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As Florence Makes Landfall, Poorest Once Again More Likely to Suffer Most From Storm's Destruction

Climate
ZACH GIBSON / AFP / Getty Images

By Jessica Corbett

As Hurricane Florence officially made landfall Friday, and forecasters warn of "life-threatening, catastrophic flash flooding," some attention has turned to residents across mandatory evacuation zones in the Carolinas and Virginia who chose to stay or were unable to leave, and how the poorest often pay the highest price when faced with a natural disaster.


Responding to a New York Times report in which an Edenton, North Carolina man who cares for his father—a cancer patient with whom he shares a double-wide trailer—explained that his family doesn't have the resources to leave, author and activist Naomi Klein tweeted Friday, "These disasters drag into the light exactly who is already being thrown away."

"Poverty lies in the path of Hurricane Florence in eastern N.C.," the Asheville Citizen Times declared Thursday. "Some people are getting out of town, but that's not an option for me. I have no money, no job, no connections," Tony Clower, a 39-year-old homeless man living in Kinston, told the newspaper. "I want to cry. All I can do is put my hands together and ask God to keep me safe."

A Vox article outlining common reasons people don't always abide by evacuations orders noted that "there are people who don't leave due to disabilities—they simply can't get out of their homes and don't have anyone to help them." Some don't want to leave behind their pets, and can't find a shelter or hotel that will allow animals.

Others may underestimate the threat or not receive timely storm updates—though Vox pointed out, "in an age when warnings can be blasted out via radio, TV and smartphones, and through old-fashioned door-to-door notifications, this is becoming less likely." And then there are those who fear their home will be looted, or those like Clower, who cannot afford to travel and stay somewhere safe.

Kathy Sexton, a 56-year-old resident of Myrtle Beach, South Carolina, spoke with the Washington Post about the various reasons she is trying to ride out the storm in her two-story townhouse:

[She] had thought about staying with relatives who live six hours away, but the long drive would be detrimental to her elderly mother, whose damaged spine keeps her from being able to sit for extended periods. She would've booked a hotel further inland, she said, but she couldn't afford the cost. She would've stayed at one of the emergency shelters, but pets aren't allowed there, she said. Sexton has two 15-year-old cats that both need medication, and she said there's no place to board them. Even if there was one, she doesn't trust anyone else to take care of them. "They're like family. There's just no way," she said.

Emergency rescues already have begun for those who wouldn't or couldn't evacuate, after coastal communities were struck by the outer bands of the storm on Thursday. In New Bern, North Carolina, as of 2:27am local time, about 150 residents were still waiting on assistance from FEMA crews, according to the city's Twitter account.

"People surrounding me are under water. They have been trapped in their attics," New Bern resident Tonya Moore told NBC News while awaiting rescue with her mother, husband, and five children. "Every road is flooded. There's nowhere to get out over here."

As Florence continued its crawl along the Southeast, FEMA on Friday cut off vouchers for 987 American families living in hotel rooms across the country after being displaced from their homes in Puerto Rico because of Hurricane Maria, which ravaged the U.S. territory last September. FEMA offered them one-way tickets back to the island—which is still struggling with widely ridiculed recovery efforts—but that offer also expires Friday.

Some of these families spoke with NBC News about their difficulties finding longer-term housing they can afford. Vimarie Cardona is a single mother of three who has lived in an Orlando hotel with her children since November. Now working as a housekeeper at Disney World, Cardona explained that landlords have refused to rent her one-bedroom apartments because of the size of her family, and two-bedroom options are outside of her price range.

"I started looking for apartments. Even before they said [the voucher payments] would end I started looking," she said Wednesday. "From day one it was hell."

Florence also comes just days after the conclusion of a multi-week nationwide prison strike to demand improved living conditions and an end to "modern day slavery" that was organized in response to an April riot at Lee Correctional Institution in South Carolina, where guards waited several hours intervene in violence that killed seven priosners and injured more than dozen.

As the hurricane approached this week, multiple other South Carolina detention facilities made headlines for refusing to evacuate inmates despite being located in a mandatory evacuation zones. Spokesmen insisted to VICE and BuzzFeed News that the facilities can safely withstand the storm.

However, as VICE outlined, there is a long history of inmates facing dangerous conditions after officials decline to evacuate due to a hurricane—or prisoners being abandoned altogether:

Inmates left behind at a federal prison near Houston following Hurricane Harvey in August 2017 reported food shortages, no drinking water, and sewage flooding. Many inmates weathered the storm still locked in their cells. And as Puerto Rico reeled in the devastated aftermath of Hurricane Maria, the U.S. Bureau of Prisons began evacuating inmates from its easternmost facility in Rio Grande due to sustained power outages. During the chaos of the relocation process after the hurricane, 13 inmates escaped.

City officials also reportedly abandoned inmates at the New Orleans Parish Prison during Hurricane Katrina in 2005. Human Rights Watch reported that correctional officers left more than 600 inmates in one building without supervision to weather the storm. Some inmates say they were left locked in their cells for days as flood water seeped into the jail, eventually reaching chest level, before they were evacuated.

Ahead of the storm on Wednesday, a group of prison reform activists gathered outside of the South Carolina statehouse to protest against the decision to keep inmates in facilities located within evacuation zones, pointing to post-Katrina conditions as well as prisoners who have died even when there isn't a hurricane forcing so many others to flee.

"In perfect conditions we see people dying," activist Stephanie Serna told The State, a local newspaper. "What makes us think that in an emergency situation they'll do better without any accountability?"

Reposted with permission from our media associate Common Dreams.

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By Sherry H-Y. Chou, Aarti Sarwal and Neha S. Dangayach

The patient in the case report (let's call him Tom) was 54 and in good health. For two days in May, he felt unwell and was too weak to get out of bed. When his family finally brought him to the hospital, doctors found that he had a fever and signs of a severe infection, or sepsis. He tested positive for SARS-CoV-2, the virus that causes COVID-19 infection. In addition to symptoms of COVID-19, he was also too weak to move his legs.

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We are neurologists specializing in intensive care and leading studies related to neurological complications from COVID-19. Given the occurrence of Guillain-Barre Syndrome in prior pandemics with other corona viruses like SARS and MERS, we are investigating a possible link between Guillain-Barre Syndrome and COVID-19 and tracking published reports to see if there is any link between Guillain-Barre Syndrome and COVID-19.

Some patients may not seek timely medical care for neurological symptoms like prolonged headache, vision loss and new muscle weakness due to fear of getting exposed to virus in the emergency setting. People need to know that medical facilities have taken full precautions to protect patients. Seeking timely medical evaluation for neurological symptoms can help treat many of these diseases.

What Is Guillain-Barre Syndrome?

Guillain-Barre syndrome occurs when the body's own immune system attacks and injures the nerves outside of the spinal cord or brain – the peripheral nervous system. Most commonly, the injury involves the protective sheath, or myelin, that wraps nerves and is essential to nerve function.

Without the myelin sheath, signals that go through a nerve are slowed or lost, which causes the nerve to malfunction.

To diagnose Guillain-Barre Syndrome, neurologists perform a detailed neurological exam. Due to the nerve injury, patients often may have loss of reflexes on examination. Doctors often need to perform a lumbar puncture, otherwise known as spinal tap, to sample spinal fluid and look for signs of inflammation and abnormal antibodies.

Studies have shown that giving patients an infusion of antibodies derived from donated blood or plasma exchange – a process that cleans patients' blood of harmful antibodies - can speed up recovery. A very small subset of patients may need these therapies long-term.

The majority of Guillain-Barre Syndrome patients improve within a few weeks and eventually can make a full recovery. However, some patients with Guillain-Barre Syndrome have lingering symptoms including weakness and abnormal sensations in arms and/or legs; rarely patients may be bedridden or disabled long-term.

Guillain-Barre Syndrome and Pandemics

As the COVID-19 pandemic sweeps across the globe, many neurologic specialists have been on the lookout for potentially serious nervous system complications such as Guillain-Barre Syndrome.

Though Guillain-Barre Syndrome is rare, it is well known to emerge following bacterial infections, such as Campylobacter jejuni, a common cause of food poisoning, and a multitude of viral infections including the flu virus, Zika virus and other coronaviruses.

Studies showed an increase in Guillain-Barre Syndrome cases following the 2009 H1N1 flu pandemic, suggesting a possible connection. The presumed cause for this link is that the body's own immune response to fight the infection turns on itself and attacks the peripheral nerves. This is called an "autoimmune" condition. When a pandemic affects as many people as our current COVID-19 crisis, even a rare complication can become a significant public health problem. That is especially true for one that causes neurological dysfunction where the recovery takes a long time and may be incomplete.

The first reports of Guillain-Barre Syndrome in COVID-19 pandemic originated from Italy, Spain and China, where the pandemic surged before the U.S. crisis.

Though there is clear clinical suspicion that COVID-19 can lead to Guillain-Barre Syndrome, many important questions remain. What are the chances that someone gets Guillain-Barre Syndrome during or following a COVID-19 infection? Does Guillain-Barre Syndrome happen more often in those who have been infected with COVID-19 compared to other types of infections, such as the flu?

The only way to get answers is through a prospective study where doctors perform systematic surveillance and collect data on a large group of patients. There are ongoing large research consortia hard at work to figure out answers to these questions.

Understanding the Association Between COVID-19 and Guillain-Barre Syndrome

While large research studies are underway, overall it appears that Guillain-Barre Syndrome is a rare but serious phenomenon possibly linked to COVID-19. Given that more than 10.7 million cases have been reported for COVID-19, there have been 10 reported cases of COVID-19 patients with Guillain-Barre Syndrome so far – only two reported cases in the U.S., five in Italy, two cases in Iran and one from Wuhan, China.

It is certainly possible that there are other cases that have not been reported. The Global Consortium Study of Neurological Dysfunctions in COVID-19 is actively underway to find out how often neurological problems like Guillain-Barre Syndrome is seen in hospitalized COVID-19 patients. Also, just because Guillain-Barre Syndrome occurs in a patient diagnosed with COVID-19, that does not imply that it was caused by the virus; this still may be a coincident occurrence. More research is needed to understand how the two events are related.

Due to the pandemic and infection-containment considerations, diagnostic tests, such as a nerve conduction study that used to be routine for patients with suspected Guillain-Barre Syndrome, are more difficult to do. In both U.S. cases, the initial diagnosis and treatment were all based on clinical examination by a neurological experts rather than any tests. Both patients survived but with significant residual weakness at the time these case reports came out, but that is not uncommon for Guillain-Barre Syndrome patients. The road to recovery may sometimes be long, but many patients can make a full recovery with time.

Though the reported cases of Guillain-Barre Syndrome so far all have severe symptoms, this is not uncommon in a pandemic situation where the less sick patients may stay home and not present for medical care for fear of being exposed to the virus. This, plus the limited COVID-19 testing capability across the U.S., may skew our current detection of Guillain-Barre Syndrome cases toward the sicker patients who have to go to a hospital. In general, the majority of Guillain-Barre Syndrome patients do recover, given enough time. We do not yet know whether this is true for COVID-19-related cases at this stage of the pandemic. We and colleagues around the world are working around the clock to find answers to these critical questions.

Sherry H-Y. Chou is an Associate Professor of Critical Care Medicine, Neurology, and Neurosurgery, University of Pittsburgh.

Aarti Sarwal is an Associate Professor, Neurology, Wake Forest University.

Neha S. Dangayach is an Assistant Professor of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai.

Disclosure statement: Sherry H-Y. Chou receives funding from The University of Pittsburgh Clinical Translational Science Institute (CTSI), the National Institute of Health, and the University of Pittsburgh School of Medicine Dean's Faculty Advancement Award. Sherry H-Y. Chou is a member of Board of Directors for the Neurocritical Care Society. Neha S. Dangayach receives funding from the Bee Foundation, the Friedman Brain Institute, the Neurocritical Care Society, InCHIP-UConn Center for mHealth and Social Media Seed Grant. She is faculty for emcrit.org and for AiSinai. Aarti Sarwal does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Reposted with permission from The Conversation.


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Democratic presidential hopefuls Joe Biden and Senator Bernie Sanders greet each other with a safe elbow bump before the start of the Democratic Party 2020 presidential debate in a CNN Washington Bureau studio in Washington, DC on March 15, 2020. Mandel Ngan / AFP / Getty Images

By Jake Johnson

Unity Task Forces formed by presumptive Democratic presidential nominee Joe Biden and Sen. Bernie Sanders unveiled sweeping party platform recommendations Wednesday that—while falling short of progressive ambitions in a number of areas, from climate to healthcare—were applauded as important steps toward a bold and just policy agenda that matches the severity of the moment.

"We've moved the needle a lot, especially on environmental justice and upping Biden's ambition," said Sunrise Movement co-founder and executive director Varshini Prakash, a member of the Biden-Sanders Climate Task Force. "But there's still more work to do to push Democrats to act at the scale of the climate crisis."

The climate panel—co-chaired by Rep. Alexandria Ocasio-Cortez (D-N.Y.) and former Secretary of State John Kerry—recommended that the Democratic Party commit to "eliminating carbon pollution from power plants by 2035," massively expanding investments in clean energy sources, and "achieving net-zero greenhouse gas emissions for all new buildings by 2030."

In a series of tweets Wednesday night, Ocasio-Cortez—the lead sponsor of the House Green New Deal resolution—noted that the Climate Task Force "shaved 15 years off Biden's previous target for 100% clean energy."

"Of course, like in any collaborative effort, there are areas of negotiation and compromise," said the New York Democrat. "But I do believe that the Climate Task Force effort meaningfully and substantively improved Biden's positions."

 

The 110 pages of policy recommendations from the six eight-person Unity Task Forces on education, the economy, criminal justice, immigration, climate change, and healthcare are aimed at shaping negotiations over the 2020 Democratic platform at the party's convention next month.

Sanders said that while the "end result isn't what I or my supporters would've written alone, the task forces have created a good policy blueprint that will move this country in a much-needed progressive direction and substantially improve the lives of working families throughout our country."

"I look forward to working with Vice President Biden to help him win this campaign," the Vermont senator added, "and to move this country forward toward economic, racial, social, and environmental justice."

Biden, for his part, applauded the task forces "for helping build a bold, transformative platform for our party and for our country."

"I am deeply grateful to Bernie Sanders for working with us to unite our party and deliver real, lasting change for generations to come," said the former vice president.

On the life-or-death matter of reforming America's dysfunctional private health insurance system—a subject on which Sanders and Biden clashed repeatedly throughout the Democratic primary process—the Unity Task Force affirmed healthcare as "a right" but did not embrace Medicare for All, the signature policy plank of the Vermont senator's presidential bid.

Instead, the panel recommended building on the Affordable Care Act by establishing a public option, investing in community health centers, and lowering prescription drug costs by allowing the federal government to negotiate prices. The task force also endorsed making all Covid-19 testing, treatments, and potential vaccines free and expanding Medicaid for the duration of the pandemic.

"It has always been a crisis that tens of millions of Americans have no or inadequate health insurance—but in a pandemic, it's potentially catastrophic for public health," the task force wrote.

Dr. Abdul El-Sayed, a former Michigan gubernatorial candidate and Sanders-appointed member of the Healthcare Task Force, said that despite major disagreements, the panel "came to recommendations that will yield one of the most progressive Democratic campaign platforms in history—though we have further yet to go."

 

Observers and advocacy groups also applauded the Unity Task Forces for recommending the creation of a postal banking system, endorsing a ban on for-profit charter schools, ending the use of private prisons, and imposing a 100-day moratorium on deportations "while conducting a full-scale study on current practices to develop recommendations for transforming enforcement policies and practices at ICE and CBP."

Marisa Franco, director of immigrant rights group Mijente, said in a statement that "going into these task force negotiations, we knew we were going to have to push Biden past his comfort zone, both to reconcile with past offenses and to carve a new path forward."

"That is exactly what we did, unapologetically," said Franco, a member of the Immigration Task Force. "For years, Mijente, along with the broader immigrant rights movement, has fought to reshape the narrative around immigration towards racial justice and to focus these very demands. We expect Biden and the Democratic Party to implement them in their entirety."

"There is no going back," Franco added. "Not an inch, not a step. We must only move forward from here."

Reposted with permission from Common Dreams.