Mariupol resistance, drug overdose deaths, mask mandate appeal : NPR

Mariupol resistance, drug overdose deaths, mask mandate appeal : NPR

Russia says it controls most of the Ukrainian port city of Mariupol. The White House has a plan to reduce drug overdose deaths. The Justice Department will appeal the mask ruling by a federal judge.



A MARTINEZ, HOST:

Russia says it wants to give the U.S. and its allies something to think about.

STEVE INSKEEP, HOST:

That’s why Russia tested an intercontinental ballistic missile, the kind that carries nuclear weapons. That threatening gesture comes at a moment of continued frustration for Russia. The U.S. is sending more weapons to Ukraine, and Russian invaders still do not quite have control of the port city of Mariupol. In one of those televised meetings that he sometimes holds, President Vladimir Putin told his defense minister not to storm a giant steel complex the Ukrainian forces still hold. The Russian leader said he would rather keep the plant sealed off and avoid losing the lives of even more Russian soldiers.

MARTINEZ: Here to make sense of all of this is NPR’s Tim Mak, who is on the road in central Ukraine. Tim, so what should we make of Vladimir Putin’s announcement?

TIM MAK, BYLINE: Well, Ukrainian media was quick to discount it, saying that Ukrainian troops, quote, “are still present in the city and continue destroying enemy equipment.” And it’s hard to make sense of how abandoning this effort to take over the last Ukrainian holdout in the city could be portrayed as a Russian success. What we can say is the fact that Russia appears to be switching tactics here and basically signaling that they’re giving up on these repeated attacks they’ve been executing on the holdouts, that’s a significant development.

MARTINEZ: There are still soldiers and civilians in the steel plant and in the city. So what does this mean for them?

MAK: Well, Ukrainians have been focused on evacuating people in the plant and in the rest of the city. There was hope that a deal had been struck between Ukrainian and Russian negotiators for an evacuation corridor for civilians in the city yesterday, but that fell through by the end of the day. Only four buses left yesterday when they were hoping to evacuate thousands of people. Ukrainian officials claimed that Russian forces wouldn’t hold to the cease-fire. They’re hoping to send in more buses today and pull out more people from the city.

MARTINEZ: Tim, what’s going on in the rest of the country?

MAK: Well, I’m on the way to a city in the east, on the edge of the Donbas, where this buildup of Russian forces has been taking place. We’re also getting a sense of what it’s like for civilians trying to leave Russian-controlled territory. I spoke with Sergei Protsenko (ph). He’s a restaurateur from Kherson. That’s near the front lines of fighting in southern Ukraine. He crossed nine Russian-held checkpoints to make it into Ukrainian-held territory. He told me about this experience.

SERGEI PROTSENKO: (Non-English language spoken).

MAK: He said he was told to strip down to see if he had any tattoos relating to the Ukrainian military. He made it out all the way to Odesa, where I found him smoking a cigarette and admiring the Black Sea. When he made it to safety on this side of the front lines, he said he felt a huge relief.

MARTINEZ: On the ground, it just seems like there are new reports of atrocities committed by Russian forces every day. I mean, where does all of this put the hope for a peace plan? ‘Cause, you know, I don’t know if anyone would blame Ukrainians if they’ve given up on that.

MAK: Well, it’s really mixed, right? There are some Ukrainian officials who believe there’s an upside to talking to the Russian government on specific issues, like these humanitarian corridors we’ve been discussing, the exchange of prisoners of war and so on. But if we’re talking about – more broadly, about talks for peace, for a broader agreement that could end the war, it just doesn’t really look promising right now. There were these broader negotiations for peace a few weeks ago, but a turning point was really when Russia pulled back from the areas around Kyiv and left evidence of atrocities in places like Bucha. You could really feel public opinion shift dramatically overnight. Even those inclined against violence said there could be no negotiations or broader discussions with the Russian government after photos of, for example, dead civilians emerged from those areas. So right now the prospects for ending this war in the short term look pretty bleak, and any serious negotiations may not take place until the results of this next Russian offensive are clear.

MARTINEZ: That’s NPR’s Tim Mak. Tim, thanks.

MAK: Thank you.

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MARTINEZ: The Department of Justice now says it will appeal the end of a federal mask mandate.

INSKEEP: A federal judge the other day blocked that pandemic measure, which applied to planes and trains and other public transit. The Centers for Disease Control and Prevention insist the mandate is, quote, “necessary for the public health.” For the moment, the CDC says they cannot order you but they do still advise you to wear masks on public transportation.

MARTINEZ: With us now is NPR health correspondent Maria Godoy. Maria, with all of these mixed signals, I can imagine people are a little confused right now. So should we mask up or not?

MARIA GODOY, BYLINE: Well, there’s no mandate. You’re not required to wear a mask now. But the science says in many situations it still makes sense to wear a mask on public transportation.

MARTINEZ: All right, let’s start with planes because people are so jam-packed together. What do we do there?

GODOY: Well, yeah, it’s counterintuitive because you are in a small, enclosed space, but the good news is that every researcher I’ve spoken with agrees that the air filtration and ventilation on an airplane is really about the best it can be for an indoor environment, meaning the cabin gets replenished with new air a lot. But there’s a big caveat to that. Here’s Dr. David Freedman. He’s president-elect of the American Society of Tropical Medicine and Hygiene.

DAVID FREEDMAN: I think it’s important to remember that this phenomenal ventilation is only phenomenal when the airplane is in the air with the wheels up, with both engines running fully.

GODOY: When you’re in the crowded jetway, getting ready to board or even sitting in your seat on the runway, that ventilation system isn’t always running at full blast, and infectious aerosols can accumulate around you. But when those systems are running, they’re quite effective. Freedman says airplanes filter the air every few minutes, and you’re really only sharing air with the people sitting close to you. Even if other people aren’t wearing a mask though, Freedman is going to keep wearing his close-fitting N95 on flights because it really does protect the wearer.

MARTINEZ: Now, airplanes are only part of this picture. What about trains and buses?

GODOY: Yeah. So data from the subway systems in New York City and San Francisco show they have good air ventilation. If you’re standing shoulder to shoulder with other riders, that ventilation alone won’t be enough. And as for buses, the situation is worse. Jesse Capecelatro of the University of Michigan has researched how air flows on urban buses.

JESSE CAPECELATRO: What we found was if the windows are closed due to sort of the recirculation of the air in the bus, whenever someone breathes out, in about 45 seconds everyone in the bus is breathing in a portion of that.

GODOY: Now, opening windows can make a big difference, but you can’t always do that on buses. Capecelatro’s modeling shows when everyone on a bus is wearing a mask, that dramatically reduces transmission risks. I also spoke with Neil Siegel. He’s a health policy researcher at the University of Maryland. And he says the fact that ventilation tends to be bad on buses raises real equity concerns. Black and Hispanic people are twice as likely to use public transit, and many people with lower incomes rely on it. So the end of mask mandates on buses means people with fewer options for safer travel are now facing increased risk.

MARTINEZ: So what’s next, then, for this battle to control public safety measures?

GODOY: Well, this fight could drag out in the courts. But if the ruling is upheld, it could set a precedent against such sweeping use of federal power in response to declared public health emergencies and limit what the CDC can do the next time there is a serious outbreak.

MARTINEZ: NPR’s Maria Godoy. Thanks a lot.

GODOY: My pleasure.

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MARTINEZ: All right, today the Biden administration offers an approach to drug overdoses.

INSKEEP: This ranks among one of the most devastating problems in the United States. CDC mortality data shows more than 100,000 people died over a 12-month period ending in April 2021. The administration’s goal is harm reduction, ensuring that drug users die less often.

MARTINEZ: Reporter Martha Bebinger of WBUR joins us now to explain the White House strategy. Martha, the White House is emphasizing harm reduction. Exactly what does harm reduction mean?

MARTHA BEBINGER, BYLINE: A, harm reduction includes all of the tools that help drug users stay alive. That’s naloxone, the drug you can squirt into someone’s nostril if they overdose to revive them. It’s also syringe exchange programs to limit the sharing of needles and the spread of infection. It’s fentanyl test strips so drug users can find out if this deadly opioid is in the drug that they’re about to inject or snort. It’s a lot of tools that critics claim enable drug use.

MARTINEZ: All right, so then why is the White House prioritizing this?

BEBINGER: Well, because these tools do save lives. The people who advocate for harm reduction stress you can’t treat someone after they’ve died of a fatal overdose. And White House drug czar Dr. Rahul Gupta insists that harm reduction is an approach that can cut across ideological lines.

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RAHUL GUPTA: This is not a red-state issue or a blue-state issue; this is America’s issue.

BEBINGER: And Dr. Gupta stresses a recent bipartisan congressional report that did recommend adoption of more harm reduction strategies when he was explaining the Biden administration’s plan to, as he says, beat the overdose epidemic.

MARTINEZ: Now, to be clear – this is a federal plan, but access to harm reduction efforts varies a lot from state to state.

BEBINGER: That’s right. There are states that restrict access to naloxone, and we’re seeing needle exchange programs close in some cities and towns around the country. That’s happening in West Virginia, the state with the highest rate of overdose deaths in the U.S. Robin Pollini is an associate professor at West Virginia University. She studies injection drug use and harm reduction efforts.

ROBIN POLLINI: Whether you have access to these services largely depends on where you live.

BEBINGER: And Pollini says there are still federal obstacles, too, like a federal ban on paying for syringes distributed to drug users, and that’s going to make expanding needle exchange programs more difficult.

MARTINEZ: Martha, what else is in the Biden administration’s plan?

BEBINGER: The White House says harm reduction is only part of a larger effort to tackle the two drivers of the overdose crisis – a lack of treatment and drug trafficking. So the other elements include a call to double the number of people in treatment with a focus on people leaving prisons or jails or those who don’t have stable housing. Those are some of the people most at risk. Then to slow the drug supply, the Biden administration is proposing sanctions on drug traffickers, tighter border controls and more international cooperation. The Biden plan also spells out the need for better real-time data on who is most at risk for an overdose. Now, all of these proposals will be sent to Congress today for debate and review.

MARTINEZ: That’s Martha Bebinger of WBUR. Martha, thanks.

BEBINGER: Thank you.

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