Joe Biden wins the Democratic Presidential primary in Nevada

Nevada’s dueling Presidential caucuses and primaries this week are creating confusion among voters, and those who cast ballots in the first contest on February 6 had the option of supporting “none of these candidates.”

Nikki Haley ran in Tuesday’s Republican primary, which won’t count for the GOP nomination, while Donald Trump is the only major candidate in Thursday’s Republican caucuses, which does. The split races have undercut the influence of the third state on the GOP calendar.

Also read | Biden sweeps South Carolina; vows to make Trump a ‘loser’

It also may have brought a ho-hum approach to Tuesday’s contests, where the day started with lower-than-expected voter turnout. In the first two hours after polls opened, officials said 183 people had voted in person in Washoe County, the state’s second-largest county by population. In Clark County, home to Las Vegas and Nevada’s most-populated county, 2,298 people voted in person during the same two-hour period. Nevada voters also have the option to vote by mail or before election day.

There was also a Democratic primary on Tuesday that President Joe Biden easily won against author Marianne Williamson and a handful of less-known challengers. Rep. Dean Phillips of Minnesota was not on the ballot.

Jeff Turner (65) came to the Reno Town Mall with a ballot checked off for “none of these candidates” — an option Nevada lawmakers decades ago added in all statewide races, and one that many Trump supporters may choose since the former president and GOP front-runner isn’t on the primary ballot.

Turner’s candidates of choice — Florida Gov. Ron DeSantis and then businessman Vivek Ramaswamy — also would not have been on the ballot had they stayed in the race, since they opted to participate in Thursday’s caucus. Turner is among those people who lament an increasingly likely rematch between Trump and President Joe Biden.

“I think it’s my duty,” Turner said of voting in an election where his candidates of choice are not on the ballot. “I think we all have the right to vote, we ought to vote. And even if it’s none of these candidates, it’s at least stating where I’m at. And I’m hoping others will see that.”

Haley, a former U.N. ambassador, has rejected the Nevada caucuses as unfair and set up by the state party to deliver a victory for the former president. Her campaign balked at the $55,000 fee the Nevada GOP was charging candidates to participate in the caucuses.

“We have not spent a dime nor an ounce of energy on Nevada. We made the decision early on that we were not going to pay $55,000 to a Trump entity to participate in a process that is rigged for Trump,” Haley campaign manager Betsy Ankney told reporters on Monday. “Nevada is not and has not been our focus.”

Haley’s campaign dismissed any concerns about how she might fare in the symbolic primary and has instead focused on her home state of South Carolina and its Feb. 24 primary.

Ralph Eastwood, a 64-year-old retired truck driver from Las Vegas, is a Biden supporter who changed his registration to Republican so he could for for Haley — mainly to vote against Trump.

“Stupid as it may seem, she’s the anti-Trump,” Eastwood said. “Who do you really want to be the president? Somebody who’s had a tried and true ability to to have no real emotional control, to have a long instinct for victimizing people because he can he can?”

Trump, meanwhile, is expected to pick up all of Nevada’s 26 Republican delegates in Thursday’s contest. He needs to accrue 1,215 delegates to formally clinch the party’s nomination but could reach that number in March.

“If your goal is to win the Republican nomination for president, you go where the delegates are. And it baffles me that Nikki Haley chose not to participate,” Trump’s senior campaign adviser Chris LaCivita said in an interview.

Though Biden faced little danger of losing the primary, he campaigned in the Western state Sunday and Monday to start energizing voters ahead of November, when Nevada will be a key swing state.

Speaking Sunday in North Las Vegas, Biden described a potential second Trump presidency as a “nightmare.”

Trump’s campaign advisers also see the primary as an opportunity to test-drive their general election operation.

“It’s a national campaign and this is what national campaigns do,” LaCivita said. “We don’t forget anybody. We don’t take anything for granted.”

The caucuses, to be held Thursday evening, are expected to heavily favor Trump. With his strong grassroots support, Trump already has an advantage when caucuses are held instead of primaries. The contests require organizing supporters around a state and prodding them to show up in person at an appointed hour.

But Nevada’s GOP tipped the scales even further, passing changes that barred any super PACs, like the kind former candidate and Florida Gov. Ron DeSantis was relying on, from helping candidates. The Nevada GOP also barred Republicans from running in the primary election, where they could show support among a broader number of voters, if they wanted to compete in the party-run caucuses.

Nevada’s early-state role is overlooked during election cycles because of its distance from Washington and the notoriety of other early contests in Iowa, New Hampshire and South Carolina.

The state’s longtime locals do not have the same tradition of playing a decisive role, having only been an early state since 2008, when the late Senate Majority Leader Harry Reid, a skilled political power broker, got his home state a slot at the top of the presidential primary calendar.

Nevada’s population moves around a lot, and the state is fast growing, drawing people who may not be familiar with its relatively nascent role.

But setting all that aside, the state has been extra neglected this year with an incumbent president running in the Democratic race, a former president running in the Republican race and his only major challenger mostly ignoring the state.

South Carolina Sen. Tim Scott and former Vice President Mike Pence had also opted to run in the Nevada primary before they ended their campaigns. Because of the timing of their announcements, their names will still appear as an option on the ballots — along with a quirk under Nevada law that allows voters to choose “none of these candidates.”

Nevada lawmakers added “none of these candidates” as an option in all statewide races as a way post-Watergate for voters to participate but express dissatisfaction with their choices. “None” can’t win an elected office but it came in first in primary congressional contests in 1976 and 1978. It also finished ahead of both George Bush and Edward Kennedy in Nevada’s 1980 presidential primaries.

The two processes have been a source of confusion and frustration for voters, said Cari-Ann Burgess, the interim registrar of voters in Washoe County, which includes Reno. For months, her office has received calls from Republican voters asking questions, including, which contest they should vote in and why Trump is not on the primary ballot they received in the mail. Those calls continued on Tuesday.

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Doctors watching for more cases after mysterious cluster of brain infections strikes kids in southern Nevada | CNN


Disease detectives with the US Centers for Disease Control and Prevention are investigating a cluster of rare and serious brain abscesses in kids in and around Las Vegas, Nevada, and doctors from other parts of the country say they may be seeing a rise in cases, too.

In 2022, the number of brain abscesses in kids tripled in Nevada, rising from an average of four to five a year to 18.

“In my 20 years’ experience, I’ve never seen anything like it,” said Dr. Taryn Bragg, an associate professor at the University of Utah who treated the cases.

Pediatric neurosurgeons like Bragg are rare. She is the only one for the entire state of Nevada, and because she treated all the cases, she was the first to notice the pattern and to alert local public health officials.

“After March of 2022, there was just a huge increase,” in brain abscesses, Bragg said. “I was seeing large numbers of cases and that’s unusual.”

“And the similarities in terms of the presentation of cases was striking,” Bragg said.

In almost every case, kids would get a common childhood complaint, such as an earache or a sinus infection, with a headache and fever, but within about a week, Bragg says, it would become clear that something more serious was going on.

After a presentation on the Nevada cases the Epidemic Intelligence Service Conference on Thursday, doctors from other parts of the country said they are seeing similar increases in brain abscesses in kids.

“We’re just impressed by the number of these that we’re seeing right now,” said Dr. Sunil Sood, a pediatric infectious disease specialist at Northwell Health, a health system in New York. He estimates they are seeing at least twice as many as usual, though they haven’t done a formal count. He urged the CDC to continue investigating and work to get the word out.

Brain abscesses are not, by themselves, reportable conditions, meaning doctors aren’t required to alert public health departments when they have these cases.

They typically only come to the attention of public health officials when doctors notice increases and reach out.

Brain abscesses are pus-filled pockets of infection that spread to the brain. They can cause seizures, visual disturbances, or changes in vision, speech, coordination or balance. The earliest symptoms are headaches and a fever that comes and goes. Abscesses often require several surgeries to treat, and kids may spend weeks or even months in the hospital recovering after they have one.

In the Clark County cluster, roughly three-quarters of the cases were in boys, and most were around age 12.

Dr. Jessica Penney is the CDC Epidemic Intelligence Service officer, or “disease detective,” assigned to Southern Nevada Health District, the health department that investigated the cases. She presented her investigation of the Clark County cluster at the CDC’s annual Epidemic Intelligence Service conference on Thursday.

Penney says as they tried to figure out what was driving the increase, they looked at a slew of factors – travel, a history of Covid-19 infection, underlying health, any common activities or exposures – and they didn’t find anything that linked the cases.

Then, she says they decided to look back in time, looking for brain abscess cases in children under 18 all the way back to 2015.

“I felt like that helped us get a better sense of what might be contributing to it,” Penney said in an interview with CNN.

From 2015 to 2020, Penney says the number of cases of brain abscesses in Clark County was pretty stable at around four a year. In 2020, the number of brain abscesses in kids dipped, probably because of measures like social distancing, school closures, and masking – things that shut down the spread of all kinds of respiratory infections, not just Covid-19. In 2021, as restrictions began to lift, the number of these events returned back to normal levels, and then in 2022, a big spike.

“So the thoughts are, you know, maybe in that period where kids didn’t have these exposures, you’re not building the immunity that you would typically get previously, you know with these viral infections,” Penney said. “And so maybe on the other end when we you had these exposures without that immunity from the years prior, we saw a higher number of infections.”

This is a theory called the immunity debt. Doctors have recently seen unusual increases in a number of serious childhood infections, such as invasive group A strep. Some think that during the years of the pandemic, because children weren’t exposed to the number of viruses and bacteria they might normally encounter, it left their immune systems less able to fight off infections.

Sood said he’s not sold on the theory that there’s some kind of immunity debt at work. Instead, he thinks Covid-19 temporarily displaced other infections for a while, essentially crowding others out. Now, as Covid-19 cases have fallen, he thinks other childhood infections are roaring back – he points to unprecedented surge in RSV cases last fall and winter as an example.

Sood says brain abscesses normally follow a very small percentage of sinus infections and inner ear infections in kids. Because they are seeing more of those infections now, the number of brain abscesses has increased proportionally, too.

If immunity debt or a higher burden of infections were to blame, it stands to reason that brain abscesses might have increased in other places, too.

Last year, the CDC worked with the Children’s Hospital Association to find and count brain abscesses in kids, to see if there was any sort of national spike. Data collected through May 2022 did not detect any kind of widespread increase, according to a study published in the Morbidity and Mortality Weekly Report last fall.

But Bragg thinks the data cutoff for the study may have been too early. She says spring 2022 was when she saw cases in her area really take off. She says the CDC is continuing to collect information on brain abscesses and evaluate local and national trends.

About a third of the brain abscesses in the Clark County cluster were caused by a type of bacteria called Streptococcus intermedius that normally hangs out harmlessly in the nose and mouth, where our immune system keeps it in check. But when it gets into places it shouldn’t be, like the blood or brain, it can cause problems.

That can happen after dental work, for example, or when someone has an underlying health condition that weakens their immunity, like diabetes.

That wasn’t the case with the kids in the Clark County cluster, however.

“These are healthy children. With no prior significant medical history that would make them more prone…there wasn’t any known immunosuppression or anything like that,” Bragg says.

Like the cases in Clark County, Sood says most of the kids they are seeing are older, in grade school and middle school. He says until kids reach this age, their sinus cavities are underdeveloped, and haven’t yet grown to their full size. This may make them particularly vulnerable to infection. He thinks these small spaces may become filled with pus and burst. When that happens over the eyebrow, or behind the ear, where the barrier between the brain and sinuses is thinner, the infection can travel to the brain.

Sood says the signs of a sinus infection in kids can be subtle and parents don’t always know what to watch for. If a child gets a cold or stuffy nose and then the next day wakes up with a red and swollen eye, or an eye that’s swollen shut, it’s a good idea to seek medical attention. They may also complain of a headache and point to the spot above their eyebrow as the location of the pain.

Bragg says so far, in 2023, she’s treated two more kids with brain abscesses, but the pace of new cases seems to be slowing down – at least she hopes that’s the case.

Some of the children she treated needed multiple brain and head and neck surgeries to clear their infections.

Sood says in his hospital, doctors have a patient who has been there for two to three months and had five surgeries, although he says she was an extreme case.

Penney says the CDC continues to watch the situation closely.

“We’re going to continue to monitor throughout the year working very closely with our community partners to see you know what, what happens down in Southern Nevada,” she said.

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