DRC Ebola: "Officials have lost track of where the virus is spreading" UPDATED

UPDATE 10:45 PM ET

On April 12 the World Health Organization published "Preliminary results on the efficacy of rVSV-ZEBOV-GP Ebola vaccine using the ring vaccination strategy in the control of an Ebola outbreak in the Democratic Republic of the Congo: an example of integration of research into epidemic response." (pdf). No time stamp on the report, nor on the news report about the report published at STAT. But given the three comments in response to the STAT report are dated the 13th, I'll venture it was published somewhat late in the day on the 12th. 

END UPDATE

Below are points I've taken from an April 12 Associated Press report headlined  Congo's Ebola outbreak might be declared global  emergency. The report was published just prior to  WHO's decision not to declare a "global health emergency," such meaning a “serious, unusual or unexpected” infectious disease threatening to progress to other countries and requiring “immediate international action.” I don't know and I am not sure I want to know whether such an emergency is the same as a PHEIC (rhymes with "fake") but moving along for now to AP report: 

• ... 75% of new Ebola cases have no obvious link to previous patients, meaning that officials have lost track of where the virus is spreading.

• Emanuele Capobianco, head of health and care at the International Federation of Red Cross and Red Crescent Societies, cited Congolese health ministry statistics showing 40 new cases over two days this week. He called the rate unprecedented in this outbreak.

• The outbreak has been like no other. Capobianco cited lack of trust about Ebola treatment in the community, which had never faced an outbreak of the virus before, and insecurity caused by rebel groups that have hurt aid efforts.

• The outbreak is occurring close to the borders of Uganda and Rwanda, with South Sudan not far away. [One  outbreak region is near Goma, a city of a million people, and which is a major cross-border transportation hub.]

Well, there goes the Ring Vaccination Tactic out the window. You can't vaccinate rings of people around somebody infected with a communicable disease if you don't know who the somebodies are. As the Director of the Center for Health Security of the Johns Hopkins Bloomberg School of Public Health put it, in what may turn out to be the Quote of the Year: "We have a high percentage of people who are appearing with Ebola after they’ve died."

Sadly for Daniel Drezner, I don't think Dr Inglesby meant to imply Ebola-infected zombies are on the loose. Most probably his tongue just got a little tangled because he was upset about WHO's decision not to declare a global health emergency.   

Even worse upsets may be in store for everyone who placed hope in the use of an experimental Ebola vaccine for ring vaccinations, which you see depend on the vaccine actually working.  

Dr James Wilson, an Associate Research Professor and Director of the Nevada Medical Intelligence Center for the School of Community Health Sciences at the University of Nevada, Reno, co-founder of the Global Health Security Alliance, and arguably the world's top biosurveillance expert, replied to Helen Branswell's April 10 report headlined WHO asks panel to weigh whether Ebola outbreak is global emergency. Dr Wilson wrote in part:

[...]

The second question, which should have been answered transparently months ago is, where is the data on vaccine effectiveness? We aren’t talking about the studies from West Africa but what is going in the DRC. WHO has ignored multiple requests, and that issue is not going away. The Ugandans, Rwandans, and Sudanese [countries bordering DRC] are counting on that vaccine actually working as advertised. And the healthcare systems of Europe and US have an expectation that requires proactive management. Meanwhile we still have reports of healthcare workers dying [from Ebola] without indication of whether they were vaccinated.

The wording of that last remark might reflect Dr Wilson's effort of civility because he surely knows governments and international aid organizations have put much emphasis on using the new vaccine firstly to protect healthcare workers who treat Ebola patients. Indeed, the lead paragraph in a  January ABC News report reads:

South Sudan on Monday began vaccinating its health workers and other front-line responders against Ebola amid fears the deadly disease could spread across the border from the Democratic Republic of the Congo, health officials said.

To return to Dr Wilson's question, it's absolutely vital to learn whether there have been documented failures of the new Ebola vaccine. Such documentation should be readily available if the vaccine had been administered to healthcare workers who'd died from Ebola.

There are a number of reasons why even an effective vaccine could fail; e.g., if it needs to be refrigerated and various batches aren't stored at the proper temperature, or if the vaccinated person doesn't have enough time to build up immunity before exposure to the disease. 

But such reasons point to a problem with what's called in the immunizations business "compassionate" vaccinations. One might question the compassion if aid organizations are using a new vaccine under the most difficult conditions on the rationale that it's better than nothing. Here's an idea of where better than nothing has led in DRC. To return to the AP report:

• Doctors Without Borders is calling for patients to be treated in existing health centers rather than Ebola-specific clinics: “It’s very clear that people do not like or trust the Ebola centers and they are not coming to be treated."

In short, there are two different things going on here. The company that makes the Ebola vaccine and WHO and governments officials tasked with overseeing its use are focused on getting the vaccine administered and tabulating results. As to where this leaves the development of a viable approach to improving Ebola patients' survival rates (currently around 38 percent) -- 

Tell me what kind of mind would think of applying the Ring Vaccination Tactic in a conflict zone, a zone with no prior exposure to Ebola disease, and whose residents distrust foreign devils dressed like invaders from Outer Space coming at them with needles and telling them in a tinny voice emanating from the space suit, 'This is good for you.'

I'll tell you what kind of mind. It's a mind that's not focused on curing people of a disease or alleviating its symptoms. 

Such is the mind of WHO. 

The World Health Organization is focused on working with vaccine manufacturers and governments in order to immunize the entire world population against all diseases that can be vaccinated against. That's who WHO is.  

Whatever the benefits of its focus, WHO is more concerned with the prevention of communicable diseases than with the curing of individuals who fall prey to disease. This means common sense can be the first casualty of the WHO approach to dealing with a lethal infectious disease outbreak.

It is the same with a panel of experts WHO put together. WHO (or the experts) gave the panel a name that translates to the acronym "SAGE." We can assume this was to impress on the yokels in places like DR Congo that WHO takes advice from very wise people. Here's a description of SAGE from April 8 summary of the panel's meeting on April 2-4:

The Strategic Advisory Group of Experts (SAGE) on Immunization was established by the Director-General of the World Health Organization in 1999 to provide guidance on the work of WHO. SAGE is the principal advisory group to WHO for vaccines and immunization. It is charged with advising WHO on overall global policies and strategies, ranging from vaccines and technology, research and development, to delivery of immunization and its linkages with other health interventions. SAGE is concerned not just with childhood vaccines and immunization, but all vaccine-preventable diseases.

From the meeting highlights (pdf), we scroll to the last item on the agenda to find mention of the Ebola outbreak -- this at a time when healthcare workers and officials in DR Congo were already tearing their hair and crying, 'My God, we've completely lost control of this outbreak!'

Ebola vaccines

> HO Health Emergencies Response provided an update on the epidemiology of the outbreak in the Democratic Republic of Congo (DRC) and on the status of the Ebola response in North Kivu and particularly noted the important contribution of vaccination in reducing transmission.

> SAGE re-visited the possible vaccination strategies by reviewing epidemiological data and impact modelling. It concluded that ring vaccination currently remains the most effective strategy in this DRC Ebola outbreak.

Geographic targeting should remain as a fall-back strategy. Mass vaccination and ring plus had less favourable overall impact for the doses used in the modelling.

> SAGE reviewed epidemiological data from North Kivu for children below 1 year of age and for lactating women.

Although clinical data on the safety and efficacy of the rVSV-ZEBOV-GP Ebola vaccine for these two specific groups are absent, SAGE considers that the high attack rates and high case fatality rates for these groups, together with the accumulating data on vaccine safety and efficacy for other groups, justify inclusion of children who are above the age of 6 months and of lactating women in the ongoing ring vaccination efforts in North Kivu.

> SAGE strongly urged the implementation of studies to evaluate additional Ebola candidate vaccines, including where possible in pregnant and lactating women and in infants.

If the more high-strung Pundita readers ask, 'Do you mean to tell me they're still on a ring vaccination kick? -- Let us turn to Helen Branswell's report (for STAT) on April 10, the same report that drew a response from James Wilson:

With new case numbers rising at an alarming rate, the World Health Organization said Wednesday it will again look at whether the Ebola outbreak in the Democratic Republic of the Congo should be declared a global health emergency.

The announcement that a panel of outside experts — a so-called emergency committee — will meet Friday to debate the question came on a day when the DRC health ministry was expected to say 18 new Ebola cases had been identified. That marked the highest one-day increase in this epidemic, now in its ninth month.

This will be the second time an emergency committee has been asked to advise WHO Director-General Tedros Adhanom Ghebreyesus on whether this outbreak meets the criteria to be declared a Public Health Emergency of International Concern, known in global health circles as a PHEIC [rhymes with "fake."] The committee met in October and though it described the outbreak as very worrying, it recommended against declaring a PHEIC at that time.

To date the outbreak has not spread to other countries, which is thought to be one of the reasons a PHEIC has not been declared. But it is occurring in what is effectively a conflict zone, a reality that time and again has impeded the response team’s ability to bring transmission to a halt. As of Tuesday there have been 1,186 cases and 751 deaths.

Every time there has been a surge in violence there has been a corresponding sharp rise in cases. But whereas the violence was directed at Congolese soldiers or the United Nations peacekeeping operation in the outbreak area last fall, increasingly the attacks have been directed at the Ebola outbreak response itself.

In late February, Ebola treatment centers at Katwa and Butembo were firebombed by armed assailants, putting both out of commission for a time. Doctors Without Borders, which had been operating those treatment centers, withdrew its staff, saying it could not ensure their safety. Both centers have since reopened and are being operated by the DRC ministry of health and the WHO.

Since those attacks, case numbers have soared, and an outbreak that looked in February like it was coming under control now looks far from it.

Community resistance to the control measures known to stop Ebola transmission remains high in Katwa and Butembo, hotspots that are fueling the outbreak at this point.

Many infected people are refusing to go to treatment centers for care, choosing instead to stay at home. That accelerates spread of the disease because the people who care for these patients will almost inevitably become infected themselves in the process.

There was hope that an experimental Ebola vaccine, made by Merck, would help to contain the outbreak. And WHO officials insist that but for the vaccine, this outbreak would be many times more severe than it already is. More than 97,000 doses of the vaccine have been administered so far in this outbreak.

But failings of the response are undermining the vaccine’s effectiveness. The vaccine is being used in what is called a ring vaccination approach — it is being offered to people who are known contacts of cases and the contacts of the contacts, as well as health workers and other frontline workers. The idea is to prevent spread of the virus by protecting people who are in contact with cases.

For that approach to work, the Ebola response needs to be able to identify as many contacts as possible. But in many cases they have been unable to do the contact tracing work needed to draw up detailed lists; cases have occurred in neighborhoods or villages where it is unsafe for them to work.

As a result, many people who should have been vaccinated have not appeared on the vaccination list.

[...]

Ms. Branswell goes on to report that the prolonged length of the outbreak is raising concerns supplies of the vaccine will run out. But barring that possibility, only howling mobs of Doctors Without Borders workers descending on WHO's headquarters in Geneva might pry SAGE from the Ring Vaccination Tactic in DRC. 

DWB aka Médecins Sans Frontières is very, very upset about WHO's decision not to declare the DRC Ebola outbreak a global health emergency or a PHEIC (rhymes with "fake") or whatever -- although WHO walked right up to the line. In the wake of the decision, DWB/MSF brushed aside WHO's terminology and called the outbreak for what it has become -- maybe not in Geneva but down there on the ground in two provinces in DR Congo: an out-of-control epidemic. And while DWB/MSF stopped short of dismissing the vaccination approach, they issued an impassioned plea for a change in strategy in battling the epidemic, one that was patient- and community-oriented.

But I'll give the last word to Dr Michael Osterholm, director of the University of Minnesota’s Center for Infectious Diseases Research and Policy. He summed the need for a new direction in combatting Ebola in DRC when he told Helen Branswell, "Doing the same thing over and over again does not appear to be working."

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London Met police confirm Assange arrest related to US extradition warrant

Assange being removed from Ecuadorian Embassy in London

Assange arrested in relation to a US extradition warrant - UK police

Published time: 11 Apr, 2019 11:36 

RT

Assange was taken into custody at a central London police station, and the arrest was made at a US extradition request, the Met Police have confirmed, saying he will appear at London Magistrates’ Court.

Julian Assange has been “further arrested on behalf of the United States authorities after his arrival at a central London police station,” the Metropolitan Police confirmed. The US cited the Extradition Act while filing the request, they informed.

“He will appear in custody at Westminster Magistrates' Court as soon as possible,” the statement reads. A car apparently carrying Assange has arrived at the court earlier.

Earlier in the day, Jen Robinson, one of Assange’s legal team, alleged that the arrest was linked to a US extradition request. “Just confirmed: Assange has been arrested not just for breach of bail conditions but also in relation to a US extradition request,” she tweeted.

[...]

Coup in Sudan

"Since December, protests triggered by the rise in consumer goods prices have engulfed Sudan. Mass rallies have prompted President Omar Bashir, who has been in power for 30 years, to dissolve the cabinet and declare a year-long state of national emergency."

Headlines from Sputnik's most recent live updates; see their report below::

Sudan's Bashir, Inner Circle Arrested - Sudanese Security Service Source (14:36)
14:17
Sudan Frees All Political Detainees - State News Agency
13:58
Protestors Reportedly Attack Intel and Security Service Facilities in Kassala and Port Sudan
13:09
Relations Between Russian and Sudan Won't Change With New Government - Kremlin
12:15
Mass Rallies Being Held in Khartoum - Reports

Sudan's Speaker to Return to Khartoum From Qatar Friday Despite Reports About Coup - Source
11:42
Situation Near Russian Embassy in Sudan Calm Amid Reports of Military Coup - Mission
11:38
Sudanese Army Raids Offices of Group Linked to President Bashir's Ruling Party - Reports
Russia to Maintain Ties With Sudan Whoever Comes to Power in Khartoum - Senior MP
11:00
High-Ranking Source in Presidential Palace Not Confirming Info on Bashir's Arrest
10:56
Bashir Absent in Presidential Palace in Capital - High-Ranking Source
10:39
Sudanese Provincial Minister Reportedly Confirms President Bashir Stepped Down, Talks to Form Military Council Underway

LIVE UPDATES: Unrest in Sudan Amid Reports of Military Coup Attempt

08:18 11.04.2019(updated 10:21 11.04.2019)

Sputnik

Over the weekend, thousands of people participated in protests in Khartoum and across the country, calling for Bashir's resignation and urging the army to side with the people. The rallies have continued this week, resulting in civilian casualties due to clashes between protesters and security forces.

According to the Lebanese TV channel Al Mayadeen, Sudanese army members have declared that President Omar Bashir has been removed from all positions amid reports of a coup in the African country following weeks of anti-government protests.

The media outlet cited sources as saying that the military personnel planned to announce the creation of a military council to govern the country during a transition period that might last for up to one year.

All of Bashir's assistants and deputies have also been allegedly sacked, with no official confirmation following so far. The TV channel also reported about an intensified military presence in Khartoum.

READ MORE: Sudanese Army Reportedly Removes President From All Posts Amid Rumours of Coup

Earlier in the day, the newspaper Sudan Tribune reported that an emergency meeting of the Sudanese Armed Forces’ General Staff took place in Khartoum without Bashir. The newspaper noted that military personnel had entered the building of a national TV broadcaster and promised to make an important statement.

Since December, protests triggered by the rise in consumer goods prices have engulfed Sudan. Mass rallies have prompted President Omar Bashir, who has been in power for 30 years, to dissolve the cabinet and declare a year-long state of national emergency.

[END REPORT]

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CFR: Telling the truth but still lying about Central America's Northern Triangle

In June 2018 the (American) Council on Foreign Relations published a paper on the causes of violence in the "Northern Triangle" countries of El Salvador, Guatemala, and Honduras in Central America. According to CFR, the violence has driven the large waves of migration to the United States from those countries during the past decade -- a view of the situation that is supported by the United Nations and the entire international establishment to include the American one. 

The very title of the CFR paper, Central America’s Violent Northern Triangle, keeps the authors confined to discussion of the link between violence and migration, which tags the rise of organized crime that drives the violence to the outcome of decades of civil wars that wracked the region:

At war’s end, a large pool of demobilized and unemployed men with easy access to weapons morphed into organized criminal groups, most notably in El Salvador. In Guatemala, groups known as illegal clandestine security apparatuses and clandestine security apparatuses grew out of state intelligence and military forces.

Having defined the Northern Triangle's migrations as flights from violence, the authors go on to explain why the violence has persisted lo these many years:

Weak, underfunded institutions, combined with corruption, have undermined efforts to address gang violence and extortion. Tax revenues as a percentage of gross domestic product (GDP) in the Northern Triangle are among the lowest in Latin America, exacerbating inequality and straining public services. Transparency International, a global anticorruption watchdog, places all three countries in the bottom half of its corruption perceptions rankings.

Then the authors, Rocio Cara Labrador and Danielle Renwick, delve into the all-important question of what governments in these countries have done in their clearly failed attempts to stop the violence and concomitant rampant crime. (In one sentence, these governments got very nasty, creating a backlash among the downtrodden that worked in the crime cartels' favor.)

The authors finish by examing what a succession of U.S. administrations (Bush 2, Obama, Trump) have done to respond to the crime crisis in the Northern Triangle, which if we take the present migration statistics as a guide, clearly hasn't been much.

This is not to disparage the paper, which presents lots of interesting data. (Did you know that 95 percent of crimes in certain regions go unpunished?) But against what's really been going on in the Northern Triangle lo these many years, the authors might as well have dredged up recipes for wiener schnitzel.

Once we look outside CFR's carefully boxed discussion, we first see entire societies that became dependent on remittances. From anthropologist Daniel Reichman's latest analysis of Central American migrations to the United States:

Since the 1990s, the economies of El Salvador, Guatemala, and Honduras have become heavily dependent on remittances, the money sent home by migrants abroad. In some years, remittances account for more than 20 percent of the gross domestic product (GDP) in these countries. There is no way for those countries to survive without remittances.

In the US, a shift from a manufacturing economy to a service economy has created a new demand for workers, particularly in food service, construction, hospitality, and health care. The pull of a strong US economy is important; if there are jobs waiting, people will come. Day laborers in Central America earn in one day what they could earn in a half hour in the United States, so people are willing to take extreme risks to get here.

But why have these countries become so dependent on remittances? For a big part of the answer, I return to a January 2017 report for The Huffington Post, which I republished at my blog in November 2018. It's titled Land Grabs Are Partly To Blame For Skyrocketing Violence In Central America: "Global firms and local elites are taking land from farmers, which pushes them to cities, where jobs are few."

But it's not just a connection between violence and the land grabs; it's the story of the Northern Triangle for much of the last century going back to the original "Banana Republic" in Honduras. It's a story that has been repeated in regions all across the world, only the story keeps getting worse. 

As early as 2008, a top British investigative journalism team, Adrian Levy and Catherine Scott-Clark, sounded the alarm by warning:

Almost half of Cambodia has been sold to foreign speculators in the past 18 months -- and hundreds of thousands who fled the Khmer Rouge are homeless once more.

By the end of 2010 GRAIN was repeating the British  journalists' warning as it applied to Latin America:

[...]

The history of Latin America is one of agrarian conflicts, and of indigenous peoples struggling to defend their ancestral territories. A new chapter of this history is opening. Another wave of land grabbing is hitting the Americas, and this time it operates from a distance and wears a halo of “neutrality”. 

Today’s land grabbers (as thoroughly explained in governmental web brochures) say that they are merely responding to food insecurity and a world crisis “that forces us to grow food wherever we can, even if we outsource production, because we will bring home this food for the benefit of our citizens”. 

But when we dig a little, the financial monster shows its tail. The land grabbers are in fact big corporations and joint ventures investing enormous amounts of money in land, food production, the export and import of commodities, and food-market speculation.

Millions of hectares of farmland in Latin America have been taken over by these foreign investors over the past few years for the production of food crops and agrofuels for export. 

Much of the money comes from US and European pension funds, banks, private equity groups, and wealthy individuals like George Soros, and it is being channelled through special farmland investment vehicles set up by both foreign and local companies.

Brazil’s largest sugar company, COSAN, has a specialised farmland investment fund called Radar Propriedades, which buys Brazilian farmland on behalf of clients such as the Teachers’ Insurance and Annuity Association–College Retirement Equities Fund of the U.S. 

Louis Dreyfus, one of the world’s largest grain-trading multinationals, has a similar fund into which American International Group (AIG) has invested US$65 million.

While media attention has focused on land deals in Africa, at least as much money and more projects are in operation in Latin America, where investors claim that their farmland investments are more secure and less controversial – ignoring the struggles over access to land being waged in practically every country on the continent.

More and more investors and governments from Asia and the Gulf are training their sights on Latin America as a safe place in which to outsource food production. Most governments in Latin America embrace these developments, with diplomatic missions frequently being sent abroad to sell the advantages of investing in their countries’ farmland.

[...]

Obviously these developments haven't trickled down to the dispossessed. That's the story behind the story of wide-scale violence and organized crime in the Northern Triangle.

As for remittances, I don't recall seeing a report from the World Bank on the downsides of migrant labor for the host countries. For example I don't think the Bank -- or the remittances-collecting governments in South Asia and the Philippines -- have ever gotten around to mentioning that imported foreign labor transformed rich Gulf Arab nations into virtual slave societies. 

And no mention from the International Financial Community that industrialized levels of remittance outflows drain much-needed revenue from communities in the United States and Europe that host large numbers of migrant workers.

As to the remittances-led Golden Age of the globalized work force, we can see how this is shaking out when governments kept in power by remittances no longer have to bother even with giving lip service to international norms of behavior established by the largest aid-giving countries.

In summary, we have raised up a system that rewards the behavior of locust swarms among large numbers of humans. Maybe the Council of Foreign Relations will get around to publishing a paper about that someday, but I wouldn't hold my breath waiting. 

See also Honduras: From Banana Republic to Remittances Republic to Failed State (Pundita, 11/2018), which at the end provides a suggestion to any government that is serious about saving its nation.  

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https://www.unrefugees.org/emergencies/central-america/
  
https://www.cfr.org/backgrounder/central-americas-violent-northern-triangle
  

https://www.rochester.edu/newscenter/crisis-at-the-border-anthropologist-overview-central-american-migration-372762/

https://www.huffpost.com/entry/landgrabs-central-america_b_586bf1a6e4b0eb58648abe1f

https://www.theguardian.com/world/2008/apr/26/cambodia

https://www.grain.org/article/entries/3995-land-grabbing-in-latin-america

https://www.independent.co.uk/voices/commentators/johann-hari/the-dark-side-of-dubai-1664368.html

https://pundita.blogspot.com/2018/11/honduras-from-banana-republic-to.html

Ya mean the Doomsday Bug is a fungus?

Well well, three wells make a river, close your mouth Pundita you'll catch flies. But I can't help but be open-jawed; all these decades scanning the horizon for a freepin' supervirus then get a tap on the shoulder: 'Hi, how are ya? I'm a fungus.'

The good news is that the fungus Candida auris only kills about 45 percent of the people it infects, and most of those are just babies and old people. Oh right, and others with weak immune systems like diabetics and there are only 500 million or so cases of diabetes worldwide although this number is projected to skyrocket as more people in the 'developing' world get fat. 

The bad news is that the fungus seems to operate on the principle that whatever doesn't kill it makes it stronger. In other words, not only is it resistant to the top treatments for fungal infections, it thrives on them. 

Now before we ask how a garden-variety fungus morphed into a killer with global reach, we need to get our priorities in order. First and foremost, who can we blame? 

Right now it looks like a tie between (a) the CDC/WHO for not sounding the alarm earlier and wider; (b) hospitals that got hit by C. auris but kept their mouths shut so as not to scare off patients; and (c) the agriculture industry with emphasis on Big Ag, although this wouldn't absolve the little guys. From the bombshell April 6 report from The New York Times, A Mysterious Infection, Spanning the Globe in a Climate of Secrecy, which has already gone, uh, viral (c) may have the edge when it comes to parceling blame:

There are different theories as to what happened with C. auris. Dr. Meis, the Dutch researcher, said he believed that drug-resistant fungi were developing thanks to heavy use of fungicides on crops.

Dr. Meis became intrigued by resistant fungi when he heard about the case of a 63-year-old patient in the Netherlands who died in 2005 from a fungus called Aspergillus. It proved resistant to a front-line antifungal treatment called itraconazole. That drug is a virtual copy of the azole pesticides that are used to dust crops the world over and account for more than one-third of all fungicide sales.

A 2013 paper in Plos Pathogens said that it appeared to be no coincidence that drug-resistant Aspergillus was showing up in the environment where the azole fungicides were used.

The fungus appeared in 12 percent of Dutch soil samples, for example, but also in “flower beds, compost, leaves, plant seeds, soil samples of tea gardens, paddy fields, hospital surroundings, and aerial samples of hospitals.”

Dr. Meis visited the C.D.C. last summer to share research and theorize that the same thing is happening with C. auris, which is also found in the soil: Azoles have created an environment so hostile that the fungi are evolving, with resistant strains surviving.

This is similar to concerns that resistant bacteria are growing because of excessive use of antibiotics in livestock for health and growth promotion. As with antibiotics in farm animals, azoles are used widely on crops.

“On everything — potatoes, beans, wheat, anything you can think of, tomatoes, onions,” said Dr. Rhodes, the infectious disease specialist who worked on the London outbreak. “We are driving this with the use of antifungicides on crops.”

Dr. Chiller [yes, that's his real name] theorizes that C. auris may have benefited from the heavy use of fungicides. His idea is that C. auris actually has existed for thousands of years, hidden in the world’s crevices, a not particularly aggressive bug. But as azoles began destroying more prevalent fungi, an opportunity arrived for C. auris to enter the breach, a germ that had the ability to readily resist fungicides now suitable for a world in which fungi less able to resist are under attack.

On the other hand, I can't see Big Ag taking the fall for this; if push comes to shove they'll take an actuarial tack, arguing that many more people will die of starvation than would be killed by a germ if crops aren't blanketed with fungicides. If worst comes to worst they can always point the finger at Big Chem: Look, we just spray the stuff; we're not to blame if these companies make fungicides that make fungi stronger.

So the biggest blame might land on (b) and there is already an indication of how the winds are blowing in this regard. To return to the NYT report:

“Why the heck are we reading about an outbreak almost a year and a half later — and not have it front-page news the day after it happens?” said Dr. Kevin Kavanagh, a physician in Kentucky and board chairman of Health Watch USA, a nonprofit patient advocacy group. “You wouldn’t tolerate this at a restaurant with a food poisoning outbreak.”

He does have a point. There is no question that health care providers have to be more forthright with the public about outbreaks of all types of lethal infections in their facilities. The point would hold doubly true for dealing with killer fungi. Scientists are concerned that C. auris could make the jump from people with weak immune systems to a healthy population. The places ripe for this opportunity are health care facilities that provide services for healthy people in addition to caring for the sick, which covers just about all medical facilities.  

Another reason to fear C. auris in the medical-care setting is that the thing is well-nigh impossible to kill off even with extreme decontamination measures -- as you will see if you read the NYT report.

From here on out, medical clinics and hospitals must take special pains to keep reasonably healthy patients separated from the sick ones. At the least, they have to start issuing an alert to the public the moment they discover an outbreak of  C. auris in their facility.

Aso to whether C. auris or another fungus could become a doomsday bug -- I think there are too many variables, too many unknowns, to make a stab at the answer at this time. Much is still unknown about C. auris, which made its first known appearance in the USA in 2013, although it had probably been loose here before that. To return once more to the NYT report:

The C.D.C. investigators theorized that C. auris started in Asia and spread across the globe. But when the agency compared the entire genome of auris samples from India and Pakistan, Venezuela, South Africa and Japan, it found that its origin was not a single place, and there was not a single auris strain.

The genome sequencing showed that there were four distinctive versions of the fungus, with differences so profound that they suggested that these strains had diverged thousands of years ago and emerged as resistant pathogens from harmless environmental strains in four different places at the same time.

“Somehow, it made a jump almost seemingly simultaneously, and seemed to spread and it is drug resistant, which is really mind-boggling,” Dr. Vallabhaneni said.

But while much remains unknown about the fungus, I think it can be said with certainty that it doesn't bode well for humanity if our immune systems are becoming weaker; there is the concern that this is happening as we become cleaner. Discussion has been going on for years about what's been dubbed the "hygiene hypothesis."  See this 2015 BBC report for an overview of the discussion.

And there is concern that bottle-fed babies have weaker immune systems than breast-fed ones. 

We could be backing ourselves into a situation not unlike the one portrayed in "War of the Worlds," where invaders from a technologically advanced alien civilization were felled by ordinary germs on our planet.

All right; I've chopped up the New York Times report enough;  I think you'd be wise to go to their site and read the whole thing from start to finish.  The lead author of the report, Matt Richtel, is a Pulitzer Prize-winning journalist who specializes in translating some pretty dry subjects into a whale of a tale, and that's certainly the case with C. auris.

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Russiagate was a hoax. Was it also a criminal offense?

[...]Having extensively investigated this abuse, House Intelligence Committee Republicans will soon be submitting criminal referrals on numerous individuals involved in these matters. These people must be held to account to prevent similar abuses from occurring in the future. The men and women of our intelligence community perform an essential service defending American national security, and their ability to carry out their mission cannot be compromised by biased actors who seek to transform the intelligence agencies into weapons of political warfare.

Above from a Washington Examiner op-ed, published April 5, by Rep. Devin Nunes, a ranking member of the House Intelligence Committee.

During his conversation last night with John Batchelor of the  John Batchelor Show, Rep. Nunes mentioned that the criminal referrals to the U.S. Department of Justice will be for about 24 Americans. And he elaborated on what a criminal referral from Congress means, how it works.  

Podcast Part 1 (from the 4:44 minute mark). Part 2 deals with the controversy surrounding the Mueller Report ginned up by the Democratic Party.

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Extent of US arms sales to Saudi Arabia, UAE not easy to spot. Here's why..

Excellent detective work. Fascinating report:

REVEALED: The full extent of US arms deals with Saudi Arabia and UAE
Commercial deals tracked by arms monitor prove the US is far more involved in the Yemen war than suspected
By Frank Andrews
April 4, 2019
Middle East Eye

The United States has struck at least $68.2bn worth of deals for firearms, bombs, weapons systems, and military training with Saudi Arabia and the United Arab Emirates since the start of their war in Yemen – billions more than previously reported – according to data collected by an American think tank.

That colossal sum includes, for the first time, both commercial and governmental arms deals and indicates that US involvement in the disastrous war may be greater than suspected. In fact, the weapons expenditure could have funded the United Nations’s 2019 humanitarian appeal for Yemen – which totalled $4bn – 17 times over.

According to the data collected by arms trade watchdog Security Assistance Monitor (SAM) and reported here for the first time, American companies have made deals worth at least $14bn with the Emiratis and Saudis since March 2015, when the coalition intervened in the conflict.

Government sales tend to be for major systems, like combat aircraft, tanks, bombs, and ships, some of which are more likely than others to be used in Yemen – partly because it can take years to finalise such deals, which frequently grab headlines.

But it’s the smaller weapons like firearms and bombs sold in commercial sales that experts say are disproportionately likely to be used in the conflict and inflict significant damage.

William Hartung, director of the arms and security project at the Center for International Policy, a progressive think tank in Washington, DC, which houses SAM, said the commercial data shows the US footprint in Yemen is "dramatically understated” because commercial sales are “so rarely discussed, compared to big glitzy deals like the fighter planes”. 

SAM’s estimate was all but confirmed by a US state department official, speaking on background, who said the overall value of American weapons deals to the Saudi-led coalition in Yemen since March 2015 totalled about $67.4bn.

New details about the arms deals come amid a continued push in the US Congress to end Washington’s involvement in the war in Yemen, which has displaced millions and led to widespread disease and malnutrition.

[...]

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"Saudi Arabia nears completion of its first nuclear reactor"

SouthFront report today with pix (Google Earth images) of the nearly completed reactor site. Why am I not jumping for joy about Saudi move into nuclear energy? 

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Syrian War in Last 24 Hours

See also:

"SYRIAN WAR REPORT – APRIL 5, 2019: RUSSIAN JETS POUND IDLIB TERRORISTS, KURDISH REBELS ATTACK TURKISH PROXIES," April 5, SouthFront

"MILITARY SITUATION IN SYRIA ON APRIL 6, 2019 (MAP UPDATE) [and summary], April 6, SouthFront
"Tens of families who have been taken hostage by the occupying US forces and their affiliated militants in al-Rukban in al-Tanf region escaped from the camp."

Syrian Army Pounds Tahrir Al-Sham's Positions, Movements in Idlib, Hama
April 6, 2019
FARS

TEHRAN (FNA)- The Damascus Army destroyed the key strongholds of Tahrir al-Sham al-Hay'at (the Levant Liberation Board or the Al-Nusra Front) in response to the terrorist group's attacks from the demilitarized zone on safe areas and military points in Hama and Idlib over the past 24 hours.

The Syrian army units on Friday responded to the terrorists' missile strikes on residential areas in the town of Mahradeh in Northern Hama which killed and wounded several civilians, with artillery and missile fire, smashing Tahrir al-Sham strongholds in the towns of Kafr Zita and al-Hawir in the Northern parts of Sahl al-Ghab in Northern and Northwestern Hama and leaving several militants dead.

The army troops also launched artillery attacks on terrorists' movements and positions in al-Tah, al-Tamane'ah, al-Khuwain, al-Zarzour and Khan Sheikhoun in Southeastern Idlib, destroying several positions of the terrorists.

Meantime, the Syrian army continued its military advances in other parts of Syria over the past 24 hours.

Tens of terrorists were killed and dozens more were injured during the Syrian army's operations in provinces across Syria.

Hama-Idlib

The Syrian army destroyed the key strongholds of Tahrir al-Sham al-Hay'at in response to the terrorist group's attacks from the demilitarized zone on safe areas and military points in Hama and Idlib.

The Syrian army units on Friday responded to the terrorists' missile strikes on residential areas in the town of Mahradeh in Northern Hama which killed and wounded several civilians, with artillery and missile fire, smashing Tahrir al-Sham strongholds in the towns of Kafr Zita and al-Hawir in the Northern parts of Sahl al-Ghab in Northern and Northwestern Hama and leaving several militants dead.

Meantime, the Arabic-language service of Sputnik reported that the army troops launched artillery attacks on terrorists' moves and positions in al-Tah, al-Tamane'ah, al-Khuwain, al-Zarzour and Khan Sheikhoun in Southeastern Idlib, destroying several positions of the terrorists.

It added that 5 Syrian army soldiers had been killed during Horras al-Din terrorist group's guided missile attacks on the town of Sham al-Haqa in Southeastern Idlib on Thursday.

Raqqa

The US-backed Syrian Democratic Forces (SDF) suppressed a protest rally held by civilians in Raqqa as Washington sent a military convoy to the province.

Local sources reported on Friday that a large number of people from Raqqa city gathered in Seif al-Dolah district on Thursday against the SDF measures in the region.

They added that the SDF militants fired at the protestors to disperse them and detained over 20 people.

The sources said that the civilians in the Western parts of Raqqa city hoisted the Syrian government's flags over the electricity pylons and wrote graffiti on the walls near al-Ba'ath dam in the village of Kadiran, calling for Raqqa's liberation from the SDF occupation.

Meantime, the Arabic-language al-Manar news channel reported that a US military convoy, accompanied by the SDF, is moving from Northern Deir Ezzur towards Raqqa province.

Homs

Tens of families who have been taken hostage by the occupying US forces and their affiliated militants in al-Rukban in al-Tanf region escaped from the camp.

The Arabic-language service of SANA news agency reported that the Syrian refugees have left al-Rukban camp for Jaliqam corridor in Badiyeh (desert areas) of Syria in the Eastern parts of Zaza region in Eastern Homs to be transferred to their hometowns which have been liberated from the terrorists' occupation by the Syrian army.

It added that tens of children and women need urgent medical care given the hard conditions in the al-Rukban camp.

The families who have escaped al-Rukban have confirmed lack of food and hygiene possibilities in the camp, adding that the US-backed terrorists keep people hungry and prevent their evacuation.

Hundreds of people fled and a number of others have so far been killed in the ill-famed Rukban refugee camp in the al-Tanf region of Homs which has been occupied by the US and its affiliated militants at the borders with Iraq.

Hasaka

Several other children were killed in al-Houl camp occupied by the SDF in Southern Hasaka.

The London-based Syrian Observatory for Human Rights (SOHR) reported on Friday that 11 children have recently been killed in al-Houl camp for an acute lack of medicine, foodstuff and hygiene possibilities.

It added that at least 218 children have been killed in the camp since last December.

The SOHR had reported in March that 71,000 people are residing in the camp.

Meantime, field sources reported that civilians in the camp held protest rallies against the SDF for hard living conditions in al-Houl, adding that the US-backed forces fired at the protestors.

[END REPORT]

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How serious are disagreements between Washington and Berlin?

Before delving into the weighty question we turn to an educational Pundita quiz:  What are two instant ways to tell if you're one of the Kremlin's useful idiots? 

1.  You think this photo is funny.

Associated Press/Even Vucci

2. You saw the photo at Sputnik, which is the only place you're going to see it outside the AP photo archives.

If you want to know why Chancellor Merkel is deciding what she'll have for dinner while President Trump makes a goldfish face at her, you'll just have to read Sputnik to find out. Oh all right; from Sputnik March 21:

US-Germany Rift Set To Blow

OPINION

By Finian Cunningham

This is going to get very ugly. Germany is openly defying US President Trump's demands to spend more on its NATO budget. Already the American ambassador to the country is crying foul, prompting German calls for his expulsion.

Of all the countries in the European Union, it is Germany that's been mostly on the receiving end of Trump's wrath since he entered the White House. In two years, bilateral relations between Washington and Berlin have plummeted under the weight of Trump's withering verbal attacks.

The American president has assailed Germany for unfair trading practices over its lucrative auto exports; and he has virtually accused Berlin of treason in its dealings with Russia for natural gas supply, threatening to slap economic sanctions on German firms over the Nord Stream 2 pipeline project under the Baltic Sea.

Germany has vehemently rejected Trump's accusations, saying its auto industry is a big investor in creating American jobs, and that its energy policies are a sovereign matter based on objective market principles.

But above all his complaints, Trump has continually rebuked Germany for not spending enough on NATO commitments, sniping that the country is freeloading on American military protection. At a NATO summit last year, Trump hectored German Chancellor Angela Merkel to raise her country's annual military budget to the designated NATO target of 2 percent of Gross Domestic Product (GDP).

For many years, especially after the end of the Cold War, German military spending has lagged at around 1 percent of GDP. Trump contends that, as Europe's largest national economy, Berlin should at least double its defence budget.

Latest figures, however, show that German military spending is nowhere near reaching the 2 percent target that Trump has been fulminating about. Indeed, the trend appears to be one of declining expenditure by Berlin on the military, not increasing.

That caused earlier this week US ambassador Richard Grenell to decry Germany's "failure" to live up to its NATO commitments.

Grenell is something of a Trump cypher. It is not the first time the envoy has harangued Germany in terms that his boss in the White House could have almost written for him. Grenell has been slamming Berlin over the Nord Stream 2 gas project with Russia and in its dealings with Chinese telecoms giant Huawei.

His condemnations this week regarding Germany's military budget have again sparked furore among the country's politicians and media, eliciting further public calls for the envoy to be expelled owing to his alleged gross interference in Berlin's internal affairs. 

"An ambassador is not supposed to act like the spokesman of an occupying power," said Wolfgang Kubicki, the deputy leader of the Free Democrat Party.

The New York Times this week reported "the timing couldn't be worse" for US-German relations. Next month marks the 70th anniversary of the founding of the NATO alliance. A major celebration is due to take place in Washington DC for the occasion. The atmosphere will be severely chilled by Germany's truculent defiance of Trump to boost its commitment to NATO.

Out of some 30 members in the US-led NATO bloc, only seven countries have managed to raise their military budgets to the 2 percent of GDP target that Trump has clamoured for. That target figure predates Trump's presidency. But since the end of the Cold War, many European members of NATO have reduced military spending.

[...]

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From that point on Finian Cunningham -- a Kremlin useful idiot if there ever was one -- engages in outright anti-US propagandizing. Well, Sputnik was established by a news agency owned by the Russian government, so one has to be prepared for propaganda along with the news, especially when it's clearly labeled "OPINION."

But American readers need to ask themselves this: Have they seen any mainstream U.S. news outlets in the past week headlining the latest furor in Germany's political establishment about American actions in the country?  

So the best answer to the question I asked in the title of this post is that you'll be the last to know if you get your news from only one side of a serious matter. 

Looked at from both sides, Germany and the U.S. will likely patch things over for the 70th-anniversary celebration of NATO's founding. Beyond that, the worst of the disagreements between the German and American government is rooted in Washington's not-unrealistic concern that Berlin and Moscow will draw closer together on key issues. The concern arose during the Obama administration's ham-handed meddling in Ukraine, which gave Berlin a not-unrealistic fright.  

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Brexit Status March 28, 2023

PM Theresa May has again agreed to step down if MPs still can't agree on any one of the 200 proposed Brexit deals that have resulted in 58 motions already shot down at Westminster. 

"I am prepared to leave this job earlier than I intended in order to do what is right for our country and our party," Mrs May said during an impromptu press conference outside No. 10.

For the status of Brexit proposals circa March 2019, see this helpful scorecard, courtesy The Sun:

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Why not find you guilty of a crime that might never happen? Russiagate Hoax, Continued

Of all the attorneys who've studied Robert Mueller's Special Counsel investigation of President Trump's relations with the Russian government, Andrew McCarthy, a former Assistant United States Attorney for the Southern District of New York, has been the most careful, the most cautious, in his criticism of the Special Counsel. But last night on the John Batchelor Show McCarthy, in his explanation of a "novel" interpretation of the legal term "obstruction," made explicit what has only been implicit in Mueller's approach to the investigation. 

What McCarthy revealed harks to the 'pre-crime' legal system in Philip K. Dick's 1956 science fiction story, "The Minority Report," in which it's routine to arrest a person who hasn't committed a crime on the suspicion that he might commit a postulated crime.  

This dystopian concept of a criminal justice system goes further than Franz Kafka's horrific tale of a man found guilty of an unspecified crime. It can be argued that the whole of civilization, and certainly the whole of Western law, is to ward off humanity's descent into the darkest, most irrational, concept of justice. But here is just that irrationality, put into practice by Robert Mueller, a man who at least on cursory inspection represents the best of the American criminal justice system. Put into practice against a sitting U.S. President.  

How did this happen in today's America? How did we end up back at the Salem Witch Trials? Listen to McCarthy's careful summary of the Mueller probe's findings to date. Listen as if your life depended on it. Here's the podcast.

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John Batchelor and Matt Taibbi dissect the corpse of US journalism. Russiagate Hoax, Continued

"The liberal media Russiagate failure and what is to be done?" with Matt Taibbi. The John Batchelor Show, March 25. Podcast, Part 1 and Part 2.

For background to the discussion, read Matt's It's official: Russiagate is this generation's WMD - "The Iraq war faceplant damaged the reputation of the press. Russiagate just destroyed it."

The article, actually a chapter from a self-published book (Hatc, Inc.: "How the Press Makes Us Hate One Another"), has been the shot heard round the news media world since it was published on March 23. It's provoked any number of defenses of the news media's handling of Russiagate and at least one thinly-disguised rant against Matt. (Joe Scarborough of MSNBC's Morning Joe.)

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