PodcastsShelter At Home – Episode 054March 29, 2020Podcasts / Words of JenIn this episode, I share a piece of my writing in which I talk about what it has been like to shelter at home during the COVID-19 outbreak. None of the changes being made to stop the spread of the virus are intrinsically easy for people to cope with. In some ways, things are harder now than ever before for people like me who have terrible immune systems. In other ways, it turns out I was already very prepared for this. I read “Shelter At Home” on episode 054 of Words of Jen. If you enjoyed this episode please consider supporting me on PayPal.me. Thank you! https://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/woj054.mp3Podcast: Play in new window | DownloadSubscribe: Android | RSS... Jen’s Lore Corner: The Angiris Council – Episode 019January 31, 2020Jen's Lore Corner / PodcastsWelcome to Jen’s Lore Corner, a podcast about the lore of the Diablo video game series. This podcast started as a segment on the Shattered Soulstone podcast. I decided to re-release those segments in their own podcast. New content started with Episode 010. In this episode, I talk about the lore connected to the Angiris Council, which is the group that presides over the angels in the High Heavens. I wrote a detailed blog post about it called: Lore of the Angiris Council before I recorded this episode. Jen’s Lore Corner: By Three They Come – Episode 18 is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you! http://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/JLC019.mp3Podcast: Play in new window | DownloadSubscribe: Android | RSS... A Crow Story – Episode 053January 25, 2020Podcasts / Words of JenIn this episode, I share a short story that was based on actual events. Part of it was originally posted on Mastodon, and the rest was added after I started writing. I read “A Crow Story” on episode 053 of Words of Jen. If you enjoyed this episode please consider supporting me on PayPal.me. Thank you! http://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/woj053.mp3Podcast: Play in new window | DownloadSubscribe: Android | RSS... A Crow StoryJanuary 25, 2020Podcasts / Words of JenI started writing this story about crows on Mastodon. It is based on real life experiences that felt magical. The crows started visiting me in mid-September. Two crows came right up to my home to “bark” at me. Never seen anything like it before. I was at my computer, working on a piece of writing. The wall behind me has no window, and the window next to me is covered by blackout curtains. The two crows parked themselves at the corner of our mobile home and “barked” as loudly as they could. It sounded like they were pointing their voices at me, despite not having any way to actually see where I was. When I went to the window, the two crows moved from the corner of the mobile home and bounced into our driveway. It had been a long time since I’d been well enough to drive, yet another thing my chronic illness stole from me. We donated the car a while back, and the driveway had been empty ever since. One crow wandered off, but the other one stayed. Moved around in the alleyway, and kept coming back. Eventually, flew away, landed on a wire, and “barked” at me again. Was I supposed to follow them? I didn’t see any quest text… The whole thing seemed really strange, so I posted a little bit about it on social media. Surely, someone out there would tell me that this had happened to them, too… right? A friend asked, “Do you have ‘View low level quests’ enabled? You may have out-leveled the area already.” “That must be the problem!” I responded. I searched around, and finally found the button to view low level quests. Click! “I’ll be ready when the crows come back!” A stranger suggested that I should start feeding the crows. I’m in California, and I think we are not supposed to feed the wildlife. I’m also in a mobile home park where I don’t think feeding crows would go over very well. I feel like these two crows were either trying to warn me about something (no idea what) or have claimed me as one of their flock. I dunno. After thinking things over, I put a few handfuls of some really stale Cheerios outside on my driveway for the crows. I wonder if they will come back? The very next day, the crows came back. They ate some of the stale Cheerios I put in the driveway. When they were done, the “barky” crow cawed a “Thank You”. The two of them wandered around the alleyway for a bit, and then left. They seemed happy. Apparently, stale Cheerios are an acceptable tribute. What have I gotten involved in? Later that day, one of the crows returned. I could hear the crow making loud, but friendlier sounding, caw sounds. When I went to the window, I could not find the crow. It had to be nearby… but where? On instinct, I glanced up. There sat the crow, on my neighbor’s roof, “smiling” at me. My husband and I had a small flock of cockatiels. There were never more than six of them at any one time. Over the years, I learned to “speak bird”, for lack of a better way to say it. A bird that looks at you with one shining eye, while sitting all fluffy and relaxed – is smiling! I smiled back at the crow, who seemed very pleased with me. All the houses in the mobile home park are close together. I could see that this crow had one white feather near their shoulder. That made it really easy for me to spot this specific crow when they visited. Having done what they came to do, the crow with the white feather flew away. There was a large area of extremely tall trees across the road and beyond the car wash. For years, I’ve been unintentionally summoning spiders. I seem to have leveled up to crows. Or, one crow, anyway. About three days later, one of our cockatiels died. She was healthy, and eating, and interacting with our other birds. The change from healthy, to very clearly not, was shocking. She was right around the maximum age for a cockatiel lifespan, and sometimes birds just… stop. My husband and I took turns holding her as she slept on our chests, beneath our hands, warm and safe, and getting her head petted. And then, she was gone. In my grief, I remembered hearing some old story about crows acting as a portent of death. Were the crows trying to warn me about this? When I fed them, it was because the weather was starting to get cold, and I thought they were hungry. Now, I worried that by giving them something they considered valuable, I had unwittingly made some sort of bargain. What have I done? Time passed by, and my husband and I started feeding the crows. Not every day. We didn’t want them to become dependent upon us. Wild creatures need to be able to fend for themselves. I considered what we were giving them as “treats”. The two crows returned shortly after my husband put out the last of the stale Cheerios. They came right into the driveway and started loudly cawing. When I looked out the window, I saw one crow picking up Cheerios from the driveway, with the other one standing by and watching over the first. The second crow turned, looked right at me, and cawed again. It was as though they wanted me to know that they, and their companion crow, were enjoying the Cheerios. Crows are not picky eaters. There were times when they landed in the alleyway and strolled right over to another neighbor’s bird feeders. Often, I would look out the window and find some crows sitting on the wire, facing toward my home. Or, they would be on top of the telephone poles, scanning the horizon. Once, we gave the crows popcorn that I failed to finish eating the night before. The wind blew it all across the alleyway. Soon, there were several crows landing, and running after the popcorn. There was a small flock of maybe six or seven crows, who seemed to think chasing windblown popcorn was a wonderfully entertaining game! My husband threw a small handful of almonds into the driveway, on more than one occasion. We learned that crows love almonds! They clearly didn’t want to share the almonds with any other crows. A strange thing started happening. Two crows, the one with the white feather and their companion, started sitting on the stone fence at the front of the mobile home park. They stayed there for what seemed like a long time. I’d never seen crows do that before, especially in an area where lots of people come and go. I have chronic illnesses, and often am too sick to leave the house. My husband and I went outside one day, just for a short time, to play an app game that requires walking. We slowly walked up to the crows who were on the stone fence. They watched us pass by, very close to them, and did not move or fly away. On the way back, we could see the two crows were still there. I was having a hard time walking, and breathing, that day. Did the crows notice that I am sick? Is that even possible? There was a day when my husband I and walked to the nearest bus stop so I could go to a doctor’s appointment. One crow, up on a telephone pole, started cawing to the other crows in the area. Then, it started flying and following me to the bus stop. A second crow arrived, and they both sat on the wire directly above me. One of them had a white feather. These were my crows! Or, I was their person. They were watching over me. I remembered, many years ago, when I was in college, and had gotten lost on campus. I could not remember how to get to the building that my class was in. Panicking, I took a moment to close my eyes, to still my breath, and to focus. When I opened my eyes, a big, black, crow was staring down at me from the roof of one of the buildings. It flew down and found a closer perch. I remember looking into the crow’s eyes, and thinking, “I am lost.” The crow … did they just nod their head at me? I must have seen that wrong. The crow made one quick caw, and started flying, circling back to make sure I was following them. So, I followed. From the air, the crow led me down paths that I hadn’t walked before. Suddenly, the crow stopped flying. They perched themselves on a rooftop, right over the doorway of a building… that turned out to be the one my class was in. “Thank you,” I thought at the crow, as I passed beneath them and opened the heavy door to the old building my art class was in. No one asked why I was late. That crow couldn’t possibly be one of my crows. We met decades ago, and half a country away from where I was now standing. This pair of crows was new to me. There was a day when I discovered that I was allergic to the blackberries that I had been eating. We decided to give what was left to the crows. My husband scattered the blackberries outside, and I went to take some allergy medication. The pair of crows arrived. They looked extremely pleased with the food we offered them. Both crows were “smiling” at us, as they leisurely walked around, pickup up blackberries. We didn’t see the crows much after that. I thought that maybe the reason was that the weather had started getting a bit colder, and more windy. Once in a while, one of the crows would come sit somewhere outside and “bark”, and wait for me to find them. Later, my husband and I noticed that we were hearing what sounded like a crow that was screaming at the top of its lungs. This happened multiple times a day, for many days. We assumed that this was just an especially angry crow. I wondered why the crows were staying away. They seemed very pleased by the blackberries, and didn’t seem to need any more food from us right now. Maybe this behavior was seasonal. One day, I woke up to the sound of a screaming crow. It was loud enough to wake me up from a deep sleep – and I am a very sound sleeper. Not quite awake, I stumbled out of bed and found my husband standing in front of the open door of our home. Outside, there were some crows, standing at the corner of our mobile home, like they did the first time we met. Two were doing insistent “barking” noises. The other one just kept screaming. Upon spotting me, the two larger crows hopped over to the edge of our stairs. They looked up, giving us “smiling” eyes again. One of them had a white feather. The other crow gently nudged the screaming one, who got a bit quieter for a minute. They looked at me expectantly, patiently waiting for me to understand. Oh! Suddenly, I knew. The screaming crow was their baby, who was now just old enough to fly over here for a visit. They were introducing their offspring to my husband and I, their people. It was a beautiful moment that didn’t last long. Baby crow was making signs that indicated it wanted to be fed. Parent crows walked with the baby crow down the alleyway, and out of the mobile home park. The took flight from the sidewalk and returned to the grove of very tall trees. One day, a while later, I saw two crows chasing a hawk out of the mobile home park. They tag-teamed the hawk, tiring it out. The hawk eventually sat on the top of a telephone pole. The two crows took turns poking at the hawk until it decided to fly away. After removing the hawk, the two crows flew to back to the wires, perched, and looked over at me as I stood next to the window. I hadn’t been able to go outside for a long, long time. My crows were still watching over me. A Crow Story is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... Jen’s Lore Corner: By Three They Come – Episode 018December 4, 2019Jen's Lore Corner / PodcastsWelcome to Jen’s Lore Corner, a podcast about the lore of the Diablo video game series. This podcast started as a segment on the Shattered Soulstone podcast. I decided to re-release those segments in their own podcast. New content started with Episode 010. In this episode, I talk about the the lore that is connected to the Diablo IV video that was released during BlizzCon 2019. I wrote a lengthy blog post about it, called Diablo IV: By Three They Come, before I recorded this episode. Jen’s Lore Corner: By Three They Come – Episode 18 is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you! https://media.blubrry.com/bookofjen/p/content.blubrry.com/bookofjen/JLC018.mp3Podcast: Play in new window | DownloadSubscribe: Android | RSS... Diablo IIILore of the Creation of SanctuaryMarch 31, 2020Diablo III / Diablo LoreIt started with Inarius. According to the Book of Cain, Inarius was an advisor to the Angiris Counsel who served Tyrael, archangel of Justice. After fighting against the demons in countless battles, Inarius began seeing the Eternal Conflict as unjust. He decided to opt-out. It is easy to see why an angel who spent his time with Tyrael, in The Courts of Justice, would develop a keen sense of what is just and what is unjust. Inarius took what he learned a bit farther than the other angels would, and determined that a never-ending, unwinnable, war could not be considered just. The Testament of Inarius, Part I, (and all of the other parts) can be found in-game in Act V. It says: They call me a hero. I slew demons beyond count. I won battles and broke sieges, but it availed me nothing. I know that this war can have no victor, only an eternity of revenge, pride, and hatred. Tyrael does not understand. He cannot see beyond the glory of battle. In time, he may, but that day is not yet here. This observation made Inarius a renegade angel. His view of The Eternal Conflict no longer matched that of the other angels, and he dared to actively seek a change that would get him out of the endless war. The Testament of Inarius, Part 2, says: There must be others who seek a way out of the endless strife. Angels and demons who feel enslaved by our fate. I cannot be unique in all of creation. I know my path: I will find those disillusioned of the war and lead them. According to the Book of Cain, Inarius ended up either wounded, or marooned, on some broken part of the Pandemonium Fortress. What happened next is a little unclear. Deckard Cain presumed that Inarius intended to meet Lilith there. However, the journals that drop in Act V of Diablo III tell a different story. Inarius didn’t know it yet, but Lilith had her own reasons for wanted to opt-out of The Eternal Conflict. The writings of Lilith can also be found in Act V of Diablo III. Part 1 says: My father is content to fight the same battles and the same foes while everything turns to ashes. Though his victories might last a day, or a year, or a hundred years, the war will never be won so long as he and his brothers lead. There is an end to it, but fools like my father are too blind to see it. Lilith’s father is Mephisto, Lord of Hatred. The Book of Cain states that Lilith “suffered from the hatred of her father from time immemorial” and had long awaited an opportunity to rebel. It seems to me that it was only a matter of time before Lilith and Inarius found each other and realized that they shared the same goal. The Testament of Inarius, Part 3, explains what happened to him after he was injured and/or marooned. I was struck down in the third charge. I lay upon the ground only to wake in chains. I did not know that demons took prisoners. I babbled like a fool about my dreams of escaping this war. My captor freed me and said that we would meet again. Her name was Lilith, daughter of Mephisto. The Writings of Lilith, Part 2, tells her side of this part of their story: I took a prisoner in battle, an angel whose light was dimming. I brought him to my lair for my amusement. But he surprised me. My touch seemed to breathe life into him. He raved like a madman about how he wished to escape the war. Perhaps I have found someone I can use. From Inarius’s perspective, he and Lilith shared the same goal. They both wanted to get away from The Eternal Conflict. Inarius would not have been safe discussing that publicly with the other angels, most of whom would have vehemently disagreed with his plan. Just the act of talking about leaving The Eternal Conflict would cause disharmony among the angels. But here was Lilith, who seemed to understand him. Angels are born seeking harmony. Inarius found that with Lilith. That must have been comforting, considering that he had yet to find any angels who thought like he did. Demons, however, have no interest in harmony. They are much more inclined to cause chaos. Lilith viewed Inarius as “someone I can use.” She was tired of the Eternal Conflict, but her main goal was to rebel against her father. What better way to get a reaction from him than to side with an angel against the war that Mephisto enjoyed fighting in? Their story continues in The Testament of Inarius, Part 4: Lilith is me, but of fire and flame. I could never have felt this way about a demon while I was mired in the endless war. The strain hold us prisoner to what we have been told to believe. She and I have made plans. We will bring others to our cause, and together, we will escape. This is the point where Inarius realizes that not only must there be other angels – but also other demons – out there who wanted out of the Eternal Conflict. All they had to do was find them. Inarius would seek out the angels, and Lilith would gather up like-minded demons. And so, they did. The next step was finding some place where all of them could go. It had to be a place that neither the angels nor the demons knew about. Lilith had a plan. The Writings of Lilith, Part 3 explains it: The angel I captured, Inarius, is in love with me. I can feel the intensity of his desire. I told him that we must liberate the Worldstone, and then we can be together. We will create something never imagined by those mired in the Eternal Conflict. A new world. The success or failure of their plan depended entirely upon whether or not they could obtain the Worldstone. The Book of Tyrael explains that it was a highly sought after item by both The High Heavens and The Burning Hells. Each side wants complete control of the Worldstone because it the artifact would give them the to power to shape worlds in their own image. The ownership of the worldstone changed hands innumerable times over the eons of battle. Neither side is able to keep it for long. The Eternal Conflict often took place in Pandemonium Fortress, where the Worldstone was kept. The Book of Cain explains the Worldstone this way: The war was most commonly fought within the realm of Pandemonium. Accordng to one of the earliest necromancers, the angels and the demons battled over control of one essential object, the Heart of Creation – the Worldstone. The Worldstone is not, as the name implies, a mere stone. It is a colossal, mountain-sized object which was believed by many (and is supported by multiple petroglyphs and ancient sculptures) to be the actual Eye of Anu, the One. According to legend, to which I subscribe, the Worldstone is an artifact of unimaginable power. The Testament of Inarius, Part 5, gives a glimpse into how Inarius managed to steal the Worldstone: Those who follow us are strong in purpose and conviction, but we are only few. Yet, if we can obtain the power of the Worldstone, it will be enough. We will scale the Windshear slope, steal into the heart of the fortress, and be gone before anyone notices the stone’s disappearance. It isn’t wasn’t immediately clear to the angels and the demons exactly how Inarius managed to steal the Worldstone. The Book of Tyrael says: Inarius then altered the frequency of the Worldstone, thrusting the crystal into a parallel reality and shrouding it from the eyes of the Heavens and the Hells. There, the renegade angels and demons created Sanctuary, a wondrous paradise world where they could spend eternity in peace. It should be noted that at the time Inarius stole the Worldstone, none of the angels, or the demons, understood what Inarius was up to. For a while, all they knew was that the Worldstone was missing. Tyrael wrote about it long after everything got sorted out. According to the Book of Cain, the Eternal Conflict came to a “grinding halt” over the Worldstone’s disappearance. Deckard Cain, of course, wrote this long after the event happened. He found it funny. Deckard Cain wrote: For my own part, it is amusing to think of what it must be like for the forces of Heaven and Hell to fight their way to the Worldstone’s usual location, only to find it missing. I would speculate that for a time both groups must have accused the other of stealing it, until they were finally convinced that their opponents were just as confused as they were. The Testament of Inarius Part 6 explains what Inarius was thinking after stealing the Worldstone: Can I truly love a demon? When I gave the Worldstone to Lilith, I knew that I had been right to seek her all along. We have created a new world. We can live here in peace, away from war. I have named this world Sanctuary. The Writings of Lilith, Part 4, show that Lilith saw things differently than Inarius did: Inarius and I stole the Worldstone, and now we have a group of renegades to follow us. I have created a new world where we can live in peace. A place of infinite possibilities. Inarius believes that escape is enough. In time, I will show him that even victory is possible. But first, I will give him children. Inarius sees Sanctuary as the end-goal. Lilith sees it as a starting point. Inarius views what happened as: “We created a new world”. Lilith sees it as “I created a new world.” She sees the renegades as people whom she can rule over. Inarius probably viewed them as equals. Lilith knew that Inarius was in love with her. She never said that she was in love with Inarius. It was only a matter of time before their place of peace turned violent. But before that happened, Inarius created Mount Arreat around the Worldstone. It would serve as a protective shell for the powerful artifact. The rest of Sanctuary was formed after that. Lore of the Creation of Sanctuary is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... Season 19: Softcore Greater RiftsMarch 1, 2020Diablo III / Diablo VideosWith Season 19 coming to an end, I realized that I won’t have time to get my Hardcore Barbarian through much more of the Season Journey. My Softcore Barbarian seemed like a better choice, but I still didn’t have enough time to complete the entire Season Journey. I blame this on my allergies, which have been terrible since the end of January when Spring pollen season started. In this video, My Softcore Barbarian ran through a couple of Greater Rifts. She got a few Legendary Gems, which I started leveling up. My intention was to get back into the game and make at least one more video before Season 19 ended, but this turned out to be the last one. More to come when Season 20 starts! Season 19: Softcore Greater Rifts is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you! https://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/Season_19_Softcore_Greater_Rift_5.mp4Podcast: Play in new window | DownloadSubscribe: Android | RSS... Season 19: The Darkening of Tristram Through Level 8February 14, 2020Diablo III / Diablo VideosIn this video, my Hardcore Barbarian continued through a few more levels of The Labyrinth. This content is part of The Darkening of Tristram event, which is only available in January. My Barbarian started out at Level 57. My goal was to get him to Level 60. This video starts where the previous one left off – right in front of the entry to Labyrinth Level 7. I quickly learned that Ares the Hardcore Barbarian was not properly geared up for this, and probably should have hit at least Level 60 before attempting it. Some near death experiences were had. In this video, my Barbarian goes through The Halls of the Blind. It is my favorite part of The Darkening of Tristram event (and the original Diablo game). It starts with a creepy poem. By the end of this video, Ares the Barbarian was Level 58. Season 19: The Darkening of Tristram Through Level 8 is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you! https://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/Season_19_Darkening_of_Tristram_Level_8.mp4Podcast: Play in new window | DownloadSubscribe: Android | RSS... Season 19: Darkening of Tristram Through Level 6February 7, 2020Diablo III / Diablo VideosIn this video, my Hardcore Barbarian continued working his way through more levels of the Labyrinth. This content is part of The Darkening of Tristram event, which is only available in January. My Barbarian started out at Level 53, which is where he left off in the previous video. I was playing on Master difficulty. I started out on Level 4 of the Labyrinth. At the end of this video, Ares the Hardcore Barbarian was at Level 57. Season 19: Darkening of Tristram Through Level 6 is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you! https://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/Season_19_Darkening_of_Tristram_through_Level_6.mp4Podcast: Play in new window | DownloadSubscribe: Android | RSS... Season 19: The Darkening of Tristram Through Level 3February 3, 2020Diablo III / Diablo VideosIn between this video and the previous one, I made a video that didn’t work out because I screwed up the sound. It was entirely unusable, so I deleted it. In this video, I went through the beginning of The Darkening of Tristram content. It is only available in January. Ares, my Hardcore Barbarian started this video at Level 49. I was playing on Master difficulty. I explain where players need to go in order to get to The Darkening of Tristram content. At the start of this video, I said it was Season 17, but that was incorrect. It was Season 19. I think I must have recorded this one while I was tired. I mentioned the cow pet that is available during The Darkening of Tristram. My intent was to do a video that shows you how to obtain it. Instead, I made a blog post about the Royal Calf that tells you what you need to do to collect this pet. My Barbarian hit Level 53 somewhere on Level 3 of the Labyrinth. The next video will pick up where this one left off Season 19: The Darkening of Tristram Through Level 3 is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you! http://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/Season_19_Darkening_of_Tristram_through_Level_3.mp4Podcast: Play in new window | DownloadSubscribe: Android | RSS... Book ReviewsThe Sovereignties of Invention – by Matthew BattlesJanuary 26, 2020Book Reviews / fictionThe Sovereignties of Invention is a book of short stories – all of which are at least somewhat creepy. Matthew Battles does a good job of keeping readers in a state of curiosity and wonder, which sometimes leads to dread and horror. This may not be the book for everyone, but I really enjoyed it. If you like stories that include strange situations that leave the reader wondering what happens next, this is the book for you. My favorite story in this book is called “The Gnomon”. It takes place at a technology convention, where everyone is walking around wearing lanyards with little plastic pockets that serve as their admission passes. The Gnomon is a black box that has no discernible ports, no lights, and absolutely no one there to explain what it does. It becomes a topic of conversation as people try to figure out what it might be. Then, it starts following the people who are attending the conference on social media. There is a point where the story goes from an interesting puzzle to true horror. The reader is never given a specific explanation of what The Gnomon is, or why it suddenly reacts the way it did. The first story in the book is called “The Dogs in Trees.” It involves a situation where people are noticing that dogs have started appearing in trees. At first, it seems like a quirky story, but it slowly becomes very disconcerting. Only the dogs seem to know why they’ve taken to the trees. A story called “I After the Cloudy Doubly Beautifully” had me interested in it just from the title alone. A librarian was given the tax of clearing out the “X cage” – a repository of things that didn’t quite fit anywhere else. The librarian finds a mechanical translator machine, that involves ball bearings with letters on them that are spun around inside a glass dome. A ticker tape comes out with the words that it makes. The machine can translate back and forth into several languages. The librarian starts translating things from one language, to another, to yet another one. I found myself wondering what the final translation would sound like. But, something happens before the librarian is finished with the machine. There are other stories that I have not mentioned and will leave the reader to discover for themselves. The Sovereignties of Invention is filled with glimpses of strange and beautiful things that can also be creepy and unnerving. I found myself thinking about these stories long after I’d finished reading the book. The Sovereignties of Invention – by Matthew Battles is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... Restoration – by Olaf OlafssonJanuary 13, 2020Book Reviews / fictionThis is a heartbreaking story of love, and loss, and loneliness. It takes place in Italy, in the 1920’s. After the war begins, everything becomes more uncertain than it was before. It is the story of love gone wrong, due to misunderstandings. There are unanswered questions, dripping with regret and second guessing. All of this is set in a breathtakingly beautiful landscape, which provides a vivid contrast to the sadness that some of the characters are experiencing. Alice is a British ex-pat who is living in Florence, Italy with her family, surrounded by other families who are also British ex-pats. She comes from wealthy family, and is expected to marry an Englishman. Instead, she marries Marchese Claudio Orsini, a titled, Italian nobleman who was the son of a landowner. He is ten years older than Alice, which doesn’t bother her. Alice’s mother, however, is completely distraught that her daughter failed to marry an Englishman (like she was supposed to). The two newlyweds fled shortly after their wedding, in an effort to escape all the pointless social necessities. Most of Alice’s family were mean to Claudio, and this made it easier for her to leave her family and start a new life with him. Long story short, they buy a large farm in Tuscany. While they do have a few people who are helping them with the work, there is still much to do. Alice knows nothing about farming, and she has difficulty adjusting. Eventually, she decides she loves this life and never wants to leave. The couple have a son, who is delightful. He becomes sick, ends up in the hospital, and dies while there. His father, Claudio was there when he died. But, Alice was absent, because she left the hospital to visit her lover. This causes a huge rift between Claudio and Alice, one that is not repaired. He leaves one morning to tend to a family who lives on their land – and never returns. Alice is left mourning their son, while also wondering if Claudio would ever return. The sense of loneliness hangs thick and heavy in the air. Time goes on, and the war begins. It eventually enters Tuscany. Refugees are fleeing the countryside as the German army advances. Many end up at the farm, which by now, has a nurse and a make-shift hospital. There are homeless children who become part of a school/orphanage. Food is scarce, and times are very difficult. There is always the threat that the German army will one day come and take the farm. Some of the people Alice (and her workers) are protecting are those that the German army would happily kill. In the midst of all this, a woman arrives at the farm. Her leg is badly injured, and she does not give her name. The reader learns her story in pieces. She was once working for a painter, who became her lover. He refused to leave his wife. The woman has all kinds of doubts about whether she made the right choices, including one that was an indirect type of revenge. The story is heartbreaking, and beautiful, and desperately sad. I feel like most of the unanswered questions are resolved by the end of the book. It is the kind of story that gives the reader a rich, visual, environment to walk around in, filled with people who are longing for someone they cannot have.... The Sleepy Hollow Family Almanac – by Kris D’AgostinoDecember 10, 2019Book Reviews / fictionCalvin Moretti dropped out of college and has returned to his parent’s home. He has student loan debt that he must be find a way to pay off. So, he gets a job in something completely unrelated to what he went to college for. His father is sick, and has been laid-off from his lifelong career as an airline pilot. His mother tells Calvin that they are behind on the mortgage and could lose the house. The story is fiction, but feels like something that many families have lived through. The entire story is from the point of view of Calvin. The very first sentence is one that he was thinking, but didn’t actually say out loud. It is: “I work with retards”. Immediately, I decide that I don’t like him. My instant dislike of him probably comes from my background as a teacher and also as a day care worker. I’ve worked with kids who have special needs, and it bothers me immensely when someone refers to intellectually disabled people as “retards”. Calvin is basically a teacher’s aide, and should know better. But, he doesn’t. Calvin moved back into his old bedroom in his parent’s house, and realizes that he has pretty much reverted back to what he was like in high school. He’s listening to the same music, not helping much around the house, and getting wasted with old friends. Other than his job, he has no responsibilities to worry about. Calvin is stunted. I think this is something that can happen to people who return to their parent’s homes after finishing (or dropping out of) college. The situation puts them back into old roles with their parents, and in an unsettling emotional imbalance of power. For whatever reason, I decided to give Calvin a chance, hoping that he would grow up. There were some signs it could happen. For example, he had a notebook where he kept track of how much money he earned, and how much he sent to pay off part of his student loan. He appeared to be trying to be an adult. To be fair, there was a lot working against him. His father, who used to be an airline pilot, got sick and could no longer work. It was a job he loved, and, like many older men who lose their job, he kind of starts falling apart. The dad honestly believes that he is dying. He does have some kind of serious illness, but there is a medical intervention that might fix it. Or, it might not. To come home after dropping out of college, and see one’s father wearing a bathrobe and moping around, would be extremely stressful for most people. The dad starts hoarding things he thinks he will need if the world ends. He also starts carrying around a gun. Calvin’s mother tearfully lets Calvin know that they have fallen behind on the mortgage – far behind. His older brother, who was able to graduate and get a good paying job, has been helping with that as much as he could. I think this may have been the start of Calvin waking up from his regression into his teenage self and his thoughts about making better choices. Speaking of big life decisions, Calvin’s younger sister tells him that she is pregnant. She wants to keep the baby, but doesn’t want anything to do with the baby’s father. The sister is still in high school. By the end of the story, things are resolved in ways that are both a relief and also heartbreaking. Calvin is finally able to not only become an actual adult, but also to meaningfully help out his family. I’m glad I decided to read the book beyond the first sentence, because if I had not, I would have missed out on watching Calvin grow up. One of the most interesting things about this story, other than Calvin and his wandering thoughts, was the way the family interacted. This is not a dysfunctional family, but rather one that has experienced a series of unfortunate events. There is plenty of love, and that’s what helps them to stick together and work things out. The Sleepy Hollow Family Almanac – by Kris D’Agostino is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... Drinking Closer to Home – by Jessica Anya BlauNovember 22, 2019Book Reviews / fictionAnna, Portia, and Emery – three siblings who are now adults, have returned to their parent’s home. Their mother, Louise, is in the hospital after suffering what has been described as a “massive” heart attack. The siblings are there to be able to visit their mother at the hospital, and also to provide emotional support for their father. Drinking Closer to Home is about a quirky family, each with their own unique problems. It is about living through situations that I would consider to be neglect, and somehow, being able to come together as a family during difficult times. The title of the book comes from a family story that involved the sibling’s mother when she was a tiny baby. It is the punchline of what, to me, is obviously an instance of severe neglect. I think this small part of the book is what makes the rest of it comprehensible. The members of this family have learned to find humor in situations that were neglectful, dangerous, and emotionally scarring. It is their way of coping. For example, the year that Anna was eleven, Portia was eight, and Emery was three, Louise told the girls that she had decided to quit being a housewife. Anna would be in charge of cooking, and Portia would be in charge of taking care of Emery. No one cleaned the house, and the backyard (including the pool) fell into disrepair. This was not a temporary situation! The book jumps around between the present – with chapters titled “Day 2” that mark time passing while Louise is in the hospital, and the past, with years as chapter titles. My impression is the the majority of the book comes from the viewpoint of one of the siblings. Portia is very pregnant with her second child, and has just gone through a divorce. She is co-parenting her first child with her ex-husband, and missing her daughter. And now, she is also very worried about her mother. Anna is an addict, who has gotten things mostly under control. (She has started eating too much red vines candy while visiting with her mother at the hospital). There is a lot of trauma in her past, in part, due to her own unfortunate choices. Anna is married, but isn’t necessarily monogamous. Emery brought his boyfriend, Alejandro, with him to his parents house. The two are an established couple, and they want to have children. This puts Emery into an uncomfortable position. How does one ask their sisters for their eggs at a time when their mother might be dying? Then, there’s Louise, who has been smoking for decades. The doctors want her to quit, but she’s not interested. Of course, she can’t smoke while she’s at the hospital, especially while recovering from a heart attack and very weak. Louise has her own issues with her parents, and also with her husband, Buzzy’s, parents. Buzzy has his own secrets to deal with. One reason I like this book so much is because the characters are vibrant and resilient. They find a way to keep going, despite using less than advantageous coping mechanisms. Overall, family honestly is very important to all of them. They manage to come together when times are tough. Another reason is because some of it reminds me of my own dysfunctional family. My mother never officially declared she decided not to be a housewife anymore – but that’s what her actions amounted to. Some of my family members were/are hoarders, and the house was never clean. In my case, my family is very toxic, and I needed to separate myself from them. So, I guess what I’m trying to say is that Drinking Closer to Home provides me with an satisfying story that allows me to imagine what it would be like if my family was able to overcome their issues and become functional. Drinking Closer to Home – by Jessica Anya Blau is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... Stories for Nighttime and Some for the Day – By Ben LooryOctober 25, 2019Book Reviews / fictionStories for Nighttime And Some for The Day is, as you may have guessed, a book of short stories. One of them could probably fit into a single Tweet! Each short story feels like a parable or a fable. I got the feeling that there was a lesson in each one, if only I could puzzle out what it was trying to tell me. This imaginative collection of stories refuses to hand the reader an obvious answer about what it all means. One of my favorite short stories in the book is called “The Octopus”. It is about an octopus who lives in an apartment. His landlady brings up his mail. All of this is presented as though it is a perfectly normal occurrence. There is a letter from his two nephews, who live in the ocean. The nephews want to come visit, and upon arriving, want their uncle to take them around the city. He wasn’t expecting they would want to do that, and is largely disappointed by having to be a tour guide. When it is time for the nephews to return to the ocean, the octopus needs to make a decision. Should he go back to his apartment, or is it time for him to return to the ocean? My take on this story is that it is about that moment when you look back upon your life, and a big decision you once made… and decide to abandon it in favor of returning to the life you had before. Your understanding of the story may be entirely different from mine. That’s the beauty of the stories in this book! Another story that caught my attention is called “The Book”. A woman buys a book only to find that all of the pages are blank. The bookstore will not let her return it or exchange it. This makes the women irrationally angry at the book. She begins complaining about the book, and her complaints … go viral, so to speak. She unintentionally makes the book even more popular than it would have been had she decided to just forget about it. Years ago, I used to work in a big chain bookstore. Every so often, someone would come in to complain about a book that was currently rising in popularity (or was, at that moment, a best seller). Catholics came in to complain about The DaVinci Code (by Dan Brown) to insist that it was blasphemous and should be removed from the shelves. Confused people, who believed that if their children read the Harry Potter books they would actually learn magic, complained about those books being in the children’s section. The result was always the same. The complaints caused more people to become curious about whatever the controversial book was. In other words, I can relate to this particular short story from personal experience. Other stories in the book are not so dreamy. There are some rather terrifying stories that are creepy and confusing. I didn’t need to know what those stories were about to feel a visceral shiver as I read through them. I found the story about martians being treated as “the help”, and another story about an alien spaceship and two people who fell in love with each other, to be fascinating. Overall, reading these short stories reminded me of when I was a child and exploring the world inside of a new book with wonder and acceptance. Stories for Nighttime and Some for the Day – By Ben Loory is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... World of WarcraftWoW Classic: Flight PlansJanuary 27, 2020World of Warcraft / World of Warcraft ClassicVaca has acquired a weapon called Goblin Smasher, and is ready to put it to use! She was Level 12, and prepared to go finish some quests. These screenshots were taken on September 12, 2019. The day started with a flight over The Barrens. The goal for Vaca, and her friend Neverlast, was to turn in a quest at Thunder Bluff. Shortly after arriving, Vaca fell right off the ramp. She sat at the bottom, waiting for Neverlast to catch up with her. They turned in the Ride to Thunder Bluff quest to Ahana the Leather Armor Merchant. As you can see, Vaca and Neverlast had matching, fancy, purple cloaks. Ahanu: Ah, a new bundle of hides. I will get to work on these immediately! Thank you, sister. You have done me a great service. Here are some coins to pay for your time and travel costs. Ahanu quickly crafted some leather goods. He put them into a bag (one for each of us to carry) and sent us to to Tal the Wind Rider Master. Tal the Wind Rider Master: Greetings, warrior! What can I do for you? The answer to that question was obvious. Now leaving Thunder Bluff – destination Crossroads. Somewhere along the way, our Wind Riders synced up and became one. After landing on solid ground, Vaca and Neverlast spoke with Jahan Hawkwing at the Crossroads. He is the Leather & Mail Armor Merchant. We gave him Ahanu’s Leather Goods. Jahan Hawkwing: Vaca, you are back from Thunder Bluff? Did you deliver the hides to Ahanu? Eventually, the Tauren found their way to Ratchet. Neverlast and Vaca found the dock, and spoke with Wharfmaster Dizzywig. Wharfmaster Dizzywig: You seek passage on the next ship, or have some item you wish to send aboard it? I honestly cannot remember who we got this quest from, or where we obtained the Secure Crate that Wharfmaster Dizzywig wanted. It didn’t take long to walk from the dock to the Flight Master. Neverlast and Vaca discovered a new flight path! They immediately made use of it! It was easy to see why this place was called Thorn Hill. Neverlast and Vaca make a good team. But, sometimes Warriors get the idea that they can take on more than they actually are capable of fighting. Both of the Tauren ended up here. The Tauren needed to collect a few more body parts from plainstriders in order to finish a quest. Vaca was very close to hitting Level 13. Killing plainstriders for experience points will do! Vaca hit Level 13 after killing a plainstrider. Neverlast was already at Level 13, and had been for a little while. The Tauren spoke with Serga Darkthorn at the Crossroads. She was the one who sent Neverlast and Vaca out to obtain plainstrider parts. Serga Darkthorn: Have you collected the plainstrider beaks? The Tauren handed over the beaks, and completed the Plainstrider Menace quest. What was Serga Darkthorn doing with the plainstrider beaks? It was a mystery. Serga Darkthorn: How many zhevra have you slain? This was a quest that the Tauren hadn’t gotten around to working on yet. Serga Darkthorn wants Vaca and Neverlast to collect zhevra hooves. It wasn’t clear what Serga was going to do with those. The Tauren decided it was better not to ask her about it. Before leaving the Crossroads, Neverlast and Vaca stopped to talk with Thork. He was the one who gave them a quest called Disrupt the Attacks and sent them out to kill Razormane. Thork gave them a new quest called The Disruption Ends. Thork: One of my scouts witnessed an attack on a caravan from Durotar, Vaca. The culprits are indeed from the Razormane tribe of quilboars. One of the quilboars in particular is leading the raids: Kreenig Snarlsnout. He was seen northeast of here, just south of the road from Durotar. If the threat is to be ended, then Kreenig must die. To be sure the attacks cease, though, I say we add insult to injury. Kill Kreenig along with more of their tribe, and return to me when you have his tusk. Before slaughtering more Razormane, Neverlast and Vaca returned to Thunder Bluff. Hunter’s Rise had class trainers that could give them access to new and improved skills. The Hunter Trainer and the Warrior Trainer share this space. Vaca spent some time – and money – getting new skills and upgrading some of the skills she already had. She would have to return here again after leveling up some more and unlocking new skills. This seemed like a good place to stop and take a rest. Much progress was made, and Neverlast and Vaca needed to gather energy to fight the Razormane when next they set out. WoW Classic: Flight Plans is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... Meipo the MageNovember 20, 2019Adventures of Meipo / World of WarcraftMeipo is my brand new little Mage in World of Warcraft. This is my favorite screenshot of her. In this blog, I have some highlights as I leveled her up. These screenshots were taken between November 5, 2018, and November 18, 2019. The reason I created Meipo the Mage was so that I could play World of Warcraft with a friend of mine. He and I both play Dungeons & Dragons together. He made a WoW character based on his D&D character a while ago. Originally, we were thinking that my Kobold, Meepo, should be a Goblin in WoW. But, that would mean we’d be in opposing factions, and unable to play together. So, the WoW version of my D&D character is a Gnome. I’m kind of bummed that it wasn’t possible to spell her name the same way. Who knew Meepo was such a popular name? I settled for an alternative spelling. Meipo’s hair is green because she is based on my green Kobold. We played together a little bit, and then both got busy. My first goal was to get Meipo to Level 50 – which is where my friend’s Gnome was at. 50 Quests Completed Level 10 Meipo became a Fire Mage. Her D&D counterpart, Meepo is a Sorcerer who used the Fire Bolt cantrip often. (She also used Lightning, but that doesn’t seem to be a Mage option in WoW). Meipo fought Mangeclaw. This is the end of a short quest chain, and it took me a few times before I was able to kill the polar bear. If I remember correctly, the reward is Mangy Gloves (which are white, like MangeClaw). Meipo got her first Cooking Award. Meipo earned the 25 Fish achievement while fishing in Ironforge. The requirements on this one are lax. It counts fish, and sickly fish, and whatever garbage your character accidentally fishes out of the water. Meipo used a Rat Catcher’s Flute on the rats in the Deeprun Tram. The Enthralled Deeprun Rats followed her to the quest giver. Her D&D counterpart would have cast Friends on them instead! I really like the fireball effects in World of Warcraft. Meipo earned the Explore Dun Morogh Achievement. Miepo earned the 5 Daily Quests Completed achievement. I was working on her Cooking and Fishing Skills because I figured it was an easy way to gain some XP (experience points). Here’s a scenic view in the Valley of Kings area in World of Warcraft. World of Warcraft celebrated its 14th Anniversary between November 16, and November 30, 2018. Players who logged in during that time got a special email. From: The WoW Dev TeamSubject: WoW’s 14th Anniversary!Wow. Yet another year has gone by for WoW!We wanted to thank you for continuing to play World of Warcraft with us. So here’s an Anniversary Gift to go with your adventures!The WoW Dev Team The letter included an Anniversary Gift Package. Inside was 200 Timewarped Badges, a Celebration Package item to increase experience and reputation gain by 14% for 1 hour, and a “Letter from the Timewalkers” which directed players to either Stormwind or Orgrimmar. It also includes a quest called The Historian. This required Miepo to go to Stormwind and find Historian Llore. He asks the player a lore question. The reward for getting it right is Overturned Corgi Goggles. It is a toy that you can find in your Toy Box. Anduin Wrynn, Corgi King of Stormwind! Corgis everywhere! The Overtuned Corgi Goggles are fun to play with. Meipo the Mage experienced her first Winter Veil. She is too low level to do most of the holiday quests. But, she did get to open some presents. He Knows If You’ve Been Naughty: Open one of the presents underneath the Winter Veil tree once they are available. At Least You’re Being Careful: Proud owner of the 2018 Vintage Winter Veil gift, the Toy Armor Set. 100 Quests Completed Achievement Progress: The Road to Thelsamar This is what Meipo was wearing when she was Level 19. The Old Gnome and the Sea: Successfully fish from a school. 50 Fish: Fish up 50 items. Meipo reached Level 20! Giddy Up!: Learn the Apprentice Riding Skill The Gnome racial mounts are fun, and bouncy, and hard to take seriously. I didn’t have to buy one for Meipo because I already had one. (My Gnome Death Knight bought it a long time ago.) It didn’t take long for me to switch over to a faster mount. I think it got updated since the last time I used it. Or, maybe I just forgot. The spots look cool, and it feels like Miepo is riding a dinosaur. Miepo was killing creatures for a quest when Lord Condar attacked. She managed to kill it before it could kill her. It didn’t drop anything special. Miepo bought a Common Grey Shirt at Ironband’s Excavation. She got a few more transmog items from finishing a quest there. Wise Man’s Belt Whispering Vest Meipo is wearing the Solstice Robe. It might be the most colorful thing she has found to wear (so far). It is also a transmog item. Solstice Robe The Seer’s Fine Stein dropped from a fox in Loch Modon. Meipo got attacked by Ashtail, a fox-like creature that had the ability to disappear into a puff of smoke. Ashtail dropped the Simple Robe of the Aurora. It is a transmog item. Fashionista: Chest: Collect 100 chest slot appearances. Meipo did not collect all of those herself. The achievement is one that takes into account all of the transmog items that your characters pick up. Meipo is wearing the Simple Robe of the Aurora. Achievement Progress: The Axis of Awful Achievement Progress: The Farstrider Lodge Miepo earned the Explore Loch Modan achievement while riding along on a Skystrider mount piloted by a Gnome named Ando. The way to finish the Twilight Threats Achievement, and complete the Loch Modan Quests Achievement, is to turn in a quest at Algaz Station. Meipo got a Bright Belt from a Leech Stalker. The Bright Belt is a transmog item. There is a quest that leads the player into Thelgen Rock to pick up an item. Doing so causes Torrention to appear. It is a huge water elemental type creature. The player doesn’t have to kill Torrention. It just stands there until the player attacks it. Kill Torrention, and it drops a Floodsurge Core – which begins a quest. Turn in the quest, and you get a Floodsurge Coat. Achievement Progress: Slabchisel Survey Miepo got Marblebeard’s Shrug – her very first shoulders! She was Level 25. Marblebeard’s Shrug is a transmog item. Miepo got the Wand of Infectious Dementia from Captain Stoutfist in Menethil Harbor. At Level 26, Meipo learned a fire shield skill. Meipo got the Cursed Eye of Paleth by completing quests involving the ghosts of soldiers and marines. It is a transmog item. Achievement Progress: The Flooding of Menethil Meipo got Steelbrow’s Old Robe. It goes nicely with her hair and eyes. So do the Merchant Marine Sandals she got from somewhere. Steelbrow’s Old Robe is a transmog item. The Merchant Marine Sandals are also a transmog item. A Simple Re-Quest: Complete a daily quest every day for five consecutive days. Lunch Lady: Learn 25 cooking recipes. I went back to Thelsalmar and finished the Explorer’s League quest. It is the one where you pick up a book and run around looking for scrolls. Torren Squarejaw: You located all of our documents! We can’t thank you enough for the help…we’d all but given up hope. It seemed sure that the Dark Irons would be able to act upon all of this information soon. It’s good to know that they’ll left blind in their attacks for quite a while yet. To thank you for all of your efforts on our behalf, we would like to offer you a gift. An artifact really… something we recovered from one of our digs. You have the appreciation of all of the Explorers’ League. The gift is a Star Shooter wand. It leaves a trail of glowing stars behind Meipo when she runs! The Star Shooter is a transmog item. Meipo fought Horrorjaw Achievement Progress: Engineers and Archaeologists A Dragonmaw Whelpstealer dropped a Demon Band ring for Meipo. The Floodlily Robes come from Ferilon Leafborn as a reward for completing a quest. It is a transmog item. Rethiel the Greenwarden is huge! If you look closely, you can see Miepo the Gnome by one of his feet. Relthiel the Greenwarden can be found in Greenwarden’s Grove. Level 30! It has been a long time since I took a low-level character across the Thandol Span for the first time. When I did it before, I was in a party with my husband. He went over the Span without me, because I was doing a pet battle. Neither one of us knew that entering the Thandol Span would start an event. I didn’t mind missing it at the time. It was nice to see this event from the start this time around. Thargas Anvilmar: Balgaras?! And the others… you were all dead! What foul trick is this? Calamoth Ashbeard: Your petty triumphs have been futile. The power of the Twilight’s Hammer is absolute! Calamoth Ashbeard: Rejoice, for you shall be the first to die. We will sweep across Khaz Modan and burn all to ash. Thargas Anvilmar: I don’t care how many times I have to kill you… I’ll take you all on to save this land! Shilah Slabchisel: Aye, and so will we! Calamoth Ashbeard: What luck! The offerings throw themselves upon the altar! Calamoth Ashbeard: ATTACK! LET NONE SURVIVE! Thargas Anvilmar, Shilah Slabchisel, Forba Slabchisel, and Captain Stoutfist: FOR KHAZ MODAN! The bad guys explode, and the battle ends. Achievement Progress: Wardens of the Wetlands Achievement Earned: Wetlands Quests The Khaz Modan mantle is a transmog item. Achievement Earned: Explore Wetlands Explore Wetlands: Explore Wetlands, revealing the covered areas of the world map. The quests involving Quae and Kinelory are fun. Read the quest text closely, and it is clear that they are a couple. Turn in the finished quest chain from Quae and Kinelory, and you get the Stormgarde Surcoat. It is a transmog item. Finish the quest where you kill Otto and Falconcrest – and bring back their heads – and you get the Demon-Trafficker’s Belt. It is a transmog item. I don’t remember which quest rewards the player with the Dustfall Bracers. It is a Transmog item. Meipo got the Scaled Cloak of the Fireflash from a spider. It is a transmog item. There is a quest in Faldir’s Cove that requires players to swim underwater and find Elven Gems. Players can use the Goggles of Gem Hunting to make the underwater gems glow. Achievement Progress: Faldir’s Cove The reward for completing the Faldir’s Cove quests is O’Breen’s Dress Robes. I went to Stormwind, temporarily abandoning the quest chain I had been working my way towards around Refuge Pointe. I thought the Noblegarden event was still going on, but it turned out it ended the day before. Meipo could use a bigger bag. The one I wanted to buy required a higher reputation with Stormwind than Meipo had. So, I started doing some Stormwind related quests. Meipo earned the Journeyman Cook Achievement after buying a bunch of recipes off of a vendor who was on the upper floor of an inn. Talk to Little Adeline in the Flower Shop in Stormwind. She will ask you if you like flowers. There is an option for players to click “Yes”. Little Adeline will drop flower petals on the player. Meipo collected Stormwind Balloons for a little Draenei girl who lost them. The tiny girl gets carried away by the balloons, and seems to be enjoying the journey. Meipo got some quests that required her to kill Kobolds (and take their candles while collecting gold dust). Somehow… that just seemed wrong. Kobold Candle – “You took it.” The Kobold Candle is a reward for completing the “I TAKE Candle!” quest. The quest giver is Jimb “Candles” McHannigan at Fulbrow’s Pumpkin Farm. It is the only reward offered to Mages. Other classes may get something else. Meipo went to The Darkmoon Faire for the very first time and got a fancy Darkmoon Top Hat. She got to ride a pony! Meipo also got to ride a Murloc on a Carousel. It matched the colors of her outfit and her hair. Going Down?: Fall 65 yards without dying. Meipo earned this Achievement at The Darkmoon Fair, after getting shot out of a rocket. She accidentally closed the parachute way too early and failed to land on the target. Meipo got the Well-Stitched Robe from Sara Timberlain. The Well-Stitched Robe is a transmog item. The Red Linen Sash, and the Red Linen Shirt also come from Sara Timberlain. Both are transmog items. The Elastic Wristguards come from Marshal McCree. It is a transmog item. Meipo earned the Fashionista: Talbard Achievement when she bought a Stormwind Talbard. The Stormwind Talbard is a transmog item. 250 Quests Completed: Complete 250 quests. Aw, Isn’t it Cute?: Obtain one of the Children’s Week reward pets through questing. Meipo earned Speedy. Meipo got the Simple Blouse of the Aurora from Fedfenel (after she killed him). It is a transmog item that apparently shows up as “Simple Blouse”. Explore Elwynn Forest: Explore Elwynn Forest, revealing the covered areas of the world map. Meipo fought Hogger. This wasn’t as exciting a battle as it was the first time I did this (on another, much older, character). A mini event happens right before the battle ends. In it, an NPC (non-player character) mentions taking Hogger to the Stormwind Stockades, and something about King Varian Wrynn. At the time Miepo went through this part of the game, King Anduin Wrynn was on the Stormwind Throne. I wish the mini event could have been updated to reflect current content. The Crime Scene Tape is a belt that comes from Lieutenant Horatio Laine. It is a transmog item. The Urchin’s Pants are a transmog item that come from Deputy Ranier. Farmer Saldean gives the player Harvester Boots… …and it shows up as Watched Watcher’s Slippers in Appearances. Meipo earned the Crime Scene Investigation Achievement. Meipo got the Sentinel Hill Surcoat from Marshal Gryan Stoutmantle. Meipo earned the Golden Sunshine Cloak after completing the Westfall Stew quest. Salma Saldean (at Saldean’s Farm) is the quest giver. Mages get this cloak as a reward. Other classes might get something else. The Mystic Riverpaw Wand comes from Captain Danuvin at Sentinel Hill. Legwork Trousers come from Marshal Gryan Stoutmantle at Sentinel Hill. The Torchlight Wand is one of the two rewards players can choose after completing The Coastal Menace quest. The quest giver is Captain Grayson, a pirate ghost who stands in front of the lighthouse. The Captain Sanders’ Hidden Treasure quest is optional. Players who finish it receive a Silver Bar, Captain Sanders’ Shirt, Captain Sanders’ Booty Bag, and Captain Sanders’ Sash. Captain Sanders’ Sash is a transmog item. Captain Sanders’ Shirt is also a transmog item. Meipo got the Curved Dagger from Mama Celeste at Fulbrow’s Pumpkin Farm. It is a transmog item. Meipo obtained the Sylverian Dreamer mount. She hasn’t learned the flying skill yet. That’s ok, because this beautiful dragon can run! Honorable Medallion: Enter a Battleground or Arena and Learn the spell Honorable Medallion. I honestly have no idea what triggered this Achievement. I don’t remember taking Meipo into a Battleground or Arena. She’s standing in Stormwind, and has never gone into the Stormwind Stockade. Flame Warden of Eastern Kingdoms: Honor the flames of Eastern Kingdoms. Meipo hit Level 39 shortly before earning this Achievement. I find that the holiday events are really good for leveling up characters. Meipo received a letter from The WoW Dev Team. It was about WoW’s 15th Anniversary! Every player who logged into WoW during the anniversary celebration got this letter on all of their characters. Wow, yet another year has gone by for WoW! We wanted to thank you for continuing to play World of Warcraft with us. So here’s an Anniversary Gift to go with your Adventures! We hope that you will join us for a very special celebration in the Caverns of Time! The WoW Dev Team The letter contained an Anniversary Gift. It included 25 Timewarped Badges, a Celebration Package that increases all Experience and Reputation gains by 15% until the celebration ends, and an Invitation from the Timewalkers, which begins a quest. Meipo was too low a level to start that quest. The Anniversary Gift included Lil Nefarian. The Anniversary Gift also included an item that was an incredibly appropriate one for Meipo (who is based on one of my Dungeons & Dragons characters). The Celebration Firework can only be used during the Anniversary Celebration. It can be used over and over again! Meipo found a shiny! The Evidence Collection Gloves are from Captain Alpert in Moonbrook. I’m not sure if they are a transmog item or not. I like to stop and take screenshots of the scenery in World of Warcraft whenever I find a nice view. Meipo hit Level 40 somewhere in Stromguarde Keep. I was unable to get a screenshot of it because it happened while she was in battle. Level 40: Reach Level 40. WoW’s 15th Anniversary: Logged in during WoW’s Anniversary. Meipo has become a terrifyingly effective Fire Mage! rThe purpose of going to Stomgarde Keep was to collect the Stromgarde Badges that were taken by enemies after they killed Alliance soldiers. The player must bring the badges to Captain Nials in Refuge Pointe. Captain Nials: Privates Horus, Tilling, Rockwell… Captain Nials: Tormil, Gamlor, Shefferd, Cowry… Captain Nials: So many lost. And so many more we must lose before this battle ends. Captain Nials: Thank you for these badges, Meipo. I will send news to the families of the deceased. Captain Nials gave Meipo the Slippers of Sorrowful Tidings. I don’t remember if they are a transmog item or if they are not. Time for a rest! A Witherbark Fisher dropped a Shimmering Stave of the Aurora. The Shimmering Stave is a transmog item. Part of a chain of quests that Meipo was working on involved killing Kobolds. It was a different group of Kobolds than the one she had to kill before. Again, this just felt wrong! Meipo was now strong enough to kill two raptors at the same time. One of the raptors dropped the Silver-Thread Amice shoulders. I have no idea how the raptor obtained this item, nor why it was carrying it around. The Silver-Thread Amice is a transmog item. Meipo hit Level 41 while fighting Cresting Exiles. Meipo found Boros, a giant bug that was a level higher than she was, and an Elite. It was somewhere in Dabyrie’s Farmstead. Meipo killed Boros! She didn’t have a quest for this, so there’s a chance she might have to return someday and kill him again. Meipo fought Kor’gresh Coldrage in Bolderfist Hall. She has a quest for that. Success! Next, Meipo fought Phalanax, a Level 42 elite. She did not have a quest for this one. She needed something to do while waiting for her hearthstone cooldown to finish so she could turn in a quest. Phalanax dropped the Elder’s Cloak of the Aurora. The Elder’s Cloak of the Aurora is pretty. The Horned Stilletto of the Aurora is a transmog item. Back to Stromgarde Keep to complete more quests! Miepo fought, and killed, Foulbelly. He dropped the Brigade Breastplate of the Quickblade, which is mail. Miepo cannot use it. Meipo also fought, and killed Or’Kalar. It was an interesting battle, because Or’Kalar’s Stomp causes knockback. I’m not sure what gender Or’Kalar identifys as, but they are wearing the skimpy type of chest armor that is typically assigned to female characters. Meipo hit Level 42 standing in front of Apprentice Kryten. He gives players a quest that requires them to obtain three objects that are inside the tower behind him. The quest must be turned in to Skuerto, who is in Refuge Point. It requires Trelane’s Phylactery, Trelane’s Orb, and Trelane’s Ember Agate. The reward is Trelane’s Leggings. Meipo was tasked with grabbing three of Trelane’s things. Those things seem really valuable, and were somewhat guarded by ogres. This brings up a question. How did Skuerto obtain Trelane’s Leggings? It seems like that item would have been in the tower with Trelane’s other possessions. Maybe some other adventurer brought Trelane’s Leggings to Skuerto, shortly before Meipo turned in the other items. Or, maybe Skuerto was ran out of bag space while in the tower, and decided to use his hearthstone to get back to Refuge Point. Achievement Progress: Refuge Pointe Miepo made friends with Trained Razorbeaks by feeding them. She got the Gryphon Down Scarf, which is a transmog item. Meipo hit Level 43 in Drywhisker Gorge. Geomancer Flintdagger is a Level 43 elite. He dropped the Twilight Robe, which is a transmog item. Meipo looks like a little kid who dressed herself for the first time. The best thing to do while flying is to take screenshots of the scenery. In this one, Meipo is flying over part of Arathi Highlands. Fast and Furious: Learn the Journeyman Riding Skill. Players must be at least Level 40 to purchase the Journeyman Riding Skill. Meipo was Level 43, and finally got around to buying it. 10 Cooking Awards Meipo made a fishing buddy! She was fishing in Stormwind, and this NPC (non-player character) walked over and started fishing next to her. Miepo needed to kill Fozuk to get the Rod of Order. This is one small part of a long quest chain. Fozuk drops the Rod of Order. It is a quest item. Players cannot equip it. Characters who have the mining profession can mine Fozuk. A Plains Creeper dropped the Dwarven Magestaff of the Fireflash. This is what the Dwarven Magestaff of the Fireflash looks like. The Dwarven Magestaff is a transmog item. The quest chain involves a fight with Thenan. Characters who have the mining skill can mine Thenan, too! Miepo released Princess Myzrael. The process was sparkly and shiny. Princess Myzrael is a Level 43 elite who is much bigger than either Fozuk or Thenan. Princess Myzrael drops the Eldritch Bracers. Players cannot mine her. That said, she does spawn a couple of large beings (that look similar to Fozuk and Thenan). You can mine them. Meipo hit Level 44 at the same time she completed this quest chain. The Eldritch Gloves are a transmog item. Arathi Highlands Quests: Complete the Arathi Highlands storylines listed below. Explore Arathi Highlands: Explore Arathi Highlands, revealing the covered areas of the world map. Miepo earned the 100 Fish Achievement in Hillsbrad Foothills. Hillsbrad Foothills is pretty! Meipo stands before Jintha’ Alor, ready to embark upon a bunch of quests that involve killiing the Trolls that dwell within it. Gan’dranda seemed very confident about fighting Miepo. He did not survive the battle. The reward for completing this quest is Theresa’s Bracers. I don’t know if this is a transmog item. Dron Blastbrew gives players a quest to go kill some peaceful, lovely, turtles. It makes me uncomfortable. The reward for this quest is Nat Pagle’s Extreme Angler, a fishing pole that Meipo is not yet big enough to use. The thing I found interesting about this item is that players no longer need to carry around a fishing pole in order to go fishing. There was a time when that was necessary – but not anymore! In addition, there used to be a series of quests that involved Nat Pagel. It’s been a while since I ran a character through them, and I’m assuming those quests are still in the game. Dron Blastbrew then gives players a quest to kill the Direglob and bring him back a sample of it. There is a lovely little quest that requires players to do nothing more than pick up bottles of alcohol that ended up along the shoreline. Meipo fought The Reak at Skulk Rock. He is a Level 46 elite. It is the only slime that is this color. The rest are green. The Reak drops the Lord’s Cape of the Fireflash. The Lord’s Cape of the Fireflash is a transmog item. Meipo hit Level 45 while fighting with a Green Sludge. The Direglob is huge and terrifying! This battle did not go well. The Direglob beat Miepo up, and then swallowed her. She ended up making the “corpse run”. I took this screenshot of The Hinterlands just because it was pretty. One more try! This time, I used a Rough Stone Statue, which was able to heal Meipo for a little while. The Direglob ate the statue, but that didn’t immediately stop the statue from healing her. Next, the Direglob ate Miepo (again). It is possible to fight The Direglob from inside it. Meipo nearly killed The Direglob, and would have succeeded, if it wasn’t for that pesky Green Sludge that joined the battle. It was time to go back to Jinta’Alor and finish up some of those quests. Maybe it would be easier to fight The Direglob after Meipo leveled up some more. Meipo hit Level 46 after turning in a quest to Fraggar Thundermantle. Fraggar Thundermantle gave Miepo the Necklace of Evil Faces. It is not a transmog item because it is jewelry. He also gave Meipo the Sandals of Tainted Blood as a reward for a different quest. A Vilebranch Wolf Pup dropped the Durable Bracers of the Fireflash. I don’t remember if it is a transmog item or not. There stands Miepo, getting ready to harass Ongo’longo. The goal is to make him angry enough to break his chains and run over some Trolls. His bright green color reminds me of The Hulk. Off he goes! The reward for completing this quest is the Blood Drinker Staff. It is a transmog item. Meipo hit Level 47 in Jintha’ Alor. Meipo fought Morta’gya the Keeper. She drops the Tablet of Shadra, which the player needs for a quest. The reward for completing this quest is the Leggings of Secret Rituals. It is a transmog item. Miepo completed the Jintha’ Alor quest chain. After leveling up a little more, Meipo returned to fight The Direglob again. As before, The Direglob swallowed her. Success! Meipo gave the Direglob Sample to Dron Blastbrew. He gave her the Wand of Oomph. Meipo has now completed the Stormfeather Outpost quests. The Wand of Oomph is a transmog item. The next quest chain comes from Gilda Cloudcaller at Quel’Danal Lodge. But first… Meipo went back to Stormwind to buy the Reagent Bank. One of the bags she carries is for mining supplies, only. She was also carring a bunch of gems, stuff for cooking, and cloth. The Reagent Bank opened up a ton of bag space for her. Miepo hit Level 48 while turning in a Fishing quest. Meipo killed a lot of big spiders, and found the Eye of Shadra at Agol’watha. The reward for this quest is the Shadraspawn Mantle. For whatever reason, it comes up as Surlis’ Mantle in the Appearances Tab. The Fang of Shadra is inside a little container and is easy to find. The next quest is to kill Qiaga the Keeper and collect the Shell of Shadra. The reward is the Gown of the Last Priestess. Meipo fought Qiagra the Keeper at the Alter of Zul, and got the Shade of Shadra. Gown of the Last Priestess is a transmog item. A lovely view of The Hinterlands. The next quest is to summon Shadra, a gigantic spider. The player needs to go to Shadra’ Alor and use the Idol of Shadra at the Southwestern, Nortwestern and Eastern Temples. Meipo earned the Explore The Hinterlands Achievement. Eastern Temple Northwestern Temple Southwestern Temple Shadra is a gigantic spider that crawls out of the lake. Miepo was able to stand back, throw lots of fire spells at Shadra, and kill her. This quest chain sends the player to Aerie Peak to speak with Gryphon Master Talonaxe. The reward for killing Shadra the Venom Queen is the Veil of Aerie Peak. Meipo got the Quel’Danil Lodge Achievement and the Hinterlands Quests Achivements at the same time by turning this quest. This is what the Veil of Aerie Peak looks like. The Veil of Aerie Peak shows up as the Darkcleric’s Veil in the Appearance Tab. I have no idea why that is. Meipo hit Level 49 while turning in a Cooking quest. Next, Meipo went to Western Plaguelands. She stopped there at some point, picked up a few quests, and didn’t bother to actually work on them. One of the quests required Meipo to collect Shaggy Black Bear flanks. The reward for this quest is Grant’s Signet. Next, Meipo started working on the Battle for Andorhal quests. Most of them come from (and are turned in to) Thassarian or Lurid. Meipo killed Dessicated Spearmen and Opengut Behemoths. She also fought Desiccated Magus enemies. The reward for turning in the War Machine’s quest is Dried-Up Bracers. The Dried-Up Bracers are a transmog item. Rattlegore is a Level 50 elite. Rattlegore died in an awkward position. Meipo fought Araj the Summoner from a distance. It worked really well! Breaking the Phylactery was a little tougher because the skeletons that Araj summoned wanted to come over and attack. Meipo hit Level 50! My goal with this blog post was to continue it until Meipo hit Level 50. It took a while to get her there, and the WoW 15th Anniversary experience buff helped speed that along. I’m not retiring this character, though! Upcoming blogs in the “Adventures of Meipo” series will appear when she levels up more. Meipo the Mage is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... WoW Classic: Odds and EndsNovember 2, 2019World of Warcraft / World of Warcraft ClassicVaca and Neverlast had picked up plenty of quests, and even started working on a few of them. The time had come to finish up as many as possible and turn them in. This involved a whole lot of running around, which can tire out any Tauren. We weren’t expecting the scenery to temporarily become just as discombobulated as we were feeling. My Tauren Warrior, Vaca, recently hit Level 10. She was ready to take her Beatstick and use it on whatever monsters the quest givers pointed her and her Druid friend Neverlast at. Vaca and Neverlast have gotten into a habit of picking up a whole lot of quests, and then slowly working through them. That’s not a bad thing. It happens a lot in games like Classic WoW. The first thing to do was talk to Pakwa the Bag Vendor in Thunder Bluff. Vaca had two empty slots that bags are supposed to go in. She could only afford two Small Brown Pouches. Bag space is super important in WoW Classic. Part of the reason is that there are so many quests that require players to keep items in their bags until they have the opportunity to turn in the quest. The other reason is because it is much harder to obtain bags in WoW Classic than it is in WoW Retail. The next thing to do was try and finish The Venture Co. quest that we got from Morin Cloudstalker. We needed to kill 14 Venture Co. Workers and 6 Venture Co. Supervisors. Picking off the Workers was pretty easy. Most of them were teeny tiny Goblins. Others were Ogres, but much smaller than the ones in Retail WoW. The Supervisors were trickier. They mostly stayed inside the little huts, doing nothing, until they got targeted by a player. The “big bad” of the group was an Ogre named Enforcer Emilgund. He was Level 11 and an Elite (with a fancy portrait frame). Vaca was still Level 10, and this fight was a bit difficult for her. Fortunately, Neverlast’s healing skill kept Vaca alive. I cannot remember if we got any good loot from killing Enforcer Emilgund. He wasn’t part of The Venture Co. quest, but he seemed important. At some point, we would turn in a quest that he was connected to and maybe get a nice reward from whomever the quest giver happened to be. We were somewhere around The Golden Plains, on the edge of the prairie, when the drugs began to take hold. There were times when the scenery simply refused to adhere to the laws of physics. Azeroth had turned into a surrealist painting. Eventually, it would catch up and fill itself in. I’ve no idea why this was happening, but figure it had something to do with playing WoW Classic on a Mac. A while ago, we picked up a quest called Dwarven Digging from Baine Bloodhoof. He wanted Vaca and Neverlast to collect 5 Prospector’s Picks from the Dwarven dig site. To do this, we had to kill many Dwarves. It moved pretty fast, and I failed to take screenshots of it. We did finish the quest, though. All we needed to do now was return to Baine Bloodhoof in Bloodhoof Village. Baine Bloodhoof: Hello, Vaca. Do you have the Broken Tools? The dwarves’ digging will enrage the kodos of Mulgore. This defilement must be stopped! Turning in the quest gave Vaca just enough experience points to hit Level 11. She was pretty close to leveling before turning in the quest. While they were still in Bloodhoof Village, Vaca and Neverlast spoke with Skorn Whitecloud. He’s the one that told them about Ghost Howl. They figured Skorn Whitecloud would want to know that Vaca and Neverlast had encountered, and killed, Ghost Howl. Perhaps it will make Skorn feel better that his nemesis is no longer out there, roaming around. Time to do some cooking! Warriors need food, especially after a difficult battle. But, the main reason I decided Vaca should pick up Cooking was because I find games with virtual food to be amusing. This is likely because I have a ton of food allergies. I’m very limited in terms of what I can safely eat in real life, but video game food is always safe! Next, we worked on a quest called Preparation for Ceremony. It requires players to obtain 6 Azure Feathers and 6 Bronze Feathers. These items can only come from certain kinds of Harpies. We quickly learned that Harpies are tough! They like to hang out around the big trees, spaced just enough apart from each other so that players end up fighting more than one at a time. Sister Hatelash is a Level 11 elite that decided to try and kill us. We did not need to kill her for the quest we were working on. But, she gave us no choice in the matter. Together, Vaca and Neverlast were successful. There were now more players in this area, working on the same quest that we were. We were all going to have to take turns and wait for the harpies to respawn. We handed the feathers we collected to Eyahn Eagletalon, in Thunder Bluff. He now had enough of them to make a headdress that his brother could use in a ceremony. Thunder Bluff seemed like a good place to stop for the night and rest, after all that running around. WoW Classic: Odds and Ends is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... WoW Classic: Ghost HowlOctober 26, 2019World of Warcraft / World of Warcraft ClassicVaca and Neverlast spent most of their time running back and forth from Thunder Bluff and collecting quests. Little did they know that they would soon be fighting Ghost Howl. The best way to hit Level 10 is when fighting two Flatland Cougars and a Swoop, while being healed by a Druid! Neverlast and Vaca turned in the Thunderhorn Totem quest to Mull Thunderhorn. It was impossible not to notice the Kodo skin that was attached to the building behind him. Mull Thunderhorn: Thank you, Vaca. The purity with which these beasts hunt is vital in the creation of the next cleansing totem. The goblins will never learn the difference between contending with the land and living in harmony with it. Mull Thunderhorn made a totem for us to use on the next water well. Mull Thunderhorn: The totem is ready, Vaca. And again, it is your task to perform the ritual of cleansing. Go to the Thunderhorn Water Well, north of the village, and use the Thunderhorn Cleansing Totem in your ritual. After you do this, return to me. May the spirits guide you. Skorn Whitecloud: Come closer, young one. In my time I could hear the flutter of a prey’s beating heart, but now you must speak up if you want your words heard. He has a quest called The Hunters Way, and a story. I wanna hear a story! Vaca: Tell me a story, Skorn. Skorn Whitecloud: I have run through these plains for many, many seasons. And I had never been bested… until I faced Ghost Howl. Long ago, the massive wolf was an ally to the Tauren and fought bravely against the Burning Legion. But he was wounded savagely by a demon, and the tear in his flesh never healed. Eventually … it drove Ghost Howl mad. Now he roams the plains in agony, seeking an end to his pain. To my shame, when we fought I lacked the strength to slay him… Skorn Whitecloud: You are eager to explore, I can tell. I too had the lust to wander, once… Wander, and hunt. For hunting is a Tauren’s greatest honor. If you truly wish to follow the ways of the hunter, then Melor Stonehoof can show you the path. He is in Thunder Bluff, on the Hunter’s Rise. And to show him your skill and resolve, bring him the claws of the flatland prowlers of Mulgore. They are tough and cunning — fitting prey for a young warrior on the hunter’s path. This quest requires the player to bring 4 Flatland Prowler Claws to Melor Stonehoof in Thunder Bluff. It sounds like The Hunter’s Way should be for those who are playing the Hunter Class. But, that’s not so. My Tauren is a Warrior, and my friend’s Tauren is a Druid – and we were both able to accept this quest. The Warrior Trainer at Bloodhoof Village is… all the way over there! I wanted to speak with Krang Stonehoof because I’d finally hit Level 10, and I figured he’d have some skills for me to buy (or level up). I cannot remember what he offered, in part, because I got distracted by the Veteran Uzzek quest. Krang Stonehoof: The Horde honors its warriors because their strength is unquestioned. But the truly great warriors are great students as well. Seek out Uzzek. He is a veteran of many battles and now instructs young warriors in the ways of combat. You will find him south of Far Watch Post, the orc garrison on the border of the Barrens and Duortar to the east. Vaca and Neverlast cleansed the Thunderhorn Well. If only it were this easy to clean up contaminated water in the real world! Arch Druid Hamuul Runetotem has a quest called The Barrens Oasis. Arch Druid Hamull Runetotem: The druids of Thunder Bluff sense a strange power leaking into the Barrens, east of Mulgore. Tonga Runetotem was sent to discover the source of this power, but we fear he will need aid. Travel to the Barrens and speak with Tonga. He will be at the Crossroads. To reach there, take the road east out of Bloodhoof Village. Enter the Barrens, then turn north when the road forks. Continue north and you will find the Crossroads. And do not leave the road, Vaca, for the Barrens is a harsh land. It is good to take the time to enjoy the beauty of Azeroth. Thunder Bluff is lovely, even from far away. Ruhauro, Magatha’s Servant, is located in Elder’s Rise in Thunder Bluff. He has two quests for us. Ruhauro: Beneath the city of Orgrimmar, stout creatures known as trogs started coming to the surface from deep below the lava filled tunnels. In her ever-benevolence, Magatha sought to make peace with the creatures, but they turned on her diplomats, killing them. She will not allow such treatment of the Tauren people and now consider the creatures a threat to all of the Horde. She asks that you put an end to this trogg threat before it overwhelms the Horde from below. Find Ragefire Chasm and destroy them all. This quest requires players to search Orgrimmar for Ragefire Chasm, then kill 8 Ragefire Troggs and 8 Ragefire Shaman before returning to Rahauro in Thunder Bluff. Next, Neverlast and Vaca returned to Bloodhoof Village to turn in the Thunderhorn Cleansing quest to Mull Thunderhorn. Mull Thunderhorn: Ancestors of the Thunderhorn clan spoke to me in a dream, praising you for your actions near their well. For their gratitude, they wish to give you this… The reward is the Thunderhorn Cloak. If I remember correctly, it was better than the one I was using. Mull Thunderhorn: There is but one water well left to cleanse, named after the Wildmane clan. For this well to be pure, the land must offer the teeth of a fierce predator, the prairie wolf alpha. Find the alphas to the north, then return to me when your hunt is finished. Alphas often wander around the base of our mighty city, Thunder Bluff. Just like that, we had to turn around and go right back to Thunder Bluff. This isn’t actually a complaint (though it may seem like one). Classic WoW involves a whole lot of running around – which players mostly do on foot. There are some flight points, but they are few and far between. It helps of you go into this game knowing how much running around you will need to do on foot. The time spent “hoofing it” goes much faster if you play with a friend. We ended up somewhere in Mulgore, not far from Thunder Bluff. Vaca got to use the aptly named Beatstick on some Prairie Wolf Alphas. This went well, thanks to Neverlast’s ability to heal. After killing of one of several Prairie Wolf Alphas, another one snuck up behind Vaca and started attacking. She hit it with her Beatstick, assuming it was just another Alpha. Instead, it was none other than Ghost Howl! By this point, Vaca was down about half of her hit points, and it was thanks to Neverlast that she was able to fight, and survive, the Ghost Howl battle. Success! We killed Ghost Howl. A Demon Scarred Cloak magically appeared in our bags. Fortunately, we both had room for one more item. This spawns a new quest. The Demon Scarred Cloak: The ragged hide of Ghost Howl still bears a terrible wound, gained from the wolf’s battles against the Burning Legion. Perhaps someone in Bloodhoof Village should know of Ghost Howl’s demise… This quest requires the player to “Find someone who knows of Ghost Howl.” We knew exactly which NPC to talk to. He’s the one that told us a story! If you still aren’t sure where to go, the rewards give a clue. Players can choose between Skorn’s Hammer and Skorn’s Rifle when they turn in the quest. WoW Classic: Ghost Howl is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... WoW Classic: Rites and CeremoniesOctober 19, 2019World of Warcraft / World of Warcraft ClassicVaca and Neverlast set out to work on some quests that involved rites, ceremonies, and fighting unbridled capitalism. We didn’t complete all of these quests in the same day, but were able to turn in ones we finished last time around. Lorekeeper Raintotem gave us a quest called A Sacred Burial. I found it interesting that it just so happened to be raining when we met an NPC (non-player character) named Raintotem. Lorekeeper Raintotem: Only the most valiant Tauren are laid to rest at Red Rocks, our sacred burial ground. It is an honor bestowed upon the great warriors who helped found and defend Thunder Bluff and those who have given their lives for the greater good of their tribes and chieftains. But it appears a foul menace has made its way onto our holy land. A band of Bristleback Interlopers is ravaging the grave site and I am too old and past my prime to drive them away. They must be driven off with force, Vaca. To complete this quest, players must kill 8 Bristleback Interlopers at Red Rocks. Completing this quest was not very difficult. There were other players working on it at the same time that we were. As you can see in the screenshot above, a random Hunter targeted this particular Bristleback we were fighting. It is nice when players just naturally work together. We found the Ancestral Spirit at Red Rocks and turned in the quest. Ancestral Spirit: You have shown great diligence in your yearning to pass the Rites of the Earthmother, Vaca. We, the Ancestral Spirits, represent the mighty Tauren who gave their lives bravely to found and protect our great city of Thunder Bluff. I hereby pass the duty of that protection over to you. You have passed the Rite of Wisdom, young warrior. Enter Thunder Bluff with pride. Ancestral Spirit: You will now be revered within our great city. Any tauren worthy of completing the Rites of the Earthmother earns that honor. For your final quest, seek out our noble leader, Cairne Bloodhoof, who dwells atop the highest mesa in Thunder Bluff. We returned to Lorekeeper Raintotem to turn in the A Sacred Burial quest. Lorekeeper Raintotem: Well done. You have sent those foul Bristlebacks a clear message. They will think twice before attempting to meddle in this holy spot again. We were hiding out on a hillside, after doing the “corpse run”, when Vaca hit level 9. Neverlast was right behind her, at Level 8. There were too many wild creatures in this area, and we couldn’t take them all down by ourselves. Veren Tallstrider, in Thunder Bluff, has a quest called Gathering Leather. It is a good one to take if you happened to have picked up Skinning. All you need to do is skin the animals you kill (or the dead animals other players – who don’t skin – left behind). Eventually, you gather up enough leather for Veren Tallstrider. Veren Tallstrider: Greetings, young one. You have a gleam in your eye; I can tell you are eager to venture back to the plains for the hunt. May you bring honor to your clan! I work with the skins of beasts, fashioning them into clothes and armor for the people of Thunder Bluff. If you hunt beasts and bring me their skins, then I will fashion something for you. To complete this quest, a player must bering 12 pieces of Light Leather to Veren Tallstrider. Vaca and Neverlast found High Chieftain Cairne Bloodhoof. We needed to turn in a quest to him. Cairne Bloodhoof: Hail, young warrior. I see you found your way to my doorstep. I found this amusing because Vaca and Neverlast are, quite literally, standing on Cairne Bloodhoof’s doorstep. He immediately gave us another quest to work on. Cairne Bloodhoof: You have passed the Rites of the Earthmother and earned your place in Thunder Bluff. But in order to maintain the spot that you strived so hard to achieve, you must continue to prove your worth to your people. We are hunters, Vaca. Down below in Mulgore there is a mighty Kodo named Arra’chea. Show me your skills in the ways of tracking and hunting by bringing me the Horn of Arra’chea. At some point, I picked up both Skinning and Leatherworking. I thought that I needed both in order to skin things. But, that’s not how it works. All I needed was Skinning. I decided to unlearn Leatherworking (since I did not actually need it.) Vhan: No part of the animals we hunt is wasted. Vhan is a Journeyman Tailor. He was able to train Vaca in the art of Tailoring. My reason for wanting to pick up Tailoring was because I wanted to learn how to make linen bags. I figured those would probably sell on the Auction House. One of the first things I learned in Classic WoW was how scarce bags are. While in Thunder Bluff, we took a quest from Eyahn Eagletalon called Preparation For Ceremony. Eyahn Eagletalon: Vaca, my brother soon stands before Chief Bloodhoof, and it is my honor to make his headdress for him. I want to ask a favor of you while I finish tanning these leather straps. There is not enough time for me to find enough feathers, and I was wondering, would you gather more for me? You can find the feathers of the correct size from the harpies residing far to the north and northwest of Thunder Bluff. I need only 6 azure and 6 bronze feathers to complete the design. The screenshot above is a good example of the progress that my friend and I had made in WoW Classic (so far). My Warrior, Vaca, is fighting a Swoop and a Cougar by herself – with no trouble at all. This is a vast improvement from earlier, when one Swoop by itself was a challenge. My friend’s Druid, Neverlast, had enough time to go pick some flowers and then return to heal Vaca up a bit. It was nice to reach the point where we were more powerful than the local wildlife. Vaca is using the appropriately named Beatstick to kill this Flatland Cougar. If I remember correctly, she got it from a Goblin. I found it extremely amusing for my Warrior to use a weapon that was so perfectly named! We stopped to let a herd of marching Kodos pass by. They aren’t very aggressive – unless you get too close. We found Morin Cloudstalker on the road, right where we left him. This time, we were able to turn in The Ravaged Caravan quest that he gave us. Doing so allowed us to get more bag space back as we handed over the Venture Co. Documents. Morin Cloudstalker gave us two new quests to work on: The Venture Co. and Supervisor Fizsprocket. Morin Cloudstalker: This explains the buildup of Venture Co. employees and equipment we’ve seen in Mulgore. Those goblins… their company is expanding too quickly for their own good. It’s how they say, show a goblin something, and you can hear the scales in the background. Greedy little things, they are. Unfortunately for their business enterprise, we Tauren cannot allow them to conduct their operations in our lands. Go to their mine northeast of the ravaged caravan and send them a message. To complete this quest, we need to kill 14 Venture Co. Workers and 6 Venture Co. Supervisors. Personally, I find it comforting that Taurens aren’t big fans of unbridled capitalism. Vaca and Neverlast have been given the task of preventing the Venture Co. from “expanding too quickly for their own good.” Morin Cloudstalker: According to the documents you salvaged from the caravan, The Venture Co. created many plans to attempt to drive us from our lands here, so that they could have free reign to plunder our lands. The depths that they would sink to accomplish their goals disgusts and appalls me. I want the mastermind behind their plans killed. His name is Supervisor Fizsprocket, and you will find him at the Venture Co. mine east of the ravaged caravan. Bring me his clipboard, we shall see if we find out anything useful. To complete this quest, we must kill Supervisor Fizsprocket, obtain his clipboard, and bring it back to Morin Cloudstalker. Put the text of these two quests together, along with what we have learned of the Tauren lifestyle so far, and it tells a story. The land here is valued and looked after by the Tauren. They take only what they need, and use as much of a slain animal as possible. They send out people to cleanse water wells. A big company run by Goblins (that is growing too quickly) has decided to take away the Tauren’s land. The greedy Goblins want to basically mine the land for everything they can take from it, leaving behind nothing at all. The company wants to accomplish this by driving the Tauren from their lands. It sounds awfully similar to what actually happened to the First Nations people across the United States (and, I presume, other locations as well). The corporate colonizers are up to no good. My friend and I aren’t powerful enough in the real world to stop big corporations from being evil. It is going to feel good to get a chance to make things right on Azeroth. But first, we needed to finish the quest that required us to use the Winterhoof Cleansing Totem to cleanse Winterhoof Water Well. Mull Thunderhorn, in Bloodhoof Village, is the Tauren who gave us that quest. Neverlast hit level 9 as we turned in the quest. Mull Thunderhorn: News of your deed reached me moments ago – – already the beasts near the well drink from it eagerly. You have done a great thing for the land, Vaca. And you have done a great thing for the Tauren people. Let’s have a moment of appreciation for whatever Tauren used their skills to create these absolutely pathetic looking human target dummies! They are comically wonderful. These dummies aren’t pretty, but they seem functional. Clearly, some Tauren Hunter came by and shot a few precious arrows into them before Vaca and Neverlast arrived. Ruul Eagletalon gave us the Dangers of the Windfury quest. We were ready to turn it in. I wonder if he is the brother of Eyahn Eagletalon, who gave us a quest to find harpy feathers that he could use to make a headdress for his brother. For whatever reason, I failed to take any screenshots of us actually fighting the Harpies. I think we were too busy trying not to die. That said, we did manage to collect 8 Windfury Talons (each) and complete the quest. Little did we know that there would be more Harpy quests coming up! WoW Classic: Rites and Ceremonies is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... Out of Spoons (Chronic Illness)Shelter At HomeMarch 29, 2020Out of Spoons / Spoonie WritingImage by 024-657-834 from Pixabay Many changes have been made as a response to dealing with COVID-19. Most of them involve things people can do to avoid catching – and spreading – the virus. My state has ordered (almost) everyone to “shelter at home”. The result has caused changes that I would not have guessed would become “the new normal” in 2020. On March 18, 2020, the county I live in issued a “Shelter at Home” order. The goal was to prevent the spread of COVID-19, a virus that has no cure and is especially contagious. Requiring people to stay home (with the exception of people who provide essential services) makes sense. The very next day, the Governor of the State of California, Gavin Newsom, issued a “Stay home except for essential needs” executive order. It is in place “until further notice”, and is a statewide order. Essential services will remain open, including: gas stations, pharmacies, grocery stores, food banks, convenience stores, take-out and delivery restaurants, banks, laundromats, and essential state and local government functions. The smaller farmers’ markets in my county are allowed to continue, so long as everyone stays at least six feet away from each other the entire time. My county has the largest farmers’ market in the United States, which happens on Thursday night – unless it rains. It has been canceled. There is no easy way to ensure a crowd that large can do effective “social distancing”. Californians can still go to the pharmacy to pick up their medication, and are allowed to grocery shop while keeping a careful distance from the other shoppers. Eye exams, teeth cleaning, and elective procedures are required to be rescheduled until… some day in the future when we are no longer required to “shelter at home”. I was supposed to have a teeth cleaning this month. Unfortunately, a few days before I was supposed to go, I developed two out of the three symptoms of COVID-19. I was having some difficulty breathing, and had developed a dry cough. There was no fever. This put me in the position of trying to guess if these symptoms were allergies, or COVID-19. There is some overlap between the two. This is not a game that I, a person with a weak immune system, wanted to play. The pollen count got too high for me to handle around the end of January. I’ve barely left the house since. This is not unusual for me during what I have come to think of as “allergy season”. So far, I have gone outside to: Bring my mail-in-ballot to the County Clerk’s office. My husband and I prefer doing it that rather than dropping them into the mail and hoping they get where they need to go. We then got breakfast at a local restaurant.I went to my acupuncturist’s office for an appointment.I walked a couple of blocks with my husband to a restaurant so he could pick up a take-out order. This was before “shelter at home” went into effect, so we were able to sit in the restaurant while waiting for his food. I’m allergic to everything this restaurant serves.I went to the DMV to replace my soon-to-expire driver’s license with a Real ID. Doing so required me to put my thumb on a tiny scanner several times. NO ONE WAS WASHING THE SCANNERS. I suspect this pushed my immune system into more distress than typical. First, I called my doctor’s office, at what I refer to as “the clinic for the poor people.” The receptionist sounded a bit tired, and extremely nervous about the virus. “Oh my god!”, she said. “I’ve never seen anything like this! It’s like a movie.” She told me some of her relatives had COVID-19 and were at home watching movies about pandemics. She told them she didn’t want to know how those movies ended. We decided that, since I didn’t have a fever, I could just wait and see what happens. I remember telling the receptionist that I didn’t want to take away a test from someone who is worse off then I am. At the time, it was clear that there was a severe shortage of tests. Next, I called my dentist’s office. The receptionist sounded absolutely exhausted. I asked her if she was ok, and she insisted she was. Our conversation went as follows: “I have two out of three symptoms of COVID-19. Do you still want me to come in for my appointment in a few days?” “NO!” We rescheduled. It is unclear to me if that appointment will happen, considering we don’t know how long “shelter at home” will last. Since then, my dentist’s office sent me an email to let me know they have closed. The dentist might or might not be able to treat dental emergencies, on a case by case basis. My husband and I are lucky, in a way, because we both work from home. I started working as a freelance writer in 2010, and he began working from home some time before that. So far, our income has been stable. Both of us are disabled. He is legally blind (which cannot be cured). I have tons of allergies and fibromyalgia (neither of which have a cure). Working from home is our “normal” and pretty much the only way we can maintain a job. Today, all across the country, people are working from home. This amazes me, because for years, the “go-to” for businesses was to insist that employees could not work from home. It was too complicated to manage; way too difficult to set up; employees would still have to commute to the office for in-person meetings. We now know that that all of those excuses were lies. The shift from the idea that everyone must be in the office, to everyone must work from home, went lightning quick (especially for the huge tech companies). I believe that working from home will become the new normal, whenever “shelter at home” ends. It has been said that anything a person does for 30 days in a row becomes a habit. The longer people work from home, the more they become used to it. My hope is that working from home will become a common option for people who have disabilities. Because my husband and I are both disabled, neither of us can drive anymore. He never could, and I lost the ability several years ago when fibromyalgia stole my ability to move my body fluidly and quickly enough to be a safe driver. I move too slowly now to see if there’s a car in the other lane, and lack the grip strength to turn the wheel. Renewing my driver’s license seemed easier than switching to a State ID, in part because I have yet to qualify for Social Security Disability. Having a driver’s license doesn’t mean I am required to drive, after all. There is a grocery store within walking distance – which also is near a bus stop. I cannot reliably go there, due to my chronic illnesses. Eventually, my husband and I switched to having groceries delivered. At first, that felt like I was giving up, letting my chronic illnesses “win”. Over time, I realized just how helpful grocery delivery was for people like us. But now, in the time of COVID-19, grocery delivery itself has become unreliable. We had one successful order from a store that has plenty of gluten-free foods that are safe for me to eat. The next order was delayed, and the delivery person was unable to find all the things on our list. The store had no toilet paper, and most of the gluten-free stuff was out of stock. The order after that never happened. The website allowed us to pick items from the few things that were still in stock. But, it refused to allow us to select a time when we wanted the food delivery to arrive. My husband has gone outside to get whatever groceries were available. We have plenty of toilet paper, for now. It is unclear if the gluten-free foods will return. We’ve been buying more fruits and veggies than usual, in part because some of them are safe for me to eat and all of them are gluten-free. Many of the local restaurants are overjoyed to take an order and deliver it to our home. This might be the only thing keeping some of them in business. One restaurant now allows people to have both food and beer delivered. That didn’t happen before COVID-19. For me, “shelter at home” is normal. I end up stuck inside for a few months every spring when the pollen is too high for me to physically handle. The same thing happens in the fall when ragweed pollen is ever-present. There are also days when my fibromyalgia decides to act up and cause me a whole lot of pain. A friend on social media pointed out that choosing to stay inside, and being required to stay inside, are two different things. This is one situation where I think healthy people are having a harder time coping with the world than I am. I’m having conflicting emotions about “shelter in place”. I’m more frightened than typical about going outside now, worried that my already weak immune system will make me a big target for the virus. But, I’m starting to miss little things like playing Pokémon GO, and being able to eat in one of the few restaurants that serves food that I’m not allergic to. Welcome to my world. All of you have to live like me now. Shelter At Home is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... A Timeline of COVID-19 – January 2020March 24, 2020Out of Spoons / Public HealthImage by Vektor Kunst iXimus from Pixabay The news cycle moves really fast, and can be difficult to keep up with. That’s why I decided to put together a timeline of COVID-19 (also called coronavirus). This blog post contains everything I could find about it from credible sources. This timeline is chronological order – but – not everything that happened was released in the order that it happened. To make this clear, I will put an asterisk and a number next to things that were released out of order. Hopefully, that will make the connections clearer. The U.S. Centers for Disease Control and Prevention (CDC) described coronavirus and the source and spread of the virus: Coronaviruses are a large family of viruses that are common in people and many different species of animals, including camels, cattle, cats, and bats. Rarely, animal coronaviruses can infect people and then spread between people such as with MERS-CoV, SARS-CoV, and now with this new virus (named SARS-CoV-2).The SARS-CoV-2 virus is a betacoronavirus, like MERS-CoV and SARS-CoV. All three of these viruses have their origins in bats. The sequences from U.S. patients are similar to the one that China initially posted, suggesting a likely single, recent emergency of this virus from an animal reservoir.Early on, many of the patients at the epicenter of the outbreak in Wuhan, Hubei Provence, China had some link to a large seafood and live animal market, suggesting animal-to-person spread. Later, a growing number of patients reportedly did not have exposure to animal markets, indicating person-to-person spread. Person-to-person spread was subsequently reported outside Hubei and in countries outside China, including the United States. Some international destinations now have apparent community spread with the virus that causes COVID-19, as do some parts of the United States. Community spread means some people have been infected and it is not yet known how or where they became exposed…. The CDC noted there was no known vaccine to protect against COVID-19 and no medications approved to treat it. Nonpharmaceutical interventions would be the most important response strategy. The CDC stated is implementing its pandemic preparedness and response plans, working on multiple fronts, including providing specific guidance on measures to prepare communities to respond to local spread of the virus that causes COVID-19. They were able to adapt pandemic guidance developed in anticipation of an influenza pandemic for a potential COVID-19 pandemic. (*1) July of 2020: The Trump administration eliminated a key American public health position in Beijing intended to help detect disease outbreaks in China. This was reported by Reuters on March 22, 2020, in an article titled: “Exclusive: U.S. axed CDC expert job in China months before virus outbreak”. It was written by Marisa Taylor. From the article: Several months before the coronavirus pandemic began, the Trump administration eliminated a key American public health position in Beijing intended to help detect disease outbreaks in China, Reuters has learned.The American disease expert, a medical epidemiologist embedded in China’s disease control agency, left her post in July, according to four sources with knowledge of the issue. The first cases of the new coronavirus may have emerged as early as November, and as cases exploded, the Trump administration in February chastised China for censoring information about the outbreak and keeping U.S. experts from entering the county to help……No other foreign disease experts were embedded to lead the program after [Dr. Linda] Quick left in July, according to the sources. [Bao-Ping] Zhu [a Chinese American who served in that role, which was funded by the U.S. Centers for Disease Control and Prevention, between 2007 and 2011] said an embedded expert can often get word of outbreaks early, after forming close relationships with Chinese counterparts. December 31, 2019: The Guardian reported: The World Health Organization (WHO) is alerted by the Chinese authorities of a string pneumonia-like cases in Wuhan, a city of 11 million people. Patients are quarantined and work begins on identifying the origin of pneumonia. December 31, 2019: World Health Organization (WHO) was informed of a pneumonia of unknown cause in Wuhan, China. (*1) (* 2) January 5, 2020: The World Health Organization posted disease outbreak news titled: “Pneumonia of unknown cause – China” From the disease outbreak news: On 31 December 2019, the WHO China Country Office was informed of cases of pneumonia of unknown etiology (unknown causes) detected in Wuhan City, Hubei Province of China. As of 3 January 2020, a total of 44 patients with pneumonia of unknown etiology have been reported to WHO by the national authorities in China. Of the 44 cases reported, 11 are severely ill, while the remaining 33 patients are in stable condition. According to media reports, the concerned market in Wuhan was closed on 1 January 2020 for environmental sanitation and disinfection.The causal agent has not yet been identified or confirmed. On 1 January 2020, WHO requested further information from national authorities to assess the risk.National authorities report that all patients are isolated and receiving treatment in Wuhan medical institutions. The clinical signs and symptoms are mainly fever, with a few patients having difficulty in breathing, and chest radiographs showing invasive lesions of both lungs.According to the authorities, some patients were operating dealers or vendors in the Huanan Seafood market. Based on the preliminary information from the Chinese Investigative team, no evidence of significant human-to-human transmission and no health care worker infections have been reported.Public Health Response National authorities have reported the following response measures: One hundred and twenty-one close contacts have been identified and are under medical observation;The follow-up of close contacts is ongoing;Pathogen identification and the tracing of the cause are underway; Wuhan Municipal Health Commission carried out active case finding, and retrospective investigations have been completed; Environmental sanitation and further hygiene investigations are under way WHO risk assessment There is limited information to determine the overall risk of this reported cluster of pneumonia of unknown etiology. The reported link to a wholesale fish and live animal market could indicate an exposure link to animals. The symptoms reported among the patients are common to several respiratory diseases, and pneumonia is common in the winter season; however, the occurrence of 44 cases of pneumonia requiring hospitalization clustered in space and time should be handled prudently. Wuhan city, with a population of 19 million, is the capital city of Hubei province, with a population of 58 million people. WHO has requested further information on the laboratory tests performed and the differential diagnoses considered.WHO advice Based on information provided by national authorities, WHO’s recommendations on public health measures and surveillance of influenza and severe acute respiratory infections still apply. WHO does not recommend any specific measures for travellers. In case of symptoms suggestive of respiratory illness either during or after travel, travellers are encouraged to seek medical attention and share travel history with their healthcare provider.WHO advises against the application of any travel or trade restrictions on China based on the current information available on this event. January 2020 January 1, 2020: The Guardian reported: The US Centers for Disease Control and Prevention (CDC) identifies a seafood market suspected of being at the centre of the outbreak and it is closed down. (*3) January 3, 2020: The Washington Post was the first to report (in March of 2020) that U.S. Intelligence reports warned President Donald Trump about coronavirus in January and February. That article is locked behind a paywall. Vox posted an article on March 21, 2020, titled: “Intelligence reports warned about a pandemic in January. Trump reportedly ignored them.” It was written by Riley Beggin. Here is the portion of the article that is relevant to January 2020: US intelligence officials reportedly warned President Donald Trump and Congress about the threats posed by the novel coronavirus beginning in early January – weeks before the White House and lawmakers began implementing stringent public health measures and as the president minimized the threat posed by the virus in his tweets and public statements.The fact those warnings were largely disregarded – something first reported by the Washington Post’s Shane Harris, Greg Miller, Josh Dawsey, and Ellen Nakashima – suggests Trump administration officials failed to take action that could have prepared the health care system to handle an influx of patients, helped Americans avoid mass social distancing, and saved lives.Top health officials first learned of the virus’s spread in China on January 3, US Health and Human Services Secretary said Friday. Throughout January and February, intelligence officials’ warnings became more and more urgent, according to The Post – and by early February, much of the Office of the Director of National Intelligence and the CIA’s intelligence reports were dedicated to warnings about Covid-19… January 3, 2020: World Health Organization Western Pacific Region posted a thread that began with this tweet: “#China has reported to WHO regarding a cluster of pneumonia cases in Wuhan, Hubei Province. The Govt has also met with our country office, and updated @WHO on the situation. Govt actions to control the incident have been instituted and investigations into cause are ongoing. 1/3” January 3, 2020: World Health Organization Western Pacific Region tweeted: “We’re closely monitoring the situation in Wuhan & are in active communication with our counterparts in China. We’ve activated our incident management system across the 3 levels of @WHO (country office, regional office, HQ), & can launch a broader response, if needed. 2/3” January 3, 2020: World Health Organization Western Pacific Region tweeted: “#China has extensive capacity to respond to public health events and is responding proactively & rapidly to the current incident in Wuhan – isolating patients, tracing close contacts, cleaning up the market, and searching for the cause and for additional cases. 3/3” January 5, 2020: World Health Organization (WHO) posted a tweet: “On 31 December 2019, WHO was informed of cases of #pneumonia of unknown cause in Wuhan City, #China. A total of 44 cases have been reported: 11 patients are severely ill, while the remaining 33 are in stable condition”. The tweet included a link to the WHO website. January 5, 2020: World Health Organization (WHO) tweeted: “Chinese authorities informed WHO that they have ruled out a number of causes of the outbreak of #pneumonia in Wuhan City. The pathogen is not influenza, avian flu, adenovirus, SARS or MERS. Work continues to identify the cause.” January 5, 2020: World Health Organization (WHO) tweeted: “Chinese authorities updated the unknown cause in Wuhan. A total of 59 cases have been reported, of which 7 are severely ill. The earliest to fall ill was on 12 Dec, the latest on 29 Dec. Investigations continue to identify any other cases or contacts.” January 8, 2020: World Health Organization Western Pacific Region tweeted a thread which started with: “Chinese authorities have made a preliminary determination of the cause of the #pneumonia in Wuhan as a novel (new) #coronavirus. @WHO continues to monitor the situation closely and is ready to support #China to investigate and respond to this outbreak. (1/7).” January 8, 2020: World Health Organization Western Pacific Region tweeted: “Preliminary identification of a novel virus in a short period of time is a notable achievement and demonstrates China’s increased capacity to manage new outbreaks. Chinese investigators conducted gene sequencing of the virus, using an isolate from 1 positive patient sample (2/7)” January 8, 2020: World Health Organization Western Region tweeted: “Coronaviruses are a large family of viruses with some causing less-severe disease, such as the common cold, and others more severe disease such as MERS and SARS. Some transmit easily from person to person, while others don’t. (3/7)” January 8, 2020: World Health Organization Western Region tweeted: “According to Chinese authorities, the virus in question can cause severe illness in some patients and does not transmit readily between people. (4/7)” January 8, 2020: World Health Organization Western Region tweeted: “Globally, novel coronavirues emerge periodically in different areas, e.g. SARS in 2002 and MERS in 2012. Several known coronaviruses are circulating in animals that have not yet infected humans. As surveillance improves more coronaviruses are likely to be identified. (5/7)” January 8, 2020: World Health Organization Western Region tweeted: “In the coming weeks, more comprehensive information is reqired to better understand the status and epidemiology of the outbreak, the clinical picture, the source, modes of transmission, extent of inflection and countermeasures. (6/7)” January 8, 2020: World Health Organization Western Region tweeted: “@WHO does not recommend any specific measures for travellers. WHO advises against the application of any travel or trade restrictions on China based on the current information available (7/7). January 9, 2020: The Guardian reported: The WHO says the outbreak in Wuhan was caused by a previously unknown type of coronavirus, a broad family ranging from the common cold to more serious illnesses like severe acute respiratory syndrome (Sars). January 9, 2020: European Centre for Disease Prevention and Control posted a risk assessment post titled: “Pneumonia cases possibly associate with a novel coronavirus in Wuhan, China”. From the Executive Summary of that report: Between 31 December and 2019 and 5 January 2020, 59 pneumonia cases possibly associated with a novel coronavirus have been reported in Wuhan, China with a common exposure link to Wuhan’s South China Seafood City market.The cases showed symptoms such as fever, dyspnoea, and radiological tests compatible with bilateral lung infiltrative lesions. Seven severe cases have been reported, but no deaths. No cases have been reported outside of Wuhan. According to Chinese authorities, no human-to-human transmission could be documented.Epidemiological investigations including contact tracing are ongoing and hygiene- and environmental sanitation activities in the affected market have been carried out in Wuhan.Three EU airports have direct flight connections to Wuhan and there are indirect flight connections to other EU hubs. Considering there is no indication of human-to-human transmission and no cases detected outside of China, the likelihood of introduction to the EU is considered to be low, but cannot be excluded. However, more epidemiological and laboratory information is needed in order to elaborate a comprehensive assessment of this event and the possible risk for the international spread.ECDC is monitoring this event through epidemic intelligence activities. For options for response and safety precautions, see EDCD’s threat assessment. January 9, 2020: The World Health Organization (WHO) posted a statement titled: “WHO Statement regarding cluster of pneumonia cases on Wuhan, China.” From the statement: Chinese authorities have made a preliminary determination of a novel (or new) cornavirus, identified a hospitalized person with pneumonia in Wuhan. Chinese investigators conducted gene sequencing of the virus, using an isolate from one positive patient sample. Preliminary identification of a novel virus in a short period of time is a notable achievement and demonstrates China’s increased capacity to manage new outbreaks.Initial information about cases of pnemonia in Wuhan provided by Chinese authorities last week – including the occupation, location and symptom profile of the people affected – pointed to a coronavirus (CoV) as a possible pathogen causing this cluster. Chinese authorize subsequently reported that laboratory tests ruled out SARS-CoV, MERS-CoV, influenza, avian influenza, adenovirus and other common respiratory pathogens.Coronaviruses are large family of virses with some causing less-severe disease, such as the common cold, and others more severe disease such as MERS and SARS. Some transmit easily from person to person, while others do not. According to Chinese authorities, the virus in question can cause severe illness in some patients and does not transmit readily between people.Globally, novel coronaviruses emerge periodically in different areas, including SARS in 2002 and MERS in 2012. Several known coranaviruses are circulating in animals that have not yet infected humas. As survillance improves more coronaviruses are likely to be identified.China has strong public health capacities and resources to report and manage respiratory disease outbreaks. In addition to treating the patients in care and isolating new cases as they may be indentified, public health officials remain focused on continued contact tracing, conducting environmental assessments at the seafood market, and investigations to identify the pathogen causing the outbreak.In the coming weeks, more comprehensive information is required to understand the current status and epidemiology of the outbreak, and clinical picture. Further investigations are also required to determine the source, modes of transmission, extent of infection and countermeasures implemented. WHO continues to monitor the situatuon closely and, together and, together with its partners, is ready to provide technical support to China to investigate and respond to this outbreak.The preliminary determination of a novel virus will assist authorities in other countries to conduct disease detection and response. Over the past week, people with symptoms of pneumonia and reported travel history to Wuhan have been identified at international airports.WHO does not recommend any specific measures for travellers. WHO advises against the application of any travel or trade restrictions on China based on the information currently available. January 10, 2020: Health Protection Scotland posted information titled: “Wuhan novel coronavirus and avian flu – advice for travellers”. From the advice: HPS is aware of a reported outbreak of a novel coronavirus in China’s Wuhan City and is monitoring the situation with Public Health England (PHE) and international partners, including the World Health Organization.The risk for the UK population is very low and the risk for travellers to Wuhan is low, but, ahead of the Chinese New Year this month, travellers are advised to take simple precautions such as practicing good hand, respiratory and personal hygiene, and minimise contact with birds and animals in markets in Wuhan as a further precaution.If travellers returning from Wuhan become unwell within 14 days of their return, they should call their GP or NHS and report their recent travel… January 10, 2020: World Health Organization South-East Asia posted a news release titled: “Novel Coronavirus in Wuhan, China”. From the press release: Chinese authorities have reported the detection of a novel (or new) coronavirus, identified in a patient with pneumonia in Wuhan.For more information, please visit WHO Statement Regarding Cluster of Pneumonia Cases in Wuhan, China.In response, Thailand has implemented early screening at all international airports that receive flights from Wuhan. A small number of individuals with fever and respiratory symptoms on arrival have been referred for further clinical assesssment and lab testing, with the full application of measures for infection prevention and control… January 11, 2020: The Guardian reported: The Chinese health authorities report the first fatality as a 61-year-old man dies from pneumonia in Wuhan. They revise downwards the number of sick people to 41. January 13, 2020: The World Health Organization (WHO) announced it is working with officials in Thailand and China following reports of confirmation of the novel coronavirus in a person in Thailand. The person was a traveler from Wuhan, China, and was identified by Thai officials on January 8, 2020, and hospitalized that day. January 13, 2020: The Guardian reported: The virus spreads beyond China’s borders for the first time with a case emerging in Thailand, according to the WHO, The victim is a Chinese woman diagnosed with mild pneumonia who was returning from a trip to Wuhan. January 13, 2020: The World Health Organization (WHO) posted “WHO statement on novel coronavirus in Thailand”. From the statement: The World Health Organization (WHO) is working with officials in Thailand and China following reports of confirmation of the novel coronavirus in person in Thailand.The person was a traveler from Wuhan, China, and was identified by Thai officials 8 January, and hospitalized that day. The person is recovering from the illness according to Thai officials.The possibility of cases being identified in other countries was not unexpected, and reinforces why WHO calls for on-going active monitoring and preparedness in other countries. WHO has issued guidance on how to detect and treat persons ill with the new virus.The genetic sequencing shared by China enables more countries to rapidly diagnose patients.WHO reiterates that it is essential that investigations continue in China to identify the source of this outbreak and any animal reservoirs or intermediate hosts.Given developments, WHO Director-General Dr Tedros Adhanom Ghebreyesus will consult with Emergency Committee members and could call for a meeting of the committee on short notice. January 13, 2020: World Health Organization South-East Asia posted a news release titled: “Thailand responding to the novel coronavirus”. From the news release: Current situation:On January 13, 2020, The Ministry of Public Health of Thailand reported an imported case of infection caused by the novel coronavirus recently identified in Wuhan, China. The concerned individual is a Chinese national who was found to have fever on arrival at Suvarnbhumi airport on 8th January. A clinical diagnosis of mild pneumonia was made after referral to a government hospital. Laboratory testing subsequently confirmed that the novel coronavirus was the cause.WHO acknowledges the capacity of Thailand’s laboratories to do the complex genetic analysis to confirm the diagnosis.Background:Since early December, a number of cases of pneumonia have been detected in persons from Wuhan city in China. Chinese authorities identified a new coronavirus as the agent causing these changes.Coronaviruses are common – many cause less severe illness such as the common cold; other are known to cause more severe illness (SARS and Middle East Respiratory Syndrome, MERS). Chinese scientists have sequenced and made available the genetic material of this virus – a remarkable achievement in such a short time. This will be critical to helping public health authorities around the world understand this illness and track it.The way these patients became infected is not yet known. To date, there has been no suggestion of human-to-human transmission of this new coronavirus. There have been no infections reported among health care workers, which can be an early indicator of person to person spread.At present, WHO does not recommend any specific health measures for travelers in relation to this event. WHO advises against the application of any travel or trade restrictions on China based on the information available. If travelers develop respiratory illness before, during or after travel, they should seek medical attention and share travel history with their health care provider.The World Health Organization is working with Thailand and other countries to track further infections caused by this new coronavirus and to ensure that they are prevented and controlled. This includes, Providing all countries with a technical package of interim guidance, including: Common case definitions to ensure patients are identified quickly; Information on laboratory methodologies to identify this and other respiratory viruses; Guidance on how to protect health care workers and others; Guidance on clinical management is being quickly reviewed by global experts and will be shared once available.Facilitating information sharing on this and other relevant health events between countries.In the longer term, using the International Health Regulations to develop and strengthen capacities of countries to detect and respond to infections like the new coronavirus. January 14, 2020: The CDC reported the onset of 2 additional COVID-19 cases in the United States. January 14, 2020: The CDC tweeted: “CDC continues to monitor this ongoing investigation to learn more about this rapidly evolving outbreak #coronavirus. #2019-nCoV” The tweet included a link to the CDC’s information about coronavirus. January 14, 2020: Health Protection Scotland posted a report titled: “Outbreak of pneumonia in Wuhan City, Hubei, China”. From the report: An outbreak of pneumonia in Wuhan City, Hubei Province, China, has been linked to a newly-discovered coronavirus.As of 12 January 2020, there have been 41 confirmed cases and one death. The death occurred in a patient with serious underlying medical conditions.Coronaviruses are a well-recognized cause of human illnesses that range from mild to severe. This outbreak has been linked ot possible exposure to infection at the South China Seafood City market in Wuhan. No cases have been confirmed outside the city.While the risk to UK travellers to Wuhan is currently considered low, because of this general ongoing risk of avian flu in China, travellers are advised to take simple precautions such as practicing good hand, personal and respiratory hygiene, and to minimize contact with birds and animals in markets in Wuhan or elsewhere in China.If travellers returning from Wuhan or elsewhere in China become unwell within 14 days of their return to the UK, particularly with respiratory symptoms, they should call their GP or NHS 111 and report their recent travel details… January 14, 2020: World Health Organization (WHO) tweeted: “Preliminary investigations conducted by Chinese authorities have found no clear evidence of human-to-human transmission of the novel #coronavirus (2019-nCoV) identified in Wuhan, #China” January 14, 2020: European Centre for Disease Prevention and Control posted information titled: “Update: Cluster of pneumonia cases associated with novel coronavirus – Wuhan, China – 2019”. From the information: …On the 13th of January, Thai authorities reported a confirmed imported novel coronavirus case in Thailand. The case is a tourist coming from Wuhan and was placed under isolation at Bamrasnarudura Institute of infectious disease in Bangkok. No further epidemiological and clinical information on this case are currently available to ECDC.Neighboring territories such as Hong Kong, Malaysia, Myanmar, the Philippines, Singapore, Taiwan, Thailand, Russia and Vietnam implemented entry screening activities to all incoming travellers from Wuhan in their transport hubs such as airports and train stations.The airport of Wuhan has direct flight connections with some EU cities: Paris (France) with six weekly flights, London (the United Kingdom) with three weekly flights and Rome (Italy) with five weekly flights. Health authorities in the concerned EU/EEA Member States remain vigilant and closely monitor the ongoing situation in China.ECDC is not aware of any implementation of exit screening in Wuhan international airport… January 15, 2020: The Guardian reported: China’s health commission says it cannot confirm human-to-human transmission of the virus but the possibility “cannot be excluded”. The next day a first case of the virus is confirmed in Japan in someone who had stayed in Wuhan in early January. January 15, 2020: World Health Organization Western Pacific posted a thread of tweets that started with this tweet: “Japan has reported 2019-nCOV in a man in his 30s in Japan who travelled to Wuhan. Japanese offcials report that he did not visit the Huanan seafood market which has been linked to many of the people with #nCov in Wuhan. The patient has been discharged from hospital in Japan. January 15, 2020: World Health Organization Western Pacific tweeted: “It is not surprising that there are cases outside of China, and it is possible that there will be cases in other countries in the future. @WHO encourages all countries to continue preparedness activities. We have issued interim guidance on how to do this.” January 15, 2020: World Health Organization Western Pacific tweeted: “According to the latest information we have, there is no clear evidence of sustained human-to-human transmission and there are no infections reported among health care workers.” January 15, 2020: World Health Organization Western Pacific tweeted: “The fact that some cases do not seem to be linked with the Huanan seafood market means we cannot exclude the possibility of limited human-to-human transmission”. January 15, 2020: World Health Organization Western Pacific tweeted: “We are still in the early stages of understanding this new virus, where it came from, and how it affects people. There is still many unknowns, and the situation may continue to evolve.” January 15, 2020: World Health Organization Western Pacific tweeted: “Good progress is being made. @WHO is working closely with officials in China, Japan and Thailand regarding the novel coronavirus.” January 15, 2020: World Health Organization Western Pacific tweeted: “Travel advice was posted by @WHO on 10 January. Based on currently available information, WHO does not recommend any restriction of travel or trade.” This was the last tweet in the thread. January 16, 2020: The CDC reported the onset of 1 additional COVID-19 case in the United States. January 16, 2020: Nippon.com (News from Japan) posted an article titled: “Wuhan-Linked Pneumonia Confirmed in Japan for First Time”. From the article: The first case in Japan of mysterious viral pneumonia, which sickened many people in the Chinese city of Wuhan, has been confirmed, Japanese government sources said on Thursday.A man in his 30s in Kangawa Prefecture, south of Tokyo, has tested positive for the same strain of coronavirus that caused a pneumonia outbreak in Wuhan, according to the health ministry.The man is believed to have been infected with the virus in the Chinese city, the sources said. January 17, 2020: The Guardian reported: A second person, a 69-year-old-man, dies in Wuhan, according to authorities. That same day, the CDC announces that it will begin screening passengers arriving from Wuhan at three airports: San Francisco, New York’s JFK and Los Angeles (LAX) airports… …Based on current information, the risk from 2019-nCoV to the American public is currently deemed to be low. Nevertheless, CDC is taking proactive preparedness precautions. Entry screening is part of a layered approach used with other public measures already in place to detect arriving travelers who are sick (such as detection and reporting of ill travelers by airlines during travel and referral of ill travelers arriving at a US port of entry by CBP) to slow and reduce the spread of any disease into the United States.CDC is deploying about 100 additional staff to the three airports (SFO, JFK, and LAX) to supplement existing staff at CDC quarantine stations located at those airports.CDC is actively monitoring this situation for pertinent information about the source of outbreak, and risk for further spread through person-to-person or animal-to-animal transmission. CDC continues and more is learned about the newly emerging virus but is an important public health tool during periods of uncertainty and part of a multilayered government response strategy. As new information emerges, CDC will reassess entry screening measures and could scale activities up or down accordingly.On January 11, 2020, CDC updated a Level 1 Travel Health Notice (“practice usual precautions”) for travelers to Wuhan City and an updated Health Alert to health care professionals and public health partners with new and updated guidance is forthcoming.China health officials report that most of the patients infected with 2019-nCoV have had exposure to a large market where live animals were present, suggesting this is a novel virus that has jumped the species barrier to infect people. Chinese authorities additionally report that several hundred health care workers caring for outbreak patients are being monitored and no spread of this virus from patients to health care workers has been seen. They report no sustained spread of this virus in the community, however there are indications that some limited person-to-person spread may have occured. CDC is responding to this outbreak out of an abundance of caution, ready to detect people infected with 2019-CoV… January 17, 2020: Centers for Disease Control and Prevention (CDC) posted a press release titled: “Public Health Screening to Begin at 3 U.S. Airports for 2019 Novel Coronavirus (“2019-nCoV”). From the press release: The Centers for Disease Control and Prevention (CDC) and the Department of Homeland Security’s Customs and Border Protection (CBP) will implement health screenings to detect ill travelers travelling to the United States on direct or connecting flights from Wuhan, China. This activity is in response to an outbreak in China caused by a novel (new) coronavirus (2019 nCoV), with exported cases to Thailand and Japan.Starting January 17, 2020, travelers from Wuhan to the United States will undergo entry screening for symptoms associated with 2019-nCoV at three U.S. airports that recieve most of the travelers from Wuhan, China: San Francisco (SFO), New York (JFK), and Los Angeles (LAX) airports……Based on current information, the risk from 2019-nCoV to the American public is currently deemed to be low. Nevertheless, CDC is taking proactive preparedness precautions.Entry screening is part of a layered approach used with other public health measures already in place to detect arriving travelers who are sick (such as detection and reporting of ill travelers by airlines during travel and referral of ill travelers arriving at a US port of entry by CBP) to slow and reduce the spread of any disease into the United States.CDC is deploying about 100 additional staff to the three airports (SFO, JFK, and LAX, to supplement existing staff at CDC quarantine stations located at those airports……On January 11, 2020, CDC updated a Level 1 Travel Health Notice (“practice usual precautions”) for travelers to Wuhan City and an updated Health Alert to health care professionals and public health partners with new and updated guidance is forthcoming.China health officials report that most of the patients infected with 2019-nCoV have had exposure to a large market where live animals were present, suggesting this is a novel virus that has jumped the species barrier to infect people. Chinese authorities additionally report that several hundred health care workers caring for outbreak patients are being monitored and no spread of this virus comes from patients to health care workers has been seen. They report no sustained spread of this virus in the community, however there are indications that some limited person-to-person spread may have occurred. CDC is repsonding to this outbreak out of an abundance of caution, ready to detect people infected woth 2019-CoV. January 17, 2020: European Centre for Disease Prevention and Control posted information titled: “Rapid Risk Assessment: Cluster of pneumonia cases caused by a novel coronavirus, Wuhan, China, 2020”. From the Executive Summary of the information: A novel coronavirus (2019-nCoV) has been isolated and considered the causative agent of the cluster of 41 pneumonia case in the area of Wuhan, Hubei province in China, and three travel-related cases in Thailand and Japan, arriving from Wuhan.The majority of detected pneumonia cases reported having visited the Wuhan Huanan Seafood Wholesale Market recently before disease onset. For a few cases there was no direct connection with a food market. The Wuhan Huanan Seafood Wholesale Market has been closed and disinfected. However, there is no information available on restrictions at any other food markets in Wuhan. If the sources of the infections are indeed certain animals sold in the market, other markets in the city may continue to pose a risk of infection. At the moment, there is no information on the source of infection or the transition mode. The occurrence of a few cases having no history of contact with the implicated market or other any similar market suggests the possibility of the infection source being even more widely distributed.As of 16 January 2020, there is no clear indication of sustained human-to-human transmission. The report of two small family clusters in Wuhan and the exposure history of the imported Japanese case (history of contact with a person with an acute, not laboratory confirmed, respiratory infection in Wuhan), suggest the person-to-person transmission may have occurred. In the absence of detailed information from the ongoing studies in China, it is impossible to quantify the potential of the 2019-nCoV for human-to-human transmission.The clinical information on confirmed 2019-nCoV cases reported so far suggests a milder disease course than that observed in SARS-CoV and MERS-CoV cases. However, in the absence of results from ongoing epidemiological investigations, it is impossible to assess whether there are population groups at higher risk of severe illness… January 19, 2020: World Health Organization South-East Asia posted a news release titled: “Update information on Thailand responding to the novel coronavirus”. From the news release: Current situation: On 17th January 2020, the Ministry of Public Health of Thailand reported a second imported case of infection caused by the novel coronavirus recently identified in Wuhan, China. The concerned individual is a Chinese national who was found to have fever on arrival at Suvarnbhumi airport on 13th January. A clinical diagnosis of mild pneumonia was made after referral to a government hospital. Laboratory testing subsequently confirmed that the novel coronavirus was the cause.WHO acknowledges the capacity of Thailand’s laboratory to do the complex genetic analyses necessary to confirm the diagnosis… January 19, 2020: World Health Organization Western Pacific Region tweeted: “The Republic of #Korea has confirmed a case of #nCoV2019 in a person who travelled from Wuhan, China. Korean authorities report that she did not visit markets in Wuhan or have contact with animals or other confirmed cases.” This was the start of a thread. January 19, 2020: World Health Organization Western Pacific Region tweeted: “The #nCoV2019 case was detected by thermal scanner during entry at Incheon Airport. She is currently in a stable condition, isolated in hospital for testing and treatment. Contact tracing is underway.” January 19, 2020: World Health Organization Western Pacific Region tweeted: “Since 3 January, Korean health authorities have strenghtened surveillance for #pneumonia cases in health facilities nationwide, and screening for travellers from Wuhan. Public risk communication has also been enhanced.” January 19, 2020: World Health Organization Western Pacific Region tweeted: “@WHO is working closely with the Republic of #Korea, and other countries to continue preparedness activities, and with global networks of experts in relation to the novel #coronavirus (nCoV-2019).” This is the last tweet in that thread. January 19, 2020: World Health Organization Western Pacific Region tweeted: “The total number of confirmed cases of #nCoV2019 reported to date is 205, including 3 deaths. All reported deaths have been in Wuhan, China.” January 19, 2020: Australian Government Department of Health posted news titled: “Chief Medical Officer’s statement on novel coronavirus” It is a statement from Professor Brendan Murphy, Australian Government Chief Medical Officer, about cases of novel coronavirus. From the news: The Australian Government Department of Health is aware of the cases of novel coronavirus (2019-nCoV) from the region of Wuhan in China, and watching developments very closely.The situation warrants close attention and an evidence-based response and there is no cause for alarm in Australia.Under Australian legislation, airlines must report passengers on board showing signs of an infectious disease, including fever, sweats or chills.Planes reporting ill travellers are met on arrival by biosecurity officers who make an assessment and take necessary actions, such as isolation and referral to hospital where required.The World Health Organization position does not currently recommend any travel advisory for China, or additional measures at airports beyond our established mechanisms.The Department of Health is aware that new cases have recently been identified, after a period of a week where no new cases had been identified.Whilst there is no clear evidence of human-to-human transmission, the recent cases, several days after the closure of the fish market that was initially identified as the likely source, raises direct transmission as a possibility.Importantly, however, there have been no reported cases of infection in the several hundred health care workers who have been exposed to patients in China.All confirmed cases have so far been people who have been in Wuhan, or visited Wuhan.Whilst there have been two deaths, one was a person with significant other medical conditions. Wuhan Tainhe international airport will commence exit screening of passengers.The World Health Organization is closely monitoring the situation and is in regular contact with Chinese authorities to provide support required. The Department of Health is also in contact with the World Health Organization.The Department of Health works in partnership with State and Territory Health Officers, to ensure that we continue an evidence based response in Australia. The Chief Health Officers will be meeting this week to further discuss the recent developments with this virus.Ausralia has processes in place to enhance border measures in relation to a communicable disease, if required, working through our established Health Protection system. January 19, 2020: World Health Organization (WHO) started a thread that began with this tweet: “China has reported 139 new cases of novel #coronavirus (2019-nCoV) in #Wuhan, #Beijing and #Shenzhen over the past two days. This is the result of increased searching and testing for 2019-nCoV among people sick with respiratory illnesses.” January 19, 2020: World Health Organization (WHO) tweeted: “For the first time, there are novel #coronavirus (2019-nCoV) cases reported outside of #Wuhan, within #China. These cases were identified because of searching and testing for cases outside Wuhan.” January 19, 2020: World Health Organization (WHO) tweeted: “WHO has provided advice to countries on how to identify people sick with the novel #coronavirus (2019-nCoV), how to care for them, and how to prevent spread.” January 19, 2020: World Health Organization (WHO) tweeted: “WHO has issued advice for individuals on how to protect themselves and others from the novel #coronavirus (2019-nCoV) January 19, 2020: World Health Organiztion (WHO) tweeted: “An animal source seems the most likely primary spurce of this novel #coronavirus (2019-nCoV) outbreak, with some limited human-to-human transmission occuring between close contacts.” January 19, 2020: World Health Organization tweeted: “WHO urges countries to continue preparedness activities for the novel #coronavirus (2019-nCoV), and continue sharing of information. Speedy information sharing has already had a positive impact on the response.” January 19, 2020: World Health Organization tweeted: “WHO is constantly analyzing data on the novel #coronavirus (2019-nCoV) as we recieve it, and working closely with global networks of experts on a range of topics.” January 19, 2020: World Health Organization tweeted: “As more #coronavirus (2019-nCoV) cases are identified and more analysis undertaken, we will get a clearer picture of disease severity and transmission patterns. We will update and expand our guidance as we learn more.” January 19, 2020: World Health Organization tweeted: “WHO is proposing studies on the novel #coronavirus (2019-nCoV) that can be done in #China and elsewhere to better understand transmission, risk factors, and where the virus is. These studies take time and resources. Some of these studies are being undertaken already.” This was the last tweet in the thread. January 20, 2020: The CDC reported 1 additional COVID-19 case in the United States. January 20, 2020: World Health Organization South-East Asia posted a news release titled: “Update information on the novel coronavirus”. From the news release: National authorities in China reported to WHO an additional 139 new cases of novel coronavirus (2019-nCoV) infection.On January 20th, 2020, national authorities in China reported to WHO an additional 139 new cases of novel coronavirus (2019-nCoV) infection, that were detected in Wuhan, Beijing and Shenzhen over the past two days. This is the result of increased searching and testing for 2019-nCoV among people who are unwell with respiratory illness… January 20, 2020: World Health Organization Western Pacific tweeted: “The total number of confirmed cases of #nCoV2019 reported to date is 222 (China: 218, Thailand: 2, Japan: 1, Rep. of Korea: 1) including 4 deaths (all in Wuhan, China). The number of people reported with 2019-nCOV in Wuhan, China, includes 15 health care workers.” This was the start of a thread. January 20, 2020: World Health Organization Western Pacific tweeted: “It is now very clear from the latest information that there is at least some human-to-human transmission of #nCoV2019. Infections among health care workers strenghten the evidence for this.” January 20, 2020: World Health Organization Western Pacific tweeted: “In addition, info about newly reported #nCoV2019 infections suggests there may now be sustained human-to-human transmission. But more information and analysis are needed on this new virus to understand the full extent of human-to-human transmission and other important details.” January 20, 2020: World Health Organization Western Pacific tweeted: “@WHO continues to work closely with governments and experts on this, and progress is underway. Director-General @DrTedros will convene an Emergency Committee on #nCoV2019 on Wednesday, 22 Jan 2020.” This tweet is the end of the thread. January 20, 2020: The Guardian reported: A third death and more than 100 new cases are announced in China, sparking concerns ahead of the annual lunar new year holiday which begins on 25 January and during which hundreds of millions of Chinese people travel nationwide. More than 200 cases have been recorded with cases reported in Beijing in the north, Shanghai in the east and Schenzhen in the south. The virus is also detected in South Korea in a Chinese person who has arrived by plane from Wuhan.In his first public comments on the outbreak, China’s president Xi Jinping says the virus must be “resolutely contained.”Human-to-human transmission is “affirmative”, a top Chinese expert on infectious diseases, Zhong Nanshan, tells state broadcaster CCTV. January 21, 2020: The CDC reported the onset of 1 more additional COVID-19 case in the United States. January 21, 2020: World Health Organization (WHO) posted a report titled: “Novel Coronavirus (2019-nCoV) Situation Report -1. The data in it was reported by January 20, 2020. From the report: As of 20 January 2020, 282 confirmed cases of 2019-nCoV have been reported for four countries including China (278 cases), Thailand (2 cases), Japan (1 case) and the Republic of Korea (1 case);Cases in Thailand, Japan and Republic of Korea were exported from Wuhan City, China;Among the 278 cases confirmed in China, 258 cases were reported from Hubei Province, 14 from Guangdong Province, five from Beijing Municipality and one from Shanghai Municipality;Of the 278 confirmed cases, 51 cases are severely ill, 12 are in critical conditionSix deaths have been reported from Wuhan City. Details of cases reported on 20 January 2020: Wuhan City: 60 new confirmed cases including three deaths.Guangdong Province: Fourteen confirmed cases (one case was confirmed on 19 January) including four severe cases, no deaths; Of the 14 confirmed cases, 12 had travel history to Wuhan and two cases had contact history with cases; Nine were male and fives were femaleBeijing Municipality: Five confirmed cases (two cases were confirmed on 19 January); Of the three new conformed cases on 20 Jan, two were male and one was a female; All five cases had a travel history to Wuhan and are currently asymptomatic.Shanghai Municipality: One confirmed case in a female; Travelled to Shanghai from Wuhan on 12 January; Two contacts have been identified for follow up. January 21, 2020: Nippon.com (News from Japan) posted an article titled: “Japan Confirms 41 People with Contacts with Pneumonia Patients”. From the article: The Japanese health ministry said Monday that it has identified 41 people who may have had long-term contacts with patients of pneumonia caused by a new strain of coronavirus that has led to an outbreak of the disease in the inland China city of Wuhan.While three of them have already left Japan, the ministry has been able to get in touch with all of the 41 people, and no new case of infection has been confirmed in the country, the ministry said.The ministry will monitor the 41 people’s health conditions for about two weeks.The ministry said last week that it has confirmed the first case of infection with the new coronavirus in Japan, noting that the patient is a Chinese man in Kanagawa Prefecture, south of Tokyo, who tested positive for the virus after returning from Wuhan.According to the ministry’s announcement on Monday, 38 of the 41 people may have spent a large amount of time with the Chinese man at the workplace or home. January 21, 2020: Health Protection Scotland posted report titled: “Outbreak of pneumonia in Wuhan City, Hubei, China: updated” From the report: An on-going outbreak of pneumonia in Wuhan City, Hubei Province, China has been linked to a newly-discovered coronavirus.The World Health Organization (WHO) reports that, as of January 20, 2020, there have been 205 cases including three deaths. Coronaviruses are a well-recognized cause of human illnesses that range from mild to severe. This outbreak has been linked to possible exposure to infection at the South China Seafood City market in Wuhan.As of 20 January, 2020, all cases are people who live in, or have travelled to, Wuhan… January 21, 2020: Australian Government Department of Health posted news titled: “Novel coronavirus update”. It is a statement from the Chief Medical Officer about novel coronavirus. From the news: The Australian Government Department of Health is working across agencies to implement additional measures to manage the risk of novel coronavirus (2019-nCoV) from the region of Wuhan in China.I want to reassure Australians that to date there have been no confirmed cases in Australia and the risk of transmission in Australia from this novel coronavirus remains low.We have well established mechanisms to detect and respond to ill travellers, and processes in place to implement further measures if the risk increases.This is a rapidly evolving matter with developments in recent days and we remain alert but not alarmed.Recent developments include significant increases in reported cases, and evidence of limited human-to-human transmission.After consulting other Government agencies and the states and territories, we are now undertaking evidence based, proportionate additional border measures, particularly in relation to the three weekly direct flights from Wuhan to Sydney. All passengers on these direct flights will recieve information abou the virus on arrival requesting that they identify themselves to biosecurity officers at the airport if they are unwell. If they have symptoms of an infectious disease they will be assessed by NSW Health.Additional information will be displayed at all major international ports around Australia, with instructions on what to do if travellers have symptoms or if symptoms develop.We are currently working with the Department of Foreign Affairs and Trade to update the travel advisory to Wuhan.We are also preparing updated advice for doctors and other health professionals in Australia and will be providing advice on the Department of Health’s website. There have been no confirmed cases of the virus in Australia.Australia’s public health systems have identified a number of individuals who have presented with relevant symptoms and travel history to Wuhan.So far, all but one have been cleared of the novel coronavirus. Laboratory testing results are pending on one remaining case in Queensland.Key details of the evolving situation and suspected cases in Australia are shared across jusrisdictions through key expert bodies such as the Australian Health Protection Principal Committee and its standing committee, the Commuicable Diseases Network Australia. Australia has world-class public health systems in place to manage any cases, including isolation facilities in each state and territory. There is currently no vaccine available for this virus; supportive care is the best available treatment if a case is confirmed… January 21, 2020: The Guardian reported: Health officials in Washington state report the first case in the US. The man is in his 30s and is in good condition at a hospital in Everett, Washington, after returning to the area last week from China. He was believed to have travelled to the Wuhan area. January 21, 2020: Centers for Disease Control and Prevention (CDC) posted a press release titled: “First Travel-related Case of 2019 Novel Coronavirus Detected in United States”. From the press release: The Centers for Disease Control and Prevention (CDC) today confirmed the first case of 2019 Novel Coronavirus (2019-nCoV) in the United States in the state of Washington. The patient recently returned from Wuhan, China, where an outbreak of pneumonia caused by this novel coronavirus has been ongoing since December 2019. While originally thought to be spreading from animal-to-person, there are growing indications that limited person-to-person spread is happening. It’s unclear how easily this virus is spreading between people.The patient from Washington with confirmed 2019-nCoV infection returned to the United States from Wuhan on January 15, 2020. The patient sought care at a medical facility in the state of Washington, where the patient was treated for the illness. Based on the patient’s travel history and symptoms, healthcare professionals suspected this new coronavirus. A clinical specimen was collected and sent to CDC overnight, where laboratory testing yesterday confirmed the diagnosis via CDC’s Real time Reverse Transcription-Polymerase Chain Reaction (rRT-PCR) test……CDC is working closely with the state of Washington and local partners. A CDC team has been deployed to support the ongoing investigation in the state of Washington, including potentially tracing close contacts to determine if anyone else has become ill……This is a rapidly evolving situation. CDC will continue to update the public as circumstances warrant. January 17, 2020: American Academy of Pediatrics (AAP) posted news titled: “CDC confirms first U.S. case of new coronavirus”. From the news: …The first U.S. case of the novel coronavirus virus has been confirmed in a man from Snohomish County in Washington state, according to the Centers for Disease Control and Prevention (CDC).The patient, a man in his 30s, became ill after her returned to the U.S. Jan. 15 from Wuhanm, China, which has been battling an outbreak of pneumonia caused by the respiratory virus (2019-nCoV) since December. He sought care at Providence Regional Medical Center – Everett in Snohomish County, where he is recovering. Based on the patient’s symptoms, a clinical specimen was sent to CDC overnight, and laboratory testing confirmed the diagnosis. A CDC team has been deployed to Washington state to support the testing investigation……In the coming week, health officials will begin public health entry screening of passengers at Chicago’s O’Hare International Airport and Hartsfield-Jackson Atlanta International Airport. Screening was already in place as of Jan. 17 at New York, Los Angeles and San Francisco international airports. To date, no one has been discovered with the virus through entry screening… January 21, 2020: World Health Organization posted “Novel Coronavirus (2019-nCoV) Situation Report – 1. From the report: Event highlights from 31 December to 20 January 2020: On 31 December 2019, the WHO China Country Office was informed of cases of pneumonia unknown eitology (unknown cause) detected in Wuhan City, Hubei Province of China. From 31 December 2019 through 3 January 2020, a total of 44 case patients with pneumonia of unknown eitology were reported to WHO by the national authorities in China. During this reported period, the causal agent was not identified.On 11 and 12 January 2020, WHO recieved further detailed information from the National Health Commission China that the outbreak is associated exposures in one seafood market in Wuhan City.The Chinese authorities identified a new type of coronavirus, which was isolated on 7 January 2020.On 12 January 2020, China shared the genetic sequence of the novel coronavirus for countries to use in developing specific diagnostic kits.On 13 January 2020, the Ministry of Public Health, Thailand reported the first imported case of lab-confirmed novel coronavirus (2019-nCoV) from Wuhan, Hubei Province, China. On 15 January 2020, the Ministry of Health, Labor and Welfare, Japan (MHLW) reported an imported case of laboratory-confirmed 2019-novel coronavirus (2019-nCoV) from Wuhan, Hubei Province, China. On 20 January 2020, National IHR Focal Point (NFP) for Republic of Korea reported the first case of novel coronavirus in the Republic of Korea. Reported incidence of confirmed 2019-nCoV, 20 January 2020 China, Hubei Province – 258China – Guangdong – 14China Beijing Municipality – 5China Shanghai Municipality – 1Japan – 1Republic of Korea – 1Thailand – 2Total confirmed cases – 282 January 21, 2020: The Centers for Disease Control and Prevention (CDC) posted a press release titled: “First Travel-related Case of 2019 Novel Coronavirus Detected in United States”. From the press release: The Centers for Disease Control and Prevention (CDC) today confirmed the first case of 2019 Novel Coronavirus (2019-nCoV) in the United States in the state of Washington. The patient recently returned from Wuhan, China, where an outbreak of pneumonia caused by this novel coronavirus has been ongoing since December 2019. While originally thought to be spreading from animal-to-person, there are growing indications that limited person-to-person spread is happening. It’s unclear how easily this virus is spreading between people.The patient from Washington with confirmed 2019-n-CoV infection returned to the United States from Wuhan on January 15, 2020. The patient sought care at a medical facility in the state of Washington, where the patient was treated for the illness. Based on the patient’s travel history, and symptoms, healthcare professionals suspected this new coronavirus. A clinical speciman was collected and sent to CDC overnight, where laboratory testing yesterday confirmed the diagnoses via CDC’s Real time Revers Transcription-Polymerase Chain Reaction (rRT-PCR) test.CDC has been proactively preparting for the introduction of 2019-nCoV in the United States for weeks, including: First alerting clinicians on January 8, 2020, to be on the look-out for patients with respiratory symptoms and a history of travel to Wuhan, China.Developing guidance for clinicians for testing and management of 2019-nCoV, as well as guidance for home care of patients with 2019-nCoV.Developing a diagnostic test to detect this virus in clinical specimens, accelerating the time it takes to detect infection. Currently, testing for this virus must take place at CDC, but in the coming days and weeks, CDC will share these tests with domestic and international partners.On January 17, 2020, CDC began implementing public health entry screening at San Francisco (SFO), New York, (JFK), and Los Angeles (LAX) airports. This week CDC will add entry health screening at two more airports – Atlanta (ATL) and Chicago (ORD).CDC has activated its Emergency Operations Center to better provide ongoing support to the 2019-nCoV response. CDC is working closely with the state of Washington and local partners. A CDC team has been deployed to support the ongoing investigation in the state of Wasington, including potentially tracing close contacts to determine if anyone else has become ill… January 22, 2020: World Health Organization Western Pacific China posted a statement titled: “Mission summary: WHO Field Visit to Wuhan, China 20-21 January 2020”. From the statement: On 20-21 January 2020, a World Health Organization (WHO) delegation conducted a field visit to Wuhan to learn about the response to 2019 novel coronavirus (2019-n-CoV). The mission was part of the on-going close collaboration between WHO and Chinese national, provincial, and Wuhan health authorities in responding to 2019-n-CoV.The delegation visited the Wuhan Tianhe Airport, Zhongnan hospital, Hubei provincial CDC, including the BSL3 laboratory in China’s Center for Disease Control (CDC). The delegation observed and discussed active surveillance processes, temperature screening at the airport, laboratory facilities, infection prevention and control measures at the hospital and its associated fever clinics, and the deployment of the rRT-PCR test kit to detect the virus.Data collected through detailed epidemiological investigation and through the deployment of the new test kit nationally suggests that human-to-human transmission is taking place in Wuhan. More analysis of the epidemiological data is needed to understand the fill extent of human-to-human transmission. WHO stands ready to provide support to China to conduct further detailed analysis……The delegation discussed with the local authorities their on-going efforts to communicat to the general public to expect more cases of 2019-nCOV to be confirmed, and to follow public health advice regarding infection control procedures. This is especially important at a time when seasonal influenza is at its highest, and over the Chinese New Year period when many people travel across China. The delegation and their counterparts agreed close attention should be paid to hand and respiratory hygiene, food safety, and avoiding mass gatherings where possible. People with fever should avoid close contact with others and seek medical help……On 21 January 2020, at the concusion of the visit the Chinese Government has relased the primers and probes used in the rRT-PCR test kit. This follows China’s rapid identification of the virus and sharing of the genetic sequence. The primers will assist with establishing real-time RT-PCR for the detection of 2019-n-CoV in other countries. Chinese experts also shared with the delegation a range of protocals that will be used in developing international guidelines, including case definitions, clinical management protocols, and infection control among others… January 22, 2020: People’s Daily, China, the largest newspaper in China, tweeted: “No people in #Wuhan, C China’s Hubei will be allowed to leave the city starting 10 a.m. of Jan 23. Train stations and airport will shut down; the city bus, subway, ferry and long-distance shuttle bus will also be temporarily closed: local authority #WuhanPnemonia #coronavirus” January 22, 2020: The European Centre for Disease Prevention and Control posted information titled: “Risk assessment: Outbreak of acute respiratory syndrome associated with a novel coronavirus, Wuhan, China: first update”. From the Executive Summary of the information: On 31 December 2019, the Wuhan Municipal Health Commision in Wuhan City, Hubei province, China reported a cluster of pneumonia cases of unknown aetiology, with a common reported link to Wuhan’s Huanan Seafood Wholesale Market (a wholesale fish and live animal market selling different animal species).On 9 January 2020, China CDC reported that a novel coronavirus (2019-nCoV) had been detected as the causative agent and the genome sequence was made publicly available. Sequence analysis showed that the newly-identified virus is related to SARS-CoV clade. Detection systems have been developed and are available for the Member States through WHO and the European Virus Archive global catalogue.As of 20 January 2020, a total of 295 laboratory-confirmed cases infected with 2019-nCoV have been reported, 291 from Wuhan, China and four travel-associated from Thailand (2), Japan (1) and South Korea (1). Four deaths have been reported among the cases. Chinese health authorities have confirmed human-to-human transmission and 15 healthcare workers are reported to have been infected in Wuhan, and in China. It is possible that further cases will also be detected among travelers from Wuhan to other countries… January 22, 2020: The CDC reported the onset of 1 more additional COVID-19 case in the United States. January 22, 2020: World Health Organization (WHO) posted “Novel Coronavirus (2019-nCoV) Situation Report – 2”. From the report: Situation update: As of 21 January 2020, a total of 314 confirmed cases have been reported for novel coronavirus (2019-nCoV) globallOf the 314 cases reported, 309 cases were reported from China, two from Thailand, one from Japan and one from the Republic of KoreaCases in Thailand, Japan and the Republic of Korea were exported from Wuhan City, ChinaOf the 309 confirmed cases in China, 270 cases were confirmed from WuhanOf the 270 cases, 51 cases are severely ill and 12 are in critical conditionSix deaths have been reported in WuhanFour of five deaths, with available epidemiological information, had underlying cormorbiditiesTo date, sixteen health care workers have been infected Reported incidence of confirmed 2019-nCoV cases Hubei Province: 270Guangdong Province: 17Beijing Municipality: 5Shanghai Municipality: 2Chongqing Municipality: 1Zhejiang Province: 5Jiangxi Province: 2Sichuan Province: 1Tianjin Municipality: 2Henan Province: 1Shandong Province: 1Yunnan Province: 1Taiwan, China: 1Japan: 1Republic of Korea: 1Thailand: 2TOTAL: 314 January 22, 2020: Nippon.com (News from Japan) posted an article titled: “Japan Struggling to Prepare for Coronavirus Threat”. From the article: As Japan prepares for an influx of Chinese visitors during the Lunar New Year holiday period, hotels and other commercial facilities are struggling to devise measures for preventing the spread of a new coronavirus strain from China.One major hotel chain operator said that it does not plan to take special measures against the threat of coronavirus. Hotel reception staff are unable to take ordinary prevention measures such as wearing surgical masks from a hospitality persepctive.Another hotel company, Prince Hotels Inc., plans to post warnings around the lobby in Japanese, English and Chinese calling on visitors to alert hotel staff if they feel unwell.Restaurant chain giants McDonald’s Co. (Japan) and Ootoya Holdings Co. <2705> are also unable to take special measures, falling back on ordinary hygiene management measures such as making employees wash their hands.One source from a major department store operator said that companies’ hands are tied, as measures to distinguish Chinese visitors from other people would be infeasible. January 22, 2020: The Guardian reported: European airports from London to Moscow step up checks on flights from Wuhan. The WHO’s chief, Tedros Adhanom Ghebreyesus says he is postponing the decision on whether or not to declare a global health emergency. “I have decided to ask the emergency committee to meet again tomorrow to continue their discussion,” he said, referring to a group of international experts who met for several hours at the WHO in Geneva. January 22, 2020: The Guardian posted an article titled: “Coronavirus: Heathrow to screen arrivals from affected Chinese region”. It was written by Sarah Boseley and Alexandra Topping. From the article: People arriving at Heathrow airport from the Chinese city at the centre of a coronavirus outbreak will be met by health teams including a doctor, the government has announced, as UK infectious disease experts doubled their estimate of the likely number of cases to 4,000.Three direct flights a week arrive in the UK from Wuhan, where the outbreak began and which has been linked to a market selling seafood and wild animals. The type of coronavirus has never been identified before and it has been confirmed that human-to-human transmission is taking place. About 460 people have become ill and nine have died so far in China……Heathrow has put health screening in place before – notably during the huge west Africa Ebola outbreak, when all arrivals from the three affected countries, Sierra Leone, Liberia and Guinea, had their temperatures checked and filled out questionnaires about any possible exposure to the virus. There will be warning messages during the direct flights from Wuhan, said the Department of Health and Social Care, and captains will be required to report on any passenger feeling unwell before takeoff.Flights will arrive in an isolated area of Terminal 4, where they will be met by a port health team including a medical inspector and a doctor. All passengers will be asked about their health and checked for symptoms, including their temperature. They will be given instructions on what to do if they begin to feel in once in the UK… January 22, 2020: World Health Organization (WHO) tweeted: “The total number of confirmed cases if the 2019 novel #coronavirus reported globally to date is 581. The total number of cases from mainland China is 571. This includes 95 severe cases and 17 people who have died. #nCoV2019”. This tweet was the start of a thread. January 22, 2020: World Health Organization (WHO) tweeted: “Hong Kong SAR has reported 1 case of #nCoV2019, Macao SAR has reported 1 case, and Taiwan, China has reported 1 case. All of these cases are people who travelled from Wuhan.” January 22, 2020: World Health Organization (WHO) tweeted: “Japan, the Republic of #Korea and the #USA have each reported 1 case of novel #coronavirus. #Thailand has reported 4 cases of #nCoV2019.” This was the last tweet in the thread. January 23, 2020: World Health Organization (WHO) posted “Novel Coronavirus (2019-nCoV) Situation Report – 3”. From the report: Situation Update: A total of 581 confirmed cases have been reported for novel coronavirus (2019-nCoV) globally.Of the 581 cases reported, 571 cases were reported from China.Cases have been reported in Thailand, Japan, Hong Kong Special Administrative Region, Taipei Municipality, China, Macau Special Administrative Region, United States of America and the Republic of Korea, all had travel history to Wuhan. Of the 571 confirmed cases in China, 375 cases were confirmed from Hubei Province.Of the 571 cases, 95 cases are severely ill.Seventeen deaths have been reported (all from Hubei Province). Reported incidence of confirmed 2019-nCoV cases: Hubei Province: 375Unspecified: 131Guangdong Province: 26Beijing Municipality: 10 Shanghai Municipality: 9Chongqing Municipality: 5Zhejiang Province: 5Jiangxi Province: 2Sichuan Province: 2Tianjin Municipality: 2Henan Province: 1Hunan Province: 1Shandong Province: 1Shandong Province: 1Yunnan Province: 1Taipei Municipality: 1Hong Kong Special Administrative Region: 1Macau Special Administrative Region: 1Japan: 1Republic of Korea: 1Thailand: 4United States of America: 1TOTAL: 581 January 23, 2020: The Guardian posted an article titled: “China virus: ten cities locked down and Bejing festivities scrapped”. It was written by Lily Kuo. From the article: Chinese authorities have imposed lockdown measures on ten cities in an unprecedented effort to contain the outbreak of the deadly new virus that has made hundreds of people ill an spread to other parts of the world during the busy lunar new year travel period.Authorities banned transport links from Wuhan, the capital of Hubei province, on Thursday morning, suspending buses, subways, ferries, and shutting the airport and train stations to outgoing passengers. Later in the day, the nearby central Chinese cities of Huanggang and Ezhou announced similar measures. Travel restrictions were also placed on the smaller cities of Chibi and Zhijang.Starting at midnight, long-distance buses, the rapid transit system, and the train station in Huanggang would be shut, according to a notice from the local government. Cinemas, internet cafes and other entertainment venues would all stop operation. Residents should not leave the city, except for “special reasons”.A government notice in Ezhou said the city’s railway would stop operating on Thursday evening. In nearby Chibi, authorities said buses and rural transport links would be halted. Officials ordered tour operators to cancel operations and said no more large-scale cultural events were to be held.On Friday, Huangshi in Hubei province also halted public transport. The People’s Daily newspaper said Xiantao, Enshi, Qianjang and Xianning were also subject to travel restrictions.There have been 830 confirmed cases in China of the coronavirus, from the same family of viruses that gave rise to Sars. Chinese authorities say 95 patients remain in a critical condition.On Thursday, Hebei’s provincial health authority said an infected patient had died, marking the first confirmed death outside Hubei provence, where the outbreak began. On Friday morning the official death toll rose to 25… January 23, 2020: The Guardian reported: As Chinese authorities say 17 people have died and more than 500 have been infected, air and rail departures from Wuhan are suspended. January 23, 2020: Nippon.com (News from Japan) posted an article titled: “Japanese Man Develops Severe Pneumonia in Wuhan”. From the article: A Japanese man has been hospitalized in the Chinese city of Wuhan due to severe pneumonia, an official at the Japanese embassy in Beijing said Thursday.Authorities are investigating whether the pneumonia was caused by a new strain of coronavirus.Cases of pneumonia stemming from the virus are spreading, mainly in China. The Chinese government confirmed 571 cases in the country as of midnight Wednesday (4 p.m. GMT). January 23, 2020: Director-General of the World Health Organization (WHO) Tedros Adhanom Ghebreysus tweeted: “I am not declaring the new #coronavirus outbreak a public health emergency of international concern today. The Emergency Committee was divided over whether the outbreak represents a PHEIC. This is an emergency in China, but has not yet become a global health emergency.” This tweet was the start of a short thread. January 23, 2020: Director-General of the World Health Organization (WHO Tedros Adhanom Ghebreysys tweeted: “This should not be taken as a sign that @WHO does not think the situation is serious. WHO is following this new #coronavirus outbreak every minute of every day, at county, regional and global level. I will not hesitate to reconvene the committee at a moment’s notice if needed.” This tweet was the end of the thread. January 23, 2020: The Hollywood Reporter posted an article titled: “Shanghai Disney Resort Shuts Down as Coronavirus Spreads”. It was written by Patrick Brzeski. The article included Disney’s full statement: In response to prevention and control of the disease outbreak and in order to ensure the health and safety of our guests and Cast, Shanghai Disney Resort is temporarily closing Shanghai Disneyland, Disneytown including Walt Disney Grand Theater and the Wishing Star Park, starting January 25, 2020. We will continue to carefully monitor the situation and be in close contact with the local government, and we will announce the reopening date upon confirmation.Shanghai Disney Resort will assist in the refund for guests who have purchased tickets for admission to Shanghai Disneyland, have booked a resort hotel, or have booked tickets for Beauty and the Beast Mandarin Production through the original ticket purchase channel, and we will introduce the detailed procedure and guidelines via the resort’s official platforms as soon as possible.We wish our guests a healthy and happy Spring Festival!! January 23, 2020: World Health Organization Western Pacific tweeted: “The total number of confirmed cases of the 2019 novel #coronavirus reported globally to date is 845. The total number of cases from mainland China is 830. This includes 177 severe cases and 25 people who have died. #nCoV2019”. This tweet was the start of a thread. January 23, 2020: World Health Organization Western Pacific tweeted: “Hong Kong SAR has reported a total of 2 cases of #nCoV2019, Macao SAR has reported 2 cases, and Taiwan, China has reported 1 case.” January 23, 2020: World Health Organization Western Pacific tweeted: “Republic of Korea has reported 2 confirmed cases of novel #coronavirus. #Japan, #Nepal, #Singapore, & #USA have each reported 1 case of #nCoV2019” January 23, 2020: World Health Organization Western Pacific tweeted: “Understanding of #nCoV2019 is still evolving. Based on current info, most confirmed cases are not severe. Among those who have died, most are over 65 yrs with underlying health conditions. But there is still much more to learn about this virus, and we continue to monitor closely.” January 23, 2020: World Health Organization Western Pacific tweeted: “WHO DG @DrTedros has not declared #nCoV2019 a public health emergency of international concern. He stressed that it is an emergency in China, but not yet a global health emergency. @WHO is following #nCoV2019 very closely and the Emergency Committee may be reconvened at any time.” January 23, 2020: Nippon.com (News from Japan) posted an article titled: “Japanese Firms Banning Travel to Wuhan due to Pneumonia Outbreak”. From the article: More and more Japanese companies are banning their employees from traveling to the Chinese city of Wuhan due to the spread of pneumonia caused by a new strain of coronavirus. Some Japanese department stores have allowed their workers to wear face masks as visitors from China are expected to increase during the Chinese Lunar New Year holiday.Honda Motor Co. <7267> which has a plant in Wuhan, where the new coronavirus originated, banned business trips there in principle, starting on Wednesday. The plant will be closed until Feb. 2 due to the holiday.Subaru Corp. <7270> notified workers that nonessential trips to China should be avoided.“We’ll secure safety for our employees and prevent a spread of the disease,” a company official said. January 24, 2020: The CDC reported the onset of 1 more additional COVID-19 case in the United States. January 24, 2020: World Health Organization (WHO) posted “Novel Coronavirus (2019-nCoV) Situation Report 4”. From the report: Situation Update: A total of 846 confirmed cases have been reported for novel coronavirus (2019-nCoV) globally. Of the 846 cases reported, 830 were reported from China.Eleven confirmed cases have been reported outside of China in six countries.Of these 11 confirmed cases, 10 had travel history to WuhanOne confirmed case in Vietnam had no travel history to any part of China but was a family member of a confirmedcase who visited Wuhan. This suggests an instance of human to human transmission that occured in Vietnam.Of the 830 confirmed cases in China, 375 cases were confirmed in Hubei Province.Of the 830 cases, 177 cases have been reported as severely ill.Twenty-five deaths have been reported to date.On 24 January 2020, the number of confirmed cases of 2019-nCoV has increased by 265 cases since the last situation report published on 23 January 2020, including China which reported additional 259 confirmed cases. Reported incidence of confirmed 2019-nCoV cases: China: Unspecified: 384Hubei Province – 375Guangdong Province – 32Beijing Municipality – 10Shanghai Municipality – 9Chongqing Municipality – 5Zhejiang Province – 5Jiangxi Province – 2Sichuan Province – 2Tianjin Municipality – 2Henan Province – 1Hunan Provance – 1Shandong Province – 1Taipei Municipality – 1Hong Kong Special Administrative Region – 2Macau Special Administrative Region – 2Japan – 1Republic of Korea – 2Viet Nam – 2Republic of Singapore – 1Thailand – 4United States of America – 1TOTAL: 846 January 24, 2020: American Academy of Pediatrics (AAP) posted news titled: “2nd U.S. case of coronavirus confirmed in Chicago”. From the news: …A second case of a novel coronavirus has been confirmed in a Chicago woman and is one of 63 potential cases under investigation in 22 states.The case follows confirmation of the virus earlier this week in a Washington state man in his 30s. Eleven other patients have tested negative, and 50 are waiting on test results, according to the Centers for Disease Control and Prevention (CDC)……The Chicago woman is in her 60s and returned from Wuhan, China, the center of the new virus’ outbreak on Jan. 13, She fell ill several days later. She has had limited contact with other people since her return and is being treated in an isolation room at a local hospital where authorities said she is doing well. Those known to have come in contact with her have not displayed symptoms of illness……The global case count has reached 881, and there have been 26 deaths, according to a tally by Johns Hopkins University. While most of the cases are in China, cases have been confirmed in Thailand, Hong Kong, Japan, Macau, Vietnam, Singapore, South Korea, Taiwan and the U.S….…In the past week, the CDC has screened about 2,000 people arriving from Wuhan at international airports in Los Angeles, New York City, San Francisco, Chicago and Atlanta. Officials said they are continuing to evaluate their approach as China implements new travel restrictions in Wuhan and other cities. January 24, 2020: Nippon.com (News from Japan) posted an article titled: “Second Case of Wuhan-Linked Pneumonia Found in Japan”. From the article: The Japanese health ministry said Friday that it has confirmed the country’s second case of infection of a new strain of coronavirus believed to be behind the pneumonia outbreak in the Chinese city of Wuhan.A man in his 40s who is a resident of Wuhan developed pneumonia and tested positive for the new virus during his visit to Japan as a tourist. He is currently hospitalized in Tokyo. January 24, 2020: CGTN, China Global Television Network, tweeted: “Liang Wudong, a doctor at Hubei Xinhua Hospital who had been at the front line of the #CoronavirusOutbreak battle in Wuhan, dies from the virus at age 62.” January 24, 2020: Prime Minister of Australia Scott Morrison tweeted: “Update on Coronavirus”. The tweet included a screenshot of that update, which said: Today the first case of Coronavirus has been confirmed in Australia.The patient, a man from Wuhan in China, flew to Melbourne from Guangong on 19 January. He is now being treated in isolation in Victoria. Authorities are tracing and contacting all passengers who traveled on the same flight to Melbourne and anyone he has been in contact with since.As previously advised by the Chief Medical Officer, Professor Brendan Murphy it was always expected that Australia would see cases of this virus.The Australian Government has already enacted new measures to protect Australians. From today, anyone arriving in Australia on flights from other parts of China will be met an provided instructions on what to do if they have symptoms, or start to develop them.Australians are being strongly advised not to travel to Wuhan or the Hubei Province in China. Chinese authorities have also imposed travel restrictions in at least five cities in the Hubei province. Australians travelling to these area may not be able to leave until restrictions are lifted.I am receiving daily briefings from health authorities and the Chief Medical Officer and we will continue to monitor and take action where necessary.Australia has a first class health system and we are extremely well prepared to diagnose, manage and isolate any case of Coronavirus. January 24, 2020: Australian Government Department of Health posted news titled: “Chief Medical Officer’s update on novel coronavirus”. It is a transcript of Professor Brendan Murphy’s press conference about novel coronavirus. From the transcription: We’ve just completed a meeting with the Australian Health Protection Principal Committee, which consists of all the senior public health officials in every state and territory in the Commonwealth and a range of technical experts. And I’ve also just finished briefing the Prime Minister, Minister Hunt, the Minister for Health, and the Foreign Minister on the discussions at that meeting and the current latest data.So, the latest data from China is that there are now 844 cases worldwide; 830 in China, 14 cases in locations outside of China, and you can see some of those on our map up on the wall there. There are now 25 deaths 24 of which have been in Wuhan, the main epicenter of this outbreak, and one in someone in Beijing. And again, the story around the deaths are that they have pretty much been elderly people or people with other medical conditions. People who are generally frail. That’s the word we’re getting from China. Approximately 25 per cent of people who contract this infection and who have been detected and diagnosed seem to get a more severe illness. But we do know, or we do suspect, that there are a number of additional cases that are so mild that they haven’t come to attention and been detected or diagnosed at the moment……In Australia, we still have no confirmed cases. There are several patients who are being tested every day. People who have had a relevant travel history and who have developed respiratory symptoms. None of those have turned out to be positive. But, as I’ve said on previous occasions, should we get a positive case in Australia, we are extremely well-prepared to isolate and manage them. The Health Protection Principle Committee discussed a range of materials which are now on our Department of Health wbsite. There’s now good clinical guidelines. We’ve provided new information to every health practicioner, relevant health practitioner, in the country and emergency department, and there’s a lot of new information up on our website… January 24, 2020: Nippon.com (News from Japan) posted an article titled: “Infectious Disease Risks Haunting Japan in Olympic Year”. From the article: Japan faces rising risks of infectious diseases being carried in from abroad, as more than 40 million people are expected to visit the country in 2020, when the Tokyo Olympics and Paralympics will be held.While the outbreak in China of pneumonia believed to be linked to a new strain of coronavirus has emerged as a new source of concern, Japan’s National Institute of Infectious Diseases has identified measles, invasive meningococcal disease (IMD), Middle infectious diseases that require caution during the 2020 Tokyo Games, after studying factors such as how contagious they are and whether there is a risk of group infections.Measles is spreading in the Philippines and other places. Japan was verified in 2015 by the World Health Organization as having achieved measles elimination but continues to see group infections due to imported cases.In 2015, four people from Scotland and elsewhere were infected with IMD at an international scouting even in Yamaguchi Prefecture, western Japan. Another infection case was reported last year after the Rugby World Cub in Japan.Although rare in Japan, IMD is one of the infectious diseases that people must exercise vigilance against, according to the Japanese Association for Infectious Diseases. January 24, 2020: Bloomberg posted an article titled: “Malaysia Reports First Confirmed Cases of Novel Coronavirus”. It was written by Anuradha Raghu. From the article: Malaysia reported its first confirmed case of the novel coronavirus, after three members of a family tested positive.A woman and her two grandchildren — Chinese nationals from Wuhan — traveled to Malaysia from Singapore, Health Minister Dzulkefly Ahmad said in a briefing in Kuala Lumpur on Saturday. They are related to a 66-year-old man and his son who had tested positive for the virus in Singapore.Singapore health authorities tipped Malaysia off that the family had entered the country. The three positive cases in Malaysia are in stable condition with cough symptoms, and have been isolated, the health minister said. Five others who were traveling with them have tested negative for the virus, Malaysia said. January 24, 2020: Reuters posted an article titled: “Malaysia confirms fourth case of coronavirus infection”. It was written by Joseph Sipalan. From the article: Malaysia reported a fourth case of coronavirus infection late Saturday, just hours after it announced its first confirmed cases.The newly identified virus can cause pneumonia, which has been deadly in some cases. It is still unclear how dangerous it is and how easily it spreads between people. Health Ministry Director-General Noor Hisham Abdullah said the latest case was a 40-year-old man from Wuhan, China, who was part of a tour group that traveled by bus to the southern state of Johor from Singapore on Wednesday.The man suffered from fever the next day and sought treatment at a hospital in Johor. Tests by Malaysia’s Crisis Preparedness and Response Centre confirmed he was suffering from the coronavirus, Noor Hisham said……Health Minister Dzulkefly Ahmad had earlier announced three confirmed cases of coronavirus infection in three Chinese nationals, the first reported in Malaysia.The three were related to a 66-year-old man confirmed by Singapore to have tested positive for the virus.The infected individuals were a 65-year-old woman, who is the wife of the man with the virus in Singapore, and their two grandsons, aged 11 and 2, Dzulkefly said… January 24, 2020: People’s Daily, China, the largest newspaper in China, tweeted: “A total of 450 professional #PLA medical staff from Shanghai, Chongqing, and Xi’an arrived at #Wuhan at 23:44 on Friday to deal with the #pneumonia caused by the novel #coronavirus.” January 24, 2020: Nippon.com (News from Japan) posted an article titled: “Japan’s Abe Orders Prompt Update on New Coronavirus”. From the article: Japanese Prime Minister Shinzo Abe instructed cabinet members Friday to provide the public promptly with accurate information about pneumonia linked to a coronavirus outbreak in the Chinese city of Wuhan.Abe also instructed them to provide support to Japanese nationals abroad through local embassies.“I want the public to take usual preventative measures against colds and stay calm without becoming overly concerned about the outbreak,” he told a meeting of relevant ministers.Japan has confirmed its second case of the new strain of coronavirus, while in China, more than 800 cases have been reported with the death toll far exceeding 20.Abe called on the ministers to continue making the utmost efforts to prevent the spread of the virus in Japan and ensure the safety of Japanese citizens abroad. January 24, 2020: UK Department of Health and Social Care posted a press release titled: “CMO for England statement on the Wuhan novel coronavirus”. It is a statement from the Chief Medical Officer for England, Professor Chris Whitty, on Wuhan novel coronaviurs. From the press release: COBR met today to discuss the situation in Wuhan, China, and elsewhere in Asia. I updated on the current situation, the preparedness of the NHS, and possible next steps. I am working closely with the other UK Chief Medical Officers. We all agree that the risk to the UK public remains low, but there may well be cases in the UK at some stage. We have tried and tested measures in place to respond. The UK is well prepared for these types of incidents, with excellent readiness against infectious diseases……There are no confirmed cases in the UK to date. We have been carefully monitoring the situation in Wuhan, China , since the beginning of the outbreak and are now implementing our planned response.A public health hub will be set up in Healthrow from today. This consists of clinicians and other public health officials, in addition to existing port health measures.The World Health Organization has rightly responded quickly and China has introduced strong public health measures. January 24, 2020: Reuters reported that Shanghai had shut down all cinemas during the Lunar New Year holidays, which last until January 30. The virus outbreak in China prompted seven Chinese films that were set to premiere during the country’s Lunar New Year holiday to postpone screenings. January 24, 2020: Centers for Disease Control and Prevention posted a press release titled: “Second Travel-related Case of 2019 Novel Coronavirus Detected in United States”. From the press release: The Centers for Disease Control and Prevention (CDC) today confirmed the second infection with 2019 Novel Coronavirus (2019-nCoV) in the United States has been detected in Illinois. The patient recently returned from Wuhan, China, where an outbreak of respiratory illness caused by this novel coronavirus has been ongoing since December 2019.The patient returned to the U.S. from Wuhan on January 13, 2020, and called a health care provider after experiencing symptoms a few days later. The patient was admitted to a hospital, where infection control measures were taken to reduce the risk of transmission to other individuals. The patient remains hospitalized in an isolation room in stable condition and is doing well.Based on the patient’s travel history and symptoms, health care professionals suspected 2019-nCoV. A clinical specimen was collected and sent to CDC, where laboratory testing confirmed the infection. The Illinois Department of Public Health (IDPH) and the Chicago Department of Public Health (CDPH) are investigating locations where this patient went after returning to Illinois and are identifying any close contacts who were possibly exposed. The patient has limited close contacts, all of whom are currently well and who will be monitored for symptoms. Since returning from China, the patient has had very limited movement outside the home.CDC is taking aggressive public health measures to help protect the health of Americans. While CDC considers this a serious public health threat, based on current information, the immediate health risk from 2019-nCoV to the general American public is considered low at this time. CDC is working closely with the Illinois Department of Public Health, the Chicago Department of Public Health, and other local partners. A CDC team has been deployed to support the ongoing investigation……It is likely there will be more cases reported in the U.S. in the coming days and weeks. CDC will continue to update the public as circumstances warrant. While the immediate risk of this new virus to the American public is believed to be low at this time, there are simple daily precautions that everyone should always take. It is currently flu and respiratory disease season, and CDC recommends getting vaccinated, taking everyday preventive actions to stop the spread of germs, and taking flu antivirals if prescribed. Right now, CDC recommends travelers avoid all nonessential travel to Wuhan, China. In addition, CDC recommends people traveling to China practice certain health precautions like avoiding contact with people who are sick and practicing good hand hygiene. January 24, 2020: CDC Travel Health tweeted: “Update: CDC recommends travelers avoid all nonessential travel to #Hubei Provence, #China, including #Wuhan.” The tweet included a link to CDC information about this recommendation. It also included a graphic of a map of the world with “Travel Notice Warning (Level 3): Avoid Nonessential Travel” on it. January 24, 2020: CNN Business posted an article titled: “McDonald’s closes restaurants in five Chinese cities because of the coronavirus”. It was written by Danielle Wiener-Bronner. From the article: McDonald’s closed restaurants in five Chinese cities and is implementing new health protocals in the region as the deadly coronavirus continues to spread.On Friday, the company shuttered locations in Wuhan, Ezhou, Huanggang, Quianjaing and Xiantao – all cities that have been impacted by the Chinese government’s travel restrictions, company spokesperson Barry Sum told CNN Business in an email. At least 10 cities in central Hubei provence are facing travel restrictions, including Wuhan, where this strain of coronavirus originated.“McDonald’s restaurant operation in Hubei province runs normally in cities where public transportation is available,” Sum said. “Staff and customers’ safety is our first priority and we have comprehensive, precautious measures being implemented to all restaurant operations and office staff.” It’s not clear when the affected restaurants will reopen… January 24, 2020: The Guardian reported: China said on Saturday that the death toll has risen to 41, with 1,287 affected. January 24, 2020: Nippon.com (News from Japan) posted an article titled: “Japan Raises Travel Advisory Level for Hubei Province”. From the article: Japan has decided to raise its travel advisory for China’s Hubei Province to Level 3, Foreign Minister Toshimitsu Motegi said Friday. The move means Japanese citizens are advised to avoid any travel to the province hit hard by a pneumonia outbreak caused by a new strain of coronavirus.The epicenter of the outbreak is Wuhan, the capital of the province. January 24: The Guardian posted an article titled: “Coronavirus: death toll reaches 41 in China with first cases in Europe”. It was written by Rebecca Ratcliffe and Denis Campbell. From the article: China has expanded an unprecedented lockdown during the country’s most important holiday to 13 cities and at least 36 million people, as efforts to contain the deadly new coronavirus were stepped up around the world and the first cases were reported in Europe.Restrictions on movement were widened on Friday in China in an effort to stop the spread of the disease. Late on Friday, authorities confirmed a further 15 deaths and 180 new cases of coronavirus, bringing the total number of fatalities to 41 people and more than 1,000 affected……Chinese officials shut down part of the Great Wall and suspended public transport in the affected cities, stranding millions of people at the start of the lunar new year holiday amid growing anger about the government’s handling of the crisis. Beijing’s famous temple fairs, a tradition during lunar new year celebrations, will not go ahead, while Shanghai Disneyland announced it would also close indefinitely. McDonalds’s announced it has also suspended its business in five affected cities.. January 24, 2020: World Health Organization Philippines tweeted: “Based on the results that came out today from the confirmatory testing done in Australia of the 5-year-old in Cebu, he is negative from the 2019 novel #coronavirus.” This tweet was the start of a thread. January 24, 2020: World Health Organization Philippines tweeted: “This means that the Philippines continues to have no confirmed case of 2019 novel #coronavirus. However, it is likely that we will see more cases in China and in other countries in coming days and weeks.” January 24, 2020: World Health Organization Philippines tweeted: “The Philippine Department of Health, Bureau of Quarantine and airport authorities are continuing active case findings for possible cases of 2019 novel #coronavirus in the country.” This was the last tweet in the thread. January 24, 2020: The Guardian posted an article titled: “French cases show coronavirus has reached Europe”. From the article: France has identified three cases of the deadly new coronavirus from China, the first cases in Europe.Two of the cases were announced by the health minister, Agnès Buzyn, on Friday evening. She said that both of those affected had traveled to China.The third case was announced a few hours after the press conference. Two of the three infected people belong to the same family, authorities said.The minister said she believes that one reason why France is the first European country to have confirmed cases is that it has developed a test allowing medics to rapidly diagnose those affected. “You have to treat an epidemic as you would a fire, that’s to say find the source very quickly,” she said. “We identified the first positive cases very quickly.”One of the patients, a 48-year-old man, passed through Wuhan, the Chinese city at the centre of the outbreak, before travelling to France on Wednesday, the minister said. He is in the south-western city of Bordeaux……She said he is a French national who traveled to China for work and lives in the Bordeaux area. He was in contact with about 10 people before he was taken into care, the minister said. French authorities are seeking to contact them……The other person referred to by Buzyn is in hospital in Paris. The minister said they also travelled to China but she had little information about that case, which was confirmed shortly before she spoke at the news conference… January 24, 2020: Nippon.com (News from Japan) posted an article titled: “Japan Govt, Firms Concerned about Supply Chain Damage from New Virus”. From the article: In the wake of the spread of pneumonia caused by a new strain of coronavirus after an outbreak in Wuhan, China, the Japanese government and companies operating in the city are strengthening their vigilance.A prolonged outbreak is likely to deal a blow to the supply chains of Japanese firms such as automakers and electronic equipment makers.“We’ll closely watch the disease’s economic impacts with high interest,” Japanese industry minister Hiroshi Kajiyama told a press conference on Friday.Wuhan is a core of supply chains in Asia, bringing together cutting-edge factories that make semiconductors and other high-tech components.Some 160 Japanese companies operate in the city, including Honda Motor Co. <7267>, Nissan Motor Co. ,<7201> Denso Corp. <6902>, and Daikin Industries Ltd. <6367>. January 24, 2020: Minister for Health & Ambulance Services, Victoria, Australia, Jenny Mikakos MP tweeted: “We have confirmed a case of the 2019 novel coronavirus in Victoria – the first in Australia. There is no need for the community to be alarmed, our health system is well prepared to manage infectious diseases.” The tweet included a link to the Victoria State Government website to a press release titled: “First novel coronavirus case in Victoria”. From the press release: Victoria’s Department of Health and Human Services has confirmed the first Australian case of the 2019 novel coronavirus.The man is in his 50s, a visitor from China, is in a stable condition with the respiratory illness. He was confirmed as positive at 2:15am today following a series of tests. The patient is being treated in an isolation room at Monash Medical Centre Clayton in accordance with recommended infection control procedure.He had been to the city of Wuhan, China in the two weeks prior to the onset of his illness… January 24, 2020: AFP News Agency correspondent Xinqi Su tweeted: “First recorded death of doctor in mainland China due to #nCoV2019 came on the first day of the Lunar New Year. Liang Wudong, and E.N.T. dept doctor of Hubei Xinhua Hospital, passed away one week after he was admitted to Jinyintan Hospital, his colleague said.” January 24, 2020: AFP News Agency correspondant Xinqi Su also tweeted: “Another doctor lost in the fight against #nCoV2019- Jiang Jijun, a 51yo veteran infectious disease doctor, died of a sudden heart arrest on his way to the fever clinic on Jan. 23. His colleague said he was exhausted by a two to three-fold surge in service demand due to the epidemic.” January 24, 2020: The Guardian reported that China’s Hainan province quarantines tourists from Hubei province. In China’s Haikou city, the capitol of the southern island province of Hainan, will start a 14-day centralized medical observation for tourists from the central Hubei province, the local government in Haikou has announced.Tourists from Hubei, especially from Wuhan city, are not allowed to leave the hotel where the medical observation will be held during the 14-day period, it said.Hubei has confirmed 729 cases of the new coronavirus, with 39 deaths as of January, the provincial health authorities said. January 24, 2020: Australian Foreign Minister & Minister for Women Marise Payne tweeted: “We have raised our travel advice for Wuhan and Hubei province to level 4 – “Do not travel.” Chinese authorities have restricted travel in at least 5 Hubei cities. Australians going there may not be able to leave until restrictions are lifted.” The tweet included in link to information about Level 4: Do not travel. At level 4, your health and safety is at extreme risk. This may be because of a high threat of terrorist attack, conflict, violent social unrest, widespread infectious disease, or critical levels of violent crime. It could be a combination of risks.If you travel to this location you’re at a high risk of death, imprisonment, kidnapping, or serious injury. If you get into trouble, the Australian Government may be unable to help. In most cases, our ability to provide consular assistance in these destinations is extremely limited.Any travel by Australian officials to ‘Do Not Travel’ locations is subject to high-level approval. It includes rigorous risk assessment and movement planning usually involving the use of armoured vehicles.You should not travel to this location. If you are already in a ‘do not travel’ area, you should consider leaving. If, despite our advice, you decide to travel to a location with a travel advice level of 4, it’s your responsibility to follow all the advice for levels 1, 2, and 3, as well as the following… January 25, 2020: CGTN, China Global Television Network tweeted: “#UPDATE Xinhua Hospital says 62-years-old ENT specialist, Dr. Liang Wudong, who is suspected to have died from the coronavirus Saturday retired in March 2019.” January 25, 2020: The CDC reported the onset of 3 additional COVID-19 cases in the United States. January 25, 2020: World Health Organization (WHO) posted a “Novel Coronavirus (2019-nCoV) Situation Report – 5”. From the report: Situation Update: A total of 1,320 confirmed cases have been reported for novel coronavirus (2019-nCoV) globally.Of the 1,320 cases reported, 1,297 cases were reported from China, including Hong Kong SAR (5 confirmed cases), Macau SAR (2 confirmed cases), and Taipei (3 confirmed cases.)A total of 1,965 suspected cases have been reported from 20 Chinese provinces, regions and cities (excluding Hong Kong SAR, Macau SAR and Taipei).Of these 23 confirmed cases, 21 had travel history to Wuhan City, China; one case in Australia had direct contact with a confirmed case from Wuhan while in China; and one confirmed case in Viet Nam had no travel history to any part of China as mentioned in the situation report published on 24 January. According to preliminary investigations, this constitutes an instance of human-to-human transmission within a family.Of the 1,287 confirmed cases (excluding Hong Kong SAR, Macau SAR, and Taipei), 237 cases have been reported as severely ill.Fourty-one deaths have been reported to date (39 deaths in Hubei province, one death in Hebei province and one in Hellongjaing province).On 25 January 2020, the number of reported confirmed cases of 2019-nCoV has increased by 474 cases since the last situation report published 24 January 2020.WHO’s assessment of the risk of this event has not changed since the last update (22 Jan): very high in China, high at the regional level and high on the global level. Reported Incidences of confirmed 2019-nCoV, 25 January 2020: China: – 1297 – including confirmed cases in Hong Kong SAR (5 confirmed cases), Macau SAR (2 confirmed cases) and Taipei (3 confirmed cases.Japan: 3Republic of Korea: 2Viet Nam: 2Republic of Singapore: 3Australia: 3Thailand: 4Federal Democratic Republic of Nepal: 1United States of America: 2French Republic: 3TOTAL: 1320 January 25, 2020: Nippon.com (News from Japan) posted an article titled: “3rd Case of Wuhan-Linked Pneumonia Found in Japan”. From the article: Japan’s health ministry said Saturday that it has confirmed the country’s third case of pneumonia caused by a new type of coronavirus originating in Wuhan, China.The patient, now in Tokyo, is a woman in her 30s from the Chinese city, the epicenter of the virus, the ministry said. January 25, 2020: People’s Daily, China, the largest newspaper in China, tweeted: “Doctor Liang Wudong at the ENT department of Hubei Xinhua Hospital who had been at the front line fighting against #nCoV2019 in Wuhan, died from teh virus on Sat at the age of 62. #RIP”. The tweet included a large, black and white, photo of Doctor Liang Wudong. January 25, 2020: The Times of India reported 12 people who returned to India from China and Hong Kong had been quarantined (as a precautionary measure) in hospitals in India. Three, including a Briton, in Mumbai, and nine in Kerla’s Ernakulam and Thrissur – as China locked down 10 cities and closed part of the Great Wall to control the coronavirus outbreak. January 25, 2020: The Japan Times posted an article titled: “Japan confirms third case of new coronavirus infection”. From the article: The health ministry said Saturday that it has confirmed a third case of a new deadly virus that has been rapidly spreading in China and beyond. The patient is a woman from the central Chinese city of Wuhan, where the outbreak of the mysterious coronavirus began, the ministry said, adding she arrived in Japan in Jan. 18.The ministry has not disclosed her nationality or which airport or port she used when she entered the country.The woman in her 30s, who is in stable condition, is said to have had no symptoms at the time of arrival but developed a fever and started coughing on Tuesday night, according to the ministry.She visited a Tokyo hospital on Thursday and later tested positive for the virus, which has killed at least 41 people in China……She came to Japan as part of a family of four. However, so far the other three have not developed any symptoms, the official said… January 25, 2020: CNN Philippines tweeted: “JUST IN: Hong Kong declares Wuhan virus outbreak an “emergency” The Hong Kong Disease contingency plan has been upgraded from “serious” to “emergency” level, Hong Kong Chief Executive Carrie Lam announces s- via @CNN” January 25, 2020: CNN Philippines also tweeted: “Lam also says schools in the city will be suspended until February 17. This is amid rising fears of the virus’s spread.” January 25, 2020: People’s Daily, China, the largest newspaper in China tweeted: “#HongKong to suspend high-speed rail and flights connecting the city with Wuhan indefinitely, HK chief executive Carrie Lam said Sat, vowing to step up quarantine efforts to curb the spread of #nCoV2019.” January 25, 2020: Masslive.com posted an article titled: “Wuhan bans cars, Hong Kong closes schools as coronavirus spreads”. The source is the Associated Press. From the article: The virus-hit Chinese city of Wuhan, already on lockdown, banned most vehicle use downtown and Hong Kong said it would close schools for two weeks as authorities scrambled Saturday to stop the spread of an illness that has infected more than 1,200 people and killed 41.Hong Kong leader Carrie Lam said her government will raise its response level to emergency, the highest one, and close primary and secondary schools for two more weeks on top of next week’s Lunar New Year holiday. They will re-open Feb. 17.Lam said that direct flights and trains from Wuhan would be blocked. The outbreak began in the city in central China and has spread nationwide and overseas, fueled by millions of people traveling during the country’s biggest holiday.In a sign of the growing strain on Wuhan’s health care system, the official Xinhua news agency reported that the city planned to build a second makeshift hospital with about 1,000 beds. The city previously announced that construction of a hospital of the same size is underway and expected to be completed Feb. 3……China cut off trains, planes and other links to Wuhan on Wednesday, as well as public transportation within the city, and has steadily expanded a lockdown to 16 surrounding cities with a combined population of more than 50 million, greater than that of New York, London, Paris and Moscow combined.The cities of Yichang, Suizhou and Jingzhour were the latest added to the list on Friday evening and Saturday… January 25, 2020: World Health Organization Western Pacific tweeted: “The total number of confirmed cases of 2019 novel #coronavirus reported from mainland China is 1,975. This includes 237 severe cases and 56 people who have died. #nCoV2019 #nCoV”. This was the first tweet in a thread. (This tweet was corrected by another tweet that followed the thread: “Correction: The total number of confirmed cases of the 2019 novel #coronavirus reported from mainland China to date is 1,975. This includes 324 severe cases and 56 pople who have died. #nCoV2019#nCoV”) January 25 2020: World Health Organization Pacific continued its thread with another tweet: “Hong Kong SAR has reported a total of 5 cases of #nCoV2019, Macao SAR has reported 2 cases, and Taiwan, China has reported 3 cases.” January 25, 2020: World Health Organization Pacific continued its thread with another tweet: “Among other countries in the @WHO Western Pacific Region, #Australia, #Malaysia & #Singapore have each reported 4 cases of the 2019 novel #coronavirus. #Japan has reported 3 cases. The Republic of #Korea and #Vietnam have each reported two cases. January 25, 2020: Australian Ministers Department of Health posted a media release titled: “First confirmed case of novel coronavirus in Australia”. It was written by The Honorable Greg Hunt, MP, Minister for Health. From the media release: The first case of novel cornavirus (2019-nCoV) has been confirmed by Victoria Health Authorities this morning.The Commonwealth Department of Health is in close contact with Victorian health authorities and has notified the World Health Organization. The patient, a man from Wuhan, flew to Melbourne from Guandong on 19 January.Minister for Health Greg Hunt said, “Australia has world-class health systems with processes for the identification and treatment of cases, including isolation facilities in each state and territory, these processes have been activated.”“Our laboratories have developed testing processes for this novel coronavirus that can provide a level of certainty within a day.”Australian Chief Medical Officer Professor Brendan Murphy said Victoria had acted swiftly and appropriately.“Victoria has followed its strict protocols, including isolating the affected person. I understand the patient has pneumonia and is in a stable condition.”The virus originated in mainland China – the overwhelming majority of cases are there – and the only clear evidence of human-to-human transmission is in the Wuhan region.Minister Hunt said, “Victorian and Commonwealth authorites will be undertaking “contact tracing” for passengers who travelled on this flight and to provide them with information and advice.”Australia will continue to monitor the situation closely and continue to act on the best available evidence and advice: Overnight, DFAT raised the level of travel advice for Wuhan and Hubei Province in China to ‘level 4 – do not travel’ and has issued a Smartraveller bulletin on the virus outbreak. The advice level for China as a whole has not changed.Border measures are already in place to detect travellers who are unwell coming into the country.Whilst, the Chinese authorities have now stopped all traffic from Hubei province as an added precaution, the Government is ensuring that all passengers on flights from other parts of China will be met and provided information on arrival.Information is also on display at all major international ports around Australia, with instructions on what to do if travellers have symptoms or if symptoms develop.Human coronavirus with pandemic potential’ is now a Listed Human Disease under the Biosecurity Act 2015, enabling the use of enhanced border measures.The Department of Health has provided primary and community health care workers and Emergency Departments in Australia with updated advice.The Chief Medical Officer convened a national teleconference of the Australian Health Protection Principle Committee (AHPPC) this morning to inform State and Territory Authorities and to coordinate further national action. Professor Murphy said it was important people who had recently arrived in Australia from Wuhan, and those in close contact with them, watch for signs of the coronavirus. “We don’t know exactly how long symptoms take to show after a person has been infected, but there is an incubation period and some patients will have very mild symptoms,” Professor Murphy said.“Symptoms include fever, cough, sore throat, vomiting and difficult breathing. Difficulty breathing is a sign of possible pneumonia and requires immediate medical attention.”“People who arrive in Australia from an international flight with these symptoms should alert their airline, or a biosecurity officer if they have disembarked.”If people start getting symptoms in the next week after arriving in Australia, they should see a doctor or go to hospital if they are very ill. If they have travelled to Wuhan, they should call ahead to ensure others aren’t put at risk… January 25, 2020: Australian Government Department of Health posted news titled: “Chief Medical Officer’s update on novel coronavirus”. It is a transcript of Professor Brendan Murphy’s press conference about novel coronavirus. From the transcript: [Confirms the first case of novel coronavirus has been identified in Australia]… from Wuhan travelled to Melbourne last Sunday on a flight on the 19th. On flight CZ321from Guangzhou and he was well when he arrived but developed an illness during last week and is currently in stable condition under isolation in a hospital in Melbourne. As we indicated earlier in this week, given the number of cases that have been found outside of China and the significant traffic from Wuhan city in the past to Australia, it was not unexpected that we would get some cases.So this is the first confirmed cases. There are other cases being tested each day. Many of them are negative but I wouldn’t be surprised if we had further confirmed cases. As I’ve said previously however Australia is very well prepared. We have excellent State and Territory health systems. All of whom have protocols to isolate and rapidly diagnose conditions such as this. And this is evidenced by what happened with this gentleman in Melbourne, who is now under isolation and being managed. This morning I convened an emergency meeting of the Australian Health Protection Principle Committee to discuss this first positive case and we discussed the protocol for contact tracing of passengers adjacent to him in the train, in the plane sorry, and providing information to other passengers on that plane.As I’ve previously advised, we have a lower risk now of people coming from Wuhan because the Chinese government have now stopped all transport out of Wuhan. However, there may be some people who have been in Wuhan, who got out before the travel ban was instituted by China and they may make their way to Australia from other ports in China.So for the time being as of this afternoon we’ll be meeting all flights from China – and there are a very large number of flights to Australia each week from China – and providing information to all passengers in English and Mandarin, encourage them if they’ve been from that Hubei province of China, particularly the city of Wuhan. And if they get any illness when they’re here to seek medical attention and identify themselves as having come from that region of China. We are intending- Minister Hunt is proposing to convene a meeting of health ministers this afternoon just to make sure that all health ministers are well apprised of the situation. And the Australian Government Crisis Committee will also be meeting just to make sure that everybody is fully prepared and fully understands the implications of having one or more positive cases in Australia… January 25, 2020: New South Wales Health posted Novel Coronavirus statistics (as of 11AM that day). Number of confirmed cases: 0. Number of cases under investigation: 5. January 25, 2020: New South Wales Health posted another Novel Coronavirus statistics (as of 5PM that day). Number of cases confirmed: 0. Number of cases under investigation: 7. January 25, 2020: The European Center for Disease Prevention and Control posted information titled: “Novel coronavirus: three cases reported in France”. From the information: French health authorities have confirmed three cases of novel coronavirus (2019-nCoV) virus in France since 24 January 2020. The first confirmed cases in Europe are not unexpected given the developments of the last few days with several 2019-nCoV cases reported in countries outside of China.The fact that these cases were identified, proved that detection and confirmation of this novel virus is working in France. showing a high level of preparedness to prevent and control possible infections of 2019-nCoV.Most EU countries have plans and measures in place to contain this kind of infections and Europe has well-equipped laboratories that can confirm probable cases in addition to hospitals that are prepared to treat patients accordingly. EU/EEA countries should ensure that timely and rigorous infection prevention and control measures (IPC) are applied around people diagnosed with 2019-nCoV, Such measures will keep the likelihood of further sustained spread in both healthcare and community settings low.In the past, systematic implementation of infection prevention and control measures were effective in controlling both SARS-CoV and MERS-CoV.ECDC is working with the EU/EEA Member States to ensure that they are prepared to manage any imported cases. ECDC is monitoring this event through epidemic intelligence activities, and provides risk assessments to guide EU Member States and the EU Commission in their response activities.At this stage, it is likely that there will be more imported cases in Europe. Even if there are still many things unknown about 2019-nCoV, European countries have the necessary capacities to prevent and control an outbreak as soon as cases are detected… January 25, 2020: China correspondent, British Broadcasting Corporation (BBC) tweeted: “The streets are empty in the small towns of Hubei Province where the #coronavirus outbreak started. #China”. The tweet included a short video, which appears to be taken from a vehicle driving through a street. There are no people in the video. January 26, 2020: The European Centre for Disease Prevention and Control posted an update titled: “Risk assessment: outbreak of acute respiratory syndrome associated with a novel coronavirus, China; First cases imported in the EU/EEA; second update” From the update: On 31 December 2019, a cluster of pneumonia cases of unknown aetiology was reported in Wuhan, Hubei Province China. On 9 January 2020, China CDC reported a novel coronavirus (2019-nCoV) as the causative agent of this outbreak, which is phylogenetically in the SARS-Cov clade.As of 26 January 2020, a total of 2,026 laboratory-confirmed 2019-nCoV cases have been reported, 1,988 in China and 38 imported cases from other countries around the world. Fifty six deaths have been reported among the cases. Chinese health authorities have confirmed human-to-human transmission outside Hubei province and 16 healthcare workers are reported to be infected.Imported cases in EuropeOn 23 January 2020, the first imported cases (3) of 2019-nCoV were identified in France.The rapid increase in the number of reported cases can be partly attributed to the ongoing improved testing protocols and epidemiological investigations on the Chinese authorities; however, since the original source remains unknown and human-to-human transmission has been documented, further cases and deaths are expected. Further cases are also expected among travellers from Hubei Province. Therefore, health authorities in Member States should remain vigilant and strengthen their capacity to respond to such an event.There are considerable uncertainties in assessing the risk of this event, due to lack of detailed epidemiological analyses… January 26, 2020: Nippon.com (News from Japan) posted an article titled: “Japan Govt Urged to Prevent Spread of New Coronavirus”. From the article: A Japanese ruling party official on Sunday called on the government to take “full-scale border control measures” to prevent the spread of pneumonia caued by a new strain of coronavirus while paying close attention to related information from the World Health Organization.In a television program, Tomomi Inada, executive acting secretary-general of the Liberal Democratic Party, also urged the government of Prime Minister Shinzo Abe to ensure that the public are fully given necessary information on the new virus originating in the inland China city of Wuhan.Noting that China’s government decided on Saturday to effectively ban oversees travel by Chinese nationals from Monday, Tetsuro Fukuyama, secretary-general of the main opposition Constitutional Democratic Party of Japan, said in the TV program that the move by Beijing is certain to have a considerable impact on Japan’s tourism industry and that the Japanese government should give consideration to the issue.According to China’s government, nearly 2,000 people in the country have developed pneumonia caused by the new virus and the death toll has topped 50. January 26, 2020: New South Wales Health another Novel Coronavirus statistic (as of 9AM that day.) Number of cases confirmed: 3. Number of cases under investigation 2. January 26, 2020: Nippon.com (News from Japan) posted an article titled: “Govt to Bring Japanese Nationals in Wuhan Back Home”. From the article: Prime Minister Shinzo Abe said Sunday that the government will bring back home Japanese nationals in Wuhan, the epicenter of a new type of coronavirus that has caused a number of people to develop pneumonia, and areas near the inland Chinese city.“As soon as coordination with the Chinese government is made, we will help all Japanese nationals willing to return home to get back to Japan using all available measures, including chartered flights,” Abe told reporters at his official residence.“We are making adjustments with the Chinese government at various levels,” he said, adding that the Japanese government will accelerate the preparations in order to have Japanese citizens in Wuhan and nearby areas return home as soon as possible.Around 710 Japanese nationals are now believed to be in Wuhan, according to Japan’s Foreign Ministry. Traffic to and from Wuhan, the capital of Hubei Province, has been shut off to prevent any further spread of the virus. Similar traffic shutdown has also been in place in some 10 other cities in the Chinese province.. January 26, 2020: New South Wales Health posted another Novel Coronaviris Statistics (as of 5PM that day). Number of cases confirmed: 3. Number of cases under investigation: 1 (see below): Preliminary test results have shown the above case currently under investigation has tested positive for the Novel Coronavirus. Confirmation is expected tomorrow. Public health follow-up of this probable case is being undertaken in accordance with the national guidelines and the patient remains in isolation.Of the five cases that were under investigation today, four have now been cleared of the infection… January 26, 2020: Australian Government Department of Health posted a transcript titled: “Chief Medical Officer’s update on novel coronavirus”. It is a transcript of Professor Brendan Murphy’s press conference about novel coronavirus in Australia. From the transcript: Well, thank you for coming this afternoon to get an update on the coronavirus situation. I can report there have been no new confirmed cases in Australia. The number of four cases; three in Sydney and one in Melbourne remains the same. The four patients, I believe, are all in stable condition in isolation in hospital. Information just released from China shows, as expected, the number of cases has increased to over 2000 and now 56 deaths.Nearly all of those deaths are in the Hubei province, which includes the city of Wuhan. That province has been the focal point of this infection. But we do know that there have been more than 40 cases exported to other countries and there have been cases seen in other provinces of China.As I have advised previously, since the Chinese have essentially locked down Hubei province and stopped people leaving, the risk of infected people who might be incubating the virus coming to Australia remains lower than it was before that time.However, because people could have left the province before the lockdown and could come to Australia via a number of flights, we are now meeting every flight from China and providing the passengers with an information sheet, asking them to identify themselves if they’re unwell on the flight, but also to identify if they become unwell, particularly with fever or cough or other respiratory symptoms after they have been in Australia……So the risk to the Australian population is – there is no risk at the moment other htan people who have come from – with that travel history or have been in contact with people. So there is no cause for general concern, but we are very focused on identifyin anyone who may have come with this disease in recent weeks… January 26, 2020: CDC tweeted: “CDC confirms 3 new cases of novel #coronavirus (#2019 infection in the U.S., 1 in AZ & 2 in CA, bringing total to 5. All US cases travelled from Wuhan, China. More cases may be identified. However, risk to US general public is considered low.” January 26, 2020: World Heath Organization (WHO) posted “Novel Coronavirus (2019-nCoV) Situation Report – 6”. From the report: Data was reported by 26 January 2020. Situation update: On 26 January 2020, the number of reported confirmed cases of novel coronavirus (2019-nCoV) has increased by 694 cases since the last situation report published yesterday.A total of 2,014 confirmed 2019-nCoV cases have been reported globally;Of the 2,014 cases reported, 1,985 cases were reported from China, including Hong Kong SAR (4 confirmed cases), Macau SAR (2 confirmed cases), Taipei (3 confirmed cases).Twenty-nine confirmed cases have been reported outside of China in ten countries. (see table-1) Of these 29 exported cases, 26 had a travel history from Wuhan City, China.Among the three cases identified in countries outside of China: one case in Australia had direct contact with a confirmed case from Wuhan while in China; one case in Australia reported today, travel history is not yet known; One case in Viet Nam had no travel history but was in contact with a confirmed case (his father with travel history to Wuhan), resulting in human-to-human transmission within a family.Of the 1,975 confirmed cases (excluding Hong Kong SAR, Macau SAR and Taipei), 324 cases have been reported as severely ill.Fifty-six deaths have been reported to date (52 deaths in Hubei province and 4 from outside Hubei)WHO’s assessment of the risk of this event has not changed since the last risk assessment conducted on 22 January: very high in China, high at the regional level and high at the global level. Reported incidence of confirmed 2019-nCoV cases (Table 1) China: 1,985Japan: 3Republic of Korea: 2Viet Nam: 2Singapore: 4Australia: 4Malaysia: 3Thailand: 5Nepal: 1United States of America: 2France: 3 TOTAL: 2,014 January 27, 2020: Nippon.com (News from Japan) posted an article titled: “Japan to Designate New Pneumonia as Specified Disease”. From the article: Japan will designate pneumonia caused by a new type of coronavirus that is spreading mainly in China as a specified infectious disease, Prime Minister Shinzo Abe said Monday.The government plans to make the move at a cabinet meeting Tuesday, Abe told the Budget Committee of the House of Representatives, the lower chamber of the Diet, Japan’s parliament.The designation under the infectious disease law will allow authorities to conduct compulsory hospitalization of infected patients and stop them from attending work. January 27, 2020: UK Department of Health and Social Care posted a statement titled: “Wuhan coronavirus: Health Secretary’s statement to Parliament”. It is a statement from the Secretary of State for Health and Social Care Matt Hancock. From the statement: …The Chief Medical Officer continues to advise that the risk to the UK population is “low” and has concluded that while there is an increased risk of likelihood that cases may arise in this country, we are well prepared and well equipped to deal with them.As of 2pm, there are currently no confirmed cases in the UK. We are working night and day with the World Health Organization and the international community and are monitoring the situation closely. Our approach has been guided by the Chief Medical Officer, Professor Chris Whitty.As I set out in my statement on Thursday, coronavirus presents with flu-like symptoms including a fever, a cough, or difficulty breathing. The current evidence is that most cases appear to be mild.However, this is a new disease and the global scientific community is still learning about it. I have therefore directed Public Health England to take a belt and braces approach, including tracing people who have been to Wuhan in the past 14 days.Coronaviruses do not usually spread if people don’t have symptoms – however we cannot be 100 per cent certain.From today, we are therefore asking anyone in the UK who has returned from Wuhan in the last 14 days to self-isolate. Stay indoors and avoid contact with other people – and to contact NHS 111. If you are in Northern Ireland, you should phone your GP……Public Health England officials are continuing to trace people who have arrived in the UK from Wuhan. Having eliminated those who we know have since left the country, there are 1,460 people we are seeking to locate.The Foreign Office is rapidly advancing measures to bring UK nationals back from Hubei Provence……The UK is one of the first countries in the world to have developed an accurate test for this coronavirus and PHE is undertaking continuous refinement of this test. PHE has this morning confirmed to me that it can scale up this test so we are in a position to deal with cases in this country if necessary… January 27, 2020: Nippon.com (News from Japan) posted an article titled: “Honda, Aeon to Bring Home Japanese Workers from Wuhan”. From the article: Honda Motor Co. <7267> and Aeon Co. <8267> will bring home Japanese workers from Wuhan, China, due to the spread of pneumonia caused by a new strain of coronavirus, officials at the two Japanese companies said Monday.The companies will use flights chartered by the Japanese government for the evacuation from Wuhan, the capital of Hubei Province, the officials said.A chartered flight will leave for Wuhan as early as Tuesday, Toshihiro Nikai, secretary-general of the ruling Liberal Democratic Party, told reporters. The new virus is believed to have originated in the inland Chinese city.Honda has an auto assembly plant in Wuhan. Japanese workers and theri family members, totaling some 30, will be brought back home, company officials said. A few Japanese workers who oversee the plant will stay there, they said.Aeon, which runs five supermarket stores in Wuhan, will allow workers who hope to go back to Japan to do so, company officials said. January 27, 2020: New South Wales Health posted another Novel Coronavirus Statistics. Number of cases confirmed: 4. Number of cases under investigation: 5. January 27, 2020: CDC Travel Health tweeted: “CDC recommends travelers avoid all nonessential travel to #China due to the ongoing #2019nCoV (#coronavirus) outbreak. The outbreak is growing and there is limited access to adequate medical care in affected areas”. January 27, 2020: World Health Organization Western Pacific posted a thread that started with this tweet: “The total number of confirmed cases of the 2019 novel #coronavirus reported from mainland China to date is 4,515. This includes 976 severe cases and 106 people who have died. #nCov #nCoV2019 #2019nCoV”. January 27, 2020: World Health Organization Western Pacific tweeted: Hong Kong SAR has reported a total of 8 cases, Macao SAR has reported 7 cases, and Taiwan, China has reported 4 cases. #coronavirus #nCoV #nCoV2019 #2019nCov” January 27, 2020: World Health Organization Western Pacific tweeted: “Among other countries in the @WHO Western Pacific Region: Austraia & Singapore have each reported 5 cases; Japan, Malaysia & the Republic of Korea: 4 cases each; Vietnam: 2 cases; Cambodia: 1 case. #coronavirus #nCoV #nCoV2019 #2019nCoV” This tweet is not the end of the thread. I am leaving out the last tweet in the thread, which provides information about good hygiene practices. January 27, 2020: Nippon.com (News from Japan) posted an article titled: “GMO Employees to Work from Home amid Coronavirus Concern”. From the article: GMO Internet Inc. <9449> said Monday it has told about 4,000 employees, about 90 pct of its workforce in Japan, to work from home amid concerns over a new coronavirus.The measure will last for about two weeks starting Monday, the Japanese internet service provider said.Subject to the measure are employees working in offices in Tokyo’s Shibuya district, the western city if Osaka and the southwestern prefecture of Fukuoka. The company said it has told workers in Beijing, Shanghai, and other places in China, including those on business trips, to return to Japan.The moves are to “secure employee’s safety and continue providing stable services,” a GMO Internet official said. January 27, 2020: Ohio Department of Health tweeted: “Ohio currently has zero cases of #Coronavirus. We are continuing to monitor the situation closely with @CDCgov.” January 27, 2020: Australian Government Department of Health posted a transcript titled: “Chief Medical Officer’s update on novel coronavirus”. It is a transcript of Professor Brendan Murphy’s doorstop about novel coronavirus”. From the transcript: …Four elsewhere in China. The average age of the deaths, the median age I should say is 71 and a half years, which suggests that they’re in an elderly population in the main. Although there have been some young people in that group. There are 54 exported cases now in a range of countries, generally in small numbers. In Australia, there are now five confirmed cases: four in New South Wales, in Sydney, currently at Westmead Hospital and one in Melbourne in Monash Medical Centre. I’m advised that all five remain stable. There are a number of other Australians who have been tested and have been negative.I’ve been regularly updating the Prime Minister, the Minister for Health, and Government on the developments. I think one thing we are noticing is that in China, whilst more than half the cases are still in the Hubei province, we are seeing increasing numbers across the other provinces in China. We still don’t know whether those increasing numbers are due to people who’ve come from the Hubei province, left that province before it was locked down and developed symptoms. There is still no evidence yet of sustained human to human transmission outside of the Hubei province. In Australia, our focus, as I’ve said on many occasions, is the early detection of anyone who may have come from China, particularly the Hubei province, within the last two weeks; the incubation period being up to 14 days. And our message remains the same: if you develop flu-like symptoms, fever, cough, contact either your GP or your local emergency department, tell them before you come that you’ve had a relevant travel history to China and attend to be tested. The majority of people that have been tested turn out to be negative.We have increased some of the border measures today. As we’ve previously advised, every flight from China now is being met by border security officers who are going on the plane and distributing information to every passenger trying to identify any unwell passengers. The airlines are also required to identify any unwell passengers and if they are unwell, there’s a process of screening them. Every passenger on those flights from China is given an information sheet in Chinese and Mandarin, sorry, Mandarin and English and told to undertake, to watch themselves, and to contact their doctor or their emergency department should they develop symptoms over the following 14 days. In addition, because there are some people who could come from China via other countries, and other ports within 14 days, we are now making announcements in the arrivals halls of airports, again in English and Mandarin, pointing out that anyone who may have come from China from whatever flight or whatever port they’re on, pointing out the risks and identifying that there is printed material available for them to collect at the airport if they have come from China so that all of the people who may have come from China can get that information.Again, we have no evidence there’s a risk to the Australian public. There’s no human to human transmission that’s been identified in this country. I convened this afternoon the Australian Health Protection Principle Committee and we have been looking at the data, and as I said, the concern, I think, is the number of cases outside of the Hubei province in China, and that’s why we are starting to look at people who have come from parts of China other than Hubei as potentially at risk. Although, our focus still remains on that Hubei province of China, which is the epicentre and which is the only place where human to human transmission has been identified… January 27, 2020: Nippon.com (News from Japan) posted an article titled: “Japan Firms to Bring Home Workers from Coronavirus-Hit Wuhan”. Many Japanese companies have decided to call back expatriate workers from the city of Wuhan, the epicenter of a pneumonia outbreak, as the Japanese government plans to charter evacuation flights.Companies will bring home Japanese workers and their families from the inland China city, currently under lockdown to prevent the spread of a new strain of coronavirus believed to be behind the disease.Honda Motor Co. <7267> will evacuate some 30 people on Japanese government-chartered planes. The automaker’s plant in Wuhan is closed until next Sunday for the Lunar New Year holiday. “We will make decisions on operations from Feb. 3 while monitoring the situation,” a company representative said.Nissan Motor Co. <7201> will also bring home employees and their families.Major chipmaking equipment maker Tokyo Electron Ltd. <8035> will bring back some 30 people to Japan, while Nippon Steel Corp. <5401> and tire maker Bridgestone Corp. <5108> will evacuate four employee and one worker, respectively. January 27, 2020: CDC posted a “Transcript of 2019 Novel Coronavirus (2019-nCoV Update). It is a Press Briefing Transcript. From the transcript: Much of the information in this press briefing was given by Nancy Messonnier, MD, the Director of the Center for the National Center for Immunization and Respiratory Diseases (NCIRD). It is part of the CDC. …To date we have 110 of what we’re calling persons under investigation or PUIs from 26 states. This is a cumulative number and will only increase. We still have only five confirmed cases overnight. This information will be posted on our website and updated on our website on Mondays, Wednesdays and Fridays.I want to give a short update of the laboratory side of our work. Last week we mentioned CDC has developed a diagnostic test called a real-time reverse transcription prelininary chain reaction, that’s RRTPCR. It can diagnose this new coronavirus in respiratory serum samples from clinical specimens. Last Friday we publicly posted the protocal for this test. This is a blueprint to make the test……Additionally, CDC uploaded the entire genome from the virus from the first and now second cases reported in the United States. All the sequences we extracted are similar the one that China initially posted a couple of weeks ago. This means that right now and based on CDC’s analysis of the available data it doesn’t look like the virus has mutated. And we’re growing the virus in cell culture which is necessary for future studies, including the additional genetic characterization……16 international locations including the U.S. have identified cases of this new virus. I’m sure you’ve seen videos coming out of China in Wuhan, particularly. Our thoughts are with the people on the front lines of this emerging public health threat in China. Right now, we are continuing to screen a few passengers from Wuhan at the five designated airports. This enhanced entry screening serves two purposes. The first is to detect illness and reapidly respond to symptomatic people entering the country. The second purpose is critica to educate travelers about these symptoms of the virus and what to do if they develop symptoms. I expect our travel recommendations will change in the coming days……Right now we have a handful of patients with this new virus here in the United States. However, currently in the U.S., this virus is not spreading in the community. For that reason, we continue to believe that the immediate health risk from the new virus to the American public is low currently……Larry Irizarry asked: One quick follow up question, its 26 states. At some point will you release which states those are?Dr. Messonnier responded: As you know, were are incredibly sensitive about releasing names of states in this kind of context. So that would really be up to a state health department whether they want to make that release. What I would say is if you want to know whether there are any PUIs in your state, please contact the state health department and let them make the decision about whether they want to relase that number or not… January 27, 2020: World Health Organization (WHO) posted “Novel Coronavirus (2019-nCoV) Situation Report 7”. From the report: Highlights: WHO Director-General Dr Tedros Adhanom Ghebreyesus and colleagues are in Beijing to meet with government and health experts supporting the response. The mission’s aim is to understand the latest developments and strengthen the partnership with China, in particular for the response.Current estimates of the incubation period of the virus range from 2-10 days, and these estimates will be refined as more data becomes available. Understanding the time when infected patients may transmit the virus to others is critical for control efforts. Detailed epidemiological information from more people is needed to determine the infectious period of 2019-nCoV, in particular, whether transmission can occur from asymptomatic individuals or during the incubation period……WHO is continually monitoring developments and on standby to reconvene the Emergency Committee on very short notice as needed. Committee members are regularly informed of developments. Countries, territories or areas with reported confirmed cases of 2019-nCoV, 27 January 2020: China – including cases confirmed in Hong Kong SAR (8 confirmed cases), Macau SAR (5 confirmed cases) and Taipei (4 confirmed cases): 2761Japan: 4Republic of Korea: 4Viet Nam: 2Singapore: 4Australia: 4Malaysia: 4Thailand: 5Nepal: 1United States of America: 5Canada: 1France: 3TOTAL: 2,798 January 27, 2020: American Academy of Pediatrics (AMA) posted news titled: “CDC: 5 US cases of coronavirus confirmed”. From the news: Five cases of coronavirus have been confirmed in the U.S., and federal health officials are preparing diagnostic kits so states can perform their own testing.Cases have been confirmed in Arizona, California, Illinois and Washington and all involved adults who traveled to Wuhan, China, the center of the outbreak, according to the Centers for Disease Control and Prevention (CDC)……Thirty-two people have tested negative, and 73 potential cases are still under investigation..…The global case count has reached 2,886, and there have been 81 deaths, according to a tally by Johns Hopkins University. While most of the cases are in China, cases have been confirmed in about a dozen other countries, including Thailand, Australia, the U.S., Japan, South Korea and France… January 28, 2020: Reuters posted an article titled: “Spain, Portugal work to repatriate nationals from coronavirus-hit Wuhan”. From the article: The government Spain and Portugal are working with China and the European Union to repatriate their nationals from the Wuhan area struck by the coronavirus, the two countries’ foreign ministers said Monday……”We’re working… with our consulate in Beijing, and officials in China and the European Union to repatriate around 20 Spaniards in Wuhan, Hubei, the epicenter of the coronavirus. We will continue to update on any advances,” Spanish Foreign Minister Arancha Gonzalez Laya wrote on Twitter.She did not provide any futher details.Portuguese Foreign Minister Augusto Santos Silva told state broadcaster RTP that the ministry was exploring whether Portuguese citizens in Wuhan could return on a civilian plane with citizens from other European countries.“Unlike other countries such as the United States or France, who have large numbers of citizens in Wuhan and carry out their own repatriation programmes, it makes more sense for country like Portugal, which has only a few citizens there, to carry out coordinated operations, if possible,” he said… January 28, 2020: The CDC reported the onset of 3 additional COVID-19 case in the United States. January 28, 2020: NPR reported that Starbucks closed more than 2,000 stores in mainland China in response to coronavirus. Starbucks said, “Currently, we have closed more than half of our stores in China and continue to modify the operating hours of all our stores in the market in response to the outbreak of the coronavirus.” January 28, 2020: Several doctors from the World Health Organization (WHO) met with President Xi Jinping of the People’s Republic of China in Beijing. The two sides agreed that WHO will send international experts to visit China as soon as possible to work with Chinese counterparts on increasing understanding of the coronavirus outbreak to guide global response efforts. This meeting came after the number of people confirmed with the virus rose to over 4500 globally on 28 January, the greatest number being in China. January 28, 2020: CNBC posted an article titled: “Facebook restricts employee travel to China as coronavorus spreads”. It was written by Annie Palmer. From the article: Facebook has started restricting employee travel to China, joining a growing list of U.S. companies that have done the same amid a growing outbreak of the coronavirus.“Out of an abundance of caution, we have taken steps to protect the health and safety of our employees,” Facebook spokesperson Anthony Harrison told CNBC in a statement.The travel restrictions were announced on Monday. Facebook has banned all non-essential travel the country, but if employees must visit China, they have to receive approval first. The company has also told employees who work in China, or who have recently traveled there, to work from home, Facebook said… January 28, 2020: The European Centre for Disease Prevention and Control posted a statement titled: “ECDC statement following reported confirmed case of 2019-nCoV in Germany”. From the statement: Based on current information, the infection in Germany followed a close contact with a visitor from China during a stay in Germany (diagnosed with 2019-nCoV after return to China) who had previously been visited by relatives from the Wuhan area. The German authorities are investing this case and taking the necessary steps to trace and inform any contracts.At this stage of the on-going outbreak in the Hubei province in China, it is likely that there will be more imported cases in Europe. As a consequence, it could be expected to see (limited) local transmission in Europe. A single detected case in Europe does not change the overall picture for Europe, nor does it change the assessment that there is currently a moderate likelihood of importation of cases of 2019-nCoV to the EU/EEA. As more and more cases are reported globally, this also increases the probability of sporadically imported cases to EU/EEA countries.Based on this, EU/EEA countries should ensure that timely and rigorous infection prevention and control measures (IPC) are applied around any detected nCoV cases in the EU/EEA, in order to prevent further spread in the community and healthcare settings. Healthcare workers in the EU/EEA need to be aware and vigilant in order to detect possible nCoV cases early and apply appropriate infection control measures when handling patients.Right now, the focus still should be on the development of the outbreak in China and the related information on the characteristics of the virus.The source of the infection is unknown and could be still active. Human-to-Human transmission has been confirmed but more information is needed to evaluate the full extent of this mode of transmission and understanding how the virus spreads. This is a rapidly evolving situation, ECDC is revising its risk assessment for Europe. January 28, 2020: Nippon.com (News from Japan) posted an article titled: “Japan Decides to Designate New Pneumonia as Specificed Disease”. From the article: The Japanese government decided Tuesday to designate pneumonia caused by the new coronavirus raging in China as a specified infectious disease, aiming to put the designation into effect in early February. The government adopted at a cabinet meeting an ordinance for the designation under the infectious disease law, which will allow authorities to conduct compulsory hospitalizations of infected patients and stop them from going to work.Under the ordinance, the disease will be designated as a quarantinable infectious disease under quarantine law.It is the first time for the government to add a disease to the list of specified diseases since 2014, when Middle East respiratory syndrome, or MERS, joined the list. January 28, 2020: Ohio Department of Health posted a tweet: “There are no confirmed cases of the 2019 novel coronavirus (2019-nCoV) in Ohio. However, ODH is closely monitoring two possible cases reported by Miami University in Butler County.” This tweet was the start of a thread. January 28, 2020: Ohio Department of Health posted a tweet: “Both students being monitored had recently returned from China. Neither individual is severely ill. They are currently in isolation pending test results.” January 28, 2020: Ohio Department of Health posted a tweet: “The CDC is conducting the testing, and results are expected by the end of the week.” January 28, 2020: Ohio Department of Health posted a tweet: “ODH has been working diligently with our health partners and local health districts across the state to ensure we are prepared if a case is confirmed in Ohio.” January 28, 2020: Ohio Department of Health posted a tweet: “Five U.S. cases of 2019-nCoV have been confirmed by the CDC. Unless you have recently traveled from China or have been around someone ill with this new virus, your risk of getting sick is low.” January 28, 2020: Ohio Department of Health posted a tweet: “Investigations are ongoing to learn more about transmission. There is no known person-to-person spread of 2019-nCoV in the U.S.” January 28, 2020: Ohio Department of Health posted a tweet: “Symptoms include fever, cough, and difficulty breathing. Seek medical care if you are experiencing symptoms and traveled from Wuhan City, China, in the 14 days before you started feeling sick.” January 28, 2020: Ohio Department of Health posted a tweet: “Also seek medical care if you are exhibiting symptoms and, in the 14 dasy before symptoms appeared, had close contact with a person who is under investigation for 2019-nCoV”. January 28, 2020: Ohio Department of Health posted a tweet: “Just like other illnesses, it’s critical to protect yourself against the virus: wash hands often, follow appropriate cough and sneeze etiquette, don’t go to work or school when you feel ill; avoid exposure to others who are sick.” This is not the end of the thread, but it is the last one with relevant information in regards to this blog post. January 28, 2020: New South Wales Health posted another Novel Coronavirus Statistics (as of 11:30 AM that day). Number of cases confirmed: 4. Number of cases under investigation: 6. January 28, 2020: Centers for Disease Control and Prevention posted a media statement titled: “HHS and CDC Supporting Safe, Expedient Departure of US Citizens”. From the media statement: The U.S. Government is relocating approximately 210 U.S. citizens from Wuhan, China back to the United States. The Department of State has the lead for the safe and expedient ordered departure of citizens. The Department of Health and Human Services (HHS) and Centers for Disease Control and Prevention (CDC) are collaborating with the Department of State on the logistics of public health evaluations for every traveler on the flight. HHS and CDC are working with partners to ensure that any traveler who develops symptoms during their journey receives appropriate medical care.Our primary objective is to facilitate the safe return of these Americans while protecting the public’s health. These individuals will be screened before they take off; monitored during the duration of the flight by medical personnel on board; screened again on landing to refuel in Anchorage, Alaska; monitored on the last leg of the flight by medical personnel on board; evaulated upon arrival at March Air Reserve Base in Riverside County, California; and then monitored for symptoms post-arrival. January 28, 2020: World Health Organization South-East Asia posted a news release titled: “Thailand announced a total of 14 cases of Novel Coronavirus detected in country”. From the news release: On 28th January, the Ministry of Public Health, Thailand announced there have been a total of 14 cases of Novel Coronavirus 2019-nCoV detected in Thailand. 13 cases had travelled from Wuhan and 1 case from Chongqing. Five of the cases are from the same family… January 28, 2020: Nippon.com (News from Japan) posted an article titled: “Toyota Bans Business Trips to China’s Hubei”. From the article: Toyota Motor Corp. <7203> has banned employees from going on business trips to China’s Hubei Province, due to an outbreak of pneumonia caused by a new coronavirus, company officials said Tuesday.Previously, the Japanese automaker had told its employees to refrain from making nonessential business trips to the provincial capital, Wuhan, where the outbreak is believed to have started.Currently, no Toyota workers are on business trips in Hubei, the officials said. January 28, 2020: World Health Organization (WHO) posted “Novel Coronavirus (2019-nCoV) Situation Report – 8” The data in it was reported by January 28, 2020. From the report: Highlights: A World Health Organization (WHO) senior leadership team, led by Director-General Tedros Adhanon Ghebreyesus, today met President Xi Jinping of the People’s Republic of China in Beijing. They shared the latest information on the outbreak and reiterated their committment to bring it under control.The discussions focused on continued collaboration to improve containment measures in Wuhan, to strengthen public health measures in other cities and provinces, to conduct further studies and transmissibility of the virus, to continue to share data, and for China to share biological material with WHO. These measures will advance scientific understanding of the virus and contribute to the development such as vaccines and treatments……WHO is launching a Global 2019-nCoV Clinical Data Platform to allow Member States to contribute anonymized clinical data in order to inform public health clinical response.WHO is continually monitoring developments and the Director-General can reconvene the Emergency Committee on very short notice as needed. Committe members are regularly informed of the developments. Countries, territories, or areas with reported confirmed cases of 2019-nCoV, 28 January 2020: China: 4,537 (this includes confirmed cases in Hong Kong (8 confirmed cases), Macau SAR (7 confirmed cases) and Taipei (7 confirmed cases).Japan: 6Republic of Korea: 4Viet Nam: 2Singapore: 7Australia: 5Malaysia: 4Cambodia: 1Thailand: 14Nepal: 1Sri Lanka: 1United States of America: 5Canada: 2France: 3Germany: 1TOTAL: 4,593 January 28, 2020: Health Protection Scotland posted a report titled: “Outbreak of pneumonia in Wuhan City, Hubei, China: updated”. From the report: An outgoing outbreak of pneumonia in Wuhan City, Hubei Province, China has been linked to a newly-discovered coronavirus. This outbreak has been linked to possible exposure to infection at the South China Seafood City market in Wuhan. The market is now closed.The European Centre for Disease Prevention and Control (ECDC) report that as of 26 January 2020, a total of 2,026 laboratory-confirmed 2019-nCoV cases have been reported. 1,988 in China and 38 imported cases from other countries aroudn the world. Fifty six deaths have been reported among the cases. Chinese health authorites have confirmed human-to-human transmission outside Hubei province and 16 healthcare workers are reported to have been infected. Confirmed cases have been reported in Australia, Nepal, Melaysia, Taiwan, Thailand, Japan, South Korea, the US, Canada, Singapore, Vietnam and France.This is a new and rapidly evolving situation where information on cases and the virus is being gathered and assessed daily.As of 27 January 2020 the Foreign and Commonwealth Office (FCO) advise against all travel to Hubei province. Travellers should check the FCO website on updates on a regular basis as travel advisories may change.All travellers to China are advised to take simple precautions such as practicing good hand, personal and respiratory hygiene, and avoid contact with birds, and animals in markets…. January 28, 2020: Nippon.com (News from Japan) posted an article titled: “Japan Confirms 1st Coronavirus Infection without Visit to Wuhan”. From the article: A person in Japan has been confirmed infected with a new coronavirus despite not having visited the Chinese city of Wuhan at the center of the pneumonia outbreak, Japanese health minister Katsunobu Kato said Tuesday.The infection marks the first time for the new virus to be confirmed in Japan from someone who did not travel to Wuhan, Hubei Province. January 28, 2020: Australian Government Department of Health posted news titled: “Update on novel coronavirus”. It is a transcript. The Chief Medical Officer joined Minister Hunt for an announcement at the Sir Peter MacCallum Center Institute. The CMO and Minister Hunt also gave an update on novel coronavirus in Australia. From the transcript: …Greg Hunt: Thank you very much. Okay, with the Chief Medical Officer Professor Murphy, we’ll give a quick update on coronavirus.As of this morning, there are five confirmed cases in Australia of coronavirus. Other cases will continue to be tested by state health authorities and as results are known they will be made available publicly.All of those five patients, we are advised, are stable, in isolation and under very high quality care.Globally, on the latest figures available, 2800 patients have been confirmed and 80 deaths, but we expect that the Chinese and World Health Organization authorities will provide an update on those figures during the course of today.Yesterday, the Prime Minister chaired a meeting of the National Security Committee to reaffirm all of the elements of our national preparedness.The World Health Organization reviewed Australia’s preparedness two years ago as part of a global survey, and we were identified as being at the absolute global forefront of preparedness.But all of those elements are being put in place now, and I will let Professor Murphy speak to those a little bit more.In particular, the Australian Government, through the embassy, has also been in contact with Chinese authorities about Australians who are in Wuhan and the broader Hubei Province.Significant progress, significant progress has been made overnight, and we are exploring all options with the Chinese authorities, both to ensure that there is support and care for Australians on the ground, and that there is a pathway to returning them home.And the advice from the Foreign Minister shortly before coming to this event is that there has been significant progress.So I want to thank the embassy and the Chinese authorities, and we will continue to ensure that we have strong broader protection, the highest quality medical care in the world, and action to protect and secure those Australians who are in Hubei Province in China. Brendan? Brendan Murphy: Thank you, Minister. So as the Minister said, given the update on the numbers, the main message that we’re trying to give still to the Australian public is that there is no cause for concern in the Australian public.There is no human to human transmission of this virus. And it’s important to note because we had some media about masks today.There is no need for the Australian public to wear masks. There is- the only people who should wear masks in relation to this virus are those who are unwell and have a relevant travel history.Our most important thing now is for those who have come back from China in the last two weeks, whom developed flu-like symptoms, particularly if they’ve come from the Hubei Province of China, they need to call ahead to their GP or their emergency department, tell them of their travel history and get tested.As the Minister said, we’re testing a large number of people across the country every day.The vast majority of them are negative, as we always expected it to be, but we all do expect that it is likely we might find some more positives over the next few days, but we are extremely well prepared.All of our state and territory health services have stood up teams to be prepared, their public health units have activated. We’ve got very, very good isolation facilities.We now have very good diagnostic facilities; same day diagnostics- turn around in diagnosis in most parts of the country.And we have also put up additional border measures that I outlined yesterday – in addition to every single flight from China, because this disease is now present in significant numbers in other parts of China, mainly from people who have come from the Hubei Province.There’s no clear evidence that there’s human to human transmission in those other parts of China, but because people are appearing with the disease in other parts of China, every flight from China is being met and entered by border security officers and making sure that everyone on the flight gets information in English and Mandarin about the need to report their travel history, if they develop symptoms after they arrive, and obviously if they have any symptoms, they should declare themselves to a border security officer at the airport.And we’ve had a three-fold increase in people reporting ill symptoms to border security officers. Mostly just trivial symptoms, but the message is getting out there.So we are well prepared. We are still concerned about what is happening in China.This outbreak is not under control. The Chinese authorities are doing a lot of things.As we know, they’ve locked down the Hubei Province, very hard to get out of there. That’s the main focus of this infection at the moment, but we are reviewing things daily.Yesterday, I convened the expert public Health Committees of the Commonwealth and states and territories to review all of our advice and all of the situations that are happening at the moment. January 28, 2020: Nippon.com (News from Japan) posted an article titled: “Chinese Buying Masks in Bulk in Japan amid Coronavirus Crisis”. From the article: Sales of face masks and other hygiene products have been surging in Japan amid the spread of pneumonia caused by a new type of coronavirus, with people from China, where the outbreak started, massively buying masks in particular.“Chinese people living in Japan have bought 10 to 20 boxes of masks at once,” the manager of a drug store in Tokyo’s Chiyoda Ward said. As masks sell out as soon as they come back in stock, the store started on Tuesday to allow one customer to buy only one box.At a different drug store, a Chinese woman in her 30s, who lives in Saitama Prefecture, north of Tokyo, said that she has already sent more than 100 boxes of masks to her family in Shanghai and will buy more because they are not available in the city.At drug stores run by Weicia Holdings Co. <3141>, sales of masks in the latest week doubled from the preceding week.A public relations official of the company said that masks are in high demand among both Japanese and Chinese people. Sales of antibacterial sprays and had sanitizers are also growing, the official said. January 28, 2020: Football Federation Australia (FFA) posted news titled: “Women’s Olympic Football Tournament Qualifiers Update”. From the news: Football Federation Australia (FFA) was this afternoon notified of the latest advice from Australia’s Chief Medical Officer, Professor Brendan Murphy, regarding the coronavirus. The updated advice follows a meeting of the Australian Health Protection Principal Committee on Wednesday afternoon. This major new development confirmed that health experts believe the coronavirus is contagious before people show symptoms, and contacts of any confirmed cases must now be isolated following exposure.The health and wellbeing of all players, staff and spectators is of paramount importance to both FFA and the Asian Football Confederation (AFC).FFA is working with the Australian Government and AFC to explore ramifications of this advice and how it may affect the staging of the Women’s Olympic Football Tournament Qualifiers.As a result of these developments, which came to light following today’s match schedule announcements, FFA will not be going on sale tomorrow with tickets for the tournament.FFA will provide a further update as soon as possible. January 29, 2020: Victoria State Government (Australia) posted a press release titled: “Second novel coronavirus case in Victoria”. From the press release: Victoria’s Department of Health and Human Services confirmed a second Victorian case of the 2019 novel coronavirus.The man in his 60s, a Victoria resident, is isolated and recovering at home. He was confirmed as positive this morning following a series of tests after experiencing a respiratory illness.After the positive result, the man was seen by doctors at the Monash Medical Centre in accordance with infection control procedures and was assessed as well enough to stay at home.The Victorian man had traveled to Wuhan City, Hubei Province, China. The man first became unwell more than two days after returning from China. There is no current evidence that passengers or crew on the flight that the man took to return to Melbourne are at risk.The department is monitoring five close contacts who live with the man. Two of the contacts are children who have been excluded from school… January 29, 2020: The CDC reported the onset of 1 additional COVID-19 case in the United States. January 29, 2020: Nippon.com (News from Japan) posted an article titled: “Chartered Plane Arrives in Wuhan to Bring Japanese Home”. From the article: An All Nippon Airways plane chartered by the Japanese government arrived at an airport in Wuhan late Tuesday night local time on a mission to bring home Japanese nationals from the city in China’s Hubei Province following the outbreak of pneumonia caused by a new type of deadly coronavirus in the country.The airplane operated by the major Japanese carrier will ferry some 200 people, who will be the first group of Japanese to be evacuated from the Chinese city at the center of the outbreak using government-charted aircraft. The ANA plane will depart from the Wuhan airport in several hours and arrive back at Haneda on Wednesday morning. Returning in the first group will be mainly people with high risks of infection, including those living near the outbreak epicenter.For the first round of airlifting operations, the plane left Haneda for Wuhan on Tuesday night, also carrying relief goods, such as face masks and protective suits, for supply to the Chinese side. As of Tuesday, some 650 Japanese nationals in Hubei said they wish to return to Japan, according to the government. January 29, 2020: New South Wales Health posted another Novel Coronavirus Statistics (as of 10AM that day). Number of cases confirmed: 4. Number of cases under investigation: 6. January 29, 2020: President Donald Trump tweeted: “Just recieved a briefing on the Coronavirus in China from all of our GREAT agencies, who are also working closely with China. We will continue to monitor the ongoing developments. We have the best experts anywhere in the world, and they are on top of it 24/7!” The tweet include four photos of President Trump, and several other men, seated at a very long table. January 29, 2020: Nippon.com (News from Japan) posted an article titled: “1st Group of Japanese Returns Home from Virus-Hit Wuhan”. From the article: A government-chartered plane arrived at Tokyo International Airport at Haneda from Wuhan on Wednesday morning, bringing back 206 Japanese nationals from the epicenter of the new coronavirus outbreak in China.They are the first group to arrive in Japan among the Japanese nationals in Wuhan waiting to return home aboard government-chartered flights.The group will be transferred by bus to medical institutions for checks. They will not use airport terminal facilities, in order to avoid contact with flight passengers there.This is the first time for the Japanese government to help its nationals return home in response to an infectious disease outbreak, according to the Foreign Ministry.The chartered All Nippon Airways plane arrived at an airport in Wuhan in the small hours of Wednesday Japan time, carrying 15,000 face masks, 50,000 gloves, 8,000 protective glasses and other emergency relief supplies for China. January 29, 2020: World Health Organization (WHO) posted “Novel Coronavirus (2019-nCoV) Situation Report – 9”. From the report: Highlights: Four confirmed cases reported in United Arab Emirates, in individuals travelling from Wuhan City.World Health Organization (WHO) in collaboration with the World Economic Forum, has set up a public private collaboration called “The Pandemic Supply Chain Network (PSCN)”. It is a Market Network that seeks to provide a platform for data sharing, market visibility, and operational coordination and connecting.Today, OSCN is launching the first of several teleconfernece calls with over 350 private sector organizations and 10 multilateral organizations to develop a market capacity and risk assessment for personal protective equipment (PPE). This assessment will be used as the basis to match the global demand for PPE with the global supply. The market and risk assessment for PPE is expected to be completed by 5 February 2020.The Emergency Committee on the novel coronavirus (2019-nCoV) under the International Health Regulations (IHR 2005) is re-convened by the World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus on 30 January. Countries, territories or areas with reported cases of 2019-nCoV, 29 January 2020: China: 5997 (cases include cases confirmed in Hong Kong (8 confirmed cases), Macau SAR (7 confirmed cases) and Taipei (8 confirmed cases).Japan: 7Republic of Korea: 4Viet Nam: 2Singapore: 7Australia: 7Malaysia: 4Cambodia: 1Thailand: 14Nepal: 1Sri Lanka: 1United States of America: 5Canada: 3France: 4Germany: 4United Arab Emirates: 46065TOTAL: 6065 January 29, 2020: Nippon.com (News from Japan) posted an article titled: “Toyota to Keep China Plants Closed until Feb. 9”. From the article: Toyota Motor Corp. <7203> will keep its plants in China closed until at least Feb. 9, in response to the spread of a new coronavirus in the country, company officials said Wednesday.Whether to reopen the plants on Feb. 10 depends on the situation, one of the officials said.Toyota has four auto assembly plants in China.Previously, the company planned to reopen a plant in Tianjin on Monday, and a plant in Guangzhou on Tuesday after suspensions during the Lunar New Year holiday.Toyota said that it will donate 10 million yuan to the Red Cross Society of China to help finance its purchases of medical supplies such as masks. January 29, 2020: Australian Government Department of Health posted news titled: “Australian Health Protection Principal Committee (AHPPC) statement on novel coronavirus on 29 January 2020.” From the news: AHPPC provides the following advice to the Australian community following advice from the Communicable Diseases Network Australia.AHPPC is aware of: very recent cases of novel coronavirus who are asymptomatic or minimally symptomatic andreports of one case of probable transmission from a pre-symptomatic case to other people, two days prior to the onset of symptoms. These data are very limited and preliminary and AHPPC still believes that most infections are transmitted by people with symptomatic disease. However, AHPPC believes that we should take a highly precautionary approach and is making the following new recommendations: People who have been in contact with any confirmed novel coronavirus cases must be isolated in their home for 14 days following exposure;Returned travellers who have been in Hubei Province of China must be isolated in their home for 14 days after leaving Hubei Province, other than for seeking individual medical care. Given the lower number of cases in China reported outside Hubei province, we do not currently recommend self-isolation for travellers from other parts of China or other countries. We are closely monitoring the development of cases outside of Hubei province and will update this advice if necessary.AHPPC recognises that the evidence for pre-symptomatic transmission is currently limited, and this policy is highly precautionary. At this time, the aim of this policy is containment of novel coronavirus and the prevention of person to person transmission within Australia.Further details of the extent of pre-symptomatic transmission is being monitored, and may result in changes to policy.Summary of evidence to support the revised adviceNew international evidence suggest that asymptomatic or minimally symptomatic infection can occur, and that pre-symptomatic transmission has occurred in at least one case cluster. 1. German case cluster: It has been reported that participants at a workshop in Munich had contact with a woman on 21 January. This woman, who had been in Wuhan, became symptomatic on 23 January and diagnosed following return to China. Four workshop attendees, with no travel history to China, have been confirmed with nCoV and several more are under investigation. 2. A 10 year old child reported in a case series was noted as having no fever; although it is likely that this case may have had a cough sufficient to produce PCR positive sputum. 3. A Japanese person reported as a case was a bus driver who transported Chinese passengers from Wuhan. The Japanese person had no history of travel outside Japan. None of the passengers were known cases. 4. Several Chinese language media reports have detailed transmission from pre-symptomatic cases, but no confirmatory evidence has been published. 5. WHO Sitrep (#8) states that 3 of 58 cases diagnosed outside China were asymptomatic. January 29, 2020: Nippon.com (News from Japan) posted an article titled: “More Aircraft May Fly to China Soon to Evacuate Japanese”. From the article: The Japanese government is in the final stages of arrangements to send additional chartered aircraft on Wednesday night to evacuate expatriates from China’s Hubei Provence, at the center of the outbreak of a new strain of coronavirus that has caused pneumonia among a number of people.The cabinet of Japanese Prime Minister Shinzo Abe will decide on Thursday to set up a task force to be headed by him to stop the new coronavirus from spreading further in the country.According to the government, some 650 Japanese nationals in China province are wishing to return home via government-chartered flights. Of them, 206 returned on the first such flight on Wednesday morning.“We’ll continue to take every possible measure to bring home all of the people hoping to come back to Japan,” Abe said at a meeting of the Budget Committee of the House of Councillors, the upper chamber of the Diet, Japan’s parliment, on Wednesday. The government will also work on preventing the spread of the virus in Japan, he added.In Japan, seven people, including one Japanese, were confirmed to be infected with the new virus. January 29, 2020: The Desert Sun posted an article titled: “Over 200 US evacuees from coronavirus epicenter begin 72-hour evaluation period at March Air Reserve Base”. It was written by Colin Atagi. From the article: As more than 200 U.S. evacuees from the epicenter of the coronavirus outbreak in China began a sequestered, 72-hour evaluation period at March Air Reserve Base on Wednesday, health officials assured the public that the risk of a similar outbreak in the United States is “very low”……A contingent of federal, state and county health experts took questions from reporters Wednesday after a chartered plane filled with U.S. diplomats, their families, and other U.S. citizens who were in Wuhan, China, landed at the air force base near Morano Valley.Authorities said the 210 passengers passed numerous screening tests to determine if they were exhibiting symptoms of the illness before being allowed on the plane, which stopped briefly in Anchorage, Alaska, where another series of screening tests were administered before continuing on to the Southern California air base.Government officials made the decision to bring the passengers to Riverside County, although none of the passengers are from the county……Authorities said the evacuees are isolated from military personnel on base. For at least the next three days, they will be monitored twice a day for fever and other symptoms……Officials said the passengers who don’t exhibit symptoms in those first 72 hours will be able to travel to their home states and on to their families or residences. They will, however, continue to be monitored for a maximum of 14 days……Authorities were quick to say that the passengers were not under a federal quarantine order……The plane was charterd by the U.S. State Department after it issued an evacuation order for U.S. diplomats and their families, officials said, adding that the flight was large enough to accomodate more people than the State Department diplomats and their families……The CDC lab in Atlanta will be testing samples from the passengers and authorities believe these checks will be completed within 72 hours.. January 29, 2020: Nippon.com (News from Japan) posted an article titled: “5 Japanese Returnees Test Negative for Wuhan Coronavirus”. From the article: Five of the 206 Japanese nationals brought back on a government-chartered plane from the Chinese city of Wuhan, the epicenter of the outbreak of pneumonia blamed on a new strain of coronavirus, have tested negative for the virus, it was learned.Feeling unwell, the five were sent to two hospitals designated as institutions to deal with specific infectious diseases following the All Nippon Airways flight’s arrival at Tokyo International Airport at Haneda. Two of them were diagnosed with pneumonia. But they and the other three were all confirmed not to have the new coronavirus later. Three of the five are men in their 30s to 50s and two are women in their 50s.According to the Tokyo metropolitian government, four of the five people were admitted to Ebara Hospital in Tokyo’s Ota Ward. Two of them – a man in his 40s and a man in his 50s – who complained of such symptoms as a cough and a fever were initially diagnosed with pneumonia following computed topography scan tests.One of the two women was admitted to Komagome Hospital in Tokyo’s Bunkyo Ward. January 29, 2020: The Honorable Scott Morrison Prime Minister of Australia posted a media release titled: “Assisted Departure and Strict Quarantine For Australians From Wuhan/Hubei” From the press release: The Australian Government is working across agencies to assist the departure of isolated and vulnerable Australians from Wuhan and to put strict quarantine arrangements in place.Australian diplomatic and consular staff have been working very closely with the Chinese authorities and with other partner countries to develop options for the departure of Australians in Wuhan and Hubei Province, in what continues to be a difficult and complex situation.The Australian Embassy in Beijing is now seeking formal approval from the Chinese Government to send a plane to Wuhan to assist the departure of Australians from Hubei Province……Australians departing on any flight arranged by the Australian Government will be flown to Christmas Island to undertake a period of quarantine of up to 14 days based on current medical advice, as a condition of their assisted departure.This will ensure we are also prioritizing public health in Australia……An Australian Medical Assistance Team (AUSMAT) will provide medical support and expert advice to returning to Australians upon arrival at Christmas Island.There are over 600 Australian citizens currently registered with the Department of Foreign Affairs and Trade. We will seek to speak with each of them in relation to the Goverment’s announcement. Our focus and priority is on vulnerable and isolated citizens……We advice that Australians do not travel to Hubei Province and reconsider their need to travel to China overall… January 29, 2020: Reuters reported that Mondelez International Inc. maker of Oreos and Chips Ahoy cookies, said it expects its first-quarter revenue will be impacted by the coronavirus spreading across China, and it has temporarily closed two factories. January 29, 2020: China Daily tweeted: “At 4:30 pm on Tuesday, about 10 million people were watching the ongoing construction of the Huoshenshan and Leishenshan hospitals – two makeshift hospitals for novel coronavirus patients in suburban #Wuhan”. The tweet included a link to a the China Daily website, where a livestream was available. January 29, 2020: Reuters reported that IKEA said on Thursday that it has temporarily closed all its stores in China because of the new coronavirus. January 29, 2020: People’s Daily, China, The largest newspaper in China, tweeted: “China is expected to resume its maks production with normal capacity on Feb 3 and produce 180m masks per day by the end of Feb. The domestic production, together with imported masks, will ease the gap between supply and demand, according to PLA Daily.” June 29, 2020: Twitter posted on its blog: “Helping the world find credible information about novel #coronavirus”. It was written by Jun Chu and Jennifer McDonald. From the blog post: As the global conversation continue around the spread of novel #coronavirus, we want to share the work we’re doing to surface the right informatio, to promote constructive engagement, and to highlight credible information on this emerging issue. We’ve seen over 15 million Tweets on this topic in the past four weeks and that trend looks set to continue.Preventing platform manipulationAt present, we’re not seeing significant coordinated attempts to spread disinformation at scale about this issue. However, we will remain vigilant and have invested significantly in our proactive abilities to ensure trends, saerch, and other common areas of the services are protected from malicious behaviors. As ever, those who engage in these practicies will be removed from our service. We do not permit platform manipulation and we encourage people to think before sharing or engaging in deliberate attempts to undermine the public conversation.Expanding search promptGiven the rapidly evolving nature of the issue and the growing international response, we’ve launched a new dedicated search prompt to ensure that when you come to the service for information about the #coronavirus, you’re met with credible, authoratiative information first. In addition, we’re halting any auto-suggest results that are likely to direct individuals to non-credible content on Twitter. This is an expansion of our #KnowTheFacts prompt, which we specifically put in place for the public to find clear, credible information on immunization and vaccination health.Our official #coronavirus partnerships are now in palce in Australia, Belgium, Brazil, Canada, Denmark, France, Germamy, Hong Kong, India, Ireland, Italy, Japan, Malaysia, New Zealand, Netherlands, Norway, Philippines, Singapore, South Korea, Spain, Sweden, Taiwan, Thailand, US, UK, and Vietnam. We will continue to expand as the need rises. January 30, 2020: The World Health Organization (WHO) held a second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus. The members of the committee were convened by teleconference. Representatives of the Ministry of Health of the People’s Republic of China reported there were now 7711 confirmed and 12167 suspected cases throughout the country. Of the confirmed cases, 1370 were severe and 170 people had died. 124 people had recovered and been discharged from hospital. WHO stated there were now 83 cases in 18 countries. Of them, only 7 had no history of travel in China. There has been human-to-human transmission in 3 countries outside China. One of those cases was severe, and there had been no deaths. The Committee re-emphasized the importance of studying the possible source, to rule out hidden transmission and to inform risk management measures. The Committee also stated that all countries should be prepared for containment, including active surveillance, early detection, isolation and case management, contact tracing and prevention of onward spread of COVID-19, and to share full data with WHO. In short, WHO Committee agreed that the COVID-19 outbreak now met the criteria for a Public Health Emergency of International Concern. January 30, 2020: The Sydney Morning Herald posted an article titled: “Australians will need to pay $1000 to be evacuated from Wuhan”. It was written by Anthony Galloway and Eryk Bagshaw. From the article: Australians trapped at the heart of the coronavirus outbreak will have to pay up to $1000 to be evacuated from the Chinese city of Wuhan to be quarantined on Christmas Island.The Morrison government is in high-level negotiations with Beijing to dispatch a Quantas jet to rescue hundreds of Australian nationals from Wuhan……The Department of Foreign Affairs and Trade has begun contacting Australians stuck in Hubei province to inform them what they will need to do to get on the emergency flight, expected to arrive in Wuhan within days.According to evacees, they will have to pay $1000 and sign a waiver allowing them to be quarantined at the Christmas Island detention centre for up to 14 days.After their stay on Christmas Island, they will be dropped off in Perth and have to pay their own way to their city of residence……Australia has yet to recieve any official clearance from China for the evacuation after Foreign Minister Marise Payne and China’s Foreign Minister Wang Yi, discussed the operation on Wednesday… January 30, 2020: Australian Medical Association (AMA) posted a transcript of Dr. Tony Bartone from the Australian Medical Association discussing coronavirus and Christmas Island on “Today”. From the transcript: …Allison Langdon: We’ve seen another two cases confrimed in Australia overnight. How do you think we’re handling this?Tony Bartone: So right from the outset, its been handled according to best practice international guidelines and processes. We’ve been prepared. We’ve been rated previously as being equal best when it comes to preparedness to deal with this kind of outbreak. And we’ve been really focused on isolation, and contact tracing of those who have been exposed and the fact that more than a week on we’ve got such a relatively small number of cases confirmed is a real sign of the success thus far of the measures that have been implemented.Karl Stefanovic: So the World Health Organization has advised Governments not to transport or evacuate their citizens from China. The solution from the Australian Government is let’s take them to Christmas Island. What are your thoughts on that?Tony Bartone: So, I can understand why the Australian Government has put that process in place. It’s important to recognize that we’ve got a group of vulnerable Australians who, through no fault of their own, found themselves at the epicenter of a significant outbreak. And they must be under a lot of stress and fear and concern. Despite WHO’s recommendation, we feel that the repatriation to Christmas Island, to a place where has been previously the focus of populations under enormous mental and physical trauma and anguish, is not a really appropriate solution. We’ll be calling on the PM and the relevant Ministers to find a much more humane solution to dealing with a group of very vulnerable and concerned Australians.Allison Langdon: But doctor, they’re not going there indefinitely. They’re going there for the two-week quarantine period. It’s not a long time to keep the rest of Australia safe.Tony Bartone: I agree with the principle, but we can find a better set of facilities to deal with that, to manage that staged return to the community. We can protect the Australian community and also be much more humane to those Australians who, as I said, through no fault of their own, find themselves the focus of this epicenter… January 30, 2020: The CDC reported the onset of 1 additional COVID-19 case in the United States. January 30, 2020: World Health Organiztion (WHO) posted “Novel Coronavirus (2019-nCoV) Situation Report – 10”. From the report: Highlights The Emergency Committee on the novel coronavirus (2019-nCoV) under the International Health Regulations (IHR 2005) is meeting today to discuss whether the outbreak constitutes a public health emergency of international concern.First confirmed cases of 2019-nCoV acute respiratory disease in Finland, India and Philippines; all had travel history to Wuhan City.On 29 January, WHO held its third press briefing to provide update on the situation……WHO recommends that the interim name of the disease causing the current outbreak should be “2019-nCoV acute respiratory disease” (where the ‘n’ is for novel and “CoV” is for coronavirus). The name complies with the WHO Best Practices for Naming of New Infectious Diseases, which were developed through a consultative process among partner agencies. Endorsement for the interim name is being sought from WHO’s partner agencies, World Organiztion for Animal Health (OIE) and Food and Agriculture Organization (FAO). The final name of the disease will be provided by the International Classification of Diseases (ICD). WHO is also proposing ‘2019-nCoV” as an interim name of the virus. The final decision of the official name of the virus will be made by the International Committee on Taxonomy of Viruses. Countries, territories or areas with reported confirmed cases of 2019-nCoV, 30 January 2020: China – (including cases confirmed in Hong Kong SAR (10 confirmed cases), Macau SAR (7 confirmed cases) and Taipei (8 confirmed cases): 7736Japan: 11Republic of Korea: 4Viet Nam: 2Singapore: 10Australia: 7Malaysia: 7Cambodia: 1Philippines: 1Thailand: 14Nepal: 1Sri Lanka: 1India: 1United States of America: 5Canada: 3France: 5Finland: 1Germany: 4United Arab Emirates: 4TOTAL: 7818 January 30, 2020: President Donald Trump tweeted: “Working closely with China and others on Coronavirus outbreak. Only 5 people in U.S., all in good recovery.” January 30, 2020: World Health Organization Philippines tweeted: “Today, the Department of Health announced the first confirmed case of 2019 novel #coronavirus in the Philippines. The patient is 38 years old from China.” January 30, 2020: World Health Organization Phillippines tweeted: “The announcement was done today by @SecDuque in a press briefing, after results were recieved from the confimatory test done at the reference laboratory in Australia.” January 30, 2020: World Health Organization tweeted photos of the @DOHgov press release. From the press release: DOH CONFIRMS FIRST 2019-NCOV CASE IN THE COUNTRY; ASSURES PUBLIC OF INTENSIFIED CONTAINMENT MEASURESThe Department of Health (DOH) today confirmed that a 38-year-old female Chinese patient under investigation (PUI) is positive for the novel coronavirus (2019-nCoV) after her laboratory results arrived today from Victorian Infectious Disease Reference Library in Melbourne, Australia. DOH, however, continues to guarantee the public that all necessary precautionary measures are being taken to halt the spread of the virus.The confirmed case arrived in the Philippines from Wuhan, China via Hong Kong last January 21, 2020. The patient sought consult and was admitted in one of the country’s government hospitals last January 25 after experiencing mild cough. She is currently aysmptomatic.“I assure the public that the Department of Health is on top of this evolving situation. We were able to detect the first confirmed case becaues of our strong surveillance system, close coordination with World Health Organization and other national agencies, and the utilization of DOH’s decision tool. We are working closely with the hospital where the patient is admitted and have activated the Incident Command System of the said hospital for appropriate management, specifically on infection control, case management and containment. We are also implementing measures to protect the health staff providing care to these patients,” Health Secretary Francisco T. Duque III said.DOH is also in close coordination with the Intre-agency Task Force on Emerging Infectious Diseases (EID) which includes representatives of the Departments of Foreign Affairs (DFA), Interior and Local Government (DILG), Justice (DOJ), Labor and Employment (DOLE), Tourism (DOT), Transportation (DOTr), and Information and Communications Technology (DICT). The Task Force will convene a high-level meeting tomorrow, January 31, 2020, to discuss the first confirmed case and developments arising from this health issue.The Bureau of Quarantine remains on high alert and is in constant coordination with authorities from all ports of entry for stricter border surveillance. DOH assures that its health facilities are equipped and prepared to recieve and care for PUI’s and confirmed 2019-nCoV cases.DOH has recorded a total of twenty-nine (29) PUI’s – eighteen (18) in Metro Manila, four (4) in Central Visayas, three (3) in Western Visayas, one (1) in MMAROPA, one (1) in Eastern Visayas, one (1) in Northern Mindano, and one (1) in Davao. Twenty-three (23) PUI’s are currently admittedand five (5) have been discharged but are still under strict monitoring. DOH also reported one PUI mortality.“I urge the public to stay calm and remain vigilant at all times. Let us continue to practice good personal hygiene and adopt healthy lifestyles,” the Health Secretary concluded. January 30, 2020: Victoria State Government (Australia) posted a press release titled: “Third Novel Coronavirus case in Victoria”. From the press release: Victoria’s Department of Health and Human Services confirmed a third case of Novel Coronavirus in Victoria.The total number of confirmed cases of Novel Coronavirus in Victoria now is three. There are currently eight pending results and a total of 71 negative results.The latest case a woman in her 40s, a visitor from Hubei Province in China, is in a stable condition with the respiratory illness. She has been confirmed positive today following a series of tests.The patient is in isolation in the Royal Melbourne Hospital in accordance with recommended infection control procedures.The woman attended a GP and was referred to the hospital immediately. Two close contacts are being provided support and education and monitored closely for signs and symptoms of illness… January 30, 2020: Ohio Department of Health tweeted: “ODH, CDC, CCBH determined that the sixth U.S. confirmed coronavirus case was not infectious during his day trip to Cleveland. It is important to remember the U.S. is still low risk for nCoV. There are no additional PUIs related to this case on OH.” January 30, 2020: Nippon.com (News from Japan) posted an article titled: “New Coronavirus Detected in 3 Japanese Returnees from Wuhan”. From the article: A new coronavirus originating in Wuhan has been detected in three of the 206 Japanese nationals who returned home aboard a government-chartered flight Wednesday, a government official said Thursday.The three are among the 12 returnees hospitalized after returning from the Chinese city, according to the health minister Katsuobu Kato.Of the 12, five tested negative for the virus, he told parliament. January 30, 2020: UK Department of Health and Social Care posted a statement titled: “Statement from the 4 UK Chief Medical Officers on novel coronavirus”. The Chief Medical Officers were: Chief Medical Officer for England, Professor Chris Whitty Chief Medical Officer for Wales, Dr. Frank Atherton Chief Medical Officer for Scotland, Dr. Catherine Calterwood Chief Medical Officer for Northern Ireland, Dr. Michael McBride We have been working in close collaboration with international colleagues and the World Health Organization to monitor the situation in China and around the world. In light of the increasing number of cases in China and using existing and widely tested models, the 4 UK Chief Medical Officers consider it prudent for our governments to escalate planning and preperation in case of a more widespread outbreak.For that reason, we are advising an increase of the UK risk level from low to moderate. This does not mean we think to risk to individual in the UK has changed at this stage, but that government should plan for all eventualities.As we have previously said, it is likely there will be individual cases and we are confident in the ability of the NHS in England, Scotland, and Wales and HSC in Northern Ireland to manage these in a way that protects the public and provides high quality care. January 30, 2020: Nippon.com (News from Japan) posted an article titled: “Human-to-Human Spread of Coronavirus Confirmed in Japan”. From the article: Human-to-human transmission of a new strain of coronavirus that caused a pneumonia outbreak in China was confirmed in Japan, the health ministry said Thursday.The ministry called on not only people who have visited the Chinese city of Wuhan, the epicenter of the coronavirus crisis, but also those who developed symptoms such as coughing after contracting people with records of staying in Wuhan, to go see a doctor after making an advance call.Following the confirmation of the human-to-human spread of the virus, the ministry expanded the scope of people who are required to call medical institutions in advance to newly include those who had secondary contacts.In Japan, a driver of a bus that carried 60 tourists from Wuhan and a guide on the same bus have been confirmed to be infected with the virus. The ministry called on people not to worry more than necessary, saying that “the virus has not become widespread at the moment”. It advised people to take steps similar to those for avoiding the flu, such as wearing masks and washing hands. January 30, 2020: New South Wales Health posted another Novel Coronavirus Statistics (as of 9:30 AM that day). Number of cases confirmed: 4. Number of cases under investigation: 7. Number of cases tested negative: 10. January 30, 2020: Nippon.com (News from Japan) posted an article titled: “Abe Regrets 2 Returnees’ Refusal of Virus Tests”. From the article: Prime Minister Shinzo Abe said Thursday that it is “very regrettable” that two Japanese returnees from Wuhan, the epicenter of the coronavirus outbreak, refused to have virus tests.Officials “tried for a long time” to persuade them to accept virus tests as the government has no legal grounds to forcibly conduct such tests, Abe told a House of Councillors committee meeting.The two were among the first batch of Japanese nationals brought back home on a government-chartered plane on Tuesday.The prime minister said the government is now asking Japanese citizens still in the locked-down Chinese city and surrounding areas, before they board additional charter flights to return home, to agree to undergo virus tests.During the Upper House committee meeting, Abe agreed to the view expressed by an opposition lawmaker that it is problematic that Taiwan was not invited to an emergency meeting of the World Health Organization on the coronavirus outbreak. January 30, 2020: New South Wales Health posted another Novel Coronavirus Statistics (as of 4PM that day). Number of new cases 4 (see below). Number of cases under investigation: 20. Number of cases cleared: 50.Of the four confirmed cases, two patients have been discharged, a 53 year old male and a 35 year old male.Two patients remain in hospital, a 21 year old female and a 43 year old male. January 30, 2020: Nippon.com (News from Japan) posted an article titled: “Japan to Do Follow-Up Survey on People Who Have Stayed in Wuhan”. From the article: Japan’s government on Thursday decided to conduct a follow-up survey on all people entering the country who have been to China’s Wuhan, the epicenter of the pneumonia outbreake caused by a new coronavirus.The decision was made at the first meeting of a task force headed by Prime Minister Shinzo Abe, set up to prevent the spread of the virus.Under the plan, the government will obtain information on the places of stay of such people, including foreigners, in Japan and conduct the follow-up survey, which will include medical checks.Meanwhile, a third government-chartered flight left Tokyo International Airport at Hanada for Wuhan, the capital of the Hubei Province, on Thursday night to bring back more Japanese nationals.“We’ll implement thorough health management, including viral tests, regardless of whether (people) display symptoms,” Abe said at the task force meeting. He instructed his cabinet members to work as one to implement necessary measures without hesitation while putting top priority on protecting the lives and health of the Japanese people. January 30, 2020: Director-General of the World Health Organization, Tedros AdhanomGhebreyesus tweeted: “I am declaring a public health emergency of international concern over the global outbreak of #2019nCoV, not because of what is happening in #China, but becaues of what is happening in other countries.” The tweet included a link to Periscope. January 30, 2020: The World Health Organization (WHO) posted “Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV)”. It included proceedings of the meeting, conclusions and advice, advice to WHO, advice to the People’s Republic of China, advice to all countries, and advice to the global community. January 30, 2020: World Health Organization Western Pacific tweeted: “The total number of confirmed cases of the 2019 novel #coronavirus reported from mainland China to date is 9,692. This includes 1,527 severe cases and 213 people who have died. #nCoV #nCoV2019 #2019nCoV” This was the start of a thread. January 30, 2020: World Health Organization Western Pacific tweeted: Hong Kong SAR has reported a total of 12 cases, Macao SAR has reported 7 cases, and Taiwan, China has reported 9 cases. #coronavirus, #nCoV #nCoV2019 #2019nCoV.” January 30, 2020: World Health Organization Western Pacific tweeted: “Other countries in @WHO Western Pacific Region: Singapore has reported 13 cases, Japan 12 cases, Australia 9 cases, Malaysia 8 cases, Republic of Korea 6 cases, Viet Nam 2 cases, Cambodia & Philippines 1 case each #coronavirus #nCoV #nCoV2019 #2019nCoV” January 30, 2020: World Health Organization Western Pacific tweeted: “It is important to note that the case numbers reflect date reported, not date of illness onset. #coronavirus #nCoV #nCoV2019 #2019nCoV” This was the last tweet in the thread. January 30, 2020: Nippon.com (News from Japan) posted an article titled: “ANA Sees China Flight Bookings Plunging amid Coronavirus Spread”. From the article: The number of bookings for All Nippon Airways flights from China to Japan in February is now nearly half the year-before level, ANA Holdings Inc. <9202> revealed Thursday.Amid the spread of a new coronavirus from the Chinese city of Wuhan, the nubmer of bookings for ANA flights from Japan to China is also far fewer, down about 40 pct, according to the parent company.The slump in bookings partly reflects the cancellation of ANA flights between Wuhan and Narita International Airport near Tokyo throughout February… January 30, 2020: The Guardian posted an article titled: “Coronavirus: Britons to be quarantined in Wirral after arriving from Wuhan”. It was written by Simon Murphy and Dan Sabbagh. From the article: Around 120 Britons will fly from the Chinese city at the centre of the coronavirus outbreak overnight and land in the UK on Friday morning where they will be taken to Wirral for a fortnight’s quarantine……Dominic Raab, the foreign secretary, announced that the emergency flight, which was delayed by 24 hours, would be taking off from Wuhan and was due to land at RAF Brize Norton in Oxfordshire at around 9am.Military doctors will be onboard the chartered plane in case immediate treatment is necessary, although any passengers displaying symptoms of the virus – which can include a sore throat, fever and breathing dificulties – will be barred from boarding.It is undersood that there will be a quarantine area in the plane in case somebody falls ill during the flight.The returnees will be bussed to Arrowe Park hospital in Wirral where they will be monitored and treated if any symptoms develop. They will be staying in an accomodation block usually designated for NHS staff. Margaret Greenwood, the Labour MP for Wirral West, said she had spoken to the health secretary, Matt Hancock, who told her that experts believed it was unlikely that those quarantined had the virus.Passengers were asked to sign contracts agreeing to the 14-day quarantine as a condition of getting the flight home. A further 50 EU nationals will also be on the chartered flight, which will fly on to Spain where it will complete its journey… January 30, 2020: Centers for Disease Control and Prevention (CDC) posted a press release titled: “CDC Confirms Person-to-Person Spread of New Coronavirus in the United States”. From the press release: The Centers for Disease Control and Prevention (CDC) today confirmed that the 2019 Novel Coronavirus (2019-nCoV) has spread between two people in the United States, representing the first instance of person-to-person spread with this new virus here.Previously, all confirmed U.S. cases had been associated with travel to Wuhan, China, where an outbreak of respiratory illness caused by this novel coronavirus has been ongoing since December 2019. However, this latest 2019-nCoV patient has no history of travel to Wuhan, but shared a household with the patient diagnosed with 2019-nCoV infection on January 21, 2020.Recognizing early on that the 2019-nCoV could potentially spread between people, CDC has been working closely with state and local partners to identify close contacts of confirmed 2019-nCoV cases. Public health officials identified this Illinois resident through contact tracing. Both patients are in stable condition.Given what we’ve seen in China and other countries with the novel coronavirus, CDC experts have expected some person-to-person spread in the US,” said CDC Director Robert R. Redfield, M.D. “We understand that this may be concerning, but based on what we know now, we still believe the immediate risk to the American public is low.”Limited person-to-person spread with 2019-nCoV has been seen among close contacts of infected travelers in other countries where imported cases from China have been detected. The full picture of how easily and sustainably the 2019-nCoV spreads is still unclear. Person-to-person spread can happen on a continuum, with some viruses being highly contagious (like measles) and other viruses being less so……CDC is working closely with Illinois health officials and other local partners. A CDC team has been on the ground since the first 2019-nCoV-positive case was identified and is supporting an ongoing investigation to determine whether further spread with this virus has occured.It is likely there will be more cases of 2019-nCoV reported in the U.S. in the coming days and weeks, including more person-to-person spread. CDC will continue to update the public as we learn more about his coronavirus. The best way to prevent infection is to avoid being exposed to this virus. Right now, 2019-nCoV has not been found to be spreading widely in the United States, so CDC deems the immediate risk from this virus to the general public to be low. However, risk is dependent on exposure, and people who are in contact with people with 2019-nCoV are likely to be at greater risk of infection and should take the precautions outlined in CDC’s guidance for preventing spread in homes and communities… January 30, 2010: The Guardian posted an article titled: “Coronavirus deaths leap in China as countries struggle to evacuate citizens”. It was written by Sarah Boseley and Justin McCurry. From the article: China has reported its biggest single-day jump in coronavirus deaths, as countries struggled to evacuate citizens still trapped in the city where the outbreak began and Russia closed it long border with its southern neighbour.The death toll rose to 170 on Thursday – up from 132 the previous day, a rise of 29%. The number of confirmed cases in China now stands at 7,736, up from 5,974 a day ago. The actual death rate has not risen, and is now at 2.2%The number of global cases is 7,818……In Moscow, the Russian prime minister Mikhail Mishustin issued a decree ordering the temporary closure of the country’s border with China, which extend for 2,600 miles (4,200 kms). The border had been de facto closed because of the lunar new year holiday, but authorities said the closure would be extended until 1 March. In addition, all train traffic between the two countries, except for one train connecting Moscow and Beijing, was stopped on Thursday.Meanwhile, the US and South Korea confirmed their first cases of person-to-person spread of the virus. The man in the US is married to a 60-year-old Chicago woman who got sick from the virus after she returned from a trip to Wuhan. The case in South Korea was 56-year-old man who had contact with a patient who was previously diagnosed with the virus.. January 30, 2020: NBC News posted an article titled: “Cruise with 6,000 people stuck on board due to coronavirus scare gets clean bill of health”. It was written by Claudio Lavanga and David K. Li. From the article: Thousands of passengers, including more than 100 Americans, were stuck on their Italian cruise ship for much of Thursday after a passenger showed symptoms of the coronavirus, officials said.But by late Thursday night, all 6,000 passengers and 1,000 crew had been given the medical OK to come and go from the Cost Smeralda, officials said. Earlier in the day, the cruise line operator announced that everyone had to stay on board after one traveler appeared to fall ill.It turns out the sickened female guest, a 54-year-old Chinese national, was “diagnosed…with the common flu,” according to a statement Thursday night from Costa Crociere……The ship has 1,143 passengers who were scheduled Thursday to end their cruise in Civitaecchia, a port city about 50 miles northwest of Rome. Health officials with the maritime authority in Civitavecchia had given those travelers permission to leave the ship earlier in the day – but that city’s mayor asked for that disembarkment to be delayed until the results of all medical tests were known.The maritime authority agreed to that delay, according to Patrick Vignola, a spokesman for the mayor.. January 30, 2020: Nippon.com (News from Japan) posted an article titled: “Honda Decides to Put Off Restart of Wuhan Plans”. From the article: Honda Motor Co. <7267> said Thursday that it has decided to keep its automobile plants in Wuhan, China, the epicenter of the outbreak of a new coronavirus, closed until Feb. 13.The Japanese automaker earlier planned to keep facilities offline through next Sunday in line with the Lunar New Year holiday in China.Meanwhile, Mitsubishi Motors Corp. <7211> plans to extend the period of closure for its two facilities in Shanghai, including a research and development base, by seven days until Feb. 9, sources in the company said.Japanese companies are scrambling to deal with the spread of the coronavirus, as prolonged effects of the outbreak are feared to disrupt supply chains for their branches in China… January 30, 2020: The New Zealand Goverment posted a release titled: “Government charters Air NZ flight to assist Wuhan departure”. It was posted by RT Honorable Winston Peters the Deputy Prime Minister of Foreign Affairs. From the release: The Government has agreed with Air New Zealand to charter an aircraft to assist New Zealanders leaving Wuhan, Foreign Minister Winston Peters has announced.The aircraft will have the capacity for around 300 passengers and will fly from Wuhan to New Zealand. Officials will be working through operational requirements with Air New Zealand and Chinese authorities.New Zealanders in the Hubei region who are registerd on Safetravel have been emailed by the Ministry of Foreign Affairs and Trade to register interest in the flight, which is subject to Chinese Government approval……Consular teams will be working with health officials to ensure that the risks of transmission of the Coronavirus to New Zealand are carefully managed throughout the evacuation process.Officials are currently developing procedures for: pre-departure health screening of passengers, infection control inflight, and isolation of all passengers arriving in New Zealand for up to two weeks.Those who do take a seat on the plan will be required to pay a nominal fee, however the government will absorb most of the cost of the charter flight… January 30, 2020: Human Rights Watch posted an article titled: “China: Respect Rights in Coronavirus Response”. From the article: The Chinese government should ensure that human rights are protected while responding to the coronavirus outbreak, Human Rights Watch said today. As of January 29, 2020, confirmed cases of the infection, formally known as 2019-nCov, globally stood at 6,065, and the death toll at 132.The Chinese government’s response to the coronavirus outbreak was initially delayed by withholding information from the public, underreporting cases of infection, downplaying the severity of the infection, and dismissing the likelihood of transmission between humans. Since mid-January, authorities have taken a more aggressive approach, quarantining 50 million people in an effort to limit transmission from the city of Wuhan in Hubei province, where the virus originated, to the rest of China. In addition, authorities have detained people for “rumor-mongoring,” censored online discussions of the epidemic, curbed media reporting, and failed to ensure appropriate access to medical care for those with virus symptoms and others with medical needs… January 30, 2020: Boston Symphony Orchestra posted a press release titled: “Boston Symphony Orchestra Tour to East Asia Under The Direction Of Andris Nelsons, February 6-16, Is Canceled Due To Widly Documented Concerns Over The Spread Of The New Coronavirus”. From the press release: The Boston Symphony Orchestra’s four-city tour to East Asia (Seoul, Taipei, Hong Kong, and Shanghai) with Andris Nelsons, February 6–16, has been canceled due to increasing concerns over widely documented official news and government agency reports assessing the spread of the new coronavirus. These concerns, along with discussions with the Shanghai Oriental Art Center—whose leadership informed the BSO about the official cancellations of their upcoming performances—followed by consultations with the tour’s presenters in Seoul, Taipei, and Hong Kong, combined to play an influential role in the cancellation of the BSO’s East Asia tour. “On behalf of everyone at the Boston Symphony Orchestra, we are all deeply disappointed that we will not be able to perform for the wonderful audiences in Seoul, Taipei, Hong Kong, and Shanghai,” said BSO President and CEO Mark Volpe……The Boston Symphony Orchestra is currently exploring the possibility of scheduling some concerts and special events in Boston during the next two weeks, the period of time when the orchestra would have been on tour. Among the activities being considered is a BSO concert, free for the community of Boston.Further details will be announced by early next week. The 2020 trip was to be the orchestra’s 29th international tour since the orchestra’s founding in 1881. On other occasions, the BSO has been forced to cancel or significantly alter tour dates and personnel due to external factors. They include the orchestra’s 1960 Asia-Australasia tour when the BSO canceled an appearance in Seoul, South Korea due to political unrest and in 1999 when the BSO canceled performances in Beijing due to the accidental bombing of the Chinese embassy in former Yugoslavia… January 30, 2020: France 24 posted an article titled: “France confirms sixth case of coronavirus infection as its citizens evacuate Wuhan”. From the article: …France has confirmed its first three cases of the Wuhan coronavirus on Friday, a fourth case on Tuesday, and a fifth case on Wednesday.Meanwhile, a jet carrying around 200 French citizens flew out of the virus-hit Chinese city of Wuhan on Froday, according to AFP journalists on board the flight.The French military aircraft is bound for southern France, where the passengers will undergo a 14-day quarantine, in case they are carrying the new coronavirus.The United States and Japan have already carried out airlifts from Wuhan for their citizens. A second US flight is planned in the coming days.Britian also plans to evacuate around 200 of its citizens on Friday and Australia nad new Zealand are among others organizing similar operations.The European Commission has said it is planning a flight to evacuate more European nationals……China’s death toll from the virus rose to 212 on Friday as hardest-hit Hubei province reported 42 new fatalities. January 30, 2020: Reuters posted an article titled: “Two first coronavirus cases confirmed in Italy: prime minister”. From the article: Italian Prime Minister Guiseppe Conte on Thursday said there were two confirmed cases of coronavirus in Italy, the first two in the countyr since the emergency exploded.Conte said Italy had closed air traffic to and from China.“We have two confirmed cases of coronavirus in Italy,” the prime minister told a news conference, adding two Chinese tourists from China had contracted the virus… January 30, 2020: American Academy of Pediatrics (AAP) posted news titled: “1st person-to-person spread of coronavirus in U.S. reported; WHO declares public health emergency.” From the news: …A novel coronavirus has spread from person-to-person in the U.S. for the first time, according to federal health officials. The World Health Organization (WHO) also declared the outbreak a public health emergency of international concern, due to the increasing cases and countries affected. A man in his 60s from Chicago appears to have caught the virus from his wife who caught it while traveling to China. The man, who is the sixth confirmed case in the U.S. had not traveled.Health officials from the Centers for Disease Control and Prevention (CDC) emphasized the two had been in close contact, and they are monitoring other potential contacts……Globally, there have been 7,834 cases of the respiratory virus and 170 deaths, according to the WHO. Most cases are in China, but they also have been reported in 18 other countries.In the U.S., 92 people are awaiting test results… January 30: 2020: Reuters posted an article titled: “Germany identifies fifth case of coronavirus”. From the article: German health officials said on Thursday they had identified the country’s fifth case of the coronavirus in an employee working at the same firm as the other four infected individuals in the northern state of Bavaria. “This concerns an employee at the company in Starnberg at which the other four known cases work,” said Bavaria’s health ministry in a statement, adding further details would be made available on Friday. January 30, 2020: Executive Director of Human Rights Watch, Kenneth Roth, tweeted: “Are Americans safe from the coronavirus? In only 3 years, Trump has eliminated the office of pandemic response, drastically scaled back the CDC’s overseas outbreak prevention efforts & discontinued a surveillance program meant to detect new viral threats.” January 30, 2020: China correspondant for the BBC, Stephen McDonell, tweeted: #Coronavirus official figures update: 213 dead; 9720 infected; 15,238 suspected to have been infected; 179 recovered and discharged. Hubei alone 5806 infected and 204 dead. Wuhan city 2639 infected and 159 dead. #China.” This was the start of a short thread. January 30, 2020: China correspondant for the BBC, Stephen McDonell, tweeted: “The number of those who’ve recovered and released does seem small. It can only mean that either they’re keeping people in hospital longer to make sure they’re OK and won’t pass the #coronavirus on or not monitoring that statistic very closely. #China” This was the end of a short thread. January 30, 2020: Kenya Airways tweeted a screenshot of a statment: Suspension of Service to Guangzhou, ChinaFurther to our prior communications regarding the current Coronavirus outbreak, we have temporarily suspended all flights to and from Guangzhou starting Friday 31st January 2020, until further notice. We however, clarify that our service between Nairobi and Bangkok remains operational.Our consultation with the Ministries of Health and Foreign Affairs will continue and we will provide updates as the situation develops.We apologizes to all customers for the inconvenience and reaffirm that the safety of our customers and staff remains our highest priority. January 30, 2020: Monash University tweeted: “We’ve had to make some difficult decisions for the safety and wellbeing of our staff, students and the wider community due to the novel coronavirus, which has been declared a global health emergency by the World Health Organization.” This tweet was the start of a thread. January 30, 2020: Monash University tweeted: “Among the difficult decisions made, all exams scheduled for February and the commencement of semseter one have been postponed.” January 30, 2020: Monash University tweeted: “We’re continuing to monitor the rapidly evolving novel coronavirus situation acting accordingly with the advice from the Department of Human Services. For more information, see our fact sheet.” The tweet included a link to their fact sheet. This tweet was the end of the thread. January 30, 2020: Reuters posted an article titled: “Spain to repatriate nationals from Wuhan in cooperation with UK”. From the article: A group of Spanish citizens will fly back from the Chinese city of Wuhan in the coming hours as part of a joine repatriation operation with the United Kingdom amid concerns over coronavirus, Spain’s ministry said on Thursday.Spain’s Health Minister Salvador Illa said earlier that the group of around 20 Spaniards will spend 14 days in quarantine when they return to the country. January 30, 2020: Reuters posted an article titled: “Factbox: Airlines suspend China flights over coronavirus”. From the article: Airlines have started suspending flights to China in the wake of a new coronavirus outbreak, which as of Thursday had killed 170 people and infected almost 8,000. Air Canada said on Jan. 28 it was canceling select flights to CanadAir France said on Jan. 30 it suspended all scheduled flights to and from mainland China until Feb. 9Air India said it was cancelling its Mumbai-Dehli -Shanghai flight from Jan. 31 to Feb 14.Air Seoul … said on Jan. 28 it had suspended all flights to China.Air Tanzania – Tanzania’s state-owned carrier said it would postpone its maiden flights to China. It had planned to begin charter flights to China in February.American Airlines said it would suspend flights from Los Angeles to Beijing and Shanghai from Feb. 9 to March 27.British Airways said on Jan. 30 it has cancelled all flights to mainland China for a month.Cathay Pacific Airways (Hong Kong) said it would progressively reduce capacity to and from mainland China by 50% or more from Jan. 30 to the end of March.Delta Air Lines said on Jan. 29 it was reducing flights to China to 21 per week from 42 starting Feb. 6 through April 30.Egyptair said on Jan. 30 it would suspend all flights to and from China starting Feb. 1.Ethiopian Airlines on Jan. 30 denied reports it had suspended all flights to China. The airline’s statement contradicted its passenger call centre, which told Reuters earlier in the day that flights to China had been suspended.Finnair (Finland) said on Jan. 28 it would suspend its flights to Nanjing and Beijing until the end of March after China suspended international group travel from the country. Finnair will suspend its three weekly flights between Helsinki and Beijing Daxing between Feb. 5 and March 29 and its two weekly flights between Helsinki and Nanjing between Feb. 8 and March 20.Lion Air (Indonesia) said on Jan. 29 it would suspend all flights to China from February. The airline has suspended six flights from several Indonesian cities to China so far and will suspend the rest next month.Lufthansa (Germany) said on Jan. 29 it was suspending Lufthansa, Swiss and Austrian Airlines flights to and from China until Feb. 9. The airline continues to fly to Hong Kong, but it will stop taking bookings for flights to mainland China until the end of February.SAS said on Jan. 30 it has decided to suspend all fights to and from Shanghai and Beijing from Jan. 31 until Feb. 9.Turkish Airlines (Turkey) said on Jan. 30 it would decrease frequency on scheduled flights to Beijing, Guangzhou, Shanghai, and Xian between Feb. 5 and Feb. 29.United Airlines (Chicago-based) said it would implement a second phase of flight cancellations between its hub cities in the United States and Beijing, Hong Kong and Shanghai, resulting in 332 additional roundtrips being called off through March 28. The cancellations will reduce the carrier’s daily departures for mainland China and Hong Kong to four daily depatures from 12. United had previously suspended 24 U.S. flights to Beijing, Hong Kong and Shanghai between Feb. 1 and Feb. 8 because of a significant drop in demand.United Parcel Service Inc. (UPS) has cancelled 22 China flights as a result of the Wuhan quarantines and normal manufacturing closures due to the Lunar New Year holiday, UPS Chief Executive David Abney said on Jan. 30. He did not specify how may flight cancellations were due to the virus.Virgin Atlantic said on Jan. 30 it would suspend its daily operations to Shanghai for two weeks from Feb. 2. It cited declining demand for flights and the safety of its customers and staff. January 30, 2020: Forbes posted an article titled: “Mammoth Biosciences Raises $45 Million For Crispr Diagnostics – And Its Tech Is Already Being Used Against Coronavirus”. It was written by Leah Rosenbaum. From the Article: Mammoth Biosciences, a company that uses gene-editing technology Crispr for disease testing, said Thursday that it had raised $45 million in Series B funding to expand into treatments. The round, led by Dechung Capital and including new investor Verily, brings total funding to over $70 million……The new capital will allow Mammoth to expand into more traditional gene editing, which can be used to treat diseases. The company also plans to double in size, [Trevor] Martin [One of the founders of Mammoth Biosciences] says. Mammoth already moved into a new lab space on the South San Francisco campus of Verily, Alphabet’s life sciences company……The technology has big implications for diagnostics, Martin says. One of Mammoth’s current partnerships is with UCSF researcher Charles Chiu, who also sits on Mammoth’s scientific advisory board, to create a rapid diagnostic test for the new coronavirus that has sickened more than 6,100 people globally and killed 132… January 31, 2020: World Health Organization (WHO) posted: “Novel Coronavirus (2019-nCoV) Situation Report – 11”. From the report: Highlights: The Emergency Committee on the novel coronavirus (2019-nCoV) under the International Health Regulations (HR 2005) was reconvened on 30 January. WHO declared the outbreak to be a public health emergency of international concern. The Emergency Committee has provided advice to WHO, to the People’s Republic of China, to all countries, and to the global community, on measures to control this outbreak. The Committee believes that it is still possible to interrupt virus spread, provided that countries put in place strong measures to detect disease early, isolate and treat cases, trace contacts, and promote social distancing measures commensurate with the risk……Today, the first two confirmed cases of 2019-nCoV acute respiratory disease were reported in Italy; both had history to Wuhan City.WHO’s Risk Communication Team has launched a new information platform called WHO Information Network for Epidemics (EPI-WIN). EPI-WIN will use a series of amplifiers to share tailored information for specific target groups. EPI-WIN began this week to establish connections to health care and travel and tourism sectors and will work with food and agriculture and business/employer sectors next week. Countries, territories or areas with repeated confirmed cases of 2019-nCoV, 31 January 2020: China (including cases confirmed in Hong Kong SAR (12 confirmed cases), Macau (7 confirmed cases) and Taipei (9 confirmed cases): 9720Japan: 14Republic of Korea: 11Viet Nam: 5Singapore: 13Australia: 9Malaysia: 8Cambodia: 1Philippines: 1Thailand: 14Nepal: 1Sri Lanka: 1India: 1United States of America: 6Canada: 3France: 6Finland: 1Germany: 5Italy: 2United Arab Emirates: 4TOTAL: 9826 January 31, 2020: CBS News posted an article titled “Global airlines suspend flights to China on virus fears”. From the article: …On Thursday, United said it would extend its suspended flights to China through March 28, cutting to just four daily departures its typical daily departures from the U.S. mainland China. United had said earlier the flight cutbacks would end on February 8.Delta said Friday that all flights to and from China would stop operating from February 6, with the airline flying reduced schedules before then “to ensure customers looking to exit China have options to do so.” Delta said the last flight from China to the U.S. would leave on February 5.British Airways said Wednesday that it is immediately suspending all flights to and from mainland China after the U.K. government warned against unnecessary travel to China amid a virus outbreak…French flagship carrier Air France announced Thursday it was suspending all normal scheduled flights to and from mainland China in a bid to help stem the spread of the new coronavirus. There wre five confirmed cases of the virus in France as of Thursday.Delta on Wednesday said it would temporarily reduce its weekly flights between the U.S. and China because of “significantly reduced customer demand.” Its flights will be cut from 42 weekly flights to 21 weekly flights, it said.China has cut off access to the central city of Wuhan, epicenter of the outbreak, and 16 other cities to prevent people from leaving and spreading the virus further. Hong Kong airlines are cutting the number of their flights to the mainlaind by about half through the end of March in response to government virus-control efforts… Air Canada – suspending all direct flights to Beijing and Shanghai effective January 30 until February 29.Lufthansa – suspending direct flights on Lufthansa, Swiss and Austrian Airline fleets to or from mainland China until 9 February.Air Seoul – first South Korean airline to suspend its flights to mainland Chinese destinations apart from Wuhan, stopping its flights to the cities of Zhangjiajie and Linyi.Indonesia’s Air Lion – canceled more than 50 fights to China well into February.Cathay Pacific Group – flights to 24 mainland destinations would be reduced to 240 weekly.Finnair (Finland) – cancelling three weekly flights to Beijing Daxing International Airport through late March, as well as its twice-weekly flights to Nanjing.Jetstar Asia – temporarily suspend flights to the Chinese cities of Hefei, Guiyang and Xuzhou starting Thursday throug the end of March due to drop in demand.Eva Air (Taiwan) – partial cancellation of flights to and from mainland China for two weeks starting Feburary 2.Kazakhstan – plans to suspend all flights, train and bus traffic and to halt issuing visas to Chinese nationals. January 31, 2020: U.S. Health and Human Services Secretary Alex M. Azar declared a public health emergency for the entire United States to aid the nation’s healthcare community in responding to 2019 novel coronavirus. The press release stated that, in declaring the public health emergency, Secretary Azar acted within his authority under the Public Health Service Act. The declaration is retroactive to January 27, 2020. January 31, 2020: The European Centre for Disease Prevention and Control posted a risk assessment titled: “Risk assessment: Outbreak of acute respiratory syndrome associated with a novel coronavirus, China: first local transmission in the EU/EEA – third update”. From the risk assessment: On 31 December 2019, a cluster of pneumonia cases of unknown aetiology was reported in Wuhan, Hubei Province, China. On 9 January 2020, China CDC reported a novel coronavirus (2019-n-CoV) as the causative agent of this outbreak, which is phylogenetically in the SARS-CoV clade.As of 30 January 2020 09:00, more than 7,000 laboratory-confirmed 2019-n-CoV cases had been reported worldwide, mainly in China, but also with more than 70 imported cases from other countries around the world. Details on the epidemiological update for 2019-nCoV can be found on ECDC’s website.So far, one hundred and seventy deaths associated with this virus have been reported. On 20 January, Chinese health authorities confirmed human-to-human transmission outside of Hubei province. Sixteen healthcare workers are reported to have been infected.On 24 January 2020, the first three cases of 2019-n-CoV imported into the EU/EEA were identified in France and one additional case was reported in 29 January 2020. On 28 January, a cluster of four locally-acquired cases, with indirect links to Wuhan, was reported in Germany. On 29 January, Finland reported an imported case from Wuhan.China CDC assesses the transmissibility of this virus to be sufficient for sustained community transmission without unprecedented control measures. Further cases and deaths in China are expected in the coming days and weeks. Further cases or clusters are also expected among travelers from China, mainly Hubei province. Therefore, health authorities in the EU/EEA Member States should remain vigilant and strengthen their capacity to respond to such an event.There are considerable uncertainties in assessing the risk of this event, due to lack of detailed epidemiological analyses… January 31, 2020: Nippon.com (News from Japan) posted an article titled: “Japan to Add New Pneumonia to Specified Disease List Sat.” From the article: The Japanese government decided Friday to designate pneumonia caused by the new strain of coronavirus raging in China as a specified infectious disease Saturday, a week earlier than initially scheduled.The government is considering covering the airfares for chartered flights it dispatched to Wuhan, the epicentr of the coronavirus crisis, to help Japanese nationals return home.Prime Minister Shinzo Abe announced these matters at the Budget Committee of the House of Representatives, the lower chamber of parliment said. The government “will reject the entry into Japan of anybody infected who try to enter the country,” Abe told the committee.The government is also considering what can be done to tighten immigration controls in order to limit the entry into Japan of those suspected but not confirmed to be infected, he added. January 31, 2020: New South Wales Health posted another Novel Coronavirus Statistics (as of 10:30 AM that day). Number of cases confirmed: 4 (see below). Number of cases under investigation: 9. Number of cases cleared: 67. Of the four confirmed cases, two patients have been discharged, a 53 year old male and a 35 year old male.Two patients remain in hospital, a 21 year old female and a 43 year old male. January 31, 2020: Nippon.com (News from Japan) posted an article titled: “3rd Evacuation Flight Brings Home Japanese from Wuhan”. From the article: The third charter jet sent to Wuhan by the Japanese government arrived at Tokyo International Airport at Hanada on Friday, bringing home 149 Japanese nationals from the Chinese city mired in the coronavirus crisis.Some of the people are complaining of ill health, officials said.Returnees who show no symptoms after taking medical checks will be transferred to designated facilities to monitor their health condition for a while.A total of 565 Japanese nationals were brought back to Japan aboard three government-chartered planes to Wuhan to evacuate all Japanese nationals who want to return home during the outbreak of pneumonia caused by the deadly virus. According to the health ministry, three people in their 40s to 50s who were aboard the first flight, which arrived in Japan Wednesday, tested positive for the virus. Two of them did not show symptoms of the coronavirus-caused pneumonia. January 31, 2020: World Health Organization Western Pacific tweeted: “The total number of confirmed cases of the 2019 novel #coronavirus reported from mainland China to date is 11,791. This includes 1,795 severe cases and 259 people who have died. #nCoV #nCoV2019 #2019nCov” This tweet was the start of a thread. January 31, 2020: World Health Organization Western Pacific tweeted: “Hong Kong SAR has reported a total of 13 cases, Macao SAR has reported 7 cases, and Taiwan, China has reported 10 cases #coronavirus #nCoV #nCoV2019 #2019nCoV”. January 31, 2020: World Health Organization Western Pacific tweeted: “Other countries in the @WHO Western Pacific Region: Singapore has reported 16 cases, Japan 13 cases, Rep of Korea 12 cases, Australia 9 cases, Malaysia 8 cases, Viet Nam 5 cases, Camboria & Philippines 1 case each #coronavirus #nCoV #nCoV2019 #2019nCoV” January 31, 2020: World Health Organization Western Pacific tweeted: “It is importan to note that case numbers reflect date reported, not date of illness onset. #coronavirus #nCoV #nCoV2019 #2019nCoV”. This was the last tweet in the thread. January 31, 2020: Nippon.com (News from Japan) posted an article titled: “Japan Travel Agencies Hit by Cancellations of China Tours”. From the article: Massive cancellations of China-bound package tours from Japan are hitting Japanese travel agencies in the wake of the outbreak of pneumonia blamed on a new strain of coronavirus spreading from Wuhan, the capital of China’s Hubei Province.As the outbreak spread throughout the world, the Japanese tourism industry is concerned that the coronavirus crisis may affect overall demand for travel abroad, sources familiar with the situation said.The outbreak is also causing travel agencies to suspend China-bound package tours not including visists to Hubei, because major tourism spots outside the province, such as the Palace Museum in Beijing and the Great Wall of China, have been closed amid the crisis.In an unusual move, JTB Corp. and H.I.S. Co <9603> have decided to give full refunds to customers for tours anywhere in China, excluding Hong Kong and Macau, without collectin cancellation fees, even if they cancel their tours just before departure.JTB, Club Tourism International Inc. and Hankyu Travel International Co. have halted tours to Wuhan after Japan’s Foreign Ministry raised its travel alert related to infectious diseases. JTB plans to continue the suspension until the advisory is lowered to Level One from the current Level 3, which calls for avoiding travel to designated areas. January 31, 2020: UK Department of Health and Social Care posted news titled: “CMO confirms cases of coronavirus in England”. It is a statement from Chief Medical Officer, Professor Chris Whitty, about cases of novel coronavirus in England. We can confirm that 2 patients in England, who are members of the same family, have tested positive for coronavirus. The patients are receiving specialist NHS care, and we are using tried and tested infection control procedures to prevent further spread of the virus.The NHS is extremely well-prepared and used to managing infections and we are already working rapidly to identify any contacts the patients had, to prevent further spread.We have been preparing for UK cases of novel coronavirus and we have robust infection control measures in place to respond immediately. We are continuing to work closely with the World Health Organization and the international community as the outbreak in China develops to ensure we are ready for all eventualities. January 31, 2020: Nippon.com (News from Japan) posted an article titled: “Nara Puts Off Accomodation Tax amid Coronavirus Outbreak”. From the article: The western Japan city of Nara will put off its plan to introduce the accommodation tax during fiscal year 2020, to limit damage on the city’s tourism industry amid the outbreak of a new coronavirus, its mayor said Friday.Mayor Motonobu Nakgawa told a press conference that the city will take various factors into consideration and decide when to introduce the tax after monitoring the situation concerning the virus.A city survey of 13 large hotels with 100 rooms or more each showed that reservations for 3,156 guests, mainly on group tours from China, had been cancelled as of Thursday, according to the city.On Tuesday, the health ministry said that a Japanese male bus driver in Nara Prefecture has been confirmed as infected with the virus. He drove tourists from the Chinese city of Wuhan, the center of the outbreak.“It has been confirmed that their is obious damage (to tourism). We need to stop for now to see how things go.” Nakagawa said. January 31, 2020: Nippon.com (News from Japan) posted “Coronavirus: 3 New Cases in Japan, Total Now 17”. The article included a video. January 31, 2020: Nippon.com (News from Japan) posted an article titled: “Japan Confirms 2 More Symptomless Returnees with New Coronavirus”. From the article: Two Japanese nationals who returned from Wuhan on Thursday aboard the second government-chartered flight have been found to be infected with the new coronavirus that spread from the Chinese city and has caused an outbreak of pneumonia, the Japanese health ministry said Friday.A man in his 30s and another man in his 50s tested positive for the virus, but have no symptoms. The number of returnees who are infected with the coronavirus but have no symptoms now stands at four. The other people returned to Japan on Wednesday aboard the first chartered flight.A total of 210 Japanese nationals returned home on the second chartered plane. The first flight brought home 206 people, with three of them, including the two symptomless people, found to have the coronavirus.The third flight chartered by the Japanese government for the evaucation operations arrived at Tokyo International Airport in Haneda on Friday moring with 149 passengers from Wuhan, bringing the total number of Japanese people brought back from the city and other parts of Hubei Province to 565.Twenty-five of the 149 passengers complained of symptoms such as coughing and were admitted to hospitals in Tokyo. The remaining passengers were sent to the National Institute of Public Health in Wako, Saitama Prefecture, north of Tokyo, or the Customs Training Institute in Kasiwa, Chiba Prefecture, east of the Japanese capital, for monitoring January 31, 2020: CDC tweeted: “The CDC, under statutory authority of the Health and Human Services (HHS) Secretary, has issued federal quarantine orders to all 195 United States citizens who repatriated to the U.S. on January 29, 2020. The quarantine will last 14 days from when the plane left Wuhan, China.” This tweet was the start of a thread. January 31, 2020: CDC tweeted: “This action is a precautionary and preventative step to maximize the containment of the virus in the interest of the health of the American public. The current epidemic in Mainland China has demonstrated the #2019nCoV’s capacity to spread globally.” January 31, 2020: CDC tweeted: “This legal order is part of a public health response that is necessary to prevent the transmission and spread of this virus in the U.S. This federal quarantine will protect the health of the repatriated US citizens, their families, and their communities. #2019nCoV” January 31, 2020: CDC tweeted: “CDC is committed to protecting the health & safety of all Americans. We continue to believe the immediate risk to the larger American public is low at this time. The #2019nCoV outbreak investigation is ongoing. For updates:” The tweet included a link to the CDC website. This was the last tweet in the thread. January 31, 2020: The Desert Sun posted an article titled: “‘A whole different ballgame’: Wuhan flight passengers at March Air Reserve Base under quarantine; evacuee shares experience”. It was written by Marie McCain and wires. From the article: Officials with the Centers for Disease Control and Prevention on Friday ordered the quarantine of all 195 U.S. evacuees from Wuhan, China, who are being screened for symptoms of the coronavirus at March Air Reserve Base near Moreno Valley.So far, none of them have exhibited symptoms of the virus, a Riverside County spokeswoman said Friday. Nevertheless, the quarantine order means they will have to remain on base for the full 14-day incubation period……Federal officials said the CDC quarantine in Southern California was one of the reasons the coronavirus outbreak was declared a public health emergency in the United States.Health and Human Services Secretary Alex Azar, on Friday, made that announcement along with another that President Donald Trump will temporarily bar entry to the U.S. of foreign nationals believed to be at risk of transmitting the virus. The new restrictions begin Sunday afternoon……Americans returning from Hubei province, the center of the outbreak, will be required to undergo 14 days of quarantine. Others returning from elsewhere in China will be allowed to self-monitor their condition for a similar period.The public health announcement came hours after the State Department issued a level 4 “Do Not Travel” advisory, the highest grade of warning, and told Americans in China to consider departing using commercial means……Friday’s order quarantining U.S. evacuees at March Air Reserve Base is the first time a federal quarantine has been ordered since the 1960s, when one was instituted over concern about potential spread of smallpox, the CDC said.A day earlier, Riverside County health ifficials ordered the quarantine of one of the evacuees after that person attempted to leave the base hours after the group arrived. January 31, 2020: Nippon.com (News from Japan) posted an article titled: “Japan to Bar Foreigners with Recent Stays in Hubei”. From the article: Japan’s government decided Friday to impose a temporary ban on entry by all foreigners with recent histories of staying in China’s Hubei Province, including its capital, Wuhan, the epicenter of the outbreak of a new coronavirus. The entry ban will be in place “for the time being” from Saturday, Prime Minister Shinzo Abe said at a meeting on the day of the government’s headquarters for responding to the ongoing spread of the new coronavirus.The move comes after the World Health Organization declared a public health emergency on Thursday, in the face of the spread of the coronavirus that has caused numerous people to develop pneumonia in China and other parts of the world. It will be the first time for the Japanese government to impose an entry ban tha specifies a certain area.Specifically, the govenrment will not accept entry applications form foreigners with histories of being in Hubei within the past 14 days and holders of Chinese passports issued by the province, regardless of whether they have been confirmed to have the virus or not. “We can’t deal with this unprecedented crisis if we stick to precedents,” the prime minister stressed, instructing cabinet ministers to respond flexibly. January 31, 2020: Nippon.com (News from Japan) posted an article titled: “Japanese Institute Succeeds in Isolating Wuhan Coronavirus”. From the article: Japan’s National Institute of Infectious Diseases said Friday that it has succeeded in cultivating and isolating the new coronavirus, first reported in the Chinese city of Wuhan, from a person in Japan who has been confirmed to have the virus.Using the isolated virus, the institute will start work to develop a vaccine and a drug for the coronavirus, as well as a test kit capable of quick diagnosis. It will also offer the isolated virus to researchers and companies, while trying to discover the infection mechanism and promoting research on the toxicity of the virus.The isolated virus’ gene sequences 99.9 pct matched those released by the Chinese government, according to the Japanese institute.In the isolated virus, there was no gene mutation leading to higher infectiousness or toxicity, the institute said. January 31, 2020: The White House posted a presidential proclamation titled: “Proclamation on Suspension of Entry as Immigrants and Nonimmigrants of Persons who Pose a Risk of Transmitting 2019 Novel Coronavirus”. From the proclamation: The United States has confirmed cases of individuals who have a severe acute respiratory illness caused by a novel (new) coronavirus (“2019-nCoV”) (“the virus”) first detected in Wuhan, Hubei Province, People’s Republic of China (“China”). The virus was discovered in China in December 2019. As of Janiary 31, 2020, Chinese health officials have reported approximately 10,000 confirmed cases of 2019-nCoV in China, more than the number of confirmed cases of Severe Acute Respiratory Syndrome (SARS) during its 2003 outbreak. An additional 114 cases have been confirmed across 22 other countries; in several of these cases, the infected individuals had not visited China. More than 200 people have died from the virus, all in China……Many of the individuals with the earliest confirmed cases of 2019-nCoV in Wuhan, China had some link to a large seafood and live animal market, suggesting animal-to-human transmission. Later, a growing number of infected individuals reportedly did not have exposure to animal markets, indicating human-to-human transmission. Chinese officials now report that sustained human-to-human tranmission of the virus is occuring in China. Manifestations of severe disease have included severe pneumonia, acute respiratory distress syndrome, septic shock, and multi-organ failure.Neighboring jurisdictions have taken swift action to protect their citizens by closing off travel between territories and China. On January 30, 2020, the World Health Organization declared 2019-nCoV outbreak a public health emergency of international concern……The CDC is closely monitoring the situation in the United States, is conducting enhanced entry screening at 5 United States airports where the majority of travelers from Wuhan arrive, and is enhancing illness response capacity at the 20 ports of entry where CDC medical screening stations are located. The CDC is also supporting States in conducting contact investigations of confirmed 2019-nCoV cases identified within the United States. The CDC has confrimed that the virus has spread between two people in the United States, representing the first instance of person-to-person transmission of the virus within the United States. The CDC, along with state and local health departments, has limited resources and the public health system could be overwhelmed if sustained human-to-human transmission of the virus occured in the United States. Sustained human-to-human transmission has the potential to have cascading public health, economic national security, and societal consequences.During Fiscal Year 2019, an average of more than 14,000 people traveled to the United States from China each day, via both direct and indirect flights. The United States Government is unable to effectively evaluate and monitor all of the travelers continuing to arrive from China. The potential for widespread transmission of the virus by infected individuals seeking to enter the United States threatens the security of our transporation system and infrastructure and the national security. Given the importants of protecting persons within the United States from the trheat of this harmful communicable disease, I have determined that it is in the interests of the United States to take action to restrict and suspend entry into the United States, as immigrants or nonimmigrants, of all aliens who were physically present within the People’s Republic of China, excluding the Special Administrative Regions of Hong Kong and Macau, during the 14-day period preceding their entry or attempted entry into the United States. I have also determined that the United States should take all necessary and appropriate measurs to facilitate orderly medical screening and, where appropriate, quarantine of persons allowed to enter the United States who may have been exposed to this virus…. Here is the short version of who this proclamation allows entry to: any lawful permanent resident of the United Statesany alien who is the spouse of a U.S. citizen or lawful permanent residentany alien who is the parent or legal guardian of a U.S. citizen or lawful permanent resident, provided that the U.S. citizen or lawful permanent resident is unmarried and under the age of 21any alien who is the sibling of a U.S. citizen or lawful permanent resident, provided that both are unmarried and under the age of 21any alien who is the child, foster child, or ward of a U.S. citizen or lawful permanent resident, or who is a prospective adoptee seeking to enter the United States pursuant to the IR-4 or IH-4 visa classificationsany alien traveling at the invitation of the United States Government for a purpose related to containment or mitigation of the virusany alien traveling as a nonimmigrant under section as a crewmember or any alien otherwise travling to the United States as air or sea crewany alien seeking entry into or transiting the United States as a foreign government official or immediate family member of an officialany alien whose entry would not pose a significant risk of introducing, transmitting, or spreading the virus, as determined by the CDC Director, or his designeeany alien whose entry would further important United States law enforcement objectives, as determined by the Secretary of State, the Secretary of Homeland Security, or their respective designees based on a recommendation of the Attorney General or his designeeany alien whose entry would be in the national interest, as determined by the Secretary of State, the Secretary of Homeland Security, or their designees. Here is what this proclamation allows: The Secretary of State and the Secretary of Homeland Security to establish procedures to enforce this proclamation. The Secretary of State, the Secretary of Transportation, and the Secretary of Homeland Security to ensure that any alien subject to this proclamation does not board an aircraft traveling to the United States.The Secretary of Homeland Security to establish standards and procedures to ensure the application and implementation of this proclamation at United States seaports and in between all ports of entryAny alien who circumvents the application of this proclimation through fraud, willful misrepresentation of a material fact, or illegal entry shall be a priority for removal by the Department of Homeland Security.The Secretary of Homeland Security is to take all necessary and appropriate steps to regulate travel of persons and aircraft to the United States to facilitate the orderly medical screening and, where appropriate, quarantine of persons who enter the United States and who may have been exposed to the virus.This proclamation shall remain in effect until terminated by the President. The Secretary of Health and Human Serices shall, as circumstances warrant and no more than 15 days after the date of this order and every 15 days thereafter, recommend that the President continue, modify, or terminate this proclamation.The proclamation is effective at 5:00 p.m. eastern standard time on February 2, 2020. January 31, 2020: The White House posted a press briefing titled: “Press Briefing by Members of the President’s Coronavirus Task Force”. From the press briefing: Secretary Azar: Well, good afternoon, everyone. I’m Alex Azar, Secretary of Health and Human Services, and Chairman of the President’s Task Force on the Novel Coronavirus.I’m going to start by turning things over to Dr. Robert Redfield, the Director of the Centers for Disease Control and Prevention, to discuss the current situation on the novel coronavirus. Dr. Redfield.Dr. Redfield: Thank you, Mr. Secretary, Let me give you an update on the current situation of the novel coronavirus. First though, I want to emphasize that this is a serious health situation in China, but I want to emphasize that the risk to the American public currently is low. Our goal is to do all we can to keep it that way.Second, I want to recognize the concern that the American public may have. And I want to reiterate what I just said: Currently, the risk of the American public is low.As of today, there are nearly 9,700 cases in China, with more than 200 deaths. Additionally, currently there are another 23 countries that have confirmed, totally, 132 cases. This also includes 12 individuals who have been confirmed in six countries who did not travel to China……To date, we have confirmed six cases of the novel virus in the United States. The most recent case had no travel history to China, but was a close personal contact of one of the previous cases that we had identified through our aggressive contact tracing. In addition, there are currently 191 individuals that are under investigation……Dr. Anthony Fauci, the Director of the National Institute of Allergy and Infectious Disease: The issue now with this is that there’s a lot of unknowns. As you can see just from the media, the number of cases have steeply inclined each and every day. You know that, in the beginning, we were not sure if there were asymptomatic infection, which would make it a much broader outbreak than what we’re seeing. Now we know for sure there are.It was not clear whether an asymptomatic person could transmit it to someone while they were asymptomatic. Now we know from a recent report from Germany that that is absolutely the case…There are a number of countries outside China that have travel-related cases. And now what we’re seeing is that there are secondary cases from them, and, as Bob mentioned, we also have that in this country. The WHO has issued, as you know, a Public Health Emergency of International Conern declaration……Secretary Azar: Following the World Health Organization’s decision to declare the 2019 novel coronavirus a Public Health Emergency of International Concern, I have today declared that the 2019 novel coronavirus presents a public health emergency in the United States. The actions we have taken and continue to take complement – complement the work of China and the World Health Organization to contain the outbreak within China.In accordance with the declaration, beginning at 5:00 p.m., Eastern Standard Time; Sunday, February the 2nd, the United States government will implement temporary measures to increase our abilities to detect and contain the coronavirus proactively and aggressively. Any U.S. citizen returning o the United States who has been in Hubei Province in the previous 14 days will be subject to up to 14 days of mandatory quarantine to ensure they are they are provided proper medical care and health screening… January 31, 2020: South China Morning Post posted an article titled: “Coronavirus: South Korea, Thailand confirm cases of human transmission”. From the article: South Korea on Friday confirmed five more cases of the deadly coronavirus, bringing the total in the country to 11, including two people who returned from Wuhan via the eastern Chinese port city of Qingdao last week.South Korea and Thailand have also confirmed cases of human-to-human transmission, as four individuals contracted the virus without travelling to China, according to Seoul and Bangkok’s health officials.In Seoul, one of them was a man in his 50s who developed symptoms after dining with South Korea’s third confirmed patient at a restaurant in the capital.The first patient to contract the virus inside Thailand was a local taxi driver, said Tanarak Pipat, deputy director-general of the Department of Disease Control……The taxi driver was one of the five other coronavirus cases confirmed in Thailand on Friday.The new South Korean cases emerged after 368 of the country’s citizens were evacuated to two facilities in Asan and Jincheon, cities about 80km south of Seoul, where they will be isolated.The country is set to send a second flight to Wuhan to evacuate some 300 more Korean citizens in the coming days.A total of 18 South Korean evacuees who arrived from Wuhan have been hospitalized after showing symptoms, Seoul’s health authorities said on Friday, as concerns mount about a wider outbreak of the virus……In response to the coronavirus crisis, North Korea postponed plans to tear down South Korean-made hotels and other facilities at the North’s Diamond Mountain resort to prevent the spread of a new virus that has reached the South after sickening thousands in China.. January 31, 2020: German Federal Foreign Office posted a press release titled: “Foreign Minister Maas on the evacuation of Germans from Wuhan.” From the press release: Foreign Minister Heiko Mass issued the following statement in Berlin today (31 January).We now have all the permits from the Chinese authorities that we need to evacuate our citizens. As I speak, a Bundeswehr plane is setting off for China, to fly the German nationals out.I am relieved that we have got to this stage, that an end will now be put to the difficult situation in which our citizens find themselves in Wuhan, that the people who want to leave can now be flow out by us.We’re talking about over 100 people. None of them has been infected. None of them is even suspected of having the virus. To guarantee the health and safety of the population in Germany, the people who have been evacuated from China will be quarantined for two weeks on Bundswher premises in order to be absolutely sure that none of the evacuees is carrying the virus.I would like to thank the Chinese Government for working together with us on this. My thanks also go to the Crisis Response Centre, the authorities involved and our consular teams in China. We hope that everyone who comes back will be in good health and will stay that way – regardless of the fact that they will be monitored by medics here January 31, 2020: BBC News posted an article titled: “Coronavirus: Two cases confirmed in UK”. From the article: Two people from the same family have tested positive for coronavirus in the UK, the chief medical officer for England has announced.The Chinese nationals were guests at the Staycity apartment-hotel in York, before being taken to the Royal Victoria Infirmary in Newcastle……The two people with coronavirus were moved from their York apartment-hotel to be treated initially at Castle Hill Hospital in Hull, before being taken to the infectious diseases unit in Newcastle.Public Health England said there was minimal risk of infection to either guests or staff at the Staycity property in York.Those identified as close contacts would be given health advic about symptoms and an emergency number in case they became unwell – but would’nt be quarantined, PHE said.Prof Whitty said the specialist unit at the Newcastle hospital was experienced in treating people with infectious diseases and there was a “high chance people would get better,” based on current information.“A lot of people will end up with a relatively minor disease,” he said.The small number who go on to be more seriously ill tend to develop respiratory problems which “will be dealt with as anyone else with a respiratory disease,” Prof Whitty added.Some GPs have started sending text messages to patients, telling them to stay away from their local surgery and phone them instead, if they feel unwell and have been to China in the last two weeks……VIrus experts said they were not surprised to see cases in the UK but there was no reason to panic. January 31, 2020; NDTV (India) posted an article titled: “Kerala Student With Coronavirus, Moved To Hospital”. From the article: The Kerala girl who has been the first patient to test positive for coronavirus case in India has been shifted to the Thissur Medical College hospital and her condition is improving, according to health authorities.According to the latest figures 1,053 people in various parts of the state are under observation for suspected cases of coronavirus, with 15 people kept in isolation wards in various hospitals in the state.It was on Thursday that state Health Minister K.K. Shailaja told the media that a girl student who arrived here from China’s Wuhan (where the virus was first reported) was the first confirmed case of the virus in the country……On Friday, it has been decided to contact all the passngers who travelled on a private airline flight from Kolkata to Cochin on January 23 – the flight that the girl student was travelling.It was on January 22 that this girl traveled from Beijing to Kolkata… January 31, 2020: Reuters posted an article titled: “Russia reports first coronavirus cases, restricts China air travel”. It was written by Olesya Astakhova and Tom Balmforth. From the article: Russia reported its first two cases of coronavirus on Friday and restricted flights direct to China, its biggest trade partner, as Russians complained of rising prices for medical masks and anti-virus medicine.The two infected people, both Chinese nationals, are in a stable condition and have been quarantined, officials said. One of the cases was identified in the Sibrerian region of Tyumen and the other in the far eastern Zabaykalsky region, Deputy Prime Minister Tatiana Golikova said……Russia will halt all direct flights to China from 2100 GMT on Friday, with the exception of those operated by its national arline, Aeroflot, Golikova said.Four Chinese airlines – China Southern Airlines, Hainan Airlines, Air China, China Eastern – will still be able to fly to Moscow, Golikova and Moscow’s Sheremetyevo International Airport said.All China-related flights will be routed through a separate terminal at the Sheremetyevo Airport, Aeroflot said, to minimize contact between those flights and other passengers.Russia’s minor Ikar airline will also continue its flights between Moscow and China, the airport said… January 31, 2020: The Guardian posted an article titled: “Coronavirus outbreak: Britons fly out of Wuhan as death toll passes 200”. It was written by Justin McCurry and Rebecca Ratcliffe. From the article: A plane carrying more than 100 British and other EU nationals trapped in Wuhan, the city at the centre of the coronavirus outbreak, has left for the UK after Chinese spouses and partners were given permission to travel.The chartered flight left Wuhan at 9:45am local time in Friday, the Foreign Office said in a statement. The plane was carrying 83 British people and 27 foreign nationals, and it was scheduled to land at RAF Brize Norton in Oxfordshire at 1pm UK time.Two patients in England, who are members of the same family, were also revealed on Friday to have tested positive for coronavirus. The Department of Health declined to say where in England the patients were from but it is understood they are not in the Wirral area, where a special facility has been set up to quarantine Britons evacuated from Wuhan.The flight will continue on to Spain following the stopover in the UK, at which point EU nationals’ home countries will take responsibility for them, it added… January 31, 2020: Reuters posted an article titled: “German coronavirus cases climb to six after child infected: ministry”. From the article: A new coronavirus that is spreading around the world has been confirmed in a child in Germany, the southern state of Bavaria said on Friday, bringing the total number of known cases in Germany to six.The new case is a child of an employee at the same firm where four more individuals in the Munich area were infected, the state health ministry said in a statement.All affected persons are in stable condition, the ministry said. January 31, 2020: The Local SE posted an article titled: “First case of coronavirus confrimed in Sweden” From the article: …A patient at the Ryhov County Hospital in Jönköping central-southern Sweden, has tested positive for the coronavirus, the Public Health Agency of Sweden (Folkhälsomyndigheten) confirmed.The patient is a woman in her 20s who landed in Sweden on January 24th after visiting the Wuhan area in China. At that point she had no symptoms, the agency said.But a few days later she developed a cough and contacted the health services in Jönköping,She is currently being kept in isolation at the clinic for infectious diseases and is not seriously ill… January 31, 2020: The Guardian reported that Lunar New Year celebrations across the UK have been cancelled because of the coronavirus outbreak. Events in Oxford, Cambridge, Colchester, Exeter, Manchester, Wigan and Bristol have all been called off. January 31, 2020: Reuters posted an article titled: “UPDATE-1 Spain confirms first case of coronavirus – Health Ministry”. From the article: Spain has confirmed the country’s first case of coronavirus after a man was diagnosed on the remote island of La Gomera in the Canaries, the Health Ministry said late on Friday. The patient is part of a group of five people taken into observation on the island and isolated on Thursday after it was found some of them had come into contact with a German man diagnosed with the virus, the ministry said.The diagnosis from Spain’s National Centre for Microbioloty came shortlyafter a plane transporting a group of 27 EU nationals from the virus;s epicentre in the Chinese city of Wuhan landed in Madrid.None of the repatraited Spaniards exhibited symptoms of the virus, but they will be quarantined at a military hospital in Madrid and held under observation for 14 days, the health ministry said.Four Danish citizens and one Norwegian who were also aboard the plane will be flown back to their home countries… January 31, 2020: Santa Clara County Public Health (California) posted a press release titled: “County of Santa Clara Public Health Department Reports First Case of Novel (new) Coronavirus”. From the press release: …The County of Santa Clara Public Health Department received confirmation today from the Centers for Disease Control and Prevention (CDC) that an adult male resident of the county has tested positive for the novel (new) coronavirus.This case recently traveled to Wuhan, China and became ill upon returning home. He was seen at a local clinic and hospital, but never was sick enough to require hospitalization. He is in stable condition and is self-isolating at home, and he did not leave home while he had symptoms except to seek medical care. Public Health Department staff are in regular contact and monitoring his symptoms and condition. Further information about the individual will not be released for reasons of medical privacy……This is the only case of novel coronavirus in Santa Clara County. There are currently six other confirmed cases in the United States… January 31, 2020: U.S. Representative Debbie Dingell (Democrat – Michigan’s 12th District) sent a letter to Mark Zuckerberg (CEO Facebook), Susan Wojcicki (CEO YouTube), Jack Dorsey (CEO Twitter) and Alex Zhu (CEO TIkTok), asking them to take steps to stop the spread of misinfirmation as it relates to coronavirus on their platforms. From the letter: …With the World Health Organization (WHO) declaring the Coronavirus a public health emergency, rising fatalities and evidence of person to person transmission this letter is being sent to you with concerns and questions on how your platforms are handling inaccurate and misleading information surrounding the dangers and risks associated with this virus.During a global health emergency, it is vital to the public interest that individuals have access to timely and accurate information. As expert’s knowledge and understanding about this virus grows, so too will the necessity of accurate and reliable information for the world. As global companies, a rampant spread of inaccurate information will have a decidely negative impact on the response efforts to contain and mitigate thsi global health emergency.With any crisis, fear and the need to understand what is happening can cloud judgement and push us to look for answers, credible or not. This is not a new phenomenon, but what is new is the global reach, impact, and negative effects finding wrong or incomplete answers will have, not only on a given user, but to their families and communities worldwide. The actions you choose to take will impact the lives of your users and those around them.Unlike nation-state disinformation campaiogns, the effects on users and the public could very well facilitate the continued spread of Coronavirus and more deaths. With that please provide responses to the following questions.(1) Is your company working with the Centers for Disease Control (CDC) or the WHO in order to prioritize and boost timely and accurate information regarding the Coronavirus? And how specifically are you ensuring that the information on your platform is accurate and continues to be accurate as experts understanding of this virus evolves?(2) Does your platform have policies and practices in place to limit, flag, or demote inaccurate user generated content pertaining to public health emergencies?(3) If so, what are these policies and practices? And does the public have access to them? (4) Are human content moderators or technology solutions being used to identify and flag these types of inaccurate content?Much like this virus, misinformation, willful or benign in nature, will continue to spread until measures are taken to limit exposure and treat symptoms. I urge you to take serious action in addressing this issue and appreciate your attention to this matter. A prompt response is appreciated. A Timeline of COVID-19 – January 2020 is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... What Happens if Trump Cuts Food Stamps?February 1, 2020Out of Spoons / Public HealthImage by ikon from Pixabay The proposed changes to SNAP will affect poor people who are unable to afford to purchase the food their families needs. It will take away access to food for “able-bodied adults” who are childless. It will also throw children off the free (or reduced) lunch program. In short – cutting food stamps will result in food insecurity and starvation. This blog contains a timeline of what happened after the Trump administration announced it was making drastic cuts to the SNAP program. Those cuts will begin on April 1, 2020 – unless someone finds a way to stop this from happening. October 9. 2018: The American Statistical Association posted a public release titled: “Leaders across five decades unite to oppose USDA plans”. From the public release: Manifesting alarm over the USDA’s plan to reorganize its statistical and research agencies, 56 former USDA, and federal statistical agency officials, including former deputy and undersecretaries, have written to Congress to warn of the likely damage to US agriculture and farming and to urge the proposed plans be abandoned.“I urge the administration to seriously consider the concerns of many stakeholders who place high value on the data, research and other intelligence provided by the Economic Research Service (ERS) and avoid actions that threaten the long-term viability of the agency or its near-term productivity,” said John Lee, ERS administrator under Ronald Regan, George H.W. Bush and Bill Clinton.“USDA’s justification for this upheaval of evidence-based policymaking is completely lacking,” said Katherine Smith Evans, ERS administrator under George W. Bush and Barack Obama……USDA Secretary Sonny Perdue announced in August that the department’s National Institute of Food and Agriculture and ERS would be moved out of Washington DC, to save money and be closer to the agricultural community. The USDA also said the move would help tackle the ERS’s poor job retention rate, which was significantly higher than the USDA as a whole.The American Statistical Association noted the USDA’s numbers on ERS were inflated by using summer interns, who all leave after their internships. Far from helping the ERS retain employees, the move is likely to create a brain drain, as economists and stateticians elect to either retire or keep their families in their homes and schools……Moving the agencies outside of Washington would also make collaborating with other federal agencies and advising Congress more difficult. The ERS’s “research agenda rises largely from the activities of every agency of USDA,” said John A. Schnittker, undersecretary and deputy secretary for USDA in the Lyndon Johnson administration. “And its research results are directly applicable to the food and agricultural policies debated and adopted by Congress. tHe Economic Research Service should remain in Washington… October 10, 2018: BuzzFeed News posted an article titled: “Childhood Hunger And Poverty Statistics Are Under Threat From the Trump Administration, Experts Warn”. It was written by Dan Vergano. From the article: Hunger, poverty, and nutrition statistics in the US might wither away, experts warn, if the Trump administration is successful in its proposal to relocate a key statistics office from Washington, DC, to the Midwest.The USDA is a $150 billion agency, and the Economic Research Service regularly churns out statistics not only on the prices of foodstuff, but for decades has also looked at childhood hunger, farmworkers, free trade, obesity, and poverty-related statistics.On Wednesday, 56 former officials at the US Department of Agriculture called for Congress to stymie agency chief Sonny Perdue’s announcement that he was relocating the Economic Research Service, the federal government’s lead producer of hunger and poverty statistics, and putting it in his office. The move would also relocate the agency’s National Institute of Food and Agriculture.Perdue said the move of more than 600 personnel will “make more logical sense or provide more streamlined and efficient services.” Critics say the proposal will hobble the office, lead to an exodous of experts, and politicize its reporting on subjects such as food stamps, poverty, and hunger……Perdue’s announcment also said he was moving the office away from Washington, DC, “to attract and retain highly qualified staff with training and interests in agriculture, many of whom coem from land-grant universities,” as well as to cut costs and place its economists and statiticians closer to farms. Lawmakers from states such as North Dakota, and Kansas have offered to host the offices……”There is not anyone else who does the kind of work done by these experts,” Offutt said, predicting economists and statatisticians would simple take jobs an the numerous universities and nonprofits that litter Washington, DC, rather than relocate to the heartland, leaving ERS bereft of expertise. “You really have to ask: What are they trying to accomplish here?”… October 3, 2019: The Trump Administration posted the “Supplemental Nutrition Assistance Program: Standardization of State Heating and Cooling Standard Utility Allowances” on regulations.gov. Here are some key parts of the proposed rule: The proposed rule would revised Supplemental Nutrition Assistance (SNAP) regulations to standardize the methodology for calculating standard utility allowances (SUAs or standards). The new methodology would set the largest standard utility allowance (HCSUA), at the 80th percentile of low-income households’ utility costs in the State. Standard allowances for other utiluty costs would subsequently be capped at a percentage of the HCSUA with the exception of an updated telecommunications SUA that would be a standard amount set nationally. These figures would continue to be updated annually and reflective of utility costs in each State……The Department is concerned that the degree of flexibility in current regulations causes inequities from State to State. The 2017 SUA Study revealed that many States’ SUAs are overinflated, which leads to additional benefits, and some States’ SUAs underestimate how much households actually pay in utilities, resulting in lower benefits. The Department believes that standardizing SUA methodology would make SUAs and the program more equitable. Removing the inequities related to this deduction will also improve integrity by ensuring SUAs better reflect what low-income households are actually paying for utilities so that eligible households receive SNAP benefit amounts which more accurately reflect their circumstances, no matter the State in which they reside……The proposed rule would eliminate the State option to vary allowances by household size and geographic areas as part of the Department’s efforts to bring greater equity across States and in recognition of the low number of States taking these options……The new telecommunications standard would be available to households with utility costs for one telephone, basic internet service, or both. Households with basic internet and/or telephone costs would be able to either receive telecommunications standard or have their actual costs counted, but actual costs would be limited up to the amount of the telecommunications standard. For example, households with more than basic internet packages, such as those combined with cable television service, would not have the cost of their entire package counted……The proposed rule would not have an impact on small entities because it primarily impacts SNAP households. Small entities, such as smaller SNAP-authorized retailers, would no be subject to the new requirement. On average, SNAP retailers would likely see a drop in the amount of SNAP benefits redeemed at stores if these provisions were finalized, but the impacts on small retailers are not expected to be disproportionate to the impacts on large entities. As of FY 2017, approximately 76 percent of authorized SNAP retailers (about 200,000 retailers) were small groceries, convenience stores, combination grocery stores, and specialty stores, store types that are likely to fall under the Small Business Administration gross sales threshold to qualify as a small business for Federal Government programs. While these stores make up most authorized retailers, collectively they redeem less than 15 percent of all SNAP benefits…The proposed rule is expected to reduce SNAP benefit payments by about $1 billion per year in net. However, not all states will see benefit losses; in some States HCSUAs will increase under the proposed rule, resulting in larger SNAP benefits for many households. In total, 29 states are expected to see a loss of SNAP benefits (about $1.54 billion annually) and 22 are expected to see a net gain (about $540 million annually). Based on USDA data, about 53 percent of stores would likely see lower redemptions and 47 percent would likely see increased redemptions.. November 2019: The Urban Institute posted a study titled: “Estimated Effect of Recent Proposed Changes to SNAP Regulations”. Here are some key points from the study: …If the proposed regulations had been implemented last year, 3.7 million fewer people and 2.1 million fewer households would have received SNAP in an average month; annual benefits would have decreased by $4.2 billion. An estimated 2.2 million participating households would no longer be eligible for SNAP and would lose an average of $127 in monthly benefits; 3.1 million others would receive an average of $37 less in benefits a month. But some households would see benefits increase under the proposed regulations: about 2.5 million participating households would receive an average of $14 more a month, and 67,000 households would begin participating because of the higher standard utility agreements (SUAs) in some states. The Proposed Changes, and the USDA’s Estimates: Tightening the criteria by which states request time limit waivers for able-bodied adults without dependents, or ABAWDs. People subject to ABAWD time limits can participate in SNAP for only three months in a 36-month period unless they meet specific work requirements. States can request waivers from time limits for areas with high unemployment. The proposed regulations would restrict the criteria used to request a waiver. According to USDA estimates, this change would cause 755,000 ABAWDs to lose eligibility in 2020 and reduce the amount spent on SNAP benefits by 2.5 percent.Restricting states’ ability to make families “categorically eligible” for SNAP based on the receipt of another government benefit. The proposed policy would end states’ ability to use broad-based categorical eligibility (BBCE) to waive asset tests and to raise gross income eligibility limits from 130 percent of the federal poverty guidelines (FPG) to as much as 200 percent of FPG. According to USDA estimates, this change would render about 9 percent of SNAP households ineligible and reduce the amount spent by 5 percent. The loss of SNAP would also cause 982,000 students to lose their automatic eligibility for free meals through the National School Lunch Program (NSLP) and the School Breakfast Program (SBP). To remain eligible, these students would need to apply for the NSLP and SPB based on their income.Creating a uniform approach to setting standard utility allowances (SUAs) and converting the telephone allowance to a telecommunication allowance that includes basic internet service. Both allowances factor in the excess shelter expense deduction, which is used to computer net income (which, in turn, is used determine eligibility and benefit level). The changes would have varying effects across states; allowances would rise in some states and fall in others. According to USDA estimates, benefits would rise for 16 percent of households and fall for 19 percent, with little lost of eligibility. The three proposed regulatory changes would have differing effects on various groups of SNAP participants, Sixteen percent of households with no children, no adults age 60 or older, and no one with a disability would lose eligibility under the proposed changes to the ABAWD regulations.Nearly 12 percent of households with an adult age 60 or older would lose eligibility under the proposed changes to broad-based categorical eligibility (BBCE). Households that include someone age 60 or older or someone with a disability are most likely to be affected by the proposed changes to the SUAs, although a larger absolute number of households with children would be affected than for either of these groups.Non-Hispanic white and Asian households would be somewhat more likely than other racial and ethnic groups to lose eligibility or benefits under the proposed BBCE and SUAs. The estimated likelihood of eligibility loss from the proposed ABAWD changes differs little among racial and ethnic groups… ConclusionAs the nation’s primary food assistance program, SNAP delivered more than $60 billion in benefits to 39.8 million people in 2018. We estimate that if the proposed regulatory changes to BBCE, ABAWD, time limit waivers, and standard utility allowances had been implemented in 2018, the average monthly number of participating households would have fallen by 2.1 million, 3.7 million fewer people would have received SNAP, and annual benefits would have fallen by $4.2 billion.While some states would be minimally affected, others would experience caseload and benefit reductions of 15 percent or more. Nearly a quarter of households with elderly members would lose eligibility as would 7 percent of households with children. Sixteen percent of households would have lower benefits, for an average monthly loss of $37 and 13 percent would have higher benefits, with an average gain of $14.Analyzing the policies both alone and in combination provides key insights into the extent to which different states and subgroups would be affected. Given the substantial effects, the policies and potential impacts should be considered carefully by policymakers and communities. November 17, 2019: HuffPost posted “Trump Administration Rule May Mean 1 Million Kids Lose Automatic Free Lunch”. From the article: Nearly a million children could lose their automatic eligibility for free lunches under a Trump administration proposal that would reduce the number of people who get food stamps.The U.S. Department of Agriculture released an analysis that says as many as 982,000 children could be affected by the change. About half would have to pay a reduced price of 40 cents for school lunch and 30 cents for breakfast. Around 400,000 would need to pay the full price, which varies depending on the district.The rest – 445,000 – would remain eligible for free meals, but their families would have to apply to qualify.Children automatically qualify for free lunches if their families receive food stamps, but the Trump administration has proposed tightening eligibility for the Supplemental Nutrition Assistance Program, or SNAP, which was once known as food stamps. The USDA is not proposing changes to the income rules for the program. It says it is addressing a loophole that gives eligibility to people who would not have otherwise qualified… November 30, 2019: NBC News posted an article titled: “Trump administration proposals could cause millions to lose food stamps.” It was written by Phil McCausland. From the article: Three proposed rule changes by the Trump administration could cause millions of poor people to lose access to food stamps and decrease the benefit for millions more, a new study has found.Over the past year, the Department of Agriculture produced three changes to the Supplemental Nutrition Assistance Program, known as SNAP or food stamps. The new rules create stricter work requirements for program eligibility, cap deductions for utility allowances and “reform” the way 40 states automatically enroll families into SNAP when they receive other forms of federal aid.A study by the Urban Institute released this week examined the three rules in combination for the first time and found that 3.7 million fewer people would receive SNAP in the average month, 2.2 million households would see their average monthly benefits drop by $127, more than 3 million others would see an average drop of $37 per month, and 982,000 students would lose access to free or reduced lunches..…These new rules also have advocates in states like Nevada worried. Nevada could see up to 22 percent of recipients lose access to food stamps, which could be devastating in a place where 12.3 percent of household face food insecurity, according to the USDA… December 4, 2019: The Guardian posted an article titled: “668,000 will lose food stamp benefits under new work rules”. It was written by Juliet Linderman. From the article: Hundreds of thousands of Americans who rely on the federal food stamp program will lose their benefits under a new Trump administration rule that will tighten work requirements for recipients.The move by the administration is the latest attempt to scale back the social safety net for low-income Americans. It is the first of three proposed rules targeting the Supplemental Nutrition Program, known as SNAP, to be finalized. The program feeds more than 36 million people.The plan, announced Wednesday, will limit states from exempting work-eligible adults from having to maintain steady employment in order to receive benefits……The new rule imposes stricter criteria states must meet in order to issue waivers. Under the plan, states can only issue waivers if a city or county has an unemployment rate of 6% or higher. The waivers will be good for one year and will require the governor to support the request.The final rule will go into effect in April… December 4, 2019: CBS News posted an article titled: “Nearly 700,000 Americans could lose food stamps under Trump administration plan”. It was written by Aimee Picchi. From the article: The Trump administration is tightening work requirements for food stamps eligibility for able-bodied adults without children, a move that could push almost 700,000 people from the program while saving $5.5 billion over five years.The reason for the new rule is to encourage adults between the ages of 18 and 49 to return to work, Department of Agriculture Secretary Sonny Perdue said Wednesday in a conference call with reporters. The food stamp program was meant to provide “assistance through difficult times, not a way of life,” he said.The new rule won’t affect children or their parents, disabled Americans or those over age 50, USDA Deputy Under Secretary Brandon Lipps said in the call. It would impact about 2% of the 34.3 million people currently receiving food stamps by challenging the way states can grant waivers for work requirements, making it tougher for individuals to qualify for the program……Experts who study food policy and the SNAP program said new rule won’t help people who are already struggling, and is likely to place a bigger burden on states and local charities to fill the gap. Although the economy is adding jobs, many of those new positions offer low-wage work and few, if any, benefits. About half of Americans now work in low-paying jobs that pay a median wage of $18,000 a year… December 4, 2019: HuffPost posted an article titled: “Trump Administration Finalizes First Food Benefit Cut”. It was written by Arthur Delaney. From the article: …It’s the first of three big changes to the Supplemental Nutrition Assistance Program the Trump administration is pursuing through regulation after Congress rejected significant cuts last year. Together, the changes would reduce enrollment by more than 3 million. More than 36 million Americans in 18 million households currently receiving monthly SNAP benefits on debit cards that can be used for food in grocery stores.The rule finalized Wednesday takes away state flexibility to waive a three-month time limit for SNAP beneficiaries who aren’t elderly and who don’t have children or disabilities, or about 7% of recipients……Agriculture Secretary Sonny Perdue suggested in a statement that the people targeted by the regulation spend too much time soaking up benefits.“We need to encourage people by giving them a helping hand, but not allowing it to become an indefinitely giving hand,” Perdue said……Of the SNAP recipients affected by the new regulation, 97% live in poverty and 81% live alone, according to an analysis published in March by Mathematica Policy Research. The rule is set to take effect next April. Democrats in Congress have already said they’ll sue to block the regulation, and anti-hunger advocacy groups have said they’ll sue as well… December 4, 2019: StarTribune posted an article titled: “Thousands of Minnesotans caught up in federal push to tighten work requirements for food aid”. It was written by Mary Lynn Smith. From the article: Thousands of Minnesotans could lose access to food stamps when a federal rule change goes into effect next year tightening work requirements for the Supplemental Nutrition Assistance Program (SNAP).Federal officials say about 7% of those on SNAP are able-bodied adults without dependents and that the rule change will save the government $5.5 billion over five years. U.S. Secretary of Agriculture Sonny Perdue said the change is about “restoring the original intent of food stamps … moving more able-bodied Americans to self-sufficiency.”But advocates who serve Minnesotans who rely on SNAP argue that the change will make it difficult for those who need help to get it and put even more pressure on food shelves and other community programs……Under current law, able-bodied adults without dependents can receive SNAP benefits for a maximum of three months during a three-year period, unless they’re working or enrolled in an education or training program for 80 hours a month.In some states, including Minnesota, that time limit has been waived in counties with high unemployment. But under the new rule, the criteria will be tightened for such waivers.When Minnesota lost its statewide SNAP waiver for able-bodied adults without children in 2013, more than 46,000 people lost their SNAP benefits in the first year, according to the state Department of Human Services. Officials said Wednesday that it’s unclear how many people will be affected by the latest rule change, but they expect to get more information when they talk to U.S. Department of Agriculture officials this week. It’s likely to affect fewer people than in 2013… December 10, 2019: CBS News posted an article titled: “Total Trump food-stamp cuts could hit up to 5.3 million households”. It was written by Aimee Picchi. From the article: …To that end, the government has introduced three proposals that would cut about 2.2 million U.S. households, or almost 4 million people, from the program, while also reducing benefits for another 3.1 million households, according to a recent analysis from the Urban Institute.The plans, one of which was formally adopted by the USDA last week, would deny food stamps to nearly 700,000 Americans – and would make it tougher for millions to qualify for food aid and cut billions from the program’s budget……Two other proposals, which are still under consideration, may have an even greater impact. The second plan would eliminate what is known as “categorical eligibility,” which allows people to enroll in food stamps automatically if they qualify for other aid programs. About 3 million people could lose access to food aid under that proposal.The third proposed rule would reduce the amount of home heating costs used to calculate a SNAP recipient’s net income, effectively making their income seem higher. That would cut benefits to about 3.1 million households, mostly those who live in cold-weather states like New York, Maine, Michigan, Minnesota, New Hampshire, Wisconsin, and Vermont, the Urban Institute said……The cuts would push more people from food stamps at a time when the program is already shrinking. About 36 million people now receive aid from the program, down from about 40 million in 2018. Pushing people from the program would also pare the program’s roughly $60 billion in annual spending by about $4 billion per year, the Urban Instituted estimates……To be sure, it’s possible the two proposals still under consideration might not move forward, or could be changed so fewer Americans are dropped from the program. Asked about the time frame for the proposals on the conference call last week, USDA Deputy Under Secretary Brandon Lipps didn’t indicate when they might be implemented… December 18, 2019: The Texas Tribune posted an article titled: “An estimated 390,000 Texans might lose access to food stamps under new Trump policy”. It was written by Stacy Fernádez. From the article: …As of November, Texas distributed more than $4.2 billion in federal money to an average of 1.5 million households – about $261 per household.The rule that passed this month won’t affect Texans in the short term, but a second rule coming down the pipeline could kick as many as 390,000 Texans off SNAP.The most recent rule change, which goes into effect in April 2020, is estimated to cut benefits for a roughly 700,000 Americans. The change would make it harder for states to waive the federal program’s work requirements in areas of high unemployment. Under current law, those unable to work 30 hours a week can only receive SNAP benefits for three months out of every three years. States that use the waiver can forego that three-month limitation, according to food policy experts.Texas hasn’t used the waiver for at least six years. In an effort to limit usage, state official decided an area’s unemployment rate has to be at 10% or higher to use the waiver, a threshold that doesn’t currently apply to any Texas counties, said Rachel Cooper, a senior policy analyst with the Austin-based Center for Public Priorities, a left-leaning think tank.The rule Texas experts are most worried about – because it could impact about 390,000 Texans – is still under review. Although SNAP is funded through the U.S. Department of Agriculture, it’s up to states to determine eligibility – like income level and car value – and distribute aid as needed. This change would implement countrywide standards.Since 2001, Texas has required applicants to make no more than 165% of the federal poverty level – about $42,000 for a family of four – to be considered for SNAP benefits. Under the new rule, that number would fall to 130% of the federal poverty line – about $33,000 for a family of four.Assets like cars are also taken into account when determining eligibility. Under Texas law, SNAP participants cannot own a car that is valued at more than $15,000. If the proposed rule change goes into effect, that number would drop to $4,650……To get a car in the $4,650 price range, it would have to be used and about 10 years old or older, according to leading car websites… December 18, 2019: CBS posted an article titled: “Why proposed changes to food stamps program could make “the poor more poor”. From the article: For more than 34 million Americans, food stamps help them survive. Now there’s concern proposed changes in the U.S. Department of Agriculture (USDA) program could drastically cut those benefits, as the Trump administration said it wants to reduce waste……The average recipient receives about $127 a month. That’s $1.40 a meal, three meals a day. But an estimated 3.7 million Americans could lose their benefits next year if the government implements three proposed changes: Removing automatic enrollment for families who qualify for other government benefits Reducing how much people can deduct for utilities like heat Requiring more able-bodied adults to work at least 20 hours a week to receive benefits. The last proposal has already been finalized and will be implemented in April… December 20, 2019: NBC News posted an article titled: “Trump administration moves to impose stricter work requirements for food stamps”. It was written by Allan Smith. From the article: President Donald Trump is attempting to do through executive action what Congress would not: tighten work requirements for the millions of Americans who receive food stamps.The Department of Agriculture, which runs the Supplemental Nutrition Assistance Program commonly referred to as food stamps, unveiled a proposed new rule at Trump’s direction on Thursday that restricts states’ ability to waive existing work requirements in areas where unemployment rates are higher than the national rate.The proposed change comes as the president is poised to sign a much-negotiated farm bill that ultimately included now significant changes to food stamps despite backing from the White House……Trump is set to sign an $867 billion farm bill Thursday afternoon that doesn’t include significant changes to SNAP. But that wasn’t for lack of trying – House bills backed by the president included significant changes to the federal food assistance program, including tougher work requirements.But none of those measures made it into the final version of the bill ultimately passed by both chambers of Congress after months of back-and-forth. Trump used his executive authority to direct the USDA to make the changes……The rule applies to nondisabled people between the ages of 18 and 49 who do not have any dependents. The elderly, disabled and pregnant women are not subjected to the change, the USDA said.Speaking at a signing ceremony for the farm bill, Trump said, “able-bodied adults without dependents will” now “have to work or look for work to keep their food stamps.”… December 20, 2019: USA Today posted an opinion piece titled: “New SNAP rules encourage productivity instead of poverty: Sonny Perdue”. It was written by U.S. Secretary of Agriculture Sonny Perdue. From the opinion piece: More than 20 years ago, Democrats and Republicans came together to reform our welfare programs to restore the system to what it was meant to be: “a second chance, not a way of life,” in the words of then-President Bill Clinton. Over time, without any changes in the underlying welfare reform legislation of 1996, that ideal has been watered down by out-of-control administrative flexibility in the Supplemental Nutrition Assistance Program (SNAP). Today, at the direction of President Donald J. Trump, we are taking steps to restore the integrity to SNAP and move people toward self-sufficiency……At a time when the jobless rate has hit 3.7 percent – the lowest since 1969 – and available jobs outnumber those seeking employment, we expect that able-bodied people who are not working, or seeking work, enter or reenter the labor force.Instead, because of a permissive regulation that allows states to grant waivers to wide swaths of their populations, millions of people who could work are continuing to receive SNAP benefits. The president has directed me, as Secretary of Agriculture, to propose regulatory reforms to ensure that those who are able to work do so in exchange for their benefits. This restores the dignity of work to a sizeable segment of our population, while it is also respectful of the taxpayers who fund the program……For Able-Bodied Adults Without Dependents (ABAWDs) – those non-disabled people between the ages of 18 and 49 – there is a reasonable expectation for them to work or look for a job. Under current SNAP requirements, ABAWDs must work or participate in an employment program for at least 20 hours a week to continue to receive benefits for more than three months over a 36-month period……Our proposed rule limits the availability of waivers for states and promotes work and self-sufficiency in the SNAP program. The proposal restricts waivers to areas where the unemployment rate exceeds 7 percent, which is when jobs are truly hard to find. It also eliminates the practice of some states which “gerrymander” multiple counties together that are not otherwise connected economically in order to maximize the reach of waiver requests. This practice leads to counties receiving waivers that would not independently qualify. For instance, Oregon’s Wheeler County had an unemployment rate of 4.65 percent in their 2018 waiver.Further, and importantly, the rule addresses the behavior of some states to “bank” exemptions to the waiver restrictions. Currently, states can exempt up to 15 percent of their ABAWDs from work each year, but if exemptions are not used, they can be kept for future years. Despite the law’s 15 percent exemption cap, current regulations have allowed for “banking,” permitting states to build up large surpluses of exemptions, each one available to use to grant one ABAWD an additional month of benefits. California, for example, has stockpiled some 800,000 exemptions over time, meaning it can exempt ABAWDs far into the future. Our proposed rule ends this hoarding of exemptions and allows only a one-year lookback.This is not a perfect solution. It would be preferable for Congress to permanently enact these important reforms to the SNAP program. However, these regulatory changes by USDA will reward more Americans with the virtue of work, save hardworking taxpayers $15 billion over ten years, and give President Trump comfort enough to support a Farm Bill he might otherwise have opposed… It should be noted that this propaganda opinion piece from Secretary Perdue was published on December 20, 2019, two days after President Trump was impeached by the U.S. House of Representatives. So, the part about asking Congress to give Trump a Farm Bill that would include the cuts to SNAP … is presumptuous. The U.S. Senate trial had not yet begun, so there was no way for Secretary Perdue to know, for certain, what the outcome of that would be. One possible outcome in an impeachment trial is for the Senate to remove the president from office. (Note: the outcome of a Senate trial CAN NOT erase that the president has been impeached.) In the meantime, the Trump administration wants to take the ability to afford food away from people – who may be working – but are unable to make enough money to avoid being food insecure. December 30, 2019: Hawaii Attorney General Clare E. Connors posted a news release titled: “Hawaii Attorney General Joins Multistate Lawsuit to Stop Elimination of Food Assistance for Nearly 700,000 Struggling Americans”. From the news release: Hawaii Attorney General Clare E. Connors joined a group of 20 Attorneys General and New York City in a lawsuit to stop the Trump administration form eliminating food assistance for nearly 700,000 Americans. The lawsuit, filed in D.C., challenges a United States Department of Agriculture (USDA) rule that would limit states’ ability to extend benefits from the Supplemental Nutrition Assistance Program (SNAP), commonly known as “food stamps”, beyond a three-month period for certain adults. AG Connors and her counterparts assert that the rule directly undermines Congress’ intent for the food-stamp program, and that the USDA violated the federal rulemaking process. Further, they argue that the rule would impose significant regulatory burdens on the states and harm states’ residents and economies. The coalition is urging the court to declare the rule unlawful and issue an injunction to prevent it from taking effect.“The USDA rule is contrary to the underlying SNAP statute and its adoption failed to follow the legal processes,” said Attorney General Connors. “Allowing this rule to take effect undermines the ability of individual states to care for its most valuable citizens.”.. December 31, 2019: The New York Times posted an article titled: “How Cutting Food Stamps Can Add Costs Elsewhere”. It was written by Austin Frakt and Elsa Pearson. From the article: The Department of Agriculture recently finished work on a new rule that may take food stamps away from nearly 700,000 Americans by tightening work requirements. Several times in the past year, the government has proposed cutting food stamp eligibility. the new rule is intended to save almost $8 billion over five years.It’s not clear how much money would actually be saved, research suggests, given the costs that might come from a decline in the health and well-being of many of the country’s 14.3 million “food-insecure” households.The Department of Agriculture defines food insecurity as a lack of consistent access to enough food for an active, healthy life. It affects low-income, single-parent, and black and Hispanic households the most, but it cuts across many demographic lines and affects 11 percent of American households over all……Food insecurity is linked to worse health outcomes, including poor mental health, high blood pressure and diabetes, with children particularly vulnerable….…”SNAP recipients often work, but their employment can be unsteady,” said Dr. Seth A. Berkowitz, an internist and assistant professor at the University of North Carolina School of Medicine. Seasonal variation in some labor markets – like agriculture or even retail consumer jobs when sales may spike around the winter holidays – can put people temporarily out of work, making it hearder for them to keep food on the table. “The way these work requirements are imposed could pull support out from under people even when they are working.”..…Feeding America estimates at least 30 percent of those with food insecurity nationwide aren’t eligible for SNAP. In some states, its nearly 50 percent. Tightening eligibility for the program, as new work requirements would do, would only increase that number. January 7, 2020: CBS Minnesota posted an article titled: “Thousands In Minnesota May Lose SNAP Benefits Under Trump Cuts”. It was written by Kate Raddatz. From the article: Thousands of Minnesotans will likely lose their food stamps under new eligibility cuts.Last month President Trump’s administration announced that benefits under the government’s Supplemental Nutrition Assistance Program (SNAP) would be limited to adults ages 18 to 49 without dependents. The Minnesota Department of Human Services says that would leave 8,000 Minnesotans without food.The average SNAP recipient recieves $127 dollars a month, or just under $1.27 for a meal. With more proposed changes to food stamp eligibility on the table, DHS says hunger would increase in Minnesota……Officials say one in 11 Minnesotans are food insecure. The first cut to SNAP benefits will go into effect in April. January 13, 2020: The New York Times posted an article titled: “What Happened When a State Made Food Stamps Harder to Get”. From the article: …Four years ago, thousands of poor people here in Caball County and eight other counties in West Virginia that were affected by a state policy change found themselves having to prove that they were working or training for at least 20 hours a week in order to keep receiving food stamps consistently. In April, under a rule change by the Trump administration, people all over the country who are “able-bodies adults without dependents” will have to do the same.The policy seems straightforward, but there is nothing straightforward about the reality of the working poor, a daily life of unreliable transportation, erratic work hours and capricious living arrangements.Still, what happened in the nine counties in West Virginia in the last four years does offer at least an indication of how it will play out on a larger scale.The most visible impact has been at homeless missions and food pantries, which saw a big spike in demand that has never receded. But the policy change was barely noticeable in the work force, where evidence of some large influx of new workers is hard to discern. This reflects similar findings elsewhere, as states have been steadily reinstating work requirements in the years since the recession, when nearly the whole country waived them.Since 1996, federal law has set a time limit on how long able-bodied adults could receive food stamps; no more than three months in a three-year period, if the recipient was not working or training for at least 20 hours a week. But states have been able ot waive those rules in lean times and in hurting areas; waivers are still in place in roughly one-third of the country.Under the new rule from the Trump administration, most of these waivers will effectively be eliminated. By the administration’s own estimate, around 700,000 people will lose food stamps. Officials say that there are plenty of jobs waiting for them in the humming economy.That was the thinking as West Virginia began lifting waivers four years ago, starting in the counties where unemployment rates were lowest……That the number of people receiving food stamps would drop significantly was, of course, by design. The question was what would become of them.According to the West Virginia Center on Budget and Policy, a research group that focuses heavily on social safety-net issues, there was no evidence of a big change in the job market. While around 5,410 people lost food stamps in the nine counties, the growth in the labor force in these counties over he ensuing three years significantly lagged the rest of the state. Average monthly employment growth in the counties actually slowed, while it nearly doubled in the res of West Virginia.“We can prove it from the data that this does not work,” said Seth DiStefano, policy outreach director at the center… January 15, 2020: NBC 4 posted an article titled: “20,000 Ohioans could lose SNAP benefits when work requirements takes effect.” It was written by Ted Hart. From the article: As many as 20,000 Ohioans could lose access to Supplemental Nutrition Assistance Program (SNAP) when new, stricter work requirements take effect……Rose County is one of 29 counties in Ohio that will no longer be eligible to waive the food stamp work requirements for able-bodied adults.Under the new rule, a county’s unemployment rate has to be more than 6 percent to continue to qualify for a waiver of the work requirement. The goal is to move more people off the benefits and into full time work.The Trump administration formalized the new work requirements last month……Will Petrick at Policy Matters Ohio says work requirements for food stamps misses the mark. “There’s kind of a basic foundation that all families need to thrive, to participate and so this moves it in the wrong direction,” Petrick said. “It takes away that basic need for food for people.”“This has been pitched as we need to push people into work but there’s really no support for employment training for education, those types of supports for families,” Petrick said… January 16, 2020: New York Attorney General Letitia James posted news on her official website titled: “AG James Files Lawsuit To Stop Trump Admin from Stripping Food Assistance From Nearly 700,000 Vulnerable Americans”. From the news release: New York Attorney General Letitia James and District of Columbia Attorney General Karl Racine today filed a lawsuit to stop the Trump Administration from eliminating food assistance for nearly 700,000 Americans. The lawsuit, which was joined by 13 attorneys general and the City of New York, challenges a United States Department of Agriculture (USDA) rule that would limit states’ ability to extend benefits from the Supplemental Nutrition Assistance Program (SNAP), commonly known as “food stamps,” beyond an three-month period for certain adults. The coalition asserts that the rule directly undermines Congress’ intent for SNAP, and that the USDA violated the federal rulemaking process. Further, they argue that the rule would impose significant regulatory burdens on states and harm states’ economies and residents. The coalition is urging the court to declare the rule unlawful and issue an injunction to prevent it from taking effect on April 1, 2020……This rule will deny access to food assistance for more than 50,000 people in New York City, and put tens of thousands more throughout New York State at risk of going hungry.SNAP has served as the country’s primary response to hunger since 1977 and has been a critical part of federal and state efforts to help lift people out of poverty. The program provides access to food for millions of Americans with limited income who would otherwise struggle with food insecurity. While the federal government pays the full cost of SNAP benefits, it shares the cost of administering the program on a 50-50 basis with the sates, which operate the program.Congress amended SNAP in 1996 with the goal of encouraging greater workforce participation among beneficiaries. The changes introduced a three-month time limit on SNAP beneficiaries for unemployed individuals aged 18-49 who are not disabled or raising children – “able-bodied adults without dependents” (ABAWDs). Congress understood that states were best positioned to assess whether local economic conditions and labor markets provided ABAWD’s reasonable employment opportunities. As a result, the law allows a state to acquire a waiver of the ABAWD time limit for areas where the unemployment rate is above 10 percent, or if it presents data demonstrating that the area lacks sufficient jobs for ABAWDs. States were also given a limited number of one-month exemptions for individuals who would otherwise lose benefits under the time limit, and were permitted to carry over unused exemptions to safeguard against sudden economic downturns.Over the last 24 years, Congress has maintained the criteria for states to obtain waivers and to carry over unused exemptions. It has reauthorized the statute four times without limiting the states’ discretion over these matters and overwhelmingly rejected attempts to add restrictions on waivers in the 2018 Farm Bill.Shortly after President Trump signed the 2018 Farm Bil into law, the USDA announced a proposed rule seeking changes almost identical to those Congress rejected. The USDA received more than 100,000 comments in total – the majority of which reflected strong opposition from a broad range of stakeholders. Regardless, USDA’s final rule went even further in restricting state discretion over waivers and exemptions than what it had initially proposed.In the lawsuit, the states collectively argue that the administration’s rule change:Contradicts statutory language and Congress’s intent for the food-stamp program: When Congress amended SNAP and added the ABAWD time limit in 1996, it included a waiver process explicitly providing for relief from the time limit if insufficient job opportunities were available for ABAWDs and clearly indicating that states were best equipped to make this determination based on local economic and employment conditions. Congress has reaffirmed this position multiple times, most recently in 2018. Yet the USDAs new rule severely restricts states’ discretion over these matters and essentially writes this basis for waiver out of the statute, in direct contravention of law and congressional intent. Major aspects of the rule mirror proposed changes that Congress explicitly rejected in 2018.Raises healthcare and homelessness costs while lowering economic activity in the states: For SNAP recipients, losing benefits means losing critical access to food, raising the risk of malnutrition and other negative health effects. Studies have shown that SNAP can counteract food insecurity and lower healthcare costs for recipients by about $1,400 per person – costs that state governments will likely bear in the absence of SNAP assistance. Without SNAP benefits, many will be forced to choose between having food to eat or place to live. Their purchasing power will decrease, harming state economies. As the USDA concedes in the rule, these impacts will be most concentrated among lower-income communities of color.Amends the law for arbitrary and capricious reasons: The Administrative Procedure Act (APA) requires agencies to adequately offer a reasoned explanation for changing long-held policies and addresses why the facts and circumstances supporting the prior policy should be disregarded. For over two decades, the USDA has accepted Congress’ premise that a state should define the geographic scope of its waiver request and support that request with a wide range of data sources that are together best able to capture employment prospects for ABAWDs. Yet the new rule strictly defines the area for which waivers may be sought and rejects data beyond general unemployment figures without any justification.Violates the federal rulemaking process: The APA governs internal procedures for federal agencies, including rulemaking. Among other requirements, agencies must solicit and consider public comments on the substance of a rule. The USDA broke from this process by issuing a final rule that diverged from its proposed rule in significant and substantial ways. For example, while the proposed rule maintained that a state could receive a waiver if it qualified for extended unemployment benefits under Department of Labor policies, the final rule eliminated this basis. Thus, commenters did not receive meaningful opportunity to comment on the full extent of the agency’s changes.New York Attorney General Letitia James and District of Columbia Attorney General Karl Racine are co-leading this lawsuit and are joined by the attorneys general of California, Connecticut, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, Oregon, Pennsylvania, Rhode Island, Vermont, and Virginia along with the City of New York. The lawsuit was filed in United States District of Columbia. The States filed a motion for Preliminary injunction concurrently with the complaint to enjoin the rule from going into effect on April 1, 2020. January 16, 2020: California Attorney General Xavier Becerra posted a press release on his official website titled: “Attorney General Becerra Joins Multistate Lawsuit Challenging Federal Rule Limiting Access to Food Assistance”. From the press release: California Attorney General Xavier Becerra today joined a coalition of 15 attorneys general and the City of New York in a lawsuit challenging a Trump Administration rule that would significantly limit access to the Supplemental Nutrition Assistance Program (SNAP) for people in need. In the complaint, the coalition argues that the rule places arbitrary and capricious restrictions on the ability of states to administer food assistance programs for able-bodies adults without dependents and disproportionately harms people of color. In the first year alone, it is estimated that more than 55,000 Californians will lose SNAP eligibility, a loss of more than $100 million in benefits.“No one should have to choose between a hot meal and paying their rent,” said Attorney General Becerra. “But this latest Trump Administration attack on low-income Americans will force them to do just that. It will cause hundreds of thousands of people to go hungry. And, yet again, the Trump Administration has failed to offer any legitimate evidence to justify decision that have real consequences for the health and well-being of our residents. Together with our partners all across the country, we’re fighting back and we’re confident the law is on our side.”The new rule is part of the Trump Administration’s ongoing campaign to curtail access to important assistance programs and limit the ability of states to protect the heath and well-being of their residents. It upends decades of cooperation between states and the federal government and will force people to make untenable decisions between food and other basic necessities. For example, the rule includes arbitrary limits on the types of data states can rely on in making determinations about who should be eligible for food assistance. It also allows the federal government to ignore the needs of certain populations by blocking waivers for entire regions if the region is designated as a labor surplus area. The new rule arbitrarily complicates states’ abilities to apply for and obtain waivers, making it more difficult for states to focus on providing access to food assistance.In the lawsuit, the coalition maintains that the Trump Administration did not fully access the impact of the proposed rule and did not consider methods for mitigating its effects, in violation of the Administrative Procedure Act. For instance, the rule turns a blind eye to the fact that, by the Trump Administration’s own admission, the rule will likely have a disparate impact on women and people of color who often face significant barriers to employment above and beyond the general population. Though the average unemployment rate since 1972 has been 6.1 percent for whites, that number is 13.9 percent for African Americans and 10.2 percent for Latinos……In filing the lawsuit, Attorney General Becerra joins the attorneys of the District of Columbia, New York, Connecticut, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, Oregon, Pennsylvania, Rhode Island, Vermont, and Virginia as well as the City of New York. A copy of the lawsuit is available here. January 16, 2020: Oregon Attorney General Ellen Rosenblum posted a media release on her official website titled: “AG Rosenblum Sues to Stop Trump Administration from Slashing SNAP Food Assistance”. From the media release: Oregon today joined fifteen states and New York City in a lawsuit to stop the Trump administration from eliminating food assistance for nearly 700,000 Americans. The lawsuit challenges a United States Department of Agriculture (USDA) rule that would limit states’ ability to extend food stamp benefits in places where jobs are scarce. The coalition of state attorneys generals is urging the court to declare the rule unlawful and issue an injunction to prevent it from going into affect on April 1, 2020.“The food stamp program (known as “SNAP”) has helped vulnerable Oregonians for over 40 years. It is hard to fathom why the federal government wants to punish thousands of adults in some of the most employment-impacted areas of our state – people who may not be able to find jobs – by taking away their access to food,” said Attorney General Ellen Rosenblum……In a declaration filed with the lawsuit, the Director of the Self Sufficiency Program for the Oregon Department of Health and Human Services, Daniel Huan, explained that as of November 2019, Oregon had 347,941 households, for a total of 586,781 Oregonians, who receive SNAP benefits statewide. Of these individuals, 21,886 Oregonians are potentially affected if this rule goes into effect. Their average food benefit ranges from $166 – $186 per month… January 16, 2020: Minnesota Attorney General Keith Ellison posted a press release on his official website titled: “Attorney General Ellison sues to stop Trump Administration from ending food assistance for more than 8,000 Minnesotans.” From the press release: Minnesota Attorney General Keith Ellison today joined a group of 15 attorneys general and the City of New York in filing a lawsuit to stop the Trump administration from eliminating food assistance for more than 8,000 Minnesotans and a total of nearly 700,000 Americans. The lawsuit challenges a U.S. Department of Agriculture (USDA) rule that would limit states’ ability to extend benefits from the Supplemental Nutrition Assistance Program (USDA), commonly known as “food stamps” beyond a three-month period for certain adults. Attorney General Ellison and the coalition assert that the rule undermines Congress’ intent for the food-stamp program, and that the USDA violated the federal rulemaking process. Further, they argue that the rule would impose significant regulatory burdens on the states’ residents and economies.The coalition is urging the court to declare the rule unlawful and issue an injunction to prevent it from taking effect on April 1, of this year.“It’s hard to believe that the Administration wants to make it even harder than it already is for people to afford their lives and even harder for some people to afford to eat, but time and time again they’ve shown us that’s what they’re up to,” Attorney General Ellison said. “It’s my job to protect the people of Minnesota. When the federal government is out to hurt them, I’ll fight back for them.”……Twenty-six Minnesota counties are currently approved for time-limit waivers, but under the new rule, 23 will no longer qualify. According to the Minnesota Department of Human Services, approximately 2,100 Minnesotans will lose their food assistance if the time-limit waiver is eliminated, and approximately 6,000 Minnesotans will lose their food assistance if Minnesota can no longer carry over unused exemptions. DHS also estimates it will cost the State at least $500,000 of staff time and retraining if the new rule takes effect on April 1… January 16, 2020: Minnesota Attorney General Keith Ellison tweeted: “It’s hard to believe the Trump Admin wants to make it harder for ppl to afford their lives & even to afford to eat, but a new Trump rule ends food assistance to 8K Minnesotans & 700K Americans. It’s my job to protect Minnesotans, so I sued to block it.” The tweet included a link to the press release above. January 16, 2020: Minnesota Governor Tim Walz tweeted: “We are not #OneMinnesota when our neighbors are hungry. The Trump Administration’s cuts to SNAP will increase hunger across the state, especially in Greater MN. Thank you @AGEllison for standing up for Minnesotans today.” This tweet included a link to the above tweet from Minnesota Attorney General Keith Ellison. January 16, 2020: Legal Aid Society of the District of Columbia posted a press release titled: “Legal Aid Sues Trump Administration to Stop ‘Cruel and Ineffective’ New Food Stamps Rule”. From the press release: The Legal Aid Society of the District of Columbia (Legal Aid) is filing a federal lawsuit today to stop implementation of a new Trump Administration rule that could cut about 700,000 Americans off food stamps. The new rule, scheduled to go into effect on April 1, would make it more difficult for states to obtain waivers of an onerous federal requirement within the Supplemental Nutrition Assistance Program (SNAP, commonly known as food stamps). The rule prevents so-called “able-bodied adults without dependents” from receiving SNAP benefits for 33 to 36 months, unless they meet certain work requirements. Historically, states and the District of Columbia have been able to obtain waivers of these time limit if they could show that the state (or an area within the state) lacked sufficient jobs for these adults.“Taking food off the table from Americans who are already struggling to make ends meet is cruel and ineffective,” said Eric Angel, Executive Director of Legal Aid. “SNAP benefits are an essential part of the safety net for a large number of people who critically need them. Implementation of this rule will not increase the employment rate among SNAP beneficiaries. But it will most definitely increase hunger.”……Legal Aid and the firm of Alston & Bird LLP are filing the lawsuit in the U.S. District Court for the District of Columbia on behalf of social services agency Bread for the City and individual DC residents currently receiving food stamps……Also today, more than a dozen states attorney generals filed a similar challenge in the U.S. District Court of the District of Columbia. Legal Aid anticipates that the lawsuit will be consolidated. January 16, 2020: Legal Aid Society of the District of Columbia tweeted: “Legal Aid filed a federal lawsuit today to stop implementation of a new Trump Administration rule that could cut about 700,000 Americans off food stamps, on behalf of individual and DC residents and @BreadfortheCity.” The tweet includes a link to the press release above. January 16, 2020: New Jersey Attorney General Gurbir Grewal posted a press release on his official website titled: “AG Grewal Files Lawsuit Challenging Federal Rollback of Food Stamps Assistance”. From the press release: Attorney General Gurbir S. Grewal today announced that New Jersey is joining 15 other states and municipalities in filing a lawsuit to block a federal rule that, if allowed to stand, would cut off federal food assistance for approximately 700,000 Americans. Thousands of New Jersey residents could be affected.The challenged rule, which was issued by the United States Department of Agriculture (USDA) in November 2019 and is scheduled to take effect in April 2020, limits states’ ability to extend Supplemental Nutrition Assistance Program (SNAP) benefits, commonly known as “food stamps,” beyond a three-month period for certain adults.Generally, non-disabled individuals without dependents must meet work requirements in order to receive more than three months of SNAP benefits beyond the usual time limits for individuals in areas of high unemployment, because those individuals often find it more difficult to meet the work requirements. The new rule restricts States’ ability to provide such extensions. Waivers have allowed New Jersey to continue to provide SNAP benefit to individuals who face education or skills challenge in acquiring jobs, barriers in matching with effective job training, or other obstacles. Time-limit waivers help individuals continue to build the skills needed to find and sustain employment, while avoiding food insecurity, which can pose its own challenges for job seekers.The complaint filed today alleges that the new rule will harm New Jersey and its residents by limiting the State’s ability to seek additional assistance for individuals in need of food assistance.“We are committed to helping everyone in New Jersey succeed in a strong and fair economy,” said Attorney General Grewal. “But too many people still struggle to make ends meet, and food insecurity only makes it harder. Taking food off the table of someone who’s struggling won’t help them thrive, and in this case, violates federal law.”“New Jersey has been able to use flexibility to help individuals without dependents who face challenging economic circumstances receive food assistance benefits beyond a three-month limit. It’s wrong to take away that flexibility when we are helping people get on a better financial footing,” said Human Services Commissioner Carole Johnson. “The Trump Administration’s rule will hurt New Jerseyans, and we hope the courts agree this is bad policy that should be stopped… January 16, 2020: Vermont Attorney General T.J. Donovan tweeted: “The Trump Admin created a rule that cuts food assistance for nearly 700,000 Americans, including more than 200 Vermont households receiving 3SquaresVT benefits. We’re suing to keep food on Vermonters’ tables and benefit-dollars in our local economies.” The tweet included a link to the press release below. January 16, 2020: Vermont Attorney General T.J. Donovan posted a press release on his official website titled: “Attorney General Donovan Joins Lawsuit to Stop Trump Administration’s Cuts to Food Assistance”. From the press release: Attorney General T.J. Donovan today joined a group of 15 attorneys general and New York City in a lawsuit to stop the Trump Administration from eliminating food assistance for nearly 700,000 Americans, including more than 200 Vermont households. The lawsuit, filed in the District of Columbia, challenges a U.S. Department of Agriculture (USDA) rule that would limit states’ ability to extend benefits from the Supplemental Nutrition Assistance Program (SNAP), known in Vermont as 3SquaresVT, beyond a three-month period for certain adults. The coalition asserts that the rule directly undermines Congress’ intent for the SNAP program, and that the USDA violated the federal rulemaking process by not allowing for a meaningful opportunity to comment on the new rule. Attorney General Donovan and his counterparts are urging the Court to declare the rule unlawful and issue an injunction to prevent it from taking effect on April 1, 2020.“The Trump Administration’s latest cut to food assistance puts benefits for more than 200 Vermont households at risk,” said Attorney General Donovan. “I will continue to fight to keep food on Vermonters’ tables and benefit-dollars in our local economies.”… Here is a link to the complaint. Here is a link to the motion for a preliminary injunction. January 17, 2020: ABC Action News 6 posted an article titled: “Several states, including Pa. and NJ, sue USDA over new food stamps work requirement.” From the article: Over a dozen states, including Pennsylvania and New Jersey, filed a lawsuit along with and New York City and Washington, D.C. against the U.S. Department of Agriculture on Thursday challenging new Trump administration regulations that will require more food stamp recipients to work in order to receive benefits.The move is a key part of the administration’s efforts to overhaul the Supplemental Nutrition Assistance Program, as the food stamp program is formally known. The new requirement, set to go into effect in April, limits states’ ability to waive existing work mandates and could result in 699,000 people losing assistance, according to the USDA.Citing a federal statute against agency actions that are “arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law,” the lawsuit alleges that “the Rule conflicts with the federal statute, the purpose of SNAP, and the clear intent of Congress to alleviate hunger and malnutrition while maintaining States’ flexibility.”Other states joining in the lawsuit include California, New York, Connecticut, Maryland, Massachusetts, Michigan, Minnesota, Nevada, Oregon, Rhode Island, Vermont and Virginia… January 17, 2020: Representative Steny Hoyer tweeted: Yesterday, MD Attorney General @BrianFrosh & 13 other states filed a lawsuit against the Trump Admin’s effort to slash nutrition assistance. We won’t sit back while the Administration advances its plan to cut this critical assistance for families.” The tweet included a link to a Washington Post article.January 20, 2020: TwinCities.com posted an article titled: “How will Trump changes to food stamps affect MN? Tens of thousands will see cuts or lose aid.” It was written by Christopher Magan. From the article: January 22, 2020: Maryland Hunger Solutions posted a press release titled: “MDHS Applauds Lawsuit to Stop the Administration from Eliminating SNAP Benefits for Nearly 30K Marylanders”. From the press release: Maryland Attorney General Brian Frosh today joined a group of 15 attorneys general and New York City in filing a lawsuit to prevent the Trump administration from implementing a Supplemental Nutrition Assistance Program (SNAP) rule change that would take food off the tables of nearly 30,000 Marylanders and 700,000 people across the nation, many of whom struggle to find sufficient hours of work in areas with few jobs. The rule is scheduled to be implemented on April 1, 2020. The litigation asks the court to find the rule unlawful and to issue an injunction to prevent it from taking effect.“Maryland Hunger Solutions strongly applauds the efforts of Attorney General Frosh to prevent USDA from sidestepping Congress, ignoring the great weight of public opinion, and taking food away from people who are struggling to find stable employment,” said Michael J. Wilson, director of Maryland Hunger Solutions. “The final rule would cause serious harm to individuals and communities across the state, from Western Maryland to Baltimore City to the Eastern Shore.”… January 23, 2020: The Baltimore Sun posted an article titled: “Feds to cut up to 15,000 in Baltimore from food stamps; Maryland, other states suing to halt change”. It was written by Talia Richman. From the article: As many as 15,000 people in Baltimore could see their food stamp benefits slashed under a new Trump administration rule that tightens eligibility requirements.Maryland recently joined more than a dozen states in suing to block the U.S. Department of Agriculture from moving forward with the cuts to the Supplemental Nutrition Assistance Program. But should the rule go into effect as planned this spring, it would have a devastating impact on Baltimore’s economy and the health of its residents, city officials wrote in a declaration of support of the plaintiffs’ request for a preliminary injunction……The Trump administration’s rule, finalized last month, would make it harder for states to waive some requirements for able-bodied adults without dependents who live in economically distressed areas……Historically, such waivers have been granted to Baltimore City where, as of October, the average 24-month unemployment rate was 5.6% – significantly higher than the national unemployment rate of 3.8% in the same period.The new rule imposes stricter criteria states must meet to issue waivers. Under the plan, states can issue waivers only if a local area has an unemployment rate of 6% or higher……Roughly 30,000 people in Maryland could be affected. It’s one of several changes to the food stamp program the Trump administration has pushed……Not only would an estimated 11,000 to 15,000 people lose food stamps, city officials say, but there would be an immediate economic impact as well. People spend food stamps at Baltimore stores, so the change would result in an annual loss of approximately $24 million to $33 million in spending……The multistate lawsuit filed Jan. 16 argues the rule contradicts Congress’ intent for the food stamp program and would result in thousands of people losing essential access to food… January 24, 2020: California Attorney General Xavier Becerra posted a press release on his official website titled: “Broad Coalition of Healthcare Providers, Historians, Policy Leaders, Legal Experts, Members of Congress, and More Join Effort to Fight Harmful Public Charge Rule.” From the press release: California Attorney General Xavier Becerra today announced that a broad coalition of healthcare providers, historians, policy leaders, members of Congress, and more filed amicus briefs in support of the state’s efforts to stop the Trump Administration’s harmful public charge rule. The rule unnecessarily targets working immigrants and their families by turning the use of critical health, nutrition, and housing programs that supplement their modest incomes into barriers to lawful admission to the United States. The amicus briefs filed with the U.S. Court of Appeals for the Ninth Circuit raise a wide range of concerns with the rule and highlight why implementation should be halted……Public benefit programs are designed to help working families make ends meet and ensure strong, healthy families in California. Long-standing guidance by the federal government defined a public charge as a person who is primarily dependent on either public cash assistance for income maintenance or institutional long-term care at the government’s expense. The new rule declares that use of additional federally funded government programs, including nutrition and food support through CalFresh (California’s Supplemental Nutrition Assistance Program), healthcare through Medi-Cal (California’s Medicaid program), and housing for families through Section 8 housing assistance may now constitute grounds for a public charge determination. These changes would discourage many eligible immigrants and mixed immigration-status families, who are not otherwise subject to the rule, from accessing benefits to which they are entitled. The rule could have an outsized impact on California, where one in four people are immigrants and one in two children have an immigrant parent. It will also make it harder for hard-working, low- and moderate- immigrants to be admitted into the United States or to get green cards. The new standards are so high that if they were applied to citizens across the country, a substantial portion would likely be considered a ‘public charge.’… January 24, 2020: Seattle Times posted an article titled: “‘SNAP benefits are not a luxury'”: DelBene, Schrier denounce food-stamp cuts that will affect thousands in Washington”. From the article: …U.S. Reps. Suzan DelBene, D-Medina, and Kim Schrier, D-Sammamish, toured the food bank Friday to discuss and denounce a new Trump administration rule that the state says would take food stamps away from nearly 70,000 people in Washington state.Announced in December, the rule change applies to able-bodied adults without children, who, if they’re not working regularly, receive food stamps (officially known as the Supplemental Nutrition Assistance Program or SNAP) for only three months every three years. States with high unemployment rates have been able to waive time limits. But the rule change, which is scheduled to go into effect April 1, would set stricter criteria.The change would cut food benefits for 688,000 people across the country, according to the U.S. Department of Agriculture (USDA). The Washington State Department of Social and Health Services (DSHS) says the change would cut food benefits for 68,000 people in Washington, in 26 counties, including King, Pierce, and Snohomish……DelBene, who noted the average household with SNAP receives about $7 a day in benefits, said the change would drive people “further into poverty.”“SNAP benefits are not a luxury, they are a need,” Schrier said, calling the cuts “incredibly draconian.”… January 26, 2020: Cleveland.com posted an opinion piece titled: “DeWine administration deserves Ohioans’ thanks for uncovering – and vowing to fix – state Medicaid mess”. It was written by The Editorial Board of Cleveland.com and The Plain Dealer. A portion of it discusses the SNAP program: Kudos to Republican Gov. Mike DeWine’s administration for its candor in exposing big flaws in a computer system, called Ohio Benefit, that’s supposed to help the state manage its part of the Medicaid, Temporary Assistance for Needy Families and food stamp (SNAP) programs……State officials say that Ohio’s Benefits’ problem are less acute in handling other federal benefits, such as SNAP (food stamps). But the state’s food banks reported multiple, similar problems a year ago, after SNAP was added to Ohio Benefits toward the end of the Kaisich administration. “The system appears to be wrongly excluding needy Ohioans while handicapping Ohio’s network of food banks in their attempt to intercede for poor and elderly food-stamp recipients,” our editorial board wrote at the time.The DeWine administration needs to do due diligence on SNAP, to reassure state taxpayers that expensive mistakes aren’t accumulating there, as well… January 27, 2020: CNBC posted an article titled: “Supreme Court allows Trump’s ‘public charge’ immigration rule to take effect.” It was written by Tucker Higgins. From the article: The Supreme Court said Monday that it will allow the Trump administration “public charge” rule to take effect after the immigration policy had been blocked by lower courts.The 5-4 vote was divided along partisan lines, with the court’s four Democratic appointees indicating that they would not have allowed the policy to be enforced.The rule, which was proposed in August, will make it more difficult for immigrants to obtain permanent residency, or green cards, if they are likely to use public benefits like food stamps and Medicaid.Under previous federal rules, a more narrow universe of public benefits, such as cash assistance and long-term hospitalization, were considered in determining whether an immigrant was likely to become a “public charge”.Civil rights groups criticized the rule, arguing that it would penalize poor immigrants and disproportionately affect non-white immigrants… January 27, 2020: Senator Patty Murray tweeted: “Just stepped out of the impeachment trial to news that the Trump Administration can begin implementing its cruel public charge rule that will threaten the lives & livelihoods of so many hardworking families in WA & across the country. This is just so wrong. January 27, 2020: Bloomberg posted an opinion piece titled: “Food-Stamp Work Requirements Just Look Cruel”. It was written by Scott Duke Kominers, (who is the MBA Class of 1960 Associate Professor of Business Administration at Harvard Business School and a facility affiliate at the Harvard Department of Economics.) From the opinion piece: In some circles, the notion that there’s no free lunch isn’t just a metaphor for our economic reality — its taken as a directive. That’s the idea behind the view that to qualify for government benefits, an able-bodied adult should either hold a job or be in school. West Virginia has been testing this theory by imposing such a requirement for eligibility in the Supplemental Nutrition Assistance Program — more commonly known as food stamps –in certain counties since 2016.The state has hoped that introducing work requirements would increase employment among SNAP beneficiaries and reduce reliance on food stamps, which ballooned during the Great Recession.The results aren’t heartening: According to a report from the West Virginia Center for Budget and Policy, work requirements did reduce SNAP participation in the affected counties, which saw a 13.6% decline in enrollment — much higher than the 5.7% decline elsewhere in the state. But employment growth in those counties has, if anything, slowed compared with the rest of West Virginia. And reducing access to food stamps without growth in the job market has in turn put pressure on local food banks and food pantries……Whatever the cause, if you’re in and out of work, you’ll have a harder time satisfying eligibility rules that require continuous employment – even if you’re working as much as you can.There’s also a broader conceptual problem with work requirements for food assistance: Taking away access to food benefits actually makes it harder to work both by reducing nutrition and forcing people to spend more time trying to find food… January 27, 2020: Senator Tammy Duckworth tweeted: “Disappointing ruling from the Supreme Court. My family teetered on the brink of homelessness when I was in high school & relied on food stamps to survive. My mom is an immigrant – & with this ruling, my family could’ve been forced to choose between her citizenship & going hungry.” The tweet includes a link to a tweet from The Washington Post, which links to an article titled: “Supreme Court allows Trump administration to implement new rules for immigrants who might use public-assistance programs.” January 27, 2020: U.S. Representative Marcia Fudge posted news on her official website titled: “Rep. Fudge on Suit to Block Administration’s SNAP Cut.” From the news: Rep. Marcia L. Fudge, Chair of the House Agriculture Subcommittee on Nutrition, Oversight, and Department Operations, in a statement Monday highlighted the House’s support of a lawsuit to block the Administration’s rule eliminating state flexibility to administer benefits based on their own need and economic condition through the Supplemental Nutrition Assistance Program (SNAP). Fudge issued the following statement on the suit, brought in Washington, and filed by the attorneys general of 15 states, including the District of Columbia:“The House is proud to stand and fight this Administration’s attack on hungry Americans. In our brief, we cut through the White House’s rhetoric in four ways: “First, no matter how the Administration tries to sell this, it is not only stripping SNAP benefits from 700,000 hungry, low-income Americans, it is boasting about this travesty as a great accomplishment. Their ‘accomplishment’ is not returning people to work, it’s kicking people off SNAP.“Second, for a White House that has criticized past Administrations for their perceived regulatory overreach, this iteration of USDA is merely using the same tactics to accomplish its own political objectives. What’s more, the Administration is pushing the same far-Right policy goals that a bipartisan Congress historically rejected in the 2018 Farm Bill.“Third, Republicans, who have long prided themselves on being the party of federalism and states’ rights, have completely exposed themselves as hypocrites by eliminating the rights of states – red and blue alike – to determine what their own citizens need and serve them accordingly.“Finally, the Administration’s rule does real harm to SNAP’s ability to accomplish its mission, even by USDA’s own analysis. SNAP combats food insecurity, erosion of public health, and family instability. It fights malnutrition and hunger, lifts millions out of poverty, and improves the health of countless low-income individuals, their families, and their communities, this Administration has pursued political cuts to it at all costs.“For our part, the House will fight this hypocritical and political cruelty. This is the first of three attempts to kick hungry people off SNAP, and we will be there at every turn, waiting to expose the Administration’s shameful actions. January 27, 2020: Speaker Nancy Pelosi posted a press release on her official website titled: “Pelosi Statement on Amicus Brief in District of Columbia, et. al. v. Department of Agriculture”. From the press release: Speaker Nancy Pelosi issued this statement as the U.S. House of Representatives filed an amicus brief in the U.S. District Court for the District of Columbia in the court case District of Columbia, et. al. v. U.S. Department of Agriculture, which seeks to block the Trump Administration’s unlawful rule that weakens states’ ability to provide food assistance for thousands of Americans relying on the lifeline of Supplemental Nutrition Assistance Program (SNAP) in high-unemployment areas:“The Trump Administration’s callous and contemptuous decision to steal food off the table of nearly 700,000 Americans is both clearly unlawful and profoundly immoral. For decades, Congress has reaffirmed SNAP’s vital importance as a lifeline for millions of Americans as a pathway out of poverty, including most recently in 2018 when Congress explicitly rejected attempts by the Administration and Republicans to insert these unjustifiable policies into the Farm Bill. As the House brief states, “the Rule effects an end-run around the 2018 Farm Bill…This Court should not countenance a rule that is so contrary to established law and punishes low-income Americans, causing irreparable injury.’“The Administration’s ongoing assault on SNAP, which is the most effective anti-hunger initiative in our nation’s history, will cause ‘irreparable harm’ to those it is intended to help and ‘will spur hunger, compounding food insecurity, dangers to public health, and risks to many families.’ This attack on SNAP, in addition to being cruel, also showcases this Administration’s anti-truth, anti-government agenda, ignoring the fact that SNAP injects $1.79 into the economy for every dollar in benefits and lowers health care costs by nearly $1,400 per person.“Since Day One of this Congress, the House has fought the Administration’s attacks on hungry Americans, and we will continue to work in the Congress and in the courts to ensure all Americans can put food on the table, instead of increasing hunger and perpetuating false-perceptions of low-income Americans, the Trump Administration should work with Congress to connect workers to good-paying jobs and address the crisis of income disparity in America.” The amicus brief mentioned by Speaker Pelosi is here. January 27, 2020: The Supreme Court of the United States issued a decision on Department of Homeland Security, et. al. v. New York, et. al. From the decision: The application for stay presented to Justice Ginsburg and by her referrd to the Court is granted, and the District Court’s October 11, 2019 orders granting a preliminary injunction are stayed pending disposition of the Government’s appeal in the United States Court of Appeals for the Second Circuit and disposition of the Government’s petition for a writ of certiorari, if such writ is timely sought. Should the petition for a writ of certiorari be denied, this stay shall terminate automatically. In the event the petition for a writ of certiorari is granted, the stay shall terminate upon the sending down of the judgment by this Court.Justice Ginsburg, Justice Breyer, Justice Sotomayor, and Justice Kagan would deny the application.Justice Gorsuch, with whom Justice Thomas joins, concurring in the grant of stay.On October 10, 2018, the Department of Homeland Security began a rulemaking process to define the term “public charge,” as it is used in the Nation’s immigration laws. Approximately 10 months and 266,000 comments later, the agency issued a final rule. Litigation swiftly followed, with a number of States, organizations, and individual plaintiffs variously alleging that the new definition violates the Constitution, the Administrative Procedure Act, and the immigration laws themselves. These plaintiffs have urged the courts to enjoin the rule’s enforcement not only as it applies to them, or even to some definable group having something to do with their claimed injury, but as it applies to anyone.These efforts have met with mixed results. The Northern District of California ordered the government not to enforce the new rule within a hodge-podge of jurisdictions – California, Oregon, Maine, Pennsylvania, and the District of Columbia. The Eastern District of Washington entered a similar order, but went much farther geographically, enjoining the government from enforcing its rule globally. But both of those orders were soon stayed by the Ninth Circuit which, in a 59-page opinion, determined the government was likely to succeed on the merits. Meanwhile, across the country, the District of Maryland entered its own universal injunction, only to have that one stayed by the Fourth Circuit. And while all these developments were unfolding on the coasts, the Northern District of Illinois was busy fashioning its own injunction, this one limited to enforcement within the state of Illinois.If all of this is confusing, don’t worry, because none of it matters much at this point. Despite the fluid state of things – some interim wins for the government over here, some preliminary relief for plaintiffs over there – we now have a single injunction to rule them all: the one before us, in which a single judge in New York enjoined the government from applying the new definition to anyone, without regard to geography or participation in this or any other lawsuit. The Second Circuit declined to stay this particular universal injunction, and so now, after so many trips up and down and around the judicial map, the government brings its well-rehearsed arguments here.Today the Court (rightly) grants a stay, allowing the government to pursue (for now) its policy everywhere save Illinois. But, in light of all that’s come before, it would be delusional to think that one stay today suffices to remedy the problem. The real problem here is the increasingly common practice of trial courts ordering relief that transcends the cases before them. Whether framed as injunctions of “nationwide”, “universal”, or “cosmic” scope, these orders share the same basic flaw – they direct how the defendant must act toward persons who are not parties to the case.Equitable remedies, like remedies in general, are meant to redress the injuries sustained by a particular plaintiff in a particular lawsuit. When a district court orders the government not to enforce a rule against the plaintiffs in the case before it, the court redresses the injury that gives rise to its jurisdiction in the first place. But when a court goes further than that, ordering the government to take (or not take) some action with respect to those who are strangers to the suit, it is hard to see how the court could still be acting in the judicial role of resolving cases and controversies. Injunctions like these thus raise serious questions about the scope of courts’ equitable powers under Article III……It has become increasingly apparent that this Court must, at some point, confront these important objections to this increasingly widespread practice. As the brief and furious history of the regulations before us illustrates, the routine issuance of universal injunctions is patently unworkable, sowing chaos for litigants, the government, courts, and all those affected by these conflicting decisions. Rather than spending their time methodically developing arguments and evidence in cases limited to the parties at hand, both sides have been forced to rust from one preliminary injunction hearing to another, leaping from one emergency stay application to the next each with potentially nationwide stakes, and all based on expedited briefing and little opportunity for the adversarial testing of evidence.This is not normal……The rise of nationwide injunctions may just be a sign of our impatient times. But good judicial decisions are usually tempered by older virtues.Nor do the courts of nationwide injunctions end there. There are currently more than 1,000 active and senior district court judges, sitting across 94 judicial districts and subject to review in 12 regional courts of appeal. Because plaintiffs generally are not bound by adverse decisions in cases to which they were not a party, there is a nearly boundless opportunity to shop for a friendly forum to secure a win nationwide…. The risk of winning conflicting nationwide injunctions is real too… And the stakes are asymmetric. If a single successful challenge is enough to stay the challenged rule across the country, the government’s hope of implementing any new policy could face the long odds of a straight sweep, parlaying a 94-0 win in the district courts into a single 12-to-0 victory in the courts of appeal. A single loss and the policy goes on ice – possibly for good, or just as possibly for some indeterminate period of time until another court jumps in to grant a stay. And all that can repeat, ad infinitum, until either one side gives up or this Court grants certiorari. What in this gamesmanship and chaos can we be proud of?I concur in the Court’s decision to issue a stay. But I hope, too, that we might at an appropriate juncture take up some of the underlying equitable and constitutional questions raised by the rise of nationwide injunctions. January 27, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra: We’ll Keep Fighting to Stop the Trump Administration’s Harmful Public Charge Rule”. From the press release: California Attorney General Xavier Becerra today issued a statement following the U.S. Supreme Court’s decision to stay the nationwide injunction on the public charge rule while litigation is ongoing. The rule unnecessarily targets working immigrants and their families by turning the use of critical health, nutrition, and housing programs that supplement their modest incomes into barriers to lawful admission to the United States.“This rule harms our children and families in communities across the country. It hurts our economy and the healthcare of so many Californians,” said Attorney General Becerra. “We are a nation of immigrants, so we will lean forward in the face of heartless attacks on working families. Together, we’ll continue to fight to stand up for the rights of each and every person who calls the United States their home.”Attorney General Becerra has fought against the Trump Administration’s public charge rule ever step of the way. In 2018, Attorney General Becerra called on the U.S. Department of Homeland Security to withdraw its initial public charge proposal. In 2019, Attorney General Becerra detailed how the rule will negatively impact California’s public health, social services, housing, educational programs, and economy. Shortly afterward, the Attorney General filed a lawsuit asserting the rule will have a chilling effect that will discourage many other immigrants, who are not otherwise subject to the rule, from accessing benefits that they need. The Attorney General also filed for a motion for a preliminary injunction to halt the rule’s implementation. Today’s decision was on the nationwide injunction in a separate public charge case out of the U.S. Court of Appeals for the Second Circuit. California’s case is currently before the U.S. Court of Appeals for the Ninth Circuit… January 28, 2020: The Palm Beach Post posted an opinion piece titled: “Point of View: Proposed SNAP cuts will hurt Palm Beach County’s hungry school kids”. It was written by June S. Neal. From the opinion piece: …President Donald Trump is proposing to cut 3 million people from the Supplemental Nutrition Assistance Program (SNAP) by reducing qualifying poverty level for benefits from 200% to 130%. That means at least half-a-million students will go hungry because SNAP benefits are tied to free or reduced school lunch eligibility.Already, one in seven American children face “food insecurity,” a euphemism for hunger. Most can’t afford to pay even reduced prices. The 2018 School Nutrition Association review of almost 1,500 districts nationally found that nearly 75.3% of them had unpaid debts.Florida is number 8 out among states with the highest number of kids dependent on free and reduced lunches. According to Casaundra Hechler, School Nutrition Services Specialist for the Palm Beach County School District, as of October 28, the district has a student enrollment of 193,672 students, with 106,193 or 55% receiving free or reduced-price lunches. Magdalena Prieto, general manager of district Food Services, predicts the Trump cuts will hurt 7,000 students……Congressmen on the U.S. House Agriculture Committee should vote to pass H.R. 5539, the “Protect SNAP Act,” which would reverse these food stamp cuts… H.R. 5349 is a bill that was sponsored by Representative Rosa L. DeLauro (Democrat – Connecticut). The bill has 109 sponsors, all of whom are Democrats. It was introduced in the U.S. House of Representatives on December 6, 2019, and was referred to the House Committee on Agriculture the same day. Nothing has happened with this bill since then. The text of the bill states: A Bill to prevent the changing of regulations governing the provision of waivers under the supplemental nutrition assistance program, and for other purposes……This Act may be cited as “Protect SNAP Act”……No rule, regulation, proposed rule, policy directive, or guideline may be issued or enforced by the Secretary of Agriculture, by te head of any entity within the Department of Agriculture (including the Food and Nutrition Service), or by any other person that…supersedes subsection (a), (b), (c), (d), (e), or (f) of section 273.24 of title 7 of the Code of Federal Regulations as in effect on December 1, 2018; ormodifies the effect or operation of any such subsection as so in effect.No Federal funds (including fees) made available for any fiscal year may be used to finalize, implement, administer, enforce, carry out, or otherwise give effect to the proposed rule entitled “Supplemental Nutrition Assistance Program: Requirements for Able Bodied Adults Without Dependents” (84 Fed. Reg. 980; February 1, 2019). January 28, 2020: The Daily Northwestern posted an article titled: “Evanston community members weigh in on new SNAP requirements, impact”. It was written by Daisy Conant. From the article: The District of Columbia and 15 states are suing the Trump administration over a recent rule from the U.S. Department of Agriculture that could result in hundreds of Evanston residents losing benefits under the Supplemental Nutrition Assistance Program.SNAP, colloquially known as “foods stamps,” provides aid for food purchases to low-income families and individuals. The new rule, set to take effect April 1, will make it more difficult for states to waive the requirement that able-bodied adults without dependents must work at least 20 hours per week to receive program benefits.Trump administration officials have claimed the new regulation will restore SNAP’s “original intent” and incentivize individuals to seek work. Diane Whitmore Schanzenbach, a labor economist and the director of Northwestern’s Institute for Policy Research, said she is wary of the officials’ assertions.She said studies have found that increasing work requirements for SNAP punishes participants according to their economic status and dampens the programs’ counter-cyclical impact……House Democrats issued their support of the multi-state lawsuit Monday.According to the 2016 American Community Survey, around 1,700 Evanston households recieve SNAP benefits, the majority of which are black. Schanzenback estimated the rule could impact between 200 and 300 Evanston residents, considering national levels of able-bodied adults without dependents… January 29, 2020: CNN posted an article titled: “Slashing food stamps hurts the poor. It also hurts their supermarkets.” It was written by Nathaniel Meyersohn. From the article: Independent grocery stores and regional supermarket chains already face brutal competition and shrinking profits. Now, they are worried about losing out on a valuable source of sales: food stamp recipients.A new Trump administration rule will require more low-income recipients to work in order to receive benefits from the Supplemental Nutrition Assistance Program, or SNAP. The change, which could save the federal government $5.5 billion over the next five years, could result in 700,000 people losing assistance, the Department of Agriculture estimates.The rule is set to go into effect in April. But a coalition of 14 states, New York City, and the District of Columbia, have filed a lawsuit challenging the rule. The lawsuit notes that cuts to the $61 billion food stamp program will have a ripple effect on grocery stores.Grocery stores often operate on 1% to 2% profit margins, and they rely on revenue from SNAP redemption spending. The rule change and lost sales from the program may mean grocers start pulling back on orders to their suppliers, reducing labor in stores or even closing down……More than $24 billion, or around 40% of the total food stamp program, was redeemed at supermarkets and grocery stores in 2018. Superstores like Walmart, Costco, Target, and others received 52% of SNAP dollars in 2018, and their share of the program has grown in recent years……Grocers located in low-income neighborhoods in both rural and urban America will get hurt the most from the SNAP cuts, experts say. They can’t suddenly make up lost sales from SNAP reductions. Some of those include Save A Lot, Ingles, Southeastern Grocers, Brookshire’s, Stater Bros. Markets, Superior Grocers and Weis Markets, according to one analyst… January 30, 2020: The Chicago Tribune posted an article titled: “Illinois joins lawsuit over Trump’s new food stamp rules that could take benefits from thousands here.” It was written by Sophia Tareen. From the article: Illinois joined a multi-state lawsuit over proposed Trump administration rules on food stamps that could cause hundred of thousands of Americans to lose benefits, Attorney Genera; Kwame Raoul confirmed Tuesday……Illinois could be hit hard. There are over 140,000 residents in the affected category; they’re able-bodied without dependents, according to state officials… January 30, 2020: The Hill posted an opinion piece titled: “Administration’s new SNAP work rule takes food off the table” It was written by Representative Marcia L. Fudge (D-Ohio), who is Chair of the House Agriculture Subcommittee on Nutrition and Representative Jim McGovern (D-Mass.), who is Chair of the House Rules Committee. From the article: A new Trump administration rule that will kick over 700,000 people off the Supplemental Nutrition Assistance Program (SNAP) – America’s premier anti-hunger program – is set to take effect in April. This rule will literally take food off the tables of American families who are already struggling to get by.This administration claims that this is all about getting people back to work. But as members of Congress who collectively represent more than a decade of chairmanship on the House Agriculture Committee’s subcommittee that oversees federal anti-hunger programs, we see clearly through this lie. And we believe this is nothing but another cynical and partisan attempt to gut benefits for those who have fallen on hard times.This president may not know what life is like for people struggling to get by, but we do. We represent tight-knit communities in Northeastern Ohio and Central and Western Massachusetts. Our districts include Democrats, Republicans, and everyone in between. Regardless of their party affiliation, our constituents believe in a hard-day’s work – and helping those who fall on hard times.They’ve seen how hard it can be sometimes to put food on the table, often through no fault of their own. And they’ve experienced how easy it can be to fall off track when unexpected bills or an illness throw budgets off balance. That is why programs like SNAP exist. Its benefits are modest, averaging about $1.40 per person, per meal. But it is a program that has kept millions of people out of food insecurity, and it continues to be one of the most efficient and effective parts of our federal safety net.The administration’s attempt to reduce SNAP would be devastating, but the House of Representatives is taking action to fight back. This week, we’re proud to stand alongside our colleagues in filing an amicus curiae, or friend of the court, brief in which introduces information from outside experts to aid the court in its decision making process. Our filing raises four distinct objections:First, the rule would strip at least 700,000 hungry, low-income Americans of their SNAP benefits when it takes effect on April 1. While many experts view this number as merely a floor for the possible total number of recipients kicked off the program as a result of the policy change, the administration is nevertheless trumpeting this systematic eviction as a great accomplishment.Second, for a White House that has criticized past administrations for their perceived regulatory overreach, this iteration of USDA is merely using the same tactics to fit its own political deliverables. It is also attempting to accomplish the far-right policy goals that a bipartisan Congress categorically rejected in the 2018 farm bill. The administration and its ultra-conservative henchmen in Congress cannot stomach that 369 representatives rejected their partisan assault n the poor.Third, the administration’s rule actively harms the very people USDA has committed to protect. The rule intentionally reduces the ability of SNAP to accomplish its mission. The administration uses the callous term “self-selection,” suggesting that individuals who can’t meet the new requirements for work or training have decided to do so on their own accord. This is a gutless abdication of responsibility, and a two-faced abandonment of its stated motto to “do right and feed everyone.”SNAP works. It prevents food insecurity, stabilizes families, boosts public health, lifts people out of poverty, helps our veterans when their transition back to civilian life hits a rough patch, and provides pathways of opportunity for those struggling to get ahead. But instead of looking for ways to end hunger, this administration is doing an end-run around Congress to make hunger worse. We think that is just plain wrong… January 30, 2020: Denverite posted an article titled: “Colorado joins a multi-state challenge to a Trump administration proposal on food stamps”. It was written by Donna Bryson. From the article: Colorado has joined 20 states and the District of Columbia in a lawsuit challenging changes that the Trump administration has proposed to food stamp rules. The proposed changes set to take effect April 1 would limit exemptions relating to the length of time Supplemental Nutrition Assistance Program, or SNAP, benefits would be available to able-bodied adults without dependents who do not meet work requirements. Of the 450,000 Colorado residents who receive SNAP benefits, traditonally known as food stamps, 7 percen could be affected, said Lawrence Pacheco, a spokesman for Attorney General Phil Weisler. Pacheco cited figurs form the state Department of Human Services.The suite was filed earlier in January and Colorado joined on Wednesday.In their court filing, the states said the proposal would “arbitrarily” reverse policy that states have followed for decades to seek waivers from SNAP work requirements in regions that lacked sufficient jobs for people receiving benefits……Earlier this week, the U.S. Supreme Court ruled that the Trump adminsitration can implement a rule seeking to withhold citizenship from immigrants that the government deems likely to rely on food, health and housing benefits while a separate legal challenge of that proposla makes its way through lower courts… January 31, 2020: Statehouse News Bureau posted an article titled: “20,000 Ohioans Set to Lose SNAP Benefits Under Trump Administration Rule Change”. It was written by Karen Kasler. From the article: 20,000 childless adults who are considered able-bodied and receive Supplemental Nutrition Assistance Program (SNAP) in 29 Ohio counties will soon be getting letters telling them their benefits are being cut off if they don’t find work quickly.42 mostly urban and Appalachian counties with high unemployment rates have used waivers to exempt non-disabled people from having to work at least 20 hours a week to get SNAP, commonly known as food stamps.But a new Trump administration rule going into effect in April raises the jobless threshold, taking away the waiver from all but 13 counties……Advocates say many of those people are mentally ill or have substance abuse issues, have low education levels, and may not have reliable transportation or steady residences……The average SNAP benefit in Ohio is around $125 a month. The Rule change is predicted to save nearly $5.5 billion over five years.. February 3, 2020: Politico posted an article titled: “‘They literally take food off their table’. It was written by Ryan McCrimmon. From the article: …USDA has also been accused of playing keep-away with some of the most important metrics related to its policy plans, like the recent proposal to curb broad-based categorical eligibility under the Supplemental Nutrition Assistance Program.The change would result in 3 million low-income Americans losing automatic eligibility for SNAP, by USDA’s own count. But anti-hunger advocates quickly homed in on another key figure: the number of school children who would lose automatic access to free or reduced-price school meals under the plan.That number was nowhere to be found when USDA released the draft rule in July.The department then declined to answer questions for months about how many students would be affected. House Education and Labor Chairman Bobby Scott (D-Va.) tried to pry the figures from USDA; he claimed that Perdue’s staff had initially suggested during a phone briefing that more than 500,000 children would no longer automatically qualify for free meals.Months later, USDA’s Food and Nutrition Service published a new analysis in October, late in the day ahead of a House committee hearing with the department’s top nutrition official. That document showed 982,000 students would lose their automatic eligibility for free school meals under the new SNAP rule – nearly double what the department had informally told the congressional staff.Lawmakers at the hearing angrily questioned why it took so long for USDA to acknowledge the extent of the potential impact on low-income school kids……To veterans of the department, USDA’s original analysis in June should have painted the full picture. [Susan] Offut, the former ERS administrator, said it’s unusual that the department didn’t explore the potential consequences for low-income schoolkids before preceding with the proposed rule.. February 6, 2020: NBC News posted an article titled: “Trump admin’s upcoming food stamp change would hurt kids, educators, and advocates testify”. It was written by Phil McCauseland. From the article: A rule change to the federal food stamp program proposed by the Trump administration would cause children in low-income families across the United States to go hungry, educators and hunger advocates told Congress on Thursday.The four people who testified Thursday said that a proposed Agriculture Department rule change to the Supplemental Nutrition Assistance Program, or SNAP, was a fundamental misunderstanding of a regulation known as broad-based categorical eligibility, or BBCE. As of now, states are allowed to waive asset tests – ignoring whether recipients have a care, assets or savings – and raise gross income eligibility limits……Critics argue that eliminating BBCE would limit states’ flexibility to address their unique populations, leave more than 3 million people without access to food through SNAP and cause nearly a million children to lose their automatic enrollment in the national school breakfast and lunch programs.The plan, the second of three proposed rule changes to SNAP by the Trump administration, is expected to take effect soon. An earlier rule will impose stricter work requirements on able-bodied adults without disabilities, and is expected to cut benefits to approximately 700,000 people when it takes effect April 1……About 96 percent of the children who would be slated to lose automatic enrollment under the Trump administration’s proposed rule would remain eligible for free or reduced school breakfasts or lunches, but they would have to fill out separate applications.SNAP provided benefits to 40.4 million people during an average month of the 2018 fiscal year, according to the Agriculture Department, with the average benefit measuring about $126 per person per month. Despite that help, 47.5 percent of households that received the benefit were food insecure……Thursday’s hearing was one of four held by the Oversight Committee to examine whether the Trump administration’s proposed regulations would harm children……Craig Gundersen, an agricultural and consumer economics professor at the University of Illinois at Urbana-Champaign who has studied the program for more than two decades, said the rule would only make food insecurity worse in the United States……Gundersen said this was a nonpartisan issue affecting blue states and red states. He said that Florida’s and Nevada’s BBCE rules are set at 200 percent above the poverty line and that Texas’ is set at 165 percent.A combined 636,800 people stand to lose access to their SNAP benefits in those three states alone, according to an Urban Institute analysis that examined the effect the rule would have had if it was implemented in 2018.State officials in Michigan expressed particular concern after they recently raised the state’s asset limit to $15,000 and where more than 125,000 people are at risk of losing benefits with the rule change……Food banks are also concerned, as they are worried they will have to make up for the 1 billion means SNAP provided last year to families, according to an analysis by Feeding America, a hunger relief organization. That would be an impossible task, according to Robert Campbell, managing director of policy at Feeding America.For every meal provided by food banks, SNAP provided nine, he said… February 10, 2020: The White House released its Budget for FY 2021. Here are the parts that will specifically cause harm to people who are eligible for SNAP, and for kids who are eligible for the free (or reduced) school lunch program: “…The Budget proposes administrative improvements to the National School Lunch (NSLP) and School Breakfast (SBP) Programs to strengthen program integrity through increased verification of household applications, and ensure that free meal benefits are better targeted to children from low-income households by closing a participation loophole in the Community Eligibility Provision (CEP).The NSLP and SBP provide nutritious means to more than 35 million children every school day. Children from low-income households are eligible to recieve meals at low or no cost based on their participation in other means-tested assistance programs like the Supplemental Nutrition Assistance Program (SNAP), or based on self-reported information about their household income and circumstances provided to their child’s school. The Budget includes two proposals that will help ensure that children receiving free meals are indeed eligible for them.The Budget would require local educational agencies to verify the information reported on eight percent of household applications, which is a modest increase from the current maximum of three percent. This would strengthen the integrity of the benefit eligibility certification process at all levels and help reduce payment error in the NSLP and SBP. The Budget would also limit participation in the CEP to only those schools where 40 percent or more their enrolled students are categorically or automatically eligible for free meals. This would close the loophole that allows local educational agencies to combine entire districts or groups of otherwise ineligible schools with high-poverty schools to serve meals at no charge to all students, better targeting free meal benefits to children in need of assistance.” When I read this, what I understand is that kids from low-income families, who are eligible for the National School Lunch and National School Breakfast program, will not be able to receive it unless their school has 40 percent or more students who are also eligible for the program. It also sounds like parents are going to have to fill out more forms than they had to before just to keep their kids on the program. Another portion of the Trump Budget affects the Supplemental Nutrition Assistance Program (SNAP). Here is what that part says: “Building upon the Administration’s regulatory efforts to reform Supplemental Nutrition Assistance Program (SNAP) by improving program integrity and promoting self-sufficiency, the Budget proposes commonsense SNAP work requirements that would require all able-bodied adult participants to work, find or train for employment in order to move those who continue receiving benefits toward self-sufficiency. The Budget would also create a new, cost-effective approach to nutrition assistance that combines traditional SNAP benefits with nutritious, American-grown, U.S. Department of Agriculture (USDA) foods provided directly to households. These reforms, combined with new initiatives to bolster program intergrity and streamline State operations by improving data matching and oversight, ensure that SNAP benefit dollars are targeted to the neediest households while significantly reducing the costs to taxpayers.SNAP provides low-income households with electronic benefits they can use to buy groceries at authorized retailers. As a primary component of the social safety net, SNAP participation grew to historic levels during the recession. However, despite significant economic improvement and a strong job market, participation has not yet declined to pre-recession levels, and too many people are still missing the opportunity to move from dependence to self-sufficiency.The Administration has made significant reforms to SNAP through the regulatory process, including changes to close eligibility loopholes and eliminate States’ misuse of work requirement waivers. Building upon these regulatory successes, which in total are estimated to save nearly $50 billion over 10 years, the Budget proposes to overhaul the SNAP work requirements by requiring that all able bodied adult participants between ages of 18 and 65 engage in at least 20 hours or more of employment, employment-related training, or community service in order to receive benefits. This would help more people get off the sidelines of this booming economy and onto the path toward self-sufficiency.The Budget also retains the America’s Harvest Box proposal which would combine traditional SNAP benefits with nutritious and 100 percent American-grown food provided directly to households. Under the proposal, households receiving $90 or more per month in SNAP benefits would receive a portion of their benefit in the form of a USDA Foods package, which would include items such as shelf-stable milk, ready to eat cereals, pasta, peanut butter, beans, canned fruit, vegetables, and meat, poultry or fish. The remainder of their benefit would continue to be provided on an Electronic Benefit Transfer card for use at approved grocery retailers. This cost-effective approach would ensure SNAP households receive nutritious food while supporting American agriculture. In addition it would result in no loss in the food benefits to participants, while generating significant savings to taxpayers. States would have substantial flexibility in designing the food box delivery system using existing infrastructure, and the proposal would expand opportunities for innovative approaches to public or private partnerships for benefit delivery and fresh produce options.In addition, the Budget proposes new program integrity initiatives that would increase monitoring and oversight maximize the use of data sharing, and increase administrative efficiencies. These proposals would improve the accuracy of SNAP eligibility determinations and reduce incidences of duplicate participation in multiple States, thereby decreasing improper payments and ensuring benefit dollars are appropriately targeted to eligible households.” February 10, 2020: The New York Times posted an article titled: “Trump Budget Would Fray Social Safety Net”. It was written by Alan Rappeport and Lola Fadulu. From the article: …The White House also wants to take a knife to the federal food stamp program, once again calling for reductions in the number of adults who can qualify for the Supplemental Nutrition Assistance Program, or SNAP. The 2021 budget proposes cutting SNAP funding by about $15 billion from last year.The White House has been making changes to the program on its own, raising eligibility requirements and tightening rules that prevent states from obtaining waivers from work requirements. That includes a rule change that goes into effect in April, which will require many adults without children who are able to work to find employment quickly or risk losing their food stamps. The administration estimates nearly 700,000 people across the country would lose access to the program.…Many of the cost-cutting measures pitched by Mr. Trump have long been championed by Republicans who have in the past expressed concern about rising deficits……But Democrats seized on the proposals on Monday as evidence that the president was out of touch with the plight of working families… THIS BLOG WILL BE UPDATED WHENEVER RELEVANT, CREDIBLE, INFORMATION IS FOUND. What Happens if Trump Cuts Food Stamps? is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... A Timeline of the GOP’s Attempts to Destroy Obamacare – Part FourJanuary 21, 2020health insurance / Out of SpoonsImage by Clker-Free-Vector-Images from Pixabay 2020 marks the fourth year of the Donald Trump Presidency. His administration, and the Republicans in Congress, are still trying to destroy Obamacare. They are also going after reproductive health care, Medicaid, Medicare, Social Security Disability, the ablity for LGBTQ people to recieve health care, and the ability for undocmented children to be covered by Medicaid. The Guardian reported that President Trump was impeached on December 19, 2019, when the House of Representatives voted 230-197 to approve a first article of impeachment. This blog post, like the ones that preceded it, has the “receipts” about every bad thing the GOP and Trump tried to do to American’s health care. (It also includes the good things that Democrats – and occasionally some Republicans – did to protect our healthcare.) If you would like the full story, you may want to start with the blogs I’ve written about this topic so far. They include: A Timeline of the GOP’s Attempts to Destroy Obamacare – Part One A Timeline of the GOP’s Attempts to Destroy Obamacare – Part Two A Timeline of the GOP’s Attempts to Destroy Obamacare – Part Three A Timeline of the GOP’s Attempts to Destroy Obamacare – Part Three – Continued January 2020 January 1, 2020: Speaker Nancy Pelosi tweeted: “For six years, Americans of every age have been protected against health insurance discrimination if they have pre-existing conditions. Now, Trump and Republicans are trying to tear away those protections. #ProtectOurCare” January 2, 2020: The New York Times posted an article titled: “It Looks Like Health Insurance, but It’s Not. ‘Just Trust God,’ Buyers Are Told.” It was written by Reed Ableson. From the article: …More than one million Americans, struggling to cope with the rising cost of health insurance, have joined such groups, attracted by prices that are far lower than the premiums for policies that must meet strict requirements, like guaranteed coverage for pre-existing conditions, established by the Affordable Care Act. The groups say they permit people of common religious or ethical belief to share medical costs, and many were grandfathered in under the federal health care law mainly through a religious exemption.These Christian nonprofit groups offer far lower rates because they are not classified as insurance nd are under no legal obligaition to pay medical claims. They generally decline to cover people with pre-existing illnesses. They can set limits on how much their members will pay, and they can legally refuse to cover treatments for specialities like mental health……The main requirement for membership is adherence to a Christian lifestyle. And the alternative sharing plans keep flourshing, especially now that the Trump administration has relaxed rules to permit alternatives to the A.C.A. that don’t provide such generous coverage.But state regulators in New Hampshire, Colorado, and Texas are beginning to question some of the ministries’ aggressive marketing tactics, often using call centers, and in some cases people who joined them were misled or did not understand how little coverage they would recieve if they or a family member had a catastrophic illness……Because the groups are not technically considered insurance, they operate with no government oversight. “Regulators haven’t been willing to assert any control or regulatory authority over these plans,” said Katie Keith, who serves as a consumer representative to the National Association of Insurance Commissioners and teaches health law at Georgetown University. “They feel their hands are tied. At the end of the day, it’s not insurance.”Families who have joined the groups recount winding up with medical bills not covered by the ministries, with no legal way to appeal decisions to reject coverage for care. Some groups ask their members to push hospitals and doctors to write off their bills rather than use members’ money to pay their expenses… January 2, 2010: The Hill posted an article titled: “More than 200 Lawmakers urge Supreme Court to ‘reconsider; Roe v. Wade”. It was written by Nathaniel Weixel. From the article: More than 200 members of Congress want the Supreme Court to “reconsider” the landmark abortion case Roe v. Wade.Led by Minority Whip Steve Scalise (R-La.), 166 House Republicans and 39 Senate Republicans signed an amicus brief calling the right to an abortion “unworkable.”Two Democrats, Rep. Collin Peterson (Minn.) and Rep. Daniel Lipinski (Ill.), also signed onto the brief. Lipinski has come under fire for his anti-abortion stance, and is being targeted in his upcoming primary by a progressive Democrat……The lawmakers were writing in support of a Louisiana law that would require doctors who preform abortions to have admitting privileges at a nearby hospital, a requirement that critics say is designed to force abortion clinics to close.The Supreme Court is set to hear oral arguments challenging the law in March. If upheld, the restrictions could leave the state with just one abortion provider… There is a PDF of the Amici Curiae mentioned in the above article. Here is a list of the members of Congress who signed it in support of Louisiana’s abortion law, and in an effort to overturn Roe v. Wade. U.S. Senate (by State): Arizona: John BoozmanArkansas: Tom CottonFlorida: Marco RubioIdaho: Mike Crapo, James E. RischIndiana: Todd Young, Mike BraunIowa: Jodi Ernst, Chuck GrassleyKansas: Jerry Moran, Pat RobertsKentucky: Rand PaulLouisiana: John Kennedy, Bill Cassidy, M.D.Mississippi: Cindy Hyde-Smith, Roger F. WickerMissouri: Roy BluntMontana: Steve DainesNebraska: Deb Fischer, Ben SasseNorth Carolina: Richard Burr, Thom TillisNorth Dakota: Kevin Cramer, John HoevenOhio: Rob PortmanOklahoma: James M. Inhofe, James LankfordPennsylvania: Pat ToomeySouth Carolina: Tim ScottSouth Dakota: Mike Rounds, John ThuneTennessee: Marsha BlackburnTexas: John Cornyn, Ted CruzUtah: Mike Lee, Mitt RomneyWisconsin: Ron JohnsonWyoming: John Barrasso, Michael B. Enzi House of Representatives (by state): Alabama: Robert B. Aderholt (04), Mo Brooks (05), Bradley Byrne (01), Martha Roby (02), Mike D. Rogers (03)Arizona: Andy Biggs (05), Rick Crawford (01), Paul A. Gosar, D.D.S., (04), French Hill (02), Debbie Lesko (08), Gary Palmer (06), David Schweikert (06), Bruce Westerman (04), Steve Womack (03)California: Paul Cook (08), Doug LaMalfa (01), Kevin McCarthy (23), Tom McClintock (04), Colorado: Ken Buck (04), Doug Lamborn (05), Doug Lamborn (05), Scott Tipton (03)Florida: Mario Diaz-Balart (25), Neal Dunn, M.D. (02), Matt Gaetz (01), Brian Mast (18), Francis Rooney (19), John Rutherford (04), Ross Spano (15), W. Gregory Steube (17), Michael Waltz (06), Daniel Webster (11), Ted S. Yoho, D.V.M (03)Georgia: Rick W. Allen (12), Earl L. “Buddy” Carter (01), Doug Collins (09), A. Drew Ferguson IV (03), Tom Graves (14), Jody B. Hice (10), Barry Loudermilk (11), Austin Scott (08)Idaho: Russ Fulcher (01), Mike Simpson (02)Illinois: Mike Bost (12), Larry Bucshon, M.D. (08), Rodney Davis (13), Adam Kinzinger (16), Darin LaHood (18), Daniel W. Lipinski (03), Greg Pence (06), John Shimkus (15)Indiana: James R. Baird (04), Jim Banks (03), Jackie Walorski (02)Iowa: Steve King (04)Kansas: Chuck Fleishmann (03), Roger Marshall, M.D. (01), Steve Watkins (02)Kentucky: Andy Barr (06), James Comer (01), Hal Rogers (05)Louisiana: Steve Scalise (01), Michael Johnson (04), Ralph Abraham M.D. (05), Garret Graves (06), Clay Higgins (03), Maryland: Andy Harris, M.D. (01)Michigan: Jack Bergman (01), Bill Huizenga (02), Paul Mitchell (10), John R. Moolenaar (04), Tim Walberg (07),Minnesota: Tom Emmer (06), Collin C. Peterson (07), Pete Stauber (08),Mississippi: Jim Hagedorn (01), Steve Palazzo (04)Missouri: Sam Graves (06), Vicky Hartzler (04), Trent Kelly (01), Billy Long (07), Blaine Luetkemeyer (03), Jason Smith (08), Ann Wagner (02)Montana: Greg Gianforte (AL)New York: Peter T. King (02), Lee Zeldin (01New Jersey: Mike Simpson (02), Christopher H. Smith (04)Nebraska: Don Bacon (02), Jeff Fortenberry (01), Adrian Smith (03)North Carolina: Ted Budd (13), Virginia Foxx (05), George Holding (02), Richard Hudson (08), Patrick McHenry (10), Mark Meadows (11), Gregory F. Murphy, M.D. (03), Mark Walker (06)North Dakota: Kelly Armstrong (AL), Dan Bishop (09), David Rouzer (07),Oklahoma: Tom Cole (04), Kevin Hern (01), Markwayne Mullin (02),Ohio: Troy Balderson (12), Steve Chabot (01), Warren Davidson (08), Bob Gibbs (07), Anthony Gonzalez (16), Bill Johnson (06), Jim Jordan (04), Doug LaMalfa (01), Robert E. Latta (05), Michael R. Turner (10), Brad Wenstrup, D.P.M. (02)Pennsylvania: John Joyce (13), Fred Keller (12), Mike Kelly (16), Daniel P. Meuser (09), Scott Perry (10), Guy Reschenthaler (14), Lloyd Smucker (11), Glenn “GT” Thompson (15)South Carolina: Jeff Duncan (03), Ralph Norman (05), Tom Rice (07), William Timmons (04), Joe Wilson (02)South Dakota: Dusty Johnson (AL)Tennessee: Tim Burchett (02), Chuck Fleishmann (03), Mark E. Green M.D. (07), Phil D. Roe, M.D. (01), John Rose (06), Texas: Jodey C. Arrington (19), Brian Babin, D.D. S. (36), Kevin Brady (08), Michael C. Burgess, M.D. (26), Michael Cloud (27), K. Michael Conaway (11), Dan Crenshaw (02), Bill Flores (17), Louis Gohmert (01), Lance Gooden (05), Kay Granger (12), Pete Olsen (22), John Ratcliffe (04), Chip Roy (21), Van Taylor (03), Randy Weber (14), Roger Williams (25), Ron Wright (06)Utah: Rob Bishop (01), John R. Curtis (03), Chris Stewart (02)Virginia: Ben Cline (06), Denver Riggleman (05), Rob Wittman (01)Washington: Dan Newhouse (04), Cathy McMorris Rogers (05)West Virginia: David B. McKinley, P.E. (01), Carol D. Miller (03), Alex X. Mooney (02),Wisconsin: Glenn Grothman (06), F. James Sensenbrenner (05), Brian Steil (01)Wyoming: Liz Cheney (AL) January 2, 2020: Emily’s List tweeted: “Abortion is under attack. Today, 207 members of Congress signed on to a briefing asking the Supreme Court to take up the issue of whether two crucial cases protection abortion – Roe v. Wade and Casey v. Planned Parenthood – should be “reconsidered and, if appropriate, overruled”. Emily’s List followed that tweet with another tweet: “The threat to abortion is here. It is real. It is urgent. That’s why it is so important to elect pro-choice Democratic women up and down the ballot across the country. Every single election.” January 2, 2020: Planned Parenthood Action tweeted: “Public: we support Roe v. Wade. 207 Anti-abortion politicians: hey SCOTUS, “if appropriate, overrule” what the people want. New year, same nonsense. January 3, 2020: Speaker Nancy Pelosi posted a press release on the Speaker’s official website titled: “Pelosi Statement on House Seeking Expedited Supreme Court Ruling on GOP’s ACA Lawsuit”. From the statement: Speaker Nancy Pelosi released the following statement as the House of Representatives filed a petition for a writ of certiorari in Republicans’ Texas v. U.S. lawsuit, asking the Supreme Court to act swiftly to uphold the Affordable Care Act in the face of the GOP’s effort to strike down the whole law. Last month, the 5th Circuit Court of Appeals had sided with Republicans and given instructions to the District Court to redetermine how much of the law to strike down, almost certainly delaying a final ruling into 2021 or later.“Everyday that Republicans’ anti-health care lawsuit is allowed to endure is a day that American families will be forced to live in uncertainty and fear. Unless the Supreme Court acts, families will continue to face needless disruption in their coverage and premiums, states will be unable to plan for the future and protections for people with pre-existing conditions will remain in peril.“The Trump Administration and its GOP allies want to delay judgement on the disaster they have sought to unleash on the health care of the American people, but there is no legal or practical justification for doing so.“The Supreme Court should hear this case now and recognize Congress’s clear intent to preserve protections for people with pre-existing conditions and other benefits and protections of the Affordable Care Act.” The writ of certiorari mentioned in the Speaker’s above statement can be viewed (as a PDF) here. January 3, 2020: New York Attorney General Letitia James posted a press release on her official website titled: “Attorney General James Seeks Supreme Court Review Of ACA Case”. From the press release: New York Attorney General Letitia James and a coalition – which includes 19 additional states and the District of Columbia – today filed a petition asking the U.S. Supreme Court to review a recent decision by the U.S. Court of Appeals for the Fifth Circuit in Texas v U.S. The decision affirmed a lower court’s ruling that the individual mandate of the Affordable Care Act (ACA) is unconstitutional, yet refused to rule on the validity of the rest of the ACA – calling into question whether the remaining provisions of the statute could still stand, including those that protect and provide coverage to Americans with pre-existing conditions. Because this decision causes uncertainty that may harm the health of millions of Americans – in addition to doctors, clinics, patients, and the healthcare market – Attorney General James and the coalition are petitioning the Supreme Court to take up the case and resolve it before the end of the court’s current term in June.The lawsuit – originally filed by a Texas-led coalition and supported by the Trump Administration – argued that Congress rendered the ACA’s individual mandate unconstitutional when it reduced the penalty for noncompliance with the law to $0. The plaintiffs further argued that the rest of the ACA should be held invalid as a result of that change. A coalition of attorneys general – that included New York – defended the ACA in its entirety, supported by a bipartisan group of amici, including scholars, economists, public health experts, hospital and provider associations, patient groups, countries, cities, and more. The Fifth Circuit held the individual mandate to be unconstitutional, but declined to further rule on the validity of the ACA’s remaining provisions. The court instead sent the case back to the Northern District of Texas to determine which provisions of President Obama’s signature health care law are still valid.Today’s petition makes clear that states, patients, doctors, hospitals, employers, pharmaceutical companies, and more will be impacted by the looming uncertainty caused by the Fifth Circuit’s decision. It asks the Supreme Court to review the case this term. The petition also highlights the important advancements in health care access made under the ACA, including: More than 12 million Americans now receive health coverage through the ACA’s Medicaid expansion;Nearly nine million individuals nationwide receive tax credits to help subsidize their health insurance coverage through individual marketplaces;Millions of working families rely on high-quality employer-sponsored health insurance plans;Important protections prohibit insurers from denying health insurance to the 133 million Americans with pre-existing conditions, like diabetes, cancer, or pregnancy, or from charging individuals higher premiums because of their health status; andNearly $1.3 trillion in federal funding has been dedicated to keeping Americans healthy and covered, which includes spending through Medicaid expansion and public health dollars. Filing today’s petition with Attorney General James are the attorneys general of California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Massachusetts, Michigan, Minnesota (by and through its Department of Commerce), Nevada, New Jersey, North Carolina, Oregon, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia, as well as the governor of Kentucky. January 3, 2020: California Attorney General Xavier Becerra posted a press release on his official website titled: “Attorney Genreal Becerra Leads Coalition Seeking Supreme Court Review of ACA Repeal Case”. From the press release: California Attorney General Xavier Becerra today, leading a coalition of 20 states and D.C., filed a petition to the U.S. Supreme Court seeking review of the Fifth Circuit’s recent decision in Texas v. U.S. The decision held the individual mandate of the Affordable Care Act (ACA) unconstitutional and called into question whether the remaining provisions of the ACA could still stand, including those that protect and provide coverage to Americans with pre-existing conditions. Because this decision causes uncertainty that may harm the health of millions of Americans, as well as doctors, clinics, patients, and the healthcare market, Attorney General Becerra and his coalition are petitioning the Supreme Court to take up the case and resolve it before the end of the Court’s current term in June.“While the Trump Administration fights to strip access to healthcare, our coalition moves forward to defend it – because a pre-existing medical condition should never again disqualify you from receiving affordable healthcare”, said Attorney General Becerra. “This dangerous repeal case jeopardizes the lives of our families, neighbors, and millions of Americans who rely on the ACA for their healthcare. We’ll continue to fight because our communities are healthier when everyone can access affordable care – whether that means gaining coverage from Medicaid expansion or by staying on a parent’s health insurance. We’re asking the Supreme Court to swiftly resolve this repeal lawsuit for the sake of saving lives and ending uncertainty in our healthcare system.”… January 3, 2020: Law.Com posted an article titled: “Donald Verrilli Returns to SCOTUS to Defend Obamacare”. It was written by Jacqueline Thomsen. From the article: The U.S House of Representatives and a Democratic group of state attorneys general on Friday placed the issue of the Affordable Care Act before the Supreme Court again, asking justices to review an appellate court decision that struck down the health care law’s individual mandate as unconstitutional.Alongside their petitions for writ of certiorari filled with the court, both the state officials and the House separately asked the justices to take up the matter on an expedited basis and schedule oral arguments for this spring.If the Supreme Court agrees to follow that schedule, that means an opinion could come down just months ahead of the 2020 presidential election, placing healthcare at the heart of the political debate……And the House’s petition, signed on by former Solicitor General Donald Verrilli, who previously defended the Affordable Care Act before the Supreme Court, said the Fifth Circuit ruling “has created an intolerable situation”… January 7, 2020: New York Attorney General Letitia James posted a press release on her official website titled: “Attorney General James Fights To Stop Restrictions On Women’s Reproductive Rights From Taking Effect”. From the press release: New York Attorney General Letitia James, along with a coalition of 19 additional attorneys general from around the nation, today filed a multistate amicus brief in support of a lawsuit that seeks to protect a woman’s right to safe and legal abortion care without the burdensome restrictions imposed by Arkansas laws. The brief – filed in support of the plaintiffs in Little Rock Family Planning Services v. Leslie Rutlidge, now before the Eighth Circuit Court of Appeals – supports the last surgical abortion clinic in Arkansas as it challenges four state laws that would restrict the ability for women in Arkansas to access abortions by banning abortions after 18 weeks and otherwise restricting women’s access to reproductive care.“Roe v. Wade has been the law of the land for 47 years and despite attempts by politicians across the country to undermine this national precedent and assert control over women’s bodies, we will not go backwards,” said Attorney General James. “We will continue to be relentless in our defense of a woman’s right to choose, relentless in safeguarding women’s freedoms, and relentless in protection the ability for women to control their own bodies. Our coalition won’t allow Arkansas, nor any other state, to make it harder for women to exercise their constitutional right to an abortion. And we will continue to use every legal tool available to prioritize the health, safety, wellness, and rights of women.”In March of last year, the governor of Arkansas signed into law several bills intended to restrict a woman’s access to abortion services throughout the state. The laws would criminalize abortions performed after 18 weeks and impose additional undue burdens on a woman’s constitutional right to an abortion. The Little Rock Family Planning Services clinic argues that these laws would make abortion care unavailable and health care services less safe for women.In July, the U.S. District Court for the Eastern District of Arkansas granted a preliminary injunction and temporarily blocked the laws restricting abortion care from taking effect. The State of Arkansas appealed the decision to the Eighth Circuit Court of Appeals shortly thereafter.In the brief filed today, Attorney General James and the coalition of attorneys general argue that the Arkansas laws violate a woman’s constitutional right to choose under Roe v Wade. The coalition further argues that limiting or eliminating women’s access to safe and legal abortion leads to worse health and socioeconomic outcomes for women.In July, the U.S. District Court for the Eastern District of Arkansas granted a preliminary junction and temporarily blocked the laws restricting abortion care from taking effect. The State of Arkansas appealed the decision to the Eighth Circuit Court of Appeals shortly thereafter.In the brief filed today, Attorney General James and the coalition of attorneys general argue that the Arkansas laws violate a woman’s constitutional right to choose under Roe v. Wade. The coalition further argues that limiting or eliminating women’s access to safe and legal abortion leads to worse health and socioeconomic outcomes for women. The brief describes the different ways that states can promote women’s health without impeding women’s rights upheld by the U.S. Constitution. Today’s brief is just the latest action in a long list of measures Attorney General James has taken to protect women’s reproductive freedom. Last month, Attorney General James filed an amicus brief defending the right to maintain full and equal access to birth control guaranteed under the Affordable Care Act for tens of thousands of women nationwide… January 7, 2020: California Attorney General Xavier Bacerra posted a press release on his official website titled: “Attorney General Becerra Leads Multistate Amicus Brief Defending Women’s Reproductive Rights”. From the press release: California Attorney General Xavier Becerra today led a multistate coalition in filing an amicus brief in Eighth Circuit Court of Appeals in support of the plaintiffs in Little Rock Family Planning Services v. Leslie Rutledge, a lawsuit that seeks to protect a woman’s right to safe and legal abortion care. The multistate coalition supports the last surgical abortion clinic in Arkansas in its challenge to four state laws that would restrict women’s access to safe and legal abortion by banning abortion after 18 weeks and otherwise restricting women’s access to reproductive care.“We’re standing up to protect women’s rights,” said Attorney General Becerra. “No woman should be blocked from making health decisions about her body that she is entitled to under the Constitution. We will continue to fight to ensure that all women can access affordable comprehensive reproductive healthcare.”.. A copy of the brief is available here. January 7, 2020: HuffPost posted an article titled: “Trump Administration Quietly Goes After Disability Benefits”. It was written by Arthur Delaney. From the article: Some Americans could lose Social Security Disability Insurance benefits under a recent Trump administration proposal – a change that could affect thousands of people but that has recieved little attention since it was first floated in November.Under the proposed change, the government would look more closely at whether certain disability recipients still qualify as “disabled” after they’ve already been awarded those benefits. While recipients already have to demonstrate their continuing disability every few years, the proposal would ramp up the examinations, potentially running still-eligible beneficiaries out of the program.The extra reviews will help “maintain appropriate stewardship of the disability program,” the administration said in the proposal, arguing current rules fail to account fully for the possibility of medical improvement……Democrats and disability advocates said the proposed new regulation would only hurt disabled people, that it hasn’t been vetted and that the rule-making process should be delayed. More than 8 million of Americans recieve disability benefits based on past employment and a loss of wage income due to the onset of a severe disability……The regulation could affect hundreds of thousands of SSDI and Supplemental Security Income recipients, [Kathleen] Romig [senior policy analyst at Center on Budget and Policy Priorities] said, potentially ending benefits for tens of thousands. The administration didn’t estimate how many would lose benefits, but said the proposal would save over $2.6 billion over a decade.The rule would not take effect until sometime after the administration releases a final version, for which no date has been set – and as with other regulations the administration has issued without imput from Congress, a lawsuit could stop it……The draft rule would add a new category: medical improvement likely, as in likelier than possible, but not as likely as expected. Reviews would occur “approximately every two years,” as opposed to within 18 months for people with expected medical improvement and within three years for those with possible improvement. Overall, according to the administration, there would be 2.6 million more reviews, an 18% increase, at an anticipated cost of $1.8 billion – almost wiping out the $2.6 billion worth of savings on benefits… January 7, 2020: Senator Bernie Sanders tweeted: “10,000 Americans died waiting for Social Security Disability Insurance in 2017. Instead of addressing this crisis, Trump wants to make it harder for people with disabilities to get the help they need to get by. Unacceptable. We must protect and expand SSDI and SSI.” This tweet was the start of a short thread. January 7, 2020: Senator Bernie Sanders tweeted: “As president, I will reverse this disastrous rule on day one of my presidency. Together, we will guarantee every person with a disability the right to live in the community with dignity and independence.” January 9, 2020: Cal Matters posted an article titled: “Gov. Gavin Newsom to propose that California manufacture its own generic drugs”. From the article: In a bold strategy to drive down prescription drug prices, Gov. Gavin Newsom is proposing that California become the first state in the nation to establish its own generic drug label, making those medications available at an affordable price to the state’s 40 million residents.The proposal, part of the new state budget Newsom is expected to send to the Legislature on Friday, would authorize the state to negotiate contracts with drugmakers to manufacture selected prescriptions on behalf of California. Such a disruption of the pharmaceutical industry, proponents say, would leverage the state’s massive market to increase competition and lower generic drug prices nationally.The strategy is one of several the Democratic governor plans to recommend to lower the cost of health care for Californians. The administration released only a summary of the proposal on Thursday without the projected price tag, but indicated that it’s part of a multi-prong effort that includes strenghtening the state’s public option for health insurance and increasing drug pricing transparency.Newsom will also continue last year’s push to establish a single drug market for drug pricing, direct the state to ask for more rebates from drug manufacturers, and open a new health care affordability office sometime this spring… January 10, 2020: Sacramento Bee posted an article titled: “From housing to health care: Here’s what’s in Gavin Newsom’s $222 billion California state budget”. It was written by Sophia Bollag. For the purpose of this blog post, I am only including the parts of the budget that are related to health care. ..Newsom is also calling for a “once-in-a-generation” revamp of Medi-Cal to increase preventative health services, boost assistance for homeless people and improve mental health care.His plan would also steer nearly $700 million in addition money to the program.His budget would allow undocumented people over the age of 65 to enroll in Medi-Cal, provided they meet the program’s income requirements. That proposal builds on the current budget’s Medi-Cal expansion to undocumented young adults.The budget proposal also contains ambitious plans to cut prescription drug costs, including creating a state-owned generic drug label and a single drug purchasing market in California… January 10, 2020: Human Rights Watch posted an article titeld: “US: ‘Unailenable Rights’ Commission Risks Rights Protections.” From the article: The United States State Department’s Commission on Unalienable Rights risks calling for a dangerous downgrading of international human rights protections. On January 10, 2020, the Human Rights Watch executive diretor, Kenneth Roth, testified at the commission’s fourth open session.While the fundamental rights set out in the human rights treaties are clear, the Trump administration has taken issue with the rights they uphold, such as reproductive freedom, or the rights of LGBT people not to face discrimination. Human Rights Watch expressed concern that the commission’s exercise in identifying “unalienable” rights is the administration’s unilateral attempt to rewrite international law basd on its own beliefs.“The US Government’s voice is needed on human rights, but it should be a voice that upholds the principled defense of all rights, not a pick-and-choose approach,” Roght said. “Repressive governments frequently justify their human rights violations by claiming that some rights are more important than others. If the Trump administration adopts its own selective approacth to human rights, it will only facilitate this classic excuse to evade the requirements of international rights law.”Secretary of State Mike Pompeo announced the formation of the commission in July 2019 to advice on the promotion of human rights in foreign policy. The commission has yet to announce the form of its final product or the role that open session testimony will have in shaping that final product. Though the commission’s meetings are open to the public, it has not provided any publicly available record or transcript of testimony.The commission’s first step should be changing President Donald Trump’s own approach to foreign policy and human rights, Human Rights Watch said.“As long as the president embraces autocrats and dictators, expressing envy of their ability to silence or compromise the democratically essential checks and balances on their authority, the US government will have little credibility on human rights,” Roth said. January 13, 2020: The U.S. House of Representatives Ways and Means Committee posted a press release titled: “Neal, Larson, and Davis Slam Harmful Draft Social Security Rule. From the press release: Today, Ways and Means Committee Chairman Richard E. Neal (D-MA), Social Security Subcommittee Chairman John B. Larson (D-CT), and Worker & Family Support Subcommittee Chairman Danny K. Davis (D-IL) released the following statement regarding reports of a draft Social Security Administration (SSA) rule that would narrow the eligibility criteria for Social Security and Supplemental Security Income (SSI) disability benefits:“Yet again, the Trump Administration is going out of its way to make life more challenging for the most vulnerable people in our country. The United States government has extremely stringent disability standards. In fact, fewer than four in 10 applicants are found eligible for Social Security disability benefits, even after all levels of appeal. This rule would further restrict eligibility, making it even harder for disabled people to access the essential income they’re qualified to recieve. We are particularly alarmed that news of this latest proposal comes on top of the Administration’s recent efforts to cut off benefits for severely disabled people whom the agency already found eligible.“Instead of working to strip disability benefits from people who qualify, the SSA should focus on its truly pressing problems. Resources should go toward cutting lengthy wait times on the phone and at field offices, eliminating benefit backlogs, and hiring personnel to improve the agency’s lacing services.“We strongly urge the Trump Administration to reject this curel proposed rule and reassess SSA’s priorities.” January 13, 2020: New York Attorney General Letitia James posted a press release on her official website titled: “AG James Stops Public Charge Rule From Taking Effect”. From the press release: New York Attorney General Letitia James issued the following statement after the United States Court of Appeals for the Second Circuit denied the Trump Administration’s efforts to immediately reverse a nationwide preliminary injunction on the president’s Public Charge Rule:“Today is a victory for the millions of immigrants in our state and in this country that have been sidelined, disrespected, and demeaned by the Trump Administration. Generations have come to this country with nothing more than a dream in their pockets, but the president’s Public Charge Rule is an egregious attempt to infringe upon the values of our nation. The court’s decision to enforce the preliminary injunction and block the president from expediting his plan to discriminate against communities of color is welcome news to millions across New York and this country. We remain committed to fighting against this misguided rule and will continue to pursue every legal took available to permanently stop it.”In August 2019, Attorney General James and a coalition that includes the attorneys general of Connecticut and Vermont, as well as the City of New York, filed a lawsuit challenging the Trump Administration’s Public Charge Rule, which aims to deny green cards to immigrants that use or have used government assistance programs. The program specifically targets immigrants of color, while putting these communities at risk, and would have short and long-term impacts on public health and the economy.In September, Attorney General James and the coalition filed a motion for a preliminary injunction to stop the rule from going into effect. After the court order the preliminary injunction, President Trump and his Administration filed to stay the order but were denied in their efforts today.The overall health and wellbeing of New York’s immigrant communities that use vital public benefit programs would be negatively impacted by the Public Charge Rule. Additionally, with the anticipated decline in Medicaid enrollment, individuals who would have otherwise had access to healthcare are at risk of living with undiagnosed and untreated conditions. Economically, impacted communities can be expected to experience increased poverty rates, housing instability, a reduced workforce, and an overall decrease in total economic productivity. January 13, 2020: Speaker Pelosi tweeted: “130 million Americans live every day with pre-existing conditions. They depend on knowing their health care, secured by protections in the ACA, is there when they need it. #ProtectOurCare” January 13, 2020: Senator Sherrod Brown tweeted: “The Affordable Care Act’s Medicaid expansion is our number one took to get Ohioans the addiction treatment they need – and President Trump wants to take it away. We must #ProtectOurCare.” The tweet included a link to a Washington Post article titled “Medicaid expansion may have saved thousands from overdose deaths”. January 13, 2020: Representative Vicente Gonzalez tweeted: “Our government should be fighting to ensure Americans have access to quality, affordable health care without facing discrimination based on their pre-existing conditions – not working to take it away from millions! #ProtectOurCare” January 13, 2020: Representative Bill Foster tweeted: “If @realDonaldTrump gets his way, families across the country will see their costs go up as they lose pre-existing condition protections. I’m fighting to #ProtectOurCare for the 314,000 residents of my district who live with pre-existing conditions. January 13, 2020: Representative Zoe Lofgren tweeted: “I’m fighting for people living with pre-existing conditions in CA-19 & all around the country. If the GOP’s Texas v US lawsuit strikes down the Affordable Care Act, millions of Americans will lose vital protections & access to care. We must #ProtectOurCare!” January 13, 2020: Representative Ted Lieu tweeted: “If Trump gets his way, families in #CA33 and across the country will see their health care costs go up as they lose pre-existing condition protections. We can’t let it happen. #ProtectOurCare”. Here are a few tweets from President Trump: January 13, 2020: President Trump tweeted: “Mini Mike Bloomberg is spending a lot of money on False Advertising. I was the person who saved Pre-Existing Conditions in your Healthcare, you have it now, while at the same time winning the fight to rid you of the very unpopular Individual Mandate… January 13, 2020: President Trump tweeted: “…and if Republicans win in court and take back the House of Representatives, your healthcare, that I have now brought to the best place in many years, will become the best ever, by far. I will always protect your Pre-Existing Conditions, the Dems will not! January 13, 2020: President Trump tweeted: “I stand stronger than anyone in protecting your Healthcare with Pre-Existing Conditions. I am honored to have terminated the very unfair, costly and unpopular individual mandate for you!” In the above tweets, President Trump is spouting propaganda. His words do not match his actions in the previous years regarding American’s health care. (For more details, read my previous blogs about the ways Republicans and Trump have been trying to take away American’s health care.) January 14, 2020: Senator Bob Casey tweeted: “If the ACA is overturned: Women lose protections against discrimination in health care settings. Insurance companies will be able to charge women more than men. Women lose essential protections for breastfeeding including vital workplace standards. #ProtectOurCare.” January 14, 2020: Senator Doug Jones tweeted: “Folks, I know there’s a lot going on right now, but we can’t forget about the nearly 1M Alabamians living with pre-existing conditions whose health coverage is under attack right now. We need to stand up to #ProtectOurCare.” January 15, 2020: The Star Tribune Editorial Board posted an Editorial titled: “Waiting game on the Affordable Care Act isn’t healthy”. From the editorial: Patients, seniors, doctors, hospitals, state lawmakers and voters are owed a swift answer from the U.S. Supreme Court about whether the Affordable Care Act (ACA) will survive the latest challenge to its existence. The court needs to remove the uncertainty hovering ominously over this landmark measure, one whose sprawling web of assistance programs consumers, hospitals and states have come to rely on for quality, accessible care.That the fate of the 2010 law is dependent on the courts for the third time in a decade is exasperating. Twice already, battles over the ACA’s constitutionality have been fought all the way to the Supreme Court. Twice, justices have upheld the law. Now, a third challenge, one that’s essentially a vanity project led by a headline-seeking Texas attorney general, is gaining ill-deserved momentum.The legal argument in this dubious Texas lawsuit is the flip side of the original 2012 Supreme Court challenge to the law. Back then, the ACA’s earliest opponents argued that the law was unconstitutional because it required people to buy insurance. The Texas AG now argues that the law is unconstitutional because Congress essentially gutted the purchase requirement in 2017 during an end-of-the year tax bill……The implications are enormous. Millions of Americans depend on the financial aid the law provides to buy private insurance. In Minnesota, the average household that applied for help through MNsure received $5,244 to buy coverage in 2020. That aid could be gone next year or in the future. The fate of the Medicare “doughnut hole” is equally uncertain, leaving seniors with frightening questions about how they’ll be able to afford medications… January 15, 2020: Senator Sheldon Whitehouse tweeted: “If Trump and the GOP succeed in overturning the Affordable Care Act, millions of Americans will lose coverage and access to life-saving prescription drugs. This is a fight for basic human rights. #ProtectOurCare”. January 15, 2020: America’s Health Insurance Plans posted a statement on their website titled: “AHIP Issues Statement Upon Filing an Amicus Brief with the Supreme Court Requesting Certiorari in TX v US”. From the statement: Matt Eyles, president and CEO of America’s Health Insurance Plans (AHIP), issued this statement as the association filed an amicus brief with the Supreme Court requesting certiorari in TX vs US and timely consideration of the validity of the Affordable Care Act (ACA):“Every American deserves affordable coverage and high-quality care. This has been – and always will be – our committment.“The district court’s original decision to invalidate the entire ACA was misguided and wrong. We urge the Supreme Court to grant certioari and remove the overhanging legal uncertainty that undermines the stability of coverage for nearly 300 million Americans, and that inhibits greater and faster progress to improve coverage and care for everyone.“As we indicated in our brief, returning this case to the district court on remand only delays what Congress has unmistakably indicated through its actions: that the ACA should continue in operation despite its zeroring out of the mandate. We are confident that the Supreme Court will ultimately recognize that zeroing out the mandate was never intended to wreak havoc across the entire American health care system.“As we continue to engage in the legal process, health insurance providers remain committed to serving all of their members, and to strengthening affordability, access, and choices for every American.” January 16, 2020: Planned Parenthood posted a press release titled: “Planned Parenthood Condemns Proposed Rules that Would Grant Recipients License to Discriminate”. From the press release: Today, as part of a series of similar rules released across several federal agencies, the Trump-Pence administration’s Department of Health and Human Services (HHS) and U.S. Agency for International Development (USAID) proposed religious refusal rules that would strip away critical protections from people rely on federally funded health and social services programs both domestically and abroad. The rules also make it substantially easier for faith-based organizations to receive tax-payer funding while simultaneously promoting their religion. They would eliminate protections that require faith-based organizations to notify people that they are serving about their rights, and refer them to other services providers if desired.This is the latest in a long line of dangerous policies that could impact peoples’ abilities to access HIV and STI prevention programs, reproductive health services and other vital health care; youth homelessness services; and foster care and adoption services. They represent a concerted effort by the Trump-Pence administration across the federal government to attack access to sexual and reproductive health care and other services by taking funds from qualified providers and give them to religious entities that may not provide comprehensive services……Discrimination in health care already prevents too many LGBTQ people from accessing care. According to the 2015 U.S. Transgender Survey, 33 percent of respondents who sought health care in the last year experienced mistreatment, including violence, because they were transgender – and nearly one-quarter avoided seeking health care service when they needed them out of fear of discrimination. Nearly one-third of transgender people surveyed said a doctor or health care provider refused to treat them due to their gender identity.When women are denied access to the full range of reproductive services, rates of unintended pregnancy, maternal mortality, mental health conditions, and sexually transmitted infections increase. Access to contraception also impacts women’s educational attainment, participation in the workforce, and economic growth. January 16, 2020: The American Civil Liberties Union (ACLU) posted a news article titled: “Arkansas Legislators’ Attack on Abortion is Unconstitutional.” It was written by Michele Goodwin and David S. Cohen. From the article: The U.S. Supreme Court has ruled time and time again that reproductive privacy is “central to personal dignity and autonomy, [which] are central to the liberty protected by” the Constitution. The Court has made eminently clear that under the Constitution, the right of a pregnant person to terminate a pregnancy prior to viability is a right so essential to our freedom that our government cannot ban or impose an undue burden on its exercise. But despite long-standing clarity of this principle, reproductive health and rights continue to come under blistering, unrelenting attack……Enough is enough. That’s why we, along with our colleagues and fellow scholars in constitutional law, filed a friend of the court brief in the 8th Circuit last week, speaking up against Arkansas’s recent attempts to interfere with the right to reproductive autonomy. Right now, Arkansas is asking the 8th Circuit to overturn a lower court order that blocked a set of abortion bans and restrictions the state passed last year from taking effect. These laws include: a ban on doctors performing abortions prior to viability if the abortion is sought after 18 weeks (18-weeks ban); a ban on doctors performing abortions prior to viability if the doctor has “knowledge” that the abortion is sought “solely” due to a belief that the fetus may have Down syndrome (reason ban); and a medically unnecessary restriction on the types of physicians who can perform abortion in the state, which would prohibit all qualified providers who are not board-certified or board-eligible in obstetrics and gynecology from continuing to provide the safe, compassionate abortion care they have been providing in Arkansas for years (OBGYN requirement).Arkansas insists that its two bans on pre-viability abortion are not actually bans but merely “regulations.” This is nothing but Orwellian subterfuge. We know a ban when we see one and so do people looking to terminate their pregnancies. Regulations are laws that control how a right can be exercised. Bans prohibit a right from being exercised at all. And that is exactly what the 18-week ban and reason ban would do if permitted to take effect……Thankfully, a district court saw through Arkansas’s sophistry and phony justifications and preliminary enjoined the state’s two bans on abortion prior to viability and OBGYN requirement, with a decision rooted in long-standing precedent and bedrock precedent of justice. Let’s hope the Eight Circuit Court of Appeals follows our brief and heeds the wisdom of the lower court, preserving not only that decision but also the civil rights and civil liberties of all people who want to terminate a pregnancy. January 16, 2020: New York Attorney General Letitia James posted a press release on her official website titled: “Multiple Groups Join Attorney General James in Urging Supreme Court To Take Up ACA Case”. From the press release: New York Attorney General Letitia James today announced that a diverse group of bipartisan patient groups, hospitals, health care providers, insurance companies, economists, and others filed multiple amicus briefs supporting a multistate effort to defend the Affordable Care Act (ACA). The amici urge the U.S. Supreme Court to grant expedited review of the coalition’s case and argue that such review is necessary to protect America’s health care system and the well-being of Americans across the nation.“Despite what the president may tweet, all he wants to do is strip health care away from 133 million Americans with pre-existing conditions, make it harder for children and young people to obtain coverage, and charge Americans more for health care,” said Attorney General James. “Obamacare has been the law of the land for a decade, but President Trump and his Administration continue to look for ways to chip away all the protections of the health care reform law. A wide-ranging and diverse group of organizations is joining our fight today to protect the ACA because health care should be a right every American has access to, not a privilege for a select few.”The amicus briefs filed today support the state coalition’s request for the Supreme Court to review a recent decision by the U.S. Court of Appeal for the Fifth Circuit that upheld a lower ruling finding the ACA’s individual mandate to be unconstitutional, and that simultaneously called into question whether the remaining provisions of the law could still stand. The state coalition has asked that the Supreme Court grant expedited review of this decision and decide the case before the court’s term ends in June – a resolution that is needed to alleviate the uncertainty created by this litigation.The ACA – also known as Obamacare – contains hundreds of protections that countless Americans rely on for health care, including: Prohibiting insurers from denying health insurance to the 133 million Americans with pre-existing conditions (like diabetes, cancer or pregnancy) or from charging individuals higher premiums because of their health status;Allowing young people, up to the age of 26, to stay on their parents’ insurance; Expanding Medicaid to provide health coverage to more than 12 million Americans, including young children and babies;Providing tax credits and financial assistance to nine million low- and middle-income individuals and families, so they can access affordable health coverage through the ACA marketplace; andPreventing insurance companies from imposing lifetime and yearly insurance limits, among other benefits. Amicus briefs in support of the state coalition’s request for expedited review by the Supreme Court were filed by America’s Health Insurance Plans (AHIP), National Hospital Associations; Small Business Majority Foundation, American Cancer Society, et al, State Hospital Associations, AARP, et all, and Bipartisan Scholars.Joining Attorney General James in defending the ACA are the attorneys general of California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Massachusetts, Michigan, Minnesota (by and through its Department of Commerce), Nevada, New Jersey, North Carolina, Oregon, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia, as well as the governor of Kentucky. January 16, 2020: California Attorney General Xavier Becerra posted a press release on his official website titled: “Diverse, Bipartisan Coalition Supports Attorney General Becerra’s Defense of the ACA, Urges Supreme Court to Act”. From the press release: California Attorney General Xavier Becerra today announced that a diverse group of bipartisan economists, patient groups, hospitals, healthcare providers, healthcare insurance companies, and others filed amicus briefs defending the Affordable Care Act. The diverse coalition of amici supports California’s state coalition in its fight to protect the Affordable Care Act. The amici urge the Supreme Court to grant review of California’s case and argue that it is necessary to protect America’s healthcare system and the well-being of Americans across the nation.“For nearly a decade, the Affordable Care Act has been the backbone of our nation’s healthcare, paving the way toward better care with protections that keep our loved once healthy and covered,” said Attorney General Becerra. “Our healthcare should never be used as a political football – people’s health isn’t a game, it’s a matter of life and death. Today, a bipartisan coalition of legal experts, patient and physician advocates, economists, and public health experts agree: This repeal lawsuit will cause immense harm and uncertainty, so our fight to save affordable healthcare must go all the way to the Supreme Court.”… January 16, 2020: The National Women’s Law Center posted a press release titled: “Federal Court Allows Challenge to Proceed Against Trump Administration and University of Notre Dame’s Back-Room Birth Control Agreement”. From the press release: Today, the U.S. District Court from the Northern District of Indiana ruled to allow a lawsuit brought by the National Women’s Law Center (NWLC) Americans United for Separation of Church and State (Americans United), the Center for Reproductive Rights (CRR), and law firms Fried Frank and Macey Swanson to proceed against the Trump-Pence Administration and University of Notre Dame.The lawsuit is brought on behalf of student group Irish 4 Reproductive Health and others on Notre Dame’s health plan and challenges the unlawful settlement agreement between the Administration and the University of Notre Dame that denies students and employees coverage of birth control guaranteed to them by the Affordable Care Act. It also challenges rules issued by the Trump-Pence Administration that allow virtually any employer or university to take birth control coverage away from employees and students. The court denied the Administration’s and University’s attempt to dismiss the lawsuit.The following is a statement by Fatima Goss Graves, president and CEO of the National Women’s Law Center (NWLC):“Today’s ruling sends a clear message to the Trump-Pence Administration that it cannot deny birth control coverage by entering into backroom deals or issuing unlawful rules. The Administration is once again trying to circumvent the law, and it must end. This is a win not only for Notre Dame students, but for everyone seeking access to birth control. We will keep fighting until every person across the country has the birth control coverage guaranteed to them by law, no matter where they work or go to school.” January 16, 2020: The American Civil Liberties Union (ACLU) of South Dakota posted a press release titled: “ACLU of South Dakota Opposes House Bill 1057”. From the press release: The ACLU of South Dakota opposes House Bill 1057, a bill that would criminalize doctors for providing medically necessary care for transgender youth.The bill, which was introduced Tuesday, would make it a felony for medical providers to treat youth consistent with evidence-based treatment protocols. HB 1057 continues the streak of bills that would codify discrimination against transgender youth that the South Dakota Legislature has attempted to pass over the last five years.Like all health care, health care for transgender youth is individualized and based on the needs of each particular person. This bill would take away private health care choices around the provision of medical care consistent with prevailing medical and scientific standards. Such choices should be made between a doctor and a patient, not politicians……By blocking medical care supported by every major medical association, including the American Academy of Pediatrics and the American Medical Association, the legislature is compromising the health of trans youth is dangerous and potentially life-threatening ways. Research shows that transgender youth whose families affirm their gender identity have a 52 percent decrease in suicidal thoughts, a 48 percent decrease in suicide attempts and significant increases in self-esteem and general health.No other state has passed a law like HB 1057. It is unconstitutional to single out one group of people and categorically ban all care, no matter how medically necessary… January 16, 2020: Governor Phil Murphy posted a press release on his official website titled: “Governor Murphy Signs Legislative Package Protecting the Affordable Care Act in New Jersey”. From the press release: Governor Phil Murphy today signed a package of bills to safeguard the provisions of the Affordable Care Act (ACA) in New Jersey. The bills, which will codify into state law the basic protections for health care consumers that are part of the Affordable Care Act, include protections for no-cost preventative care and contraception, prohibt exclusions for pre-existing conditions, allow children to stay on their parents’ plan until age 26 and incorporate mental health and maternity care as part of essential benefits, among others. The Governor highlighted the importance of these bills during an armchair discussion with Hackensack Meridian Health Chief Executive Office Bob Garrett… The Governor signed the following bills into laws: A5500 Expands rate review process in DOBI for certain individual and small employer health plans.AB5501 Requires continuation of health benefits dependent coverage until child turns 26 years of age.A5503 Establishes open enrollment period under Individual Health Coverage PlansA5504 Applies 85 percent loss ratio requirement to certain large group health benefits carriersA5506 Repeals statute authorizing offering of “Basic and Essential” health benefits plans under individual health benefit plans and other statutes concering basic health plans; makes confirming amendments.A5507 Requires health benefits coverage for preventative services.A5508 Revises law requiring health benefits coverage for contraceptivesA5248 Preserves certain requirements that health insurance plans cover essential health benefitsS626 Clarifies prohibition on preexisting condition exclusion in health insurance policies. As a clarification, A5508 is described as: “Federal changes to the Affordable Care Act aimed to jeopardize women’s access to safe, preventative care. This new law will remove those obstacles in New Jersey and preserve the benefits afforded to residents’ under the ACA. With this law, women will continue to have insurance that covers contraception without having to pay out of pocket.” January 16, 2020: The American Civil Liberties Union (ACLU) posted an article titled: “Lawmakers Playing Politics with Trans Kids’ Lives at the Start of the Decade”. It was written by Chase Strangio, Deputy Director for Transgender Justice. From the article: We’re just days into the first state legislative sessions of 2020 and across the country, lawmakers are once again targeting transgender young people with a slate of proposed laws that would bring devastating harms to the transgender community.In 2016, lawmakers fixated on where transgender people go to the bathroom. This year, lawmakers are zeroed in on transgender people playing sports and receiving life-saving medical care. It’s hard to imagine why state legislators have decided to prioritize barring transgender young people from sharing in the benefit of secondary school athletics or disrupting medical treatment consistent with prevailing standards of care. But here we are, the state of a session, a time to fight.As has been the case since 2015, South Dakota is leading the way with legislation targeting transgender youth. On the first day of this legislative session, South Dakota lawmakers introduced HB 1057, a bill that would make it a felony for medical providers to affirm a transgender minor’s gender. This bill would not only compromise positive health outcomes for transgender youth, but it would lead to the arrest and imprisonment for doctors simply for treating patients consistent with prevailing medical standards……Denying best practice medical care and support to transgender youth can be life-threatening. It has been shown to contribute to depression, social isolation, self-hatred, risk of self-harm and suicidal behavior, and more. The “problem” this bill and other similar bills in Florida, South Carolina, and Missouri is supposed to be addressing? That medical providers are treating children in accordance with long-established standards of medical care and the Hippocratic oath they took to do no harm.Lawmakers want to stop people from being transgender and they are willing to put doctors in jail and tell transgender youth that they shouldn’t receive health care in order to achieve their aims… January 17, 2020: Representative Hakeem Jeffries tweeted: “More than 100 million ppl have a preexisting condition. President Obama’s leadership provided healthcare protection for these Americans. Donald Trump is trying to strip it away. Those are the FACTS.” January 17, 2020: Reuters posted an article titled: “Supreme Court to hear Trump appeal in Obamacare contraception fight”. It was written by Lawrence Hurley. From the article: The U.S. Supreme Court on Friday took up an appeal by President Donald Trump’s administration seeking to enforce new federal rules allowing employers to obtain religious exemptions from an Obamacare requirement that health insurance that they provide to employees pays for women’s birth control.At issue is a challenge by the states of Pennsylvania and New Jersey to the administration’s 2018 rule that permits broad religious moral exemptions to the Affordable Care Act’s contraception mandate and expands accommodations already allowed under the 2010 law dubbed Obamacare. The administration has asked the Supreme Court to reverse a nationwide injunction issued by a lower court blocking the rule from taking effect.Arguments in the case before the high court, which has a 5-4 conservative majority including two justices appointed by Trump, are likely to be in April with a ruling due by the end of June……The legal question is whether Trump’s administration had legal authority to expand the exemption both under the Obamacare law itself and another federal law, the Religious Freedom restoration Act, which allows people to press religious claims against the federal government.The Philadelphia-based 3rd U.S. Circuit Court of Appeals last year upheld a nationwide injunction issued by a district court judge in the lawsuit by New Jersey and Pennsylvania, blocking implementation of the rule. Separately, the San Francisco-based 9th U.S. Circuit Court of Appeals last year upheld a lower court’s injunction on blocking the rule in a group of 14 states… January 17, 2020: Senator Bob Casey tweeted: “The ACA dramatically reduced racial disparities in health insurance coverage. In PA alone, the uninsured rate among Black and Hispanic adults each decreased by more then 11% from 2013 to 2018. This obscene Republican lawsuit threatens these gains. We must #ProtectOurCare” January 17, 2020: CBS News posted an article titled: “Supreme Court to hear Obamacare birth control case”. From the article: The Supreme Court will weigh in on contraceptive coverage under the nation’s health care law this term, agreeing to hear a case involving the Obamacare rule requiring large companies to help pay for their employees’ birth control. The high court will review whether the Trump adminisration was on solid ground when it gave religious employers and universities broader religious and moral exemptions to the Obamacare contraception mandate, which requires health care plans to offer free birth control.This is another case involving the Little Sisters of the Poor, an order of Roman Catholic nuns that objected to the birth control mandate and prevailed in its request from the Supreme Court for a religious exemption in 2016.Now the court will consider allowing the Trump adminisration to enforce rules that allow more employers to deny coverage for contraceptives to women.The case is likely to be heard in April. The Supreme Court will review an appeals court ruling that blocked the Trump administration rules because it did not follow proper procedures. The new policy on contraception, issued by the Department of Health and Human Services (HHS), would allow more categories of employers, including publicly traded companies, to opt out of providing no-cost birth control to women by claiming religious objections.The policy would also allow some employers, though not publically traded companies, to raise moral objections to covering contraceptives… January 17, 2020: National Women’s Law Center posted a press release titled: “SCOTUS to Hear Case That Threatens Access to Birth Control, Says NWLC”. From the press release: Today, the Supreme Court decided to hear a case – Trump v. Pennsylvania – that will determine whether employers and schools can deny insurance coverage of birth control to employees and students.In November 2018, the Trump-Pence administration finalized rules to undermine Affordable Care Act’s birth control benefit by allowing virtually any employer or university to deny birth control coverage otherwise required by law. These rules were challenged in courts across the country including by the National Women’s Law Center. In a case brought by Pennsylvania and New Jersey, the 3rd Circuit Court of Appeals issued a nationwide injunction blocking the rules.The following is a statement from Fatima Goss Graves, President and CEO of the National Women’s Law Center:“Birth control should never be determined by where someone lives or goes to school. The Supreme Court should affirm the lower court’s decision that these rules are illegal and harmful. We won’t stop fighting until all people have access to birth control despite these vicious attacks by the Trump-Pence administration.” January 17, 2020: Planned Parenthood posted a press release titled: “Supreme Court to Consider Trump Policy Allowing Employers and Universities to Deny Birth Control Coverage to Employees and Students”. From the press release: Today, the Supreme Court announced it would consider the validity of the Trump-Pence administration’s rules that allow employers and universities to refuse to provide insurance coverage for all contraception to their employees or students. These rules are currently blocked by the courts.This is the first time the Supreme Court will consider the issue of contraceptive coverage since Trump-appointed justices Neil Gorsuch and Brett Kavanaugh joined the Court……The Trump-Pence administration’s birth control rules allow employers, universities and any entity that provides health insurance to deny a person birth control coverage based on religious or moral objection. These harmful rules could have far-reaching implications for the Affordable Care Act’s requirement to guarantee birth control coverage which has benefited more than 62 million women, including 17 million Latina women and 15 million Black women.Data shows that an overwhelming majority of Americans believe women should have birth control coverage, regardless of their employer’s personal objections. This rule puts the Trump-Pence administration in direct opposition to the overwhelming majority of voters. January 18, 2020: SFGATE posted an article titled: “Louisiana Medicaid managed care contract awards thrown out”. It was written by Melinda Deslatte. From the article: Multibillion-dollar Medicaid contracts awarded by Gov. John Bel Edwards’ administration have been scrapped by Louisiana’s chief procurement officer, who determined the health department mishandled the bid process for deals to provide health services to 1.5 million people.Louisiana’s state procurement officer Paula Tregre said the health department failed to follow state law or its own evaluation and bid guidelines in determining which private companies should receive contracts to manage care for most of Louisiana’s Medicaid patients. In a decision issued late Friday, Tregre wrote the health department’s actions “resulted in a fatally flawed procurement process.”In response to protests filed by two losing bidders, Tregre rescinded the three-year contract awards estimated to be worth about $21 billion. She said the health department will have to redo the bid process to choose the insurance companies that will oversee care for about 90% of Louisiana’s Medicaid enrollees – mostly adults covered by Medicaid expansion, pregnant women and children.Tregre’s decision, which can be contested, won’t disrupt Medicaid health services to nearly one-third of Louisiana’s population. The Edwards administration signed emergency contracts to keep the state’s five current Medicaid managed care contractors in place this year because of the ongoing disputes about the contract awards and bid process… January 18, 2020: Morning Call posted an article titled: “Pennsylvania Democrats prod Republicans over Obamacare’s fate this election year”. It was written by Ford Turner. From the article: Pennsylvania House Democrats have dusted off a seldom-used legislative maneuver to push Republican action on health bills – including one on pre-existing conditions – that Democrats say will help if the Affordable Care Act gets nullified in the courts.“Discharge resolutions” filed in the state House last week push four stalled bills that work as a package, according to Democrat spokesman Bill Patton……The move comes as Democrats nationwide, cognizant of election-year ramifications, take steps to draw attention to the Trump administration’s vow to end Obamacare. A special focus is being placed on the law’s widely popular guarantees of preexisting condition coverage and parental plan coverage of offspring up to age 26……Pennsylvania’s House Democrats, including Allentown’s Peter Schweyer, said the state must act. Schweyer is prime sponsor of a bill that would preserve access to insurance and doctors by people with preexisting conditions even if Obamacare is thrown out. New Jersey’s Democratic governor on Thursday signed into law a bill on the same topic.Three other Pennsylvania bills mandate that insurance policies sold in Pennsylvania include coverages required by Obamacare, preserve coverage for adult children up to age 26, and ensure there are no “lifetime limits” on health care coverage……But the four have received no action in the House Insurance Committee despite being sent there more than 10 months ago. Republicans control the state House and Senate… January 19, 2020: NJ.com posted an article titled: “Murphy enacts laws to protect Obamacare benefits in N.J. from Trump cuts”. It was written by Susan K. Livio. From the article: Gov. Phil Murphy has signed a package of legislation that enshrines the tenets of the Affordable care Act into state law, giving New Jersey the authority to operate its own insurance marketplace and protect people with pre-existing conditions from losing coverage.The laws are a guard against pending legal threats to the landmark health care law, which in New Jersey insured 500,000 low-income people through the Medicaid program and 255,000 others who found coverage through the public marketplace last year.Murphy expects the state will operate its own Healthcare.gov marketplace later this year, enabling it to keep the $50 million it sends to the U.S. Centers for Medicare and Medicaid Services every year to handle that responsibility. The state would also be able to set a longer open enrollment period, which President Donald Trump’s administration cut in half to six weeks.The nine bills Murphy, a Democrat, signed into law Thursday protects benefits, such as coverage for pre-existing conditions and adult children up to age 26, that may be at risk should the courts or Congress repeal or furthe weaken the Affordable Care Act, also known as Obamacare… Here is a list of the bills Governor Phil Murphy signed: S626 – prevents carriers from denying a policyholder coverage because of a pre-existing medical conditionA5248 – requires insurance companies to cover benefits deemed essential under Obamacare and protects older people and people with disabilities from discriminationA5500 – creates a more rigorous review process for carriers seeking more than a 10 percent annual rate increaseA5501 – allows adult children to remain on their parents’ health coverage until they turn 26A5503 – establishes an open enrollment period for the state’s existing Individual Health Coverage ProgramA5504 – requires large insurance carriers to report their “medical loss ratio” to the state to prove they are spending at least 85 percent of premiums on medical-related expenses and keeping no more than 15 percent on administration, fees and profits. Policyholders would receive a credit if carriers keep too much money.A5506 – repeals the law allowing insurance carriers to offer “basic and essential” plans that do not contain the 10 benefits required under the ACA, such as maternity care, substance abuse treatment and mental health treatment and prescription drugsA5507 – provides free cancer and other preventative health screeningsA5508 – requires coverage for contraceptives January 19, 2020: Senator Patty Murray tweeted: “Let me be clear: the Republicans’ partisan health care lawsuit would put them one step closer to getting the health care plan they’ve always wanted – one that kicks millions of people off their care & takes away protection they rely on. We must keep fighting to #ProtectOurCare”. January 19, 2020: Herald-Tribune posted a Guest-Editorial titled: “Floridians are losing access to affordable health care.” It was written by Florida House of Representatives Margaret Good. From the Guest-Editorial: The health of Florida families is in jeopardy. More than 2.5 million Floridians are not covered by health insurance and prescription drug costs continue to rise.These are among the issues I hear about most from the people I serve. It is time for the Legislature to make real change to increase coverage and lower costs. This session, I filed House Bill 1293, which addresses access and costs.While Florida already has one of the highest uninsured rates in the country, the stage is set for the crisis to worsen. More than 3.5 million Floridians with preexisting conditions may lose access to affordable care, depending on the outcome of a court case challenging parts of the Affordable Care Act. If the special interests behind this lawsuit are successful, insurers will be free to charge Floridians with preexisting conditions whatever they want, effectively pricing people with preexisting conditions out of the market.This is especially concerning because of a bill that passed the Florida Legislature last session that allows insurers to sell short-term health insurance policies that avoid the pricing and term requirements of the ACA. Consumers who purchase these policies often believe they have comprehensive coverage, when, in fact, the short-term policy may exclude medically necessary treatment. This leaves Floridians, especially those with preexisting conditions, vulnerable……There are no federal or Florida regulations of the pharmaceutical industry’s pricing structure. House Bill 1293 holds pharmaceutical companies accountable by creating a Prescription Drug Affordability Commission, which would review increases in prescription drug prices, ensuring that companies cannot raise prices indiscriminately… January 19, 2020: Senator Ron Wyden tweeted: “Thanks to Republicans’ lawsuit against the Affordable Care Act, health care coverage for Americans with pre-existing conditions is once again on the chopping block. One thing remains certain: @morethanmySLE and I are committed in the fight to #ProtectOurCare” January 19, 2020: Axios posted an article titled: “Scoop: “Birth tourism” is Trump’s next immigration target”. It was written by Stef W. Knight and Jonathan Swan. From the article: The Trump administration has a new target on the immigration front – pregnant women visiting from other countries – with plans as early as this week to roll out a new rule cracking down on “birth tourism,” three administration officials told Axios.Why it matters: Trump has threatened to end birthright citizenship and railed against immigrant “anchor babies.” The new rule would be one of the first tangible steps to test how much legal authority the administration has to prevent foreigners from taking advantage of the 14th Amendment’s protection of citizenship for anyone born in the U.S……How the new regulations would work: It would alter the requirements for B visas (or visitor visas), giving State Department officials the authority to deny foreigners the short-term business and tourism visas if they believe the process is being used to facilitate automatic citizenship… January 20, 2020: The Columbus Dispatch posted an article titled: “‘Business negotiations’ result in Ohio’s Medicaid network losing 272 pharmacies”. It was written by Marty Schladen. From the article: Ohio Medicaid Director Maureen Corcoran says she was told that both CVS and Walgreens demanded last year that the other be excluded from the network of the state’s largest managed-care provider – a statement they both deny,Despite months of questions about the matter, it was the first time the state’s Medicaid chief acknowledged that she had been told that both pharmacy giants had demanded cuts to the provider network as the price of doing business with the federal-state health-care program. She also said it was hearsay.Meanwhile, CareSource, the Dayton-based company that, according to Corcoran, told her of the demands, continues its practice of not answering questions on the subject from The Dispatch.CareSource receives almost $8 billion a year from Ohio taxpayers. It is the largest contractor and its biggest Medicaid managed-care organization. But Corcoran expresses a disinterest in negotiations that have slashed 272 pharmacies from a network that serves almost 3 million poor Ohioans……CareSource would not comment on whether the big chains demanded each others’ ouster……As it has since this past fall, Walgreens said it did not ask that CVS be eliminated……CVS also said it did not demand that Walgreens be dropped… January 20, 2020: Senator Patty Murray tweeted: “Republicans are putting health care in our country on a completely avoidable, catastrophic crash course w/ their partisan lawsuit. I urge President Trump & Republicans to listen to patients & drop their partisan & deeply harmful attacks on families’ health care. #ProtectOurCare” January 20, 2020: The Hill posted an article titled: “Trump scrambles to defend pre-existing conditions record amid ObamaCare lawsuit”. It was written by Peter Sullivan. From the article: President Trump, who is backing a court challenge to the Affordable Care Act that would overturn the law and eliminate its protections for people with pre-existing conditions, is now tweeting about how he saved those protections.In an election year where Democrats are vowing to focus on health care, Trump’s tweets suggest he is recognizing the political danger posed by his support for the GOP-led lawsuit.Trump’s efforts have been undercut not only by the court challenge but also his repeated vows to repeal the 2010 law, including support for a House Republican bill in 2017 that would have allowed for weakening protection for pre-existing conditions… January 20, 2020: Reuters posted an article titled: “Women rarely regret decision to get abortion”. It was written by Lisa Rapaport. From the article: Five years after an abortion, most women still say it was the right decision even if they struggled with their choice at the time, a U.S. study suggests.Researchers surveyed 667 women who had abortions in 21 states a week after they had the procedures and then once every six months for five years. By the end of that period, 84% of women had either positive or neutral feelings about their choice.“We found no evidence of emergent negative emotions about the abortion over the five years,” said study leader Corinne Rocca of the University of California, San Francisco.“In fact, of all the emotions we looked at, relief remained the most commonly reported one at all times, even five years out,” Rocca said by email.Opponents of abortion have argued against legal access to these procedures in part because of concerns that abortion harms women by causing emotions and regret, researchers note in Science and Medicine. This idea has contributed to state laws and court decisions limiting abortion as well as state policies requiring women seeking abortions to be warned it might cause lasting emotional or mental harm, the study team notes… January 20, 2020: Houston Chronicle posted an article titled: “Critics: consumers should be wary of short-term health plans”. It was written by Kelli Kennedy. From the article: Consumers who bought short-term health insurance thinking they had found a better deal than “Obamacare” during the open enrollment season may be in for a shock when they show up at their doctor’s office this year.The low-cost plans aren’t required to cover basics such as prescription drugs or maternity care.The Trump administration rolled back restrictions on short-term plans in 2018. But critics quickly labeled them junk insurance, warning they come with gaps and don’t have to cover pre-existing medical conditions……With premiums about a third of the cost of comprehensive coverage, short term plans are significantly cheaper but don’t meet requirements under the Affordable Care Act. And while they cover major catastrophes such as a car accident, they don’t have to cover the law’s “essential benefits” – including mental health and substance abuse treatment and they won’t cover pre-existing conditions……Some short-term insurance companies are calling customers directly and repeatedly, said Islara Souto, a program director for Epilepsy Florida, which helps consumers secure health plans in Miami.“These plans are being targeted to those consumers in Spanish with misleading facts,” said Souto, adding some try to appear they’re from the federal marketplace by calling themselves the “Coverage Department”… January 21, 2020: CBS News posted an article titled: “Supreme Court declines to fast-track Obamacare case”. From the article: The Supreme Court refused Tuesday to consider a fast-track review of a lawsuit that threatens the Obama-era health care law, making it highly unlikely that the justices would decide the case before the 2020 election. The decision comes hours before Chief Justice John Roberts will preside over the president’s impeachment trial.The court denied a request by 20 mainly Democratic states and the Democratic-led House of Representatives to decide quickly on a lower-court ruling that declared part of the statute unconstitutional and cast a cloud over the rest……The justices did not comment on their order. They will consider the appeal on their normal timetable and could decide in the coming months whether to take up the case… January 21, 2020: New York Attorney General Letitia James posted a press release on her official website titled: “Attorney General James’ Statement On Supreme Court Decision to Not Expedite ACA Case”. From the press release: New York Attorney General Letitia James today released the following statement after the U.S. Supreme Court announced that it was denying a motion to expedite review of a decision in litigation threatening the Affordable Care Act (ACA):“While the Supreme Court has said it will not expedite its review, we are still urging the court to hear arguments next term. Day after day, President Trump makes false statements, sends misleading tweets, and spouts outright lies about Obamacare and the many protections the law has provided to millions across the country. Our coalition will never stop fighting against the president’s continued efforts to strip health coverage away from American families, including the 133 million Americans with pre-existing conditions.”Earlier this month, Attorney General James and a coalition of attorneys general from around the nation filed a motion asking the Supreme Court to expedite its review of a recent decision by the U.S. Court of Appeals for the Fifth Circuit in Texas v. U.S. The decision affirmed a lower court’s ruling that the individual mandate of the Affordable Care Act (ACA) is unconstitutional, yet refused to rule on the validity of the rst of the ACA – calling into question whether the remaining provisions of the statute could still stand, including those that protect and provide coverage to Americans with pre-existing conditions. Because this decision causes uncertainty that many harm the health of millions of Americans – in addition to doctors, clinics, patients, and the healthcare market – Attorney General James and the coalition petitioned the Supreme Court to take up the case and resolve it before the end of the court’s current term in June.While the Supreme Court did not expedite its review of the states’ petition, it is still reviewing the petition and has not yet determined whether it will grant review and hear arguments next term. Under the Fifth Circuit’s decision, the district court that originally ruled on the case will rehear and reconsider the validity of the rest of the health care reform law…. January 21, 2020: AARP posted information on its website titled: “Supreme Court Says No to Fast Review of ACA Ruling”. It was written by Dena Bunis. From the information: The U.S. Supreme Court will not take up a federal court ruling that said a key provision of the Affordable Care Act (ACA) is unconstitutional. The high court’s refusal on Tuesday to fast-track a review means all the protections of the ACA remain in force but the long-term status of the law remains uncertain.AARP and AARP Foundation joined two otehr nonprofit groups that fight for older Americans – Justice in Aging and the Center for Medicare Advocacy – in filing an amicus brief on Jan. 15 asking the high court to review a December 2019 rulng by the Court of Appeals for the 5th Circuit. That decision struck down the ACA’s individual mandate but left the fate of the rest of the law in the hands of a lower court judge who has already declared the entire law invalid. While the justices declined to fast-track an appeal, the Supreme Court could decide to hear the case at a later time… January 21, 2020: California Health & Human Services Agency posted a press release titled: “Health and Human Services Agency Announces Formation of Governor Newsom’s Behavioral Health Task Force to Address Urgent Mental Health and Substance Use Disorder”. From the press release: Following the unveiling of his budget proposal with its robust focus on improving behavioral health services, the California Health and Human Services Agency announced the formation today of Governor Gavin Newsom’s Behavioral Health Task Force to address the urgent mental health and substance use disorder needs across California. The panel will advise the Administration’s efforts to advance statewide behavioral health services, prevention, and early intervention to stabilize conditions before they become severe.“Behavioral health services and wellness are essential to living a healthy, happy, and fulfilling life,” said Governor Newsom. “All Californians should be able to get the mental health and substance use disorder assistance they need when they need it. We must also prevent these conditions when possible, and intervene early to reduce their severity, particularly among younger Californians.”The task force, chaired by Health and Human Services Agency Secretary Dr.Mark Ghaly, will consist of a broad range of stakeholders, including people living with behavioral health conditions – including mental health and substance use disorders, family members, adovocates, providers, health plans, counties, and state agency leaders……The mission of the task force is to develop recommendations for the Governor about ho California can best provide timely access to high-quality behavioral health care for all of its residents. The task force will include representatives from both the public and private sectors to align efforts to address behavioral health challenges from a public health perspective. What’s more, the task force will inform and bolster the state’s work to prevent mental health and substance use disorders and ensure that health and social service providers are able to intervene early to stabilize conditions before they become severe… January 21, 2020: The Hill posted an article titled: “Trump health chief: “Not a Need” for ObamaCare replacement plan right now.” It was written by Peter Sullivan. From the article: Secretary of Health and Human Services Alex Azar said Tuesday that “there’s really not a need” for the Trump administration to put forward an ObamaCare replacement plan at the moment. Azar was asked where the administration’s replacement for the health law is in an interview on the “Kevin Wall Radio Show.” He replied that there is not a need for one until the Supreme Court issues a final ruling on a GOP-backed lawsuit seeking to overturn the law……He also added that the administration could need a replacement if Republicans win back the House in this year’s election but noted that the current Democratic-led House has no interest in repealing and replacing ObamaCare……Azar’s comments stand in contrast to what President Trump said in an interview with ABC News in June. “We’ll be announcing that in about two months,” Trump said at the time when asked about an ObamaCare replacement plan… January 21, 2020: Speaker Pelosi posted a press release on her official website titled: “Pelosi Statement on Supreme Court’s Decision to Delay Review of ACA Lawsuit”. From the article: Speaker Nancy Pelosi issued this statement following the decision by the U.S. Supreme Court to not expedite review of Republicans’ Texas v. U.S. lawsuit, which, last month, the 5th Circuit Court of Appeals sided with the Republicans and instructed the District Court to redetermine how much of the Affordable Care Act to strike down:“Today’s disappointing decision by the Supreme Court only prolongs and worsens the uncertainty and fear that Republicans’ anti-health care agenda is inflicting on American families. The longer this GOP lawsuit continues, the longer it will needlessly drive up costs and endanger life-saving protections for people with pre-existing conditions.“The Trump Administration and its GOP allies have engaged in an outrageous sabotage campaign to systematicaly destroy protections for the millions of Americans with pre-existing conditions as well as every last benefit and protection provided by the Affordable Care Act. In the courts and in the Congress, the Democratic House Majority will continue to fight relentlessly to defend Americans’ health care as we work to preserve protections for people with pre-existing conditions and deliver lower health costs and prescription drug prices for all Americans.” January 21, 2020: New Jersey Governor Phil Murphy posted a press release on his official website titled: “Governor Murphy Signs Prescription Drug Bill to Limit Out-Of-Pocket Prescription Drug Expenses for New Jersey Families”. From the press release: Governor Phil Murphy today signed legislation (A2431) to help limit out-of-pocket prescription drug expenses for New Jersey families. The bill, which requires health insurers to provide plans that limit patient cost-sharing concerning prescription drug coverage, will improve affordability and access for thsoe who require necessary medication.“Few issues have a greater financial impact on New Jersey families than the unpredictable and ever-increasing cost of preventative drugs,” said Governor Murphy. “Cost-sharing too often presents a barrier to a patient’s ability to access medically-necessary treatments. This legislation will improve the affordability of medical care for many residents who unfortunately must make sacrifices in order to pay for their required medications.”… January 21, 2010: New Jersey Governor Phil Murphy posted a press release on his official website titled: “Governor Murphy Signs Legislation to Improve Hospital Transparency and Expand Reporting Requirements.” From the press release: Govenor Phil Murphy today signed legislation (A5916 and A5918) to improve hospital transparency and expand reporting requirements. The bills, which will provide more financial and operational insight into New Jersey’s hospitals, will ensure that these facilities will not abruptly discontinue services and leave communities without access to care. Today’s signings build upon Governor Murphy’s signing of A5917 last week, which increased the Department of Health’s oversight of hospital finances.“New Jersey is home to some of the nation’s leading hospitals, health care facilities, and treatment centers,” said Governor Murphy. “By requiring these institutions to disclose financial distress and expand their reporting obligations, we will enhance operational transparency and ensure that our communities have access to high-quality, affordable health care.: Governor Murphy signed the following bills: A5916 – Authorizes DOH to notify elected officials of financial distress of certain hospitalsA5918 – Expands hospital reporting requirements January 22, 2020: Texas Observer posted an article titled: “In Texas, Thousands of Kids Lose Medicaid Coverage Each Month”. It was written by Sophie Novak. From the article: …Texas has made it extremely difficult for kids to stay on Medicaid. While many states check children’s eligibility yearly, Texas moved in 2014 to a system of income checks multiple times per year, burdening families with heaps of paperwork. According to Adriana Kohler, policy director at Texans Care for Children, families have just 10 says – starting from when the when the state puts papers in the mail – to recieve the forms, gather necessary documentation, fill them out, and send them back. This caused thousands of eligible kids to lose Medicaid coverage each month. State lawmakers have repeatedly declined to pass bills to move to 12-month continuous coverage.There are other causes too: Attacks on the ACA from Trump and GOP lawmakers have reduced enrollment outreach and confused families. Anti-immigrant policies – particularly Trump’s “public charge” rule, which would make it harder to get a green card if applicants might need public assistance – have led families to pull kids out of benefit programs for fear that they could negatively affect the parents’ immigration status. The rule is currently blocked by the courts, but the “horrible” policy is already “having the desired effect,” according to Jason Terk, a Keller pediatrician and the former head of the Texas Pediatric Society. Missed vaccinations are one tangible effect of these coverage lapses, and they’re riskier than ever. Vaccine exemptions for kids have skyrocketed from about 2,300 in 2003 to 64,176 in 2018, and there were 21 confirmed measles cases in Texas this year… January 22, 2020: Planned Parenthood posted a press release titled: “On the 47th Anniversary of Roe v. Wade, Trump Administration Allows Texas To Bar Care at Planned Parenthood.” From the press release: Today, the Trump administration rewarded Texas’s long-standing effort to cut off people’s access to health care. The administration approved Texas’ request to implement a Medicaid family planning program that bars patients from accessing care at Planned Parenthood and other sexual and reproductive health providers that also provide abortion. This is the first time the federal government has allowed a state to explicitly waive Medicaid’s free choice of provider for family planning provision. This move upends longstanding federal law and sets a dangerous precedent for other states to pursue similar state-level measures, with grim consequences for health care access nationwide.By approving Texas’ request, the Trump administration puts federal funding behind a failed program that was designed to limit people’s access to health care and directly resulted in people losing health care. Because federal law safetuards the right of Medicaid patients to access reproductive health care at the qualified provider of their choice, six years ago, Texas rejected federal funding for its state family planning program and launched a fully state-funded program in order to bar access to care at Planned Parenthood. Prior ot this, and draconian family planning cuts in 2011, Planned Parenthood affiliates served more than 40 percent of patients in the program……Planned Parenthood provides important preventative health care including lifesaving cancer screenings, birth control, and STI testing and treatment. Nationally, 75 percent of Planned Parenthood patients have incomes at or below 150 percent of the federal poverty level (FPL), and at least 60 percent of Planned Parenthood patients access care through the Medicaid program. These approved waivers take away rights and freedoms from people who already face unequal and unfair treatment, including LGBTQ people, people of color, people with disabilities, and women. These groups are more likely to have lower income and rely on programs like Medicaid. Blocking access to Planned Parenthood and other providers can make it impossible to get the care they need. January 22, 2020: Speaker Pelosi posted a press release on her official website titled: “Pelosi Statement on the Anniversary of Roe v. Wade”. From the press release: Speaker Nancy Pelosi released the following statement marking the 47the anniversary of the Roe v. Wade decision today:“For 47 years, the Supreme Court’s decision in Roe v. Wade has stood as the law of the land, ensuring that a woman’s reproductive health decisions are her own – in consultation with her family, her physician and her faith. This fundamental principle is rooted in our founding values of liberty and equality for all, and it must be fiercely safeguarded from brazen attempts to roll back women’s constitutional rights.“Women’s freedom of choice is currently under unprecedented threat from this Administration, and from Republicans in Congress and in state capitols across the country who are determined to insert themselves into women’s private health care decisions. For millions of women and their families, this relentless GOP assault continues to jeopardize their future and threatens to undo decades of progress towards women’s equality.“Yet, American women are fearlessly standing up and speaking out to demand an end to Republican’s outrageous efforts to undermine the landmark Roe v. Wade decision. Together, with these tireless women, House Democrats are committed to ending the attack on Roe v. Wade. We will not rest until all women have access to the comprehensive health care they need and are treated equally under the law.” January 22, 2020: The American Civil Liberties Union (ACLU) posted an article titled: “47 Years Later, We’re Fighting to Make Roe a Reality Everywhere”. it was written by Jessica Arons, Senior Advocacy and Policy Counsel for Reproductive Freedom. From the article: …This Spring, the Supreme Court will hear arguments in June Medical Services v. Gee and could uphold state abortion restrictions identical to ones it struck down only four years ago, thereby allowing states to continue shutting down abortion clinics with no medical justification. Unsatisfied, 207 abortion opponents in Congress have asked the Court to overturn Roe entirely and pave the way for states to ban abortion outright.But while this high-stakes showdown plays out at the Supreme Court, we cannot take our eyes off the states. In 2019, seven states throughout the South and Midwest tried to ban abortion (all have been blocked so far) while seven other states passed eight affirmative measures to protect and expand access to abortion. This year will include new threats, as well as new opportunities to build on recent victories.…Already in 2020, bills that would ban abortion from the earliest days of pregnancy – like those passed in Georgia and Alabama last year – have been introduced in 13 states, with more likely to be filed in the coming days and weeks. Not all will advance, but there is a genuine risk that at least five more abortion bans could be enacted this year.Less aggressive but equally harmful and extreame measures are also being considered: a Florida bill that would force young people to obtain parental consent for an abortion, which would increase risks to vulnerable youth; bans on the standard of care for abortion after 14 weeks in Michigan and Nebraska; and an Ohio measure that promotes the dangerous and unproven theory that an abortion with pills can be “reversed”. Additionally, abortion opponents are taking steps to eliminate abortion protections or pass new restrictions via ballot measures in Colorado, Kansas, Kentucky, Louisiana, and elsewhere.But it’s not all bad news……Massachusetts is working to pass the ROE Act, which would, among other things, improve youth access to abortion and ensure coverage for abortion regardless of income or immigration status. In the wake of an historic election in Virginia, legislators are lining up to show their support with a bevy of proactive bills. And New Jersey Gov. Phil Murphy recently called for efforts to codify reproductive rights into state law.The reality is, however, that we will never break free from the relentless cycle of harmful state laws and court battles without federal action by Congress – which is why we are joining calls for Congress to pass the Women’s Health Protection Act. Already supported by more than 200 co-sponsors in the House and 42 in the Senate, WHPA would prohibit states from shutting down abortion clinics and banning abortion outright…. January 22, 2020: ABC News posted an article titled: “Trump suggests he may be open to entitlement cuts in future”. It was written by Ricardo Alonso-Zalidvar and Aamer Madhani. From the article: President Donald Trump appeared to suggest in a television interview Wednesday that he’s willing to consider entitlement cuts in the future, a move that would mark a tectonic shift from his stance during his 2016 run for the White House.Trump suggested he was open to a cut in social safety net benefits, such as Medicare and Social Security, in comments during a CNBC interview on the sidelines of the World Economic Forum in Davos, Switzerland……Asked if entitlement cuts would ever be on his agenda, Trump reponded, “At some point they will be.”……In the CNBC interview, Trump called tackling entitlement spending “the easiest of all things” and suggested higher economic growth would make it easier to reduce spending on the programs… January 23, 2020: Center for Reproductive Rights posted a press release titled: “Trump Administration ‘Defunds’ Reproductive Health Services Providers in Texas”. From the press release: Yesterday, on the 47th anniversary of Roe v. Wade, the U.S. Department of Health and Human Services (HHS) approved a previously-denied waiver request by the state of Texas for federal Medicaid funding to administer a family planning that discriminated against reproductive health care providers. The approval upends a longstanding Medicaid requirement that enrollees be able to recieve services from the qualified provider of their choice – including Planned Parenthood and other providers who also provide abortion services…. January 23, 2020: Politico posted an article titled: “Trump administration finalizing Medicaid block grant plan targeting Obamacare”. It was written by Dan Diamond. From the article: The Trump Administration is finalizing a plan to let states convert a chunk of Medicaid funding to block grants, even as officials remain divided over how to sell the controversial change to the safety net health program……Capping Medicaid spending, even among just Obamacare’s expansion population, would be a major transformation of how the federal government finances the safety net health care program that has grown to cover about 1 in 5 Americans. The plan is guaranteed to enrage critics and invite attacks from Democrats in an election year.Republicans have long argued that states should recieve defined funding for Medicaid, instead of the current open-ended structure in which the federal government matches state spending. Democrats, along with many hospital and physican groups, have fiercely opposed the idea, warning that strict funding constraints would result in cuts to enrollment and health care services.Democratic lawmakers have promised to fight the administration on block grants, contending CMS doesn’t have the authority to restructure the program’s financing without congressional approval……Congress has not been supportive of the idea. Lawmakers during the failed Obamacare replacement effort in 2017, rejected a similar plan to cap spending on Medicaid expansion and private health insurance subsidies, which would have resulted in millions losing coverage.The Trump administration is seeking to bypass congressional opposition by using existing Medicaid authority to test states’ health care ideas under what’s known as demonstration waivers.Several Republican-led states are pursuing plans to convert their Medicaid programs into block-grant funding. Tennessee, which has not expanded Medicaid, in November became the first state to submit a block grant plan to the Trump administration. That plan remains under review… January 24, 2020: California Attorney General Xavier Becerra posted a press release on his official website titled: “Attorney General Becerra Asks Court to Protect California’s Title X Family Planning Program”. From the press release: California Attorney General Xavier Becerra asked the Northern District of California court to rule on its complaint that alleges the federal government illegally promulgated a Final Rule (Gag Rule) to undermine the Title X program, the nation’s only federal family planning program. The Trump-Pence Administration’s Gag Rule attacks Title X by limiting access to preventative healthcare including access to birth control, restricting healthcare providers’ ability to provide comprehensive information to patients, and prohibiting referrals for abortion. California and other plaintiffs are still waiting for a ruling from the Ninth Circuit Court of Appeals regarding the federal government’s appeal of the district court’s earlier grant of a preliminary injunction halting the implementation of the Gag Rule.“The Title X program is a critical tool that helps low-income women and families access essential healthcare in California and across the nation,” said Attorney General Becerra. “This is yet another attack on women and their reproductive rights by the President and Vice President who circumvented the law and the public by jamming this Gag Rule through the process. That’s unacceptable. California won’t watch struggling families go without basic healthcare.”California’s renewed push against the Title X regulation is based on the physical separation requirement of the Title X Final Rule which will take effect on March 4, causing further devastating consequences for California’s Title X network. The physical separation requirement would require both physical and financial separation between any Title X program participant and any faculty that provides abortion services. This means a provide must have, at minimum, separate examination and waiting rooms, office entrances and exits, phone numbers, email addresses, educational services, websites, staff and personnel, electronic or paper-based health care records, and workstations. The financial and administrative burdens this requirement would impose on Title X providers would only increase the exodus of providers from the program. California has already experienced significant loss of Title X providers since the Gag Rule took effect. Without relief before the March 4 deadline, California may no longer have a Title X network, causing untold harm to thousands of women and families across the state. California seeks to resolve its Administrative Procedures Act (APA) claims before the physical separation deadline to mitigate this harm.In the brief, California argues that the Trump Administration’s final rule is in violation of the APA because it is arbitrary and capricious as well as contrary to federal statutes that require non-directive counseling and that forbid the federal government from creating unreasonable barriers to appropriate medical care. A copy of the the motion is available here. January 24, 2020: The U.S. Department of Health and Human Services (HHS) posted news on its official website titled: “HHS Issues Notice of Violation to California for its Abortion Coverage Mandate”. From the news: Today, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR), announced an action to protect human life and the conscience rights of all Americans.OCR is issuing a Notice of Violation to the sate of California, formally notifying California that it cannot impose universal abortion coverage mandates on health insurance plans and issuers in violation of federal conscience laws……OCR’s investigation arose from two complaints alleging that California engaged in unlawful discrimination when California’s Department of Managed Health Care (DMHC) ordered, in August 2014, that all health plan issuers under its jurisdiction must offer coverage for elective abortion in every plan they offer. The two complainants are the Missionary Guadalupanas of the Holy Spirit, a Catholic order of religious sisters, and Skyline Weslyan Church, a non-profit Christian church – organizations whose religious beliefs preclude them, in good conscience, from helping to pay for insurance coverage for elective abortions.Pursuant to 45 CFR Part 88 (effective March 2011), OCR completed the investigation of the complaints and determined that California violated the Weldon Amendment by mandating that California health care plan issuers cover elective abortion in each plan product, and continues to violate federal law by continuing to require objecting health care entities protected by the Weldon Amendment to cover elective abortion. With this notice, OCR requests that California inform OCR, within thirty days, whether California will continue to enforce its requirement that all health plans cover elective abortions, or whether it will agree to take corrective action and remedy the effect of its discriminatory conduct.If after 30 days, OCR does not receive sufficient assurance that California will come into compliance with federal law, OCR will forward the Notice of Violation and the evidence supporting OCR’s findings in this matter to the HHS funding components from which California recieves funding for appropriate action under applicable grants and contracts regulations. This action may ultimately result in limitations on continued reciept of certain HHS funds.This is not the first time OCR has found California to be in violation of federal conscience statutes. In January 2019, OCR found that California violated the Weldon and Coats-Snowe Amendments when it subjected pregnancy resource centers in the state to potential fines and discrimination for refusing to post notices referring for free or low-cost abortions… I want to make this perfectly clear: the Trump-Pence administration has decided that states rights can be usurped by the complaints of Catholic and Christian organizations who wish to impose their will upon the people of a state. This means that the Trump-Pence administration has established a national religion. The Third Article of the U.S. Constitution clearly states: Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press, or the right of the people to peaceably assemble, and to petition the Government for a redress of grievances. NOTE: It does not say that the federal government is allowed to establish one religion – Christianity in this example – above all others and above the rights of people who do not follow any particular religion. Freedom to exercise one’s religion does not mean that religious groups are allowed to take away rights from … well, everyone else. January 24, 2020: California Attorney General Xavier Becerra posted a press release on his official website titled: “Attorney General Becerra Issues Response to Trump Administration’s Baseless Allegations of Weldon Violaton”. From the press release: Attorney General Becerra today issued a statement in response to a letter from the Trump Administration’s Office for Religious Consciousness that alleges California law violates the Weldon Amendment, a federal approprations rider that restricts abortion.“Women’s health should never be dangled as bait for the sake of political grandstanding. Today, Donald Trump is using the official levers of government to advance his political agenda. Sound familiar? In California, we will continue to protect our families’ access to healthcare, including women’s constitutional right to abortion. Nothing changes.”.. January 24, 2020: California Governor Gavin Newsom posted a tweet on his personal account: “Trump is threatening to take away ALL OF OUR HEALTHCARE FUNDING. TENS OF BILLION of dollars. 10 MILLION PEOPLE who are: poor, sick, kids, seniors, families, will LOSE their healthcare. And yet you call yourself “pro-life” @realDonaldTrump?? You sicken me.” The tweet included a link to the following Politico article. January 24, 2020: Politico posted an article titled: “Trump threatens to cut California funding over abortion coverage.” It was written by Alice Miranda Ollstein. From the article: The Trump administration on Friday threatened to cut off some federal funds to California unless it drops a state requirement that private health insurers cover abortion.The administration says the policy violates a federal ban on discriminating against health care entities that refuse to cover abortion services or refer patients for the procedure when taxpayer dollars are involved. HHS is giving the state 30 days to comply or face the loss of unspecified funds……Five other states – Illinois, Maine, New York, Oregon, and Washington – have similar laws on teh books. But HHS is, for now, only singling out California.California Gov. Gavin Newsom indicated the state won’t change the policy.“The Trump administration would rather rile up its base to score cheap political points and risk access to care for millions than to do what’s right,” he said. “California will continue to protect a woman’s right to choose, and we won’t back down from defending reproductive freedom for everybody – full stop.”California’s Attorney General Xavier Becerra tweeted: “California won’t be deterred. We will fight this by any means necessary.”The move is in line with other Trump administration actions targeting the progressive state over issues including environmental standards, immigration policies and homelessness. It was also timed to coiencide with the March for Life on the National Mall, where President Donald Trump will become the first president to address the anti-abortion demonstration in person as he works to shore up support from social conservatives……While public insurance programs like Medicaid have long been barred from covering abortion services, Friday’s announcement also marks the escalation of the administration’s efforts to extend the prohibition to private coverage. In December, HHS unveiled a rule requiring private insurers on Obamacare markets to send patients separate monthly bills to separate the portion of the premium that goes toward abortion coverage. The added administrative burden could prompt some insurers to drop abortion care altogether… January 24, 2020: The Hill posted an article titled: “Trump administration threatens to cut health funding for California over abortion insurance law”. It was written by Jessie Hellmann. From the article: The Trump administration is threatening to withhold federal funds from California over the state’s requirement that all insruance plans cover abortion.Officials with the Department of Health and Human Services (HHS) argued the insurance requirement forces people to pay for other people’s abortions and is a violation of federal law.The state will have 30 days to come into compliance with federal law or risk losing some of the health funding it gets from HHS……The decision by HHS also serves as a warning to the five other states that mandate abortion coverage in insurance plans, including Maine, Illinois and New York.California passed a state law in 2014 requiring all insurance plans, including those offered by employers, to cover abortion. Religious organizations argued the requirement is illegal because it violates their religious rights……The announcement from HHS came on the same day as the March for Life, the annual march against abortion in Washington, D.C.President Trump will become the first sitting president to speak at the march as he seeks to galvanize his conservative base ahead of the November election……The Supreme Court will hear a case this year challenging a Trump rule that allows employers with religious objections to contraception to opt-out of covering it in their insurance plans.Another rule issued by the Administration that was blocked in court would have penalized organizations that require employees to participate in abortions or other procedures that violate their consciences… January 24, 2020: National Women’s Law Center posted a press release titled: “Trump Administration Attempts to Take Away Comprehensive Health Coverage for Californians, says NWCL”. From the press release: Today, the Department of Health and Human Services’ (HHS) Office of Civil Rights has taken the extraordinary action of threatening to withhold critical funding to California – just because the state protects its residents by requiring all health insurance plans to cover the full range of reproductive services, including abortion. The Trump Administration is claiming that these plans violate the Weldon Amendment – one of several federal laws that allow various health care providers to refuse to provide care to a person seeking an abortion. This decision comes on the same day as the annual March for Life, an anti-abortion rally where Trump is proudly touting his record of limiting women’s rights.The following is a statement by Fatima Goss Graves, President and CEO of the National Women’s Law Center (NWLC):“It is no mistake that on the same day of the extremist anti-abortion March, the Trump Administration is trying to deny millions access to comprehensive health insurance that includes abortion. They claim they are ‘pro-women’ and ‘pro-life’, yet this action proves cruelty is the point for this administration. The very people they claim to be marching for are those who will be hurt by this decision. This is an illegal attempt to bully and punish the state of California for ensuring its residents have comprehensive health coverage that includes abortion. All health insurance plans should cover all basic health services and the full range of pregnancy-related care.” January 24, 2020: Planned Parenthood posted a press release titled: “Trump’s Travel Ban Targets and Discriminates Against Pregnant Women of Color”. From the press release: The Trump-Pence administration will allow the State Department to deny temporary visas to pregnant women. The new rule is expected to take effect today and will give discretion to consular officers to reject women they believe are traveling to the United States and its territories to give birth, making their children U.S. citizens. This policy will include visas issued for pleasure, medical treatment, or to see friends and family. The rule will primarily affect travelers from Africa, Asia, and Latin America, because it will not apply to countries in the Visa Waiver Program. Thirty one of the 39 countries in this protected program are from Europe.This rule is part of a long line of attacks on immigrants by the administration, including ending temporary protected status for several countries; the physical separation of children form their parents at the U.S.-Mexico border; the rollback of parental rights as part of immigration proceedings; and increased enforcement of detention and deportation……This isn’t the first time the administration has used visas as a tool for its extreme anti-immigrant ideology. Within months of taking office, Trump announced a travel ban against Muslims. The relentless attacks on immigrants by the administration have contributed to a culture of fear in immigrant communities, and often keep far too many from seeking the lifesaving care they need. January 24, 2020: Illinois Governor JB Pritzker posted a news release titled: “Gov.Pritzker Signs Law Capping Insulin Costs at $100/Month for 1.3 Million Illinoisans”. From the news release: Gov. JB Pritzker signed SB 667 into law today, capping out of pocket insulin costs at $100 for a 30-day supply. The new law is an important step forward in lowering healthcare costs for working families making Illinois a leader in ensuring healthcare is a right, not a privilege. The 1.3 million Illinoisans who rely on insulin will no longer face soaring prescription drug prices that force them to make tough decisions.“Health care is a right for all, not a privilege and that’s why I am so proud tha we created an insulin price cap that successfully puts patients above profits,” said Governor Pritzker. “As we work to address the high cost of prescription drug prices that are burdening millions of all our our state, this new law is an essential step in fulfilling our promise to put state government back on the side of working families.”Diabetes affects approximately 1,300,00 adults in Illinois. All people with Type 1 diabetes and some with Type 2 diabetes need insulin, but regular price hikes make insulin difficult to afford for the uninsured and those whose coverage requires significant cost sharing.Many patients either forgo insulin or they ration their prescribed insulin dose to stretch it until they can afford the next prescription. One if four Type 1 diabetics have reported insulin underuse due to the high cost of insulin… January 25, 2020: New York Attorney General Letitia James posted a press release on her official website titled: “Attorney General Secures Victory for Women Seeking Abortions in Rochester”. From the press release: New York Attorney General Letitia James today released the following statement after the Honorable David Larimer of the Western District of New York issued a decision authorizing the City of Rochester to continue to enforce a 2005 order establishing a sidewalk “buffer zone” outside a local Planned Parenthood facility:“In the nearly 50 years since Roe v. Wade, anti-choice activists have attempted to inflict theri will on women’s bodies, but this decision is another confirmation by the courts that no one has the right to interfere with women’s reproductive choices. Despite their denials, these anti-abortion activists attempted to harass, threaten, and block women from entering a local Planned Parenthood and strip them of the right to make a deeply personal choice to use every legal tool at its disposal to prioritize the reproductive rights of women. We thank the court for its decision and for ensuring Roe v. Wade is enforced in Rochester without interruption.”Deborah McDell-Hernandez, Senior Director of Public and Community Affairs of Planned Parenthood of Rochester added, “Planned Parenthood is very appreciative of the attention that the New York Attorney General’s Office offered to this case. This positive outcome will help ensure that we are able to continue to provide a welcoming and safe environment to patients and staff. Accessibility to quality, affordable health care is our priority.”In 1989, the Office of the New York Attorney General won a decision – in New York ex rel. Spitzer v. Operation Rescue Nat’l – establishing a buffer zone prohibiting protests, picketing and the blocking of the entry within 15 feet of “entrances and driveways of facilities that perform abortions in the Western District of New York,” including Planned Parenthood of Rochester.Despite this ruling, two years ago, anti-abortion activist Jim Havens and his group ROC Love Will End Abortion, began protesting women who were entering the Planned Parenthood of Rochester facility. When they were prohibited from continuing their protests within 15 feet of the facility, Havens and his group filed a lawshit against both the State of New York and the City of Rochester, asserting that they were being improperly prevented from conducting their protests.Under Attorney General James’ leadership, the Office of the New York Attorney General opposed the motion for a preliminary injunction and moved to dismiss the lawsuit, stating that Havens and his group were indisputably acting “in active concert or participation” with the original defendants to the state lawsuit.Yesterday afternoon, Judge Larimer denied the motion for a preliminary injunction and dismissed the lawsuit in its entirety, stating that Havens and his group were indisputably acting “in active concert or participation” with the original defendants of the state lawsuit. The court took particular note of Havens’ and the original defendants named ‘ shared common goal of deterring ‘abortion-minded’ women from seeking services at PPR,” and further held that Havens’ legal arguments wer based on “wishful thinking on [their] part,” concluding, “Any suggestion that plaintiffs acted ‘independent’ from thes Named Defendants… is not only disingenuous, but is also belied by plaintiffs’ own allegations.”… January 25, 2020: MSN posted an article titled: “Kansas lawmakers begin debate on Medicaid expansion”. From the article: While a bipartisan plan in Topeka seeks to end years of gridlock on the issue, Kansas Governor Laura Kelly says there is a long way to go before declaring victory.Supporters of Medicaid expansion in Kansas say the time is now for this to happen as the state senate’s public health and welfare committees start to debate the issue……Republican Senate Majority Leader Jim Denning and Democratic Governor Laura Kelly hammered out a compromise from previous proposals. That compromise calls for Medicaid expanding to Kansans who fall within 138 percent of the poverty line.It includes work requirements where applying for Medicaid will have to fill out a form showing they are looking for work or show why they are not able to work. Enrollees would pay monthly premiums of up to $25 per month, or $100 for a family of four, as proposed in the proposed bill. A hardship provision is also included.The plan also includes a re-insurance program to support Kansans who buy health insurance through the exchange. That program would go into effect no later than January 1, 2022… January 26, 2020: Cleveland.com posted an opinion piece titled: “DeWine administration deserves Ohioans’ thanks for uncovering – and vowing to fix – state Medicaid mess”. It was written by The Editorial Board of Cleveland.com and The Plain Dealer. From the opinion piece: Kudos to Republican Gov. Mike DeWine’s administration for its candor in exposing big flaws in a computer system, called Ohio Benefits, that’s supposed to help the state manage its part of the Medicaid, Temporary Assistance for Needy Families and food stamp (SNAP) programs.Instead, a system into which the state has already sunk more than a billion dollars — yes, nine zeros — is so flawed that it’s wrongly thrown an unknown number of Ohioans off Medicaid by erasing their eligibilty histories, failing to handle renewals correctly, or simply causing applicants to disappear from the system. It’s also violated recipients’ privacy by sending paperwork to the wrong address and, in one case, linked a baby to an 11-year-old who wasn’t the child’s parent……The state has already spent $1.2 billion on Ohio Benefits [State Medicaid Director Maureen] Corcoran said. And it likely will have to spend more to fix it…..In effect, the state is all but yoked to the vendor. And all told, Ohio Benefits has nearly 1,100 defects, cleveland.com’s Laura Hancock reports, citing Corcoran’s findings.The state adopted the benefits system six years ago when Kasich was governor, to help manage Ohio’s benefits systems, starting with Medicaid… January 27, 2020: Representative Debbie Dingell tweeted: “4,110,300 people in Michigan have a pre-existing condition. Because of the Affordable Care Act, insurance companies cannot deny their coverage. We must #ProtectOurCare.” January 27, 2020: The Supreme Court of the United States released a ruling on Department of Homeland Security, Et. Al. v. New York, Et. Al. on an application for a stay on the Trump administration’s Public Charge rule. It starts with: The application for stay presented to Justic Ginsburg and by her referred to the Court is granted, and the District Court’s October 11, 2019 orders granting a preliminary injunction are stayed pending disposition of the Government’s appeal in the United States Court of Appeals for the Second Circuit and disposition of the Government’s petition for a writ of certiorai, if such writ is timely sought. Should the ptetition for a writ of certiorari be denied, this stay shall terminate automatically. In the event the petition for a writ of certiorari is granted, the stay shall terminate upon the sending down of the judgement of this Court.Justice Ginsburg, Justice Breyer, Justice Sotomayor, and Justice Kagan would deny the application.Justic Gorsuch, with whom Justice Thomas joins, concurring in the grant of stay… It should be noted that the reason Chief Justice John Roberts is not mentioned in the ruling could be because he was presiding over President Trump’s impeachment trial in the U.S. Senate. January 27, 2020: CNBC posted an article titled: “Supreme Court allows Trump’s ‘public charge’ immigration rule to take effect.” It was written by Tucker Higgins. From the article: The Supreme Court said Monday that it will allow the Trump administration “public charge” rule to take effect after the immigration policy had been blocked by lower courts.The 5-4 vote was divided along partisan lines, with the court’s four Democratic appointees indicating that they would not have allowed the policy to be enforced.The rule, which was proposed in August, will make it more difficult for immigrants to obtain permanent residency, or green cards, if they are likely to use public benefits like food stamps and Medicaid.Under previous federal rules, a more narrow universe of public benefits, such as cash assistance and long-term hospitalization, were considered in determining whether an immigrant was likely to become a “public charge”.Civil rights groups criticized the rule, arguing that it would penalize poor immigrants and disproportionately affect non-white immigrants… January 27, 2020: Senator Patty Murray tweeted: “Just stepped out of the impeachment trial to news that the Trump Administration can begin implementing its cruel public charge rule that will threaten the lives & livelihoods of so many hardworking families in WA & across the country. This is just so wrong. January 27, 2020: The American Civil Liberties Union (ACLU) tweeted: “The “Public Charge” rule enshrines the false stereotype that people with disabilities do not contribute to our society. Congress has repeatedly declared that disability discrimination violates federal law. This rule must be stopped.” The tweet included a screenshot of a statement by the ACLU that said: In a 5-4 ruling, the Supreme Court, allowed the Trump administration’s “public charge” rule to temporarily take effect. The rule imposes new restrictions on green cards and visas, and particularly affects individuals with disabilities as well as low-income families. The American Civil Liberties Union opposes the rule. Claudia Center, senior staff attorney with the ACLU’s Disability Rights Program, had this reaction to the Supreme Court’s action:“This policy is yet another way for the Trump administration to hurt immigrants. It enshrines the false stereotype that that people with disabilities do not contribute to our society. Families will suffer. Congress has repeatedly declared that disability discrimination violates federal law. This rule must be stopped.” January 27, 2020: Representative Alexandria Ocasio-Cortez tweeted: “This is shameful. America shouldn’t have a wealth test for admission. It’s a place where millions of people are descendants of immigrants who came w noting & made a life. The American Dream isn’t a private club with a cover charge – it’s the possibility of remaking your future.” Representative Alexandria Ocasio-Cortez was responding to a tweet from Greg Stoher, a Supreme Court reporter for Bloomberg News, who tweeted: “BREAKING: On 5-4 vote, Supreme Court lets Trump administration start enforcing new immigrant wealth test, designed to screen out green card applicants seen as at risk of becoming “public charges.” January 27, 2020: Women’s Law Project posted statement titled: “WLP Statement on Trump’s Cruel “Public Charge” Rule”. From the statement: Today, in a 5-4 vote along ideological lines, the U.S. Supreme Court Justices said they would let the controversial immigration rules go forward even as lower courts wrestle with multiple legal challenges against them. “Today is another sad day for immigrants and a shameful one for our country. We have shut the golden door on the poor and huddled masses. Trump’s public charge rule effectively creates an immigration system that favors weatlh over hard-working individuals and families,” says Women’s Law Project staff attorney Christine Castro, who authored WLP’s comments on the rule. “These radical proposed changes will undermine they health and safety of immigrant families, especially immigrant mothers.”Under current policy, immigration officials can deny certain immigrants a visa or a green card if the official finds the immigrant would be a “public charge,” meaning someone deemed likely to become “primarily dependent” on current or past reciept of cash assistance programs like Supplemental Security Income (SSI) and Temporary Assistance for Needy Families (TANF) when predicting whether someone will become a “public charge”. (Only 3 percent of noncitizens use thes programs.)Trump’s new rule exapands the list of factors to be counted against a person to include safety-net programs like SNAP (“food stamps”), Section 8, Medicaid, earning a low income, English proficience, age (specifically, being over 60 or under 18 years old), having a low credit score, having a large family, and having a medical condition.“The rule’s preference for immigrants who speak English would codify the Trump Administration’s xenophobic rhetoric into actual policy and clearly targets people of color who are less likely to already speak English,” says Castro.Under the new rule, legal immigrants could be denied green cards or visas if they’ve ever used or are suspected of having used Medicaid, SNAP, or other safety-net programs. Currently, one in seven Americans rely on Medicaid, including two out of every five children, five in eight nursing home residents, and one in three people with disabilities… January 27, 2020: Southern Poverty Law Center posted a short thread that started with this tweet: “Today’s ruling allows yet another discriminatory and xenophobic Trump administration policy aimed at low-income Black and brown immigrants.” – SPLC’s Samuel Brooke”. The tweet included a link to the CBS News article (posted earlier in this blog post). Southern Poverty Law Center also tweeted: “The @DHSgov’s ‘public charge’ rule only hurts families struggling to make ends meet. It effectively cuts essential aid that helps ensure immigrants’ basic human right to housing, food and health care” – SLPC’s Samuel Brooke.” January 27, 2020: Senator Bernie Sanders tweeted: “In 2017, 10,000 people died waiting for Social Security Disability Insurance. Instead of addressing this crisis, Trump wants to make it harder for people with disabilities to get the help they need to get by. We will defeat him and undo this cruelty.” The tweet included a link to the following article from USA Today. January 27, 2020: USA Today posted an opinion piece titled: “Trump administration cuts to Social Security disability benefits among the cruelest.” It was written by Rebecca Vallas. From the article: Hardly a day goes by without the Trump administration finding a new way to slash the safety net.But its latest proposal – which would cut Social Security disability benefits by $2.6 billion over 10 years – is one of the cruelest. It would require millions of beneficiaries to re-prove their disability – and navigate a complex web of red tape and paperwork – every two years. Hundreds of thousands of people could lose benefits even though their condition has not changed……Proving eligibility for benefits is an ardurous process that can take months if not years, and hundreds, if not thousands of pages in medical evidence. America has among the strictest eligibility standards in the world. Over 60% of applicants are denied, and tens of thousands of people die each year waiting for benefits.While vital, benefits are so modest – averaging roughly $1,200 per month for Social Security Disability Insurance and $536 for Supplemental Security Income – that many beneficiaries live in poverty. Unspeakable hardship will result if this proposal takes effect.. January 28, 2020: Planned Parenthood posted a press release titled: “Planned Parenthood Denounces Supreme Court’s “Public Charge” Ruling”. From the press release: The Supreme Court furthered the Trump-Pence administration’s discriminatory and cruel attacks against immigrants yesterday by allowing its final “public charge” rule to go into effect. Under the rule, people may be denied entry into the U.S. or an adjustment in their immigration status (i.e. obtaining a green card), simply because they have received certain public benefits in the past – including health care, nutrition assistance, and public housing – or are judged likely to use benefits in the future. It is designed to keep families separated, and to scare immigrants already in the U.S. from accessing health care and other basic care and benefits, to which they are legally entitled, out of fear of retaliation from the administration……The Supreme Court’s 5-4 decision comes on the heels of other attacks on immigrants by this administration, such as banning pregnant women from entering the U.S.; ripping millions of families apart by rescinding DACA (Deferred Action for Childhood Arrivals) and ending TPS (temporary protected status) for several countries; the physical separation of children from their parents at the U.S.-Mexico border; the rollback of parental rights for parents involved in immigration proceedings; and increased enforcement of detention and deportation. January 28, 2020: A group of U.S. Senators sent a letter to Commissioner Andrew M. Saul of the Social Security Administration opposing the cuts to Social Security. From the letter: …We write to oppose the Social Security Administration’s (SSA) proposed regulations altering when and how often SSA conducts continuing disability reviews (CDR), published in the Federal Register on November 18, 2019. The proposed rule would dramatically increase the number of CDRs the agency conducts every year and burden millions of Americans with disabilities with more frequent, unjustified reviews of their eligibility for Social Security Disability Insurance (SSDI) benefits. At a time when leadership from SSA is sorely needed to further reduce unacceptably long disability application wait times and eliminate the disability hearing backlog, it is alarming that the agency appears more concerned with devoting limited resources toward making it harder for people with disabilities to receive essential benefits. This proposal appears to be yet another attempt by the Trump Administration to make it more difficult for Americans to access essential supports.Specifically, we oppose SSA’s proposal to create a new medical diary category with a two-year CDR review period, to change the criteria used to assign cases into each medical diary category and to change the frequency with which the agency performs CDRs for cases in one existing medical diary. In its Notice of Proposed Rulemaking (NPRM), SSA fails to justify the need for this rule. Specifically, SSA fails to clearly establish a need for these changes, fails to justify the specific procedural changes proposed, fails to fully evaluate the effects these changes will have on beneficiaries and fails to provide an adequate cost-benefit analysis. SSA does not even provide a cursory estimate of the number of people who will lose access to benefits earlier than they would have had otherwise as a result of this rule…Failure to Justify Proposed Procedural ChangesThroughout the NPRM, SSA repeatedly fails to justify the specific changes it is proposing to make. For example, in explaining what cases will be included in the new MIL diary category, SSA provides no ratinale for including step 5 allowances, which are cases in which beneficiaries were determined eligible for disability benefits at the last step of the five-step disability claims process. SSA never explains why this arbitrary administrative distinction, and not medical evidence, should dictate that these individuals have their cases reviewed every two years. Furher, SSA provides no medical or administrative rationale for assigning children approaching ages 6 and 12 to the new MIL diary category other than stating tha these are ages at which many children transition into formal education or transition into adolescence. SSA provides no explanation for how such transitions relate to a child’s underlying medical condition of likelihood of experiencing MI nor does SSA explain why such beneficiaries would require more frequent review of ongoing eligibility.The proposed changes to the Medical Improvement Not Expected (MINE) diary category similarly lack justification. For example, SSA states that step 5 allowances based only on 17 specific impairments or conditions will continue to be included in the MINE diary category, but provides no explanation of the criteria used to distinguish these impairments and conditions from all others. In proposing to change the CDR review period for cases in the MINE diary category from between 5 and 7 years to every 6 years, SSA does not provide any explanation of why a 6-year review period is more appropriate than a 7-year period and provides no data on current MINE case review periods to justify the proposed change. In addition, SSA does not explain why, despite the agency repeatedly citing the need for greater flexibility as among the primary reasons it has issued this proposed rule, the agency is proposing to significantly curtail its flexibility to schedule CDRs for the wide variety of cases included in the MINE category.Failure to Fully Evaluate Effects on BeneficiariesSSA also fails to fully evaluate the effects the proposed rule would have on beneficiaries. The only aspect of beneficiary welfare that SSA provides any analysis of is the proposed rule’s potential impact on beneficiary employment outcomes, and that analysis is entirely insufficient. On the issue of beneficiaries’ potential return to employment, SSA selectively references only intersection SSDI and SSI benefit receipt and employment outcomes. SSA also interprets the findings of these few studies – which seemingly show that the majority of people who lose their SSDI benefits are not able to consistently earn significant income in the years after losing access – as somehow being supportive of the agency’s position that the proposed rule will improve overall beneficiary outcomes. The only additional evidence SSA cites to support its assertions are numbers the agency produced itself looking at the relationship between time spent out of the labor force and future earnings. SSA, however, then admits that its numbers provide no evidence of a casual relationship between the factors examined, rendering the agency’s findings completely immaterial to its analysis of the proposed rules’ effects.SSA provides no analysis of how the proposed rule will impact beneficiaries’ financial security, health or any other measure of individual wellbeing. These exclusions are not explained in the NPRM. SSA’s contention that this rule could have positive effects on for beneficiaries cannot be considered complete if the agency arbitrarily selects which aspects of beneficiary welfare it analyzes. Employment is not the only outcome of importance to the welfare of beneficiaries.Perhaps the most egregious omission from SSA’s analysis of effects on beneficiaries is that the agency provides no estimate of the number of children, yought and adults who will lose acces to benefits more quickly than they would have otherwise as a result of the proposed rule. This includes losing access to SSDI and SSI cast benefits, but also Medicare and Medicaid coverage that are frequently tied to a person’s eligibility for SSDI and SSI. SSA should be capable of producing such estimates with available data, and the fact that SSA already presents estimates of the proposed rule’s effects on SSDI and SSI benefit expenditures in the NPRM suggests that SSA has already produced an estimate. Without an estimate of the number of children, youth and adults who would lose access to their cash and health care benefits sooner than under current rules, the public cannot evaluate the effects of the proposed rule… Here are the Senators who signed the letter (by state): California: Kamala Harris. Diane FeinsteinColorado: Michael F. BennetConnecticut: Richard BlumenthalDelaware: Christopher A. Coons, Thomas R. CarperIllinois: Tammy Duckworth, Richard J. DurbinHawaii: Mazie Hirono, Brian SchatzMaine: Angus S. King, Jr.Maryland: Benjaman L. Cardin, Chris Van HollenMassachusetts: Edward J. Markey, Elizabeth WarrenMichigan: Debbie Stabenow, Gary C. PetersMinnesota: Amy Klobuchar, Tina Smith,Nevada: Catherine Cortez Masto, Jackie RosenNew Hampshire: Margaret Wood Hassan, Jeanne ShaheenNew Mexico: Tom Udall, Martin HeinrichNew Jersey: Cory A. Booker, Robert MenendezNew York: Kristen Gillibrand, Charles E. SchumerOhio: Sherrod BrownOregon: Ron Wyden, Jeff MerkleyPennsylvania: Robert P. CaseyRhode Island: Jack Reed, Sheldon WhitehouseVirginia: Tim KaineVermont: Bernard Sanders, Patrick LeahyWashington: Maria Cantwell, Patty MurrayWisconsin: Tammy Baldwin January 28, 2020: Reuters posted an article titled: “Trump Administration urges Supreme Court not to expedite Obamacare hearing”. It was written by Antonita Madonna. From the article: The Trump administration has asked the U.S. Supreme Court to deny the Democrats’ request to expedite its review of a lower court’s decision on the validity of the Affordable Care Act.Attorneys general in Democrat-led states had appealed to the Supreme Court to review a ruling of the Fifth Circuit Court of Appeals on Dec. 18 that one component of the ACA – the soc called “individual mandate” – was unconstitutional but sidestepped a decision on the validity of the entire law by sending it back to a federal judge in a lower court for further analysis……Attorneys general in 20 states and the District of Columbia asked the Supreme Court to expedite its decision on the matter, citing the impact of the decision on the health care of millions of Americans and the health insurance market, at large.The Trump administration, however, argued in its filing last week that the appeals court’s decision has no “imminent consequences,” as the individual mandate it ruled unconstitutional was already repealed as part of the tax overhaul in 2017 in which the tax penalty associated with it was removed……Attorneys General in 11 Republican states, led by Texas also asked the Supreme Court to deny the Democrats petition… The Trump administration’s request is here. The request made by 11 Attoneys General of Republican states is here. January 28, 2020: Hawaii Attorney General Clare E. Connors posted a news release titled: “Hawaii Attorney General Joins a Multistate Brief Challenging Restrictive Abortion Laws”. From the news release: Hawaii Attorney General Clare E. Connors today joined a multistate coalition led by California and Illinois in filing an amicus brief in the Eighth Circuit Court of Appeals in Reproductive Health Services v. Planned Parenthood of St. Louis challenging the constitutionality of several recently enacted abortion bans in Missouri. Planned Parenthood of St. Louis, the only remaining abotion clinic in Missouri, and its Chief Medical Officer Dr. Colleen McNicholas, are seeking to overturn two state laws that would significantly curtail women’s rights and creates barriers to safe and legal abortion. The multistate coalition argues that these laws are unconstitutional restrictions on women’s right to choose.“The law is planly unconstitutional and would put the health and wellbeing of women at risk by denying access to healthcare,” said Attorney General Connors. “Because any attack on reproductive freedom is dangerous, we are committed to protecting women’s rights throughout the country”……Joining Attorney General Connors in today’s filing are the attorneys general of California, Illinois, Colorado, Connecticut, Delaware, Hawaii, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia. January 28, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Fights Missouri’s Restrictive Abortion Laws”. From the press release: New York Attorney General Letitia James today continued her fight to protect a woman’s right to choose, pushing back against obstructive laws passed in the State of Missouri that impose unconstituional restrictions on a woman’s right to have an abortion. In a multistate amicus brief filed in support of the defendants in Reproductive Health Services v. Planned Parenthood of St. Louis, Attorney General James, part of a coalition of 20 attorneys general from around the nation challenged the constitutionality of several recently enacted abortion bans in Missouri. Planned Parenthood of St. Louis – the only remaining abortion clinic in Missouri – and its Chief Medical Officer, Dr. Colleen McNicholas, are seeking to overturn several state restrictions that would significantly curtail women’s rights and create barriers to have safe, legal abortions.“Nearly 50 years ago, the courts ruled that women across the country have the right to control their own bodies, but nearly every day since anti-choice legislators have tried to impost their personal beliefs on the wills of millions of women nationwide,” said Attorney General James. “These laws simply aim to control our bodies, control our choices, and control our freedom, which is why we will never stop fighting. We will not allow Missouri, nor any other state to undo all the progress we have made by restricting access to safe, legal, abortions.”Missouri recently enacted several anti-choice laws meant to deny women access to abortion care in the state. Included in those laws are several “Gestational Age Bans” that make it a felony for physicians to perform abortions before the stage of viability recognized by the Supreme Court and, in some cases, before women would even know they were pregnant. In particular, the bans prohibit abortion after 14, 18, and 20 weeks so that if the court strikes down the eight-week ban, for example, the 14-week ban woudl still be in effect. Also included in the Missouri laws is a “Reason Ban” that prohibits a doctor from performing a pre-viability abortion if the doctor “knows” that a patient is seeking an aborton “solely because” of a prenatal diagnosis of Down syndrome.In August 2019, Planned Parenthood of St. Louis secured a preliminary injunction in the U.S. District Court for the Western District of Missouri against the enforcement of the Gestational Age Bans. The district court subsequently issued an addition order prohibiting the state from enforcing the “Reason Ban.” Missouri appealed both decisions. Attorney General James and the coalition of attorneys general are today arguing that the challenged laws are unconstitutional, do not promote women’s healthcare, and deny women access to safe, legal abortions. As the coalition explains, states can advance their interests in support of women’s health while simultaneously protecting the rights of persons with Down syndrom without infringing on women’s reproductive rights.Today’s brief is just the latest victory in a long list of measures Attorney General James has taken to protect women’s reproductive freedom. Last week, Attorney Genral James secured a victory for women in Rochester seeking to have an abortion without being harassed, threatened, or blocked before entering a clinic when a district court judge dismissed a lawsuit by anti-abortion activists seeking to bypass a 15-foot “buffer zone” outside a local Planned Parenthood clinic……Joining Attorney General James in filing today’s brief are the attorneys general of California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia January 28, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorney General Becerra Leads Multistate Brief Challenging Restrictive Abortion Laws”. From the press release: California Attorney General Xavier Becerra and Illinois Attorney General Kwame Raoul today led a multistate coalition in filing an amicus brief in the Eight Circuit Court of Appeals challenging the constiutionality of several recently enacted abortion bans in Missouri in Reproductive Health Services v. Planned Parenthood of St. Louis. Planned Parenthood of St. Louis, which provides the only remaining abortion services in Missouri, and its chief Medical Officer Dr. Colleen McNicholas, are seeking to overturn two start laws that would significantly curtail women’s rights and create barriers to safe and legal abortion. The multistate coalition argues that these laws are unconstitutional restrictions on women’s right to choose.“No government, state or federal, has the right to make personal decisions for a woman about her body or her healthcare,” said Attorney General Becerra. “Missouri’s anti-choice laws are blatently unconstitutional and leave women in Missouri with no option within the state for safe, legal abortion care. We will continue to stand with women and the Constitution to protect theri access to comprehensive healthcare.”… A copy of the complaint is here, January 28, 2020: The American College of Physicians (ACP) posted a press release titled: “Internists Say Court’s Decision on Public Charge Rule Jeopardizes Health Care for Immigrants”. This statement is attributable to Robert McLean, MD, MACP, President of American Collge of Physicians. From the press release: The American College of Physicians (ACP) is deeply disappointed that the Supreme Court decided to allow the Administration’s “public charge” rule to take effect in most of the United States while legal challenges play out. ACP is greatly concerned that this decision will jeopardize the health of children, their families, and create barriers to care for legal immigrants.As a physician, I fear that with the changes to the public charge rule in place patients will forgo necessary care rather than face the threat of deportation or family separation, putting their own health and the health of their communities at risk. I worry that patients who are legal immigrants will opt out of health care services for themselves and their children – avoiding critical preventative services and leaving urgent medical conditions untreated.ACP has been on record opposing the changes to greatly expand the scope of the public charge rule. When the changes were first proposted, the ACP wrote to the Department of Homeland Security to say that the changes “would undermine the physician-patient relationship and disrupt care continuity, and it is anthetical to the College’s mission to ensure meaningful access to health care for our patients. The rule will have negative impacts that will reverberate across populations, including U.S. citizens and legal residents.” That is why just last week ACP and other major physician groups filed an amicus brief in the Supreme Court case, opposing the new rule and outlining the harms that it would cause if it went into effect.ACP asserts that immigration policy should not interfere with patient-physician relationship, and that health policy should not foster discrimination against any patient, regardless of immigration status. We will continue to urge the courts to issue a final ruling tha the public charge is unlawful and unconstitutional. At the same time, we also urge Congress to act to block its implementation. January 29, 2020: The Hill posted an article titled: “Appeals court reufses to reconsider ruling striking down ObamaCare mandate”. It was written by Harper Neidig. From the article: A federal appeals court voted against rehearing a legal challenge to ObamaCare after a three-judge panel struck down the health care law’s individual mandate.The 5th Circuit Court of Appeals voted 8-6, mostly along ideological lines, against rehearing the case, after one of the judges asked for a vote.Neither party in the lawsuit had asked the circuit court to rehear the case. A coalition of blue states has already appealed to the Supreme Court , which is currently deciding whether to take up the law…. January 29, 2020: The American Civil Liberties Union (ACLU) posted an article titled: “We’re Back in Court this Week Defending Access to Safe Abortion in Kentucky”. It was written by Amber Duke, Communications Director. From the article: The ACLU is back in court today once again to stop Kentucky’s attempt to block access to abortion. We’ve been here before. Over the past three years, the Kentucky General Assembly has passed bill after bill that limits – and even bans – a person’s ability to get an abortion. And time after time, we’ve gone to court to protect people’s rights to get the care they need.At issue this week is a law that makes it a crime for doctors at Kentucky’s last remaining abortion clinic to perform an abortion procedure that is the standard of care. In reality, the law is nothing more than a backdoor abortion ban: It would bar the only procedure available in the state after about 15 weeks of pregnancy.Following a trial last year, a federal district court blocked the law, finding that it imposed “a substantial obstacle to a woman’s right to an abortion” – as other courts around the country similarly found. But the Commonwealth of Kentucky appealed, and we are arguing the appeal in the U.S. Court of Appeals for the Sixth Circuit today.The commonwealth’s opposition to this type of procedure is blatently political, not medical. Leading medical expets such as the American Medical Association and the American College of Obstetricians and Gynecologists oppose these bans, saying they interfere with a doctor’s ability to provide the best possible care for their patient….…today Kentucky has only one clinic left in the entire state. And the state is trying to force that last clinic to close its doors, leaving Kentuckians with no abortion provider at all. It’s only because we went with the clinic, EMW Women’s Surgical Center, to get a court order that the doors are still open; this case is on appeal… January 29, 2020: Politico posted an article titled: “‘Block grants’ no more: Trump’s Medicaid overhaus has a new name, same goals”. It was written by Dan Diamond and Rachel Roubein. From the article: The Trump administration will rebrand its Medicaid block grant program and look to safeguard the policy against an expected wave of legal challenges from patient advocates, according to two officials with knowledge of the plan set for release Thursday.The forthcoming block grant program comes with a new name – “Healthy Adult Opportunity” – but retains the original mission long sought by conservatives: allowing states to cap a portion of their spending on Medicaid, a radical change in how the safety net health program is financed.The block grant plan, which invites states to request capped funding for poor adults covered by Obamacare’s Medicaid expansion, also would let states limit health benefits and drugs avaialble to some patients……Aware of criticism that any cap on Medicaid funding would target vulnerable patients, [Seema] Verma will stress during Thursday’s announcement that her plan, by focusing just on the Obamacare expansion, will not affect the poorest or disabled patients. Verma has long argued Medicaid expansion is siphoning away resources from the most vulnerable patient covered by the program CMS will frame the block grant as a way to reinvest any savings into care improvements for Medicaid beneficiaries.States will be required to report their performance in real time, such as whether Medicaid patients see declines in access to providers or health outcomes, which one official said would allow the administration to gague whether the block grant was truly working to make adults healthier. One official said this could help CMS guard the program against legal challenges as advocates who say the administration doesn’t have the authority to cap Medicaid……The Trump administration also will allow participating states to limit the drugs offered by their Medicaid programs, a sticking point for states frustrated by the requirements that the safety net program include an expansive list of medications. Patients with behavorial health needs of HIV would be protected under the Trump administration plan, said one official… January 29, 2020: Several U.S. Representatives signed a letter to U.S. Department of Health and Human Services Alex M. Azar, II and Administrator of Centers for Medicare and Medicaid Services regarding the Trump administration’s approval of Medicald block grant waivers. From the letter: …We write to express our strong concerns regarding your intent to approve Medicaid block grant waivers. Previous statements from those in the Administration make it clear that the goal of these block grants is to cut benefits and further limit access to publicly funded health care. Additionally, the approval of such waivers would directly oppose federal statutes, which describe how the agency must make matching funds available to state Medicaid programs.Medicaid was created in 1965 for the purpose of expanding access to healthcare to low-income children, families, people with disabilities, seniors and other adults. Section 1115 explicitly permits waivers of specific sections of the Social Security act, but does not allow waivers for Section 1903, the section that directs federal matching funds to states. Therefore, the Centers for Medicare and Medicaid Services (CMS) is required to match state’s spending as the statute prescribes and is powerless in determining alternative state payments, including capping the Medicaid funds it disburses. The power and responsibility to change these payments lies solely with Congress. The intent of the current structure and the federal match is to help states provide adequate medical support for their poorest residents.By contrast, the purpose of block grant waivers is to overhaul the state’s Medicaid program by capping federal funding. In turn, states would be given a lump sum of federal money, freed from federal oversight or accountability measures; measures which encourage baseline benefits and quality of care to be available to all enrollees. These waivers would give states the ablity to remove enrollees or cut certain health care benefits and rates, if they believe they are too costly or unnecessary.Permitting waivers to allow for less spending in return for limited oversight directly contradicts Congress’s intent when establishing Medicaid; a safety-net health program. Medicaid block grants necessitate cost-cutting measures like restricting enrollment, decreasing provider reimbursement, and limiting eligibility and benefits through managed care. These actions endanger the lives of the most vulnerable patients, the population Medicaid was created to protect.Not only do Medicaid block grants directly oppose Congress’s intent for the Medicaid program, but they are illegal under Section 1115.Earlier this month, House Energy and Committe Chairman Frank Pallone, Jr. and Senate Finance Ranking Member Ron Wyden sent a letter to the Office of Inspector General in the Department of Health and Human Services citing the illegality of Medicaid block grants. Chairman Pallone and Ranking Member Wyden are both members of the two Committees with jurisdiction over Medicaid; the agency should heed their concern over the lack of program integrity should these waivers be approved.Guidance providing states a roadmap to obtain Medicaid block grant waivers not only defies Congress and the federal Medicaid statute but if implemented, will threaten health care for millions of individuals, hurting them whne they are the most vulnerable. The Administration should not issue any guidance encouraging block grant waivers, should reject these waviers and the concept of block grants, and urge any state that is considering this misguided policy to commit its energy to implementing Medicaid as Congress intends. Here are the Representatives who signed this letter (by state): Alabama: Terri A. SewellArizona: Ann Kirkpatrick, Donald S. Beyer Jr.California: Ro Khanna, Grace NapolitanoColorado: Jason CrowConnecticut: Rosa L. DeLauroFlorida: Darren Soto, Cathy Castor, Debbie Mucarsel-Powell, Val B. DemmingsIowa: Abby FinkenauerKansas: Sharice L. DavisMaine: Chellie PingreeMassachusetts: Joseph P. Kennedy, III, Ayanna PressleyMichigan: Debbie Dingell, Daniel Kildee Minnesota: Angie Craig, Ilhan OmarNew Hampshire: Chris PappasNew York: Thomas R. Suozzi, José E. Serrano, Eliot Engel, Adriano Espaillat, Nydia M. VelázquezNorth Carolina: G.K. ButterfieldOhio: Marcia L. FudgePennsylvania: Susan Wild, Mike DoyleTennessee: Jim Cooper, Steve CohenTexas: Eddie Bernice JohnsonVermont: Peter WelchVirginia: Jennifer WextonWisconsin: Gwen Moore January 29, 2020: WiscNews posted an article titled: “Wisconsin further delays Medicaid work requirments for childless adults.” It was written by David Wahlberg. From the article: Wisconsin’s work requirement for childless adults on Medicaid, initially schedulled to begin Nov. 1 and delayed until Thursday, has been postponed again – with a new requested start date of April 29.Premiums and some other stipulations adopted by former Republican Gov. Scott Walker and approved by President Donald Trump’s administrtion are set to begin Saturday……Wisconsin plans to limit Medicaid coverage to four years for poor adults without dependent children unless they work, train for a job, or particiapte in certain other activities.Gov. Tony Evers, a Democrat who took office last year, tried to block the work requirment, but the Republican-controlled Legislature kept it. Evers’ administartion has said it would implement it. January 29, 2020: The American Civil Liberties Union (ACLU) posted a press release titled: “ACLU of South Dakota Urges Lawmakers to Stop Hurting Transgender Youth”. From the press release: Ahead of today’s full chamber vote on House Bill 1057, legislation that would criminalize doctors for providing medically necessary care for transgender youth, some South Dakota legislators continue their attempts to codify discrimination against trans kids.The ACLU of South Dakota opposes Senate Bill 88 and Senate Bill 93.Senate Bill 88 would mandate that school counselors, school psychologists or social workers disclose to a parent any young person’s identification as transgender, exploration of gender identity or reference to potential symptoms of gender dysphoria. This bill could result in forced disclosure of someone’s trans or questioning status to a non-affirming parent which could result in the young person becoming homeless or physically harmed.“When transgender youth face discrimination and victimization at school, it can often lead to serious negative health and mental health consequences,” said Libby Skarin, policy director for the ACLU of South Dakota. “Senate Bill 88 infringes on the rights of privacy of youth and deters young people from seeking support from trusted adults in positions to consel them.”Senate Bill 93 would give a parent the right to refuse to consent to a range of health care treatment options, including mental health treatment, for transgender young people. Parents, however, already have broad constitutional and common law powers to make decisions about medical treatment for minor children in their care and custody that cannot be limited by legislation.“Transgender yough are among society’s most at-risk populations,” Skarin said. “Senate Bill 93 just amounts to a proclamation of government disapproval of transgender young people and contributes to the already dangerous rates of family rejection for transgender youth.”Like House Bill 1057, Senate Bill 88 and Senate Bill 93 would hurt transgender yough, violate federal law and expose South Dakota to legal liability. The ACLU of South Dakota is committed to ensuring that transgender South Dakotans can live openly without discrimination remains strong and urges South Dakota lawmakers to stop hurting transgender youth… January 29, 2020: The Buffalo News posted an article titled: “Lawmakers push back against Cuomo Medicaid deficit reduction ideas”. It wa written by Tom Precious. From the article: …Before Health Commissioner Dr. Howard Zucker and Medicaid Director Donna Frescatore departed a legislative hearing room Wednesday, they were told by lawmakers in no uncertain terms that: fiscal books are somehow being cooked; facts are being withheld; painful service cuts are aimed at elderly, poor and disabled New Yorkers; and county taxpayers are going to be harmed by cost shifts proposed by Cuomo……[State Senator Gustavo] Rivera, and others were frustrated by a lack of specifics, the blocking of information to legislative staff experts and a plan by Cuomo to create a private, outside panel to come up with $2.5 billion in Medicaid savings that won’t report its findings until sometime shortly before a state budget is due March 31……Officials in New York City, which accounts for about half of Medicaid costs in the state, said Cuomo’s cost shift plan could, based on recent insurance cost levels, hit the city with a $1.1 billion tab in the coming year. [Cuomo officials later said the city’s $1.1 billion claim was vastly overstated by at least $880 million.]……Last week, Erie County Executive Mark Poloncarz said Medicaid costs would have been about $8 million higher in each of 2017 and 2018 had Cuomo’s new cost-sharing plan been in effect. How muchcould it be in 2020 is anyone’s guess at this point.The state is facing a $6.1 billion deficit in the coming fiscal year, with two-thirds of that generated by Medicaid red ink. High costs for providers meeting the state’s new minimum wage requirements and rising long-term care costs for seniors and disabled people are among the big expense drivers. The Cuomo administration has solved part of the problem by rolling over – or delaying – payments to providers from one fiscal year to the next.Cuomo has two other ideas now: incentivize counties to help find Medicaid savings by raising state costs onto them if those savings aren’t realized, and, create a panel – called the Medicaid Redsign Team (MRT) – to find $2.5 billion in savings. With budget talks already underway, Cuomo has yet to appoint the panel, except its two co-chairs: a longtime health care union leader and the New York head of a hospital system that is the state’s largest. One lawmaker Wednesday pondered out loud about potential conflicts of interest inherent in having a hospital boss decide winners and losers in Medicaid cuts… January 30, 2020: The Guardian posted an article titled: “South Dakota lawmakers vote to jail doctors for treating trans teens”. It was written by Guardian staff and agency. From the article: South Dakota lawmakers voted in favor of a law that would see doctors jailed for giving puberty-blocking drugs to transgender children, the latest in a slew of such bills sweeping the United States.The bill, which cleared the South Dakota house of representatives on Wednesday but still has to clear the state’s senate, would bar doctors in the state from providing anyone under 16 with the drugs, which can temporarily stop the body from producing the hormones that lead to puberty, a reversable process.Critics of the proposed ban say the drugs play a crucial role in allowing trans children struggling with the onset of puberty to hit pause.“One of the biggest problems for these kids is… their sense of who they are isn’t matching their body,” Anne Dilenschneider, a South Dakota psychologist, told the Thomson Reuters Foundation.“They’ve got a body developing in a way that is causing a huge crisis. And they want it to stop,” said Dilenschneider, warning that this could make young people suicidal.Studies have found that young trans people have a much higher suicide rate than their peers……The bill follows the introduction in South Carolina of measures that could see the licenses of doctors who treat trans children revoked, one of a series of such measures in conservative US states……Experts and parents of trans children warn such restrictions could harm young people already struggling with the challenges of adolescence and gender dysphoria……The ban passed with 46 votes to 23 in the state’s Republican-controlled house of representatives. It will still have to clear the senate, where it may face greater opposition. The state’s govenor will have the final say. January 30, 2020: The American Academy of Pediatrics (AAP) posted news titled: “AAP opposes new Medicaid guidance on block grants, per capita caps”. It was written by Trish Korioth. From the news: Sweeping new federal guidance on Medicaid issued by the Centers for Medicare & Medicaid Services (CMS) would be detrimental to children and families, according to the AAP, five other major medical organizations and several health groups. The guidance announced by CMS Thursday allows caps on federal funding and offers states the option to use block grants and per capita caps for low-income adult populations, including parents with young children.“The American Academy of Pediatrics urges CMS to immediately rescind this guidance and instead pursue policis that strengthen Medicaid. CMS must instead work to revers the troubling trend of rising child uninsurance rates due to children losing Medicaid and CHIP (Children’s Health Insurance Program) coverage,” AAP President Sara “Sally” H. Goza, M.D., FAAP, said in a statement.Medicaid enrolls 37 million children nationwide. When parents lose coverage, their children are more likely to lose coverage as well. However, the full impact of the guidance on children remains unknown. The AAP and health groups isued a joint statement “united in opposition to any threat to Medicaid that would dismantle a pillar program millions of families rely on.”The block grant or per capita financing mechanism for Medicaid also violates joint principles on Medicaid waivers supported by the six major medical organizations that represent more than a half-million U.S. physicians. Children, including those with special health care needs and those from low-income families, make up the single largest group of people who rely on Medicaid.Following the release last September of the U.S. Census Bureau data showing 425,000 fewer childrne had health insurance coverage in 2018, the groups called for immediate action by Congress and the Trump administration to protect and improve health coverage for all children……The Medicaid program guarantees specific benefits designed for children, known as Early and Periodic Screening, Diagnostic and Treatment (EPSDT). As a result, children on Medicaid are more likely to get checkups, miss less school, graduate and enter the workforce than their uninsured peers. But under the new guidance, states also will be allowed to opt out of providing EPSDT to some populations.“We urge CMS to immediately rescind the guidance and keep Medicaid strong,” Dr. Goza said. “Simply put: Medicaid works.” The letter from six major medical organizations is here. It includes the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American College of Obstetricians and Gynecologists, American Osteopathic Association, and American Psychiatric Association. January 30, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General james Sues Trump Administration For Attempting To Raise Costs Of Abortion Services Under ACA”. From the press release: New York Attorney General Letitia James today co-led a coalition of seven attorneys general in suing the Trump Administration for making it more difficult for women in New York and across the nation to access abortion services under the Affordable Care Act (ACA). In late December 2019, the U.S. Department of Health and Human Services (HHS) issued a final rule that unlawfully reinterpreted Section 1303 of the ACA by requiring qualified health plans that particupate in the state exchanges – like the New York State of Health – to send separate bills and collect separate payments of at least one dollar for abortion services. In their lawsuit, Attorney Geeneral James and the colaition argue that HHS’s new onerous and confusing requirement threatens women’s access to abortion. The lawsuit also highlights that the new rule is incompatible with the ACA’s requirement of equitable access to health care and disproportionately affects states – like New York, California, Maine, Oregon, and Vermont – that are committed to ensuring access to comprehensive reproductive health care by requiring health plans to provide abortion coverage.“Every day, the Trump Administration and anti-choice activists look for new ways to undermine Roe v. Wade and impose burdensome restrictions on women’s reproductive freedoms,” said Attorney General James. “This new rule is just another attempt to control women’s bodies and make it harder for those struggling financially to exert their constitutional right to an abortion. New York will not sit idly by as this Administration continues its assault on women. We will never stop fighting to ensure every woman is able to make her own reproductive choices.”Under New York law, all private health plans regulated by the state are required to offer abortion coverage as part of their basic health care services, but the new federal rule requires insurers to separately bill for the portion of health insurance premiums attributable to abortion coverage. The rule also requires consumers to make a separate payment of at least one dollar for these services or risk losing all of their health care coverage. HHS itself has conceeded that requiring separate bills and separate payments will inevitably lead to confusion for the more than 260,000 New Yorkers that have already enrolled in a qualified health plan this year. The rule will also burden states with unnecessary administrative costs and harm consumers who will face higher insurance premiums as a result to increased cost to carriers. For example, initial compliance is expected to cost all impacted insurance companies nearly $400 million, with another $100 million in estimated annual costs to maintain the separate systems. These excessive costs put pressure on insurers to remove abortion coverage from their plans and punish those companies that do business in states, like New York, where abortion coverage is required.In the lawsuit filed today – led by Attorney General James and California Attorney General Xavier Becerra – the coalition aruges that the new rule is unlawful because it:Imposes onerous and unnecessary regulatory barriers aimed at restricting women’s constitutionally-protected right to access abortion care;Seeks to frustrate state sovereignty by coercing states to change their policies relating to the protection of abortion care;Violates section 1554 of the ACA, which prohibits the prmulgation of any regulation that creates unreasonable barriers to the ability of individuals to obtain appropriate medical care; andExceeds HHS’s statutory authority under Section 1303 of the ACA..…Joining Attorney General James and Attorney Genearl Becerra in filing today’s lawsuit were the attorneys general of Maine, Maryland, Oregon, Vermont, and the District of Columbia. A copy of the brief is here. January 30, 2020: California Attorney General Xavier Becerra posted a press release titled: “Attorneys General Becerra and James File Lawsuit Challenging Trump Administrtion Attack on Healthcare Access and Reprodcuctive Rights”. From the press release: California Attorney General Xavier Becerra and New York Attorney General Letitia James, leading a coalition of six states and the District of Columbia, today sued the U.S. Department of Health and Human Services (HHS) for its unlawful reinterpretation of Section 1303 of the Affordable Care Act (ACA). On December 27, 2019, HHS issued a final rule requiring qualified health plans participating in the state exchanges like Covered California to send separate bills and collect separate payments of at least one dollar for abortion coverage. This onerous and confusing requirement threatens women’s access to abortion and puts millions at risk of accidentally losing critical health insurance coverage. The lawsuit highlights that the new rule is incompatible with the ACA’s requirement of equitable access to healthcare and disproportionatelly affects states that are committed to ensuring reproductive healthcare.“This new rule is just another Trump Administration attack on women and reproductive rights,” said Attorney General Becerra. “We have a long history of protecting women’s access to comprehensive reproductive healthcare, including abortion. We won’t let an unlawful administrative rule change that. And we will defend California’s ability to enact and enforce laws that promote the health of its residents.”Under California law, all health plans regulated by the state are required to offer abortion coverage as part of their basic healthcare services. The new federal law requires insurers to separately bill for the portion of health insurance premiums attributable to abortion coverage. The rule also requires consumers to make a separate payment of at least one dollar for these services or risk losing all of their healthcre coverage. HHS itself has conceded that requiring separate bills and separate payments will inevitably lead to confusion, putting more than 1.4 million enrolles in California alone at risk of losing coverage if they inadvernently fail to make full premium payments on time. The rule will also burden carriers. For example, initial compliance is expected to cost all impacted insurance companies nearly $400 million, with another $100 million in estimated annual costs to maintain the separate systems. These excessive costs put pressure on insurers to remove abortion coverage from their plans and punish those companies that do business in states like California where abortion coverage is required……Attorney General Becerra was joined in filing today’s lawsuit by the attorneys general of New York, Maryland, Maine, Oregon, Vermont and the District of Columbia. January 30, 2020: The Department of Health and Human Services Centers for Medicare and Medicaid Services sent a letter to state Medicaid directors about “Healthy Adult Opportunity”. From the letter: Dear State Medicaid Director:The Centers for Medicare & Medicaid Services (CMS) is pleased to announce a new opportunity for states to potentially achieve new levels of flexibility in the administration and design of their Medicaid programs while providing federal taxpayers with greater budget certainty. The Healthy Adult Opportunity (HAO) initiative will allow states to carry out demonstrations under section 1115 (a)(2) of the Social Security Act (the Act) to provide cost-effective coverage using flexible benefit designs under either an agressive or per-capita financing model for certain populations without being required to comply with a list of Medicaid provisions identified by CMS.CMS recognizes that states, as administrators of the program, are in the best position to assess the needs of their respective Medicaid-eligible populations to drive reforms that result in better health outcomes. States that agree to implement demonstrations under either of these financing models and to increased transparancy and accountaiblity for effective administration of their programs, quality and access to care, which in the judgement of CMS, are likley to assist in promoting the objectives of the Medicaid program, will be granted extensive flexibility to test alternative approaches to implementing their Medicaid programs, including the ability to make many ongoing program adjustments without the need for demonstration or state plan amendments that require prior approval. The list of Medicaid provisions with respect to which we will consider providing flexibility for states participating in demonstrations approved under the HAO initiative is provided in Appendex A. This includes flexibility on provisions such as retroactive coverage, cost-sharing limits, presumptive eligibility, and other requirements that CMS historically has waived under section 1115 of the Act.Through the HAO initiative, CMS is inviting states to design demonstrations for consideration by CMS that will promote the objectives of the Medicaid program, including the furnishing of medical assistance in a manner that promotes the sustainability of government health care spending through the use of an annual budget neutrality limit, calculated in the aggregate or on a per capita basis. While federal funding will be capped, federal financial participation (FFP) will continue to flow to states as it does today; nothing in this letter changes the need for states to submit claims reflecting actual expenditures to obtain federal matching funds for the Medicaid program. Demonstrations approved utilizing this approach will ofeer states far greater flexibility and discretion than is available under ordinarily-applicable Medicaid rules without the need for complex amendments or advance federal approval of certain changes……The HAO initiative encourages states to apply for all flexibilities that been previously approved in other demonstrations where such flexibilities would be likely to promote the objectives of the Medicaid program, such as… The ability to cover adults who qualify for Medicaid on a basis other than disability or need for long-term care services and supports and who are not covered under the state plan, including covering all individuals… that would apply if they were covered under the state plan;Providing populations covered under an HAO demonstration with coverage more consistant with insurance benefits provided the the Exchanges, rather than the traditional Medicaid benefit package;The ability to pay for services that cannot be funded by Medicaid, including those deisgned to address certain health determinants, such as enhnaced case management services that link individuals to housing or other supports;Design of flexible premium and cost sharing structures that are not required to comply with the terms of section 1916(f) of the Act;The ability to impose additional conditions of eligibility, such as community engagement requirements for non-elderly, non-pregnant Medicaid beneficiaries who are eligibile for Medicaid on a basis other than disability;The ability to make certain changes in benefits, premiums, and co-payments during the course of the demonstration without the need for state plan or demonstration amendments and further approval by CMS;The ability to change eligibility and enrollment processes, such as eliminating retroactive eligibility. Additionally, the HAO initiative potentially offers states new opportunities, including: The ability to make certain administrative changes during the course of the demonstration, such as certain changes in provider payment rates and application of claims review prior to making payment, without amendments or further approval by CMS;The ability to adopt a closed forumulary in line with Essential Health Benefit (EHB) requirements (with special protections for individuals with HIB and behaviorial health conditions);The ability to include coverage of services provided by a federally qualified health center as part of the state’s value-based payment reform option;The opportunity to propose alternate approaches to compliance with statutory managed care provisions that differ from those set forth in regulations;The opportunity for states implementing an aggregate cap demonstration to be elibible for shared savings when actual FFP is less than FFP allotment under the aggregate cap, provided a state meets certain performance criteria. …States will have the opportunity to impose conditions of eligibility on coverage under an HAO demonstration that do not generally apply to Medicaid coverage under state plans, such as community engagement requirements, … and consistent with other applicable laws, including title VI of the Civil Rights Act of 1964, section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act of 1990, the Age of Discrimination Act of 1975, and section 1557 of the Patient Protection and Affordable Care Act (PPACA). CMS, in consultation and coordination with the Department of Health and Human Services (HHS) Office for Civil Rights, is available to assist states in designing projects that comply with the civil rights laws……States choosing to participate in the HAO initiative also will ahve the opportunity to set the income standard for eligibility for coverage under an HAO demonstration, as well as to change the standard over the course of the demonstration, and/or to limit coverage to a defined subset of individuals, such as individuals with severe mental illness, individuals needing treatment for substance use disorder, or individuals with HIV/AIDS. States may also propose to require an asset test for individuals seeking coverage under an HAO demonstration. Under the HAO initiative, and in other demonstration projects covering the adult group under section 1115(a)(2) authority, increased FMAP will be availble in accordance iwth sections 1905(y) and 1905(z) of the Act, provided that demonstration includes a standard for eligibility based on a household income standard of at least 133 percent of the federal poverty level (FPL), no asset test for those with income at or below 133 percent FPL, and eligibility for all individuals described in the adult group, even when benefits are not provided in accordance with section 137 of the Act… …For populations covered under an HAO demonstration, CMS will not require compliance with the effective date of eligibility prescribed under 42 CFR 435.914. Instead, states may propose to not to provide retroactive eligibility, as well as to establish a prosptective effective date of coverage – for example, to coincide with enrollment in a managed care plan or a Qualified Health Plan (QHP). States could also propose to conduct an individual’s first regularly-scheduled renewal of eligibility prior to the end of the 12-month renewal called for in 42 CFR… in order to align with the open enrollment period for Exchange coverage. In addition, many states may propose to not comply with the requirment to operate Hospital Presumptive Eligibility (HPE), … although states implementing an HAO demonstration can elect to offer such coverage to individuals covered under an HAO demonstration……States may propose under an HAO demonstration may propose to noe be required to comply with restrictions on premiums and cost-sharing imposed under sections 1916 and 1916A of the Act… Instead, states will have broad flexibility to propose alternative premiums and cost sharing structures. We would expect states to adhere to two overarching limitations:(1) Aggregate out-of-pocket costs incurred by beneficiaries covered under the demonstration would not exceed 5 percent of the beneficiary’s household income, meaured on a monthly or quartly basis.(2) Premiums and cost-sharing charges for tribal beneficiaries as well as individuals needing treatment for substance use disorder and individuals living with HIV, as well as cost-sharing charges for prescription drugs needed to treat mental health conditions, would not exceed amounts permitted under the statute and implementing regulations. States similarly would not be permitted to suspend enrollment for such individuals for failure to pay premiums or cost-sharing, even if authorized for other individuals under the demonstration……While nothing in this letter represents final approval of any program or is binding on any state or any Medicaid recipient, CMS hppes this information is helpful and looks forward to continuing to work with states to consider and implement innovative solutions to improve their Medicaid programs. CMS is available to provide technical assistance to states, as well as to preview states’ draft section 1115 proposals to help ensure states have the best chance possible of meeting federal requirements… January 30, 2020: The American College of Physicians (ACP) posted a press release titled: “Internists Say Changes to Medicaid Program Will Put Health Care at Risk for Vulnerable Patients”. This statement is attributable to Robert McLean, MD, MACP, President of American College of Physicians. From the press release: The American College of Physicians (ACP) is greatly concerned that the new Healthy Adult Opportinity Plan announced by the administration today will put access to health care at risk for Medicaid beneficiaries. ACP strongly opposes transforming Medicaid’s existing financial structure into a block grant approach because it will increase the nimer of people without health insurance coverage for essential health care services. Likewise, the per-capita cap option will restrict crucial health care funding.The Medicaid program is meant to provide a safety net for those most in need. For states that apply for the new demonstration project there would be a cap on the federal funding provided to cover adults under age 65 who are primarily eligible for Medicaid through Medicaid expansion, giving those states only a fixed amount of money no matter the need in the state. Just as troubling, they would also no longer need to ensure that their program is providing those beneficiaries with the same benefits and coverage. Fewer patients will be covered, and those who remain covered will have less access to health care services.We are concerned that enacting a cap on Medicaid funding leaves states unprepared to respond quickly to potential public health crises. In the event of an economic downturn, states would be unable to quickly accomodate people who might be unexpectedly and suddenly dealing with a loss of insurance and employment. States will have more ability to impose premiums and cost-sharing on adult Medicaid beneficiaries under these changes. We know that imposing cost-sharing dissuades low-income beneficiaries from seeking needed care.We are also concerned that this may encourage states, in a cost-saving effort, to cut prescription drug benefits. They also will be permitted to cut non-emergency transporation benefits tha could be vital to those seeking necessary care in rural or remote locations.Further, by restricting federal funding available to states, they may reduce payments to physicians under Medicaid. Currently, many state Medicaid programs reimburse at much lower rates than Medicare and commercial payers. Encouraging states to further reduce payments to physicians will have a particularly adverse impact on primary care physicians, making i more difficult for them to continue seeing Medicaid beneficiaries.As a physician, I worry abotu what will happen to my patients who depend on Medicaid for their health care. Medicaid programs across the country are vital in the effort to ensure that our nation’s most vulnerable population has access to health coverage. ACP calls on the Centers for Medicare and Medicaid Services to reverse this guidance that would drastically weaken coverage under the Medicaid program for low-income adults and instead focus on policies that would strenghten it.Our current healthcare system with problems of accessiblity and affordability already leaves too many patients behind. ACP is greatly concerned this Medicaid change will exacerbate these problems. Our patients deserve better. January 30, 2020: Planned Parenthood posted a press release titled: “Trump Administration Greenlights Massive Cuts to Medicaid”. From the press release: Today, the Trump administration announced what could lead to a major overhaul to Medicaid, paving the way for states to slash Medicaid funding and jeopardize health care coverage for people with low incomes, including reproductive and sexual health care……The Trump administration’s move to allow states to overhaul Medicaid into a block grant system would result in drastic cuts to funding, and could cause women with low incomes across the country to lose access to their health care. About one in five women of reproductive age rely on Medicaid for their health care, and women account for over half of all adult Medicaid enrollees. Medicaid covers more women’s health services than any other payer. Medicaid is also the largest payer of reproductive health care coverage, paying for nearly half of all births in the United States and 75 percent of family planning services.The attack on Medicaid comes barely a week after the Trump administration granted Texas federal funding for their state program that blocks patients in the program from accessing care at Planned Parenthood health centers, setting a dangerous precedent for other states that may follow suit. After Texas barred Planned Parenthood from providing care through the program in 2013, there was a sharp decline in access to women’s health services, resulting in nearly 45,000 fewer women accessing health care services through the Texas program… February 2020 February 1, 2020: The Gainesville Sun posted an article titled: “State House Speaker seeks health care reform”. It was written by John Kennedy. From the article: Backed by a scorched earth attack on Big Pharma and the “health care industrial complex”, House Speaker Jose Oliva is promoting wide ranging changes to the state’s medical landscape that may cause a possible side effect.Republicans hope they help at the ballot box in the nation’s biggest presidential swing state.With polls showing health care access and cost among the top issues for voters, Oliva is among a chorus of Florida Republicans getting behind President Donald Trump’s promise last spring to make the GOP “the party of health care.”But in a state when Republican leaders’ opposition to the Affordable Care Act also has left it among the few not to expand Medicaid coverage for lower-income residents, some think the Miami Republican is more interested in the optics and political messaging of reform……Indeed, the issue has fallen out of discussions among lawmakers even as 36 states have embraced Medicaid expansion, which is 90 percent financed by the federal government.About 2.8 million Floridians are uninsured, or 14 percent of the state’s population, a survey by the Centers for Disease Control shows… February 4, 2020: NARAL Pro-Choice America posted a press release titled: “NARAL Pro-Choice Iowa Speaks Out Against Proposed Constitutional Amendment Seeking to Ban Abortion in the State”. From the press release: Iowa Republicans in the House are today debating a proposed constitutional amendment (HSB577), which would roll back the right to access abortion in the state. Republicans are trying to sneak through discussion of the amendment by scheduling the hearing the morning after the biggest day in Iowa politics, the presidential caucus. This extreme measure is dramatically out of step with Iowans’ values and beliefs that decisions about pregnancy should be made by a woman, not politicians.NARAL Pro-Choice America National Communications Director Kristin Ford released the following statement:“Anti-choice Republicans in Iowa are trying to steamroll Iowans with their extreme agenda, attempting to roll back access to abortion by changing the state constitution. Every Iowan must be able to decide if, how, and wen to grow a family. Iowans overwhelmingly support protecting the right to access abortion and believe that politicians have no place interfering in personal decisions best left up to a woman with the support of those she loves and trusts. Iowa is ground zero in the fight for reproductive freedom, and NARAL Iowa members will continue to take politicians to taks for attacking our fundamental freedoms.”SJR2001, the corresponding Senate version of the bill which passed out of the Senate State Government committee earlier this year, proposes an amendment to the Constitution of Iowa tha would declare that there is “no right to an abortion” in the state……It’s clear that abortion is a critical issue to caucus-goers and voters in Iowa. Abortion and reproductive freedom remain a top issue for Iowa caucus-goers. When researching presidential candidates, “abortion” was among the top two most-searched issues in Iowa over the past week, according to Google Trends. Similarly, 8 out of 10 likely Democratic caucus-goers call support for abortion rights a “must have” for any candidate they would support, according to a recent CNN poll. Americans are aligned in their support for reproductive freedom and Roe v. Wade is more popular than ever. The vast majority of Americans (including Republicans!) support the landmark Supreme Court ruling, and there is no state in the country where banning abortion is popular. February 5, 2020: Kaiser Family Foundation posted an issue brief titled: “Implications of CMS’s New “Health Adult Opportunity” Demonstrations for Medicaid”. It was written by Robin Rudowitz, MaryBeth Musumeci, Rachael Garfield, and Elizabeth Hinton. From the issue brief: On January 30, 2020, the Centers for Medicare and Medicaid Services (CMS) released guidance inviting states to apply for new Section 1115 demonstrations known as the “Healthy Adult Opportunity” (HAO). These demonstrations would permit states “extensive flexibility” to use Medicaid funds to cover Affordable Care Act (ACA) expansion adults and other nonelderly adults covered at state option who do not qualify on the basis of disability, without being bound by many federal standards related to Medicaid eligibility, benefits, delivery systems, and program oversight. In exchange, states would agree to a limit on federal funding financing in the form of per capita or aggregate cap. States that opt for the aggregate cap and meet performance standards could access a portion of federal savings if actual spending is under the cap.HAO demonstrations differ from other Medicaid demonstrations already granted by this Administration in several ways, including the scope and flexibility offered to states and the capped federal funding……Background……Today, states operate their Medicaid programs within federal minimum standards and a wide range of state options in exchange for federal matching funds that are available with no limit. The matching structure provides states with resources that automatically adjust for demographic and economic shifts, health care costs, public emergencies, natural disasters and the changing program’s role in covering a low-income population with limited resouces and often complex health needs. Over time, states have transformed tand updated their Medicaid programs to adopt new service deliver models, payment strategies, and quality initiatives.Capped financing can present challenges for health programs. Unlike Medicaid in the states, the U.S. territories operate Medicaid under a federal cap, which has been set too low to meet enrollees’ needs and inflexible when responses to emerging health issues and natural disasters are required. Anotehr capped entitlement, the Children’s Health Insurance Program (CHIP), has been successful mainly becaise most states administer CHIP in conjunction with Medicaid (which is not capped), and the federal funding caps for CHIP have been set at levels that have not required states to make substantial program cuts. However, requirements to reauthorize federal CHIP funding and failure of Congress to act timely resulted in state budget issues and confusion for some enrollees……The Trump administration has used Section 1115 authority to implement substantial policy changes to the Medicaid program. Previous administrations have also used 1115 authority to advance policy priorities, but the Trump administration marked a new direction for Medicaid demonstrations beginning with the release of revised demonstration approval criteria in November 2017 that no longer included expanding coverage among stated objectives. Section 1115 demonstrations issued under the Trump administration to date hve included state programs to condition Medicaid eligibility on fullfillment of work and reporting requirements; use of premiums, copayments, and benefit restrictions not otherwise allowed under federal law; and behavioral health programs to use Medicaid funds for inpatient psychiatric hospital payments, among others… The HAO demonstrations also will use Section 1115 (a) (2) expenditure authority, which CMS maintains enables the Secretary to permit states to “not apply” federal Medicaid requirements to expenditures for individuals covered under the HAO demonsrations…. In using Section 1115 (a) (2), this Administration is inviting states to choose from a “menu” of provisions included in other approved demonstrations to date, and it is offering states the opportunity to modify or eliminate some program rules not previously granted.Key Provisions of HAO DemonstrationsFinancing The HAO demonstrations will be subject to an annual spending cap.The HAO spending caps differ from current methods used to determine budget neutrality for demonstrationsIn exchange for greater risk, states choosing an aggregate cap can obtain 25 to 50% of federal savings if spending is below the cap and performance benchmarks are met.States would be able to propose adjustments to an approved cap to account for changes in projected expenditures or enrollment due to unforseen circumstances outside the state’s control such as a public health crisis or major economic event. EligibilityStates could include in HAO demonstrations ACA expansion adults and other adults under age 65 that do not qualify on the basis of disability. These adult groups include low-income parents and pregnant women covered at the state option and other populations currently covered under Section 1115 demonstration authority. All children, mandatory pregnane women (those with incomes up to 138% FPL), manditory low-income parents (those up to the state’s 1996 cash assistance levels), and adults eligible based on a disability or long-term care need are excluded from the new demonstrations. Still, some people included in HAO demonstrations may have functional or other disabilities, as a large share of Medicaid adults have such disabilities even though they do not qualify on the basis of a disability. The guidance also notes that CMS may consider state requests to include other adult populations who are not covered under the state plan, which may open these demonsrations up to additional adult populations. States could use HAO demonstrations to extend coverage to groups not already covered. States could also terminate current state plan authority for optional groups and move that coverage to an HAO demonstration with additional restrictions.States could limit eligibility for certain adults under HAO demonstrations. States could set an income limit for expansion adults below 138% FPL and apply an asset test to limit eligibility for any demonstration enrollees. However, states can only recieve enhanced matching funds for ACA expansion adults if they cover the full population (alll adults with incomes under 138% FPL) without an asset test. Under the ACA, asset tests are not allowed for low-income parents, pregnant women, and expansion adults. States also can use HAO demonstrations to cover a subset of ACA expansion adults (at the regular matching rate), using other (non-financial) criteria, such as establishing geographic limits or restricting coverage to people with specific illnesss, such as behavoral health diagnoses.Under the HAO demonstrations, states could limit Medicaid eligibility in other ways not allowed by current law……Benefits and Cost Sharing The HAO demonstrations would allow staets to limit covered benefits compared to current law. States would not have to provide the full Medicaid alternative (formerly known as benchmark) benefit packate to demonstration enrollees.. …States could recieve enhanced ACA matching funds for expansion adults without provideing the full benchmark benefits package as required by current law…States could establish closed prescription drug formularies, a change from current Medicaid rules that generally require states to include all FDA-approved drugs from manuracturers with Medicaid rembate agreements.States would have broader authority to impose cost-sharing on enrollees… February 6, 2020: Planned Parenthood posted a press release titled: “House of Representatives Oppose Trump-Pence Attacks on Medicaid”. From the press release: Today, the House of Representatives voted to oppose the Trump-Pence administration’s invitation to states to cut Medicad funding, and jeopardize health care coverage for people with low incomes, including reproductive and sexual health care……The Trump-Pence administration’s move to allow states to shrink Medicaid into a block grant system would result in drastic cuts to funding, and could cause people with low incomes across the country to lose access to their health care or provider. Half of the people seeking care at Planned Parenthood health centers across the country use Medicaid. About one in five women of reproductive age rely on Medicaid for their health care, and women account for over half or all adult Medicaid enrollees. Medicaid covers more women’s health services than any other payer. Medicaid is also the largest payer of reproductive health care coverage, paying for nearly half of all births in the United States and 75 percent of family planning services. February 6, 2020: The U.S. House of Representatives voted on H.Res 826. It is titled: “Expressing disapproval of the Trump administration’s harmful actions towards Medicaid.” It is a resolution, which means it does not have the force of law. Here is the text of the resolution: Whereas Medicaid and the Children’s Health Insurance Program (CHIP) provide comprehensive, quality health care to 71 million Americans and children;Whereas Medicaid expansion has provided coverage to millions of adults and reduced the uninsured rate for both adults and children;Whereas Medicaid is a lifeline for some of our most vulnerable populations, including children with complex medical needs, people living with disabilities, low-income seniors, and individuals with mental illness and substance use disorders;Whereas Medicaid expansion has improved access to diagnoses and treatment for people with life-threatening conditions, including heart disease, and substance use disorder;Whereas Medicaid expansion improves and saves lives;Whereas research shows that Medicaid expansion saved at least 19,000 lives since 2014;Whereas Medicaid is the larges payer of behavioral health services in the country;Whereas Medicaid is the largest payer of long-term services and supports, including those provided in community-based settings;Whereas the opioid epidemic has claimed hundreds of thousands of lives, and Medicaid provides access to evidence-based treatment for individuals with opioid use disorder;Whereas researchers found that Medicaid expansion is linked to a 6-percent reduction in the opioid death rate, an 11-percent lower death rate for heroin, and a 10-percent lower death rate for fentanyl;Whereas Medicaid and CHIP play a key role in maternity services, pay for nearly half of all births in the United States, and provide access to prenatal and postpartum care;Whereas nearly all States and the District of Columbia provide Medicaid coverage to pregnant women with incomes higher than the minimum Federal standards;Whereas maternal mortality rates have risen nationally and disproportionately affect women of color;Whereas access to health care can prevent, detect, and treat conditions that put women at increased risk of pregnancy-related complications;Whereas research shows that Medicaid expansion improves postpartum care for women, reduces maternal and infant death, and reduces the likelihood a woman will experience a gap in coverage;Whereas research shows that Medicaid expansion improves postpartum care for women, reduces maternal and infant death, and reduces the likelihood a woman will experience a gap in coverage;Whereas rural hospitals are closing at an alarming rate, jeopardizing access to care for the 20 percent of Americans who live in rural areas, including 13,000,000 children, and research has found that States that expanded Medicaid had fewer rural hospital closures, and that rural hospitals in those States experienced improved financial peformance;Whereas Medicaid expansion reduces medical debt for individuals receiving coverage, which improves their individual and family financial security;Whereas once in office, President Trumo has gone further than any President in the history of the proram to make life harder for working families who rely on Medicaid for their health and well-being;Whereas the President has waged an unrelenting war on Medicaid, making it easier for States to take coverage away and create barriers for reenrollment;Whereas on President Trump’s watch, the number of uninsured children has increased, reversing years of declines, largely as a result of substantial losses in Medicaid coverage for children – many of whom remain eligible;Whereas under President Trump, over 1,000,000 children have lost Medicaid and CHIP coverage and over 750,000 adults have lost Medicaid coverage; andWhereas, despite President Trump’s campaign promise that he would “save Medicaid”, his administration has – (1) issued guidance to allow States to cap their Medicaid funding through a block grant, putting the financial viability if the States’ programs at risk and taking coverage and access to health care away from our citizens;(2) proposed regulations to roll back access standards put in place to ensure beneficiares recieve the care they need;(3) issued guidance to allow State Medicaid programs to restrict access to prescription drugs by adopting closed formularies;(4) proposed massive, annually componding cuts in Federal funding to the program in direct contradiction to an explicit campaign promise; and(5) allowed States to institute policies that have resulted in people improperly losing Medicaid coverage; Now, therefore be itThat it is the sense of the House of Representatives that –(1) the illegal actions taken by the Trump administration to undermine the Medicaid program, including the beneficiary protections, are a cruel attack on a program that provides for the health and well-being for some of our most vulnerable citizens;(2) the Trump administration should immediately withdraw its illegal block grant guidance and cease its campaign to undermine and weaken Medicaid; and(3) the Trump administration should uphold its responsibility to faithfully execute the law, including the Medicaid Act, and cease any and all efforts that threaten the care of the millions of Americans who rely on Medicaid. Here are the Representatives who voted YES on H.Res 826 (by state): Alabama: Terri Sewell (Democrat – district 7)Arizona: Tom O’Halleran (Democrat – district-1), Raúl Grijalva (Democrat – district 3), Ruben Gallego (Democrat – district 7), Greg Stanton (Democrat – district 9)California: Jared Huffman (Democrat – district 2), John Garamendi (Democrat – district 3), Mike Thompson (Democrat, district 5), Doris Matsui (Democrat, district 6), Ami Bera (Democrat, district 7), Jerry McNerrey (Democrat, district 9), Josh Harder (Democrat, district 10), Mark DeSaulnier (Democrat, district 11), Barbara Lee (Democrat, district 13), Jackie Speier (Democrat, district 14), Eric Swalwell (Democrat, district 15), Jim Costa (Democrat, district 16), Ro Khanna (Democrat, district 17), Anna Eshoo (Democrat, district 18), Zoe Lofgren (Democrat, district 19), Jimmy Panetta (Democrat, district 20), TJ Cox (Democrat, district 21), Salud Carbajal (Democrat, district 24), Julia Brownley (Democrat, district 26), Judy Chu (Democrat, district 27), Adam Schiff (Democrat, district 28), Tony Cárdenas (Democrat, district 29), Brad Sherman (Democrat, district 30), Pete Aguilar (Democrat, district 31), Grace Napolitano (Democrat, district 32), Ted Lieu (Democrat, district 33), Jimmy Gomez (Democrat, district 34), Norma Torres (Democrat, district 35), Raul Ruiz (Democrat, district 36), Karen Bass (Democrat, district 37), Linda Sánchez, (Democrat, district 38), Gilbert Cisneros (Democrat, district 39), Lucille Roubal-Allard (Democrat, district 40), Mark Takano, (Democrat, district 41), Maxine Waters (Democrat, district 43), Nanette Barragán (Democrat, district 43), Katie Porter (Democrat, district 45), Alan Lowenthal (Democrat, district 47), Harley Rouda (Democrat, district 48), Mike Levin (Democrat, district 49), Juan Vargas (Democrat, district 51), Scott Peters (Democrat, district 52), Susan Davis (Democrat, district 53)Colorado: Diana DeGette (Democrat, district 1), Joe Neguse (Democrat, district 2), Jason Crow (Democrat, district 6), Ed Perlmutter (Democrat, district 7)Connecticut: John Larson (Democrat, district 1), Joe Courtney (Democrat, district 2), Rosa DeLauro, (Democrat, district 3), James Himes (Democrat, district 4), Jahana Hayes (Democrat, district 5)Delaware: Lisa Blunt Rochester (Democrat – at large)Florida: Al Lawson (Democrat – district 5), Stephanie Murphy (Democrat, district 7), Darren Soto (Democrat, district 9), Val Demmings (Democrat, district 10), Charlie Crist (Democrat, district 13), Kathy Castor (Democrat, district 14), Alcee Hastings (Democrat, district 20), Lois Frankel (Democrat, district, 21), Theodore Deutch (Democrat, district 22), Debbie Wasserman Schultz (Democrat, district 23), Frederica Wilson (Democrat, district 24), Debbie Mucarsel-Powell (Democrat, district 25), Donna Shalala (Democrat, district 27)Georgia: Sanford Bishop (Democrat, district 2), Hank Johnson (Democrat, district 4), Lucy McBath (Democrat, district 6), David Scott, (Democrat, district 14)Hawaii: Ed Case (Democrat, district 1)Illinois: Bobby Rush (Democrat, district 1), Robin Kelly (Democrat, district 2), Daniel Lipinski (Democrat, district 3) Jesús Garcia (Democrat, district 4) Mike Quigley (Democrat, district 5), Sean Casten (Democrat, district 6), Danny Davis (Democrat, district 7), Raja Krishnamoorthi (Democrat, district 8), Jan Schakowsky (Democrat, district 9), Bradley Schneider (Democrat, district 10), Bill Foster (Democrat, district 11), Lauren Underwood (Democrat, district 11), Cheri Bustos (Democrat, district 17)Indiana: Peter Visclosky (Democrat, district 1), André Carson (Democrat, district 7)Iowa: Abby Finkenauer (Democrat, district 1), David Lobesack (Democrat, district 2), Cynthia Axne (Democrat, district 3)Kansas: Sharice Davids (Democrat, district 3)Kentucky: John Yarmuth (Democrat, district 3)Louisiana: Cedric Richmond (Democrat, district 2)Maine: Chellie Pingree (Democrat, district 1), Jared Golden (Democrat, district 2)Maryland: Dutch A. Ruppersburger (Democrat, district 2), John Sarbanes (Democrat, district 3), Anthony Brown (Democrat, district 4), Steny Hoyer (Democrat, district 5), David Trone (Democrat, district 6), Jamie Raskin (Democrat, district 8)Massachusettes: Richard Neal (Democrat, district 1), Jim McGovern (Democrat, district 2), Lori Trahan (Democrat, district 3), Joseph Kennedy (Democrat, district 4), Katherine Clark (Democrat, district 5), Seth Moulton (Democrat, district 6), Ayanna Pressley (Democrat, district 7), Stephen Lynch (Democrat, district 8), William Keating (Democrat, district 9)Michigan: Daniel Kildee (Democrat – district 5), Elissa Slotkin (Democrat – district 8), Andy Levin (Democrat – district 9), Haley Stevens (Democrat – district 11), Debbie Dingell (Democrat, district 12), Rashida Tlaib (Democrat – district 13), Brenda Lawrence (Democrat, district 14)Minnesota: Angie Craig (Democrat, district 2), Dean Phillips (Democrat, district 3), Betty McCollum (Democrat, district 4), Ilhan Omar (Democrat, district 5), Collin Peterson (Democrat, district 7)Mississippi: Bennie Thompson (Democrat, district 2)Missouri: Clay Lacy (Democrat, district 1)Nevada: Dina Titus (Democrat, district 1), Susie Lee (Democrat, district 3), Steven Horsford (Democrat, district 4)New Hampshire: Chris Pappas (Democrat, district 1), Ann Kuster (Democrat, district 2)New Jersey: Andy Kim (Democrat, district 3), Josh Gottheimer (Democrat, district 5), Frank Pallone (Democrat, district 6), Tom Malinowski (Democrat, district 7), Albio Sires (Democrat, district 8), Bill Pascrell (Democrat, district 9), Donald Payne (Democrat, district 10), Mikie Sherrill (Democrat, district 11), Bonnie Watson Coleman (Democrat, district 12)New Mexico: Debra Haaland (Democrat, district 1), Xochitl Torres Small (Democrat, district 2), Ben Luján (Democrat, district 3)New York: Thomas Suozzi (Democrat, district 3), Kathleen Rice (Democrat, district 4), Gregory Meeks (Democrat, district 5), Grace Meng (Democrat, district 6), Nydia Velázquez (Democrat, district 7), Yvette Clarke (Democrat, district 8), Jerrold Nadler (Democrat, district 9), Max Rose (Democrat, district 11), Carolyn Maloney (Democrat, district 12), Adriano Espaillat (Democrat, district 13), Alexandria Ocasio-Cortez (Democrat, district 14), José Seranno (Democrat, district 15), Eliot Engel (Democrat, district 16), Nita Lowey (Democrat, district 17), Sean Mahoney (Democrat, district 18), Antonio Delgado (Democrat, district 19), Paul Tonko (Democrat, district 20), Anthony Brindisi (Democrat, district 22), Brian Higgins (Democrat, district 26)North Carolina: G.K. Butterfield (Democrat, district 1), David Price (Democrat, district 4), Alma Adams (Democrat, district 12)Ohio: Joyce Beatty (Democrat, district 3), Marcy Kaptur (Democrat, district 9), Marcia Fudge (Democrat, district 11), Tim Ryan (Democrat, district 13)Oklahoma: Kendra Horn (Democrat, district 5)Oregon: Suzanne Bonamici (Democrat, district 1), Earl Blumenauer (Democrat, district 3), Peter DeFazio (Democrat, district 4)Pennsylvania: Brendan Boyle (Democrat, district 2), Dwight Evans (Democrat, district 3), Madeleine Dean (Democrat, district 4), Mary Scanlon (Democrat, district 5), Chrissy Houlahan (Democrat, district 6), Susan Wild (Democrat, district 7), Matthew Cartwright (Democrat district 7), Connor Lamb (Democrat, district 17), Mike Doyle (Democrat, district 18)Rhode Island: David Cicilline (Democrat, district 1), Jim Langevin (Democrat, district 2)South Carolina: Joe Cunningham (Democrat, district 1), Jim Clyburn (Democratic, district 6)Tennessee: Jim Cooper (Democrat, district 5), Steve Cohen (Democrat, district 9)Texas: Lizzie Fletcher (Democratic, district 7), Al Green (Democrat, district 9), Vicente Gonzalez (Democrat, district 15), Veronica Escobar (Democrat, district 16), Shelia Jackson Lee (Democrat, district 18), Joaquin Castro (Democrat, district 20), Henry Cuellar (Democrat, district 28), Sylvia Garcia (Democrat, district 29), Eddie Johnson (Democrat, dsstrict 30), Colin Allred (Democrat, district 32), Marc Veasey (Democrat, district 33), Filemon Vela (Democrat, district 34), Lloyd Doggett (Democrat, district 35)Utah: Ben McAdams (District 4)Vermont: Peter Welch (Democrat at large)Virginia: Elaine Luria (Democrat, district 2), Bobby Scott (Democrat, district 3), Donald McEachin (Democrat, district 4), Abigail Spanberger (Democrat, district 7), Donald Beyer (Democrat, district 8), Jennifer Wexton (Democrat, district 10), Gerald Connolly (Democrat, district 11)Washington: Suzan DelBene (Democrat, district 1), Rick Larsen (Democratic, district 2), Derek Kilmer (Democrat, district 6), Pramila Jayapal, (Democrat, district 7), Kim Schrier (Democrat, district 8), Adam Smith (Democrat, district 9), Denny Heck (Democrat, district 10)Wisconsin: Mark Pocan (Democrat, district 2), Ron Kind (Democrat, district 3), Gwen Moore (Democrat, district 4) The vote was 223 YES (54%) to 190 NO (46%). February 6, 2020: The American Civil Liberties Union (ACLU) of Oklahoma posted a press release titled: “ACLU of Oklahoma Statement on HB 1182”. From the press release: In response to today’s scheduled floor hearing of HB 1182, a bill equal to an abortion ban, the ACLU of Oklahoma released the following statement:The following is attributable to Nicole McAfee, Director of Policy and Advocacy:“Less than five days after members of the Oklahoma Legislature cheered the Governor’s commitment to reducing wasted taxpayer dollars, the first major piece of legislation to be considered this session on the House floor is HB 1182, an unconstitutional measure which undermines reproductive autonomy and inserts the government in private healthcare decisions by punishing abortion care providers. Yet another legal fight over yeat another unconstitutional bill is an unfortunate misuse of power that our state cannot afford.Across the country, politicians have created a web of medically unnecessary, politically-motivated restrictions that push aboriton care out of reach for many, but particularly for low-income people, young people, and people of color. And while this pandering attack is business as usual for the Oklahoma legislature, it is disappointing to see the body so quickly into session use their power to try and push this thinly veiled attempt at an abortion ban.As we turn our eyes to the House floor for this scheduled vote, we call on leadership and legislatuors from across the aisle and across the state to stop this dangerous and stigmatizing attempt to score partisan political points. This session provides real opportunity for change, and instead of continuing to violate fundamental rights and liberties protected by the Constitution, the legislature should prioritize being good stewards of Oklahoma taxpayer dollars by focusing on issues like healthcare access, education funding, and criminal justice reform that reqire their urgent attention.” February 6, 2020: The American Civil Liberties Union (ACLU) of South Dakota posted a press release titled: “South Dakota Lawmakers Need to Focus on Real Issues, Not Discriminatory Bills”. From the press release: Issues that matter most to South Dakotans are being ignored as some South Dakota legislators continue their attack the LGBTQ and Two Spirit community and erode their rights with bills that stoke fear and hatred amid discriminatory rheortic.Bills like House Bill 1057, which will be heard in the Senate Health and Human Services Committee on Monday, House Bill 1215 and Senate Bill 109 detract from the state’s real problems. House Bill 1057 would criminalize life-saving medical treatment for transgender youth. No other state has passed a law like HB 1057. It is unconstitutional to single out one group of people and categorically ban all care, no matter how medically necessary.House Bill 1215 would prohibit the state from endorsing or enforcing certain policies regarding same-sex marriage. Marriage equality is the law of the land in South Dakota and the entire nation. South Dakota lawmakers cannot defy the U.S. Supreme Court based on their extreme personal views.Senate Bill 109: would allow health care providers, medical institutions, and health insurance providers to refuse to care for a patient on religious, moral, ethical, or philosphical grounds. This means a public school counselor could refuse to care for a young LGBTQ person in distress or an EMT could refuse care to a gay man in an emergency situation. “With serious and complex issues like the lack of adequate education funding for teacher salary increases to access drug addiction treatment in the rural areas of our state, it’s disturbing that legislators have spent so much time attacking vulnerable transgender youth and the LGBTQ and Two Spirit community as a whole,” said Libby Skarin, ACLU of South Dakota policy director. “Bill after bill seems fixated on the incorrect notion that some of our friends and neighbors are not entitled to the same dignity and respect as others. Our committment to ensuring that LGBTQ and Two Spirit South Dakotans can live openly without discrimination remains strong. We urge South Dakota lawmakers to focus in the issues that really matter.”South Dakotans agree.On behalf of the Human Rights Campaign, Change Research polled 720 likely voters in South Dakota between Jan. 28-30 and found 69% say that “legislators are too focused on divisive issues and should be focusing on pressing issues that will actually have an impact on South Dakotans, like growing the economy.” Additionally, nearly two-shirts of voters say “we need to stop stigmatizing transgender people as a society.” February 7, 2020: Representative Jan Shakowsky (D-Illinois) posted a press release on her official website titled: “Schakowsky Votes to Protect Medicaid from Caps and Cuts”. From the press release: This week, Congresswoman Jan Schakowsky, Senior Chief Deputy Whio and Chair of the Energy and Commerce Consumer Protection and Commerce Subcommittee, voted YES on H.Res. 826, a resolution expressing disapproval of the Trump Administration’s harmful actions towards Medicaid. Last week, the Trump Administration unveiled its illegal Medicaid block grant plan, inviting states to cap and slash Medicaid. The plan would essentially allow states to recieve a waiver to block grant their Medicaid programs for certain low-income Medicaid recipients.The Administration’s Medicaid block grant plan undermines crucial protections of the Medicaid program and gives states broad authority to scale back important beneficiary protections, restrict eligibility standards and limit access to prescription drugs. The effect would be to push Medicaid recipients off lifesaving medicines, impose unaffordable premiums to maintain coverage and leave more vulnerable families exposed to catastrophic medical bills – with ruinous and even fatal consequences for the most vulnerable in our communities.The Resolution of Disapproval affirms the sense of the House of Representatives that:The illegal actions taken by the Trump Administration to undermine the Medicaid program, including beneficiary protections, are a cruel attack on a program that provides for the health and well-being for some of our most vulnerable citizens;The Trump Administration should immediately withdraw its illegal block grant guidance and cease its campaign to undermine and weaken Medicaid; andThe Trump Administration should uphold its responsibility to faithfully execute the law, including the Medicaid Act, and cease any and all efforts that threaten the care of the millions of Americans who rely on Medicaid… February 10, 2020: The American Civil Liberties Union (ACLU) of South Dakota posted a press release titled: “ACLU of South Dakota Commends Decision to Kill House Bill 1057”. From the press release: Today, in a 5-2 vote, the Senate Health and Human Services Committee voted to kill amended legislation that would prohibit doctors for providing medically unnecessary care to transgender youth and take away parents’ rights to make decisions about their children’s care.The ACLU of South Dakota opposed House Bill 1057. It is unconstitutional to single out one group of people and categorically ban all care, no matter how medically necessary.“Though supporters claimed House Bill 1057 was aimed at protecting vulnerable youth, it was clearly fueled by a fear and misunderstanding of transgender South Dakotans,” said Libby Skarin, policy director for the ACLU of South Dakota. “It’s time we stop these attacks and the very real harm they cause to transgender youth across our state. Let this be a signal to the South Dakota Legislature that discrimination against a marginalized group is a distraction from the needs of the state and hurts us all.In addition to the ACLU of South Dakota, companies and organizations like the Sanford Health, the South Dakota Chapter of the American College of Obstetricians and Gynecologists, the South Dakota Pharmacists Association, the South Dakota Chamber of Commerce and Industry, the South Dakota State Medical Association, the South Dakota Retailers Association, the Sioux Falls Area Chamber of Commerce, LEAD South Dakota and the Human Rights Campaign also opposed House Bill 1057. February 10, 2020: The White House released the President’s Budget for fiscal year 2021. For the purpose of this blog post, I will focus on the things that are related to health care that the Trump administration wants to eliminate. Agency for Healthcare Research and Quality (AHRQ): The 2020 budget funded AHRQ 338 million dollars. The Trump budget reduces that funding for 2021 to zero. The Agency for Healthcare Research and Quality (AHRQ) is the lead Federal agency charged with improving the safety and quality of America’s health care system. AHRQ develops the knowledge, tools, and data needed to improve the health care system and help Americans, health care professionals, and policymakers make informed health decisions. Some of AHRQ’S areas of focus include: Project ECHO (Extention for Community Healthcare Outcomes) for training and supporting primary care clinicians in rural communities to provide specialized care for patients. Re-Engineered Discharge (RED) is a structured protocol and suite of implementation tools that helps hospitals rework their discharge processes to reduce readmissions by determining patients’ needs and carefully designing and communicating discharge plans. Comprehensive Unit-based Safety Program (CUSP) is a highly effective method of preventing healthcare-associated infections. Consumer Assesment of Healthcare Providers and Systems survey, which provide valid assessments of patients’ experience of care in hospitalss, nursing homes, and doctor’s offices. Medical Expenditure Panel Survey data helped the Medicaid and CHIP Payment and Access Commission develop estimates of eligibility for Medicaid and the Children’s Health Insurance Program. CDC Chronic Disease Activities: The 2020 budget funded it with $1,240 million. The Trump budget is going to reduce that amount by $427 million in 2021. Part of the CDC includes the National Center for Chronic Disease Prevention and Health Promotion. Its website points out that six in ten adults in the US have a chronic disease and four in ten adults have two or more. Chronic disease includes, but is not limited to, the following: heart disease or stroke; cancer; diabetes. Here is what the National Center for Chronic Disease Prevention and Health Promotion does: Works to reduce the risk factors for chronic diseases, especially for goups affected by health disparities which are differences in health across different geographic, racial, ethnic and socioeconomic groups. Finds out how chronic diseases affect populations in the United States. Studies interventions to find out what works best to prevent and control chronic diseases. Funds and guides states, territories, cities, and tribes to use interventions that work. Shares information to help Americans understand risk factors for chronic diseases and how to reduce them. Health Workforce Programs: In 2020, it was funded $734 million. The Trump budget reduces that by $484 million for 2021. The Health Workforce website says that it is part of the Health Resources & Services Administration (HRSA). It improves the health of underserved and vulnerable populations by strengthening the health workforce and connecting skilled professionals to communities in need. HSRA programs provide health care to people who are geographically isolated, economically or medically vulnerable. This includes people living with HIV/AIDS, pregnant women, mothers and their families, and those otherwise unable to access high quality health care. HRSA also supports access to health care in rural areas, the training of health professionals, the distribution of providers to areas where they are needed most, and improvements in health care delivery. Low Income Home Energy Assistance Program: In 2020, this program was funded $3,740. The Trump Budget will reduce that funding to zero. The Low Income Home Energy Assistance Program (LIHEAP) helps keep families safe and healthy through initiatives that assist families with energy costs. It is part of the Office of Commiunity Services. The Purpose of LIHEAP is: to assist households with low incomes, particularly those with the lowest incomes that pay a high proportion of household income for home energy, primarily in meeting their immediate home energy needs. National Institute for Occupational Safety and Health: In 2020, it was funded $343 million. The Trump Budget reduces that by 153 million in 2021. The National Institute for Occupational Safety and Health (NIOSH) is part of the Centers for Disease Control and Prevention. Its vision is: safer, healthier workers. Its mission is: To develop new knowledge in the field of occupational safety and health and to transfer that knowledge into practice. NIOSH mission goals include: Goal 1: Conduct research to reduce worker illness and injury, and to advance worker well-being. Goal 2: Promote safe and healthy workers through interventions, recommendations and capacity building. Goal 3: Enhance worker safety and health through global collaborations. Federal Emergency Management Agency State and Local Grants/Training was funded $2,052 million in 2020. The Trump budget reduces it by 535 million in 2021. Federal Emergency Management Agency (FEMA) supports citizens and emergency personnel to build, sustain, and improve the nation’s capacity to prepare for, protect against, respond to, recover from, and mitigate all hazards. It is responsible for disaster assistance, the national flood insurance program, and U.S. fire adminisration. The national flood insurance program is government-run, and is the only one allowed to sell flood insurance. This type of insurance covers your home and the things inside it, and helps people to cope with the costs of flood damage. The Trump Budget also reduces Flood Hazard Mapping and Risk Analysis Program from the $263 million it was funded in 2020 by 163 million for 2021. The National Flood Insurance Program Flood Hazard Mapping program is also part of FEMA. This program identifies flood hazards, assesses flood risks, and partners with states and communities to provide accurate flood hazard and risk datat to guide them to mitigation actions. Flood hazard mapping is an important part of the National flood Insurance Program (NFIP), as it is the basis of the NFIP regulations and flood insurance requirements. FEMA mantains and updates data throigh Flood Insruance Rate Maps (FIRMs) and risk assessments. FIRMs incude statistical information such as data for river flow, storm tides, hydrolic/hydraulic analyses and rainfall and topographical surveys. In addition, the Trump Budget has a list of things that it wants to “reform”. Here are the things that directly relate to health: Federal Disability Programs …The Budget would introduce new reforms that remove barriers to work for people with disabilities and improves access to services to help them return to work… The changes will impose the following upon people who have disabilities: Test New Approaches to Increase Labor Force Participation: Allows the administration to test new program rules and requires manditory participation by program applicants and beneficiaries. This proposal calls on Congress to establish an expert panel that will identify specific changes to program rules that increase LFP and reduce participation on disability programs based on the results of successful demonstrations of other evidence. The panel would be responsible for making recommendationg to reduce participation levels that would be directly tied to reaching a five percent reduction in Disability Insurance (DI) and Supplemental Security Income (SSI) projected outlays by 2032. SSI Youth Transition to Work: Institutes initial disability reviews at age 6 and age 12. Disregards all earned income and elminiated income reporting requirements through age 20. Improves access to vocational rehabilitition services for SSI transition-aged youth by allowing the Social Security Administration to make referrals to these services. Replaces that Ticket To Work (TWW) program: It will replace this program with block grants to the states. Create a Sliding Scale for Multi-Recipient SSI Families: “Currently, multi-recipient SSI families are eligible to recieve an equal full benefit amount for each SSI child recipient. However, economies of scale in some types of consumption such as housing reduce per capita living expenses so that two children generally do not need twice the income of one child….” Eliminate Workers’ Compensation (WC) and Temporary Disability Reverse Offset Allow State Hearing Officers to Hold Disability Hearings: This proposal would allow State disabilitiy hearing officers to conduct hearings resulting from disabiity cessation determinations issued by a Federal component. This would allow additional flexibility for SSA to manage workloads at a national level, while preserving the individual’s right to an evidentiary hearing. Modernize the Commissioner’s Collection of Medical Evidence: This proposal would allow SSA to more quickly recieve the medical evidence it needs to determine initial and continuing entitlement to disability benefits by allowing custodians to release medical records to SSA without the signed authorization of the person applying for or recieving disability benefits. What follows is the Trump Budget’s proposed changes to Medicare: This section of the Trump Budget is titled: “Medicare: Address Wasteful Spending, Fraud, and Abuse”. …The budget includes two proposals aimed at reforming how the Federal Government reimburses hospitals for certain “add-on” payments that are not directly tied to Medicare beneficiary care. These reforms improve the sustainability of the Medicare Trust Fund and ensure that Medicare funds are spent on meeting the health needs of the Nation’s seniors. In addition, thes proposals better align the Medicare program with private sector health insurance business practices. Medicare currently makes payments to hospitals related to uncompensated care for non-Medicare beneficiaries. The Budget proposes to reform uncompensated care payments by removing the payment from the Medicare payment system, moderating the rate of growth of spending, and establishin a new process to distribute uncompensated care amounts to hospitals based on their share of chairty care and non-Medicare bad debt… … The Budget includes several additional proposals aimed at eliminating wasteful spending in Medicaire. Establish a unified payment system for post-acute care providers: …The budget would transition payment for post-acute care to site-neutral payments over five years. It would reduce the growth rate of post-acute care payment during the transition period. The proposed value-based payment system is based on the anticipated clinical needs and risk factors of the patient, rather than the site of services. All types of facilities would remain available, and patients with their doctors would determine the right site of care. Pay all hospital-owned physician offices located off-camous at the physician office rate:…The Budget would equalize Medicare payment for all physician practices and off-campus facilities, regardless of whether they are hospital-owned or when established, lowering out-of-pocket costs for seniors receiving services at those facilities. Pay on-campus hospital outpatient departments at the physician office rate for certain services: …The Budget proposes to make site-netural payments between on-campus hospital outpatients departments and physician offices for certain servics to include imaging tests, clinic visits, and drug administration. Authorize long-term care hospital (LTCH) site neutral exceptions criteria: The Budget proposes to better align payments to LTCHs based on patient need by modifying the criteria for payment… Researchers, including the nonpartisan Medicare Payment Advisory Commission (MedPAC), have suggested that the current criterion of at least three days in the intensive care unit (ICU) may be too low, and that a higher number of days may more accurately identify patients who require the intensity of care provided at an LTCH. The Budget proposes to extend the criterion to at least an eight-day stay in an ICU, as recommended by MedPAC, to better identify chronically ill patients who would more likely benefit from an LTCH. Reduce Medicare coverage of bad debts: The budget would reduce the amount Medicare pays to certain institutional providers to cover copayments or deductibles that beneficiaries fail to pay. Medicare currently reimburses certain providers at 65 percent of bad debt. Private insurance companies do not typically cover any portion of uncollected cost-sharing, which is the responsibility of the beneficiary. The Budget would bring Medicare more in line with the private sector by gradually reducing reimbursement to 25 percent of bad debt over three years. Reform and expand durable medical equipment competitive bidding: The Budget proposes to implement a more rational approach for setting payment rates in competitively bid areas by eliminating the single payment amount, and paying winning durable medical suppliers at their bid amounts… Expand basis for benefiary assignment fir Accountable Care Orgnizations (ACOs): …ACOs are designed to help reduce wasteful Medicare spending and improve quality by coordinating patient care and preventing unnecessary duplication of services. The Budget proposes to provide additional flexibilities to increase providers, including nurse practitioners, physician assistants, and clinical nurse specialists, moving more beneficiaries from fee-for-service Medicare to value-based care, without affecting beneficiaries access to providers or the care they recieve. Modify payment for hospital care provided to beneficiaries in skilled nursing facilities: Currently, Medicare pays hospices the same rate for care provided in skilled nursing and nursing facilities as it does for care provided in other settings, such as the home. This results in overpayment to hospice providers since nursing facilities are staffed with professional caregivers and are often paid separately under Medicare and Medicaid. Therefore, the Budget proposes to reduce hospice reimbursement by $10 per day to account for separate Medicare and Medicaid payments already provided for personal care services delivered to beneficiaries who elect hospice in skilled nursing and nursing facilities. Remove the cap on Medicare Advantage benchmarks and remove the doubling of quality bonus payments in qualifying counties: The Budget proposes to remove two Medicare Advantage payment mechanisms put in place by the Affordable Care Act. Removing the benchmark caps will allow Medicare Advantage organizations to fully realize their quality bonus payments by removing caps set by spending patterns that are over 10 years old. Removing double bonus payments will eliminate inequitable payments made to plans based on their geographic location that are not tied to quality. Taken together these two proposals result in a streamlined Medicare Advantage payment methodology that also produces net savings to Medicare…. February 11, 2020: The American College of Physicians (ACP) poste a press release titled: “Internists Say President’s Budget Would Harm the Health of Americans”. The statement is attributed to Robert McLean, MD, MACP, President of American College of Physicians. From the press release: The American College of Physicians (ACP) is extremely disappointed in the proposed fiscal year 2021 budget proposal released by President Trump. The drastic cuts to key government health programs would harm the health and healthcare of Americans.The budget proposes deep cuts in funding for both Medicare and Medicaid, hurting the programs that our elderly and vulnerable depend on to access necessary health care services. Medicare would be cut by $756 billion over ten year. These cuts would include drawing down payments for uncompensated care, expanding costlier Medicare Advantage plans at the expense of traditional Medicare, and promoting high deductable health plans for seniors. Medicaid would be cut by $920 billion over ten years by limiting eligibility, imposing work requirements, and offering states waivers to curtail Medicaid spending. All of thes changes would hurt access to coverage and care for Medicaid beneficiaries.The proposal would cut funding for the Department of Health and Human Services by 9 percent or almost $10 billion in FY2021. This would include $2.6 billion in cuts to the National Institutes of Health (NIH) threatening the U.S. standing as a world leader in medical and biomedical research. Nearly $700 million is cut from the Centers for Disease Control and Prevention, harming public health at a critical time. The proposal moves or consolodates the Agency for Healthcare Research and Quality (AHRQ) into NIH without specific details about ow that change would be structured, while providing nearly $100 million less for the agency to meet its mission.The budget proposal also includes cutes to many of the programs that support our health care workforce. For instance, over $50 billion would be cut for vital payments to the Graduate Medical Education program, by which graduated medical students become competent physicians in a particular field of medicine and add to the nation’s physician supply. The proposal would also eliminate a large portion of Title VII health professions funding including $49 million of Section 747 training in Primary Care Medicine, the only federal program dedicated to funding and improving training of primary-care physicians. Budget cuts that harm support for training physicians and other health care professionals would reverberate for years to come. Congress should set aside this flawed plan. Instead, Congress should enact a budget that woudl support the health and well-being of all Americans. February 11, 2020: California State Senator Lena A. Gonzalez (Democrat – district 33) posted a press release on her official website titled: “Equal Insurance HIV Act announced to end discrimination against HIV-positive Californians for life and disability income insurance”. From the press release: Today, Senator Lena Gonzalez (D- Long Beach), Insurance Commissioner Ricardo Lara, and Equality California announced the Equal Insurance HIV Act to stop insurance companies from denying life and disability income insurance coverage based solely on HIV status. This bill proposal would enact anti-discrimination to ensure they have equal access to the coverage they deserve.“Everyone deserves access to life and disability income insurance, regardless of preexisting conditions,” said Senator Lena Gonzalez. “I am so proud that my first bill introduced in the legislature will ensure access to these critical resources for residents who are HIV-positive. It is time that we end the practice of insurance companies refusing to provide services to those who need it most.”This proposed bill overturns a law passed in 1989 when treatment for someone who tested HIV-positive was extremely limited. Therapies were ineffective, and came with severe side effects causing many individuals who were HIV-positive to bypass treatment. Today, with access to health care, advancement in HIV testing, and more effective treatment, a person who is HIV positive and undergoes and remains on treatment can live a long healthy life. HIV status is treated by medical professionals like any other treatable chronic condition……With HIV-positive people living longer healthier lives, their need for life and disability income insurance is imperative to protect themselves and their families. Current California law allows insurers to deny coverage for life or disability income insurance to HIV-positive individuals based on positive results of an ELISA test followed by a positive Western Blog Assay performed by or at the direction of the insurer – tests that are no longer commonly used today……A person’s HIV positive status should be treated in the same way as any other chronic condition in the writing of life and disability income insruance. This bill will ensure that life and disability insurance companies can no longer use outdated and discriminatory insurance underwriting law that allows insurers to refuse life and disability income insurance applications for HIV-positive individuals based solely on a positive HIV test… February 11, 2020: The American Civil Liberties Union (ACLU) posted a press release titled: “ACLU, Planned Parenthood, And Consumers Challenge Trump Administration Rule That Threatens Insurance Coverage For Abortion”. From the press release: The Rule Imposes More Than $1 Billion In Unnecessary Costs In An Effort To Coerce Insurance Companies to Stop Offering Coverage For Abortion, Affecting More Than 3 Million Consumers.Planned Parenthood of Maryland, Inc. and several consumers around the country filed a lawsuit today challenging the Trump administration’s new rule designed to make insurance companies stop offering coverage for abortion. They are represented by attorneys with the American Civil Liberties Union (ACLU), Planned Parenthood Federation of America, Inc., and Brown Goldstein & Levy, LLP.In December 2019, the Department of Health and Human Service (HHS) and the U.S. Centers for Medicare and Medicaid Services (CMS) released a new rule that, if implemented, would force insurance companies that sell plans in the Affordable Care Act individual marketplaces to send two separate bills to customers – onefor the coverage of abortion care, and another for coverage of other health care. Insurers will also have to instruct their customers to pay the bills using two checks, two money orders, or two electronic transactions every month.As the adminsitration acknowledged in finalizing the rule, the extensive administrative burdens will lead to higher premiums for consumers and will cause some insurers to drop insurance coverage for abortion altogether. As the administration also acknoweledged, confusion about these new requirements will lead some people to miss payments and risk losing their health insurance coverage entirely.“If this rule takes effect, I face the terrifying risk of losing not only my insurance coverage for abortion, but my insurance coverage entirely, which would be devistating for me given my pre-existing condition,” said Rebecca, a resident of Washington, D.C., and plaintiff in the case. “That’s why I’m joining the ACLU and Planned Parenthood to fight back. It is curel and unacceptable that the Trump administration is interfering in my health care and trying to interfere with how health insurance companies do business, just because they want to make it more difficult for me to access my right to abortion.”..…More than 3 million consumer would be affected by the rule’s onerous restrictions, including the individual plaintiffs in the lawsuit from Maryland, the District of Columbia, New Jersey, and Maine. The rule would also affect one-third of the individual market exchange plans nationwide, including every individual plan offered on the marketplaces in Maryland. A fact sheet on the impact can be found here……The lawsuit was filed in the U.S. District Court for the District of Maryland. February 12, 2020: California Attorney General Xavier Becerra posted a press release on his official website titled: “Attorney General Becerra Files Reply Brief in Supreme Court, Asks to Resove the ACA Repeal Lawsuit”. From the press release: Attorney General Becerra today led a coalition of 20 states and D.C. in filing a reply brief in the U.S. Supreme Court in California v. Texas. In the brief, the attorneys general reiterate the harms this ACA Repeal Case is causing our healthcare system and Americans’ healthcare. The brief also opposes arguments by the Trump Administration and the Texas coalition that the case should be sent back to the district court, and urges the Supreme Court to take up teh case to resolve uncertainty in the healthcare market.“Today, our coalition made clear that we must end the uncertainty and harm in our healthcare system caused by the Trump Administration and Texas coalition’s Repeal Lawsuit,” said Attorney General Becerra. “We are hopeful that the Supreme Court agrees with hospitals, bipartisan economists, public health experts, patients groups, businesses and others, and swiftly resolves this lawsuit.” A copy of the brief is here. February 12, 2020: Center for Reproductive Rights posted a press release titled: “In Congressional Testimony, Center for Reproductive Rights Urges Congress to Pass Historic Abortion Rights Legislation that Answers Calls to ‘Codify Roe;”. From the press release: Today, Nancy Northup, President and CEO of the Center for Reproductive Rights, testified in the U.S. House of Representatives on the Women’s Health Protection Act (H.R. 2975/S. 1645), federal legislation that answers the recent calls to ‘codify Roe’ by safeguarding the right to access abortion care for all people in the United States.In her testimony, Nancy Northup described the growing crisis in abortion care across the United States and urged Congress to take action on the landmark legislaton:“Our Constitution protects the right of each of us to chart our own life path and to make the deeply personal decisions that impact our lives, our families, and our health, including whether and when to become a parent. One in four women in the United States will make the decision to have an abortion in the course of her life. Yet in large parts of the United States, obtaining abortion care is difficult – and in some cases, impossible – due to a coordinated, nationwide strategy to eliminate access to abortion care.The Women’s Health Protection Act would ensure the right to abortion recognized nearly fifty years ago in Roe v. Wade is a day-to-day reality for people in the United States, no matter what state they live in … We need this law now – because the crisis is now.”Read Nancy Northup’s testimony here.The Women’s Health Protection Act establishes a statutory right for health care providers to provide, and their patients to recieve, abortion care free from medically unnecessary restrictions and bans.The hearing took palce in the House Energy and Commerce Subcommittee on Health, chaired by Representative Anna Eshoo (D-CA.). The Women’s Health Protection Act was introduced in the House of Representatives by Judy Chu (D-CA.), Lois Frankel (D-FL.), and Marcia Fudge (D-OH), on May 23, 2019. The bill has earned the support of over 210 cosponsors in the House, nore than in any previous Congress. Senators Richard Blumenthal (D-CT) and Tammy Baldwin (D-WI) introduced an identical bill in the Senate with 42 cosponsors… February 12, 2020: Planned Parenthood posted a press release titled: “Planned Parenthood Applauds Historic Women’s Health Protection Act”. From the press release: Today, the U.S. House Committee on Energy and Commerce, Subcommittee on Health will hold a historic hearing on the Women’s Health Protection Act (WHPA).WHPA is a critical piece of legislation that would protect against medically unnecessary abortion restrictions being pushed foward by politicians. Reproductive health champions Rep. Judy Chu (D-CA-27) and 215 co-sponsors in the House of Representatives, and Sen. Richard Blumenthal (D-CT) and 42 co-sponsors in the Senate, are pushing the legislation forward……During the 2019 state legislative sessions alone, 58 new restrictions on abortion were enacted into law. All in all, in 2019, a record 25 abortion bans were enacted in 12 states. At the bottom of the above press release, Planned Parenthood linked to a Fact Sheet about the Women’s Health Protection Act. From the Fact Sheet: Roe v Wade recognized the constitutional right to abortion. But for many people in the United States, accessing abortion is difficult and, in some places, nearly impossible. We need a federal law to assure that the right to access abortion first recognized in Roe v. Wade is a reality in every state. The Women’s Health Protection Act is that law.There is a coordinated, nationwide strategy to eliminate abortion accessIn 2016, the U.S. Supreme Court reaffirmed the right to access abortion care without undue burden. Yet anti-abortion lawmakers have escalated their attacks, pushing through over 170 harmful laws since them, and nearly 450 since 2011.These laws: Delay and obstruct accessLower the quality of care that is deliveredAre designed to shame those seeking abortionRequire providers to preform medically unnecessary procedures and tell patients factually incorrect informationIncrease costs and risks of reproductive health care servicesCreate gross inequities in access to health care These restrictions do nothing to protect health or safety of patients and can have long-lasting socioeconomic consequences for people and their families. The harms these barriers create are deeply unequal, falling most heavily on underserved people and commmunities, including people living in poverty, people of color, young people, LGBTQ people, and people living in rural or medically underserved areas.How does the Women’s Health Protection Act work?The Women’s Health Protection Act (WHPA) creates a nationwide safeguard against bans and medically unnecessary restrictions that single out abortion care, and protects the long-held constitutional right to access abortion. WHPA works by establishing a statutory right for health care providers to provide, and for their patients to receive, abortion care free from medically unnecessary limitations and bans. February 12, 2020: The House Committee on Energy & Commerce held a hearing titled: “Protecting Women’s Access to Reproductive Health Care”. The statements of some Committee members and the testimony of some of the participants will be included in this blog post. Opening Statement Chairman Frank Pallone, Jr. Today’s hearing is on legislation to protect women’s access to abortion care.This legislation is necessary today because states have passed an onslaught of ideological bans and restrictions intended to interfere with women’s personal medical decision-making and to severely limit women’s access to abortion care.Since 2011 alone, anti-abortion state lawmakers have passed nearly 450 restrictive laws with the sole purpose of making it more difficult for women to access this care. They’ve passed mandatory that waiting periods, requirements for multiple in-person visits, and requirements that doctors provide their patients with medically inaccurate information about the potential risks of the procedure. They have also passed rediculous and unnecessary building requirements for abortion providers tha are intended solely to shut down clinics that provide abortion services.The result of these increasingly restrictive laws is that women all across the country are having a harder time accessing abortion care, which they have a constitutional right to obtain. Comprehensive health care means having access to affordable abortion care, which is a safe medical procedure with far fewer risks than many routine medical procedures. Repeated studies have confirmed the safety of abortion, including comprehensive findings by the National Academics of Science, Engineering, and Medicine. It is a safe and legal procedure, but ideological state legislators continue to put up roadblocks for women and providers.Today, nearly 90 percent of American counties are without a single abortion provider, and six states only have one abortion clinic in the entire state. The unfortunate reality in America is that your constitutionally guaranteed health care rights are now dependent upon where you live, and that is wrong.Sadly, we know that anti-abortion restrictions fall hardest on those who already face significant barriers to health care: low-income women, women of color, LGBTQ people, young people, and people living in rural communities. At a time when we should all be working together to reduce health care disparities, we are watching states across the country actively pass legislation that increases those disparities, we are watching states across the country actively pass legislation that increases those disparities. Their actionsare putting access to care further out of reach. One particularly alarming study from the Center for Reproductive Rights and Ibis Reproductive Health found that states with more anti-abortion lawas have poorer health outcomes generally for both women and children than states that have fewer restrictions. This should be alarming to all of use especially as we are faced with an increasingly dire national maternal health crisis that we also know disproportionately impacts women of color.It is for all these reasons that we are holding this important and timely hearing on the Women’s Health Protection Act. This legislation simply ensures that patients can access, and health care providers can provide, abortion services. It prevents medically unnecessary and burdensome restrictions that single out abortion providers and deny women access to care. It is long past time that we affirm women’s health care rights by ensuring that they can actually utilize those rights. The Women’s Health Protection Act would do just that by ensuring the constitutional right to have an abortion is a reality for all people, no matter where they live… The full text of H.R. 2975 The Women’s Health Protection Act is here. Opening Statement Chairwoman Anna G. Eshoo Nearly 50 years ago, the Supreme Court affirmed the right of every woman to make decisions about her own life, body, and future.Now that right is under threat by state laws restricting and banning reproductive healthcare and abortion care.Since 2011 states have passed more than 450 medically unnecessary restrictions on reproductive care.For example, Alaska, Kansas, Oklahoma, and Texas force doctors to lie to their patients by having them inaccurately link abortion and breast cancer in theri patient counseling.Louisiana, Texas, and Wisconsin require providers to perform medically unnecesssary ultrasounds and show and describe the images to women who have already decided to have an abortion.Eighteen states have specific requirements for procedure rooms and corridors, as well as requiring facilities to be near and have relationships with local hospitals. These requirement do not improve patient care but set expensive standards that make it difficult for clinics to stay open.Today, 90 percent of counties in our country are without a single abortion provider, and six states have only one abortion clinic.So, why is this a problem that the Subcommittee should address?First, these restrictions deny women access to safe health care. Restricting abortion doesn’t stop abortion. It makes it less safe.A nonpartisan study by the National Academies of Sciences found that the biggest threats to the quality and safety of abortion care are state regulation that create barriers to trained abortion providers.When abortion is accessible and legal, it is extremely safe. The rate of serious complications in first-trimester abortions is less than 0.05 percent, making abortion 40 times safer than a colonoscopy.But when abortion care is restricted, women face devistating consequences.The landmark Turnaway Study, a five-year longitudional study by reserachers at UCSF, followed 1,000 women who sought, but did not always obtain, abortion care. The researches found that the women who were denied health care consistently fared worse outcomes than those who recieved it.The women forced to carry a pregnancy were more likely to experience eclampsia and were more likely to stay with abusive partners. They were four times more likely to be living below the poverty level. Two women who were denied abortion care died of pregnancy-related causes. The Women’s Health Protection Act makes sure that every Americanhas equal access to comprehensive reproductive health care, no matter where they live.This legislation follows in the tradition of the Voting Rights Act of 1965 where Congress safeguarded a constitutionally-protected right. That’s because states don’t get to pick and choose what part of the Constitution to follow… Holly Alvarado – advocate – provided testimony in support of H.R. 2975: The Women’s Health Protection Act. From her testimony: In her testimony, Holly Alvarado stated that she served in the United States Air Force from 2006 to 2011 as a law enforcement officer. In 2009, she was given orders for deployment with a 10 person team. Two weeks before her deployment, she wsa gathering supplies, packing, and moving her apartment into a storage unit, she realized she could be pregnant. ….I knew immediately that I did not want to continue this pregnancy. I knew me. 22 year old me knew that what now 33 year old me wanted out of life and this pregnancy was not part of my plan. Even though this was an immediate feeling, I took time to think about how I was not financially or emotionally in a state of my life where I was ready to continue a pregnancy and raise a child. While serving in the military, I saw the many challenges facing servicewomen with children… I made a deeply ethical and moral decision by myself and was resolute on what I needed to do……I called Planned Parenthood of North Dakota and learned that the closest facility that could perform abortions was in Fargo, ND, approximately 2 hours away. North Dakota only has one abortion clinic. which means longer wait times for an appointment. They did not have any appointments in the next two week and were unable to help me. I was encouraged to call St. Paul, MN’s Planned Parenthood office, 4 hours away. I called and scheduled my first and second appointment……My first appointment was needed to verify my pregnancy with an ultrasound and urinalysis, they would give me information, and an ultrasound picture. I needed to book a second appointment for the procdure itself. This was not due to any medical reason and it was certainly not my preference. Minnesota law mandates a 24 hour waiting period between the first appointment and the day of the procedure. And because of the wait times for an appointment at the clinic I would have to wait 3 days between appointments. I would spend a total of 4 days in Minnesota without resources. The day before my appointment I would have to wait for a mandatory phone call. I was told to wait by my cell phone and be somewhere with good service because I would need to answer and couldn’t miss the call. If I had missed the call they would have to cancel my appointment for the next day and I would have to start the process all over again. If that had happened I would have missed my deployment deadline, I would have been financially unable to repeat this process, and close to the gestitational limit of having an abortion. In that phone call I would be told I have options like adoption or continuing the pregnancy, that I am eligbile to receive child support and WIC, that my procedure could be dangerous and prevent me from having children in the future, and then I would need to confirm my appointment for the next day if I did not want to continue the pregnancy……I confirmed my appointment the next morning. The state laws, the biased counseling, the waiting period, the protesters in front of Planned Parenthood, all felt like a slap in the face……I chose the surgical abortion because it was a one day procedure with no follow up. If I took the medication abortion, I would need to have a follow up appointment after a week of taking the medication to make sure the pregnancy had ended. I would not be able to do that because I would be in training for deployment on an isolated base, so the only option was a surgical abortion…. The appointment was long as I would need another pregnancy test, an RH test, another ultrasound, and counseling with an RN. …When the procedure was complete I felt relief…..Because of a federal ban on abortion coverage I was unable to use TRICARE as my healthcare insurance and was unsure what I would do if there had been any complications… ….Regardless, the abortion was a saf procedure and I had zero complications, I returned to duty within 12 hours of having my procedure.The procedure for an abortion was approximately 500 dollars, coupled with preperation in purchasing gear for deployment, needs for gas, and food and the 4 hour, 600 mile roundtrip journey to get the healthcare I needed. I had 16 dollars to my name the day I drove back to North Dakota and pay day was 1 week and a half away… Nancy Northup, President and CEO of the Center for Reproductive Rights, provided testimony in support of the Women’s Health Protection Act. From her testimony: …Our Constitution protects the right of each of us to chart our own life path and to make the deeply personal decisions that impact our lives, our families, and our health, including whether and when to become a parent. One in four women in the United States will make the decision to have an abortion in the course of her life. Yet in large parts of the United States, obtaining abortion care is difficult – and in some cases, impossible – due to a coordinated, nationwide strategy to eliminate access to abortion care.Anti-abortion rights lawmakers in state legislatures are doing whatever they can to ensure that patients face insurmountable barriers to care and that clinics are forced to close – effectively banning abortion without ever havin to touch Roe v.Wade. Since 2011, nearly 450 laws restricting and banning abortion care have been pushed through state legislatures. These laws close clinics, increase health care costs, exacerbate ineqhalities, and harm women and their families. In 1992, the year that Planned Parenthood v. Casey was decided, there were 2,380 clinics in the United States. In 2017, there were 1,587 – a decrease of one third. Already six states are down to one abortion clinic, and nearly 90 percent of American counties are without a single abortion provider. The harms caused by the decimation of abortion access are deeply unequal, falling most heavily on marginalized and underserved people and communities who already experience stignificant structural and systemic barriers to accessing quality health care including abortion. These communities include low-income people, people of color, immigrants, young people, and people living in rural and other medically underserved areas. The Women’s Health Protection Act would ensure that the right to abortion first recognized nearly 50 years ago in Roe v. Wade is a day-to-day reality for people in the United States, no matter what state they happen to live in. This bill would create a federal statutory right for providers to provide abortion services, and a corresponding right for their patients to receive abortion services, free from medically unnecessary restrictions and bans that single out abortion and impede access to care.Congress has the authority under the Commerce Clause to regulate health care as interstate commece, and the authority under Section 5 of the Fourteenth Amendment to protect against the abridgement of constitutionally protected rights. It must exercise this authority now and protect the right to access abortion care first recognized in Roe by passing the Women’s Health Protection Act… Yashica Robinson, MD, who is a board certified obstetrician-gynecologist, provided testimony. She serves on the board of directors of Physicians for Reproductive Health and is the medical director of Alabama Women’s Center. From her testimony. …I came to this work because of my passion for young people, one that is deeply connected to my personal experience with teen pregnancy. Prior to finishing high school, I learned I was pregnant. As a result of fear and lack of resources, by the time I confided in my mother and grandmother, I had no choice – I was going to be a mother. Becoming a mother as a teenage came with many harsh realities. I love ny children with all my heart, but I know that everyone should be able to make the decision to parent for themselves. I have been in the shoes of many of the young people I see in my clinic, and it’s important for them to know that regardless of their decision, that I am here to support them.I support the Women’s Health Protection Act becasue it would help ensure tha access to care does not look differently depending on your zip code. In states like California or Maryland, today a patient can access abortion care without the state forcing medically inaccurate information on them, or making them endure a medically unnecessary waiting period. This is what care should look like. Unfortunately, today that is not the case for my patients in Alabama.Providing abortion care in Alabama is challenging. Just last year, the legislature passed a near total ban on abortion. Under that ban a physician could be sent to prison for 99 years for performing an abortion. This law, should it ever go into effect, it would threaten doctors like myselfwith prison for providing ethical, medically appropriate care. There is no other area of medicinewhere politicians threaten physicians with prosecution for doing their jobs. Represented by the ACLU, I and other abortion providers in the state filed suit to prevent this bill from going into effect. Thankfully, the ban was blocked, and abortion remains legal in Alabama, as it is in every other state.…It is not unusual for patents to travel up to eight hours, or from as far away as Louisiana and Florida – because so many other providers have been forced to shut their doors. Then they are required to wait an additional 48 hours before I can provide the care they need due to a state-imposed waiting period. I know people who have slept in their cars as a result of this manditory delay period because they had no other options.The state also requires that my patients recieve outdated materials as part of so-called “counseling” that are filed with misinformation that I then need to correct. We are required to do ultrasound examinations, even when they are unnecessary and provide no medical value. These restrictions only add costs and delays. Their effects on my patients are painful for me to see.Alabama also bans abortion after 20 weeks post-fertilization. Patients needing care after that point have to travel out of state, making care even more expensive. And young people in Alabama have to navigate an onerous, time-intensive process to have an abortion if they cannot involve a parent. I have cared for a 12-year-old victim of incest who faced many delays before finally getting judicial approval for the abortion she needed. Even though I met her in her first trimester of pregnancy, she was nearing Alabama’s legal limit by the time she navigated all of these hurdles……in 2018, the National Academies of Sciences, Engineering, and Medicine (NASEM) published a comprehensive study affirming that abortion is extremely safe and the biggest threat to patient safety is the litany of medically unnecessary regulations that raise costs and delay procedures, ultimately putting women’s health at risk. They confirmed what we already know: that access to safe abortion care all too often depends on where you live and how much money you have……The bottom line is this: Abortion is healthcare! The Women’s Health Protection Act would bring needed federal protections for my patients and safeguard their right to abortion care. Protecting abortion care will also protect access to pregnancy care because they are interconnected. Health care in any speciality should be patient-centered, and medical decisions should remain between the patient and her physician, without political interference. There were also two anti-choice people who provided testimony. Their words do not belong in my blog post. February 13, 2020: New York Attorney General Letitia James posted a press release titled: “AG James Voices Support for Legalization of Surrogacy In New York”. From the press release: Attorney General Letitia James released the following statement in support of legalizing gestational surrogacy in New York. “Our antiquated surrogacy ban makes it prohibitively expensive and burdensome for many New Yorkers to become parents. Countless families, particularly members of the LGBTQ community and those with fertility issues, have been unable to have a child through surrogacy because of this outdates law. The current proposal has been well-researched, well-written, and will not only support families, but provide critical legal and medical protections to surrogates, parents, and children. I respect the legislative process and look forward to meeting with members of the legislature to address their concerns so we can move forward to adopt this proposal.”“New York is one of the most progressive states in the nation and a leader in LGBTQ and women’s rights, and yet we are only one of three states that does not allow LGBTQ individuals and people struggling with fertility to conceive a child and start a family through gestational surrogacy,” said Governor Andrew M. Cuomo. “We need to right that wrong, and with the support of the Attorney General and our broad coalition of advocates, this year we will get it done and complete marriage and family equality”… February 18, 2020: The American Civil Liberties Union (ACLU) posted an article titled: “There is a Coordinated Attack Agains Trans Youth in State Legislatures”. It was written by Rose Saxe. From the article: Less than a month and a half into 2020, this state legisative session has seen unprecedented attacks on LGBTQ people, and an alarming focus on bills that would harm trans youth……Right now, bills are pending in 10 states that would criminalize life-saving, best practice medical care for trans youth, putting govenrment in the way of decisions that should be left up to the young person, their parents, and their medical providers. Proponents of these bills repeat similar lies about medical care, but these bills are opposed by all major medical associations that just want to be sure all kids can get the health care they need.At the same time, 16 states currently are considerin bills that would ban young trans athletes from participating in athletic activities consistent with their gender (bills in Missouri and Idaho have hearings this week.) Some of the bills only exclude girls who are trans, echoing language tha was once used to keep cisgender women out of sports. Others also require boys who are trans to participate solely on girls’ teams. Statewide scholastic sports organizations typically regulate the terms of participation in sports to ensure all youth can participate fairly. These bills would instead authorize invasive medical examination of young athletes, and would substitute a categorical exlcusion from school sports that doesn’t match up even with the most strignent regulations governing elite competition like the Olympics.And still, other bills would allow all health care providers to refuse care based on religious objections to trans people, or make it harder for schools to support trans youth.These bills – and dozens of other anti-LGBTQ measures – are pending in states across the country from Alaska to Florida. That’s not a coincidence. These efforts are part of an orchestrated national campaign led by groups like Heritage Foundation, Alliance Defending Freedom, – who last week filed a lawsuit attacking trans student athlethes – and the Family Policy Alliance, to demonize trans youth and drive a wedge among supporters of LGBTQ equality. We can’t let them succeed… February 18, 2020: New York Attorney General Letitia James posted a press release titled: “Attorney General James Condems Federal Proposal To Roll Back Critical Anti-Discrimination Protections For Patients and Students”. From the press release: New York Attorney General Letitia James today sent two multistate comment letters to the Trump Administration, opposing federal proposals that roll back critical anti-discrimination protections for patients and students. Both proposals stem from President Trump’s Executive Order that allows faith-based organizations to deny services to various groups. In the first proposal, the U.S. Department of Health and Human Services (HHS) would eliminate transparency requirements for faith-based providers that help patients to understand their rights and access referrals to care from alternative providers. In the second, the U.S. Department of Education is vastly expanding the definition used to claim a religious exemption under Title IX of the Education Amendments Act of 1972. This would allow schools to discriminate on the basis of sex against students or faculty based on the moral beliefs and practices of administrators, even if those practices have no connection with a religion. Together, these federal proposals are part of the Trump Administration’s ongoing assault on the rights of women, survivors of sexual harassment and violence, and LGBTQ+ individuals.“The president’s Executive Order is nothing more than a veiled attempt to discriminate against our nation’s patients, students, and those who are most vulnerable,” said Attorney General James. “Religion should never be used as weapon, yet the Trump Administration has repeatedly worked to pit Americans against each other by using faith as a wedge between us. Our coalition is fighting the president’s attempts to divide Americans along religious lines, and will continue to do everything in our power to protect women, LGBTQ+ individuals, and those who need these vulnerable protections.”In the first comment letter, the coalition of 23 attorneys general contends that HHS’ proposal fails to safeguard the rights of women and LGBTQ+ individuals – both groups which already disproportionately face barriers to care. particularlu when it comes to obtaining accurate information about theri health care and referrals. The reciept of accurate and impartial information from providers is vital to a patient’s health and could mean the difference between the life and death. Under the proposal, faith-based providers will no longer be required to notify patients of their rights, including the right to a referral. For instance, removing notice and referral requirements will adversely impact a woman’s ability to access critical reproductive care, including an abortion. In fact, religiously-affiliated crisis pregnancy centers – which have seen an uptick in federal funding under the Trump Administration – have been known to offer patients misleading information in an attempt to discourage them from obtaining an abortion or accessing contraception. In the comment letter, the coalition maintains that HHS’ proposal is arbitrary and capricious because it failes to consider evidence or adequately justify the proposed changes.In the second comment letter, the coalition of 20 attorneys general highlights how the Department of Education’s proposal to expand religious expemptions under Title IX could give schools free rein to discriminate against students or faculty on the basis of sex – significantly harming people who have suffered discrimination, including sexual harassment and violence. Currently, Title IX contains a narrow religious exemption for educational institutions controlled by a religious organization. The proposal would allow more schools to discriminate on the basis of sex by broadening the criteria for institutions to claim a religious exemption, such that even schools with a tenuous relationsip with religion could claim exemption from Title IX requirements. As a result, under the proposal, a student could unlawfully face discrimination – for using birth control, being pregnant or parenting a child out of marriage, or for being LGBTQ+ – simply because of the moral beliefs or practices of school administators. Sexual harassment and violence survivors could also be denied the protections of Title IX by schools claiming to be exempt under the proposed rule. This kind of discrimination can needlessly and seriously disrupt a student’s academic trajectory and career and could have a detrimental long-term effect on their mental health. The coalition also notes that the proposal is arbitrary and capricious because the federal government failed to provide any substantive reasoning that would justify this dramatic departure in policy, which is contrary to the goals of Title IX.Joining Attorney General James in sending the first letter to HHS are the attorneys general of California, Connecticut, Delaware, Hawai’i, Illinois, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, North Carolina, Oregon, Pennsylvania, Vermont, Virginia, Washington, Wisconsin, and the District of Columbia.Joining Attorney General James in sending the second letter to HHS are the attorneys general of California, Colorado, Connecticut, Delaware, Hawai’i, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, North Carolina, Oregon, Pennsylvania, Vermont, and the District of Columbia. February 20, 2020: The American Civil Liberties Union (ACLU) posted a press release titled: “ACLU, Center for Reproductive Rights, Planned Parenthood File Motion For Summary Judgement In Georgia Abortion Ban Lawsuit”. From the press release: Today, the American Civil Liberties Union, the ACLU of Georgia, the Center for Reproductive Rights, and Planned Parenthood filed a motion for summary judgement in their lawsuit challenging Georgia’s abortion ban, SisterSong v. Kemp. The motion asks the court to block the ban permanently from taking effect.The lawsuit, which was filed in June 2019, challenges Georgia’s abortion ban which was set to take effect on January 1, 2020. The law would ban abortion care from the earliest weeks of pregnancy, before many women even know they are pregnant.According to the lawsuit, Georgia’s abortion ban is in clear violation of Roe v. Wade and nearly a half century of Supreme Court precedent reaffirming Roe’s central holding. Writing for the court in 1992, U.S. Supreme Cout Justice Sandra Day O’Connor wrote, “The ability for women to participate equally in the economic and social life of the Nation has been facilitated by their ability to control their reproductive lives.”On October 1, 2019, the federal district court granted the plaintiffs motion for preliminary injunctive relief and temporarily blocked the ban from taking effect while the lawsuit is pending. The preliminary injunction will remain in place until the court explicitly says otherwise.If plaintiffs’ motion for summary judgement is granted, the abortion ban will be permanently blocked unless an appeals court says otherwise.“As a reproductive justice organization based in Georgia for over 20 years, SisterSong is committed to centering and amplyfying the needs of those communities historically pushed to the margins. Georgia’s maternal mortality rate is the second highest in the nation and Black women in our state are dying at six times the national average. SisterSong is bringing this lawsuit to protect maternal health and reproductive rights so that every person – especially persons of color – can thrive in their families and communities as well as maintain their reproductive lives,” said Monica Simpson, executive director of SisterSong……According to a 2019 Atlanta Journal-Constitution poll, 70 percent of Georgians support Roe v. Wade, the landmark U.S. Supreme Court case that guaranteed the right to an abortion……The organizations bringing forward the lawsuit are SisterSong Women of Color Reproductive Justice Collective, Feminist Women’s Health Center, Planned Parenthood Southeast, Inc., Atlanta Comprehensive Wellness Clinic, Atlanta Women’s Medical Center, FemHealth USA d/b/a carafem, Columbus Women’s Health Organization, P.C., Summit Medical Associates, P.C., Carrie Cwiak, M.D., MPH., Lisa Haddad, M.D., M.S., M.P.H., and Eva Lathrop M.D., M.P.H.The defendants in the case are Georgia Governor Brian Kemp, Attorney General Christopher M. Carr, Commissioner for the Department of Public Helath Kathleen Toomey, the Executive Director and Members of the Georgia Composite Medical Board, and the District Attorneys for the counties where the plaintiffs provide medical care – all sued in their official capacities… A copy of the lawsuit can be found here. February 20, 2020: Center for Reproductive Rights posted a press release titled: “Appeals Court Blocks Mississippi’s Six-Week Abortion Ban”. From the press release: Today, the Fifth Circuit Court of Appeals temporarily blocked Mississippi’s six-week abortion ban, upholding a lower court’s decision from May 2019. The case was brought by the Center for Reproductive Rights, civil right attorney Robert B. McDuff, of Jackson, Miss., Paul, Weiss Rifkind, Wharton & Garrison, and the Mississippi Center for Justice on behalf of Jackson Women’s Health Organization (JWHO) – the last remaining abortion clinic in Mississippi. On December 13th of last year, the Fifth Circuit struck down a 15-week ban passed by Mississippi.In today’s decision, a three-judge panel of the Fifth Circuit wrote, “[A]ll agree that cardiac activity can be detected well before the fetus is viable. That dooms the law. If a ban on abortion after 15 weeks is unconstitutional, then it follows that a ban on abortion at an earlier stage of pregnancy is also unconstitutional.” “This is now the second time in two months the Fifth Circuit has told Mississippi that it cannot ban abortion,” said Hillary Schneller, senior staff attorney at the Center for Reproductive Rights. “Despite the relentless attempts of Mississippi and other states, the right to legal abortion remains the law of the land.”The six week abortion ban was signed into law in March 2019 and blocked in May by District Judge Carlton W. Reeves. In his decision, he wrote, “Here we go again: Mississippi has passed another law banning abortions prior to viability.” He went on to say that, [This law] prevents a woman’s free choice, which is central to personal dignity and autonomy.”“A ban at six weeks of pregnancy means many of our patients would lose their right to have an abortion before they even know they’re pregnant,” said Shannor Brewer, director of Jackson Women’s Health Organization. “Most of our patients are past that point. Some have spent weeks saving money for the procedure and have driven hundreds of miles to reach us. Keeping thsi law blocked means abortion remains legal in Mississippi and gives those women a chance to access it.”The ban violates Supreme Court precedent dating back to Roe v Wade affirming that a state may not ban abortion prior to viability, meaning the point at which a fetus can survive for a sustained period outside the womb… February 24, 2020: The American Civil Liberties Union (ACLU) of Wyoming posted an article titled: “ACLU of Wyoming Supports Funding Mental Health, Substance Use Diversion Programs”. From the article: Mental health and substance use diversion programs are an effective way to redirect people out of the criminal legal system and into supportive community treatment. Current diversion efforts in Wyoming, however, have proven ineffective because of a lack of adequate upfront funding. That’s why ACLU of Wyoming supports House Bill 31, legislation that would require the Department of Health and the Department of Corrections to collaborate to reduce criminal offender recidivism by improving mental health and substance use programming and funding. House lawmakers passed House Bill 31 last week. The ACLU of Wyoming urges the Senate to take up consideration of the bill as soon as possible……Although House Bill 31 comes with a price tag – the Legislative Service Office estimates it would cost $648,760 to fund – diversion programs like this are cheaper and more effective than incarceration……Expanding the use of mental health and substance use diversion programs is among the proposed reforms in the ACLU of Wyoming’s Blueprint for Smart Jusice report. The report includes an overview of Wyoming’s incarcerated populations, including analysis on who is being sent to jail and prison and the racial disparities that are present, what drives people into the system, how long people spend behind bars and why people are imprisioned for so long. It also offers a calculation on the impact of certain reforms by 2025 on racial disparities in the prision population, fiscal costs and progress toward a 50 percent decarceration goal. February 24, 2020: Planned Parenthood posted a press release titled: “Court Denies Relief for Title X Patients”. From the press release: Today, an en banc panel of the U.S. Court of Appeals for the 9th Circuit voted 7-4 to uphold the Trump administration’s unethical and dangerous gag rule on Title X, the nation’s program for affordable birth control and reproductive health care. Planned Parenthood sued the Trump administration in March to block to tell patients how or where to access abortion, and imposes cost-prohibitive and unnecessary “physical separation” restrictions on health centers that provide abortion. These moves were obvious and ultimately successful tactics to push Planned Parenthood health centers and other reproductive health care providers out of Title X.In “strongly” dissenting, Judge Paez, joined by three other judges, wrote, “In vacating the preliminary injunctions, the majority blesses an executive agency’s disregard of the clear limits placed on it by Congress. The consequences will be borne by the millions of women who turn to Title-X funded clinics for lifesaving care and the very contraceptive services that have caused unintended pregnancy – and abortion – to plummet.”… February 24, 2020: The American Civil Liberties Union (ACLU) posted an article titled: “ACLU Response to Ninth Circuit Ruling on Title X Family Planning Program”. From the article: The U.S. Ninth Circuit of Appeals upheld a Trump administration policy that is destroying the Title X family planning program.The rule prohibits family planning clinics – which previously served as the source of health care for more than four million low-income people every year – from providing Title X patients with referrals for abortion care and imposes other onerous requirements that have resulted in the widespread loss of critical Title X providers.The Eastern District of Washington blocked the Trump administration’s rules, but the Ninth Circuit overturned that decision and issued a ruling on the merits.“We are deeply disappointed that today’s decsion allows the Trump administration to once again make it harder and harder for people to get the health care they need, including family planning care,” said Ruth Harlow, senior staff attorney at the ACLU Reproductive Freedom Project, who argued the case before the Ninth Circuit. “We are looking at any further options to rescue the Title X program and to restore the critical care it has provided to marginalized patients for almost five decades.”The ACLU’s lawsuit was brought on behalf of the National Family Planning & Reproductive Health Association and Cedar River Clinics. February 24, 2020: The American Medical Association posted an article titled: “U.S. appeals court upholds Title X gag rule on physicians”. It was written by Senior News Writer, American Medical Association, Andis Robeznieks. From the article: …The Trump administration gag rule that violates the AMA Code of Medical Ethics by mandating that physicians serve as government mouthpieces in discussions with patients in the Title X program will be allowed to take effect. The 9th U.S. Circuit Court of Appeals, in a 7-4 decision, vacated orders previously entered by federal district courts in California, Oregon, and Washington.“The AMA is disappointed by – and strongly disagrees with – the reasoning behind a federal appeals court’s decision to allow the Trump administration to enforce a gag rule on physicians,” said AMA President Patrice A. Harris, MD, MA.The ruling upholds the decision made last June by a three-judge panel from the same court that lifted a nationwide injunction issued by the district court. The AMA appealed that decision in the case, AMA v. Azar, and asked for it to be heard by a larger, “en banc” panel from the 9th Circuit.A brief filed by the AMA and its co-plaintiffs included arguments against the gag rule and noted that the Health and Human Services Department (HHA) “cannot point to one instance where Title X funds have been misapplied.”The court dismissed the arguments….…Dissenting Judge Richard A. Paez cited the decision from last April by U.S. District Judge Michael McShane. That judge blocked the rule’s implementation arguing that the gag rule contradicted the Code of Medical Ethics’ prohibition on withholding information from patients and that it instructed doctors “to intentionally mislead patients.”“The majority would return us to an older world, one in which a government bureaucrat could restrict a medical profession from informing patients of the full range of health care options available to her,” Paez wrote……Unless it is appealed to the Supreme Court, the ruling ends proceedings regarding injunctions on the gag rule and other new HHS regulations. The decision also hands the case back to the district court “for further proceedings consistent with this opinion.”In the immediate future, however, Paez predicted it will be patients who will feel the biggest impact.“In vacating the preliminary injunctions, the majority blesses an executive agency’s disregard of the clear limits placed on it by Congress,” he wrote. “The consequences will be borne by the millions of women who turn to the Title X-funded clinics for lifesaving care and the very contraceptive services that have caused rates of unintended pregnancy – and abortion – to plummet.”Dr. Harris said the AMA will continue to oppose gag rules on physicians… February 26, 2020: The American College of Physicians (ACP) posted a press release titled: “Internists Say Court Decision to Uphold Title X Changes Will Harm Patient-Physician Relationship”. The statement is attributable to Robert McLean, MD, MACP, President, American College of Physicians. From the press release: The American College of Physicians (ACP) is disappointed in the federal appeals court decision to allow the Trump administration’s restrictions on the Title X program to go into effect. The changes will interfer in the patient-physician relationship, restricting the counsel that physicians can provide to their patients.Restricting the program will jeopardize access to health care for vulnerable, often working, low-income patients who may have limited to no access to health insurance. They rely on the clinics who depend on Title X funding to provide preventative car and contraception services.ACP opposes any restrictions that interfere with the patient-physician relationship. We will continue to fight against this or any other regulations that would prevent the physician from using sound medical judgement to counsel patients. February 26, 2020: American Civil Liberties Union (ACLU) posted an article titled: “Stopping the Anti-Abortion Ordinances of East Texas”. It was written by Anjali Salvador. From the article: Waskon. Naples. Joaquin. Tenaha. Rusk. Gary. Wells. These names might sound unfamiliar now, but you’ll be hearing more about the soon enough.They are seven cities in East Texas that, within the last several months, each passed so-called “sanctuary city for the unborn” ordinances – moves that are blatently unconstitutional. Waskom, Texas, was the first municipality to pass such an ordinance in July 2019. Soon after, other east Texas cities followed suit. The ordinances attempt to ban abortion within the cities if Roe v. Wade is overturned and some of them even try to ban emergency contraception.The ordinances also declare organizations working to protect the right to abortion, including our clients Lilith Fund and Texas Equal Access Fund (TEA Fund), as “criminal organizations,” even though they have done absolutely nothing wrong. The ordinances function to silence abortion advocates, preventing them from operating and even speaking about abortion within the city limits.These ordinances constitute an outright attack on abortion and free speech, which is why today we filed a lawsuit against these seven cities……Under these local laws, our clients cannot speak up about abortion rights, recruit volunteers to help them do their important work, or congegate to share informational materials in these cities without worrying about getting sued. The laws intentionally and unconstitutionally obstruct our plaintiffs’ ability to do their jobs, impeding the advocacy work that is intregral to their mission.In contrast, anti-abortion organizations face no such restrictions, remaining free to undermine access to reproductive health care without legal ramifications. It’s this targeted and discriminatory suppression of speech and assembly that violates our clients’ First Amendment rights – and exactly what we are challenging in our lawsuit… February 27, 2020: Openstates posted information about Georgia House Bill HB 1060, which is called “Vulnerable Child Protection Act; enact”. The purpose of the bill is to prevent doctors from providing gender-affirmative health care to minors – even if the minor’s parent believes it is the healthiest choice for their child. The Abstract says: A BILL to be entitled an Act to amend Title 31 of the Official Code of Georgia Annotated, relating to health, so as to prohibit certain licensed, certified, or registered professionals from engaging in certain acts upon minors; to provide for a short title; to provide for definitions; to provide for exceptions; to provide for a penalty and private cause of action; to explicitly waive sovereign immunity, qualified immunit, and official immunity for such a private cause of action; to provide for related matters; to provide for an effective date and for applicability; to repeal conflicting laws; and for other purposes. Here are some of the cruelest things in this bill: This is the part where the bill denies minors recognition of their gender. It also prevents minors from accessing the gender-affirming health care they want. …’Sex’ means the biological state of being female or male, based on sex organs, chromosomes, or endogenous hormone profiles……no health care professional shall engage in any of the following practices upon a minor, or cause such practices to be performed, for the purpose of attempting to affirm the minor’s perception of such minor’s sex, if that perception is inconsistent with such minor’s sex:(1) Performing any surgery that sterilizes, including, but not limited to, castration, vasectomy, hysterectomy, oophorectomy, metoidioplasty, orchiectomy, penectomy, phalloplasty, or vaginoplasty;(2) Performing a mastectomy;(3) Removing any otherwise healthy or nondiseased body part or tissue; or(4) Administering or supplying medications that induce transient or permanent infertility, including, but not limited to:(A) Puberty-blocking medication to stop or delay normal puberty;(B) Supraphysiologic doses of testosterone to females; or(C) Supraphysiologuc doses of estrogen to males…. Here’s the part where the bill takes away parent’s rights to make decisions that would allow their minor child to recieve gender-affirming health care: The chapter shall not apply to the medical decision of a parent or guardian of a minor born with one of the following medically verifiable genetic disorders of sex development:(1) A minor with external biological sex characteristics that are irresolvably ambiguous, such as a minor born with 46 XX with virilization or 46 XY with undervirilization; or a minor with both ovarian and testicular tissue; or(2) When a physician has otherwise diagnosed a sex development order, in which the physician has determined through genetic testing that the minor does not have the normal XY sex chromosome structure for a male or XX sex chromosome structure for a female. Here’s the part that criminalizes health care professionals who provide gender-affirming health care to a minor who wants it and whose parent wants them to have it: …(a) Any health care professional who violates this chapter shall be held guilty of a felony and, upon conviction thereof, shall be punished by imprisonment for not less than one nor more than ten years.(b) Within ten days of a conviction, a health care professional who is convicted of violating this chapter shall notify in writing the applicable licensing board for his or her licensure, certification, registration, or other authorization to conduct such health care professional’s occupation. Upon being notified and notwithstanding any law, rule, or regulation to the contrary, the appropriate licensing board shall revoke the license, certification, registration, or other authorization to conduct such health care professional’s occupation… February 27, 2020: Center for American Progress posted a press release titled: “Virginia Legislature Removes Medically Unnecessary Barriers to Abortion Access”. Today, the Virginia General Assembly passed the Reproductive Health Protection Act, which will expand access to abortion care by repealing medically unnecessary restrictions that have made it more difficult for Virginians to access safe and legal abortion care for years.The Act strikes down the following restrictions:The Two-Trip Mandatory Delay Law: A law forcing pregnant people to undergo an unnecessary ultrasound, listen to state-mandated biased counseling, and then wait at least 24 hours before their procedure. This means pregnant people are unnecessarily delayed in accessing care because they must make at least two trips to the clinic, creating onerous burdens – especially for poor and low-income people – seeking care in the Commonwealth.The Licensing Law: A law targeting abortion providers that subjects them to a burdensome, medically unnecessary regulatory scheme that applies to no other medical professionals and has no legitimate medical bias.The Physicians Only Law: A law prohibiting trained and qualified advanced practice clinicians from providing first-timester abortion care… March March 2, 2020: President of the American Federation of Teachers (AFT) Randi Weingarten, posted a press release titled: “AFT President Randi Weingarten on the U.S. Supreme Court Decision to Grant Cert on the Affordable Care Act”. From the press release: Randi Weingarten, president of the American Federation of Teachers, whose 1.7 million members include nurses and healthcare professionals, issued the following statement after the Supreme Court’s decision today to accept review of another challenge to the Affordable Care Act:“The fact that yet another challenge to the ACA has been brought by President Trump and Republican governors to the Supreme Court demonstrates their continued callous disregard to the healthcare needs of Americans. This is a ‘which side are you on?’ moment. The Republican Party wants to deny coverage for anyone with a pre-existing condition and then pretend they will not be pauperized because of their or a family member’s cancer, asthma, diabetes or any of the pre-existing conditions that millions of Americans have. Because the White House was unsuccessful in its attempt to repeal the ACA in Congress, it will use any means to destroy our country’s prevailing healthcare law.“It is sadthat the Republicans are not even honest about their strategy; they should at the very least have joined with Democrats in their motion to expedite having the case heard and decided before the 2020 election. Instead, the Republicans have lied about their intent in public, presumably because they, too, know the public is against them. But the decision by the Supreme Court to hear the case offers an opportunity to stop this assault on the ACA, working people and individuals with pre-existing conditions.“During this moment while we are dealing with the coronavirus and an international health crisis, we need to expand access to healthcare, not restrict it, as President Trump and the GOP have tired to do more than 50 times with their lawsuits against the ACA. High-quality, affordable healthcare should be a human right guaranteed to all; people with underlying health conditions and those in underserved communities are especially at risk.“More than 70 percent of Americans support the ACA and its protections for people with pre-existing conditions. Rather than seek to eliminate coverage, President Trump and the Republicans could work with Senate Democrats to lower drug costs; the House has already passed H.R. 3, The Elijah E. Cummings Lower Drug Costs Now Act.“If Donald Trump is re-elected and Republicans have free rein on the government, they will strip these protections from millions of Americans. It is up to voters to turn the tide on the insidious policies of this administration so that countless Americans facing an affordability crisis are no longer forced to exist in perpetual instability.” March 3, 2020: ABC News posted an article titled: “Virginia bans conversion therapy for LGBTQ minors”. It was written by Ella Torres. From the article: Virginia became the 20th state in the country to outlaw conversion therapy for LGBTQ minors after Gov. Ralph Northam signed the ban into law on Monday.Conversion therapy is described as a practice to forcibly change an individual’s sexual orientation or gender identity.“Conversion therapy sends the harmful message that there is something wrong with who you are,” Northam said in a statement. “This discriminatory practice has been widely discredited in studies and can have lasting effects on our youth, putting them at a greater risk of depression and suicide.”……LGBTQ youth who had undergone conversion therapy were more than twice as likely to attempt suicide compared to those who did not, according to the organization.The other states that have banned conversion therapy for minors are California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maryland, Massachusetts, Maine, Nevada, New Jersey, New Hampshire, New Mexico, New York, Oregon, Rhode Island, Utah, Vermont and Washington.The Virginia bill outlaws any health care provider in any profession licensed by a regulatory board of the Department of Health from engaging in conversion therapy, according to a copy of the bill.The bill also notes that no state funds will be allocated for the purpose of conversion therapy.It goes into effect July 1. March 3, 2020: CBS News posted an article titled: “Roe v. Wade might not matter after Supreme Court decides this case”. It was written by Katie Smith. From the article: For nearly 50 years, access to abortion has been largely protected by Roe v. Wade, the 1973 Supreme Court deicision that legalized abortion nationwide. But a case before the high court this week could erode the landmark decision without ever challenging it directly.The Supreme Court will hear oral arguments Wednesday for June Medical Services v. Russo, a case that challenges a 2014 Louisiana law. The result coudl impact abortion access across the country, and advocates fear the relatively recent additions of two conservative justices make it more likely that the court upholds the law.Known as the Louisiana “Unsafe Abortion Practice Act,” the law requires doctors who provide abortions to have privileges to admit patients at a nearby hospital. Supporters of the law say its designed to improve patient safety, but critics say it’s intended to shut down clinics that provide abortion.When the law was signed in 2014, only one of the state’s six abortion clinocs at the time had a physician who was compliant with its regulations. The law has been largely blocked from implementation, but was briefly allowed to go into effect in early 2016, prompting the closure of two of the state’s remaining clinics.Today, Louisian has just three abortion clinics across the state. If the Supreme Court finds Louisiana’s law constitutional, all of them would stop offering the procedure, as first reported by CBS News. The court’s ultimate decision is expected early this summer……The Supreme Coirt isn’t expected to make a decision in June Medical Service v. Russo until later this year. When it does, abortion rights supporters warn that if the court upholds the law, the ramifications would go beyond Louisiana and could create a patchwork of abortion access across the country… March 3, 2020: Representative Barbara Lee tweeted: “Instead of working to improve residents’ health, Louisiana lawmakers are blocking access to abortion with a clinic shutdown law. Let me be clear: Abortion is #MyRightMyDecision, regardless of income, zip code, or the opinions of anti-choice politicians”. The tweet included a link to an article from The New York Times. March 3, 2020: ABC News posted an article titled: “Mississippi seeks abortion ban for race, sex, genetic error”. It was written by Emily Wagster Pettus. From the article: Mississippi’s Republican-led Legislature is trying to restrict the reasons women may seek abortion, after federal courts blocked time limitations that the state tried to put on the procedure the past two years.Abortion would be prohibited if a woman is seeking one because of the race, sex or genetic abnormality of the fetus, under a bill that passed a state House committee Tuesday. The only exception would be in a case of a medical emergency. Other states have been sued over similar laws, and opponents questioned whether Mississippi is inviting another lawsuit over abortion.House Bill 1297 moves to the full House for more debate……Anyone who performs an abortion because of race, sex, or genetic abnormality could face one year to 10 years in prison. The woman having the abortion would not face penalties.Democratic Rep. Sonya Williams-Barnes of Gulfport voted against the bill.“Women should have a right to make a choice for themselves whether they want to have a child or not,” Williams-Barnes said after the committee meeting.She questioned whether women would even know about potential genetic abnormalities early enough in a pregnancy to consider abortion. Mississippi law bans abortion at 20 weeks, about the midpoint of a full-term pregnancy. Speaking of the genetic abnormality portion of the bill, Wiliams-Barnes said: “My concern is, you make the woman have the child that has these deficiencies, but yet are you going to give her any medical aid or home care assistance for the child?”… March 4, 2020: Representative Jackie Speier tweeted: “Abortion is extremely safe. The risk of complication is lower than from a colonoscopy, wisdom tooth removal, or a tonsillectomy, which do not require admitting privileges. The law before #SCOTUS is all about chipping away at Roe, NOT about protecting women. #MyRightMyDecision” The tweet included a video of Representative Jackie Spier speaking with a reporter as representatives gathered to walk to the Supreme Court. March 4, 2020: Congresswoman Ayanna Pressley tweeted: “Today SCOTUS is hearing a case on Louisiana’s clinic shutdown law. Today, we are reaffirming that abortion care IS healthcare. Every person, regardless of income, sexual orientation, or gender, deserves equitable access to comprehensive medicine. #MyRightMyDecision”. March 4, 2020: New York Attorney General Letitia James tweeted: “We took action in this case because in this nation women have a constitutional right to reproductive freedom, and New York will always defend that right. #MyRightMyDecision”. The tweet included a tweet of her’s from December 3, 2019, in which she states: “I’m fighting in the Supreme Court to ensure women across the nation aren’t denied their constitionally-protected right reproductive freedom”. It includes a screenshot of the lawsuit. March 4, 2020: Representative Jerrry Nadler tweeted: “Today, the Supreme Court considers Louisiana’s admitting privileges law, a nearly identical alw to the one SCOTUS struck down as unconstitutional in 2016. If this law is upheld, Roe v. Wade will be gutted. What’s a constitutional right if you can’t exercise it? #MyRightMyDecision”. Jerry Nadler followed that tweet with a second tweet: “This case is not an isolated attack. It’s another effort by national anti-abortion groups to chip away at abortion rights and exert control over women and their bodies. As the Supreme Court already found in 2016, these laws don’t make abortion safer, they just shut down clinics.” Jerry Nadler also posted a third tweet in this thread: “If this law stands, there would only be one clinic in all of Louisiana. So much is on the line, but it’s really quite simple: the Supreme Court must follow precident and strike down the law. For everyone, abortion must be #MyRightMyDecision.” March 4, 2020: Center for Reproductive Rights tweeted: “Abortion is a human right, one that the majority of Americans support and want people ot have access to. This is not a controversial issue, it’s basic health care. We’re fighting to protect abortion access at #SCOTUS. #MyRightMyDecision”. The tweet included a photo of the outside of the Supreme Court building, filled with people, many of whom are holding up signs in support of abortion access. March 4, 2020: Ilyse hogue, president of NARAL Pro-Choice America, tweeted: “It’s a beautiful day to defend abortion rights and demand women’s freedom from the Kavenaugh Court. #MyRightMyDecision”. The tweet included a photo from outside the Supreme Court building. A large gathering of people are there. Several are holding signs. March 4, 2020: Senator Chuck Schumer tweeted: “#MyRightMyDecision SCOTUS just heard the 1st big case on a woman’s right to make her own health care decisions since Justices Kavanaugh & Gorsuch It looks at 1 of 100s of draconian, anti-choice restrictions states tried to pass. We’re here to send a message: Not on our watch!” The tweet includes a video of Senator Chuck Schumer speaking at a podium outside of the Supreme Court. March 4, 2020: CAPWomen, the Women’s Initiative at American Progress, tweeted: “We’re here at the Supreme Court today rallying in support of abortion rights because abortion is healthcare. #MyRightMyDecision” The tweet included a photo of about ten people, all of who are holding up signs in support of abortion access. March 4, 2020: Alexis McGill Johnson, Acting President and CEO of Planned Parenthood Action Fund and Planned Parenthood Action, tweeted: “Today is about our right to control our own bodies. To imagine our futures. To be free. I promise you this: Planned Parenthood will never stop fighting to keep abortion safe and legal. We will never stop fighting to make it more accessible. The tweet included a selfie-style photo of herself in front of the outside of the Supreme Court building. A crowd of people are behind her. March 4, 2020: Planned Parenthood Action tweeted: “Abortion is health care. We will not stop fighting for the basic right to control our own bodies, lives, and futires. We are down at the Supreme Court today, adding our voice. #MyRightMyDecision”. The tweet included a photo from the outside of the Supreme Court. A crowd of people are holding up signs. The largest one in the photo says “Trust Women”. March 4, 2020: Reprsentative Sylvia Garcia tweeted: “Proud to march with my comrade @RepEscobar and @HouseDemocrats as we make it clear to the #SCOTUS that we stand for a woman’s right to choose. #MyRightMyDecision”. The tweet included three photos. One is of herself with Representative Escobar. Another is a group of Representatives, wearing light blue scarves, and holding signs, are standing in a group. The third photo is of Representative Ayanna Pressley speaking behind a podium in front of the outside of the Supreme Court. March 4, 2020: NPR posted an article titled: “Beginning Of The End For Roe? Supreme Court Weighs Louisiana Abortion Law”. It was written by Nina Totenberg. From the article: Abortion rights are on the chopping block Wednesday as the Supreme Court hears arguments in a case nearly indentical to one decided just four years ago.It’s the first major abortion case to come before the court since the 2018 retirement of Justice Anthony Kennedy, making it the first time the majority of justices hearing an abortion case have anti-abortion-rights judicial records.In 2016, the justices struck down a Texas law that required abortion-clinic doctors to have admitting privileges at a nearby hospital. In that case, Texas argued that admitting privileges, which allow doctors to admit and care for their patients in hospitals, would protect the health and safety of women seeking abortions.The justices, however, concluded that rather than protecting women’s health, these requirements simply created unconstitutional obstacles to abortion access by making it difficult or impossible to staff abortion clinics.Before the court is a Louisiana admitting privileges law that the state conceeds is identical to the Texas law……Even though the law has not gone into effect, Louisiana argues that requiring admitting privileges for abortion providers really would make women safer.But every major medical group in the country – from the American Medical Association to the American College of Obstetricians and Gynecologists – contradicts that assertion. Indeed, although the Trump administration is backing Louisiana in this case, the federal government iteself recently eliminated privilege requirements for doctors who treat Medicare and Medicaid patients at outpatient surgical centers. The federal government found admitting privilege requirements to be burdensome and unnecessary……There is one new twist in Wednesday’s case. For the first time, Louisiana and the Trump administration, are claiming that doctors and clinics do not have the legal standing to challenge an abortion law on behalf of patients.“The doctors who are seeking to have less oversight and reduce regulations upon them do not share the same interests as women,” Louisiana Solicitor General Murrill said of the doctors and clinics who bring lawsuits on behalf of their patients.For more than 40 years, the Supreme Court has recognized the rights of doctors to challenge abortion laws, not just on behalf of themselves, but on behalf of their patients, too……In short, abortion providers see thsi new procedural challenge as a backdoor way to prevent future challenges to anti-abortion laws, or a wolf in sheep’s clothing….…No court has found that the Hope clinic in Shreveport, which is at the center of Wednesday’s case, to be unsafe. It has long provided about 3,000 abortions a year, and the district court found that in the past 23 years, only four patients had to be transfeerred to a hospital because of a complication… March 4, 2020: Center for Reproductive Rights posted a press release titled: “U.S. Supreme Court Hears Pivotal Abortion Rights Case”. From the press release: Today, the U.S. Supreme Court heard oral arguments in June Medical Services v. Russo – the first abortion rights case to be heard under the current makeup of the Supreme Court. The case challenges a Louisiana law that would shut down every abortionclinic in the state except for one. The law (Act 620) bans doctors from providing abortion care unless they have admitting privileges at a hospital within 30 miles.In a 2016 case also brought and won by the Center – Whole Woman’s Health v. Hellerstedt – the Supreme Court struck down an identical law in Texas, finding that admitting privilege requirements pose an “undue burden” on the right to abortion and are medically unnecessary. In the courtroom today, Center for Reproductive Rights’ Senior Litigation Director Julie Rikelman argued to the Justices that Act 620 should meet the same fate, as nothing has changed since 2016 that would justify a different outcome. Rikelman also argued that the law would close an even greater percentage of clinics in Louisiana than in Texas, and that the medical consensus opposing this kind of law has only grown stronger since 2016.The Center also argued against Louisiana’s claim that abortion providers and clinics lack legal standing to fight for their patients’ rights in court. Rekelman argued that the state’s attack on standing contradicts 40 years of precedent, and is designed to insulate unconstitutional abortion restrictions from being challenged in court. Nearly all abortion cases today are brought by doctors and clinics. If they did not have third-party standing, patients would have to initiate court proceedings themselves and file a case while still pregnant, at the same time they are urgently seeking abortion care.Act 620 and the State’s challenge to standing have been denounced by a coalition of leading voices of medicine, law, and public policy who joined with abortion patients and advocates to submit 27 amicus briefs to the Supreme Court in support of the Center’s case.While the Supreme Court heard arguments, thousands of supporters gathered outside the courthouse to rally against a growing tide of political attacks on women’s reproductive rights. More than 40 speakers addressed the crowd including: celebrities Elizabeth Banks and Busy Phillips; legislators such as Senator Charles Schumer (D-NY.), representatives Diana DeGette (D-CO.), Barbara Lee (D-CA.), Ayanna Pressley (D-MA.), and Judy Chu (D-CA.); abortion providers; faith leaders; and women who have had abortions and experienced first-hand the barriers created by anti-abortion laws. March 4, 2020: The Guardian posted an article titled: “Abortion rights case is first test for right-leaning US supreme court.” It was written by Jessica Glenza. From the article: The US supreme court, and its new conservative majority, will hear one of the most consequential abortion rights cases in decades. Oral arguments in the case, called June Medical Services LLC v Russo, take place Wednesday morning.The case represents the first test for how the nine-member court, which has swung toward the right, will handle a high-profile reproductive rights case. The case hinges on whether doctors performing abortions at standalone clinics should be required to have “admitting privileges” at local hospitals. If such a law were upheld, it could close abortion clinics across the country and severely limit women’s access to the procedure, without improving women’s health in the process.Already, the case in question breaks with precedent. The supreme court rarely takes cases similar to recent rulings. Oral arguements Wednesday will focus on a law identical to one the court overturned just four years ago……Attorneys for the case will answer questions from the nine justices for one hour. Justices will have the rest of the spring to review briefs, and issue a ruling in June. There is no limit on how broadly or narrowly the court may rule……The latest case, June Medical Services v Russo, stems from a law in Louisiana called HB 620. The law required doctors who preform abortions at clinics to have “admitting priviliges” at hospitals within 30 miles.Such privileges allow a doctor to admit a patient for treatment, but are difficult to obtain. Doctors who have them are typically employed as members of the hospital staff. In rural settings, a clinic may be more than 30 miles from the nearest hospital.Finally, in America’s private healthcare system, hospitals operate independently and are sensitive to the political concerns of the community. Many actively avoid connections with abortion clinics or doctors who perform them, and won’t grant the doctors the admitting rights they need to continue performing abortions….…In the June Medical Services case, the government also asked the justices to weigh in on a less high-profile question: should doctors be able to sue states that pass abortion restrictions, on behalf of their patients? Doctors have been able to sue on behalf of women seeking abortions since at least the 1973 Roe v Wade landmark.The question is a matter of what is called “standing”,or rights to sue, in legal communities. If justices find doctors cannot sue on behalf of women seeking abortions, it could make it far more difficult to challenge even patently unconstitutional anti-abortion laws. March 6, 2020: Virginia Mercury posted an article titled “Virginia General Assembly caps costs at $50 a month”. It was written by Kate Masters. From the article: One of the biggest bills of the year is one nobody is talking about, Del. Mike Mullin, D-Newport News, wrote in a tweet on Friday – a hard cap on the price of insulin in Virginia.Insurers are now limited to chargin a maximum of $50 a month for the drug after Del. Lee Carter, D-Manassas, urged colleagues to accept a Senate amendment to his bill. This price is a little higher than his original cap of $30, but still the lowest ceiling for insulin in the country, he said on the House floor……There have been Congressional hearings over the rising costs, but federal regulators have still haven’t settled on a solution to lower prices. Virginia is the third state to pass a law limiting the cost of insulin.The bill will go to Gov. Ralph Northam for final approval…The legislation prohibits Virginia insurers from setting a patient’s cost-sharing payment for insulin above $50 a month – including deductibles and copays. The bill was supported by the Medical Society of Virginia and the American Association of Retired Persons, but, unsurprisingly, not by the Virginia Association of Health Plans, which argued that the cap on the cost-sharing payments would be offset by a rise in premiums… March 11, 2020: Human Rights Watch posted an article titled: “US State Department Again Ignores Women’s Reproductive Rights”. It was written by Acting Co-Director, Women’s Rights Division, Amanda Klasing. From the article: The US State Department released its annual human rights Country Reports today. For careful readers of the reports issued under the Trump administration, the glaring gaps will seem familiar.For the past two reports, Human Rights Watch and other human rights and reproductive rights organizations have decried the Trump administration’s cutting of most mentions of key human rights abuses that disproportionately impact women and girls, including country analyses of maternal mortality rate, and unmet contraceptive needs. It’s not just an editorial cut – this deliberate exclusion has repercussions for the promotion of women’s human rights globally.That record is clear: From the “global gag rule” to a domestic gag rule, the defunding of United Nations Populations Fund, the extraordinary threat of vetoing a UN Security Counsil resolution on women, peace and security becaues it mentioned survivors’ sexual and reproductive health and rights, to the establishment of the Commission of Unalienable Rights that apepars to directly threaten sexual and reproductive health and rights, to the Women’s Global Development and Prosperity initiative that completely disregards the need women and girls have to access health care to succeed in their own economic empowerment.The administration is also playing an invidious role at international forums, recruiting other anti-choice governments to push back on the global consensus around sexual and reproductive health and rights.Frankly, it is exhausting to have to continue, 25 years after the Beijing women’s conference, to fight so hard to have basic recognition that women’s rights are human rights. Individuals, organizations, and the US Congress should not relent, despite the constant assault. Without delay, the Global HER Act, repealing the global gag rule permanently, and the Reproductive Rights are Human Rights Act, requiring the State Department to report on violations of women’s reproductive rights, should be passed. THIS BLOG WILL BE UPDATED WHENEVER ADDITIONAL CREDIBLE INFORMATION IS FOUND. A Timeline of the GOP’s Attempts to Destroy Obamacare – Part Four is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... Still Always at the Doctor’s OfficeDecember 28, 2019Doctor Appointments / Out of SpoonsPhoto by Abby Anaday on Unsplash Earlier this year, I wrote a blog post called Always at the Doctor’s Office because it seemed like I had been spending an increasing amount of time there. That blog post covered January to the end of May of 2019. This blog picks up where the first one left off. The main reason I am writing this is to track how often I go to the doctor, as well as how sick I had become before going to one. July Sometime in early July, I used telemedicine for the first time ever. I had yet another sinus infection, and has been trying to fight it off. My bad immune system was eventually overwhelmed, and I had to seek out medical attention. My health insurance covers telemedicine – where you contact a doctor from your home, and the doctor calls you to hear about your symptoms. The “clinic for the poor people” had been hit or miss when it comes to scheduling appointments. So, I tried telemedicine. It turns out that sinus infections are one (of many) things that the doctors can diagnose over the phone. I’d had more sinus infections than I can count, so I knew exactly what it was. The doctor was nice. She contacted the pharmacy of my choice and told them to fill my prescription for a “Z-pack” (the generic version). I do pretty well on that antibiotic, so I knew it would work. It also knew it would make me extra tired not only while I was taking it, but also for at least a week after that. On July 22, 2019, I wrote on Mastodon: “I’m over here, taking some CBD, because I did a whole lot of cleaning today and my fibromyalgia is making my muscles hurt now. CBD stops the pain. I’ll still be sick tomorrow due to allergen exposure. There are other drugs for that.” On July 26, 2019, I went outside. At the time I am writing this blog post, I don’t remember what it was that I went outside to do. The very next day, I wrote the following on Mastodon: “Yesterday, I went outside. Long story short, this fucked up my fibromyalgia, and I ended up in a whole lot of pain for the rest of the day/night.” “Today, slept in. Still not recovered yet. So, I have to spend a bunch of time trying to get my body to be functional enough to do some paid work. It’s annoying.” August On August 7, 2019, I had a doctor’s appointment with my rheumatologist. The purpose was to see what the results of the blood tests were. Based on the results, I was told that I do have the RH factor, but do not have any signs of rheumatoid arthritis. This is good news, because rheumatoid arthritis eats your cartilage and makes it increasingly difficult for your joints to move as they should. The unexpected news was that I didn’t actually have any other type of arthritis, either. The bad news (which I was honestly expecting) was that I definitely had fibromyalgia. I was prescribed a low dose of a pain medication, which I started researching on my phone while still in the doctor’s office. The pain medication was not an opioid. It also wasn’t something specifically made to treat fibromyalgia. There doesn’t appear to be any medication that is specifically designed for my disease. I’m cynically figuring that the reason is because the majority of people who have fibromyalgia are women, and modern medicine has a terrible track record when it comes to not only ignoring women who tell the doctors that they are in pain, but also in actually treating their pain appropriately. Either that is the reason there are no drugs designed to treat fibromyalgia, or the pharmaceutical companies don’t think women who are in chronic pain are going to make them a significant amount of money. If I remember correctly, the drug I was prescribed is one designed to treat depression and anxiety. I have neither of those, and I told that to my rheumatologist. All he could say was that this drug has helped some patients who have fibromyalgia. So, I scrolled through my phone, doing preliminary research about the medication I was being prescribed. Right away, I found that two of the inactive ingredients were coconut (or derived from coconut.) I am allergic to coconut, so there was absolutely no way I could safely take this medication. I pointed that out to my rheumatologist. “You don’t know all of my allergies,” I explained. He agreed, “You’re right. I don’t.” My rheumatologist means well. It’s not his fault that he doesn’t have any other options for me. When we were done, he recommended that I seek out my general practitioner for help with fibromyalgia (instead of him). We both agreed that he had done everything he was able to for me. On August 20, Fall pollen season started. I start struggling when the pollen count hits 7.0 or higher. I don’t bounce back until long after a pollen season ends. There is no way to know how long it will last. On August 30, I realizes that I had lost two pounds since the end of July. That brought me to a total of 50 pounds since I started trying to lose weight. That effort began in 2017. The weight loss had been increasing, in part, because I have a history of getting really sick and losing too much weight, too quickly. I weighed myself that day because I had gotten sick, again, and had been sick for a while. What caused it? There’s no way to know for certain, but going to doctor’s offices tends to result in me getting sick. Little did I know that this was the start of a long, lingering, sickness that was affected by multiple factors. In short, my terrible immune system was already under attack. September On September 5, 2019, out of the blue, my fibromyalgia decided to flare up at the two points on the back of my shoulders. This was new! It was quick, and strong, and felt like very localized electrical shocks. Fortunately, my bottle of CBD was right there on my desk and within easy reach. I used some, and waited for it to kick in and stop the severe pain. At the time, I assumed that this was my body’s way of reminding me that I’m trying to do too much while the pollen count is too high. It was 9.0 that day, and had been in the nines for more than a week straight. The reason I am doing too much is because I’m desperately trying to make money. I’m a freelance writer who gets paid to post things on other people’s blogs. Freelance writers don’t get paid sick days. We either get the work done, or we starve. On September 6, 2019, I posted the following on Mastodon: “Right now, I am using a heating pad across the back of my shoulders (sort of) because I moved and my fibro flared up there. Also using a straw to finish my iced tea so I don’t have to tilt my head to drink it. I have an acupuncture appointment in a few days.” The pollen count that day was 9.0 (again). When the pollen count hits nine, it affects people who don’t even have allergies. For me, days where the pollen count is at nine are days where I’m in horrific pain. In the past, it was mostly in my sinuses. This year, the inflammation caused by pollen exposure had started triggering my fibromyalgia. On September 10, 2019, the pollen count went down to 7.3. This is not good for me, and I would struggle while on the way to and from my acupuncturist’s office. I don’t have any memory about what we talked about before starting treatment, or what points she put needles in. This is what happens when I’ve been sick for too long from a too high pollen count, without time to recover. This lack of memory thing is referred to as “fibro fog”. It makes people like me forget most or all of the things that happened while we were in pain and struggling. I do remember that I took an excellent nap on the acupuncture table, and a really long, good, nap after I got back home. On September 18, 2019, I made the mistake of eating food from a local sandwich shop that does have gluten-free bread. They make tasty subs, and their workers are trained to put on a new pair of gloves before touching the gluten-free bread. Subs made with gluten-free bread are made in a separate area, far away from where the “regular” (full of gluten) bread is made. This is admirable, and I’m happy they do that. There’s just one problem. When the worker is done carefully cutting the gluten-free bread in a safe area, and putting the meat on it, the worker then hands the sandwich to the worker who puts on the veggies (and condiments). That worker has been handling “regular” bread all day, which means that the veggies are cross-contaminated with gluten. I got really sick after eating the (so-called) gluten-free sandwich from this sub shop. Exposure to gluten is painful, and really messes up my digestive system. It takes at least a week or two to fully get out of my system, no matter what I do. This is when I decided to become extraordinarily picky about the restaurants that I am willing to eat food from. I do this in self-defense. if they don’t care enough to prevent me from getting sick, then I don’t care enough to give them my money. October On October 4, I wrote on Mastodon: “I’ve been sick for about… two months or so now. Starting to feel better. So, if you’re wondering why I’m responding to old toots… that’s why. I cannot keep up with this world.” Toots, for those who do not know, are what posts on Mastodon are called. Also on October 4, 2019, at around 5 in the morning, I wrote on Mastodon: “Gonna go to sleep for a while. If I feel ok after I wake up, I might attempt to do some Inktober art. I no longer have the energy to do a “one thing every day” project, so I’m just gonna do whatever I can, on my own timeframe. Blame it on the fibromyalgia.” I remember being very sad about writing that toot. In 2017, I was able to complete one tiny pen & ink drawing, on a specific theme, every day in October. In 2018, I only was able to make it about half-way through the themes. This year, I was seriously struggling to do any art at all. All of my energy was going towards sleeping in the hopes of feeling better, trying to get my body to function properly and actually be able to move, and desperately trying to get paid work done. I was exhausted, and starting to get scared that from this point onward, my body would continue to decline. I had a couple of dental appointments in October. One was to remove a broken cap that my dentist put in not long ago. I guess he, or one of the dental technicians, did something wrong with it. The good news was that I wasn’t being charged any money to have them replace it. The process required me to have the old cap removed – which is unpleasant but something I can tolerate. I also had to have a mold made for the new permanent cap, and had to get a temporary cap put in. I was exhausted when I left because the physical experience was not painful when it was happening, but set off my fibromyalgia after I left. The temporary cap greatly limited what I was able to safely eat – and that’s before considering all the foods I cannot eat due to food allergies. I lost some weight in the previous month because I was really sick, and then lost more waiting for my permanent cap to be ready. The permanent cap was put in a few days before my husband and I were scheduled to leave for a short vacation. It is unpleasant to have a temporary cap removed, and then to have gums already irritated by dental work to have a permanent cap put on. This left me exhausted because all of that pounding on my jaw triggered my fibromyalgia Fortunately, I got lucky and was able to mostly recover by the time my husband and I were going to take a short vacation. We saved up our money and decided that this year’s anniversary present would be a trip to LA to see The Who at the Hollywood Bowl, followed by a trip to Anaheim to visit the Star Wars section of Disneyland. (Our wedding anniversary is not in October – but that’s when the concert was.) To make this work, we had to give up on funding some of the home improvement projects that were in various stages of incompleteness. Nothing serious, just a few things that needed some work. The concert was wonderful! It was an outdoor arena, at night, which meant that there wasn’t any pollen to worry about. There also wasn’t any smoke effects coming from the stage (which makes it hard for me to breathe). The bench seating was surprisingly comfortable. Unfortunately, the air in LA was terrible, and my sinuses were on fire the whole time. I suspect this had something to do with the pollution in the air. I’ll write a separate blog about Disneyland, but for now, I’ll point out that Disneyland lets people rent wheelchairs. For me, this was great and awful at the same time. Without a (manual) wheelchair, I would not have had the ability to walk from the gate to the Star Wars section. My fibromyalgia would have caused leg cramps and muscle spasms long before I got there. Shawn was able to push my rented wheelchair around, and that made visiting Disneyland together possible. The awful part was that the experience made me realize just how disabled I am. I honestly needed that wheelchair. When I had to leave the wheelchair behind in order to get on a ride, I had a hard time walking just a few feet. When we turned in the wheelchair, I had great difficulty standing. The workers noticed, and gently suggested I could take my time. Was this a glimpse of my future? How long do I have before I can’t walk? On October 17, 2019, after returning from vacation, I wrote this on Mastodon: “I’m back from vacation. It was really fun. Unfortunately, I encountered gluten twice because restaurants can’t be bothered to give a fuck about people like me who get super sick from gluten. I’m never eating anything from any restaurant ever again.” “Also, this trend of scented hotel rooms needs to die. My sinuses are still on fire from that.” “There needs to be a law – nationwide – that FORCES food preparers to learn about allergies and cross-contamination before they can finish school/get a job working with food. If they fuck it up after that – and make even one person sick -they should never be allowed to prepare food for a living ever again.” “And hotels should be FORCED to use unscented, allergy friendly, cleaning products. AND have allergy friendly soap/shampoo. It won’t happen, though, because no one cares.” Guess what? It’s pretty much impossible to find safe food for me to eat while on vacation. I brought safe food with me, but it wasn’t enough to last the few days we would be away from home. In other words, after just barely recovering enough to go on vacation, I was now sick again. The mobile home park we live in started tearing apart all of the roads within the park on the day we left for vacation. We returned to ripped up roads, construction equipment, and all the particulate matter and odors that come with it. The project was supposed to last three weeks. A few days before October 31, 2019, I woke up with a sore throat. At first, I assumed it was allergies, and figured it would go away if I drank lots of water and took allergy medication. Instead, it got worse. The throat pain reminded me when I had tonsilitis in 2017. The difference was that this time, the pain was mostly on one side. When I tried to make a doctor’s appointment, I was told that my regular doctor did not have any appointments open. The receptionist was able to get me an appointment on Halloween with a doctor I’d never seen before. I took it! The doctor was very nice, and seemed knowledgeable. He looked into my throat, nose, and ears, and declared that everything was red. His diagnosis was strep throat, which would require an antibiotic. I was exhausted, and in pain, but I sort of remember what the doctor told me. He said we could do a strep test, but that would cost more money. From what he could see, he was very certain it was strep. I was going to end up with the same antibiotic anyway. I opted to trust his judgement and skip the strep test. The doctor said I would need take two antibiotics a day until I ran out. I should call for another appointment if the medication didn’t help. Previous to planning our anniversary vacation, we had considered going to BlizzCon. It was a good thing that didn’t happen, because I wouldn’t have been able to get a doctor’s appointment before going and would have spread strep throat to everyone who attended. November On November 8, 2019, I wrote on Mastodon: “Hi people! I haven’t been on here much lately because I’m trying to see how quickly I can get my freelance writing work done. While on antibiotics. Because I have/had? strep throat. Through daylight savings time. I don’t recommend doing this, but I’m still gonna give it a try.” I was pushing myself to try and get as much paid work done as possible, in part because I was concerned that I wouldn’t be able to make enough money to help pay the bills if I rested. With all my chronic illnesses, it was impossible to feel “good” anyway. I was also starting to worry that the Trump Administration would – by going through the courts – rip away the only chance I had at getting affordable health care. At the time, the Republican’s Obamacare case was heading to the Supreme Court. I’m always at the doctor’s office. Lack of access to affordable health care would kill me. So, I tried to make what money I could before that happened. It’s not the best idea, and I wouldn’t recommend other “spoonies” try it. But, I know that many of us are afraid right now about what could happen when we can’t see a doctor anymore (or pay for medications, or blood tests, or whatever else we need). Most of November was blurry. I was exhausted from the antibiotics. Somewhere along the way, I re-read the bottle and learned that I was supposed to have been taking one pill three times a day, not twice like my doctor said. Perhaps I had the generic, and that made the dosage different? I felt like I was failing at taking my medication. There was another thing that was stealing away my energy. The mobile home park construction project did not end by the three week mark we were promised. It took six weeks to complete. Every day, I was exposed to more allergens and dust and dirt. Shawn developed a bad cough. Our portable air conditioner, and my air cleaner, were no match for the ever present construction crew. On November 21, 2019, I wrote this on Mastodon: “What was supposed to be three weeks of construction work very close to my home had turned into six weeks. There is no end in sight. This is my life now.” “I am physically overwhelmed by the constant dust (and other particulate matter) that is constantly in the air now. A neighbor next door did some additional work the other day. Two more nearby are making indoor and outdoor renovations.” “I am tired of being sick and exhausted from stuff I cannot control.” I was on antibiotics for the majority of November. It took a while longer for my body to “bounce back” to use a phrase that I’ve heard healthy people use after completing antibiotics. I did not “bounce back”. I slowly crawled back towards what passes for “healthy-ish” for me. December On December 19, 2019, I was fortunate enough to get to have an acupuncture appointment. I hadn’t been there in a couple of months, and really needed to go. Why didn’t I go sooner? Because I was too sick to do so. Acupuncture can help treat the symptoms of several kinds of illnesses. This time, I was there to deal with stress and chronic pain. My fibromyalgia had been acting up a lot, and I figured it had something to do with inflammation. As someone with both allergies, and fibro, I struggle with that. My wonderful acupuncturist knew just what to do, as always. I was able to take a really good nap after the needles had been put into the appropriate locations. My husband and I took a Lyft to the office, but when I was done with my appointment, I was able to walk home. My acupuncturist recommended I get more liquid Vitamin D3 from her (mine had run out). She also said I should stay away from sugar, which causes inflammation. For me, dairy does that as well. Shawn went to visit with his family on Christmas Eve, and returned home on Christmas day. I love his family, but their house is filled with allergens. I’m not saying their house is dirty – it is probably cleaner than our home is. They typically get a real Christmas tree, and I am allergic to that (no matter if it is pine or fir, my body stopped being able to tell the difference between them a long time ago). They have multiple (adorable) little dogs, and chickens in the backyard. Celebration can sometime include grilling on the patio, on burning wood, that makes me sick. Or, it includes food that I cannot safely eat due to my many food allergies. Their home is often scented by candles which make me cough. In the past, I was able to drive out there on Christmas day, and then return home. It got to the point where I was so sick after visiting that driving was difficult, and I was exhausted. I could not take Benadryl until after safely arriving home. As such, I don’t visit their home on or around Christmas anymore. I am extremely lucky that they understand. They drove Shawn home on Christmas day, and brought both his and my presents with. I honestly love everything they got for me. Soft pajamas and slippers, an electric throw to keep me warm. Fuzzy socks. “Spoonie” things! The Christmas scents clung to the presents, and all clothing needed to be washed immediately. I was sick for days afterwards, with burning sinuses. This isn’t their fault. Most people can safely handle all the scents that come with Christmas, and they have the right to make their home smell however they please. If my immune system was better, it wouldn’t be a problem. I’m going to be optimistic and assume I won’t get sick – again – in the last remaining days of 2019. If it happens, then I will update this blog post. Still Always at the Doctor’s Office is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... Other Video GamesMy Pokédex – Unova RegionFebruary 13, 2020Other Video Games / Pokémon GOPokémon GO began releasing Pokémon from the Unova Region on January 10, 2020. Here is a look at the ones I have caught (so far). This blog post will be updated whenever I catch a Unova Region Pokémon that is new to me. The Sinnoh Region of Pokémon ended on number 477. The Unova region begins with number 494. Where did all the numbers in between go? It remains a mystery. 504 Patrat 506 Lilipup 509 Purrloin 515 Panpour 519 Pidove 529 Drilbur 543 Venipede 550 Basculin 590 Foongus 607 Litwick 613 Cubchoo 616 Shelmet My Pokédex – Unova Region is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... Seekers Notes: Family Heirlooms CollectionFebruary 2, 2020Other Video Games / Seekers NotesSeekers Notes is a game where the player becomes the Seeker and tries to solve mysteries and locate lost items. The game has an interesting story line and cast of characters. These screenshots were taken in 2018. Helen: Seeker, I think it could be in your interest to visit the train station, but today I receive the unfortunate news that the key to it is missing. You must find it to reach the train station. The game includes a bunch of unique areas in which a player can hunt for hidden objects. Whenever the story line leads to a new location, the player must find the corresponding key. In this case, the player is directed to visit the Mayor’s Office location. I found the Train Station key. Helen: They say that every day a ghost train appears at the train station accompanied by the sound of screeching wheels and whistling pipes. And then it disappears. The Curse must have resurrected ghosts from the past. I wonder what happened at the station all those years ago. Lady Byron: Hello, Seeker. I’m Ursula Byron, a direct descendant of the Founders of our great town of Darkwood. I’ve heard quite a bit about you and your appearance. It’s a shame you met the mayor before meeting me. Lady Byron is referring to Mayor Felix Smallcat, whom the player met while working on the quests connected to the Stationary Kit Collection. I hit Level 4! Lady Byron: Who wouldn’t be overjoyed to hear that you’ve been appointed to such an honored position? After all, we haven’t had a Seeker in… hmm… well, several decades. I believe you can help me, but we’d better talk somewhere more private. The quest text gives a hint to the player: Search the Station. I used the train station key to unlock the Train Station location. I was able to find all of the required hidden objects in the Train Station location. Doing so will always result in at least one useful item. Lady Byron: I’m glad you got here so quickly. Almost no one comes here since we were afflicted by the Curse. You see, the last train left Darkwood and never came back. Lady Byron: If you can find our family’s oak walking stick I’ll be convinced that you’re just the man Darkwood needs. I am aware that there is an old phrase that goes: “You’re the man for the job.” It’s possible that Lady Byron is simply using that phrase. It seems to me that Darkwood has been under a Curse for a long time, and it’s possible that the phrase hasn’t gone out of style yet. Darkwood is very isolated. That said, it bothers me that the story line of the game is written in a way that presumes that the player is male. I think it would have been better if Lady Byron said “…you’re just the person Darkwood needs.” I found the Old Walking Stick. Lady Byron: That you could find my family heirloom in a such a short span of time is certainly praiseworthy. Now listen – the Curse that has afflicted our town appeared very suddenly. Nothing like it has ever happened before… and this terrifies us. Lady Byron: Please try to find a bag with a false bottom – it belonged to my father. I found the Bag with a false bottom. Lady Byron: As you know, Darkwood was founded by the Founding Fathers. Legend has it there was a reason they chose this place to found the town. Collector Achievement: You have assembled 1 collection. What Collection did I assemble? That would be the Stationery Kit Collection. Completing the Collector Achievement unlocks a new trophy. It also gives the player a ruby – which can be used to buy an item that can help players find one item in any location. Helen: You can get a reward from a trophy every 12 hours! Continue unlocking achievements to upgrade trophies you have and get new ones! Lady Byron: You really are a talented Seeker. Sometimes Smallcat gets things right. I’m convinced you’re just the person to find my great-grandmother’s lost antique chest. Why does Lady Byron look so disapproving in the above screenshot? It is because the characters can blink. I took the screenshot at exactly the wrong moment. This quest requires player to go to the Cafe location. That location must be in Silhouette mode, or it won’t drop the item that Lady Byron wants the player to find. If you are lucky, the Cafe will be in the Silhouette mode. If not, then you will have to play through it – and finish it successfully – a few times before the Silhouette mode will appear. I found the antique chest. Lady Byron: A lot of things changed in our town once Smallcat came to power. I think the Curse appeared precisely because of him! Lady Byron is very likely the richest person in Darkwood. She’s also among the oldest people who live there. It is not unusual for older people to fear change. That’s understandable. However, it’s rather petty of Lady Byron to tell the Seeker that she thinks that the Curse was somehow caused by Mayor Smallcat. Put that together with what she said earlier, that it was a shame that the Seeker visited the Mayor before visiting her. It sounds like Lady Byron was hoping to get the Seeker alone so she could influence them to dislike Mayor Smallcat as much as she does. Her words and attitude make her seem distrustful. Lady Byron: I remember that my mother always wore an antique medallion. Do you think you could find it? This quest requires the player to solve the Treasure Box puzzle. I found the antique medallion. Lady Byron: Thank you for finding the medallion! You’ve done me a real kindness, Seeker. I reached Level 5! Doing so increases my maximum amount of energy by 5. A player uses energy every time they play a location. It is a limited resource that returns slowly, in real time. I also got 1 ruby. Players who reach Level 5 can unlock the Fortune Teller (which is a crafter), and the Mosaic (which is a puzzle). Lady Byron: We used to have a seal in the shape of our family crest that my uncle simply adored. Unfortunately, it was lost after the last member of our family left the post of mayor of Darkwood. To find this item, the player must explore the Train Station. Lady Byron’s uncle used to be the Mayor of Darkwood. He left the post (for reasons she doesn’t explain). I found the Crest-Shaped Seal. Lady Byron: In my opinion Darkwood was founded by a Byron. That means his descendant should be sitting in the mayor’s seat! Unfortunately, many people in Darkwood love Smallcat and have forgotten our town’s history. In general, mayors are elected. Lady Byron doesn’t seem to like that idea. She thinks that it should always be one of her family members that holds the position of mayor, for no reason other than it was Byron who founded the town. I’m not one to look kindly upon those who think they are entitled to an elected position due to nepotism. I’m not sure if Seekers Notes was intending to make Lady Byron unlikable – but that’s what they have achieved. I have now found all of the items that are part of the Family Heirlooms Collection. This collection also requires an additional item before it can be completed. Fortunately, I had plenty of those. Completing this collection uses up all of the items that are part of it. The result is a ring. Here are the rewards for completing the Family Heirlooms Collection. Lady Byron: Oh, just look, Seeker! It has our family crest on it! This is it – it’s the very ring! As a sign of my gratitude, please take my advice: the Curse has brought the very darkest aspects of Darkwood to light. Be careful. It seems to me that one of the “darkest aspects of Darkwood” is Lady Byron’s attitude! Then again, it’s entirely possible that her bad attitude predates the Curse. Completing this quest chain – and the collection it produces – adds information about Lady Byron into the Seekers Journal. Her chapter is called “The Noble Lady”. I had a meeting with Ursula Byron, head of the Byron family, one of the most influential and respected families of Darkwood. Lady Byron was very wary of my appointment to the position of Seeker and therefore wanted to test my abilities. Fortunately, I passed her tests brilliantly. I think I’m starting to get used to my abilities, and my Map is very helpful. But back to Ursula Byron. From the conversation it became clear that things are strained between the Byrons and the Smallcats. Lady Byron argues that a true descendant of the Founders should be in charge of the city. Hopefully, in the future we will be able to reconcile the two families. Seekers Notes: Family Heirlooms Collection is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... Neko Atsume: HermeowneJanuary 30, 2020Neko Atsume / Other Video GamesHermeowne is a rare cat in the Neko Atsume game. The only item she likes is called Egg Bed (Nightview). It costs 38 gold fish in the Neko Atsume Store. The flavor text for that item says: Romantic view of the night sky decorated by twinkling stars. Tucked into a soft, fluffy bed, a sweet dream is guaranteed. I’ve only seen Hermeowne once in the time I have been playing Neko Atsume. The Neko Atsume Wiki says that this cat does not like Frisksy Bits, but is willing to eat all of the other varieties of food. I’ve been feeding the cats Frisky Bits. I should switch it out for any of the other kinds of food. Doing so could influence Hermeowne to return more often. Other cats will use the Egg Bed (Nightview), too. Sooty Caramel Smokey Pepper Snowball Apricot Lexy Cocoa Maple Quicksilver Neko Atsume: Hermeowne is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... Neko Atsume: Snow DomeJanuary 20, 2020Neko Atsume / Other Video GamesNeko Atsume is a game where the goal is to collect all the cats. Players do this by putting different things into their yard/home. Cats will come to use those items. The Snow Dome can be bought in the Neko Atsume Store for 10 Gold Fish. The flavor text for this item says: The falling white snow decorates the inside of this beautiful dome. It invites your heart into a silvery world. The screenshot doesn’t show it, but there are little white and blue dots inside the Snow Dome that move around in the game. Patsy Sunny Snowball Pickles Dottie Bolt Pumpkin Tabitha Breezy Spooky Willie Pepper Neko Atsume: Snow Dome is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... Kitchen Scramble App: Mangotego BayJanuary 2, 2020Kitchen Scramble / Other Video GamesMangotego Bay is the fourteenth town in the Kitchen Scramble game. Some of the recipes include fruity drinks (that do not appear to be alcoholic). Many recipes must be cooked on a grill, or thrown into a fryer. It’s a good idea to get the highest level fryer before starting this town. Players should also save up plenty of gold, because they must make an appliance purchase before they can start Mangotego Bay levels. As usual, players must wait 24 hours, in real time, for Truck Maintenance to finish. Those who don’t want to wait that long can pay real world money to speed up the wait. New Appliance! Grill: Food tastes better if it’s cooked on a grill! This is a required purchase. It is not possible to play the levels in Mangotego Bay if your Food Truck lacks a grill. The Grill costs 100,000 gold (the in-game currency). Players who don’t have that much gold can go back to previous towns, and play through levels, to earn more. Pepper: Wow, what a beautiful sunset! At long last, I’ve arrived at Mangotego Bay. Brio: Greetings, welcome! What brings you to our waters? The Kitchen Scramble Wiki says that this new character is called Brio. He is a scuba diver. I find this interesting because, unlike Pepper, the majority of the Kitchen Scramble characters are named after their job. In Mount Foodji, the new character was named Mei. She was a student. So far, they are the only exceptions to the rule of naming characters after what they do. Pepper: The world class snorkeling and the world class food, of course! I’ve been dreaming of fresh grilled plantains… The new recipes for Level 315 are: Grilled Pineapple Grilled Plantains Mango Salsa Rice and Peas This is what the inside of the Food Truck looks like at the start of Mangotego Bay. It has the Level 1 Grill, and it is slow. I got three stars on Level 315. Pepper: Aren’t fresh mangos the best? By the way, I don’t think I caught your name. Brio: Everyone calls me Brio. It means “brave”. They think I’m fearless because I dive with the lions… Pepper: There are lions around here?! Brio: Oh! I meant the fish kind, not the jungle kind. Lionfish are common around the reef here. Brio: They are highly venomous, but I keep a respectful distance. I got three stars in Level 316. The two “new” recipes for Level 317 aren’t actually new. Players first saw them in Molassessippi. They are: Baked Sweet Potato Sweet Potato Fries I got three stars in Level 317. The new recipe for Level 317 is: Jerk Chicken I got three stars in Level 317. To complete this level, players had to serve at least 6 Jerk Chicken dishes to customers. I got two stars in Level 319. The new recipes for Level 320 are: Coconut Mango Smoothie Pineapple Coconut Smoothie Mango Pineapple Smoothie What do you need if you intend to make a lot of smoothies? A blender, of course! It should come as no surprise that players are required to buy a blender before they can begin Level 320. Blender: Basic blender. It’ll blend its way right into your heart! The Basic Blender costs 100,000 gold (which is the in-game currency). Players who do not have that much gold cannot continue through Mangotego Bay until they obtain it and buy this blender. Here is what the inside of the Food Truck looks like at this point in Mangotengo Bay. The Basic Blender is on the front counter. It is incredibly slow! I got three stars in Level 320. This level required players to serve at least 4 Mango Pineapple Smoothies to customers. Brio: I just saw the most terrible thing while I was out diving! Pepper: Oh no, what was it? Brio: I found an underwater pipe leading into the water. It was spewing out pollution! The reef is sick, and the fish are leaving! Pepper: That’s horrible! Do you know where it is coming from? Brio: Yes, the pipe leads back to a new restaurant in town. Who would pollute the waters like that?! Pepper: Wait…you said it was a NEW restaurant? I might have an idea who is behind this! By the time a player gets this far into Kitchen Scramble, they likely have a good guess about exactly who Pepper is thinking of. The new recipes for Level 321 are: Shrimp and Pineapple Kebab Chicken and Onion Kebab I got two stars on Level 321. The new recipe for Level 322 is: Fried Bake To make this recipe, the player must pick up some dough from the shelf and throw it directly into the fryer. I got two stars on Level 322. After players complete Level 322 (with at least one star) the Blender L2 unlocks. It is an upgrade to the Basic Blender. Grill L2 is also unlocked. Each of these new appliances costs 200,000 gold. Players are going to have to make a choice about which one to buy first – unless they happen to have 400,000 on them. Grill L2: Listen to your kebab sizzle over the flames. I decided to buy the Grill L2 first because it is used to make more recipes than the blender does. My next goal was to earn another 200,000 gold so I could buy the Blender L2 later. Here is the Grill L2 inside the Food Truck in Mangotengo Bay. The Basic Blender is missing because I was playing an earlier level when I took this screenshot. It was one that did not involve smoothies. Candace: I was wondering when you would show up and try to ruin everything again. Candace is Pepper’s rival. They are polar opposites when it comes to food. Pepper uses fresh meat and vegetables. Players can earn – or buy – ingredients that are organic. The customers pay more for dishes that include premium ingredients. Candace, on the other hand, has a bad reputation. In Mozzarama, she got caught injecting “a strange green liquid” into some old tomatoes, and she dumped chemical waste into the river. In Chef Academy 2, Candace was hired to teach Regional Cuisine. All of her students were failing the class, in part because she wasn’t teaching them the basics. Pepper offers to let the students learn how to cook certain things by watching her do it at her Food Truck. Candace flunked her entire class, and was asked to resign. And now, Candace has opened a restaurant in Mangotego Bay and is polluting the water. Pepper: You’re the one who’s ruining everything, Candace! Your pollution is damaging the reef, and making the fish sick. Candace: Like I care about some stupid fish! A little waste is unavoidable when you’re serving the most exotic seafood in town. Pepper: There won’t be any seafood left if you keep this up! The new recipe for Level 323 is: Pilau I got three stars on Level 323. To complete this level, players had to serve at least eight Pilau dishes. I got three stars on Level 324. The Premium Grill unlocks after players complete Level 324. It costs 39 Kitchen Cash. I only had 2 Kitchen Cash, so I was not able to buy it. The new recipe for Level 325 is: Tostones I got two stars on Level 325. The new recipe for Level 326 is: Beef Patties I got two stars on Level 326. I completed the first half of Mangotego Bay. There is always a Token Gate between the first half, and the second half, of all of the towns in Kitchen Scramble. Players must have a certain number of Tokens in order to make progress. Fortunately, the game gives players plenty of opportunities to earn tokens. This Token Gate requires 120 Tokens. The new recipes for Level 327 are: Coconut Fried Chicken Coconut Shrimp I got three stars on Level 327. This Level required players to serve at least four Coconut Fried Chicken dishes. The new recipe for Level 328 is: Chicken Curry and Rice I got two stars on Level 328. Blender L2: Blends faster, but please don’t try blending your cell phone! I gathered up 200,000 gold and purchased the Blender L2. It makes smoothies a little bit faster than the previous version. Here is what the Blender L2 looks like inside the Food Truck. Birdwatcher: I heard about Candace’s water pollution, but have you seen her menu? Birdwatcher: Her “exotic” seafoods are all endangered species! We have to stop her! Pepper: I have an idea, but we’ll need all the help we can get. Fortunately, if there’s one thing I know how to do, it’s how to win people over with my cooking! I got two stars on Level 329. This level required players to serve at least five Chicken Curry and Rice dishes to customers. I got three stars in Level 330. I got three stars on Level 331. Candace: I know what you’re up to, Pepper, and it’s not going to work. You’ll never steal my customers with your silly little food truck! Pepper: You’re going to make your customers sick with all those chemical additives, just like you’re doing to the fish in the bay! Candace: Nonsense, I eat my own cooking every day, and look at me! I’m fine! I got three stars on Level 332. This level required players to serve at least three Shrimp and Pineapple Kebab dishes to customers. I got two stars on Level 333. Pepper: My gosh, if Candace has been eating her own chemically enhanced food all this time, it’s not enhanced food all the time, it’s no wonder she’s half crazy! Cop: She’s definitely breaking a few laws, but it’ll take months to legally prove it and shut her down. Pepper: Well, word is spreading fast about her slimy tactics. I think we’ll put her out of business before too long. I got two stars on Level 334. It required players to serve at least nine servings of Mango Salsa. I got three stars on Level 335. I got three stars on Level 336. I got three stars on Level 337. Candace: You might have pushed me out of another town, but this isn’t over! I’ll find other people to buy my food! Pepper: Other people to exploit, you mean! I hope you stop and think about what those chemicals are doing to YOU Candace! I got two stars in Level 338. This level required players to serve at least four Coconut Shrimp dishes to customers. Pepper: It’s hard to believe that Candace and I were once friends… she used to be so different! Brio: The good news is, now that she’s gone, the water is clearing up and the fish are returning to the reef! Thank you for all your help! I got three stars on Level 339. This one required players to serve at least three tostones to customers. Pepper: Something tells me I won’t be able to rest, so long a Candace is out there. She’s plotting something. I just know it. Chef Crisp: Then we should follow her! You might be the only person who can stop Candace before she does something unconscionable. Pepper: You might be right, Chef Crisp. In that case, it looks like we’ll be catching the next ferry boat out to those islands. Here’s what the second half of Mangotego Bay looked like when I was done. I finished all of the location goals for Mangotego Bay. Kitchen Scramble App: Mangotego Bay is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!... TV & Movie ReviewsGrace and Frankie – Season OneJune 2, 2017TV and Movie ReviewsGrace and Frankie is a show on Netflix. It is a Netflix Original. Grace (Jane Fonda) is married to Robert (Martin Sheen). Frankie (Lilly Tomlin) is married to Sol (Sam Waterson). In the very first episode, right at the start, the husbands announce they want to divorce their wives. The reasons why the men want divorces is because they have fallen in love… with each other. And they want to get married. Warning: There are tons of spoilers. Episode 1: The husbands announce they want to divorce their wives because they have fallen in love with each other and want to get married. Robert: “We can do that now.” When Robert married Grace, and Sol married Frankie, same-sex marriage wasn’t legal anywhere in the United States. Robert and Sol have been having a secret love affair for the past 20 years. Later, Sol and Frankie are alone back at their home. Frankie asks Sol if that is why he got Cialis. Sol answers: “Everyone gets Cialis at my age.” Robert and Grace are alone at their home. She is sad. Robert tries to console her. “Were you ever really happy with me?” he asks. Grace thinks about it. She says they didn’t have the most romantic life. “But I thought we were normal”. This indicates that Grace and Robert hadn’t had a sex life together in a very long time. Grace thought the end of their sex life was a normal part of being a couple, or maybe because of their age. Now, she discovers that wasn’t so. She DOES NOT say she was happy with Robert. Robert says that he “wanted more.” The implication is that he wasn’t happy in his marriage with Grace, and found what he needed with Sol. * Both couples have children who are now adults. Sol and Frankie’s sons (Coyote and Nwabudike) try and console their mother. They repeat a lot of the positive encouraging phrases she must have told them. She tells them all that is “bullshit”. Grace and Robert’s daughters, (Brianna and Mallory) are angry about what happened. They immediately take their mother’s side, and don’t want to talk to their father right then. Mallory has kids. She asks “How am I going to explain this to my kids?” I don’t think this question is entirely about her father’s relationship with Sol. It’s also about the sudden divorce. * A chair is delivered to Robert and Grace’s house. She opens the box, and finds a chair that has a photo of Ryan Gosling’s face on the seat. Robert is delighted that the chair arrived so quickly and explains it is a joke between him and Sol. * For the first time, Grace notices that Robert’s office has a framed drawing of a nude man. She notices a small frame on the shelf that contains a old photo of two men, one of whom has taken the arm of the other (as a man might do with a woman). She sees books on the shelf, one of which is called “The Male Member”. And suddenly, she realizes she’s missed all these signs. * Grace and Frankie get into an argument over which one of them is more upset. Frankie says “I lost my best friend. You never liked Robert.” * Robert says he can finally breathe again – now that he’s divorcing Grace to be with Sol. Sol says he feels really guilty because he devastated someone he loves very much. It’s clear that Sol and Frankie were not just spouses, but also good friends. Grace and Robert were not friends. * Grace freaks out about the divorce. “I did everything right. I played by the rules.” She is angry. Grace asks Frankie why she isn’t angry. Frankie says she is heartbroken. * Later, Frankie acknowledges that there were times she “knew” but ignored it. She says Sol once asked her to wear a dildo. She and Grace think that could only mean that Sol was gay. Episode 2: * Sol and Robert spent the night together and are still snuggling in bed. Sol says he wants to go up on the roof and shout: “I am a homosexual and I am in love with Robert Hanson, who is also a homosexual.” Robert smiles, and jokingly talks him out of it. * As the men are getting ready to go to work, Robert says “Just because we’re out now doesn’t mean we’re gonna be gay with a vengeance.” * Two of Frankie’s friends come over to console her and take her to lunch. One of the friends is gay. Sol and Robert aren’t the only gay men in Frankie’s life. Sol sent the two friends over because Frankie won’t answer her phone when he calls her and he was worried about her. * Robert cuts off Grace’s credit card (which she discovers while trying to pay for lunch). It turns out Sol cut off Frankie’s credit card, too. Robert feels absolutely nothing about doing this to Grace – citing that he and Sol are divorce lawyers and that’s what people who are divorcing are supposed to do. Sol feels terrible about it and is upset that he knows Frankie will be upset when she finds out. * Robert asks Sol, “Which is better, feeling terrible with me, or without me.” Sal says “with you.” * Grace sends her daughters to her (and Robert’s) home to get some of her things. (She’s staying at the beach house). The daughters notice the remains of breakfast on the table and realize that Sol spent the night there. They look sad. * Frankie has a fight with Sol and kicks him out of their house. She tells him to go live with Robert. Sol says they weren’t ready to move in together yet. * Later, Frankie asks: “Was any of it real?” That’s a normal question people ask after a breakup. But, Frankie is also asking if her marriage to Sol, who had been having an affair with Robert for 20 years, was ever real. Episode 3: * Robert and Sol are having their children over for dinner. Sol is nervous. Robert tries to calm him by saying they’ve already had lots of dinners together. Sol responds: “That was before I became their new stepmother.” * Mallory and Brianna arrive together for dinner. They wait at the door of the house they grew up in. Brianna wants to just walk in. Mallory stops her and says they can’t do that because it’s not their house anymore. Brianna responds “I’ve lost both of my virginities in that house” and proceeds to just walk right in. * During dinner, Robert and Sol hold hands for a brief moment. Robert’s daughters and Sol’s sons stare at them – not really knowing how to feel about that. * Coyote tells Mallory (who is mad at him) “We’re step people now.” * Brianna and Bud have a conversation in the kitchen. Bud is preparing a cake. Brianna mentions something about how Bud seems fine with what their dad’s are doing. She asks “Would you be cool with it if they had cheated with women?” * After returning to the table, after everyone starts eating cake, an argument ensues where the kids let out some of their anger and frustration. Bud says he is “not allowed to be mad”. When Sol asks why not, Bud answers “because you’re gay.” Episode 4: * Someone who worked with Robert and Sol has died. They are going to the funeral. Sol says that this will be the first time people see him without his wife by his side. Robert says the funeral “is not our coming out party.” * Meanwhile, Grace is pushing Frankie to get ready to go to the funeral early – so they can leave before it becomes Robert and Sol’s coming out party. * Grace and Frankie see Robert and Sol – as a couple – for the first time at the funeral reception. It makes Grace and Frankie sad. * Grace notices that Sol is wearing a tie that she gave to Robert as a Father’s Day present. This makes her angry. Frankie is angry too. “They can’t leave us AND share clothes!” * Robert and Sol haven’t decided what to call each other. Robert think’s they’re too old for boyfriend. “Soulmate?” Sol asks. Robert responds, “No! I don’t even like that one with straight people.” At the funeral reception, Sol tries to use the word partner, but then awkwardly explains that they are business partners at the law firm, but also partners with each other. He confuses the people he was speaking to. * A very old man who must have worked at the same company as the deceased tells Robert and Sol that he knows they are a couple – and that they are brave. He then asks: “When did you know you were attracted to men?” He goes on to say that he had “an experience” when he was in Korea. Sol kindly walks away with him and answers the man’s question. * Robert’s sister tells Grace that she had no idea that her brother was gay. * Later, Robert’s sister accidentally mentions that her daughter is having a baby shower. It becomes clear that Grace was not invited. Robert’s sister explains that the aunties would be there (Robert’s family is Irish) and that there would be drama and it was the daughter’s day. She asks if Grace understands. Grace says of course she understands, it’s for family. After Robert’s sister walks away, Grace looks sad. * Robert gets frustrated with Sol and yells at him for talking to the widow for too long. He yells at Sol about his shoes (that Robert doesn’t like). Robert yells “You’re just not doing anything right.” Sol responds: “Oh my god. You’re angry that I’m not Grace.” Robert sits down and starts to sob. It’s probably the first time he’s cried about the divorce. Sol consoles him, saying something like he “has one, too”. Robert apologizes, and they start using the word “boyfriend”. * Frankie speaks with the widow. The widow says to her: “Oh, I think your situation is much worse than mine.” The widow points out that Frankie might live another 20 years. The implication is that Frankie will be spending those 20 years alone. * As they are leaving the funeral reception, Grace tells Robert she is so mad at him. “I’ve lost everything,” she says. She lost her husband, her house, her family… * Frankie, upset by what the widow said, and by an unfortunate comment Grace said to Robert about Frankie when Grace was expressing her anger at Robert, leaves the funeral with Grace trailing behind her. Sol drives up in his car – to pick up Robert. Frankie gets into the passenger seat out of habit. She quickly realizes what she has done, gets out, and tells Robert “I think this is for you.” Episode 5: * Brianna tells her mother, Grace, that Grace needs a boyfriend. Grace tells her daughter, Brianna “I’m sending that sentence right back to you.” Brianna is single. Her sister, Mallory, is married with two kids. * Brianna shows Grace a profile of a handsome doctor on a dating website, in an effort to convince Grace to make a profile there. Brianna says she has used dating websites and has met some “passable” guys. Brianna mentions that one of the guys had a micropenis. Apparently, Brianna still considered him “passable”. * Grace tries to make a profile on the dating site. She struggles to describe herself. Brianna sees that Grace listed her age as 70 – which is her age. Brianna argues that Grace should say she is 65, because she looks 65. Grace says that wouldn’t be honest. Brianna says it is honest because that’s the age Grace looks. * Grace doesn’t know what to put in the section of the profile marked “turn-ons”. Frankie walks past the couch Grace and Brianna are sitting on and suggests: “That he’s NOT gay!” Brianna tells her mother to say she is “open minded”. Grace hesitates, concerned that it might mean some “weird sex thing”. * Later in the episode, Grace apologizes for saying something unkind about Frankie at the funeral. Frankie accepts her apology, but wants Grace to treat her better. Frankie points out that she is Grace’s friend. Frankie also says “I’m the other person this happened to” – meaning both she and Grace are going through divorces because their husbands are gay and their husbands want to marry each other. * Grace eventually finished filling out her dating profile and posting it. * During the episode, Grace drives Brianna and Frankie to the frozen yogurt shop (at their request). Both Brianna and Frankie are high. Brianna notices that the cashier is named Brian, and that he and her have the same name – except for the “na”. Later, Brianna tells Grace and Frankie that Brian sent her friend request on Facebook. She says “That must have taken a lot of stalking,” followed by “That was sweet.” She smiles. Episode 6: * Someone on the dating website wants to have lunch with Grace. The two of them have been briefly talking on the website for a while. The man wants to have lunch with Grace today – and she doesn’t want to go because she thinks she isn’t ready for that yet. She tells Frankie she likes the attention she gets on the dating website – and likes that she can get that attention and stay home. Frankie encourages her to go to lunch with the man from the dating website. Grace says she doesn’t know him. Frankie informs her that this is what going to lunch is for – to get to know him and to get laid. * Grace realizes that this will be her first date in 40 years. * Frankie gives Grace some condoms. Grace says she doesn’t need them because she’s well past being able to get pregnant. Frankie tells Grace that because of the “penis drugs”, older people are having sex and aren’t using condoms – and are spreading STDs. Frankie says she read that in an AARP article. There is, in fact, an AARP article from 2010 that explains why older people should use condoms. The article is written by Dr. Pepper Schwartz. * An earthquake happens, and Frankie freaks out. Robert and Sol had just made plans for dinner. (They plan to order paella from a restaurant). Immediately after the earthquake is over, Sol tells Robert that Frankie is terrified of earthquakes and that he needs to go help her calm down. Sol says: “It’s her first quake alone, and she only has Grace to comfort her.” Robert immediately responds: “Go!” * Coyote rides his bike over to Mallory’s house to deliver a children’s book called And Tango Makes Three. The book was written by Justin Richardson and Peter Parnell and was published in 2005. The story is about three Chinstrap penguins at the Central Park Zoo, and is based on something that really happened. Roy and Silo were two male penguins in the zoo’s penguin exhibit. Roy and Silo liked to do everything together. A zookeeper noticed that they built a nest together, just like the other penguins couples do. But, Roy and Silo could not lay an egg. One day, the zoo had an extra Chinstrap penguin egg that was produced by another penguin couple who could not care for it. The zookeeper gave the egg to Roy and Silo, who took turns keeping it warm until the egg hatched. The zookeeper named the baby penguin Tango because “it takes two to tango”. Tango is a girl. Coyote takes the book to Mallory because he remembered that Mallory said that her kids were having a difficult time understanding what was happening with their grandfather and Sol. Coyote is working as a substitute teacher, so it makes sense that he had heard of this children’s book. * Grace’s date does not go well. After they are seated, she asks Charles if he’s “done it a lot”. He gives her a funny look. She clarifies that she means “this” and gestures at the table. She wanted to know if he goes to lunch with women he met on the dating website a lot. He obviously thought she was asking him if he had a lot of sex. * Charles tells Grace to watch out for liars on the dating website. It’s an odd comment to start out a new (potential) relationship with. He gives the example of someone who said she loved to play tennis – but he later learned that she was in a wheelchair. It’s hard to know if Charles was making up that example, or if he met someone like that. As the lunch date goes on, Charles gets stranger and stranger. He doesn’t seem to understand the subtle social cues Grace gives him indicating she doesn’t think he’s funny. He tells her if he’s too much to say: “Charlie it’s too much.” Grace immediate responds: “Charlie, it’s too much.” Charlie laughs and doesn’t take her seriously. Not long after that, Charlie starts making inappropriate, and gross, comments about Grace’s mouth and the steak she is eating, and this makes Grace so uncomfortable that she quickly ends the lunch date. * After helping Frankie calm down, Sol asks if she would like to get a bite to eat. They go to lunch. Sol texts Robert that he is going to be late (which leads to a misunderstanding – more on that in a bit). During lunch, Frankie asks Sol how it started with Robert. Sol is a bit taken aback. He didn’t expect to be sharing that today. Frankie honestly wants to know, so Sol tells her. Robert and Sol were at a law conference together, and later got drunk together at the hotel bar. They rode the elevator together. Sol says Robert gave him this look that scared him. The look gave him a feeling. Robert kissed Sol. Frankie asked if it was a big kiss. Sol says they kept kissing until the elevator stopped at their floor – the 26th floor. Sol says his whole body became alive. Frankie asks if that’s when their relationship started. Sol says no, that he and Robert didn’t talk about what happened. Frankie asks: “Why not?” Sol says they couldn’t talk about it – they didn’t know how to talk about it. The relationship between Robert and Sol evolved from sex to love. Sol didn’t want to tell Frankie about it because he loved her, and he loved their family, and he didn’t want to hurt them or lose them. * Grace returns home after the awful lunch date and finds one of Frankie’s art students in the kitchen, eating a ham sandwich. Grace has seen all three of Frankie’s students once before, the day she was trying to rush Frankie to get ready for the funeral. Grace knows the men in Frankie’s art class are all “ex-cons.” Grace is surprised and asks how he got in there. She tells him Frankie wasn’t home. The man says he found the studio empty so he went inside the house to make sure Frankie was ok. The man starts flirting with Grace. She is so surprised, she drops her purse. The condoms Frankie gave her fall out, and the man sees them. He makes a comment, and Grace clarifies that Frankie put those into her purse. It is clear that Grace is attracted to the man. She is a bit flustered. He tells her that he knows about her husband and Frankie’s husband. He says: “Please tell me that if he wasn’t fucking you somebody else was.” Another earthquake tremor happens, and Grace and the man end up passionately kissing in the kitchen (which leads to them making out for a little while before Grace stops it). The man leaves. Grace is smiling. * Later, Grace tells Frankie that one of her students was in the kitchen, eating a ham sandwich. Frankie says “That must be Byron. He loves ham.” Grace doesn’t mention the kissing. * Sol comes home to Robert three hours late. Robert invited some friends over (Al and Eddie, who are a couple). They are eating Paella. Robert and Sol start bickering, and Al and Eddie run away. Robert and Sol have an argument. Robert asks “Why did we blow up our lives if you are just going to go running back to her?” Sol said he texted Robert that he would be late, and thought Robert said it was ok. It turned out there was a miscommunication. The two make up. Robert goes to get some food for Sol. While he isn’t looking, Sol texts Frankie “goodnight”. Episode 7: * Grace comes home from an awful date. Grace tells Frankie that she took her anecdote (about saving a little bird). Frankie isn’t thrilled with that. Grace goes on to say that her date’s anecdote was about his fatty lipoma. He had a tumor that he named Farley – and it had teeth. A lipoma is a slow-growing fatty lump that’s most often situated between your skin and the underlying muscle tissue. It can feel doughy. It is not cancer. * Grace says she has another date tomorrow. Frankie points out that would be three dates in one week. * Brianna is cooking because she has a date coming over. She calls Bud to help her. Bud points out that she destroyed the Brisket, so he’s going to help her make stew out if it. Brianna says stew isn’t a second date food. Bud infers her date is with “Racist Dave”. Brianna corrects Bud – “Border Patrol Dave”. Dave sends Brianna a text, in which he cancels the date. Brianna now calls him “Racist Dave”. Brianna says that she doesn’t know what she wants (meaning in a relationship). Bud says she wants what everyone wants “Someone you can come home to at the end of the day who is happy to see you.” Brianna says she is getting a dog. * A big part of this episode focuses on the Spelling Bee, which is televised. Frankie and Sol watch it every year (it’s one of their rituals). Frankie can’t get Grace interested in the Spelling Bee, and Sol can’t get Robert interested in it. Sol unexpectedly brings Frankie a bread maker and some laser discs. Frankie sees that as an excuse to come over. Sol asks her to come over and watch the Spelling Bee with him. Frankie hesitates, unsure if that’s a good idea now that they are getting a divorce. Sol wants to continue their rituals, like watching the Spelling Bee together. Frankie says that she will be strong and say “no”. * Brianna adopts a foster dog she saw on the internet. The man who is fostering the dog brings him over. The man is cute and near Brianna’s age. She flirts with him – badly. He doesn’t appear to be interested in her, but is excited to give this great dog a forever home. Brianna is not so enthused about the dog. The dog is shy, at first. Brianna says the dog is ugly, and asks if it is the dog she saw on the internet. The foster dog “dad” gives Brianna the food the dog has been eating, and his toys. He makes a joke (about the dog leaving his patio furniture and grill so the other dogs could use it) – which Brianna doesn’t get. Foster dog man says she can call him if she has any trouble. Brianna spends hours trying to get the dog to love her. She fails at it. So, she calls the Foster dog guy, who comes over. He doesn’t see any problem with the dog (who is happily waltzing down the hallway and checking out other rooms.). The Foster dog guy makes a comment implying he thinks Brianna called to get HIM to come over. She basically agrees. They have sex. He leaves right after. Brianna is sad – until the dog leaps into her arms and starts loving her. * Frankie ends up going over to Sol and Robert’s to watch the Spelling Bee with Sol. She brought popcorn and tea. He is thrilled! They have a great time until Robert comes home and looks upset. Frankie leaves. Robert is miffed about Sol hanging out with Frankie. Robert admits that he is scared about Sol’s relationship with Frankie. He didn’t like that Sol didn’t tell him Frankie was coming over. Sol said he didn’t know she was coming over. Sol tells Robert that Frankie will always be part of his life, and that Robert has nothing to worry about. Robert agrees to watch the Spelling Bee with Sol – and they both have fun! * Grace goes on date three (of the week). It is with a man who owns a yacht and is an architect. His “name” on the dating website is “yachtcatect”. Grace thinks that is clever. She gets a table where they are supposed to meet. Unexpectedly, she sees a friend whom she hasn’t seen in years. His name is Guy, and he is a world traveler. But now, he wants to settle down. The yacht guy shows up, but hasn’t seen Grace yet. He is dressed like a television captain – hat, coat, and all. Guy asks Grace if she wants to meet that man. She doesn’t. Guy offers to sneak her out of the restaurant if she will have ice cream with him. They have ice cream together. Guy says he thinks there has always been a spark between them. They slowly start a relationship. He takes Grace to her door, and Grace kisses him. Neither expected that. Frankie sees Grace kiss Guy through the window. She leaves the television on – and the Spelling Bee – and goes upstairs. Episode 8: * Grace lets Frankie know that Guy is coming over for dinner (and she wants Frankie to either leave or stay in her room). Frankie says that Grace and Guy are gonna have sex. Frankie asks Grace if she is worried “because it’s the first time a straight man has seen you naked in 40 years.” Grace says she isn’t worried because she will turn the lights out (and he won’t see her naked). Frankie asks Grace if she is worried about vaginal dryness. Grace responds: “I am now.” * Frankie gives Grace something Frankie refers to as her “secret weapon”. It is a jar of “Frankie’s homemade yam lube.” Frankie calls it “Vag-a-kadabra.” She keeps it in the refrigerator. Grace is disturbed because she’s been eating the yam lube on toast. Frankie reassures Grace that that is good, and that her gynecologist says “You shouldn’t put anything in your vagina that you wouldn’t put in your mouth.” Overall, this advice is not a bad idea. * Grace doesn’t want to hear about the yam lube. Frankie says “It’s not a dildo. It’s a facilitator!” Frankie also says that she makes dildos. * Grace tells Frankie that men and women cannot be friends. Frankie disagrees. She is friends with Sol, and several other men, including Jacob (who grows the yams Frankie uses in her lube). Grace later informs Frankie that Jacob was flirting with Frankie. This takes Frankie by surprise. * Guy comes over for dinner with Grace. They sit on the couch afterward making boring small talk. Eventually, Grace asks: “Do you want to have sex?” Guy responds: “Oh boy yes.” Grace does, in fact, keep the lights out and does not let Guy see her naked. * The next day, Frankie asks Grace how the sex was, and wants to hear details. Grace says Guy “was no slouch in the boudoir.” Cut scenes make it clear that Grace and Guy had sex, but it was far from being good sex. Frankie asks if the sex was bad. Grace doesn’t really answer. Frankie asks Grace if she had an orgasm. Grace angrily responds: “You’re a child!” Frankie concludes, “So, that’s a no.” * Later, Frankie tries to encourage Grace to tell Guy what she likes in bed. She asks if he knows that clitoral stimulation is important. Grace is mortified – and it’s only her and Frankie who can hear this conversation. Grace says she has never talked about her clitoris. * The next day, Grace gets off the phone and tells Frankie “Well, Guy and I made plans for him to have another orgasm tonight.” * Frankie realizes that Jacob is flirting with her. She tells Grace, who gives Frankie some advice – but Frankie isn’t skilled at flirting. Eventually, she let’s Jacob know that Grace thought he was flirting with her, and so she tried to flirt with him – but is bad at it. Jacob says he thought Frankie was having a heart attack. The two of them smoke pot together. Right before Jacob leaves, he tells Frankie that he WAS flirting with her. * Guy comes over. He says he brought a flashlight. (He injured himself trying to find the bed in the dark the other night). He wants to take Grace upstairs. She stops, plays some music, and guides Guy through dancing with her. This is the closest Grace has probably ever gotten to telling a sexual partner what she likes. The dance becomes a metaphor for sex. Episode 9: * Grace got an invite to Robert and Sol’s wedding. She and Frankie make fun of the script (which is florid and loopy and overdone). Frankie asks: “I wonder how they decided whose name goes on top.” That conversation quickly ends. Typically, wedding invitations go one of two ways: (1) The parents who are hosting the wedding are listed, followed by the parents who are not hosting the wedding – and then it states that the parents are inviting people to the wedding. (2) If the couple us hosting the wedding themselves, the name of the bride always appears first (or “on top”). Neither Grace nor Frankie want to consider which of their husbands is “on top” in the bedroom, or to wonder if the order of names on the invitation match that situation. * Frankie, after seeing the wedding invitation, asks Grace to pull her finger, which Grace refuses. Frankie was asking for help – because she tried to remove her wedding ring the day of the funeral but it was stuck on her hand. Grace helps Frankie take off the wedding ring. * Frankie is making another batch of her “Vag-a-kadabra” homemade yam lube. Brianna comes over (to pick up her dog that Frankie was babysitting). Brianna asks what Frankie is making, and Frankie tells her. Brianna responds: “Mom, Frankie verbally molested me!” Surprisingly, it is Grace who explains the virtues of the lube that Frankie is making. The reason is because Brianna took over Grace’s company when she retired. Grace thinks Brianna could sell the lube because it works, and cites a statistic of how many women have dry vaginas (especially older women). This, of course, grosses out Brianna. Grace says: “It’s all natural – from farm to vagina.” Frankie says: “Personal lubricant is for everyone.” Grace makes Brianna take a jar of the lube with her to work. * Frankie calls out Grace for lying. Guy likes golf, and hoagies, and Grace is pretending to like those things too – but she really doesn’t like those things. Frankie keeps insisting that Grace needs to tell Guy the truth. Eventually, Grace says that when you are in a new relationship you lie and pretend to like things that you don’t like. Grace is worried that Guy will break up with her if he learns that they don’t like the same things. Grace is afraid of losing Guy if she is honest with him. Frankie encourages her to be honest with Guy, anyway. * Grace takes a small revenge on Robert by asking him to come over while Guy is there. Robert is coming over to borrow Grace’s wedding book – a huge binder that apparently has tons of information that is useful for people who are planning huge weddings. Grace wants Robert to know that she has a boyfriend. Robert comes over to get the wedding book and sees that Guy is there – and is overjoyed! They are friends. They are happy to see one another. Grace makes it clear that she and Guy are in a relationship. Robert is surprised, but seems ok with that. Guy says that he and Robert should get together – and Robert agrees and says he will call Guy. Grace says the she will attend Robert’s wedding – with Guy as her date. Later, Grace goes golfing with Guy, and Robert shows up. Guy says he invited Robert. The three go golfing, with Grace trying to quietly tell Robert that she doesn’t want him there. She accuses him of trying to flirt with Guy. Guy hits the ball very far, and Robert congratulates him. The two men put their arms around each other, and Guy recites part of a poem (written by Rumi) It turns out that Robert said he had no one to officiate the wedding, and Guy, who is an officiant, volunteered. He hoped Robert liked the poem so he could use it at the wedding. Robert later tells Grace that he thought having Guy officiate was perfect because Sol wanted a multicultural wedding and Guy has been around the world. * Brianna takes the yam lube to work and repeats what Grace said about it, and the “personal lubricant is for everyone” statement that Frankie told her. She puts some yam lube into small containers and asks her team to try it for themselves, and then come back the next day to talk about it how it made them feel. Brianna wants to move the company in a new direction with this product. Brianna mentions dry vaginas a lot – grossing out one of her team members. The team is made up of a woman (who just broke up with her boyfriend) a guy who is straight and may or may not be single, and a guy who is gay. The guy who is gay does not want to hear about vaginas. Brianna ends up using the yam lube with a co-worker – Barry, who is an accountant. She has sex with someone she not only works with but also is one of her employees. The next day, when the team is sharing their experiences with the yam lube, Brianna insists she used the lube “with herself”. * Frankie gets upset because Grace got an invitation to Robert and Sol’s wedding, but she did not. She makes an unexpected visit to Sol, who is living with Robert. Frankie brings him a chip and dip plate shaped like a sombrero. She also used the bread maker Sol brought her to make bread – which she brought to Sol – along with “better” (a non-dairy form of butter she hand made.) Sol asks why she brought him those things. She said she was there to remind him to get a flu shot – and that this is the last time she will remind him – because they need to have boundaries. He agrees, and the two try and work on that. Before she leaves, she tells Sol she is upset that Grace got an invite and she did not. Sol insists that Robert mailed Frankie an invite. This leads to a big, confusing, fight between Sol and Robert about why Frankie’s invite didn’t arrive. (Which gets resolved later.) Later, Sol visits Frankie (who is still living at the beach house with Grace). Frankie is in her studio, working on some art. Sol hands Frankie her invitation. She sets it aside – with a pile of mail, which has Frankie’s invitation. She made some art on the envelope, and forgot about it. Sol and Frankie get serious and ask their subconsciouses (which they have given names to) if Frankie really wants to go to Sol’s wedding. She discovers that she doesn’t want to go because it would be too painful. Sol is sad, but understands. They start acknowledging that they need to work on “divorce stuff”. * Frankie got so caught up with Sol t
