Category: From California Healthline.org

INDIANAPOLIS — Nine years ago, Nina Porter gave birth in a hospital bed with one of her ankles chained to the frame.

Corrections officers stood watch as Porter held her daughter, Gianna, to her chest for the first time. Back at a nursery inside Indiana Women’s Prison, Gianna slept in a crib in her mother’s cell, about 2 feet from her pillow.

The prison program allowed Porter to keep her baby with her — including when she went out into the yard — until her discharge nearly a year later. She didn’t recall ever bonding so closely with her previous 11 kids. She finally felt her life moving in a positive direction.

“I didn’t want to be a messed-up person,” she said. “I didn’t want to be a messed-up mom once I realized what a real mom is.”

When Porter was released in 2012, however, she didn’t know how to stay on that path and resorted to what she knew: drugs and crime. She never returned to prison, but her struggles eventually led to a new mission of supporting incarcerated moms as they adjust to life on the outside.

This month, a program Porter developed called Mothers on the Rise is set to launch in the same unit where the 46-year-old raised her daughter. The project, among the first of its kind, aims to help formerly incarcerated mothers maneuver a post-prison world that can often be unwelcoming.

Research shows that recently incarcerated moms are likely to have a variety of mental and physical health problems and lack access to stable housing, employment, education and social services.

“They’re released with maybe no place to stay and go to. And if they do have a place, it may be transient. They don’t have money, might not have a cellphone — and they have to take care of a baby,” said Jack Turman, an Indiana University public health professor who is advising Porter on her project. “How does one navigate all of that?”

The number of incarcerated women in the United States exploded from about 26,000 in 1980 to roughly 231,000 today, with African American women imprisoned at twice the rate of white women.

But incarcerated women often lack programs that help them transition back into society, even though research has found they expressed more of a need for them than have men or juveniles. There are also few reentry resources outside of prison, especially those designed for the nearly two-thirds of imprisoned women who have children.

The group “at the greatest disadvantage coming out of prison is going to be women,” said Pamela Lattimore, a leading expert on prison reentry and researcher for the nonprofit research organization RTI International. “Family support for women is — we found pretty consistently across our data — much less than what was available for men.”

An estimated 2,000 women a year give birth while incarcerated, but Indiana is one of the few states that allows new mothers to raise their babies in prison. The nursery — where moms and infants have private rooms and get help from inmates who are trained to be nannies — assists the women in planning for reentry with a checklist of needs and services. But until now, there’s been no peer support or mentoring for new moms or moms-to-be from anyone who’s been through it.

A Chance Encounter

Until recently, Porter lived such a chaotic, difficult life that she contemplated suicide. Her early years were filled with abuse and neglect. She’d spent much of her adulthood behind bars, mostly for fraud and forgery.

She thought the last time she left prison would be different. But when she and Gianna got out, they bounced around from place to place for a few years. Porter tried to survive the only way she knew how.

“My scum of the pond was I took advantage of anything — however I had to get money. I was just a con artist,” she said. “I’ve been charged with prostitution. I was actually charged with it, not doing it, but … when you’re a crack addict, you’re going to do anything you need to do to get that dope.”

So, in March 2019, she planned to take her life. She had a gun at the ready.

Then there was an unexpected visitor at her apartment. It was Ashley Phillips, project manager for a program Porter was involved in, Grassroots Maternal and Child Health Leadership Training Project.

Turman, the IU professor, had started that program in 2018 to help lower the infant death rate in a state — and city — with one of the highest in the nation. The project trains women who have overcome personal struggles to develop initiatives and policies that support other vulnerable moms.

Porter had begun attending the training that same year, but only because it offered $300 in gift cards. She never considered herself a community leader and didn’t think she had any business telling women how to be mothers.

When Phillips stopped by that day, she handed Porter a flower, comparing it to the women in the project: You plant a seed, watch it grow, and it eventually blossoms into something beautiful.

“She actually saved my life,” Porter said. “I had sent the kids to their dad’s. I was overwhelmed, and I wasn’t sad about taking my life. I was just so tired and ready. … Then Ashley came.”

From that day until she graduated last December, Porter stuck with the leadership training. She’d been hoping to help other moms since she was in prison, and the training gave her the tools to start her own program.

Mothers on the Rise was born.

Program Offers Support and Savings

Porter’s idea drew the interest of the Indiana State Department of Health, which is providing nearly $60,000 in one-time funding for the project. Agency spokesperson Jeni O’Malley said it “aligns with our priorities of reducing preventable deaths among women and children, reducing health disparities and inequities, and strengthening mental, social and emotional well-being.” The program will be evaluated after the first year for possible future funds and expansion.

The state Department of Correction is allowing women in the prison nursery to join the initiative, albeit virtually for now, because of coronavirus. Indiana stands to save money if the women stay out of prison; it costs about $55 a day to keep them locked up.

Mothers on the Rise will initially assist 10 women, helping them secure housing, child care and, if needed, addiction and mental health treatment. Porter will advise them 90 days before their release and another 90 days afterward on tasks such as connecting with doctors, finding employment and opening bank accounts.

The program will also pay for three months of child care and bus fare for the women and provide infant supplies such as strollers, baby wipes and clothing.

Porter will operate in tandem with the nursery’s social worker.

“My advantage is I know the street mentality, if you will,” Porter said. “I can cut the crap with the women from the beginning.”

She will act as a trusted guide in returning to a society that isn’t always so forgiving to ex-offenders, particularly mothers of young children.

“We like to ostracize those in the justice system and then we’re surprised when they fail — fail at reentering the community they’re not welcome in,” said Maranda Sparks, transitional health care manager for the Indiana DOC.

After she last got out of prison in 2012, Porter visited Garfield Park, a historical, 126-acre green space on Indianapolis’ south side. She snapped a picture of Gianna sitting on the ground next to a fountain. From time to time, she still looks at it, reminding her of a hopeful yet precarious moment in their lives.

Porter went back to the park on a recent late-summer day, the sky powder-blue. Gianna, now almost 9, was there too. So were Porter’s younger kids, 6-year-old Kevin and nearly 2-year-old Kamiah. The children raced one another and scrambled up trees. Flowers bloomed all around.

Watching her children play, Porter pondered how her life might have been different had someone helped her navigate the post-prison experience.

“I think I would have gotten here, but with more healing,” she said. “Because I didn’t even realize a lot of the stuff I was doing was wrong, that life didn’t have to be like that.”

This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

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As the return of college students to campuses has fueled as many as 3,000 COVID-19 cases a day, keeping track of them is a logistical nightmare for local health departments and colleges.

Some students are putting down their home addresses instead of their college ones on their COVID testing forms — slowing the transfer of case data and hampering contact tracing across state and county lines.

The address issue has real consequences, as any delay in getting the case to the appropriate authorities allows the coronavirus to continue to spread unchecked. Making matters worse, college-age people already tend to be hard to trace because they are unlikely to answer a phone call from an unknown number.

“With that virus, you really need to be able to identify that case and their contacts in 72 hours,” said Indiana University’s assistant director for public health, Graham McKeen.

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And if the students do go home once infected, where should their cases be counted? The Centers for Disease Control and Prevention highlighted this issue in a recent study of an unnamed North Carolina university’s COVID outbreak, stating that the number of cases was likely an underestimate. “For example, some cases were reported to students’ home jurisdictions, some students did not identify themselves as students to the county health department, some students did not report to the student health clinic, and not all students were tested,” it said.

The White House Coronavirus Task Force even addressed the problem in weekly memos sent to the governors of Missouri, Arkansas, Iowa, Kentucky and New Jersey. “Do not reassign cases that test positive in university settings to hometown as this lessens ability to track and control local spread,” it recommended late last month in the memos, made public by the Center for Public Integrity.

While the full scope of the address confusion is unclear, the health departments of California, Indiana, Iowa and Virginia all acknowledged the challenges that arise when college cases cross state and county lines.

The maze of calls needed to track such cases also lays bare a larger problem: the lack of an interconnected COVID tracking system. Colleges have been setting up their own contact tracing centers to supplement overstretched local and state health departments.

“It is very patchwork, and people operate very differently, and it also doesn’t translate during a pandemic,” said McKeen, whose own university has had more than 2,900 cases across its Indiana campuses. “It made it very clear the public health system in this country is horribly underfunded and understaffed.”

Colleges’ transient populations have forever bedeviled public health when it comes to reportable infectious diseases, such as measles and bacterial meningitis, Association of Public Health Laboratories spokesperson Michelle Forman said in an email to KHN. But the coronavirus infections spreading across the country’s universities, and the mass testing conducted to find them, are something else altogether.

“COVID is just a different scale,” she said.

Lisa Cox, a spokesperson for the Missouri Department of Health and Senior Services, said the issue of transient addresses affects more than just college students. Jails and rehab facilities also have people moving in and out, exacerbating the risk of disease spread and the difficulty in tracking it.

The crush of student cases at the start of a new term, though, can be overwhelming. As students returned to the University of Missouri, the Columbia/Boone County Department of Public Health and Human Services saw a COVID spike, with the peak reaching more than 200 new cases per day.

“So, first of all, we’re delayed anyway because we can’t keep up with the onslaught of cases,” said Scott Clardy, assistant director of the health department.

But then, he added, these address mishaps required his department to spend time attempting to reclassify counts and contact possibly infected people.

“It slows us down,” he said, estimating the department was up to five days behind in mid-September on contacting infected people and reaching out to those who may have been exposed to the virus.

The University of Missouri has had more than 1,600 cases so far, but spokesperson Christian Basi said the number of new cases has dropped significantly. By the end of September, the health department had finally caught up, Clardy said, letting staffers trace contacts more quickly.

This address issue can also mean some cases are potentially being undercounted, double counted or initially counted incorrectly as state health departments sort out where these infected students actually are staying, Indiana University’s McKeen said — potentially skewing case counts and positivity rates for local jurisdictions. He has noticed several such cases.

Iowa and Indiana officials said they were working with localities to ensure cases did not go miscounted, including developing directions for college students to put down their school address. Virginia officials said their contact tracers work diligently to identify the infected person’s current location and share it with other health departments if it is out of Virginia.

In Massachusetts, Pat Bruchmann, chief public health nurse for the Worcester Division of Public Health, said she had noticed some students at the 11 colleges in her district were getting tested off campus or when they went home for the weekend. In response, her department now proactively looks for positive test results among people who are of typical college age. So far, she’s had 10 or so cases reassigned to her department from other areas because of address issues, Bruchmann said.

Back in Missouri, freshman Kate Taylor said she fell through the cracks amid the initial rush of cases at the University of Missouri at the end of August.

After testing positive for COVID-19, Taylor said, she was told there wasn’t enough room for her to quarantine on campus. The university’s Basi denied that any students had been told the school didn’t have enough space but said he could not discuss details of Taylor’s case without her consent.

The 18-year-old student said she went home 2½ hours away to Jefferson County, where she was told her case would be transferred to local officials. But after nine days of quarantining, Taylor said, she never heard from anyone at her local health department.

She said her contact tracing experience wasn’t much better: Her boyfriend at the university got a call about her case, but the tracer got him confused with her roommate. The tracer then hung up.

The week that Iowa reported its 90,000th confirmed case of COVID-19, Sen. Joni Ernst sat behind a plexiglass partition and told a debate audience watching from home what she thinks about masks.

“Even though they’re homemade, they work,” said Ernst, an Iowa Republican, showing off a mask emblazoned with the logo of Iowa State University, the largest university in the state.

But what about requiring people to wear masks when they cannot safely distance themselves? On that, she sided with the state’s Republican governor and President Donald Trump, contradicting evidence that states with mask mandates have seen bigger drops in coronavirus cases than those without: “We know that it doesn’t work,” she asserted about mandates.

Trump and COVID-19 loom large in this race and they are putting Ernst in a precarious position. In less than six years, she has gone from being a rising star — who was reportedly under consideration to become Trump’s vice presidential running mate in 2016 — to running neck and neck against a political newcomer, businesswoman Theresa Greenfield. The race is critical to the Republicans’ hopes of keeping control of the Senate.

Part of her problem is Trump. A Des Moines Register/Mediacom Iowa poll last month showed more than 1 in 3 Iowa voters think Ernst’s relationship to Trump is “too close.”

Art Cullen, a Pulitzer Prize-winning journalist who runs The Storm Lake Times in northwestern Iowa, recently wrote: Ernst “is in lockstep with Trump and McConnell on nearly every issue,” referring to the Senate’s Republican majority leader, Mitch McConnell. “Iowans don’t like that. They like mavericks.”

But another part of her problem is how the Trump administration has mishandled the response to the pandemic. Iowa suffered from some of the nation’s bigger COVID-19 outbreaks, with the state reporting in recent days record numbers of hospitalizations. It has been bad enough that last week the White House coronavirus task force called on Iowa to institute a statewide mask mandate.

Greenfield is capitalizing on Ernst having toed the party line on downplaying the COVID-19 threat. The Register poll found that Greenfield, who is campaigning on the ideas that Ernst has done too little to protect Iowans during the pandemic and been too friendly to corporate donors, had a slight edge over the incumbent senator, 45% to 42%. That result is well within the poll’s margin of error. A Quinnipiac poll released Wednesday also found Greenfield has a slight lead over Ernst, 50% to 45%, just outside the poll’s 2.8-point margin of error. Political analysts say the race is a toss-up.

It doesn’t help Ernst that Trump has lost strength in Iowa. Polls show the president, who won the Iowa vote by more than 9 percentage points in 2016, is in a dead heat with the Democratic nominee, former Vice President Joe Biden.

And that decline could very well be because of COVID-19. A New York Times analysis released this summer showed voter support for Biden grew by about 2.5 percentage points locally when a county experienced “extremely high levels” of COVID-19 fatalities — similar to the way support for elected officials drops during wartime in areas that have lost troops.

Those deaths were costing Republicans running for the Senate “as much as they are costing the president,” the analysis found.

In August, Ernst fanned the flames of a conspiracy theory amplified by Trump and at least one other vulnerable Republican that only 10,000 Americans had died of COVID-19. (More than 185,000 had died at that point.) She said at a campaign event in Waterloo, Iowa, that she was “so skeptical” of the official death toll and raised the possibility that doctors were inflating the numbers for financial gain.

Her comments sparked a sharp backlash and, a few days later, she released a statement concurring with the official death toll from public health experts. The Ernst campaign did not respond to an interview request for this story.

In a statement last week, Greenfield said elected officials must listen to public health experts and set clear examples to help Iowans take the crisis seriously. “By pointing fingers and playing politics, not passing the relief Iowans urgently need, and refusing to apologize for her dangerous comments about the Covid-19 death toll, Senator Ernst has failed to put Iowa first during this pandemic,” she said.

Last spring the virus spread through the state’s meatpacking plants, potentially exposing thousands after Trump ordered the plants to stay open. In early October the state’s fourth-largest city, Sioux City, ranked in the top 10 of affected metropolitan areas nationwide, with about 64.3 cases per 100,000 residents.

Students returning to Iowa State University and the University of Iowa in August sparked two of the largest outbreaks nationwide at that time, prompting an editorial in the University of Iowa’s student newspaper: “The University of Iowa is not safe.”

Gov. Kim Reynolds, a Republican who has refused calls to impose a mask mandate, closed bars in six counties for less than three weeks before working to loosen quarantine restrictions — against the recommendations of the Centers for Disease Control and Prevention.

About 15% of likely voters in Iowa said COVID-19 is the most important issue, although just 1% of Republican voters said the pandemic is their top concern, according to a recent Des Moines Register/Mediacom Iowa poll. The most important issue is the economy, 31% of likely voters say.

Iowa has borne the blow of Trump’s trade disputes, with farmers forced to accept millions in federal bailout money after a tit-for-tat tariff war with China and other nations cut off crop exports.

Leonard Foster of Mason City, Iowa, 82, spoke of a neighbor who was struggling to sell his grain and cattle because of the disputes. The future of Social Security and Medicare are his biggest concerns, though he said he also worries about his children and grandchildren contracting COVID-19. A lifelong Democrat who had voted for Chuck Grassley, Iowa’s other Republican senator, he is not planning to back Ernst.

“She’s agreeing with Trump too much, as far as I’m concerned,” he said.

Ernst faces pressing questions about her party’s failure to agree on a replacement for the Affordable Care Act. The Supreme Court will hear a case next month that could overturn the law, an outcome that looks more likely if Trump’s latest nominee, Amy Coney Barrett, is seated in time to participate. Ernst has insisted she supports the ACA’s popular protections for preexisting conditions as critics point out that her past votes to repeal the law would have eliminated those protections.

Congress’ failure to renew aid for struggling businesses and families has left some Iowans feeling, at best, that the government is not doing enough and, at worst, that politicians like Trump are hampering economic recovery.

Melissa Warren of Wellman, Iowa, said her husband has been sick with COVID symptoms and unable to work since March. Though he was hospitalized for pneumonia and remains ill, she said he has not tested positive for the virus. That disqualifies him from the few federal protections against COVID-19 bills.

Their high-deductible insurance plan is expensive, and he does not qualify for other benefits. After visits to specialists like cardiologists and pulmonologists, the medical bills are piling up, Warren said.

A Methodist pastor who works with low-income communities, Warren described presiding over one of the first funerals in Iowa for a COVID victim and the fear and pain of a family that could not even gather to grieve due to public health restrictions.

“Watching, for example, the president choosing to not wear masks, to give information that’s incorrect, has been very devastating for communities trying to build themselves up and care for one another,” she said in an interview before the announcement of Trump’s own diagnosis.

This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

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LIBBY, Mont. — Frank Fahland has spent most days since the pandemic began at the site of his dream house, working to finish a 15-year labor of love while keeping away from town and the people closest to him.

Like thousands of people from Libby and Lincoln County in the far northwestern corner of Montana, the 61-year-old Fahland has scarred lungs after years of breathing in asbestos fibers from dust and soil contaminated by the town’s now-defunct plant that produced vermiculite, a mineral used in insulation and gardening.

Fahland recently gave a visitor a tour of his partially finished log home overlooking a meadow that stretches to the foothills of the Cabinet Mountains. He struggled to climb a small hill and stopped to reach for his inhaler.

“It feels like someone is standing on your chest, or almost like someone stuffed a pillow down there in your lung,” he said.

Fahland’s condition makes him more vulnerable to complications from COVID-19, so he’s keeping his distance from people in hopes of avoiding infection. He hasn’t visited his son and granddaughter in months and he recently wrote his will.

He’s not alone in taking such precautions. Lincoln County has one of the nation’s highest asbestos mortality rates. At least 400 people have died from asbestos-related diseases, which can include asbestosis, mesothelioma and lung cancer. At least 1 in 10 people in Libby have an asbestos-related illness, said Miles Miller, a physician assistant at the Center for Asbestos Related Disease.

“Our patients having an underlying lung disease that would make recovery from COVID-19 more difficult,” Miller said.

Lincoln County, population 20,000, largely was spared from outbreaks of the novel coronavirus at the beginning, which Miller chalked up to the community’s vigilance in testing, tracking and prevention efforts.

But by the fall, cases began to climb in the county along with the rest of Montana. By early October, the number of confirmed cases in Lincoln County was 170, nearly double the count at the end of August. County health officials said in a Facebook post that cases were all over the county and “it would be irresponsible to classify any towns as safe.”

The vermiculite mine closed in Libby in 1990. For decades before that, Miller said, the mine constantly spewed asbestos-laden dust throughout Libby.

“During the heyday, I don’t think you could shop for groceries in this town without breathing some of the dust,” he said.

The extent of the public health disaster in Libby became known only after the Seattle Post-Intelligencer published a series of stories by journalist Andrew Schneider in 1999. Lawsuits began pouring in from across the nation, and W.R. Grace filed for bankruptcy protection in 2001, putting a hold on more than 100,000 pending claims against it.

The Environmental Protection Agency added Libby and the surrounding area as a Superfund site in 2002 and declared a public health emergency in 2009. The EPA spent more than $600 million to clean up 2,600 homes and properties and removed more than 1 million cubic yards of contaminated soil, according to the agency.

The company and its executives were acquitted in 2009 of federal charges that the company had conspired to conceal the mine’s health risks. Grace emerged from bankruptcy in 2014 after a legal settlement that set up trust funds to pay for current and future asbestos victims’ medical costs. The company agreed to pay $250 million for the cleanup in 2008.

Asbestos victims also sued the state of Montana, saying that state officials knew the danger but failed to stop it. Settlements in 2011 and 2017 totaled $68 million.

The threat isn’t over. People are still being diagnosed with asbestos-related diseases. Three decades or more can pass between exposure and the development of symptoms, according to the Centers for Disease Control and Prevention.

Also, the former mine site and surrounding forest have not been cleaned, leading the EPA to classify the Superfund site as still not under control for human exposure to asbestos. Those most at risk of exposure are loggers, firefighters and trespassers, the EPA said.

The county public health officer has issued an order requiring people to wear masks in public regardless of how many cases of COVID-19 the county has — a more stringent rule than the statewide requirement to wear a mask in counties where there are four or more active cases.

Though many in the community have accepted public health guidelines to avoid the coronavirus, a strong libertarian streak runs through this remote county on the U.S.-Canada border, where residents’ distrust of government is heightened by the town’s history with the mine.

Doug Shaw, 69, is another resident with lungs scarred from breathing in asbestos. He blames W.R. Grace and the state government for covering up the contamination for decades and calls Libby’s asbestos deaths murder.

Grace officials did not directly respond to Shaw’s accusation, but instead referred to the company’s financial relief fund for residents with asbestos-related illness.

Shaw said he’s frustrated by the government’s COVID restrictions on events and businesses.

“It’s nuts. Nobody has to live like this. We need to get back to work,” he said.

The area depends on summer tourism to keep its economy healthy. The county has allowed large public events such as a rodeo and an international chainsaw competition to occur, raising concerns that visitors to those events could spread COVID-19 in the community.

“We need people to come here and spend money and jolt the economy,” Fahland said. “Problem is, with that rodeo, there were faces in that crowd that have different license plates that came from different places that may have had issues.”

Julie Kendall, a phlebotomist at a local hospital who was diagnosed with an asbestos-related disease two months ago, echoed that concern.

“These people that come to these events from out of town are going to our gas stations and our grocery stores,” she said. “They could be exposing you right there.”

Kendall sat at a picnic table near a railroad track where she was exposed to asbestos as a child. The area used to be home to a community swimming pool and children would play near piles of mine waste. She said she sees a similarity between asbestos and the novel coronavirus.

“It’s unseen,” she said. “You can be doing the most innocent thing and it could still get you.”

But Kendall also believes those parallels have given folks like her a leading edge on dealing with this pandemic.

“We’re already afraid here,” she said. “So it’s kind of like one more shake of the dice. You can’t live every day in fear. But here we do.”

This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

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Dr. Katherine Pannel was initially thrilled to see President Donald Trump’s physician is a doctor of osteopathic medicine. A practicing D.O. herself, she loved seeing another glass ceiling broken for the type of doctor representing 11% of practicing physicians in the U.S. and now 1 in 4 medical students in the country.

But then, as Dr. Sean Conley issued public updates on his treatment of Trump’s COVID-19, the questions and the insults about his qualifications rolled in.

“How many times will Trump’s doctor, who is actually not an MD, have to change his statements?” MSNBC’s Lawrence O’Donnell tweeted.

“It all came falling down when we had people questioning why the president was being seen by someone that wasn’t even a doctor,” Pannel said.

The osteopathic medical field has had high-profile doctors before, good and bad. Dr. Murray Goldstein was the first D.O. to serve as a director of an institute at the National Institutes of Health, and Dr. Ronald R. Blanck was the surgeon general of the U.S. Army. Former Vice President Joe Biden, challenging Trump for the presidency, also sees a doctor who is a D.O. But another now former D.O., Larry Nassar, who was the doctor for USA Gymnastics, was convicted of serial sexual assault.

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Still, with this latest example, Dr. Kevin Klauer, CEO of the American Osteopathic Association, said he’s heard from many fellow osteopathic physicians outraged that Conley — and by extension, they, too — are not considered real doctors.

“You may or may not like that physician, but you don’t have the right to completely disqualify an entire profession,” Klauer said.

For years, doctors of osteopathic medicine have been growing in number alongside the better-known doctors of medicine, who are sometimes called allopathic doctors and use the M.D. after their names.

According to the American Osteopathic Association, the number of osteopathic doctors grew 63% in the past decade and nearly 300% over the past three decades. Still, many Americans don’t know much about osteopathic doctors, if they know the term at all.

“There are probably a lot of people who have D.O.s as their primary [care doctor] and never realized it,” said Brian Castrucci, president and CEO of the de Beaumont Foundation, a philanthropic group focused on community health.

So What Is the Difference?

Both types of physicians can prescribe medicine and treat patients in similar ways.

Although osteopathic doctors take a different licensing exam, the curriculum for their medical training — four years of osteopathic medical school — is converging with M.D. training as holistic and preventive medicine becomes more mainstream. And starting this year, both M.D.s and D.O.s were placed into one accreditation pool to compete for the same residency training slots.

But two major principles guiding osteopathic medical curriculum distinguish it from the more well-known medical school route: the 200-plus hours of training on the musculoskeletal system and the holistic look at medicine as a discipline that serves the mind, body and spirit.

The roots of the profession date to the 19th century and musculoskeletal manipulation. Pannel was quick to point out the common misconception that their manipulation of the musculoskeletal system makes them chiropractors. It’s much more involved than that, she said. Dr. Ryan Seals, who has a D.O. degree and serves as a senior associate dean at the University of North Texas Health Science Center in Fort Worth, said that osteopathic physicians have a deeper understanding than allopathic doctors of the range of motion and what a muscle and bone feel like through touch.

That said, many osteopathic doctors don’t use that part of their training at all: A 2003 Ohio study said approximately 75% of them did not or rarely practiced osteopathic manipulative treatments.

The osteopathic focus on preventive medicine also means such physicians were considering a patient’s whole life and how social factors affect health outcomes long before the pandemic began, Klauer said. This may explain why 57% of osteopathic doctors pursue primary care fields, as opposed to nearly a third of those with doctorates of medicine, according to the American Medical Association.

Pannel pointed out that she’s proud that 42% of actively practicing osteopathic doctors are women, as opposed to 36% of doctors overall. She chose the profession as she felt it better embraced the whole person, and emphasized the importance of care for the underserved, including rural areas. She and her husband, also a doctor of osteopathic medicine, treat rural Mississippi patients in general and child psychiatry.

Given osteopathic doctors’ likelihood of practicing in rural communities and of pursuing careers in primary care, Health Affairs reported in 2017, they are on track to play an increasingly important role in ensuring access to care nationwide, including for the most vulnerable populations.

Stigma Remains

To be sure, even though the physicians end up with similar training and compete for the same residencies, some residency programs have often preferred M.D.s, Seals said.

Traditional medical schools have held more esteem than schools of osteopathic medicine because of their longevity and name recognition. Most D.O. schools have been around for only decades and often are in Midwestern and rural areas.

While admission to the nation’s 37 osteopathic medical schools is competitive amid a surge of applicants, the grade-point average and Medical College Admission Test scores are slightly higher for the 155 U.S. allopathic medical schools: The average MCAT was 506.1 out of 528 for allopathic medical school applicants over a three-year period, compared with 503.8 for osteopathic applicants for 2018.

Seals said prospective medical students ask the most questions about which path is better, worrying they may be at a disadvantage if they choose the D.O. route.

“I’ve never felt that my career has been hindered in any way by the degree,” Seals said, noting that he had the opportunity to attend either type of medical school, and osteopathic medicine aligned better with the philosophy, beliefs and type of doctor he wanted to be.

Many medical doctors came to the defense of Conley and their osteopathic colleagues, including Dr. John Morrison, an M.D. practicing primary care outside of Seattle. He was disturbed by the elitism on display on social media, citing the skills of the many doctors of osteopathic medicine he’d worked with over the years.

“There are plenty of things you can criticize him for, but being a D.O. isn’t one of them,” Morrison said.

KHN reporter Victoria Knight discussed this week’s vice presidential debate with Newsy’s “Morning Rush” on Thursday.

• Click here to watch Knight on Newsy
• Read “In Debate, Pence and Harris Offer Conflicting Views of Nation’s Reality,” by the staffs of KHN and PolitiFact

KHN chief Washington correspondent Julie Rovner discussed Trump’s COVID-19 diagnosis on WFAE’s “Charlotte Talks” on Monday. She discussed the public’s right to know about the president’s health with Wisconsin Public Radio’s “Central Time” on Tuesday.

• Click here to hear Rovner on WFAE
• Click here to hear Rovner on Wisconsin Public Radio

KHN correspondent Rachana Pradhan discussed COVID testing at the White House with Newsy’s “Morning Rush” on Tuesday.

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• Read “Inside the Flawed White House Testing Scheme That Did Not Protect Trump,” by Pradhan, KHN Midwest correspondent Lauren Weber and KHN senior correspondent Liz Szabo.

KHN Montana correspondent Katheryn Houghton discussed Seeley Lake’s long-term wildfire smoke health effects on Los Angeles Times’ “Second Opinion” on Oct. 2.

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• Read Houghton’s “Wildfires’ Toxic Air Leaves Damage Long After the Smoke Clears”

KHN correspondent Aneri Pattani discussed COVID-19 and herd immunity on Newsy’s “The Briefing” on Oct. 1.

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• Read Pattani’s “Corralling the Facts on Herd Immunity”

Pharmaceutical giants Regeneron and Gilead Sciences got the kind of publicity money can’t buy this week after President Donald Trump took their experimental drugs for his coronavirus infection, left the hospital and pronounced himself fully recovered.

“It was, like, unbelievable. I felt good immediately,” Trump said Wednesday in a tweeted video. “I call that a cure.”

He praised Regeneron’s monoclonal antibody cocktail, which mimics elements of the immune system, and mentioned a similar drug under investigation by Eli Lilly and Co. The president also took Gilead’s remdesivir, an antiviral that has shortened recovery times for COVID-19 patients in early research.

There is no scientific evidence that any of these drugs contributed to the president’s recovery, since many patients do fine without them. It is also not known whether the president has been “cured,” since the White House has released few specifics about the course of his illness.

Yet as his campaign for reelection enters its final stretch, Trump is not feeling the love in campaign contributions. Regeneron, Gilead, Lilly and the industry as a whole are sending more money elsewhere.

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Reversing a trend in which contributions from drugmakers’ political committees and their employees have gone largely to Republican candidates for president and Congress, so far for 2020 the industry has tilted toward Democrats.

The shift may reflect industry expectations that Democratic presidential candidate Joe Biden will win, said Steven Billet, who teaches courses in corporate lobbying and political donations at George Washington University. Pharma companies may see campaign largesse as leverage if Biden follows through on promises to address high drug prices, he said.

In a year when complaints about high prescription drug prices have been overshadowed by the pandemic, donors with ties to pharma manufacturers have given around $976,000 to Biden, according to data from the Center for Responsive Politics. That’s nearly three times the pharma contributions to Trump, who recently switched his tune from complaining about “rip-off” prescription prices to describing drug firms as “great companies.”

“Traditionally the industry tends to favor Republicans,” said Sarah Bryner, CRP’s research director. “But this cycle, we’re seeing that flipped,” partly reflecting Democrats’ overall greater success in fundraising, she said.

Of $177,000 given so far to 2020 federal candidates by Regeneron’s employees and political action committee, four-fifths have gone to Democrats, including $35,203 to Biden, according to CRP.

Regeneron CEO Leonard Schleifer, a billionaire who has known Trump for years and belongs to the Trump National Golf Club Westchester in New York’s Westchester County, has a long history of giving to Democrats. He gave $5,400 to Hillary Clinton’s 2016 presidential run and $120,000 in 2018 to a political action committee attempting to flip the Senate to Democratic control.

Schleifer has made no registered political donations since last year, when his contributions went mainly to his son, Adam Schleifer, a Democrat running for Congress who lost in a primary this summer.

North Carolina Sen. Thom Tillis, representing a state with a large biotech industry and running for reelection in a tight race, has been the biggest Republican recipient of Regeneron dollars for 2020 races, tallying $5,526 so far.

“This is a company that looks as though they’ve always been committed to Democrats,” said Billet, a former AT&T lobbyist who teaches PAC management. “And my guess is they just have a Democratic culture in this company.”

A spokesperson for Regeneron, which has applied for emergency use authorization to bypass the Food and Drug Administration approval process for its drug, declined to comment on campaign donations and said the company will continue clinical trials.

The drug is expected to cost thousands of dollars per dose. “You’re going to get them for free,” Trump said of the COVID-19 drugs he took. The government has agreed to make initial doses of Regeneron’s antibody treatment “available to the American people at no cost,” the company says.

But details of the contract, including the price, remained secret. In any event, if patients get the drug at no direct cost, “it doesn’t mean they’re not paying for it,” said James Love, director of Knowledge Ecology International, a nonprofit that works to expand access to medical technology. “They’re just paying for it through taxes.”

The government is giving Regeneron $450 million to make and supply the antibody cocktail.

Donors with Gilead ties also lean left, giving two-thirds of their roughly $284,000 in contributions so far this cycle to Democratic candidates for Congress and president, the CRP data shows, including about $36,000 to Biden.

At Lilly, where Health and Human Services Secretary Alex Azar once ran the U.S. division, 54% of the money has gone to Democrats and 46% to Republicans. Lilly employees have given $45,000 to Biden and $13,000 to Trump, according to CRP.

Biden does not accept donations from corporate PACs; all his Regeneron, Lilly and Gilead dollars came from their employees.

Much of this year’s overall pharma shift to Democrats comes in the presidential race. KHN’s Pharma Cash to Congress data tracking sitting members still shows a preference this cycle of pharma PACs targeting congressional Republicans, $6 million so far compared with $4.7 million given to Democrats.

“Joe Biden has Big Pharma — as well as Big Tech and big banks — in his pocket because he’s worked for them for nearly 50 years, rather than the American people,” said Samantha Zager, a spokesperson for the Trump campaign.

On the campaign trail, Biden has focused largely on improving health insurance. But he also proposes letting Medicare negotiate drug prices, tying drug-price increases to inflation and allowing patients to buy imported pharmaceuticals.

Biden “will further reduce health care costs while expanding coverage, end practices like surprise billing, lower premiums and stand up to abuses of power by prescription drug companies,” said campaign spokesperson Rosemary Boeglin.

Before Trump took office, he said pharma companies were “getting away with murder” over the prices they charge. Despite the president’s claims and promises, he has done little to lower prescription drug prices, according to experts and fact-checkers.

A Trump executive order this month would require Medicare to pay no more for drugs than other developed nations, but it starts with a test program and could take months or years to implement.

Pharma companies were among the biggest beneficiaries of Trump’s 2017 tax cut, saving billions by being able to bring home untaxed foreign cash and billions more in lower rates.

KHN data editor Elizabeth Lucas contributed to this report.

The convergence of the coronavirus pandemic and election season has complicated this year’s voting for residents of nursing homes, assisted living facilities and other long-term care centers.

Many seniors who need help to get or fill out their ballots may be stymied by shifting rules about family visits. Voting procedures — whether in person or by mail — are under increased scrutiny, adding to the confusion. Facilities that used to host voting precincts likely won’t do so this year because of concerns about the spread of COVID-19.

“We’re basically not allowed to go out into the public right now, we’re more vulnerable, and our immune systems are compromised anyway,” said Janice Phillips, a 14-year resident of Village Square Healthcare Center, a skilled nursing facility in San Marcos, California. “We’re basically locked in.”

Phillips, 75, who has rheumatoid arthritis, has voted by absentee ballot for years without problems. This year she is encouraging her fellow residents to vote by mail as well. She works with the facility’s activities staff, going resident by resident, to make sure folks are registered. As president of the resident council, Phillips has also raised the issue at community meetings.

Older Americans are a consistent voting bloc courted by both parties.

According to AARP, 71% of Americans 65 and older voted in the 2016 presidential election, compared with 46% of people 18-29. “For many older adults, it’s a point of pride for them that they’ve voted in every election since they were 18,” said Leza Coleman, the executive director of California’s Long-Term Care Ombudsman Association.

But hardly anyone has been allowed inside skilled nursing facilities since the start of the pandemic, except for staff members and the occasional state health official, or family members in certain circumstances. In California and beyond, facilities are beginning to open up in counties with low transmission rates, since federal rules changed in September to allow for more lenient visiting policies.

At the same time, outbreaks continue to plague some senior facilities, despite improved testing of staff and other safety measures. On Wednesday, Santa Cruz County health officials reported a major outbreak at the Watsonville Post-Acute Center, which has infected 46 residents, killing nine of them, and infecting 15 staff members.

California officials are pressing nursing homes and senior centers to give residents who want to vote the opportunity. The Department of Public Health on Oct. 5 sent a letter to all those facilities, explaining they have an obligation to inform and assist residents with voting, including what actions are permissible for staffers to undertake in helping voters. It also includes advice about maintaining a safe environment through the election by limiting nonessential visitors, properly using protective gear such as gloves and handling ballots as little as possible.

In years past, civic groups such as the League of Women Voters would stop by to give presentations on what’s on the ballot. Candidates for local office would hit nursing homes to make pitches. “In the context of a pandemic, we just can’t do it this year,” said Michelle Bishop, voter access and engagement manager with the National Disability Rights Network.

Before the pandemic, nursing homes and assisted living facilities also often served as polling places. Residents could easily access voting booths, often set up in a lobby or community room. That was especially important because nursing homes are likely to be accessible to people with mobility problems, Bishop said.

Otherwise, facilities would often organize bus trips and outings to polling places.

In California, the last day to register to vote online or by mail is Oct. 19, though voters can register in person up to and including Election Day. All registered voters will receive a ballot in the mail, and those postmarked by Nov. 3 will still be counted in California for 17 days after the election. Advocates say it’s important for newer residents at skilled nursing facilities to make sure they’ve registered at their new address or have plans to get their ballot delivered to them from their former homes.

Other states are also sending ballots to all registered voters by mail this year on various time frames. All states permit seniors or people who have trouble reaching polling stations to request an absentee ballot.

Once they have a ballot in hand, some older adults need help from family or staff at their facilities to complete it correctly and send it back to election officials. The federal directive to relax visiting rules could ease some of that pressure, but the situation varies by facility. For people whose relatives cannot help them, it may fall to staff members to set up calls and video chats between residents and their families, or provide the assistance to residents themselves.

Some states don’t allow nursing home staffers to help with ballots to avoid influencing votes. Even if they can assist, employees may be stretched too thin to help. In a year when nursing home staff members are spending an extra hour each day putting on protective gear, there isn’t always extra time to make sure every resident is registered and voting, said Dr. Karl Steinberg, chief medical officer for Mariner Health Central, a nursing home management company in California.

“There’s a perennial workforce shortage in nursing homes and it’s been exacerbated by this” pandemic, Steinberg said. “This year with all the chaos, there may be less staff time available to help people with voting.”

Tracy Greene Mintz, whose business, Senior Care Training, trains senior care workers, is responsible for staffing at 100 nursing homes in California. She said she started ringing alarm bells about voting rights in August.

“Elected officials do not care about nursing homes, period,” Greene Mintz said. “They assume residents don’t vote and don’t make contributions.”

She asked the California Department of Public Health, which surveys skilled nursing facilities every six weeks about COVID-19 infection control, to add a question on how facilities were planning for elections. The department declined.

So she set up webinars with facility administrators and the Los Angeles County Registrar-Recorder/County Clerk to go over information on how to submit and track absentee ballots.

She has also urged state officials to provide a statewide plan that facilities could use as a blueprint. She wrote one herself that was emailed out by a trade group, the California Association of Health Facilities.

Still, California is in better shape than some other states, said Raúl Macías, a lawyer with the Democracy Program at the Brennan Center for Justice, a law and public policy institute. Elsewhere, residents may have to apply for an absentee ballot, and sometimes must provide a reason they can’t vote in person.

California also has the Voter Bill of Rights, which allows individuals to designate someone to help them fill out and drop off their ballot. In some states, such as North Carolina, assistance can come only from designated bipartisan voting assistance teams, which may be harder to recruit during a pandemic, Macías said.

No matter the state, state and county elections officials and facility administrators should draft voting plans, said Bishop, of the Disabilities Rights Network. It will help staff know the proper way to assist residents without influencing their votes, and residents know their voting rights.

“There is a bit of a gray area on whose responsibility this is,” Bishop said. “It’s one of the years when we start asking ‘Whose responsibility is it?’ Who cares? We have to get it done.”

If they can’t get access to ballots or need help, California residents can contact the state’s long-term care ombudsman program, which can investigate complaints, help them resolve the issue and take the problem to the Department of Public Health if it can’t be fixed.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

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La convergencia de la pandemia de coronavirus y las elecciones ha complicado la votación de este año para quienes viven en residencias, centros de vivienda asistida y otros espacios de atención a largo plazo para adultos mayores.

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Muchos seniors que necesitan ayuda para obtener o llenar sus boletas podrían sufrir la consecuencias por el cambio de las reglas sobre visitas familiares. Los procedimientos de votación —ya sea en persona o por correo— están bajo un mayor escrutinio, lo que aumenta la confusión. Las residencias, que solían albergar centros de votación, probablemente no lo harán este año debido a la preocupación de que se propague COVID-19.

“Básicamente, en este momento no se nos permite salir, somos más vulnerables, y nuestros sistemas inmunológicos ya están comprometidos”, dijo Janice Phillips, residente durante 14 años del Village Square Healthcare Center, en San Marcos, California. “Estamos encerrados”.

Phillips, de 75 años, quien padece artritis reumatoide, ha votado por correo durante años sin problemas. Esta vez está animando a sus compañeros de residencia a que también voten por correo. Colabora con el personal de actividades del centro, hablando con cada uno de los residentes, para asegurarse de que se hayan registrado.

Como presidenta del Consejo de Residentes, Phillips también ha planteado el tema en las reuniones de la comunidad.

Los estadounidenses mayores son un bloque de votantes consistente, cortejado por ambos partidos.

Según AARP, el 71% de los estadounidenses mayores de 65 años votó en las elecciones presidenciales de 2016, comparado con el 46% de las personas de 18 a 29 años. “Muchos adultos mayores se sienten orgullosos de haber votado en cada elección desde que cumplieron los 18 años”, señaló Leza Coleman, directora ejecutiva de la Long-Term Care Ombudsman Association de California.

Sin embargo, desde el comienzo de la pandemia, a casi nadie se le ha autorizado la entrada en las residencias de mayores, excepto al personal y al ocasional funcionario de salud del Estado, o a familiares en determinadas circunstancias. En California y otros lugares, los centros empiezan a abrirse en condados con bajas tasas de transmisión, ya que las normas federales cambiaron en septiembre para permitir una norma de visitas más indulgentes.

Al mismo tiempo, los brotes siguen asolando algunas residencias de mayores, a pesar de que las pruebas al personal han mejorado, así como otras medidas de seguridad. El miércoles 7, funcionarios de salud del condado de Santa Cruz informaron de un importante brote en el Post-Acute Center de Watsonville, que ha infectado a 46 residentes, matando a nueve de ellos, e infectando a 15 miembros del personal.

Funcionarios de California están presionando a las residencias y a otros centros de mayores para que faciliten el acceso al voto de los residentes. El Departamento de Salud Pública envió, el 5 de octubre, una carta a todos los centros, explicando que tienen la obligación de informar y ayudar a los residentes a votar, e indicando lo que el personal podía hacer para ayudar a los votantes.

También se incluyeron consejos sobre cómo mantener un entorno seguro durante las elecciones, controlando el número de visitantes no esenciales, utilizando adecuadamente el equipo de protección y procurando que se toquen las boletas lo menos posible.

En años anteriores, grupos cívicos como la League of Women Voters les ofrecían  presentaciones sobre lo que figuraba en la boleta. Y los candidatos locales iban a las residencias para incentivar el voto. “En el contexto de una pandemia, este año no podemos hacerlo”, explicó Michelle Bishop, directora de acceso y participación de la Red Nacional de Derechos de los Discapacitados.

Antes de la pandemia, las residencias y los centros de vivienda asistida también solían servir como lugares de votación. Los residentes podían acceder fácilmente a las cabinas de votación, a menudo instaladas en un vestíbulo o en una sala comunitaria. Esto era especialmente importante porque las residencias son más accesibles para las personas con problemas de movilidad, dijo Bishop.

De lo contrario, los centros organizaban viajes en autobús y salidas a los colegios electorales.

En California, el último día para registrarse para votar por Internet o por correo es el 19 de octubre, aunque los votantes pueden inscribirse en persona hasta el día mismo de las elecciones. Todos los votantes inscritos recibirán una boleta por correo, y las que tengan el sello postal antes del 3 de noviembre serán parte del conteo, en California, durante 17 días después de la elección.

Los activistas aseguran que es importante que los nuevos residentes en centros de adultos mayores se aseguren de que se han registrado en su nueva dirección, o que se han organizado para que les envíen la boleta desde donde solían vivir.

Otros estados también envían por correo las boletas a los votantes registrados este año, en diferentes plazos. Todos los estados permiten a los mayores, o a las personas que tienen problemas para llegar a los colegios electorales, solicitar un voto en ausencia.

Una vez que consiguen la boleta, algunos adultos mayores necesitan ayuda de la familia o del personal de sus residencias para completarla correctamente y enviársela a los funcionarios electorales. La directiva federal de flexibilizar las normas de visita podría aliviar parte de esa presión, pero la situación varía según el centro. En el caso de las personas cuyos familiares no pueden ayudarles, correspondería al personal establecer llamadas y videoconferencias entre los residentes y sus familias, o prestar ellos mismos la asistencia a los propios residentes.

Algunos estados no permiten que el personal de las residencias de mayores ayude con las boletas para evitar influir en el voto. Pero aunque puedan ayudar, los empleados tal vez están demasiado ocupados para hacerlo.

En un año en que el personal de las residencias necesita una hora extra, cada día, para ponerse el equipo de protección, no siempre hay tiempo para asegurarse de que todos los residentes estén registrados y voten, señaló el doctor Karl Steinberg, director médico del Mariner Health Central, una compañía de administración de residencias en California.

“Hay una perenne escasez de mano de obra en las residencias de mayores que se ha visto exacerbada por esta pandemia”, añadió Steinberg. “Este año, con todo el caos, el personal puede tener menos tiempo disponible para ayudar a los residentes con el voto”.

Tracy Greene Mintz, cuya empresa, Senior Care Training, forma a trabajadores para el cuidado de las personas mayores, es responsable de dotar de personal a 100 residencias en California. Dijo que empezó a hacer sonar la alarma sobre el derecho al voto en agosto.

“A los funcionarios electos no les importan las residencias de mayores, punto”, expresó Greene Mintz. “Asumen que los residentes no votan y no hacen contribuciones”.

Greene Mintz le pidió al Departamento de Salud Pública de California, que encuesta cada seis semanas a las residencias de mayores sobre el control de la infección por COVID-19, que añadiera una pregunta sobre cómo se planeaban las elecciones en los centros. El departamento se negó.

Así que organizó seminarios web con los administradores de los centros y el Secretario del Condado de Los Ángeles para revisar la información sobre cómo enviar y rastrear las boletas de ausentes.

También ha instado a los funcionarios estatales a que proporcionen un plan que las residencias puedan utilizar como modelo. Ella misma escribió uno que la Asociación de Centros de Salud de California envió por correo electrónico.

Aún así, California está mejor que otros estados, aseguró Raúl Macías, abogado del Programa Democracia en el Centro Brennan para la Justicia, un instituto de leyes y políticas públicas. En otros lugares, los residentes deben solicitar una boleta de ausente, y a veces tienen que explicar la razón que les impide votar en persona.

California también cuenta con la Declaración de Derechos del Votante, que permite a las personas designar a alguien para que les ayude a llenar y entregar su boleta. En algunos estados, como Carolina del Norte, la ayuda sólo puede provenir de equipos bipartidistas de asistencia electoral, que pueden ser más difíciles de reclutar durante una pandemia, explicó Macías.

No importa el estado del que se trate, los funcionarios electorales del estado y el condado, junto a los administradores de las residencias, deben elaborar planes de votación, señaló Bishop, de la Red por los Derechos de los Discapacitados. Esto ayudará al personal a conocer la forma adecuada de asistir a los residentes sin influir en su voto, y a los residentes a conocer su derecho al voto.

“Hay un área un poco gris sobre de quién es la responsabilidad de todo esto”, dijo Bishop. “Es uno de esos años en los que empezamos a preguntarnos: ¿De quién es la responsabilidad? ¿A quién le importa? Tenemos que hacerlo”.

Si no pueden acceder a las boletas o necesitan ayuda, los residentes de California pueden contactar al programa estatal del defensor del pueblo, que puede investigar las quejas, ayudarles a resolver el problema y llevar el caso al Departamento de Salud Pública, si no se puede arreglar.

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Los gigantes farmacéuticos Regeneron y Gilead Sciences obtuvieron el tipo de publicidad que el dinero no puede comprar luego que el presidente Donald Trump tomara sus medicamentos experimentales para tratar su infección por coronavirus, y se declarara completamente recuperado después de dejar el hospital.

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“Fue increíble. Me sentí bien de inmediato”, dijo Trump el miércoles 7 de octubre en un video posteado en Twitter. “Yo llamo a eso una cura”.

Trump elogió el cóctel de anticuerpos monoclonales de Regeneron, que imita elementos del sistema inmunológico, y mencionó un fármaco similar que Eli Lilly & Co. está investigando. El presidente también tomó remdesivir, de Gilead, un antiviral que ha acortado los tiempos de recuperación de los pacientes con COVID-19 en una investigación preliminar.

No hay evidencia científica de que alguno de estos medicamentos haya contribuido a la recuperación del presidente, ya que muchos pacientes se sienten bien sin consumirlos. Tampoco se sabe si el presidente se ha “curado”, ya que la Casa Blanca ha publicado pocos detalles sobre el curso de su enfermedad.

Sin embargo, cuando su campaña para la reelección está en la recta final, Trump no está sintiendo el afecto de las farmacéuticas a través de contribuciones. Regeneron, Gilead, Lilly y la industria en su conjunto están enviando más dinero en otra dirección.

Revirtiendo una tendencia en las contribuciones de las farmacéuticas, que enviaban mucho dinero a los republicanos, en lo que va de 2020 la industria se ha inclinado hacia los demócratas.

El cambio puede reflejar las expectativas de la industria de que gane el candidato presidencial demócrata Joe Biden, dijo Steven Billet, quien imparte cursos de cabildeo corporativo y donaciones políticas en la Universidad George Washington. Las farmacéuticas podrían usar esta “generosidad” a su favor si Biden cumple sus promesas de abordar los altos precios de los medicamentos, agregó.

En un año en el que las quejas sobre los altos precios de los medicamentos de venta bajo receta se vieron ensombrecidas por la pandemia, los donantes vinculados con las farmacéuticas han dado alrededor de $976,000 a Biden, según datos del Center for Responsive Politics (CRP).

Eso es casi tres veces las contribuciones de las farmacéuticas a Trump, quien recientemente pasó de llamar a los altos precios “estafas”, a describir a las farmacéuticas como “grandes empresas”.

“Tradicionalmente, la industria tiende a favorecer a los republicanos”, dijo Sarah Bryner, directora de investigación de CRP. “Pero este ciclo, estamos viendo que cambió”, lo que refleja en parte el mayor éxito general de los demócratas en la recaudación de fondos, explicó.

Las compañías farmacéuticas y sus grupos comerciales tienen un historial de apoyo a Trump y otros republicanos indirectamente a través de organizaciones sin fines de lucro de “dinero oscuro” difíciles de rastrear. Pero esas contribuciones pueden no ser divulgadas hasta mucho después de la elección, si es que alguna vez se conoce.

De los $177,000 que Regeneron ha otorgado hasta ahora a los candidatos federales de 2020, cuatro quintas partes se han destinado a los demócratas, incluidos $35,203 para Biden, según CRP.

Leonard Schleifer, director ejecutivo de Regeneron, un multimillonario que conoce a Trump desde hace años y pertenece al Trump National Golf Club Westchester, en Nueva York, tiene una larga historia de donaciones a los demócratas. Dio $5,400 a la carrera presidencial de Hillary Clinton en 2016 y $120,000 en 2018 a un comité de acción política que intentaba que los demócratas volvieran a controlar el Senado.

Schleifer no ha hecho donaciones políticas registradas desde el año pasado, cuando sus contribuciones fueron principalmente para su hijo, Adam Schleifer, un demócrata que se postulaba para el Congreso y que perdió en una primaria este verano.

El senador de Carolina del Norte Thom Tillis, que representa a un estado con una gran industria biotecnológica y que se postula para la reelección en una contienda reñida, ha sido el mayor receptor republicano de dólares de Regeneron para las elecciones de 2020, con un total de $5,526 hasta ahora.

“Esta es una compañía que parece que siempre ha estado comprometida con los demócratas”, dijo Billet, un ex cabildero de AT&T que enseña administración de PAC. “Y supongo que solo tienen una cultura demócrata en esta empresa”.

Un vocero de Regeneron, que solicitó una autorización de uso de emergencia para eludir el proceso de aprobación de la Administración de Alimentos y Medicamentos (FDA) para su medicamento, se negó a comentar sobre las donaciones de la campaña y dijo que la compañía continuará los ensayos clínicos.

Se espera que una dosis del medicamento cueste miles de dólares. “Los tendrás gratis”, dijo Trump sobre los medicamentos para COVID-19 que tomó. El gobierno acordó hacer que las dosis iniciales del tratamiento con anticuerpos de Regeneron “estén disponibles para el pueblo estadounidense sin costo”, dice la compañía.

Pero los detalles del contrato, incluido el precio, permanecieron en secreto. En cualquier caso, si los pacientes obtienen el medicamento sin costo directo, “no significa que no lo estén pagando”, dijo James Love, director de Knowledge Ecology International, una organización sin fines de lucro que trabaja para ampliar el acceso a la tecnología médica. “Simplemente lo pagan a través de impuestos”.

El gobierno le está dando a Regeneron $450 millones para fabricar y suministrar el cóctel de anticuerpos.

Los donantes con vínculos con Gilead también se inclinan hacia la izquierda, dando dos tercios de sus aproximadamente $284,000 en contribuciones hasta ahora en este ciclo a candidatos demócratas al Congreso y a la presidencia, muestran datos de CRP, incluidos alrededor de $36,000 a Biden.

En Lilly, donde el secretario de Salud y Servicios Humanos, Alex Azar, dirigió una vez la división estadounidense, el 54% del dinero se destinó a los demócratas y el 46% a los republicanos. Los empleados de Lilly han donado  $45,000 a Biden y $13,000 a Trump, según CRP.

Biden no acepta donaciones de PAC corporativos; todos sus dólares de Regeneron, Lilly y Gilead fueron de empleados de la farmacéutica.

Gran parte del cambio general de los laboratorios este año hacia los demócratas se produce en la carrera presidencial. Los datos de Pharma Cash to Congress de KHN que monitorea a los miembros en funciones todavía muestran una preferencia hacia los republicanos del Congreso, $6 millones hasta ahora en comparación con $4,7 millones otorgados a los demócratas.

“Joe Biden tiene a las grandes farmacéuticas, así como a las grandes tecnológicas y a los grandes bancos, en su bolsillo porque ha trabajado para ellos durante casi 50 años, en lugar de para el pueblo estadounidense”, dijo Samantha Zager, vocera de la campaña de Trump.

En la campaña electoral, Biden se ha centrado principalmente en mejorar el seguro médico. Pero también propone dejar que Medicare negocie los precios de los medicamentos, vincular los aumentos de precios a la inflación y permitir que los pacientes compren medicamentos importados.

Biden “reducirá aún más los costos de atención médica mientras expande la cobertura, pone fin a prácticas de facturación sorpresa, primas más bajas y se enfrentará a los abusos de poder de las farmacéuticas”, dijo Rosemary Boeglin, vocera de la campaña.

Antes que Trump asumiera el cargo, dijo que las compañías farmacéuticas se estaban “saliendo con la suya” por los precios que cobran. A pesar de las afirmaciones y promesas del presidente, ha hecho poco para reducir los precios de los medicamentos recetados, según expertos y verificadores de datos.

Una orden ejecutiva de Trump este mes requeriría que Medicare no pague más por los medicamentos que otras naciones desarrolladas, pero comienza con un programa de prueba y su implementación podría demorar meses o años.

Las farmacéuticas estuvieron entre los mayores beneficiarios del recorte de impuestos de 2017 de Trump, ahorrando miles de millones al poder traer a casa efectivo extranjero libre de impuestos y miles de millones más con tasas más bajas.

Elizabeth Lucas, editora de datos de KHN, colaboró con este informe.