pandemic continues.

“He was saying, ‘I know one thing, I’m not going to Loretto,’” she said. But he did, and she is resolute in her belief that her father would have lived longer had he been at a better resourced hospital. His family tried having him transferred but said they were told he was too critical to be moved.

“I feel like he didn’t even have a chance to fight,” she said.

He died March 29.

Mark A. Walker, spokesman for The Loretto Hospital, said that the hospital has the capacity to care for its patients and is doing its best to communicate with families.

“This hospital has gone through hard times,” he said. “We’re doing everything we can. We’re learning along with everybody else. But better resourced communities don’t have to fight for the same divvy of health care resources that we do.”

Although L.B. Perry was 78 and suffered from hypertension and diabetes, nothing usually kept him in bed. So when he didn’t wake at 6:30 for his morning oatmeal and coffee, his family began to worry.

As he grew weaker and needed help walking to the bathroom, his family urged him to go to the hospital. After a few days, he relented and went to Holy Cross Hospital in Chicago Lawn on the South Side, but he was sent home, his daughter Vernice Perry said.

“That’s why I’m so upset,” she said. “He was in the age bracket, and he has all these health conditions, and he had some of the symptoms.”

His condition worsened at home, and his daughter said she begged him to let her drive him to another hospital. Four days later, his wife called an ambulance in the early morning of March 30, and he returned to Holy Cross Hospital. He died on April 2.

Dan Regan, a spokesperson for Sinai Health System, did not answer questions about specific patients, citing privacy restrictions. He said that its hospitals, including Holy Cross, are “thoroughly prepared for handling the COVID-19 pandemic,” having created dedicated COVID-19 teams, using mobile triage trailers outside facilities to handle sick patients, and isolating COVID-19 patients in specialized rooms.

“It is worth noting though that the challenging nature of COVID-19 is that patients can look fine at one point and be discharged home with monitoring and follow-up, only to deteriorate and have to return to the hospital,” said Regan. “This has been seen in many cases nationwide.”

At least 110 patients from community hospitals, including Holy Cross, have been transferred to Rush University Medical Center, a large, well-equipped facility that has been touted as having been “built for a pandemic.”

“They’re really patients that otherwise, in all likelihood, would not survive at those hospitals,” said Dr. Paul Casey, Rush’s acting chief medical officer. “The resources just aren’t the same. Nor is the ability within critical care to provide a lot of the life-saving therapies.”

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The City’s Response

On April 6, when Mayor Lightfoot publicly announced that the coronavirus was disproportionately affecting the city’s black residents, the virus had been in Chicago at least since January, and more than 100 people were dead. The majority were black.

“When we talk about equity and inclusion, they’re not just nice notions,” Lightfoot said at the time. “They are an imperative that we must embrace as a city. And we see this even more urgently when we look at these numbers and this disparity. It’s unacceptable. No one should think that this is OK.”

That day, the city announced the Racial Equity Rapid Response Team in partnership with West Side United, with a goal to “bring a hyper local public health strategy to targeted communities.” In the weeks since, the team has held tele-town halls, delivered thousands of door hangers and postcards with targeted information, and distributed 60,000 masks for residents in the predominantly black communities of Austin, Auburn Gresham and South Shore.

Dr. Allison Arwady, the city’s public health commissioner said in an interview that officials had worked behind the scenes to combat rumors that black people couldn’t contract the coronavirus, reaching out to community and faith leaders on the South and West sides in February and March to let them know the city was seeing cases across all races.

Arwady said the department at first hoped to contain the spread. It had tracked the cases for weeks as the virus crept through the city, and then exploded. By the end of March, more than 40 Chicagoans had died from the virus, according to the county medical examiner data, though the city said its tally of deaths was less than half of that.

For the most part, Lightfoot has received plaudits for her handling of the pandemic. Illinois was one of the first states in the country to release statistics on COVID-19 deaths by race. Lightfoot herself has even become something of a national political star, with viral videos and memes of her urging residents to stay home. She also gave several high-profile interviews discussing the disproportionate impact of COVID-19 on black communities and emphasizing the importance of tracking demographic data.

The city also encountered some challenges. Early on, it found that up to 30% of the testing data it collected didn’t list race. At the April 6 press conference, which came one day after a WBEZ news report detailed the death disparities, the city released a detailed race analysis. The city also issued a public health order mandating demographic data of COVID-19 cases be reported in hopes of being better able to track and assist individuals and communities falling victim to the coronavirus.

Still, to some in the community, the city appeared a step behind. Niketa Brar, co-founder and executive director at Chicago United for Equity, which advocates for racial equity in the city, said officials didn’t do enough to engage the communities they knew would be hardest hit. As soon as the virus entered Chicago, she said, the city should have used racial, health and economic data to predict where it would take hold and then begin working with residents in those communities on how best to protect and support them. The Racial Equity Rapid Response Team was dispatched much later, she said.

“We’ve seen enough maps to know what the next map is going to look like,” Brar said. “And yet we consistently fail to engage those who are closest to the harm time and time again.”

Lightfoot said in an interview Friday she believes the city responded robustly to the virus from the start.

“I feel pretty good about where we are,” she said. “Has it been perfect? Has any of this been perfect? No, because you’re not going to be able to undo literally 100-plus years of racial disparities across black and brown Chicago. But I’m going to be a champion for people in my city, and particularly people who look like me and who grew up in circumstances like mine.”

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The Perils of Connection

It made sense that they were out on Election Day — Revall Burke, a 60-year-old city worker, who served as an election judge for the March 17 primary, and John J. Hill Jr., 53, who was campaigning for a friend outside of City Hall, handing out masks and shaking hands.

Their community connections had shaped their lives. Both grew up in public housing. Burke went on to help form a building committee to give back to the neighborhood, including organizing picnics where he would give away school supplies. Hill, who built a successful business and counted among his proudest moments catering a campaign event for Barack Obama, met his wife at the iconic Rock ‘N’ Roll McDonald’s where she worked as a teenager. He came in to buy ice cream nearly every day; when she was sick, he got her a “get well soon” card signed “the ice cream man,” sparking a 40-year romance and two sons.

For black residents in a city as segregated as Chicago, connections to family, church and community can be a vital resource. During the 1995 Chicago heat wave, connectedness sometimes meant the difference between life and death: Sociologists found that compared with more affluent neighborhoods, Auburn Gresham had fewer deaths, in part because residents knew their neighbors and checked on one another during the extreme temperatures, just as they did every day.

Yet those deep connections put black Chicagoans in harm’s way as the novel coronavirus spread largely undetected, said Jaime Slaughter-Acey, a social epidemiologist at the University of Minnesota who did her doctoral work in Chicago. “What we’re seeing in the time of COVID is that this virus has taken this really important, health-promoting resource [of social connectivity] that we’ve created and used it against communities of color.”

Both men died on April 1, two weeks after the election.

The Chicago Department of Public Health and the CDC mapped one cluster of 16 known or suspected infections — and three deaths — dramatically illustrating the path the virus tore through families and friends who attended an intimate dinner, a funeral, a birthday celebration or a church service. Jennifer Layden, the department’s deputy commissioner, said the case study shows how insidious the virus could be in social settings — even a gathering of just three loved ones could be deadly.

Eboney Harrell was aware of the risk and barred all visitors from stopping by after her daughter SaDariah brought home her newborn baby. A single mother, Harrell was an anchor for SaDariah, rarely leaving her side after she learned her daughter became pregnant. Harrell went to the doctors’ appointments and hosted a circus-themed baby shower with custom T-shirts; hers read “Grandma.” After her grandson was born at the University of Chicago Medical Center on March 19, she took every opportunity to hold him.

Her friends believe she may have gotten the virus at the hospital.

When it came time for Harrell to be the patient, nobody was allowed to be by her side. She died on April 4, alone.

A bedside advocate is important for anyone in the medical system but especially the seriously ill. Sociologists say that, though critical, barring visitors during the pandemic to contain the virus may inadvertently magnify its deadly impact.

Human connections had fueled Rosa Lynn Franklin’s recovery after she suffered a stroke several years ago. Though Franklin had to retire from her longtime career as a social worker in her native Alabama, she filled her days with family, friendships and prayer. She moved to Chicago last year to be near her only child, finding a new community in extended family and a church down the street.

As COVID-19 encroached, Franklin, 64, became homebound, worried about how the virus might affect her fragile health. Despite all her precautions, she got sick, and by March 24, she was having such difficulty breathing that her daughter took her to the emergency room at University of Illinois Hospital.

“Because of social distancing, you can’t really do a lot of touching,” her daughter Jimeria Williams said, “so I just kind of patted her on the back and said, ‘I love you, I’ll see you.’”

Franklin was intubated the day after she was admitted, and while Williams was able to talk with the doctors, she could not communicate with her mother, not even by phone. It was the opposite of what had happened after the stroke, when Williams was a constant presence at her mother’s bedside.

“I couldn’t be there to hold her hand. I know she knew that, even though she was unconscious,” she said. “I think that had a metaphysical impact on her health.”

In the early evening of April 3, the hospital was able to connect Williams with her mother through FaceTime. A few minutes after hearing her daughter’s voice, Franklin died.

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I live in Pennsylvania, just outside Philadelphia, in Montgomery County. Currently, Montco is the worst hit county in Pennsylvania for the COVID-19 outbreak. Consequently, the governor ordered all non-essential businesses to close more than a week ago in Montco, and yesterday expanded that order statewide.

Because most of my work is from home, the outbreak has not yet affected my ability to provide client service; however, for the foreseeable future all live speaking engagements are cancelled.

I was scheduled to deliver the device workshop at DIA advertising conference last week and also had some workshops scheduled with FDAnews for May and June. DIA's conference was been delayed with a decision about how to proceed still to be determined. I'll post an update here when I know more.

The May FDAnews workshop has been cancelled, and the June workshop is on hold. When I know more, I'll post an update.

In addition, I am part of the leadership committee for the Philadelphia RAPS chapter. We held our last event on March 5 at Temple University, and the next day, RAPS HQ sent out a notice asking chapters to hold off on live meetings for March and April. Currently, the chapter leadership is discussing other options, such as webinars to continue getting information to our membership during the outbreak.

While we adjust to life during a pandemic, I'll provide updates as I can. Stay safe and wash your hands!

The development of myocardial injury in COVID-19 patients is associated with an increased risk of death, researchers have found.

To read the whole article click on the headline

A manufacturer has announced plans to move production of hydroxychloroquine — currently being trialled as a COVID-19 treatment — to the UK from abroad to combat potential shortages.

To read the whole article click on the headline

The latest information about the novel coronavirus identified in Wuhan, China, and advice on how pharmacists can help concerned patients and the public.

To read the whole article click on the headline

NHS England has advised pharmacies to risk assess staff who may be particularly vulnerable to COVID-19, including those from a black, Asian or minority ethnic background.

To read the whole article click on the headline

March 23, 2020 – As the United States grapples with the COVID-19 outbreak and its ongoing fallout, there is another pressing issue that is crucial to the American public: ensuring safe and fair elections between now and Nov. 3. “The Coalition believes it is important for all Americans to be active in the political process […]

March 30, 2020 – In addition to providing millions of Americans and many industries with financial support during the coronavirus outbreak, the emergency relief bill passed by Congress and signed into law by President Donald Trump on Friday accrues additional funding for the Food and Drug Administration’s coronavirus efforts and makes important changes to how […]

April 13, 2020 – The Food and Drug Administration (FDA) is responding to the challenges of COVID-19 in new ways that streamline product review and policy approaches, while also ensuring that entities promoting unapproved products that claim to be effective against the virus do not go unchecked. Last week, the FDA and the Federal Trade […]

April 27, 2020 – As the COVID-19 pandemic continues, the Food and Drug Administration (FDA) must balance safeguarding public health with the desire for timely product reviews. Staff members at the Center for Drug Evaluation and Research and the Center for Biologics Evaluation and Research are working diligently to keep all of these balls in […]

Inovio Pharmaceuticals’ stock has climbed higher and higher over the past month since it said it was working on a speedy COVID-19 vaccine.

BioMarin Pharmaceutical is boosting its early-stage pipeline by penning a deal with Swiss startup Dinaqor.

Australia’s largest biotech company CSL says it is working on a plasma-based therapy for patients with more severe forms of COVID-19.

PTC Therapeutics is adding to its rare disease pipeline with a midstage biotech buyout with a low upfront payment tied in with stock and biobucks.

GlaxoSmithKline is hard at work with partner Sanofi in getting a vaccine tested for COVID-19, but this morning it said it was now also entering the race to treat patients already hit with the disease.

Johnson & Johnson taps Khan for chief data role; Icon poaches AstraZeneca vet Buck as CMO; Intellia signs on Lebwohl as CMO.

Fortress Biotech has licensed a treatment for KRAS-driven cancers from Columbia University. Sticking to its blueprint, Fortress has set up a new biotech, Oncogenuity, to advance the preclinical asset and work to generate more oligonucleotides from the underlying platform.

Tough times at Orchard Therapeutics as it swings the ax across staffers and facilities, phases in new pipeline advances and reduces interest in others.

Some producers of essential oils have thrown their hats into the coronavirus claims ring, according to recent warning letters from the US Food and Drug Administration and the Federal Trade Commission.

While dietary supplement sales have surged in recent months, the extent of the economic damage caused by the novel coronavirus and COVID-19 could lead to some very tough quarters as families and businesses start to run out of money.

Consumers are turning to dietary supplements in record numbers, but the industry must deliver on the results the products are promising if the industry is to convert them to long term customers, says Steve Mister.

The GMP Starter Kit aims to help guide brands through current Good Manufacturing Practices (cGMP) regulations and FDA compliance for nutritional and dietary supplement brands.

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The tech giant announces it is extending its previous work-from-home plans for most of its staff and will begin reopening offices this summer.