“A migrant mother said her 14-month-old son was “full of dirt and lice” after being separated from his family for months by the Trump administration.
Olivia Caceras’s claims are included in a lawsuit against the Trump administration’s immigration policy separating families that was filed by 17 states and the District of Columbia, PBS News Hour reported Thursday.
Caceras’s testimony is one of many in the nearly 1,000-page court filing.
Caceras said she was separated from her son for roughly 12 weeks before they were reunited.
“He continued to cry when we got home and would hold on to my leg and would not let me go,” Caceras said in her testimony, as reported by PBS. “When I took off his clothes, he was full of dirt and lice.”
“It seems like they had not bathed him the 85 days he was away from us,” she added.” (A)
“The Trump administration asked a judge Friday for more time to reunite families who were separated at the border under its “zero-tolerance” policy to prosecute every person who enters the country illegally.
Hours before a hearing in San Diego, the Justice Department filed papers seeking an extension of the deadline, which is July 10 for all parents with children under 5 and July 26 to reunite everyone else.
The administration says federal law requires it to ensure that children are safe and that requires more time. Administration officials also say that they won’t be able to confirm a child’s parentage by the deadline if DNA testing is inconclusive. They will need more time to collect DNA samples or other evidence from parents who have been released from government custody.” (B)
“Government lawyers said Friday that they cannot locate the parents of 38 migrant children under the age of 5, as a federal judge indicated he is open to extending the deadline for reuniting nearly 3,000 children separated from their mothers and fathers while crossing the US-Mexico border.
In a status hearing with U.S. District Judge Dana Sabraw of the Southern District of California, who ordered the reunification, government lawyers said the Health and Human Services Department would only be able to reunify about half of approximately 100 children under the age of 5 by the court-ordered deadline of July 10.
For 19 children, their parents have been released from custody into the U.S. and their whereabouts are unknown. The parents of another 19 children have been deported.
“The way [a family separation] is put in the system is not in some aggregable form, so we can’t just run it all,” said Sarah Fabian, the Justice Department attorney representing the government before Sabraw.
Sabraw said he would agree to delay the deadline for reunifying the youngest children if the government could provide a master list of all children and the status of their parents. Sabraw ordered the administration to share a list of 101 children with the American Civil Liberties Union by Saturday afternoon.” (C)
“Records of the separated children are embarrassingly spotty, a Health and Human Services (HHS) spokesperson admitted on a July 5 call with press. HHS is charged with reuniting the children, who were originally separated and processed by agents from another federal agency, the Department of Homeland Security. Its own records must therefore be cross-checked with data from other sources, including records from Immigrations and Customs Enforcement (which reports to DHS) and the Office of Refugee Resettlement (ORR).
Cross-referencing may not be enough, said the spokesperson. As the New York Times reported, hundreds of files have already been deleted by border patrol staff. HHS secretary Alex Azar has additionally “ordered a hand audit of the records of every single child in our care,” but that’s more than 12,000 children, only some of which came to the border with their families.
That’s right: The HHS needs to review thousands of case files by hand for clues to which children were taken from their parents—just the beginning of a process that would also require talking with case managers to verify information and then trying to locate their families. The task is so massive that the agency is asking staff to work overtime reviewing the records, according to the Times, which obtained an internal email stating that “[e]veryone here is now participating in this process, including the Secretary who personally stayed until past midnight to assist.” (D)
“How is President Donald Trump dealing with that crisis? By tweeting, of course.
Trump unleashed a trio of tweets Thursday morning — all dealing with immigration.
“Congress must pass smart, fast and reasonable Immigration Laws now,” he tweeted. “Law Enforcement at the Border is doing a great job, but the laws they are forced to work with are insane. When people, with or without children, enter our Country, they must be told to leave without our Country being forced to endure a long and costly trial. Tell the people ‘OUT,’ and they must leave, just as they would if they were standing on your front lawn. Hiring thousands of ‘judges’ does not work and is not acceptable – only Country in the World that does this!”
For good measure, Trump added: “Congress – FIX OUR INSANE IMMIGRATION LAWS NOW!”
What you may have noticed in Trump’s tweets is that there is a) no mention of the children already separated from their parents due to the Trump administration’s “zero-tolerance” policy and b) no clear directive to Congress about any sort of comprehensive immigration reform proposal aside from “FIX OUR INSANE IMMIGRATION LAWS NOW,” which is, um, sort of non-specific…
By July 26, all children separated from their parents at the border have to be reunited.” (E)
“Felicia Baez teaches English as a second language at a shelter in South Florida where anywhere from 30 to 100 migrant children in federal custody live at one time. Most stay about two months, but some leave after only a few days.
“It’s always like the first day of school,” Ms. Baez said of the turnover at the shelter, His House Children’s Home, in the suburb of Miami Gardens. And the wide range of academic ability among her students — some haven’t been in a classroom in years, while others graduated from high school in their home countries — means she is constantly making adjustments.
These are just some of the challenges of educating the thousands of migrant children now housed in youth shelters and family detention centers across the country.
Federal law requires that all children on American soil receive a free public education, regardless of their immigration status. As the Trump administration expands the number of people detained at the border, shelters and detention facilities are ramping up their roles as makeshift schools, teaching English and civics classes, offering cooking lessons and setting up field trips to art museums.
But according to lawyers and educators with firsthand knowledge of the child detention system, the education offered inside the facilities is uneven and, for some children, starkly inadequate.
Teachers at the schools are sometimes not state-certified as teachers, according to these accounts. Some shelter instructors cannot communicate effectively in Spanish, and in other cases the curriculum is so limited and classes are so wide-ranging in age groups that students seem bored and disengaged.” (F)
(A) Lawsuit: Migrant child returned to parent with lice after 85 day separation, by Morgan Gstalter, http://thehill.com/latino/395752-lawsuit-trump-dhs-returned-lice-ridden-migrant-child-after-85-days
(B) Trump Administration Wants More Time to Reunite Families Separated at the Border, http://time.com/5332091/trump-reunify-families-extension/
(C) Trump admin lost track of parents of 38 young migrant children, by Julia Ainsley, https://www.nbcnews.com/politics/immigration/trump-admin-asks-more-time-reunite-kids-parents-separated-border-n889301
(D) The scramble to reunite immigrant kids with their families is a case study in poor project management, by Annalisa Merelli & Heather Timmons, https://qz.com/1322700/how-will-hhs-and-dhs-reunite-separated-immigrant-children-with-parents/
(E) Donald Trump has no answers for the border crisis. And things are about to get worse, by Chris Cillizza, https://www.cnn.com/2018/07/05/politics/immigration-separation-border-trump/index.html
(F) In a Migrant Shelter Classroom, ‘It’s Always Like the First Day of School’, by Dana Goldstein and Manny Fernandez, https://www.nytimes.com/2018/07/06/us/immigrants-shelters-schools-order.html
Nonetheless, that was the situation during a recent court hearing for a child represented by the Immigrant Defenders Law Center in Los Angeles…
Court hearings are beginning for the 2,000 or more children who have been separated from their parents under the federal policy of “zero tolerance” for illegal border crossings, the Tribune says. And those notices are highlighting the fact that unaccompanied minors don’t get court-appointed attorneys in immigration court—meaning that most of them won’t have any lawyer at all.
That situation is not new, as the Tribune notes. By federal law, nobody gets a public defender in immigration court, because being removable from the United States is not a crime. That’s true even if the immigrant is a young child, despite immigrant advocates’ efforts to change that. As a result, minors separated from their parents must either find a lawyer on their own or represent themselves.
That’s an extraordinarily difficult task, advocates for the children say. Typically, parents seeking asylum—as the vast majority of the people subject to the “zero tolerance” policy are—are tried with any children they entered with, and therefore can explain the circumstances that led them to flee their home countries. Those facts often concern physical and sexual violence, because the Central American countries from which the immigrants come are effectively controlled by criminal gangs.
As a result, Toczylowski says, the parents often have kept the facts from children too young to understand them. This puts the children “in a disadvantageous position to defend themselves,” she told the Texas Tribune.” (A)
“Unaccompanied immigrant children face many challenges navigating the immigration system alone, including:
No right to court-appointed counsel. Unless they can afford attorneys or secure pro bono counsel, they appear in court without legal representation.
A confusing and complex court system. Deportation proceedings against children often begin in the jurisdiction where the child is placed in the custody of the Department of Health and Human Services (HHS) Office of Refugee Resettlement (ORR). Once a child is released from an ORR shelter to a sponsor or to foster care, it is the child’s responsibility – regardless of age or legal representation – to submit paperwork to inform the court that he or she has moved and to file a formal motion to change venue if the new address is under the jurisdiction of a different court. If a child does not properly update his or her address, he or she could be ordered deported in absentia for failing to appear in court.” (B)
:As many as 3,000 migrant children remain in government custody after being separated from their parents at the border, more than a week after a court ordered the Trump administration to reunite families, Health and Human Services Secretary Alex Azar said Thursday.
The Trump administration is currently in the process of reuniting families, in part by using DNA tests to confirm whether they are related. But the government has yet to return children to their parents in immigration custody, Azar said. He said the administration will meet the order to reunite families.
That means the families split up under President Donald Trump are only being reunited if the parent agrees to deportation or if the child was released to another relative in the U.S.
The Trump administration began a zero tolerance policy earlier this year to prosecute as many illegal border crossings as possible. That has included detaining parents separately from their children while they undergo brief criminal proceedings.
About 100 children under the age of 5 have been identified as potentially separated from parents, out of a total of as many as 3,000 kids, Azar said.
Azar said the administration will use “every minute of every day” to confirm the parentage of children and to make sure they have a suitable caretaker. He said the court order limits the government’s ability to do its typical screening process.” (C)
“Health and Human Services Secretary Alex Azar said Thursday that officials are racing against a federal judge’s “extreme” deadlines to reunite “under 3,000” migrant children separated from their parents at the U.S. border.
Azar did not provide a precise number of children who have been separated from their parents under the Trump administration, but he said hundreds of government employees are working to verify that information, including through DNA testing. The children are being held in shelters overseen by HHS. Their parents are in federal immigration jails.
Azar signaled that, once reunited, the families will likely remain together in the Department of Homeland Security’s custody to await asylum interviews or deportation hearings.” (D)
“Immigration advocates on Thursday criticized the Trump administration’s plan to conduct genetic testing on migrant children and parents separated as a result of its “zero tolerance” policy, saying the move is invasive and raises concerns over what the government might do with the biological data.
The federal government will be conducting the DNA tests — via a cheek swab — for every detained migrant child and then seeing if the DNA matches that of their purported parents, Cmdr. Jonathan White, assistant secretary for preparedness and response at the Department of Health and Human Services (HHS), said Thursday morning.
The move to collect DNA also raises serious concerns about consent for the children involved, said Jennifer Falcon, communications director for the immigrants rights group RAICES. “They’re essentially solving one civil rights issue with another — it’s a gross violation of human rights,” she said. “These are minors with no legal guardian to be able to advice on their legal right, not to mention they’re so young how can they consent to their personal information being used in this way?” “…
“To apply it categorically to an entire population of people who have been separated by the government — that is a new addition to what the Trump administration is doing to immigration law enforcement,” (E)
(A) Immigrant children begin appearing in court without lawyers or parents, by Lorelei Laird, https://edwardkundahlsite.wordpress.com/2018/07/02/immigrant-children-begin-appearing-in-court-without-lawyers-or-parents/
(B) Unaccompanied Immigrant Children, http://www.immigrantjustice.org/issues/unaccompanied-immigrant-children
(C) (C)As Many As 3,000 Migrant Kids Haven’t Been Reunited With Parents, Elise Foley, https://www.msn.com/en-us/news/politics/as-many-as-3000-migrant-kids-havent-been-reunited-with-parents/ar-AAzDgYJ
(D) HHS Secretary says Trump administration rushing to reunite separated migrant families, by Maria Sacchetti, https://www.sfgate.com/news/article/HHS-secretary-says-Trump-administration-rushing-13051774.php
(E) DNA tests for separated families slammed by immigration advocates, by Daniella Silva, https://www.msn.com/en-us/news/us/dna-tests-for-separated-families-slammed-by-immigration-advocates/ar-AAzDCkx
Though the HHS and DHS have bungled the reunification effort beyond comprehension, the blame ultimately lies with the Trump White House. Officials were well aware that the “zero tolerance” policy would result in family separation, but no consideration was given as to how to reunite parents with their children. Federal agencies tasked with cleaning up the mess caused by the administration’s recklessness have been overwhelmed and underprepared. The system at the border wasn’t designed to hold unaccompanied toddlers in custody, and no apparatus was put in place for reuniting scared children with parents who may have been deported, may have been released into the United States or may still be in custody.” (A)
“The government’s top health official could barely conceal his discomfort.
As Health and Human Services secretary, Alex Azar was responsible for caring for migrant children taken from their parents at the border. Now a Democratic senator was asking him at a hearing whether his agency had a role in designing the Trump administration’s “zero tolerance” policy that caused these separations.
The answer was no.
“We deal with the children once they’re given to us,” responded Azar. “So we don’t — we are not the experts on immigration.”
Separating families while sidelining the agency responsible for caring for the children was only one example of a communication breakdown in the federal government that left immigrant children in limbo, parents in the dark about their whereabouts and enraged Americans across the country.
Today, the Trump administration is still dealing with the fallout: It’s still not clear how officials will implement the policy or comply with a court order requiring that families be reunited within 30 days.
Instead, the administration is hoping Congress will fix the mess, despite its recent failure to pass immigration legislation.
“We are happy to change the policy when Congress gives us the tools to do it. That’s what we’re asking for,” Marc Short, White House director of legislative affairs, said on MSNBC.” (B)
“Federal officials are struggling to reunite migrant children with their families despite a court deadline, and agencies do not have the resources or procedures to help thousands of children detained at the border back into the arms of their parents, according to a dozen current and former officials, advocates and experts.
With a July 10 deadline looming, staffers at the Office of Refugee Resettlement, the division within HHS that oversees the care of unaccompanied children, have received no instructions on how to proceed, the sources say.
“It’s been really difficult to start the reunification process because we just don’t have a lot of direction from leadership,” said one official at the refugee office, who spoke on the condition of anonymity. “That’s been slowing things up, because there’s just been a lot of confusion.”
U.S. District Court Judge Dana Sabraw ruled last week that the Trump administration had until July 10 to reunite migrant children under 5 with their parents, and until July 26 to reunite the rest. But the refugee office is still struggling to answer basic questions such as how many children in its custody were separated from their parents.” (C)
“One thing that has been the case for many, many years that is particularly problematic as it relates to reuniting families is that ICE tends to move people in its custody frequently. In the time that a parent is in ICE custody, he or she might be in four different facilities in very, very different parts of the country, moved with no warning, without having any sort of attorney that’s tracking their whereabouts. I am familiar with an attorney who was representing an ICE detainee who couldn’t locate their own client. This has been a common practice within ICE. I am trying to facilitate communication right now between a dad and his daughter. He has already been in a couple of different facilities and doesn’t have anyone that is representing him, and therefore his daughter, who is currently across the country from where he is located, hasn’t been able to get in touch with him. She has a caseworker through the Office of Refugee Resettlement who has called ICE multiples times, left ICE multiple messages, and nobody has called back.” (D)
“Relatives of migrant children who were separated from their parents at the US-Mexico border are being forced to cover huge airfare costs in order to be reunited…
But for a migrant child to leave one of these facilities, parents and other relatives are required to pay hundreds or even thousands of dollars to cover the one-way plane ticket and a return ticket for an adult escort, according to report from The New York Times.
Marlon Parada, a construction worker in California, was told by authorities his cousin’s 14 year-old-daughter, who was separated from her mother at the border, couldn’t travel by bus and instead he had to pay the $1,800 airfares from Houston to Los Angeles. “They notified me a day before her release,” Parada told The Times. “I had no choice.”..
But the recent separation of migrant families has meant parents are often still being held in detention. It is now falling to relatives, many who earn just a few hundred dollars a week, to use their savings or rely on donations to be able to have the children released into their custody…
Aside from airfares, The Times also reported that all family members who will live in the home of a migrant child are also being forced to provide fingerprints to Immigration and Customs Enforcement (ICE).” (E)
“After a court order to reunite more than 2,000 migrant children who were separated from their parents in May and June, the Trump administration has instructed immigration agents to give those parents two options: leave the country with your kids — or leave the country without them, according to a copy of a government form obtained by NBC News.
The new instructions to agents do not allow parents who were separated from their children under President Donald Trump’s “zero tolerance” policy to reunite with their children while they await a decision on asylum, a protection sought by thousands of migrant families fleeing violence in Central America.
Advocates say that even migrants who have already passed their initial asylum screenings are being presented with the form. “We are seeing cases where people who have passed credible fear interviews and have pending asylum claims are being given this form,” said Lee Gelernt, a lawyer with the American Civil Liberties Union who is leading a class action lawsuit for family reunification.” (F)
(A) Meanwhile, at the Border, Migrant Families Are Still Separated, by Ryan Bort, https://www.rollingstone.com/politics/politics-news/family-separation-stats-
(B)Trump administration agencies confused over border separations, by Jae C. Hong,https://www.nbcnews.com/health/health-news/trump-administration-agencies-confused-over-border-separations-n888276
(C) As deadline looms, Trump officials struggle to reunite migrant families, by TED HESSON and DAN DIAMOND, https://slate.com/news-and-politics/2018/07/child-separation-now-why-its-still-so-difficult-for-immigrant-families-to-be-reunited.html
(D) “This Entire System Is Designed to Make Things Impossible for Immigrants”, by ISAAC CHOTINER, https://slate.com/news-and-politics/2018/07/child-separation-now-why-its-still-so-difficult-for-immigrant-families-to-be-reunited.html
(E) Immigrant families are being forced to pay massive airfares to reunite with children separated by the Trump administration, by Tara Francis Chan,
https://www.msn.com/en-us/news/politics/immigrant-families-are-being-forced-to-pay-massive-airfares-to-reunite-with-children-separated-by-the-trump-administration/ar-AAzspJf
(F) New Trump admin order for separated parents: Leave U.S. with kids or without them, by Julia Ainsley and Jacob Soboroff, https://www.nbcnews.com/politics/immigration/new-trump-admin-order-separated-parents-leave-u-s-kids-n888631
From 1967 to 1970, during the Vietnam War, I served first as a 2nd Lieutenant and Chief Administrative Officer of the 4th Casualty Staging Flight attached to Wilford Hall USAF Medical Center, Lackland AFB in San Antonio, Texas. We received combat casualties still in battlefield bandages, often within 24 hours of injury, and either admitted them to Wilford Hall or further transported them to hospitals near home.
Here’s what hospital care looked like during the Revolutionary War period.
“When the Revolutionary War began its actual skirmishes in 1776, early attempts to prepare for the medical needs related to War were made in the City of New York. During the spring and summer of 1776, Samuel Loudon was publishing his newspaper the New York Packet, in which he included numerous articles and announcements regarding the Continental Army. On July 29, for example, came the following announcement written by Thomas Carnes, Stewart and Quartermaster to the General Hospital of King’s College, New York. Anticipating an increase demand for medically trained staff, he filed the following request for volunteers:
“GENERAL HOSPITAL New-York, July 29, 1776 Wanted immediately in the General Hospital, a number of women who can be recommended for their honesty, to act in the capacity of nurses: and a number of faithful men for the same purpose…King’s College, New York” (A)
“One of the most famous surgeons, and the first, was Cornelius Osborn. He was recruited in the Spring of 1776 and had little training even as a physician. The Continental Congress was even concerned about the well-being of the troops and the militia. They passed several ordinances and helped establish the order for the several field Hospitals during the War. The hospitals served about 20,000 men in the fight. Each hospital was required for each surgery to have at least one physician or surgeon, and one assistant, which was usually and apprentice of some sort. Each hospitals staff numbers varied on how many wounded it served and the severity of the wounds….
Most of the deaths in the Revolutionary War were from infection and illness rather than actual combat. The common practice if a limb was badly infected of fractured was amputate it. Where most amputees died of gangrene a result of not properly cleaning instruments after surgeries. Only 35% of amputees actually survived surgery. There was no pain killers quite developed back then. So at most the patient were given alcohol and a stick to bite down on while the surgeon worked. Two assistant would hold him down, a good surgeon could perform the entire process in a mere 45 seconds, after which the patient usually went into shock and fainted. This allowed the surgeon to stich up the wound, and prepare for the next amputation. Another way they decided to clean wounds, disease, or infection was by applying mercury directly to the cut of injured space, and letting it run through the blood stream which usually resulted in death.” (B)
“To seek treatment for any serious ailment, a soldier would have had to go to a hospital of sorts. Military regiments had a surgeon on staff to care for the men, so the soldier’s first stop would be with the surgeon. During battles, the surgeon could be found in a makeshift or “flying” hospital that consisted of a tent, an operating table, and some medical equipment. If the surgeon could not treat the soldier, he might be sent to a hospital. Many regimental hospitals were in nearby houses, while general hospitals for more in-depth treatment were sometimes set up in barns, churches, or other public buildings. The conditions were often cramped, which resulted in the rapid spread of contagious illnesses and infections….
Woe to the soldier who required surgery after being wounded on the battlefield! The conditions in “flying” hospitals were deplorable. Not only was the operating room simply a table in a tent, but there was little thought given to keeping the table and tools clean. In fact, wounds were sometimes cleaned using plain water from a bucket, and the used water would be saved to clean out the next soldier’s wounds as well. (C)
Hospitalization was a serious problem during the American Revolutionary War. Plans were made quite early to care for the wounded and sick, but at the best they were meager and inadequate. However on April 11, 1777 Dr. William Shippen Jr., of Philadelphia was chosen Director General of all the military hospitals for the army. Consequently the reorganization of hospital conditions took place.
Four hospital districts were created: Easter, Northern, Southern and Middle. The wage scale was as follows: Director General’s pay $6.00 a day and 9 rations; District Deputy Director $5.00 a day and 6 rations; Senior Surgeon $4.00 a day and 6 rations; Junior Surgeon $2.00 and 4 rations; Surgeon mate $1.00 and 2 rations.
After the battle of Brandywine, September 11, 1777, hospitals were established at Bethlehem, Allentown, Easton and Ephrata. After the battle of Germantown, October 4, 1777, emergency hospitals were organized at Evansburg, Trappe, Falkner Swamp and Skippack. Hospitals at Litiz and Reading were also continued. By December 1777, new hospitals were opened at Rheimstown, Warwick and Shaeferstown. Yellow Springs (now Chester Springs) an important hospital was organized under the direction of Dr. Samuel Kennedy. At Lionville, Uwchlan Quaker Meeting House was also made a hospital for a time. Apothecary General Craigie’s shop, Carlisle, was the source of hospital drugs….
It seems there was carelessness in making necessary health reports, consequently Washington ordered on January 2, 1778: “Every Monday morning regimental surgeons are to make returns to the Surgeon Gen’l. or in his absence to one of the senior surgeions, present in camp or otherwise under the immediate care of the regimental surgeons specifying the mens names Comps. Regts. and diseases.” [Weedon’s Valley Forge Orderly Book, p. 175]
January 13, 1778. “The Flying Hospitals are to be 15 feet wide and 25 feet long in the clear and the story at least 9 feet high to be covered with boards or shingles only without any dirt, windows made on each side and a chimney at one end. Two such hospitals are to be made for each brigade at or near the center and if the ground permits of it not more than 100 yards distance from the brigade.” [Weedon’s Valley Forge Orderly Book, p. 191] The Commander-in-Chief always solicitous about the comfort of his soldiers issued the following order January 15, 1778: “The Qr. Mr. Genl. is positively ordered to provide straw for the use of the troops and the surgeons to see that the sick when they are removed to huts assigned for the hospital are plentifully supplied with this article.” [Weedon’s Valley Forge Orderly Book, pp. 192-199-204-216] “ (D)
(A) https://brianaltonenmph.com/6-history-of-medicine-and-pharmacy/hudson-valley-medical-history/revolutionary-war-doctor/
(B) https://prezi.com/uwl_a877t2ia/hospitals-and-medicine-during-the-revolutionary-war/
(C) http://www.dosespot.com/medicine-in-the-revolutionary-war
(D) http://www.ushistory.org/valleyforge/served/surgeons.html
“Just seven weeks after an Ebola outbreak was discovered in the Democratic Republic of Congo, it’s already looking like the end is in sight.
According to the DRC’s health ministry, as of June 28, all people who were potentially exposed to the Ebola virus have finished a 21-day incubation period. It can take that long for a person exposed to Ebola to show symptoms of the disease. All those people remaining healthy means the epidemic is under control.
Oly Ilunga Kalenga, the DRC’s health minister, said in a statement, “This is an important milestone in the Ebola response, as it marks the start of the countdown towards the end of the ninth Ebola outbreak in the Democratic Republic of Congo.”
It’s also a testament to what can happen when national and international health officials work together to swiftly stop the virus from harming and killing people. We know how to stop outbreaks of Ebola, and we just proved it again in the DRC.
What this means is that with some effort and coordination, the world can rapidly stamp out an Ebola outbreak. What this doesn’t mean is that the world is ready for the next pandemic…
Still, it’s too early to declare total victory over Ebola or any other pandemic threat for several reasons…
This combination of experience with a known virus, a vaccine, and a relatively convenient geography won’t be there in every outbreak. That’s why it’s too early” (A)
“The DRC’s previous experiences with Ebola has also proved useful. The MSF rapidly employed 470 trained experts in the field, mainly locals – who all knew how to deal with an outbreak. Extensive surveillance, rapid detection and diagnosis are key, as well as comprehensive tracing of contacts, prompt patient isolation, supportive clinical care and rigorous efforts to prevent and control infection. And then there is the question of safely engaging local and remote communities with appropriate and dignified burial of the victims.
The response “has been swift and rigorous”, says professor Peter Piot, director of the London School of Hygiene and Tropical Medicine and part of the team that first discovered the virus. “The DRC has a strong record of containing Ebola outbreaks, and I am not surprised the Congolese are once again doing a good job,” he adds.
Crucially, in the DRC there has been no deadly delay in administering intravenous fluids. The DRC Ministry of Health, MSF and other NGOs quickly set up several Ebola treatment centres. There is a 12-bed unit in Mbandaka and a 20-bed centre in Bikoro, which also has a survivors’ clinic for post-Ebola complications and mental health issues. Further afield in Kinkole, the suburbs of the capital Kinshasa, there is a ten-bed unit that was completed with training of health care workers covering personal protection measures, treatment procedures and transport of patients. There is also a unit in Itipo.” (B)
“Ebola is endemic to Congo’s rain forests. Because of its prevalence in the country, Congo’s health officials have had more practice than anyone else in containing the virus, and they are generally reputed to be the most skilled at it in the world.
But Ebola is not a virus that one simply contains and forgets about.
“As Ebola is a virus whose natural reservoir is located in the Equatorial Forest, we must prepare ourselves for the 10th Ebola outbreak,” said Ilunga.
“Moreover, with the greater mobility of the population, we can expect to have other outbreaks in urban zones in the future. We must learn the lessons from this response and strengthen our system in order to detect and respond even more efficiently to the next outbreak.”” (C)
“On average, in one corner of the world or another, a new infectious disease has emerged every year for the past 30 years: mers, Nipah, Hendra, and many more. Researchers estimate that birds and mammals harbor anywhere from 631,000 to 827,000 unknown viruses that could potentially leap into humans. Valiant efforts are under way to identify them all, and scan for them in places like poultry farms and bushmeat markets, where animals and people are most likely to encounter each other. Still, we likely won’t ever be able to predict which will spill over next; even long-known viruses like Zika, which was discovered in 1947, can suddenly develop into unforeseen epidemics.” (D)
“The first confirmed human case of Keystone virus has been diagnosed in a Florida teen, but it’s likely that infection with the mosquito-borne disease is common among state residents, researchers report.
The virus can cause a rash and mild fever. It’s named after the location in the Tampa Bay area where it was first identified in 1964. It has been found in animals along U.S. coastal regions from Texas to the Chesapeake Bay.
University of Florida researchers describe the case of a teenage boy who went to an urgent care clinic in North Central Florida with a rash and fever in August 2016, during the Zika virus epidemic in Florida and the Caribbean.
Tests on the patient were negative for Zika or related viruses, but did reveal Keystone virus infection, according to the study published June 9 in the journal Clinical Infectious Diseases.
“Although the virus has never previously been found in humans, the infection may actually be fairly common in North Florida,” said corresponding author Dr. J. Glenn Morris. He is director of the university’s Emerging Pathogens Institute.
“It’s one of these instances where if you don’t know to look for something, you don’t find it,” he added in a university news release.”” (E)
“A bird flu that started in China five years ago has slowly started to spread. Some experts worry it could be this year’s “Disease X.”
New fears are starting to grow as there’s a strain of bird flu that’s killed over one-third of those it infects. Some experts warn that it has the potential to be the next pandemic.
As of June 15, 1,625 people in China have become infected with this virus and 623 are now dead — a total of 38 percent…
However, one good piece of news is that the virus doesn’t infect humans very easily. Most bird flu infections are transmitted between birds and only spread to humans who have close contact with the animals…
Although this virus was found in China, experts worry that in today’s globalized world it can have ramifications across continents.
This year, experts have already detected cases of global spread: Two cases of the virus were seen in Canada and one case in Malaysia. The CDC also reported that two cases of H7N9 were found on farms in Tennessee last year, despite having weaker features for human transmission.” (F)
“Reports are now emerging that these efforts succeeded and officials are cautiously optimistic that the outbreak is over. Health workers used a “ring vaccination” strategy in which all contacts of known patients were vaccinated to stop the spread. Surprisingly, the acceptance of the vaccine was very high with almost everyone offered the vaccine agreeing to be vaccinated. Furthermore, the supply of Merck’s vaccine is far from exhausted. The company has a stockpile of 300,000 emergency use doses.
J&J is still pushing forward with their vaccine efforts as well. While Merck’s vaccine is ideal for “ring vaccination”, J&J’s approach uses a two-part vaccine which could enable it to be longer lasting. Thus, these vaccines could complement each other. J&J has already tested its vaccine on 5,000 volunteers in 11 different trials and has confirmed both its safety and its ability to generate an immune response.
Here are two of the world’s largest pharmaceutical companies working on an Ebola vaccine – a vaccine that offers NO potential for financial return. These same R&D efforts could easily be used to find vaccines that are needed in the western world, vaccines that certainly would prove to be financially rewarding…” (G)
“The next global epidemic is likely around the corner—and no amount of U.S. retrenchment from globalization will halt that outbreak at the U.S. border…
Klain identified several large gaps in U.S. preparedness for the next global outbreak.
• A leadership gap. “There is no one at the White House right now who is in charge of this problem,” Klain said.
• A funding gap. “We’re underfunding, underinvesting” in preparedness, he said.
• A facilities and training gap. Klain said that there was exhaustive training of first responders carried out right after the Ebola outbreak in 2014. But there are other diseases for which they are still unprepared. “Training needs to be renewed. People need to be drilled,” he said. “Our first responders need to be trained. We need better and more facilities.”
• A science gap. “We haven’t yet developed all the vaccines and the therapeutics we need,” Klain added.
• A policy gap. “The holes in American law that we need to fill about licensing people in medical emergencies to practice in other states or,” he said, “using the Stafford Act”—the federal law that governs relief and emergency assistance for state and local governments during a natural disaster—“to respond to emergencies.”
But the biggest gap, he said, is the global gap: “We can’t be safe here in America when there’s a risk of pandemics around the world,” Klain said. “The world’s just too small. Diseases spread too quickly. … There is no wall we can build that is high enough to keep viruses and the disease threat out of the United States. We have to engage in the world.”” (H)
“Ebola is one of a series of previously unknown diseases – others include Sars and Zika – that have recently appeared without warning and devastated communities, having jumped from animal populations to humans. HIV spread to humans from chimpanzees, for example.
And in future new killers will emerge as humans spread into previously inaccessible areas and come into contact with infected creatures, causing deadly new pandemics.
Now a group of scientists believe they have solution. They have launched a remarkable new project which aims to spot the next pandemic virus. The international initiative is known as the Global Virome Project (GVP) and it aims to pinpoint the causes of fatal new diseases before they start to make people ill.
Advocates of the project say they will achieve this remarkable task by genetically characterising viruses found in wild animals – particularly those that have been major sources of viruses deadly to humans. By pinpointing viruses at greatest risk of infecting humans,, counter-measures, such as vaccines can be prepared.” (I)
“The big picture: The total number of outbreaks every 10 years “has more than tripled since the 1980s,” Yong says. Bill Gates told Yong that if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days.
“Boy, do we not have our act together.” — Bill Gates” (D)
(A) Good news: the Ebola outbreak in DRC is contained, by Julia Belluz, https://www.vox.com/2018/6/29/17518144/ebola-outbreak-drc-contained
(B) How science beat Ebola, by Alexander Kumar, http://www.wired.co.uk/article/ebola-vaccine-outbreak
(C) We Have Some Great News About The Ebola Outbreak in Congo, https://www.sciencealert.com/congo-ebola-outbreak-may-be-finally-contained
(D) The Next Plague Is Coming. Is America Ready?, by Ed Yong, https://www.theatlantic.com/magazine/archive/2018/07/when-the-next-plague-hits/561734/
(E) Florida teen first human case of another mosquito-borne virus, https://medicalxpress.com/news/2018-06-florida-teen-human-case-mosquito-borne.html
(F) This Strain of Bird Flu Kills One-Third of Patients, by Rajiv Bahl, https://www.healthline.com/health-news/this-strain-of-bird-flu-kills-one-third-of-patients#5
(G) Big Pharma Rises To The Ebola Challenge, by John LaMattina, https://www.forbes.com/
(H) How Will Trump Lead During the Next Global Pandemic?, Krishnadev Calamur, https://www.theatlantic.com/health/archive/2018/06/the-next-epidemic/563546/
(I) Scientists aim to stop the devastation of Zika-like pandemics, by Robin McKie, https://www.theguardian.com/science/2018/jun/24/global-pandemic-prevented-map-animal-virus-ebola-sars-zika
Congress goes on vacation again without addressing immigrant family separation
“The House rejected the GOP’s compromise immigration measure Wednesday following weeks of negotiations and a last-minute endorsement from President Donald Trump.
Lawmakers overwhelmingly rejected the bill in a 121-301 vote, falling short of the roughly 218 votes needed to pass. No Democrats voted in favor of the bill.
While 121 Republicans voted in favor of the bill, 112 Republicans voted against it even after the president called on them to support the measure this morning. A number of those who opposed the legislation are members of the conservative Freedom Caucus…
The compromise bill would have provided nearly $25 billion in funding for Trump’s border wall, limited legal and illegal immigration, provided protection from deportation and a path to citizenship for 1.8 million Dreamers, and keep undocumented families together who had crossed the border if the parents were facing prosecution.” (A)
“The government was separating migrant parents from their kids for months prior to the official introduction of zero tolerance, running what a U.S. official called a “pilot program” for widespread prosecutions in Texas, but apparently did not create a clear system for parents to track or reunite with their kids…
A DHS official told NBC News that the practice of dividing parents and kids predates the Trump presidency. “DHS has continued a long-standing policy by the previous administration,” said the official, listing risk to the child and criminal prosecution of the parent as among the reasons for separation…
The idea of separating migrant children from their mothers was discussed during the earliest days of the administration as a way to deter asylum-seekers, according to notes from an asylum officers’ meeting.” (B)
“… The past few weeks in the family separation crisis, which led on Tuesday to a District Court judge in California ordering the Trump administration to cease the practice and immediately reunite separated families, should mark a clarifying moment for the citizens of this country…
This is just an order, though. We have to see how the Trump administration responds to it. Given recent history—the government has been waging a bitter campaign to defend its child separation practice and avoid family reunification—it seems as though this president will try to get away with anything he can. Further, reunification may be nearly impossible in some cases—as the judge noted, there have been reports of parents being deported without their children, and the government has taken many infants who may not even be able to say their parents’ names.
In the midst of this crisis, the congressional majority has wholly abdicated its constitutional responsibility to conduct oversight of the Trump administration; its failure to hold emergency hearings is the point of abject disaster. That these crimes against humanity didn’t prompt Congress to act tells us nothing ever will. Only a dead heart is unstirred by the intentional infliction of suffering on children and babies as a weapon of deterrence.” (C)
“Congress members have left town for a week-long Fourth of July recess without taking action to stop the continuing crisis of family separations at the U.S.-Mexico border.
House and Senate leaders had expressed hope that Congress could act quickly this week to pass a narrow bill that would allow migrant children to remain with their parents at detention centers beyond the current 20-day limit. At least five bills have been offered so far, but lawmakers have been unable to unite around any one of them.
Both chambers adjourned Thursday without a solution. They will return on July 9.” (D)
(A) House overwhelmingly rejects compromise immigration bill despite Trump support, by Rebecca Shabad, https://www.nbcnews.com/politics/congress/reversing-course-last-minute-trump-calls-house-gop-pass-immigration-n886916
(B) Trump admin ran ‘pilot program’ for separating migrant families in 2017, by Lisa Riordan Seville and Hannah Rappleye, https://www.nbcnews.com/storyline/immigration-border-crisis/trump-admin-ran-pilot-program-separating-migrant-families-2017-n887616
(C) Will President Trump Ignore the Court Order Against His Lawless Family Separation Policy?, by WALTER M. SHAUB JR., https://slate.com/news-and-politics/2018/06/will-president-trump-ignore-the-court-order-against-his-family-separation-policy.html
(D) Congress leaves town without voting on fix to stop family separations at border, by Erin Kelly, https://www.usatoday.com/story/news/politics/2018/06/29/congress-leaves-town-without-voting-fix-stop-family-separations/745304002/
“Alex M. Azar II, the secretary of health and human services, told a Senate committee on Tuesday that his department had custody of 2,047 migrant children who had been separated from their parents.
Before releasing the children to parents or other relatives, he said, the government must “vet them.” That task can take weeks, officials said.
“These children are often being captured by traffickers, gangs, cartels,” Mr. Azar said. “That journey through Mexico is a horrific journey of rape and violence and deprivation. We do see traffickers and very evil people sometimes claiming to be the parents of children.”..
“We’re not allowed to have a child be with the parent who is in custody of the Department of Homeland Security for more than 20 days,” Mr. Azar said. “And so, until we can get Congress to change that law to — the forcible separation of the family units — we’ll hold them or place them with another family relative in the United States.”
“We need Congress to fix that,” Mr. Azar said.
Mr. White said the Department of Health and Human Services was also holding, in its shelters, about 9,000 children who did not have a legal immigration status and were not accompanied by parents or guardians.” (A)
“Dozens of law enforcement officials from both parties wrote an open letter to top lawmakers on Wednesday urging them to adopt alternatives to the Trump administration’s policy of detaining immigrant families…
The officials wrote that while they were encouraged by President Trump’s order ending the policy of separating immigrant families at the border, they “do not believe that across-the-board family detention is the solution to family separation.”
“Most families do not pose a threat to the community at large and, accordingly, our juvenile detention system is designed around keeping the family together,” the letter reads.
The letter noted “risks to children’s physical and emotional development posed by prolonged detention,” and stated that “most” families “pose no threat to their communities.”
The officials also highlighted a cancelled Obama-era pilot program meant to keep immigrant families together and out of detention as a possible solution. The Trump administration cancelled the program last year, citing high costs.” (B)
“The Department of Health and Human Services’ (HHS) inspector general is launching a review of the conditions at the agency’s shelters for unaccompanied migrant children.
The probe will only focus on safety and health concerns, the Office of Inspector General (OIG) said Wednesday.
“Specifically, this review will focus on a variety of safety- and health-related issues such as employee background screening, employees’ clinical skills and training, identification and response to incidents of harm, and facility security,” the OIG said.
The inspector general’s office said it will review the efforts of HHS’s Office of Refugee Resettlement (ORR) “to ensure the safety and health of children placed at ORR facilities, especially when the program experiences a sudden increase in the number of children placed in its care.”
The federal watchdog said it will deploy teams of evaluators, auditors, investigators and lawyers on site-visits to ORR facilities across the country.” (C)
“HHS Secretary Alex Azar on Tuesday defended the administration’s tracking system, claiming that parents should be able to locate their children “within seconds” using an online government database. He said hundreds of children separated at the border have been placed with a parent or relative, though more than 2,000 kids remain in his department’s care.
The agencies also face logistical challenges as they work to put families back together. Bob Carey, who ran ORR under President Barack Obama, told POLITICO’s “Pulse Check” podcast on Tuesday that “all the systems” in the refugee office were developed to reunite children with parents who were already in the United States.
That’s very different from trying to reunify a child with a parent who may be in a detention facility,” he said.” (D)
“IN THE FACE of the Trump administration’s neglect and indifference toward the reunification of the thousands of immigrant families it has forcibly separated, some lawmakers, activists, and celebrities have called for the use of DNA testing, along with other biometrics, as a means to return some 3,700 children to their parents. So far, at least two direct-to-consumer genealogy companies have heeded those calls. MyHeritage and 23andMe have both offered to donate DNA sampling kits for the purposes of verifying kinship…
The founder of Silicon Valley startup 23andMe, Anne Wojcicki, tweeted that the company had reached out to RAICES, a prominent Texas-based immigrant aid group, who has been working on family reunifications for over 30 years. RAICES, however, sees the well-intentioned offer as potentially creating more problems than it solves.
“We appreciate the offer, but that’s not a strategy that we really agree with,” Jennifer Falcon, communications director at RAICES, told The Intercept. “These are already vulnerable communities, and this would potentially put their information at risk with the very people detaining them. They’re looking to solve one violation of civil rights with something that could cause another violation of civil rights.” (E)
“Melania Trump boarded a plane in Washington, D.C, Thursday morning en route to Arizona where she met with Border Patrol officials and visited a Phoenix shelter for migrant children…
“I’m here to support you and give my help wherever I can,” Trump said.
After a round-table discussion, during which the first lady heard from officials who work along the border, the first lady was given a tour of the US Customs and Border Protection Facility in Tucson.
Similar to her visit to Tucson, the first lady took part in a round table where she heard from officials at the Phoenix facility.
“It’s great to be here,” Trump said to the group. “I wanted to come here and see your facility and meet the children. And wanted to thank all of you for what you do.”
Trump said she was there to “support” them, adding “let me know what I can do to help you.”
The first lady asked several questions regarding the children: how many were there in the facility, what are their ages and how long do they typically stay in the facility.” (F)
“The Trump administration has more than 2,000 children it separated from their parents in its custody. In a six-day span, that number only went down by six children.
It’s still unknown, though, whether those children were reunited with parents, other family or otherwise transferred out of Health and Human Services custody, and the government has not answered questions about the circumstances of their release.” (G)
(A) Trump Administration Cites Difficulties in Meeting Judge’s Timetable for Family Reunification, https://www.nytimes.com/2018/06/27/us/politics/trump-immigration-borders-family-separation.html
(B) Police chiefs group opposes Trump policy detaining immigrant families, by JACQUELINE THOMSEN, http://thehill.com/latino/394508-police-chiefs-come-out-against-trump-policy-detaining-immigrant-families
(C) HHS watchdog launches probe into conditions at child detention centers, http://thehill.com/homenews/administration/394507-hhs-ig-launches-investigation-into-conditions-at-child-detention?utm_source=Sailthru&utm_medium=email&utm_campaign=Issue:%202018-06-28%20Healthcare%20Dive%20%5Bissue:15973%5D&utm_term=Healthcare%20Dive,
(D) Federal officials launch two reviews into Trump’s handling of migrant children, by DAN DIAMOND, https://www.politico.com/story/2018/06/27/trump-border-migrant-children-investigation-680626
(E) DNA TESTING MIGHT HELP REUNITE FAMILIES SEPARATED BY TRUMP. BUT IT COULD CREATE A PRIVACY NIGHTMARE, by Ava Kofman, https://theintercept.com/2018/06/27/immigration-families-dna-testing/
(F) From Tucson to Phoenix: Melania Trump tours immigration facilities in Arizona, https://www.wusa9.com/article/news/from-tucson-to-phoenix-melania-trump-tours-immigration-facilities-in-arizona/75-568631380
(G) In 6 Days, Trump Admin Reunited Only 6 Immigrant Children With Their Families, http://ktla.com/2018/06/27/in-6-days-trump-admin-reunited-only-6-immigrant-children-with-their-families/
