Between one-third and one-half of U.S. clinicians experience burnout and addressing the epidemic requires systemic changes by health care organizations, educational institutions, and all levels of government, says a new report from the National Academy of Medicine.

Medicine regulatory authorities — including the U.S. Food and Drug Administration (FDA) — should strengthen cooperation with other countries’ regulators to ensure the quality, safety, and efficacy of medicines, says a new report from the National Academies of Sciences, Engineering, and Medicine.

Though sector expert Michael Ballanger's focus is on the precious metals, given current market conditions he sees potential in oil as well.

Visit the aureport.com for more information and for a free newsletter

Rubber stoppers are placed onto filled vials of the investigational drug remdesivir at a Gilead manufacturing site in the United States.; Credit: /AP

Updated at 4:59 p.m. ET

The Food and Drug Administration has given emergency use authorization to the antiviral drug remdesivir to treat hospitalized patients with the coronavirus, President Trump on Friday told reporters at the White House.

Gilead CEO Daniel O'Day said remdesivir maker Gilead Sciences is donating 1.5 million vials of the drug and will work with the federal government to distribute it to patients in need.

The news comes days after preliminary results from a study of the drug showed it can help patients recover faster. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, hailed the findings earlier this week as "quite good news."

The authorization means remdesivir can be distributed in the U.S. and given intravenously to treat COVID-19 patients — both adults and children — who are hospitalized with severe disease, the FDA says. The agency defines that category as "patients with low blood oxygen levels or needing oxygen therapy or more intensive breathing support such as a mechanical ventilator."

Discussing the findings about the drug's ability to help COVID-19 patients, O'Day cautioned earlier Friday that remdesivir is used to treat advanced cases, in which people are already hospitalized. The recent positive findings, he said, are a starting point in the fight against the respiratory disease.

"We want to continue to see how we can expand remdesivir to more patient populations," O'Day said on NBC's Today show. "Clearly with other medicines and vaccines to come, this is part, I think — the beginning of our ability to make an impact on this devastating virus."

This content is from Southern California Public Radio. View the original story at SCPR.org.

Supreme Court Justice Ruth Bader Ginsburg, seen in February, has been released from the hospital after treatment for a gallbladder condition.; Credit: Patrick Semansky/AP

After being treated on Tuesday for a gallbladder infection at Johns Hopkins Hospital in Baltimore, Supreme Court Justice Ruth Bader Ginsburg was discharged on Wednesday.

"She is doing well and glad to be home," according to a Supreme Court press release.

The court said over the next few weeks Ginsburg will return to Johns Hopkins Hospital for follow-up outpatient visits, and for a nonsurgical procedure to remove the gallstone.

Ginsburg, 87, participated in a virtual Supreme Court hearing on Wednesday from her hospital room. The justices and lawyers held unique oral argument sessions by phone all week because of the coronavirus pandemic.

Last year Ginsburg underwent three weeks of radiation for a cancerous tumor on her pancreas, and in December she was operated on for lung cancer.

This content is from Southern California Public Radio. View the original story at SCPR.org.

The Trump administration asked the Supreme Court to block Congress from seeking the materials, saying, "The government will suffer irreparable harm absent a stay."; Credit: Andrew Harnik/AP

The Supreme Court has temporarily put on hold the release of redacted grand jury material from the Russia investigation to a House panel.

The Trump administration is trying to block the release.

Last October, a district court judge ruled the Justice Department had to turn over the materials, which were blacked out, from former special counsel Robert Mueller's report into Russian interference in the 2016 election.

An appeals court upheld the decision, but the Trump administration, hoping to keep the evidence secret, appealed to the Supreme Court.

Chief Justice John Roberts' order temporarily stops the process. Lawyers for the House Judiciary Committee have until May 18 to file their response to the Justice Department's attempts to keep the materials from the House panel.

The Justice Department had until Monday to turn over the material following the appeals court order. But on Thursday, the Trump administration asked the Supreme Court to block Congress from seeking it, saying, "The government will suffer irreparable harm absent a stay."

This content is from Southern California Public Radio. View the original story at SCPR.org.

His expression said it all.  KPCC Director of On-Air Fundraising Rob Risko walked into my studio about 10:45 a.m. to update me on where we stood with our Fall member drive.  I knew we had a $10,000 challenge that had started first thing in the morning, but didn't have any idea how far behind we had fallen in reaching the required 1,000 member threshold.

 Rob gave it to me straight -- we had to attract well over 500 members during "AirTalk" to meet the challenge.  I knew that was nearly impossible during a full two-hour show, let alone one that would be significantly pre-empted by the President's news conference.  Regardless, I knew we had to do our best and hope our listeners would contribute in a record-setting way.  Boy, did they.

We didn't start our show until 11:25 a.m., following the news conference.  Right off the bat the phones started ringing and the KPCC website starting humming.  The volume of member contributions stayed high with only a few exceptions.  There were times we could barely keep track of how many members were coming in.  It was one of the most exciting and rewarding experiences I've had in all my years hosting "AirTalk."

I've been on a high all afternoon thinking about how commited our listeners are to the mission of KPCC.  You've made me very happy, and very proud of our audience.  Thank you for a wonderful show of support.  I will long remember this day.

By the way, we set a fundraising record for "AirTalk" with today's show.  We're still tallying it all up.  I'll have the totals for you tomorrow morning at 11.

This content is from Southern California Public Radio. View the original story at SCPR.org.

2006-2011

Virus Melt

; Credit: J. Scott Applewhite/AP

What does the right to a unanimous jury verdict have to do with abortion, or school prayer, or federal environmental regulations? Stay tuned.

The U.S. Supreme Court Monday struck down state laws in Louisiana and Oregon that allowed people accused of serious crimes to be convicted by a non-unanimous jury vote. The 6-to-3 decision overturned a longstanding prior ruling from 1972, which had upheld such non-unanimous verdicts in state courts.

And these days, any decision to overturn a longstanding precedent rings the alarm bells in the Supreme Court.

In the short run, Monday's decision was a victory for Evangelisto Ramos, who in 2016 was convicted of second-degree murder by a jury vote of 10-to-2 in Louisiana.

Only two states--Louisiana and Oregon--had provisions allowing non-unanimous verdicts, and Louisiana just recently changed its law to be like those in 48 other states and the federal government.

Justice Neil Gorsuch, writing for the majority, laid out the history behind the laws in both states. Gorsuch noted that the measure was first added to the Louisiana state constitution in 1898, after the Supreme Court ruled that racial minorities could not be barred from juries; that same year, Louisiana added the non-unanimous jury provision to its state constitution as part of a package of amendments that deliberately made it difficult for black citizens to vote or otherwise participate meaningfully in the state's governance. Specifically, Gorsuch said, the non-unanimous jury provision was a way to ensure that even if one or two African Americans made it on to a jury, their participation would be "meaningless."

The adoption of the non-unanimous jury rule in Oregon, Gorsuch wrote, "can similarly be traced to the rise of the Ku Klux Klan and efforts to dilute the influence of racial and ethnic and religious minorities on Oregon juries."

Despite these state provisions, there has never been any dispute that the unanimous jury requirement applies to the federal government. The question in this case was whether that aspect of the Sixth Amendment right to a jury trial applied to the states as well.

Over the last 75 years or so, the court has applied just about every other provision of the Bill of Rights to the states, but in 1972 it deviated from that practice, declining to apply the unanimous jury requirement in a similar fashion.

On Monday, however, the 1972 decision came tumbling down. The six-justice court majority — composed of conservatives and liberals — said the earlier ruling was a mistake.

The decision, written by the conservative Gorsuch, was joined in whole or in part by liberal Justices Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor, and conservative Justice Brett Kavanaugh. Justice Clarence Thomas, another conservative, agreed with the result, but on entirely different grounds.

Writing for the dissenters, Justice Samuel Alito — joined by Chief Justice John Roberts and for the most part, Justice Elena Kagan — maintained that the principle of adhering to precedent should be followed in this case because to do otherwise would require "a potentially crushing" number of new trials for people currently imprisoned under the old rule.

"Where is the justice in that?" replied Justice Gorsuch. "Not a single member of this court" is prepared to say that the 1972 decision was correct, he noted. "Every judge must learn to live with the fact that he or she will make mistakes ... But it is something else entirely to perpetuate" a wrong "only because we fear the consequences of being right."

The consequences of Monday's decision will likely be felt more in Louisiana, which allowed non-unanimous verdicts for more serious crimes than Oregon. The court's decision will require retrials for any prisoner who still has appeals pending.

There are about 100 of those cases in Louisiana, says Jamila Johnson, the managing attorney at the Promise of Justice Initiative, which represented Ramos. But there are also at least 1,700 prisoners in the state who might qualify for a new trial if the court eventually holds that Monday's decision is retroactive.

The high court left that question open for another day.

Altogether the majority, concurring, and dissenting opinions totaled a whopping 86 pages and reflected an important subtext--divergent views about when the court should follow its usual rule of adhering to precedent and when it should not.

It's important because, the new ultra-conservative court majority has very different views than the courts of the last 75 years on topics as diverse as abortion, voting rights, federal regulation, and the clash between religious views and generally applicable laws.

"The court's views about when it's OK to overrule prior precedent have always been more about the eye of the beholder than they have been about a rule that is easy or straightforward to apply," says Deborah Pearlstein, professor and co-director of the Floersheimer Center for Constitutional Democracy at Cardozo School of Law. Ultimately, she said, "all of these major questions that are coming before the court are going to be fought along these lines."

This content is from Southern California Public Radio. View the original story at SCPR.org.

; Credit: J. Scott Applewhite/AP

The U.S. Supreme Court is no stranger to controversy, but it still gets higher marks in public opinion polls than the other branches of government. Now though, for the first time in memory, the court is not just split along ideological lines, but along political lines as well: All the conservatives are Republican appointees, all the liberals Democratic appointees. That division could put the court in the crosshairs of public opinion if it is forced to make decisions that affect the 2020 election.

Chief Justice John Roberts has worked hard to persuade the public that the justices are fair-minded legal umpires--not politicians in robes. That image got pretty scuffed up earlier this month when the conservative court majority shot down accommodations for the coronavirus that would have allowed six more days for absentee ballots to be received in Wisconsin's election for 500 school board seats, over 100 judicial seats, and thousands of other state and local positions.

In the weeks leading up to the election, the COVID-19 pandemic had become a public health crisis. Encouraged by local officials, about a million more voters than usual requested absentee ballots, and local officials were unable to keep up with the surge. To mitigate that problem, the lower courts allowed an extra six days for election officials to receive completed absentee ballots.

But the day before the election, the Supreme Court overturned the lower court ruling by a 5-to-4 vote. The result was that tens of thousands of people who had not yet even received their absentee ballots were forced to, as the dissenters put it, choose between their health and their right to vote.

The TV footage of people wearing masks waiting for hours to vote at the very few precincts that were open amid the pandemic was, to say the least, not a good look. Health officials in Milwaukee have since identified six voters and one poll worker who appear to have contracted the virus during the election.

The majority opinion was unsigned, so no one knows who the principal author was. But we do know some things.

First, the emergency appeal in the case came through the justice assigned to that region of the country, Brett Kavanaugh. Typically, when a justice refers a case to the full court, he or she writes a memo about the issues, likely with a recommendation. Kavanaugh almost certainly did that. But other justices would then chime in. And in a voting case, Chief Justice Roberts assuredly would have played a pivotal role.

"John Roberts' fingerprints are on this as chief justice and as someone who has owned this area of the law," says Joan Biskupic, a Supreme Court biographer and CNN legal analyst who is the author of a critically acclaimed biography about Roberts.

Indeed, Roberts was invested in voting-rights law as far back as 1982 when he was a staffer in the Reagan administration. Back then, he led the effort to narrow the landmark 1965 Voting Rights Act. When that failed, President Reagan signed the broad extension of the law, rejecting advice to veto it. But years later, on the Supreme Court, Roberts wrote the decision in Shelby County v. Holder, gutting a key provision of that law.

So, it was no surprise when the conservative majority refused to make even a modest accommodation to the pandemic. What was surprising was the tone of the opinion. Critics of the opinion, including some Roberts defenders, called the language "callous," "cynical," and "unfortunate."

In fact, the word "pandemic" appears not once in the court's unsigned opinion. Rather, the majority sought to portray the issue before the court as a "narrow, technical question." The majority said the lower court had overstepped the Supreme Court's established rule that courts should "ordinarily not alter the election rules on the eve of an election."

The dissenters replied that the court's treatment of the current situation as ordinary "boggles the mind." Writing for the dissenters, Justice Ruth Bader Ginsburg opined that "a voter cannot deliver...a ballot she has not yet received. Yet tens of thousands of voters who timely requested absentee ballots" are being asked to do just that.

"I do think there's something to this idea that we need to stick with the rules even in the context of an emergency," says law professor Rick Hasen, an election expert at the University of California, Irvine.

He and others see the legal question before the court as a close call, but say the decision was, at the very least, tone deaf in light of the reality of a pandemic.

Hasen says that the court could have recognized "the inhumanity of making people vote in this way," but that instead the tone of the opinion was "really dismissive of the entire threat facing these voters."

Chief Justice Roberts has, on some occasions tried to bridge the two wings of the court, in a couple of big cases siding with the court's liberals, or sometimes trying to fashion a compromise. But as Hasen observes, "there really is not any case I can think of involving elections where Roberts has forged a larger consensus."

Roberts must have anticipated at least some of the outcry over the Wisconsin decision. He is, after all, an astute political observer.

But as any student of the court knows, Roberts is a reliable, and often leading member of the conservative majority when it comes to a whole host of issues involving campaigns, voting and elections. That includes decisions he has written striking down laws aimed at limiting the role of big money in campaigns and decisions upholding partisan gerrymanders. Moreover voting rights in particular "is an area of the law where John Roberts has not been deterred by anticipated public criticism," says Biskupic, his biographer.

For the chief, says Biskupic, "It's not just voting rights. It's a broader overlay of representation" in his decisions, a pattern that "often will favor Republicans, but more fundamentally, it seems to favor entrenched powers, the status quo in many states, against ordinary citizens. And we certainly saw that in Wisconsin."

Uncertainties around COVID-19 remain, with states facing decisions about when to reopen and what size of public gatherings are safe. As November inches closer, those decisions could affect the 2020 election. Who gets to vote, when, and how, are unanswered questions and states are surely exploring different plans to keep voters safe. But Roberts' Supreme Court may be the ultimate arbiter of what changes and accommodations to voting are allowed.

The majority opinion "tried to tell the public that this was a very small decision," says Biskupic. "But as the dissent pointed out, it laid down a very serious marker about how voters will be accommodated in the middle of the coronavirus crisis."

This content is from Southern California Public Radio. View the original story at SCPR.org.

; Credit: Patrick Semansky/AP

The U.S. Supreme Court has once again punted on the question of gun rights, throwing out as moot a challenge to New York City's strict gun regulations on transporting licensed guns outside the home.

New York City, in the name of public safety, has very strict gun regulations. It allows people to have a permit for guns in their homes, but those regulations originally barred people from transporting their guns anywhere except shooting ranges within the city. The New York State Rifle & Pistol Association challenged the regulation as a violation of the Second Amendment right to bear arms and lost in the lower courts.

But, after the Supreme Court agreed to review the case, New York state and New York City changed their laws to allow gun owners to transport their guns outside the city to shooting ranges, to competitions, and to second homes. That gave the challengers exactly what they asked for in their lawsuit, and so on Monday, the court, by a 6-to-3 vote, dismissed the case as moot--in short, it no longer presented a live controversy.

The unsigned opinion was joined by Chief Justice John Roberts, the court's four liberals, and Trump appointee Brett Kavanaugh.

But Kavanaugh wrote separately to stress that while he agreed with the majority on procedural grounds, he agreed with the dissenters--Justices Samuel Alito, Clarence Thomas, and Neil Gorsuch--on one key issue.

Those three said that the lower courts were using the wrong test to evaluate gun laws, a test that is far too deferential to gun regulators. The dissenters mainly argued however, that the court essentially had been gamed on the mootness question, and that the justices should have decided the case, and decided it for the gun owners.

Gun-safety advocates breathed a sigh of relief that there was no decision adverse to gun regulations. But they worry that gains they are making in some state legislatures may be taken away by a conservative court majority.

"The reality is that the gun-safety movement is winning in state houses and at the ballot box, so the NRA is turning to the court to try to change the tide," says Eric Tirschwell, managing mirector of Everytown for Gun Safety.

Monday's decision was the first in a major gun case in 10 years, the first since a landmark set of decisions in 2008 and 2010. In those cases, a sharply divided court ruled that the Second Amendment right to bear arms is an individual right, not a right associated with the militia, as the court had previously implied. Those decisions marked a huge victory for the NRA and other gun-rights organizations.

In the decade following that decision, however, the court did not agree to hear any of the dozens of challenges to gun restrictions in cases appealed to the court. In part because the composition of the court made outcomes uncertain.

The previous big gun cases were decided by 5-to-4 votes, with Justice Anthony Kennedy casting the fifth and decisive vote. Kennedy, according to court sources, insisted, as the price of his vote, on adding limiting language that likely would have resulted in some, maybe even most, gun restrictions being upheld. With neither side of the court sure how Kennedy would vote on most regulations, neither the pro-gun, nor the pro-gun-control side wanted to risk an adverse ruling.

That changed when Kennedy retired in 2018 to be replaced by Justice Kavanaugh, who has a much more gun-friendly record than Kennedy did.

Nothing Kavanaugh said in his concurring opinion Monday would dissuade anyone from thinking he has changed his mind.

Bottom line here is that when it comes to gun control, there look to be four pretty solid votes against a lot of the measures enacted in recent years after mass shootings. Specifically, laws that bar carrying weapons in public places, and bans on assault weapons and large ammo magazines. All these, plus so called red-flag laws and other measures could be in jeopardy.

The question is where Chief Justice Roberts will be on these and other gun-control questions. To date, he has never been much of a supporter of gun-control laws, but he hasn't been an outspoken opponent, either. All we really know is that he was part of the 2008 and 2010 majority that for the first time declared that the Second Amendment is an individual right, not, as the court had previously implied, a collective right that was attached to the colonial militia.

This content is from Southern California Public Radio. View the original story at SCPR.org.

The U.S. Supreme Court, in an 8-1 ruling, said the federal government must pay health insurers $12 billion under a provision of the Affordable Care Act.; Credit: Patrick Semansky/AP

The U.S. Supreme Court has told the federal government that it has to pay $12 billion to insurance companies, money that was promised in the Affordable Care Act as part of the start-up costs of Obamacare in the first three years of its existence.

The law, as enacted, promised to limit profits and losses for insurance companies in the first three years of the Obamacare program. Some companies made more money than allowed by the formula, and had to pay some back to the government, and other companies lost money and were owed money by the government under the formula.

But in 2014, the first year that the ACA's plan was in place, the Republican-controlled Congress reneged on the promise to appropriate money for the companies that had lost money. It did the same for the next two years as well, adding to appropriation bills a rider that barred the government from fulfilling the promise in the statute. After President Trump was elected, his administration supported the GOP-led refusal to pay.

The insurance companies sued, and on Monday the Supreme Court ruled that the federal government has to pay up.

The vote was 8-to-1, with Justice Sonia Sotomayor writing for the majority that the decision reflects a principle "as old as the nation itself. The government should honor its obligations."

She noted that the language of the ACA was "rare" in that it permitted lawsuits to enforce the provisions at issue here, provisions that declare the government"shall pay" the losses suffered by insurance companies that participated over the first three years.

The lone dissenter was Justice Samuel Alito, who called the decision "a massive bailout" for the insurance industry, which "took a calculated risk and lost."

Monday's decision was the third involving Obamacare at the Supreme Court. Conservative groups, and now the Trump administration, have consistently sought to invalidate or undermine the law — so far, with limited or no success. But next year, the Supreme Court is scheduled to consider once again whether the law is unconstitutional.

Despite repeated efforts by Republicans in Congress and the Trump administration to either undermine or entirely do away with the program, Obamacare has remained popular, likely because it has enabled millions of Americans, including those with pre-existing conditions, to obtain medical insurance and medical coverage for the first time.

This content is from Southern California Public Radio. View the original story at SCPR.org.

The Supreme Court; Credit: Mark Sherman/AP

The U.S. Supreme Court begins an extraordinary two weeks of oral arguments Monday. It will be the first time in history that the court has allowed live streaming of its audio, and the first time that the court is hearing arguments via telephone hookup, instead of in the flesh.

The justices are trying to simulate their normal arguments as much as possible, beginning with Chief Marshal Pamela Talkin calling the court to order with a slightly modified version of her usual "Oyez, oyez, oyez...."

After that, very little will be as usual.

Because the arguments are conducted over the phone, the justices and the lawyers cannot see one another, and listeners will all try to imagine where the justices and lawyers are sitting or standing in their homes to hear or present arguments.

While most of the lawyers will be in their homes, the government's lawyers will be making their arguments from the office of the Solicitor General, and in a bow to formality, they plan to wear their usual formal morning coat attire.

The lawyers we sampled, to a person, said they are more comfortable standing, or even standing at a lectern, as they usually do during oral arguments, even though nobody can see them. The arguments are limited to a half hour on each side. And, as usual, each side will get to make an opening argument for two minutes uninterrupted.

After that, under normal circumstances, the justices engage in rapid-fire questioning of the lawyers, interrupting counsel frequently, and even, on occasion, each other.

But starting Monday, the justices will ask questions in order of seniority, for two or three minutes each, with Chief Justice John Roberts starting off, followed by Justice Clarence Thomas — if he has any questions, which he rarely does. (If Thomas asks a question, it will be the first time he has spoken from the bench in over a year, when he broke a three-year silence, which was preceded by a whopping 10-year silence from the bench.)

Next Justice Ruth Bader Ginsburg, who often asks the first question in oral arguments, will be at bat, and so on, ending with the court's newest appointee, Brett Kavanauagh. More questions will be permitted if there is time left at the end of the first round of questioning.

Lawyers say there will be big challenges with the new format.

"You lose the ability to read body language. That's No. 1," says Jay Sekulow, who will be representing President Trump in cases testing whether the president can be subpoenaed for his pre-presidential financial records either by Congress or by a state grand jury subpoena in a criminal case.

As Sekulow observes, oral argument is typically a "pretty intimate event when you're actually arguing in the courtroom. You see them. You can see their reactions. You see if they nod to each other. Here you're doing this literally over a telephone line. So you lose the intimacy."

Stanford Law professor Jeff Fisher, who will be arguing a religion case a week from Monday, agrees. "I just feel that not being able to see their faces and body language is going to be a real challenge. It's just a cost for how effective and useful the arguments are going to be."

The audio argument format presents another interesting twist for the court: For the first time ever, oral arguments will be available via livestream. Typically, Supreme Court arguments are followed by a narrow group of lawyers, law students and court watchers. But with millions of Americans stuck at home, and arguments carried live online and on C-Span, the justices will likely have a larger audience than usual.

Monday's case presents a trademark question — not exactly the kind of thing to rivet public attention. And it is the only case of the day. Clearly, the court is using this relatively unimportant case to see how the system is working, and whether it needs to be adjusted in any way — in short, to work out the bugs.

This content is from Southern California Public Radio. View the original story at SCPR.org.

It was a new day at the Supreme Court, which for the first time ever live-streamed oral arguments.; Credit: Andrew Harnik/AP

The U.S. Supreme Court made history Monday. The coronavirus lockdown forced the typically cautious court to hear arguments for the first time via telephone, and to stream the arguments live for the public to hear.

Chief Justice John Roberts was at the court as the telephone session began, one or two other justices were in their offices at the court, and the rest of the justices dialed in from home.

The first and only case heard Monday involved an arcane trademark question only a lawyer could love. Online travel search engine Booking.com is appealing a U.S. Patent and Trademark Office refusal to grant a trademark to the company.

With the justices asking questions in order of seniority, the first big surprise was that Justice Clarence Thomas, who in the past has gone years without asking a question, did ask one, several in fact, when it came his turn.

"Could Booking acquire an 800 number ... that's a vanity number, 1-800-BOOKING, for example?" Thomas asked Assistant Solicitor General Erica Ross.

Yes, replied Ross, but domain names pose a different problem than phone numbers. Ultimately, she argued "the core problem with Booking.com is that it allows [Booking.com] to monopolize booking on the internet" to the exclusion of other sites like hotelbooking.com.

Justice Stephen Breyer followed up when his turn came: "Same question as Justice Thomas ... good morning, anyway ... You can have a trademark that's an address. You can have a trademark that's a telephone number. So why can't you have a trademark that's a dot-com?"

Justice Samuel Alito noted that the court's prior decision in this area of the law was more than 100 years old, and the statute dealing with trademarks was similarly enacted decades ago.

"How can a rule that makes sense in the internet age be reconciled with the language" in these "pre-Internet era" laws? asked Alito.

Next up to her lectern from her home was lawyer Lisa Blatt. This was her 40th Supreme Court argument and despite being a veteran, she said later that she was, as usual, sick to her stomach beforehand.

But once at the lectern "it's always a rush of excitement," she said, and this time it was a special rush.

"I loved getting a question from Justice Thomas ... I would go to the phone for the foreseeable future if I could get Justice Thomas to ask questions. That was wonderful," she said.

Indeed, despite the new format Blatt and Ross seemed to have had a good time.

"Your client would not object to the registration of any trademark that simply made a slight variation in Booking.com?" asked Alito.

"There's a million booking registrations already," parried Blatt.

Alito: "Would you just answer the question."

Blatt: "They don't and have not and would not."

Not, she added, unless another company ripped off the trademark with no variation. That would be theft, she said.

So, when when the argument was over, what was her reaction?

"After I hung up, I screamed, 'That was hard!' Because you're saying enough to answer, but not too much. And you don't have any like visual feedback, so it was hard."

In the end, she said, the argument felt more like an oral exam than an oral argument.

Tom Goldstein, publisher of Scotusblog, had a similar reaction. Goldstein, who has argued 43 cases before the court, said he thought the argument was probably more useful to the public than usual.

"But I bet it was less useful for the justices," he said. "Because there was less opportunity to follow up on lines of questions and less opportunity to influence someone ... so there's much less engagement in the oral argument."

Still there were no major hitches on this first day. Justice Sonia Sotomayor briefly forget to unmute her phone at one point, prompting a "Sorry, chief." Justice Breyer's voice broke up in static for a second or two. But as Goldstein observes, this was a big change for the court.

"Culturally a change, technologically a change. And it could have been a big embarrassment if it didn't go well, but it went fine," he said. "I think they're happy."

This content is from Southern California Public Radio. View the original story at SCPR.org.

The Supreme Court's second day of arguments by phone was devoted to a new version of a case it decided seven years ago involving federal money to fight AIDS around the world.; Credit: Andrew Harnik/AP

The Supreme Court kicked off a second day of telephone arguments Tuesday with a case that mingles sex, the HIV/AIDS epidemic and free speech.

At issue is whether the government can require private nonprofits to denounce prostitution in order to qualify for U.S foreign aid grants aimed at fighting the worldwide AIDS epidemic. This is the second time the court has faced this issue, but this time it comes with a twist.

In 2003, Congress, at the urging of President George W. Bush, enacted a major foreign aid program to fight the HIV/AIDS pandemic and prevent new infections worldwide. In appropriating the money, Congress included a provision requiring any private organization that received funding through the program to adopt an explicit policy denouncing prostitution and sex trafficking.

In 2013, the Supreme Court struck down that provision, declaring it unconstitutional because it compelled U.S. nonprofits to adopt an explicit policy as a condition for receiving grant money. By a 6-2 vote, the high court said such a requirement interfered with the free speech rights of private U.S. organizations engaged in the fight against AIDS.

The case was back Tuesday, but this time, the question was whether foreign organizations closely affiliated with those same U.S. nonprofits can be required to adopt the policy denouncing prostitution.

Defending the provision was Assistant to the Solicitor General Christopher Michel. He argued that foreign affiliates of U.S. organizations like Save The Children, CARE and WorldVision are separate legal entities from their parent U.S. organizations, and that as foreign entities, they have no rights under the U.S. Constitution.

Chief Justice John Roberts, who wrote the 2013 decision, seemed unpersuaded.

"Is it reasonable to insist on formal corporate ties in this context?" he asked. "It's undisputed that to be effective in many of the foreign countries involved here, you have to operate through a foreign entity."

Michel responded that if the U.S. nonprofits "make the choice to operate through a foreign entity because they decide that is more convenient or more effective, they have to accept the bitter with the sweet."

Roberts still seemed doubtful, noting that the U.S. nonprofits and their foreign affiliates "have the same name, the same logo, the same brand. And I wonder if it makes more sense to think of the foreign entity as simply another channel for the domestic entity's speech."

Representing the nonprofits was lawyer David Bowker. He maintained that for all practical purposes, there is no difference between the U.S. nonprofits and their foreign affiliates, so making the affiliate adopt an anti-prostitution message effectively puts words in the mouth of the U.S. nonprofit.

Questioned by Justice Clarence Thomas, Bowker said that the harm suffered by the U.S. nongovernmental organizations is that their foreign affiliates must either lose their funding by refusing to comply with the anti-prostitution policy or undermine their mission by denouncing the very people they need to work with — namely prostitutes. And if the foreign affiliates make the pledge needed to get funding, he said, the U.S. parent organizations have to disavow their own affiliates' anti-prostitution pledge, thus harming the entire anti-AIDS fight.

"It's a Catch-22 for these U.S. organizations," said Bowker.

Justice Stephen Breyer followed up: "So why don't you simply write a grant to get all the money yourself and then you give it to CARE India? Why doesn't that work?"

Because, replied Bowker, under the statute, CARE USA, in subcontracting a grant to CARE India, would be required to impose the anti-prostitution pledge on its own affiliate on behalf of the government.

Justice Samuel Alito, who signed on to the court's 2013 decision, said he had more concerns in this case — mainly "that it will force Congress to either withhold foreign aid entirely or allow foreign aid to be used in ways that are contrary to the interests of the people of this country."

Justice Brett Kavanaugh followed up: "Suppose the U.S. government wants to fund foreign NGOs that support peace in the Middle East but only if the NGOs explicitly recognize Israel as a legitimate state. Are you saying the U.S. can't impose that kind of speech restriction on foreign NGOs that are affiliated with U.S. organizations?"

Bowker said that kind of a restriction would likely be acceptable because the aid in that case would be tied to the U.S. relationship with Israel.

Kavanaugh moved on to another question, noting, "The government says your position would unleash foreign affiliates of U.S. corporations to pump money" into U.S. election campaigns, something that is explicitly barred under current law.

Bowker replied that U.S. campaign laws, as ruled on by the Supreme Court in prior cases, allow the ban on foreign contributions because they do not come from U.S. entities at all.

A decision in the case is expected some time this summer. While the court usually concludes its work by the end of June, it is expected that this term will extend into July because the arguments in this and nine other cases were postponed for more than a month because of the coronavirus.

This content is from Southern California Public Radio. View the original story at SCPR.org.

Supreme Court Justice Ruth Bader Ginsburg poses for the official photo at the Supreme Court in Washington, D.C. in 2018.; Credit: Mandel Ngan/AFP via Getty Images

Supreme Court Justice Ruth Bader Ginsburg underwent non-surgical treatment Tuesday for a benign gallbladder condition, according to a press release from the Supreme Court. She plans to participate in oral arguments from the hospital on Wednesday, according to the release.

In pain on Monday, Ginsburg went to Sibley Memorial Hospital in Washington after hearing the first-ever Supreme Court teleconference of oral arguments. At Sibley, she was diagnosed with acute cholecystitis, a condition in which a gallstone migrates to the cystic duct. She nonetheless participated in arguments from home on Tuesday, but was in enough pain that she went to Johns Hopkins Hospital in Baltimore for treatment of the infected duct later Tuesday.

Doctors not involved in Ginsburg's care said non-surgical treatment typically involves antibiotics and insertion of a tube to drain the infected duct.

Friends said the justice was in good spirits on Tuesday night, and watching the Metropolitan Opera on her iPad.

Ginsburg's emergency treatment coincides with the U.S. Supreme Court's historic live-streaming of its oral arguments in which the justices are participating by telephone because of the coronavirus. According to the court statement, Ginsburg, 87, is "resting comfortably" and plans to participate in oral arguments again on Wednesday when the court considers an important birth control case.

She is expected to remain in the hospital for another day or two.

Last year, Ginsburg completed three weeks of radiation treatment after a cancerous tumor was discovered on her pancreas. It was the fourth time in 20 years that she had been treated for cancer, and the second time in a year. In December 2019, she was operated on for lung cancer.

This content is from Southern California Public Radio. View the original story at SCPR.org.

Nuns with the Little Sisters of The Poor, including Sister Celestine, left, and Sister Jeanne Veronique, center, rally outside the Supreme Court in Washington on March 23, 2016.; Credit: Jacquelyn Martin/AP

The birth-control wars return to the Supreme Court Wednesday, and it is likely that the five-justice conservative majority will make it more difficult for women to get birth control if they work for religiously affiliated institutions like hospitals, charities and universities.

At issue in the case is a Trump administration rule that significantly cuts back on access to birth control under the Affordable Care Act. Obamacare, the massive overhaul of the health care system, sought to equalize preventive health care coverage for women and men by requiring employers to include free birth control in their health care plans.

Listen to the arguments live beginning at 10 a.m. ET.

Houses of worship like churches and synagogues were automatically exempted from the provision, but religiously affiliated nonprofits like universities, charities and hospitals were not. Such organizations employ millions of people, many of whom want access to birth control for themselves and their family members. But many of these institutions say they have a religious objection to providing birth control for employees.

For these nonprofits, the Obama administration enacted rules providing a work-around to accommodate employers' religious objections. The workaround was that an employer was to notify the government, or the insurance company, or the plan administrator, that, for religious reasons, it would not be providing birth-control coverage to its employees. Then, the insurance company could provide free birth-control options to individual employees separately from the employer's plan.

But some religiously affiliated groups still objected, saying the work-around was not good enough, and sued. They contended that signing an opt-out form amounted to authorizing the use of their plan for birth control. Among those objectors was the Little Sisters of the Poor, an order of Catholic nuns that runs homes for the elderly poor.

The Supreme Court punted in 2016

The Little Sisters sued, and their case first reached the Supreme Court in 2016. At the time, Sister Constance Viet explained why she refused to sign any opt-out form, saying that "the religious burden is what that signifies and the fact that the government would ... be inserting services that we object into our plan. And it would still carry our name."

Back then, when the Little Sisters' case got to the Supreme Court, the justices basically punted, telling the government and the sisters to work together to try to reach a compromise that would still provide "seamless birth control" coverage for employees who want it, without burdening the Sisters' religious beliefs. Although the Little Sisters did eventually get relief from the lower courts, the fight over the accommodations rules continued right up to the end of the Obama administration.

But when President Trump came into office, the administration issued new rules that would give broad exemptions to nonprofits and some for-profit companies that have objections to providing birth-control coverage for their employees. And the new rules expanded the category of employers who would be exempt from the birth-control mandate to include not just those with religious objections, but those with moral objections, too.

New rules

Those new rules, currently blocked by lower courts, are what is at issue Wednesday in the Supreme Court.

"Many states are suing and none of them can find a single actual woman who claims she's been harmed," says Mark Reinezi, president of the Becket Fund for Religious Liberty, which is defending the Trump rules against challenges brought by Pennsylvania and other states.

And, he adds, "there are many other ways to provide contraceptive coverage to people if they happen to work for religious objectors."

Rienzi says that employees who work for birth-control objectors can get coverage from their spouse's insurance plan, or by switching to a different insurance plan on an Obamacare exchange. And he says that birth control is also available under a program known as Title X, which gives money to state and local governments to provide health care for women.

But Brigitte Amiri, the deputy director the of ACLU's Reproductive Freedom project, says the idea that Title X could make up for the lost coverage is "a joke." Amiri notes that the Title X program has been underfunded for years, and the Trump administration has issued new regulations that in her words "decimated the program."

According to Amiri, "the Trump administration and Vice President [Mike] Pence have long wanted to ... take away coverage for contraception. They want to block access to birth control. They want to block access to abortion ... so this is all part and parcel of the overall attack on access to reproductive health care."

Potential consequences

She maintains that if the expanded Trump rules are upheld for religious objectors, hundreds of thousands of women across the country will lose their contraceptive coverage. Ultimately, Amiri says, there just is no way to maintain birth-control coverage for employees who work for religiously affiliated institutions unless that employer, as she puts it, is willing to "raise their hand" to opt out.

A break in birth-control coverage that big could have serious consequences, say say birth-control advocates. They note that the National Academy of Medicine, a health policy nonprofit, recommended the original rules because birth control is prescribed not just to avoid pregnancy but also to treat various female medical conditions. In fact, it is the most frequently taken drug for women ages 15-60. And it is expensive, $30 a month and more for pills, and as much as $1,000 for buying and having an IUD inserted.

Birth-control advocates say that's the very reason that a broad requirement to cover birth control in insurance was included in Obamacare. They say the new Trump rule improperly undermines that mandate.

But selling that argument to the Supreme Court will be hard. When the court last considered this issue in 2016, its makeup was far less conservative than it is now. Since then, two Trump appointees have been added to the court. And both of those appointees — Neil Gorsuch and Brett Kavanaugh — have already indicated strong support for the notion that religious rights may often trump other rights.

This content is from Southern California Public Radio. View the original story at SCPR.org.

The Supreme Court justices heard oral arguments remotely this week, and for the first time the arguments were streamed live to the public.; Credit: Saul Loeb/AFP via Getty Images

For the first time in its 231-year history, the Supreme Court justices heard oral arguments remotely by phone and made the audio available live.

The new setup went off largely without difficulties, but produced some memorable moments, including one justice forgetting to unmute and an ill-timed bathroom break.

Here are the top five can't-miss moments from this week's history-making oral arguments.

A second week of arguments begin on Monday at 10 a.m. ET. Here's a rundown of the cases and how to listen.

1. Justice Clarence Thomas speaks ... a lot

Supreme Court oral arguments are verbal jousting matches. The justices pepper the lawyers with questions, interrupting counsel repeatedly and sometimes even interrupting each other.

Justice Clarence Thomas, who has sat on the bench for nearly 30 years, has made his dislike of the chaotic process well known, at one point not asking a question for a full decade.

But with no line of sight, the telephone arguments have to be rigidly organized, and each justice, in order of seniority, has an allotted 2 minutes for questioning.

It turn out that Thomas, second in seniority, may just have been waiting his turn. Rather than passing, as had been expected, he has been Mr. Chatty Cathy, using every one of his turns at bat so far.

Thomas broke a year-long silence on Monday in a trademark case testing whether a company can trademark by adding .com to a generic term. In this case, Booking.com.

"Could Booking acquire an 800 number, for example, that's a vanity number — 1-800-BOOKING, for example?" Thomas asked.

2. The unstoppable RBG

Justice Ruth Bader Ginsburg participated in Wednesday's argument from the hospital. In pain during Tuesday's arguments, the 87-year-old underwent non-surgical treatment for a gall bladder infection at Johns Hopkins Hospital later that day, according to a Supreme Court press release.

But she was ferocious on Wednesday morning, calling in from her hospital room in a case testing the Trump administration's new rule expanding exemptions from Obamacare's birth control mandate for nonprofits and some for-profit companies that have religious or moral objections to birth control.

"The glaring feature" of the Trump administration's new rules, is that they "toss to the winds entirely Congress' instruction that women need and shall have seamless, no-cost, comprehensive coverage," she said.

3. Who flushed?

During Wednesday's second oral argument, Barr v. American Association of Political Consultants, a case in which the justices weighed a First Amendment challenge to a federal rule than bans most robocalls, something very unexpected happened.

Partway through lawyer Roman Martinez's argument time, a toilet flush could be distinctly heard.

Martinez seemed unperturbed and continued speaking in spite of the awkward moment.

The flush quickly picked up steam online, becoming the first truly viral moment from the court's new livestream oral arguments.

4. Hello, where are you?

Justice Sonia Sotomayor, considered one of the most tech-savvy of the justices, experienced a couple of technical difficulties with her mute button.

In both Monday and Tuesday arguments, the first time she was at bat, there were prolonged pauses, prompting Chief Justice John Roberts to call, "Justice Sotomayor?" a few times before she hopped on with a brief, "Sorry, Chief," before launching into her questions.

By Wednesday she seemed to have gotten used to the new format, but the trouble then jumped to Thomas, who was entirely missing in action when his turn came. He ultimately went out of order Wednesday morning.

5. Running over time

Oral arguments usually run one hour almost exactly, with lawyers for each side having 30 minutes to make their case. In an attempt to stick as closely as possible to that format, the telephone rules allocate 2 minutes of questioning to each justice for each round of questioning.

Chief Justice John Roberts spent the week jumping into exchanges, cutting off both lawyers and justices in the process, to keep the proceedings on track. Even so the arguments ran longer than usual.

But in Wednesday's birth control case, oral arguments went a whopping 40 minutes longer than expected.

Justice Alito, for his part, hammered the lawyer challenging the Trump administration's new birth control rules for more than seven minutes, without interruption from the chief justice.

Referencing a decision he wrote in 2014, Alito said that "Hobby Lobby held that if a person sincerely believes that it is immoral to perform an act that has the effect of enabling another person to commit an immoral act, the federal court does not have the right to say that this person is wrong on the question of moral complicity. That is precisely the question here."

Christina Peck is NPR's legal affairs intern.

This content is from Southern California Public Radio. View the original story at SCPR.org.

Remdesivir, an experimental antiviral drug made by Gilead Sciences, has been authorized by the Food and Drug Administration for emergency use in treating severely ill COVID-19 patients.; Credit: Ulrich Perry/POOL/AFP via Getty Images

Now that the Food and Drug Administration has authorized remdesivir for emergency use in seriously ill COVID-19 patients, the experimental drug is another step closer to full approval. That's when most drugs get price tags.

Gilead Sciences, which makes remdesivir, is donating its initial supply of 1.5 million doses, but the company has signaled it will need to start charging for the drug to make production sustainable. It's unclear when that decision might be made.

"Going forward, we will develop an approach that is guided by the principles of affordability and access," Gilead CEO Daniel O'Day told shareholders during the company's annual meeting Wednesday.

In a quarterly financial filing made the same day, Gilead said its investment in remdesivir this year "could be up to $1 billion or more," much of it for scaling up manufacturing capacity.

The company also acknowledged that it's in the spotlight. "[G]iven that COVID-19 has been designated as a pandemic and represents an urgent public health crisis, we are likely to face significant public attention and scrutiny about any future business models and pricing decisions with respect to remdesivir," Gilead said in the quarterly filing.

How will the company balance its business calculations with the drug's potential value to society?

"Gilead has not yet set a price for remdesivir," company spokeswoman Sonia Choi wrote in an email to NPR. "At this time, we are focused on ensuring access to remdesivir through our donation. Post-donation, we are committed to making remdesivir both accessible and affordable to governments and patients around the world."

Among potential treatments for COVID-19, remdesivir, an intravenous drug that was once studied for Ebola, is one of the furthest along.

"It's hard to imagine a situation in which there will be more public scrutiny," said Michael Carrier, a professor at Rutgers School of Law who specializes in antitrust and pharmaceuticals. "On the one hand, Gilead will try to recover its R&D in an atmosphere in which it is able to potentially make a lot of money. On the other hand, the pressure will be intense not to charge what's viewed as too high a price."

Breaking with its usual practices, the Institute for Clinical and Economic Review, or ICER, an influential nonprofit that analyzes drug pricing, issued an expedited report on remdesivir.

"Under normal circumstances, we would be unlikely to do a report when the evidence is this raw and immature," ICER President Steven Pearson said in an interview with NPR. "But it was quite clear that the world is moving at a much quicker pace."

If the price is based just on the cost of making the drug, then a 10-day course of remdesivir should cost about $10, according to the ICER report. (Gilead said results of a recently completed study suggest a five-day course of treatment may be just as effective.)

But if the drug is priced based on the drug's effectiveness, ICER estimates it should cost around $4,500 — assuming the drug is proven to have some benefit on mortality. If it doesn't and the drug only shortens hospital stays, that value-based price goes down to $390.

Results from a federally funded study described by Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, suggested that remdesvir could reduce recovery time by a median of four days — 11 days to recovery for patients treated with remdesivir compared with 15 days for those who got a placebo. A potential survival benefit is less clear.

Rutgers's Carrier said he expects Gilead to set the remdesivir price somewhere between the $10 and $4,500 that ICER estimated. The company has already shown that it can respond to public pressure when it asked the FDA to rescind the orphan drug status it won for remdesivir, he pointed out.

"When you see that $10 figure, that sets a benchmark for a figure that is eminently affordable," Carrier said. Ultimately, he said a price more than $1,000 per treatment course would be unpopular.

Gilead "will be watched very carefully," he said, because of its prior history of pricing. He referred to two other Gilead drugs that drew scrutiny over high price tags. The company charged $1,000 per pill for Sovaldi, a cure for hepatitis C. And its HIV drug Truvada can cost $22,000 per year.

But there is such a thing as pricing remdesivir too low, said Craig Garthwaite, who directs the health care program at Northwestern University's Kellogg School of Management.

"We don't think this is the only drug we need," he said, adding that remdesivir doesn't appear to be a "home run" against the coronavirus, based on existing data. "The thing that would worry me the most is that we're somehow telling people that if you take the risky bet to try, and you'll go after a coronavirus cure and you do it, you're not going to get paid."

Instead, he said he would like to see acceptance of a generous price for remdesivir to send the message to drug companies that the best thing they can do is "dedicate every waking moment to trying to develop that cure, and that if they do that, we will pay them the value they create," he said.

During a Gilead earnings call on April 30, analysts asked executives whether they could expect similar financial returns on remdesivir as they've seen with Gilead's other drugs.

"There is no rulebook out there, other than that we need to be very thoughtful about how we can make sure we provide access of our medicines to patients around the globe," Gilead CEO O'Day said. "And do that in a sustainable way for the company, for ... shareholders, and we acknowledge that."

On May 1, the FDA authorized remdesivir for emergency use, meaning it will be easier to administer to hospitalized patients with severe disease during the pandemic, but the drug is not yet officially approved. The federal government is coordinating distribution of the treatment.

Day acknowledged on the recent earnings call that the company "could" charge for remdesivir under an emergency use authorization, but he stressed that Gilead is donating its current supply, which should last through "early summer."

To date, the National Institutes of Health said it has obligated $23 million toward its COVID-19 remdesivir trial. And the U.S. Army Medical Research Institute of Infectious Diseases did some of the early in vitro and animal studies with the medicine prior to the pandemic.

"Taxpayers are often the angel investors in pharmaceutical research and development, yet this is not reflected in the prices they pay," Reps. Lloyd Doggett, D-Texas, and Rosa DeLauro, D-Conn., wrote in a April 30 letter to Health and Human Services Secretary Alex Azar.

Concerned about remdesivir's price, they asked for a full breakdown of taxpayer funds that have gone toward the development of the medicine. "An unaffordable drug is completely ineffective," they wrote in the letter. "The substantial taxpayer investments in COVID-19 pharmaceutical research must be recognized."

This content is from Southern California Public Radio. View the original story at SCPR.org.

Remdesivir, an experimental antiviral drug made by Gilead Sciences, has been authorized by the Food and Drug Administration for emergency use in treating severely ill COVID-19 patients.; Credit: Ulrich Perry/POOL/AFP via Getty Images

Now that the Food and Drug Administration has authorized remdesivir for emergency use in seriously ill COVID-19 patients, the experimental drug is another step closer to full approval. That's when most drugs get price tags.

Gilead Sciences, which makes remdesivir, is donating its initial supply of 1.5 million doses, but the company has signaled it will need to start charging for the drug to make production sustainable. It's unclear when that decision might be made.

"Going forward, we will develop an approach that is guided by the principles of affordability and access," Gilead CEO Daniel O'Day told shareholders during the company's annual meeting Wednesday.

In a quarterly financial filing made the same day, Gilead said its investment in remdesivir this year "could be up to $1 billion or more," much of it for scaling up manufacturing capacity.

The company also acknowledged that it's in the spotlight. "[G]iven that COVID-19 has been designated as a pandemic and represents an urgent public health crisis, we are likely to face significant public attention and scrutiny about any future business models and pricing decisions with respect to remdesivir," Gilead said in the quarterly filing.

How will the company balance its business calculations with the drug's potential value to society?

"Gilead has not yet set a price for remdesivir," company spokeswoman Sonia Choi wrote in an email to NPR. "At this time, we are focused on ensuring access to remdesivir through our donation. Post-donation, we are committed to making remdesivir both accessible and affordable to governments and patients around the world."

Among potential treatments for COVID-19, remdesivir, an intravenous drug that was once studied for Ebola, is one of the furthest along.

"It's hard to imagine a situation in which there will be more public scrutiny," said Michael Carrier, a professor at Rutgers School of Law who specializes in antitrust and pharmaceuticals. "On the one hand, Gilead will try to recover its R&D in an atmosphere in which it is able to potentially make a lot of money. On the other hand, the pressure will be intense not to charge what's viewed as too high a price."

Breaking with its usual practices, the Institute for Clinical and Economic Review, or ICER, an influential nonprofit that analyzes drug pricing, issued an expedited report on remdesivir.

"Under normal circumstances, we would be unlikely to do a report when the evidence is this raw and immature," ICER President Steven Pearson said in an interview with NPR. "But it was quite clear that the world is moving at a much quicker pace."

If the price is based just on the cost of making the drug, then a 10-day course of remdesivir should cost about $10, according to the ICER report. (Gilead said results of a recently completed study suggest a five-day course of treatment may be just as effective.)

But if the drug is priced based on the drug's effectiveness, ICER estimates it should cost around $4,500 — assuming the drug is proven to have some benefit on mortality. If it doesn't and the drug only shortens hospital stays, that value-based price goes down to $390.

Results from a federally funded study described by Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, suggested that remdesvir could reduce recovery time by a median of four days — 11 days to recovery for patients treated with remdesivir compared with 15 days for those who got a placebo. A potential survival benefit is less clear.

Rutgers's Carrier said he expects Gilead to set the remdesivir price somewhere between the $10 and $4,500 that ICER estimated. The company has already shown that it can respond to public pressure when it asked the FDA to rescind the orphan drug status it won for remdesivir, he pointed out.

"When you see that $10 figure, that sets a benchmark for a figure that is eminently affordable," Carrier said. Ultimately, he said a price more than $1,000 per treatment course would be unpopular.

Gilead "will be watched very carefully," he said, because of its prior history of pricing. He referred to two other Gilead drugs that drew scrutiny over high price tags. The company charged $1,000 per pill for Sovaldi, a cure for hepatitis C. And its HIV drug Truvada can cost $22,000 per year.

But there is such a thing as pricing remdesivir too low, said Craig Garthwaite, who directs the health care program at Northwestern University's Kellogg School of Management.

"We don't think this is the only drug we need," he said, adding that remdesivir doesn't appear to be a "home run" against the coronavirus, based on existing data. "The thing that would worry me the most is that we're somehow telling people that if you take the risky bet to try, and you'll go after a coronavirus cure and you do it, you're not going to get paid."

Instead, he said he would like to see acceptance of a generous price for remdesivir to send the message to drug companies that the best thing they can do is "dedicate every waking moment to trying to develop that cure, and that if they do that, we will pay them the value they create," he said.

During a Gilead earnings call on April 30, analysts asked executives whether they could expect similar financial returns on remdesivir as they've seen with Gilead's other drugs.

"There is no rulebook out there, other than that we need to be very thoughtful about how we can make sure we provide access of our medicines to patients around the globe," Gilead CEO O'Day said. "And do that in a sustainable way for the company, for ... shareholders, and we acknowledge that."

On May 1, the FDA authorized remdesivir for emergency use, meaning it will be easier to administer to hospitalized patients with severe disease during the pandemic, but the drug is not yet officially approved. The federal government is coordinating distribution of the treatment.

Day acknowledged on the recent earnings call that the company "could" charge for remdesivir under an emergency use authorization, but he stressed that Gilead is donating its current supply, which should last through "early summer."

To date, the National Institutes of Health said it has obligated $23 million toward its COVID-19 remdesivir trial. And the U.S. Army Medical Research Institute of Infectious Diseases did some of the early in vitro and animal studies with the medicine prior to the pandemic.

"Taxpayers are often the angel investors in pharmaceutical research and development, yet this is not reflected in the prices they pay," Reps. Lloyd Doggett, D-Texas, and Rosa DeLauro, D-Conn., wrote in a April 30 letter to Health and Human Services Secretary Alex Azar.

Concerned about remdesivir's price, they asked for a full breakdown of taxpayer funds that have gone toward the development of the medicine. "An unaffordable drug is completely ineffective," they wrote in the letter. "The substantial taxpayer investments in COVID-19 pharmaceutical research must be recognized."

This content is from Southern California Public Radio. View the original story at SCPR.org.

The Trump administration asked the Supreme Court to block Congress from seeking the materials, saying, "The government will suffer irreparable harm absent a stay."; Credit: Andrew Harnik/AP

The Supreme Court has temporarily put on hold the release of redacted grand jury material from the Russia investigation to a House panel.

The Trump administration is trying to block the release.

Last October, a district court judge ruled the Justice Department had to turn over the materials, which were blacked out, from former special counsel Robert Mueller's report into Russian interference in the 2016 election.

An appeals court upheld the decision, but the Trump administration, hoping to keep the evidence secret, appealed to the Supreme Court.

Chief Justice John Roberts' order temporarily stops the process. Lawyers for the House Judiciary Committee have until May 18 to file their response to the Justice Department's attempts to keep the materials from the House panel.

The Justice Department had until Monday to turn over the material following the appeals court order. But on Thursday, the Trump administration asked the Supreme Court to block Congress from seeking it, saying, "The government will suffer irreparable harm absent a stay."

This content is from Southern California Public Radio. View the original story at SCPR.org.

The Supreme Court justices heard oral arguments remotely this week, and for the first time the arguments were streamed live to the public.; Credit: Saul Loeb/AFP via Getty Images

For the first time in its 231-year history, the Supreme Court justices heard oral arguments remotely by phone and made the audio available live.

The new setup went off largely without difficulties, but produced some memorable moments, including one justice forgetting to unmute and an ill-timed bathroom break.

Here are the top five can't-miss moments from this week's history-making oral arguments.

A second week of arguments begin on Monday at 10 a.m. ET. Here's a rundown of the cases and how to listen.

1. Justice Clarence Thomas speaks ... a lot

Supreme Court oral arguments are verbal jousting matches. The justices pepper the lawyers with questions, interrupting counsel repeatedly and sometimes even interrupting each other.

Justice Clarence Thomas, who has sat on the bench for nearly 30 years, has made his dislike of the chaotic process well known, at one point not asking a question for a full decade.

But with no line of sight, the telephone arguments have to be rigidly organized, and each justice, in order of seniority, has an allotted 2 minutes for questioning.

It turn out that Thomas, second in seniority, may just have been waiting his turn. Rather than passing, as had been expected, he has been Mr. Chatty Cathy, using every one of his turns at bat so far.

Thomas broke a year-long silence on Monday in a trademark case testing whether a company can trademark by adding .com to a generic term. In this case, Booking.com.

"Could Booking acquire an 800 number, for example, that's a vanity number — 1-800-BOOKING, for example?" Thomas asked.

2. The unstoppable RBG

Justice Ruth Bader Ginsburg participated in Wednesday's argument from the hospital. In pain during Tuesday's arguments, the 87-year-old underwent non-surgical treatment for a gall bladder infection at Johns Hopkins Hospital later that day, according to a Supreme Court press release.

But she was ferocious on Wednesday morning, calling in from her hospital room in a case testing the Trump administration's new rule expanding exemptions from Obamacare's birth control mandate for nonprofits and some for-profit companies that have religious or moral objections to birth control.

"The glaring feature" of the Trump administration's new rules, is that they "toss to the winds entirely Congress' instruction that women need and shall have seamless, no-cost, comprehensive coverage," she said.

3. Who flushed?

During Wednesday's second oral argument, Barr v. American Association of Political Consultants, a case in which the justices weighed a First Amendment challenge to a federal rule than bans most robocalls, something very unexpected happened.

Partway through lawyer Roman Martinez's argument time, a toilet flush could be distinctly heard.

Martinez seemed unperturbed and continued speaking in spite of the awkward moment.

The flush quickly picked up steam online, becoming the first truly viral moment from the court's new livestream oral arguments.

4. Hello, where are you?

Justice Sonia Sotomayor, considered one of the most tech-savvy of the justices, experienced a couple of technical difficulties with her mute button.

In both Monday and Tuesday arguments, the first time she was at bat, there were prolonged pauses, prompting Chief Justice John Roberts to call, "Justice Sotomayor?" a few times before she hopped on with a brief, "Sorry, Chief," before launching into her questions.

By Wednesday she seemed to have gotten used to the new format, but the trouble then jumped to Thomas, who was entirely missing in action when his turn came. He ultimately went out of order Wednesday morning.

5. Running over time

Oral arguments usually run one hour almost exactly, with lawyers for each side having 30 minutes to make their case. In an attempt to stick as closely as possible to that format, the telephone rules allocate 2 minutes of questioning to each justice for each round of questioning.

Chief Justice John Roberts spent the week jumping into exchanges, cutting off both lawyers and justices in the process, to keep the proceedings on track. Even so the arguments ran longer than usual.

But in Wednesday's birth control case, oral arguments went a whopping 40 minutes longer than expected.

Justice Alito, for his part, hammered the lawyer challenging the Trump administration's new birth control rules for more than seven minutes, without interruption from the chief justice.

Referencing a decision he wrote in 2014, Alito said that "Hobby Lobby held that if a person sincerely believes that it is immoral to perform an act that has the effect of enabling another person to commit an immoral act, the federal court does not have the right to say that this person is wrong on the question of moral complicity. That is precisely the question here."

Christina Peck is NPR's legal affairs intern.

This content is from Southern California Public Radio. View the original story at SCPR.org.

Maurice Jackson of Proven and Probable speaks with Andy Schectman, president of Miles Franklin Precious Metals Investments, about the present situation with physical precious metals.

How can employees stay motivated and productive while teleworking during the COVID-19 crisis?

The post Keep calm and carry on working (remotely) appeared first on WeLiveSecurity

Getting cybersecurity right in the work-from-home world can feel daunting. ESET Chief Security Evangelist Tony Anscombe shares 6 best practices that will steer you in the right direction.

The post 6 tips for safe and secure remote working appeared first on WeLiveSecurity

As work from home is the new norm in the coronavirus era, you’re probably thinking of enabling remote desktop connections for your off-site staff. Here’s how to do it securely.

The post Work from home: Securing RDP and remote access appeared first on WeLiveSecurity

Scammers rehash old campaigns, create credit card-stealing websites and repurpose information channels to milk the COVID-19 crisis for all it's worth

The post It’s no time to let your guard down as coronavirus fraud remains a threat appeared first on WeLiveSecurity