“Among Americans there is no shared scar tissue from the wars,” said J. Kael Weston, a retired foreign service officer who served in Iraq and Afghanistan alongside General Nicholson and has been part of the network. “A culture gap opened up.”
In rural Virginia, Ms. Hemp and others are still working to save more Afghans. She has three young grandchildren and doesn’t have to do this, given that many Americans have already forgotten Afghanistan, or scarcely paid attention to it before.
“I was raised with the Golden Rule, an honor code,” she said. “You do not lie to people. You honor your promises.”
She looked out at her crab apple tree and the rolling green fields. “People today don’t want to take responsibility for their actions. ‘Choices have consequences’ is now ‘choices have consequences for everyone but me.’ People are just so angry.”
On many days, Mr. Sappenfield speaks on Zoom with P, the interpreter. They exchange videos of their children but more often they talk about fear and frustration. The fear is about the Taliban. The frustration is with the State Department, which has been slow walking his visa application for many years.
“They are not taking any action,” P said in a Zoom call. “I feel hopeless. I feel I will be killed in front of my kids.”
For more than a decade, P has been caught in the Catch-22 labyrinth of the State Department’s Special Immigrant Visa, or SIV, application process. He has already had two visa interviews — on March 3, 2020, and April 6 of this year — at the now closed U.S. Embassy in Kabul.
Yet in a Sept. 21 email to Ms. Hemp, a foreign service officer wrote that P still needed another interview. “Obviously,” the officer added, “that will not be happening in Kabul.”
He concluded, “Sorry this is so murky and chaotic.”
Ms. Hemp responded bluntly. “In this day and age of online meetings, zoom conference calls, FaceTime calls, Messenger video chat, why can’t they do an online interview?” she wrote.
The foreign service officer checked with a colleague in Washington, who confirmed that, given the closure of the embassy in Kabul, there was no way for P to get another interview unless he managed to leave Afghanistan.
“Then the SIV case can be transferred to that country,” the officer wrote. “So, it seems to be a Catch-22 situation.”
Alejandro N. Mayorkas, the homeland security secretary, said on Capitol Hill last month that only about 3 percent of the Afghans evacuated to the United States during the American withdrawal actually have special immigrant visas.
P’s application was first submitted in April 2010, when Mr. Sappenfield’s unit was rotating out of Helmand. Had the process not been so labyrinthine, P would have gotten out of Afghanistan before it fell to the Taliban. Now he is trapped.
In an email, a State Department spokeswoman said the effort to help people like P was “of utmost importance” but acknowledged that “it is currently extremely difficult for Afghans to obtain a visa to a third country” in order to have a visa interview.
P has not given up. Every day there is a different word on flights. So far, none have had a spot for him.
Ms. Hemp, Mr. Sappenfield, Mr. Britton and General Nicholson haven’t given up, either.
“Since the weather is changing, people are asking me to find blankets and warm clothes for their families in Afghanistan,” Ms. Hemp wrote recently. “Of course, they continue to ask when their loved ones will be evacuated. No clue, probably never, but I don’t dare tell them that.”
Mr. Sappenfield, a religious man, also recently wrote: “Haunted by the promises I made but my government wouldn’t allow me to keep, I ponder my own Judgment Day.
“Irreverently, perhaps, I am hoping for a front row seat when that day of reckoning comes for those responsible for these crimes against humanity.”
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Ibrahim’s parents fled political turmoil in China for Afghanistan more than 50 years ago. At that time, Mao Zedong had unleashed the Cultural Revolution, and life was upended for many Uyghurs, the mostly Muslim ethnic group in Xinjiang that included Ibrahim’s parents.
Ibrahim was born in Afghanistan. But now he, too, is trying to escape the clutches of Chinese authoritarianism.
He and his family have been afraid to leave their home in Afghanistan since the Taliban, the country’s new rulers, took control last month, venturing outside only to buy essentials. “We are extremely worried and nervous,” said Ibrahim, whose full name is being withheld for his safety. “Our children are worried for our safety, so they have asked us to stay home.”
For years, Chinese officials have issued calls for leaders in Afghanistan to crack down on and deport Uyghur militants they claimed were sheltering in Afghanistan. The officials said the fighters belonged to the East Turkestan Islamic Movement, a separatist organization that Beijing has held responsible for a series of terrorist attacks in China since the late 1990s.
locked up close to a million Uyghurs in camps and subjected those outside to constant surveillance. China says the camps are necessary to weed out extremism and to “re-educate” the Uyghurs.
Wang Yi, China’s foreign minister, standing side by side with leaders of the Taliban in July. Earlier this month, Mr. Wang pledged $30 million in food and other aid to the new government, as well as three million coronavirus vaccine doses; on Thursday, he said Afghanistan’s overseas assets “should not be unreasonably frozen or used as a bargaining chip to exert pressure,” obliquely referencing American control of billions of dollars belonging to the Afghan central bank.
Since the late 1990s, Beijing has succeeded in pressuring several countries to deport Uyghurs. The Uyghur Human Rights Project, an advocacy group based in Washington, has counted 395 cases of Uyghurs being sent to China since 1997. The group said in an August report that journalists and human rights organizations have documented 40 cases of detentions or renditions from Afghanistan to China, though it has verified only one of them.
cash shortages. People have been unable to withdraw money from banks. Grocery prices have shot up. The Taliban have also looked to China for help avoiding a possible economic collapse.
their origin story and their record as rulers.
“The lines are blurred on China’s part between who constitutes a terrorist and who constitutes someone who has simply been politically active,” Mr. Small said. “Individuals who are politically and economically connected with any activities they find problematic” are likely to be targeted, he said.
The uncertain future of Uyghurs in Afghanistan has caught the attention of Abdul Aziz Naseri, a Uyghur activist who was born in Afghanistan and now lives in Turkey. Mr. Abdul Aziz said he had compiled a list of roughly 500 Afghan Uyghurs who want to leave the country.
“They say to me: ‘Please save our future, please save our children,’” he said.
He shared the names and photographs of these people with The New York Times, but asked that their information be kept private. At least 73 people on the list appeared to be under the age of 5.
Shabnam, a 32-year-old Uyghur, her mother and two sisters managed to get out of Afghanistan last month. The women rushed to the airport in Kabul during the frenzied United States evacuation. Her sisters boarded one flight, her mother another. Shabnam said she was the last to leave.
In an interview, she described being separated from her husband while getting through the chaotic security lines at the airport. She was holding his passport and begged the security guards to deliver it to him. No one helped, she said.
Shabnam waited for her husband for four days, while the people around her at the airport encouraged her to leave.
She finally did — boarding a U.S. military plane with hundreds of other Afghans late last month. Her trip took her to Qatar, Germany and finally the United States, where she landed on Aug. 26. She is now in New Jersey and still trying to get her husband out of Afghanistan.
“I was happy that I got out of there, thank God,” Shabnam said. “I like it here. It’s safe and secure.”
Nilo Tabrizy contributed reporting.
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The handwritten doctor’s order was just eight words long, but it solved a problem for Dundee Manor, a nursing home in rural South Carolina struggling to handle a new resident with severe dementia.
David Blakeney, 63, was restless and agitated. The home’s doctor wanted him on an antipsychotic medication called Haldol, a powerful sedative.
“Add Dx of schizophrenia for use of Haldol,” read the doctor’s order, using the medical shorthand for “diagnosis.”
But there was no evidence that Mr. Blakeney actually had schizophrenia.
Antipsychotic drugs — which for decades have faced criticism as “chemical straitjackets” — are dangerous for older people with dementia, nearly doubling their chance of death from heart problems, infections, falls and other ailments. But understaffed nursing homes have often used the sedatives so they don’t have to hire more staff to handle residents.
one in 150 people.
Schizophrenia, which often causes delusions, hallucinations and dampened emotions, is almost always diagnosed before the age of 40.
“People don’t just wake up with schizophrenia when they are elderly,” said Dr. Michael Wasserman, a geriatrician and former nursing home executive who has become a critic of the industry. “It’s used to skirt the rules.”
refuge of last resort for people with the disorder, after large psychiatric hospitals closed decades ago.
But unfounded diagnoses are also driving the increase. In May, a report by a federal oversight agency said nearly one-third of long-term nursing home residents with schizophrenia diagnoses in 2018 had no Medicare record of being treated for the condition.
hide serious problems — like inadequate staffing and haphazard care — from government audits and inspectors.
One result of the inaccurate diagnoses is that the government is understating how many of the country’s 1.1 million nursing home residents are on antipsychotic medications.
According to Medicare’s web page that tracks the effort to reduce the use of antipsychotics, fewer than 15 percent of nursing home residents are on such medications. But that figure excludes patients with schizophrenia diagnoses.
To determine the full number of residents being drugged nationally and at specific homes, The Times obtained unfiltered data that was posted on another, little-known Medicare web page, as well as facility-by-facility data that a patient advocacy group got from Medicare via an open records request and shared with The Times.
The figures showed that at least 21 percent of nursing home residents — about 225,000 people — are on antipsychotics.
The Centers for Medicare and Medicaid Services, which oversees nursing homes, is “concerned about this practice as a way to circumvent the protections these regulations afford,” said Catherine Howden, a spokeswoman for the agency, which is known as C.M.S.
“It is unacceptable for a facility to inappropriately classify a resident’s diagnosis to improve their performance measures,” she said. “We will continue to identify facilities which do so and hold them accountable.”
significant drop since 2012 in the share of residents on the drugs.
But when residents with diagnoses like schizophrenia are included, the decline is less than half what the government and industry claim. And when the pandemic hit in 2020, the trend reversed and antipsychotic drug use increased.
A Doubled Risk of Death
For decades, nursing homes have been using drugs to control dementia patients. For nearly as long, there have been calls for reform.
In 1987, President Ronald Reagan signed a law banning the use of drugs that serve the interest of the nursing home or its staff, not the patient.
But the practice persisted. In the early 2000s, studies found that antipsychotic drugs like Seroquel, Zyprexa and Abilify made older people drowsy and more likely to fall. The drugs were also linked to heart problems in people with dementia. More than a dozen clinical trials concluded that the drugs nearly doubled the risk of death for older dementia patients.
11 percent from less than 7 percent, records show.
The diagnoses rose even as nursing homes reported a decline in behaviors associated with the disorder. The number of residents experiencing delusions, for example, fell to 4 percent from 6 percent.
A Substitute for Staff
Caring for dementia patients is time- and labor-intensive. Workers need to be trained to handle challenging behaviors like wandering and aggression. But many nursing homes are chronically understaffed and do not pay enough to retain employees, especially the nursing assistants who provide the bulk of residents’ daily care.
Studies have found that the worse a home’s staffing situation, the greater its use of antipsychotic drugs. That suggests that some homes are using the powerful drugs to subdue patients and avoid having to hire extra staff. (Homes with staffing shortages are also the most likely to understate the number of residents on antipsychotics, according to the Times’s analysis of Medicare data.)
more than 200,000 since early last year and is at its lowest level since 1994.
As staffing dropped, the use of antipsychotics rose.
Even some of the country’s leading experts on elder care have been taken aback by the frequency of false diagnoses and the overuse of antipsychotics.
Barbara Coulter Edwards, a senior Medicaid official in the Obama administration, said she had discovered that her father was given an incorrect diagnosis of psychosis in the nursing home where he lived even though he had dementia.
“I just was shocked,” Ms. Edwards said. “And the first thing that flashed through my head was this covers a lot of ills for this nursing home if they want to give him drugs.”
Homes that violate the rules face few consequences.
In 2019 and 2021, Medicare said it planned to conduct targeted inspections to examine the issue of false schizophrenia diagnoses, but those plans were repeatedly put on hold because of the pandemic.
In an analysis of government inspection reports, The Times found about 5,600 instances of inspectors citing nursing homes for misusing antipsychotic medications. Nursing home officials told inspectors that they were dispensing the powerful drugs to frail patients for reasons that ranged from “health maintenance” to efforts to deal with residents who were “whining” or “asking for help.”
a state inspector cited Hialeah Shores for giving a false schizophrenia diagnosis to a woman. She was so heavily dosed with antipsychotics that the inspector was unable to rouse her on three consecutive days.
There was no evidence that the woman had been experiencing the delusions common in people with schizophrenia, the inspector found. Instead, staff at the nursing home said she had been “resistive and noncooperative with care.”
Dr. Jonathan Evans, a medical director for nursing homes in Virginia who reviewed the inspector’s findings for The Times, described the woman’s fear and resistance as “classic dementia behavior.”
“This wasn’t five-star care,” said Dr. Evans, who previously was president of a group that represents medical staff in nursing homes. He said he was alarmed that the inspector had decided the violation caused only “minimal harm or potential for harm” to the patient, despite her heavy sedation. As a result, he said, “there’s nothing about this that would deter this facility from doing this again.”
Representatives of Hialeah Shores declined to comment.
Seven of the 52 homes on the inspector general’s list were owned by a large Texas company, Daybreak Venture. At four of those homes, the official rate of antipsychotic drug use for long-term residents was zero, while the actual rate was much higher, according to the Times analysis comparing official C.M.S. figures with unpublished data obtained by the California advocacy group.
make people drowsy and increases the risk of falls. Peer-reviewed studies have shown that it does not help with dementia, and the government has not approved it for that use.
But prescriptions of Depakote and similar anti-seizure drugs have accelerated since the government started publicly reporting nursing homes’ use of antipsychotics.
Between 2015 and 2018, the most recent data available, the use of anti-seizure drugs rose 15 percent in nursing home residents with dementia, according to an analysis of Medicare insurance claims that researchers at the University of Michigan prepared for The Times.
in a “sprinkle” form that makes it easy to slip into food undetected.
“It’s a drug that’s tailor-made to chemically restrain residents without anybody knowing,” he said.
In the early 2000s, Depakote’s manufacturer, Abbott Laboratories, began falsely pitching the drug to nursing homes as a way to sidestep the 1987 law prohibiting facilities from using drugs as “chemical restraints,” according to a federal whistle-blower lawsuit filed by a former Abbott saleswoman.
According to the lawsuit, Abbott’s representatives told pharmacists and nurses that Depakote would “fly under the radar screen” of federal regulations.
Abbott settled the lawsuit in 2012, agreeing to pay the government $1.5 billion to resolve allegations that it had improperly marketed the drugs, including to nursing homes.
Nursing homes are required to report to federal regulators how many of their patients take a wide variety of psychotropic drugs — not just antipsychotics but also anti-anxiety medications, antidepressants and sleeping pills. But homes do not have to report Depakote or similar drugs to the federal government.
“It is like an arrow pointing to that class of medications, like ‘Use us, use us!’” Dr. Maust said. “No one is keeping track of this.”
published a brochure titled “Nursing Homes: Times have changed.”
“Nursing homes have replaced restraints and antipsychotic medications with robust activity programs, religious services, social workers and resident councils so that residents can be mentally, physically and socially engaged,” the colorful two-page leaflet boasted.
Last year, though, the industry teamed up with drug companies and others to push Congress and federal regulators to broaden the list of conditions under which antipsychotics don’t need to be publicly disclosed.
“There is specific and compelling evidence that psychotropics are underutilized in treating dementia and it is time for C.M.S. to re-evaluate its regulations,” wrote Jim Scott, the chairman of the Alliance for Aging Research, which is coordinating the campaign.
The lobbying was financed by drug companies including Avanir Pharmaceuticals and Acadia Pharmaceuticals. Both have tried — and so far failed — to get their drugs approved for treating patients with dementia. (In 2019, Avanir agreed to pay $108 million to settle charges that it had inappropriately marketed its drug for use in dementia patients in nursing homes.)
‘Hold His Haldol’
Ms. Blakeney said that only after hiring a lawyer to sue Dundee Manor for her husband’s death did she learn he had been on Haldol and other powerful drugs. (Dundee Manor has denied Ms. Blakeney’s claims in court filings.)
During her visits, though, Ms. Blakeney noticed that many residents were sleeping most of the time. A pair of women, in particular, always caught her attention. “There were two of them, laying in the same room, like they were dead,” she said.
In his first few months at Dundee Manor, Mr. Blakeney was in and out of the hospital, for bedsores, pneumonia and dehydration. During one hospital visit in December, a doctor noted that Mr. Blakeney was unable to communicate and could no longer walk.
“Hold the patient’s Ambien, trazodone and Zyprexa because of his mental status changes,” the doctor wrote. “Hold his Haldol.”
Mr. Blakeney continued to be prescribed the drugs after he returned to Dundee Manor. By April 2017, the bedsore on his right heel — a result, in part, of his rarely getting out of bed or his wheelchair — required the foot to be amputated.
In June, after weeks of fruitless searching for another nursing home, Ms. Blakeney found one and transferred him there. Later that month, he died.
“I tried to get him out — I tried and tried and tried,” his wife said. “But when I did get him out, it was too late.”
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“I hear it from kids all the time: I want to get out of here,” said Kristin Johnson, a 24-year-old middle school teacher at Mount View who lives in Princeton, W.Va., about an hour’s drive away, and is itching for a teacher job to open there. “Those who do get an education know they can make more money somewhere else.”
Ms. Keys returned, in part, out of loyalty. “When I was in high school, we started losing a lot of teachers,” she said. “People feared there would be nobody there to take those jobs.” But a stable teaching job, as well as free housing at her grandmother’s old house, played into her calculations.
This may not be enough to hold her, though. Even dating locally is complicated. Her boyfriend lives over an hour away, outside Beckley. “There is nobody here that is appealing,” Ms. Keys said.
Consider Emily Hicks, 24, who graduated from Mount View in 2015. She is at the forefront of Reconnecting McDowell’s efforts, an early participant in the mentoring program meant to expand the horizons of local youths.
She didn’t even have to leave home to get her bachelor’s degree at Bluefield State College, commuting from home every other day. Today she teaches fifth grade at Kimball Elementary School. Her father is a surveyor for the coal mines; her mother works for the local landfill. But her boyfriend, Brandon McCoy, is hoping to leave the coal business and has taken a couple of part-time jobs at clinics outside the county after getting an associate degree in radiology.
Her brother, Justin, who graduated from high school in June, is going to college to get a degree in electrical engineering. “I have no idea what I’m going to do after that,” he said. “But there’s not a lot to do here.”
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A constellation of 5,400 offshore wind turbines meet a growing portion of Europe’s energy needs. The United States has exactly seven.
With more than 90,000 miles of coastline, the country has plenty of places to plunk down turbines. But legal, environmental and economic obstacles and even vanity have stood in the way.
President Biden wants to catch up fast — in fact, his targets for reducing greenhouse gas emissions depend on that happening. Yet problems abound, including a shortage of boats big enough to haul the huge equipment to sea, fishermen worried about their livelihoods and wealthy people who fear that the turbines will mar the pristine views from their waterfront mansions. There’s even a century-old, politically fraught federal law, known as the Jones Act, that blocks wind farm developers from using American ports to launch foreign construction vessels.
Offshore turbines are useful because the wind tends to blow stronger and more steadily at sea than onshore. The turbines can be placed far enough out that they aren’t visible from land but still close enough to cities and suburbs that they do not require hundreds of miles of expensive transmission lines.
approved a project near Martha’s Vineyard that languished during the Trump administration and in May announced support for large wind farms off California’s coast. The $2 trillion infrastructure plan that Mr. Biden proposed in March would also increase incentives for renewable energy.
The cost of offshore wind turbines has fallen about 80 percent over the last two decades, to as low as $50 a megawatt-hour. While more expensive per unit of energy than solar and wind farms on land, offshore turbines often make economic sense because of lower transmission costs.
“Solar in the East is a little bit more challenging than in the desert West,” said Robert M. Blue, the chairman and chief executive of Dominion Energy, a big utility company that is working on a wind farm with nearly 200 turbines off the coast of Virginia. “We’ve set a net-zero goal for our company by 2050. This project is essential to hitting those goals.”
rely on European components, suppliers and ships for years.
Installing giant offshore wind turbines — the largest one, made by General Electric, is 853 feet high — is difficult work. Ships with cranes that can lift more than a thousand tons haul large components out to sea. At their destinations, legs are lowered into the water to raise the ships and make them stationary while they work. Only a few ships can handle the biggest components, and that’s a big problem for the United States.
A 1,600-mile round trip to Canada.
Government Accountability Office report published in December. That is far too small for the giant components that Mr. Eley’s team was working with.
So Dominion hired three European ships and operated them out of the Port of Halifax in Nova Scotia. One of them, the Vole au Vent from Luxembourg, is 459 feet (140 meters) long and can lift 1,654 tons.
Mr. Eley’s crew waited weeks at a time for the European ships to travel more than 800 miles each way to port. The installations took a year. In Europe, it would have been completed in a few weeks. “It was definitely a challenge,” he said.
The U.S. shipping industry has not invested in the vessels needed to carry large wind equipment because there have been so few projects here. The first five offshore turbines were installed in 2016 near Block Island, R.I. Dominion’s two turbines were installed last year.
Had the Jones Act not existed — it was enacted after World War I to ensure that the country had ships and crews to mobilize during war and emergencies — Dominion could have run European vessels out of Virginia’s ports. The law is sacrosanct in Congress, and labor unions and other supporters argue that repealing it would eliminate thousands of jobs at shipyards and on boats, leaving the United States reliant on foreign companies.
Demand for large ships could grow significantly over the next decade because the United States, Europe and China have ambitious offshore wind goals. Just eight ships in the world can transport the largest turbine parts, according to Dominion.
200 more turbines by 2026. Dominion spent $300 million on its first two but hopes the others will cost $40 million each.
Fishermen fear for their livelihoods.
For the last 24 years, Tommy Eskridge, a resident of Tangier Island, has made a living catching conchs and crabs off the Virginia coast.
One area he works is where Dominion plans to place its turbines. Federal regulators have adjusted spacing between turbines to one nautical mile to create wider lanes for fishing and other boats, but Mr. Eskridge, 54, worries that the turbines could hurt his catch.
The area has yielded up to 7,000 pounds of conchs a day, though Mr. Eskridge said a typical day produced about half that amount. A pound can fetch $2 to $3, he said.
Mr. Eskridge said the company and regulators had not done enough to show that installing turbines would not hurt his catch. “We just don’t know what it’s going to do.”
who died in 2009, and William I. Koch, an industrialist.
Neither wanted the turbines marring the views of the coast from their vacation compounds. They also argued that the project would obstruct 16 historical sites, disrupt fishermen and clog up waterways used by humpback, pilot and other whales.
the developer of Cape Wind gave up in 2017. But well before that happened, Cape Wind’s troubles terrified energy executives who were considering offshore wind.
Projects up and down the East Coast are mired in similar fights. Residents of the Hamptons, the wealthy enclave, opposed two wind development areas, and the federal government shelved the project. On the New Jersey shore, some homeowners and businesses are opposing offshore wind because they fear it will raise their electricity rates, disrupt whales and hurt the area’s fluke fishery.
Energy executives want the Biden administration to mediate such conflicts and speed up permit approval.
“It’s been artificially, incrementally slow because of some inefficiencies on the federal permitting side,” said David Hardy, chief executive of Orsted North America.
Renewable-energy supporters said they were hopeful because the country had added lots of wind turbines on land — 66,000 in 41 states. They supplied more than 8 percent of the country’s electricity last year.
Ms. Lefton, the regulator who oversees leasing of federal waters, said future offshore projects would move more quickly because more people appreciated the dangers of climate change.
“We have a climate crisis in front of us,” she said. “We need to transition to clean energy. I think that will be a big motivator.”
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LONDON — During a contentious meeting over proposed climate regulations last fall, a Saudi diplomat to the obscure but powerful International Maritime Organization switched on his microphone to make an angry complaint: One of his colleagues was revealing the proceedings on Twitter as they happened.
It was a breach of the secrecy at the heart of the I.M.O., a clubby United Nations agency on the banks of the Thames that regulates international shipping and is charged with reducing emissions in an industry that burns an oil so thick it might otherwise be turned into asphalt. Shipping produces as much carbon dioxide as all of America’s coal plants combined.
Internal documents, recordings and dozens of interviews reveal what has gone on for years behind closed doors: The organization has repeatedly delayed and watered down climate regulations, even as emissions from commercial shipping continue to rise, a trend that threatens to undermine the goals of the 2016 Paris climate accord.
One reason for the lack of progress is that the I.M.O. is a regulatory body that is run in concert with the industry it regulates. Shipbuilders, oil companies, miners, chemical manufacturers and others with huge financial stakes in commercial shipping are among the delegates appointed by many member nations. They sometimes even speak on behalf of governments, knowing that public records are sparse, and that even when the organization allows journalists into its meetings, it typically prohibits them from quoting people by name.
Homes are washing away. Much of the nation could become unlivable in the coming decade.
was almost denied a seat. International Registries, which represented the Marshall Islands on the I.M.O., initially refused to yield to the foreign minister, Mr. Woodroofe recalled.
United Nations climate meetings, countries are typically represented by senior politicians and delegations of government officials. At the maritime organization’s environmental committee, however, one in four delegates comes from industry, according to separate analyses by The New York Times and the nonprofit group Influence Map.
Representatives of the Brazilian mining company Vale, one of the industry’s heaviest carbon polluters and a major sea-based exporter, sit as government advisers. So does the French oil giant Total, along with many shipowner associations. These arrangements allow companies to influence policy and speak on behalf of governments.
Connections can be hard to spot. Luiz Gylvan Meira Filho sat on the Brazilian delegation in 2017 and 2018 as a University of Sao Paulo scientist. But he also worked at a Vale-funded research organization and, during his second year, was a paid Vale consultant. In an interview, he described his role as mutually beneficial: Brazilian officials relied on his expertise, and Vale covered his costs.
“Sometimes you cannot tell the difference. Is this actually the position of a nation or the position of the industry?” said David Paul, a Marshallese senator who attended an I.M.O. meeting in 2018.
Hundreds of other industry representatives are accredited observers and can speak at meetings. Their numbers far exceed those of the approved environmental groups. The agency rejected an accreditation request by the Environmental Defense Fund in 2018.
Industry officials and the maritime organization say such arrangements give a voice to the experts. “If you don’t involve the people who are actually going to have to deliver, then you’re going to get a poor outcome,” said Guy Platten, secretary general of the International Chamber of Shipping.
openly opposed strict emissions regulation as a hindrance to economic growth. And an informal bloc of countries and industry groups helped drag out the goal-setting process for three years.
Documents show that China, Brazil and India, in particular, threw up repeated roadblocks: In 2015, it was too soon to consider a strategy. In 2016, it was premature to discuss setting targets. In 2017, they lacked the data to discuss long-term goals.
a Cook Islands diplomat.
The I.M.O. almost never puts environmental policies to a vote, favoring instead an informal consensus-building. That effectively gives vocal opponents blocking power, and even some of the agency’s defenders acknowledge that it favors minimally acceptable steps over decisive action.
So, when delegates finally set goals in 2018, Mr. de Brum’s ambition had been whittled away.
The Marshall Islands suggested a target of zero emissions “by the second half of the century” — meaning by 2050. Industry representatives offered a slightly different goal: Decarbonization should occur “within” the second half of the century, a one-word difference that amounted to a 50-year extension.
Soon, though, the delegates agreed, without a vote, to eliminate zero-emissions targets entirely.
What remained were two key goals:
First, the industry would try to improve fuel efficiency by at least 40 percent. This was largely a mirage. The target was set so low that, by some calculations, it was reached nearly the moment it was announced.
Second, the agency aimed to cut emissions at least in half by 2050. But even this watered-down goal is proving unreachable. The agency’s own data say emissions may rise by 30 percent.
When delegates met last October — five years after Mr. de Brum’s speech — the organization had not taken any action. Proposals like speed limits had been debated and rejected.
What remained was what several delegates called the “refrigerator rating” — a score that, like those on American appliances, identified the clean and dirty ships.
European delegates insisted that, for the system to work, low-scoring ships must eventually be prohibited from sailing.
China and its allies wanted no such consequence.
So Sveinung Oftedal of Norway, the group’s chairman, told France and China to meet separately and compromise.
Delegates worked across time zones, meeting over teleconferences because of the Covid-19 pandemic. Shipping industry officials said they weighed in through the night.
The Marshallese were locked out.
“We’re always being told ‘We hear you,’” Mr. Ishoda said. “But when it comes to the details of the conversation, we’re told ‘We don’t need you to contribute.’”
Ultimately, France ceded to nearly all of China’s requests, records show. The dirtiest ships would not be grounded. Shipowners would file plans saying they intended to improve, would not be required to actually improve.
German delegates were so upset that they threatened to oppose the deal, likely triggering a cascade of defections, according to three people involved in the talks. But European Union officials rallied countries behind the compromise, arguing that Europe could not be seen as standing in the way of even limited progress.
“At I.M.O., that is as always the choice,” said Damien Chevallier, the French negotiator. “We have the choice to have nothing, or just to have a first step.”
All of this happened in secret. The I.M.O.’s summary of the meeting called it a “major step forward.” Natasha Brown, a spokeswoman, said it would empower customers and advocacy groups. “We know from consumer goods that the rating system works,” she said.
But the regulation includes another caveat: The I.M.O. will not publish the scores, letting shipping companies decide whether to say how dirty their ships are.
A Storm on the Horizon
Ms. Kabua, the Marshallese minister, is under no illusions that reclaiming the diplomatic seat will lead to a climate breakthrough.
But if it works, she said, it might inspire other countries with private registries to do the same. Countries could speak for themselves rather than through a corporate filter.
Regardless of the outcome, the political winds are shifting. The European Union is moving to include shipping in its emissions-trading system. The United States, after years of being minor players at the agency, is re-engaging under President Biden and recently suggested it may tackle shipping emissions itself.
Both would be huge blows to the I.M.O., which has long insisted that it alone regulate shipping.
Suddenly, industry officials say they are eager to consider things like fuel taxes or carbon.
“There’s much more of a sense of momentum and crisis,” said Mr. Platten, the industry representative. “You can argue about, ‘Are we late to it,’ and all the rest. But it is palpable.”
Behind closed doors, though, resistance remains. At a climate meeting last winter, recordings show that the mere suggestion that shipping should become sustainable sparked an angry response.
“Such statements show a lack of respect for the industry,” said Kostas G. Gkonis, the director of the trade group Intercargo.
And just last week, delegates met in secret to debate what should constitute a passing grade under the new rating system. Under pressure from China, Brazil and others, the delegates set the bar so low that emissions can continue to rise — at roughly the same pace as if there had been no regulation at all.
Delegates agreed to revisit the issue in five years.
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Sarah Cavey, a real estate agent in Denver, was thrilled last fall when Colorado introduced an app to warn people of possible coronavirus exposures.
Based on software from Apple and Google, the state’s smartphone app uses Bluetooth signals to detect users who come into close contact. If a user later tests positive, the person can anonymously notify other app users whom the person may have crossed paths with in restaurants, on trains or elsewhere.
Ms. Cavey immediately downloaded the app. But after testing positive for the virus in February, she was unable to get the special verification code she needed from the state to warn others, she said, even after calling Colorado’s health department three times.
“They advertise this app to make people feel good,” Ms. Cavey said, adding that she had since deleted the app, called CO Exposure Notifications, in frustration. “But it’s not really doing anything.”
announced last year that they were working together to create a smartphone-based system to help stem the virus, their collaboration seemed like a game changer. Human contact tracers were struggling to keep up with spiking virus caseloads, and the trillion-dollar rival companies — whose systems run 99 percent of the world’s smartphones — had the potential to quickly and automatically alert far more people.
Soon Austria, Switzerland and other nations introduced virus apps based on the Apple-Google software, as did some two dozen American states, including Alabama and Virginia. To date, the apps have been downloaded more than 90 million times, according to an analysis by Sensor Tower, an app research firm.
But some researchers say the companies’ product and policy choices limited the system’s usefulness, raising questions about the power of Big Tech to set global standards for public health tools.
Stephen Farrell and Doug Leith, computer science researchers at Trinity College in Dublin, wrote in a report in April on Ireland’s virus alert app.
CA Notify in December, about 65,000 people have used the system to alert other app users, the state said.
“Exposure notification technology has shown success,” said Dr. Christopher Longhurst, the chief information officer of UC San Diego Health, which manages California’s app. “Whether it’s hundreds of lives saved or dozens or a handful, if we save lives, that’s a big deal.”
In a joint statement, Apple and Google said: “We’re proud to collaborate with public health authorities and provide a resource — which many millions of people around the world have enabled — that has helped protect public health.”
Let Us Help You Protect Your Digital Life
Based in part on ideas developed by Singapore and by academics, Apple and Google’s system incorporated privacy protections that gave health agencies an alternative to more invasive apps. Unlike virus-tracing apps that continuously track users’ whereabouts, the Apple and Google software relies on Bluetooth signals, which can estimate the distance between smartphones without needing to know people’s locations. And it uses rotating ID codes — not real names — to log app users who come into close contact for 15 minutes or more.
said last year in a video promoting the country’s alert system, called Corona-Warn-App.
But the apps never received the large-scale efficacy testing typically done before governments introduce public health interventions like vaccines. And the software’s privacy features — which prevent government agencies from identifying app users — have made it difficult for researchers to determine whether the notifications helped hinder virus transmission, said Michael T. Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
“The apps played virtually no role at all in our being able to investigate outbreaks that occurred here,” Dr. Osterholm said.
Some limitations emerged even before the apps were released. For one thing, some researchers note, exposure notification software inherently excludes certain vulnerable populations, such as elderly people who cannot afford smartphones. For another thing, they say, the apps may send out false alarms because the system is not set up to incorporate mitigation factors like whether users are vaccinated, wearing masks or sitting outside.
Proximity detection in virus alert apps can also be inconsistent. Last year, a study on Google’s system for Android phones conducted on a light-rail tram in Dublin reported that the metal walls, flooring and ceilings distorted Bluetooth signal strength to such a degree that the chance of accurate proximity detection would be “similar to that of triggering notifications by randomly selecting” passengers.
Kimbley Craig, the mayor of Salinas, Calif. Last December, when virus rates there were spiking, she said, she downloaded the state’s exposure notification app on her Android phone and soon after tested positive for Covid-19. But after she entered the verification code, she said, the system failed to send an alert to her partner, whom she lives with and who had also downloaded the app.
“If it doesn’t pick up a person in the same household, I don’t know what to tell you,” Mayor Craig said.
In a statement, Steph Hannon, Google’s senior director of product management for exposure notifications, said that there were “known challenges with using Bluetooth technology to approximate the precise distance between devices” and that the company was continuously working to improve accuracy.
The companies’ policies have also influenced usage trends. In certain U.S. states, for instance, iPhone users can activate the exposure notifications with one click — by simply turning on a feature on their settings — but Android users must download a separate app. As a result, about 9.6 million iPhone users in California had turned on the notifications as of May 10, the state said, far outstripping the 900,000 app downloads on Android phones.
Google said it had built its system for states to work on the widest range of devices and be deployed as quickly as possible.
Some public health experts acknowledged that the exposure alert system was an experiment in which they, and the tech giants, were learning and incorporating improvements as they went along.
One issue they discovered early on: To hinder false alarms, states verify positive test results before a person can send out exposure notifications. But local labs can sometimes take days to send test results to health agencies, limiting the ability of app users to quickly alert others.
In Alabama, for instance, the state’s GuideSafe virus alert app has been downloaded about 250,000 times, according to Sensor Tower. But state health officials said they had been able to confirm the positive test results of only 1,300 app users. That is a much lower number than health officials would have expected, they said, given that more than 10 percent of Alabamians have tested positive for the coronavirus.
“The app would be a lot more efficient if those processes were less manual and more automated,” said Dr. Scott Harris, who oversees the Alabama Department of Public Health.
Colorado, which automatically issues the verification codes to people who test positive, has reported higher usage rates. And in California, UC San Diego Health has set up a dedicated help line that app users can call if they did not receive their verification codes.
Dr. Longhurst, the medical center’s chief information officer, said the California app had proved useful as part of a larger statewide public health push that also involved mask-wearing and virus testing.
“It’s not a panacea,” he said. But “it can be an effective part of a pandemic response.”
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WASHINGTON — From California to Virginia, many states that faced devastating shortfalls in the depths of the pandemic recession now find themselves flush with tax revenues because of a rebounding economy and a soaring stock market. Lawmakers who worried about budget cuts are now proposing lucrative increases in school spending, tax cuts and direct payments to their residents.
That turnaround is partly the product of strong income tax receipts, particularly in states that heavily tax high earners and the wealthy, whose finances have fared well in the crisis. The unexpectedly rosy picture is raising pressure on President Biden to repurpose hundreds of billions of dollars of federal aid approved this year, in order to help fund a potential bipartisan infrastructure deal.
Last week, Senator Mitt Romney, Republican of Utah, suggested that Mr. Biden and Republican negotiators look to “some of the funding that’s been sent to states already under the last few bills” to help pay for that agreement. “They don’t know how to use it,” Mr. Romney said. “They could use that money to finance part of the infrastructure relating to roads and bridges and transit.”
Some economists and budget experts support that push, arguing that the money could be better spent elsewhere and that states’ spending plans could add to a risk of rapid inflation breaking out across the country. Other researchers and local budget officials say that the federal aid is rescuing harder-hit cities and states, like New York City and Hawaii, from a cascade of layoffs and spending cuts.
$1.9 trillion economic assistance package that Mr. Biden signed in March. They say the aid will help ensure that the economic rebound does not repeat the years of state and local budget cutting that followed the 2008 financial crisis, which slowed the recovery from recession and contributed to millions of Americans waiting years to reap its benefits.
“We still feel strongly that the state and local plan is critical to ensuring we have a strong insurance policy for the type of strong growth we want, the type of equitable recovery the country deserves,” Gene Sperling, a senior adviser to Mr. Biden who oversees fulfillment of the March assistance package, said in an interview, “and to coming back from the 1.3 million jobs lost at the state and local level.”
Even if the administration wanted to recoup or divert the funds, it is unlikely that it could repurpose the money or make significant changes to how it is used without congressional action.
The debate over the state and local funding comes as Mr. Biden navigates a critical week of negotiations with Republicans over infrastructure in search of a deal, and as he prepares to travel to Cleveland on Thursday to speak about the economy. How to pay for any new spending is a primary hurdle in the talks, with Mr. Biden pushing to raise taxes on corporations and Republicans preferring increased user fees like the gas tax.
Repurposing unspent funds could help advance an agreement, particularly given Republican opposition to bankrolling state aid in previous rescue packages. Democrats pushed hard to include lucrative financial assistance for states, cities and tribes in Mr. Biden’s rescue bill. Republicans fought those efforts, warning they would serve as a “bailout” to high-tax, high-spend liberal states. They also cited a series of projections from Wall Street firms and other analysts suggesting that many states’ revenues were faring better than officials had feared in the early months of the pandemic.
do not need more federal money. That is particularly true in states that do not rely primarily on the tourism or hospitality industries for tax revenues. Those with progressive tax systems that have caught surging revenues from investment income enjoyed by wealthy residents — like Silicon Valley moguls — are also faring well.
California officials expect a $15 billion surplus this fiscal year, after fearing a $54 billion shortfall. Virginia has seen nearly $2 billion in unanticipated revenues. As has Oregon, where economists recently upgraded the state’s revenue forecasts — moving it from projected deficits to surplus — in a report that surprised and delighted many lawmakers.
“It’s extremely surprising,” said Mark McMullen, the Oregon state economist.
“Obviously, when the shutdowns first set in and we saw these catastrophic employment losses, we treated them as a normal recession in our forecasts,” he said.
But surging income tax revenues and several rounds of federal assistance have now put the state “above our prepandemic forecasts,” Mr. McMullen added.
The strong revenue figures come as more federal relief money is just beginning to roll out the door. The Treasury Department began sending funds to states this month and has so far distributed more than $100 billion — about half of what is available to be disbursed immediately. Local governments are expected to receive the rest next year, although states still experiencing a sharp rise in unemployment will get a lump sum right away.
as a much lower risk than Mr. Summers does.
Other analysts warn that state budget situations could sour if the stock market dips sharply or economic growth fizzles. Many cities, like New York, have struggled with sluggish tax revenues and still are reliant on federal to help avoid further layoffs.
New York expects to receive more than $22 billion in Covid-19 federal aid, according to the nonpartisan Citizens Budget Commission. Despite the funds, the city is still anticipating budget gaps in the coming years, the result of declining revenues like property taxes.
In retrospect, said Lucy Dadayan, a senior research associate at the Tax Policy Center, the March law should have included “more targeted funding” for the states and cities that need it most.
$8.8 billion from the federal government. Ben Watkins, the director of the Florida Division of Bond Finance, said the state was using the relief money to invest in infrastructure and water quality projects and directing some of its surplus funds to hurricane preparedness.
He described the windfall as staggering.
“It’s a good problem to have,” Mr. Watkins said, “but that doesn’t mean that it’s not excessive.”
States have substantial leeway in how they use the money, though they are prohibited from using the funds to subsidize tax cuts. Several Republican-led states have sued the Treasury Department, arguing that the restriction infringes on state sovereignty.
The lawsuits do not appear to be slowing the delivery of the funds. Ohio failed to win an injunction blocking the restrictions from being enforced this month, and Missouri had its case thrown out of court after a federal judge said the state did not demonstrate that the law caused it harm.
$26 million corporate tax cut last week, and lawmakers have told The Omaha World-Herald that they believe that by keeping the federal funds in a separate account from the state’s general fund, they will be in compliance with the law.
Nicholas Fandos and Dana Goldstein contributed reporting.
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Paul J. Hanly Jr., a top trial lawyer who had been central to the current nationwide litigation against pharmaceutical companies and others in the supply chain for their role in the deadly opioid epidemic, died on Saturday at his home in Miami Beach. He was 70.
The cause was anaplastic thyroid cancer, an extremely rare and aggressive disease, said Jayne Conroy, his longtime law partner.
Over his four-decade career, Mr. Hanly, a class-action plaintiffs’ lawyer, litigated and managed numerous complex legal cases, involving among other things the funding of terrorists, stemming from the attacks of Sept. 11, 2001, and allegations of the sexual abuse of dozens of boys by a man who ran an orphanage and school in Haiti.
But nothing compares to the national opioid cases that are pending in federal court in Cleveland on behalf of thousands of municipalities and tribes against the manufacturers and distributors of prescription opioid pain medications. The federal opioid litigation is regarded by many as perhaps the most complex in American legal history — even more entangled and far-reaching than the epic legal battles with the tobacco industry.
settled with Purdue for $75 million. It was one of the few instances in which a drug maker agreed to pay individual patients who had accused it of soft-pedaling the risk of addiction.
Mr. Hanly had a history of taking on complex cases with vast numbers of plaintiffs. Shortly after the 2001 terrorist attacks, he represented some of the families who had lost loved ones on the planes and in the World Trade Center. He also filed suit to stop the sale of tanzanite, a raw stone used as a cash alternative to fund terrorist activities. That lawsuit was expanded to include foreign governments, banks and others that supported Al Qaeda. Portions of it remain pending.
Another of his important cases was a 2013 landmark settlement of $12 million on behalf of 24 Haitian boys who said they had been sexually abused by Douglas Perlitz, who ran programs for underprivileged boys and was subsequently sentenced to 19 years in prison. Mr. Hanly said the defendants, including the Society of Jesus of New England, Fairfield University and others, had not properly supervised Mr. Perliitz. Mr. Hanly filed additional charges in 2015, bringing the total number of abused youths to more than 100 between the late 1990s and 2010.
“Paul was a lawyer’s lawyer,” said Ms. Conroy, his law partner. She said he was renowned for his exhaustive trial preparation, his creative trial strategies and his nearly photographic memory of the contents of documents.
He was also known for veering sartorially from the muted grays and blacks of most lawyers to more jaunty attire in bright yellows, blues and pinks. He favored bespoke styles that were flashy yet sophisticated. His two-tone shoes were all handmade.
John V. Kenny, a former mayor of Jersey City and a powerful Hudson County Democratic boss known as “the pope of Jersey City,” who was jailed in the 1970s after pleading guilty to charges of income tax evasion.
Mr. Hanly took a different path. He went to Cornell, where his roommate was Ed Marinaro, who went on to play professional football and later became an actor (best known for “Hill Street Blues”). Mr. Hanly, who played football with him, graduated in 1972 with a major in philosophy and received a scholar-athlete award as the Cornell varsity football senior who combined the highest academic average with outstanding ability.
He earned a master’s degree in philosophy from Cambridge University in 1976 and a law degree from Georgetown in 1979. He then clerked for Lawrence A. Whipple, a U.S. District Court judge in New Jersey.
Mr. Hanly’s marriage in the mid-1980s to Joyce Roquemore ended in divorce. He is survived by two sons, Paul J. Hanly III and Burton J. Hanly; a daughter, Edith D. Hanly; a brother, John K. Hanly; and a sister, Margo Mullady.
He began his legal career as a national trial counsel and settlement counsel to Turner & Newall, a British asbestos company, one of the world’s largest, in its product-liability cases. The company was purchased by an American firm, Federal-Mogul, in 1998, after which it was overwhelmed with asbestos claims and filed for bankruptcy in 2001.
Mr. Hanly and Ms. Conroy spent much of their time steeped in negotiations with plaintiffs’ lawyers. They soon switched to representing plaintiffs themselves.
“We recognized over time that that was more important to us,” Ms. Conroy said, “to make sure victims were compensated for what happened.”
Jan Hoffman contributed reporting.
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