2001 Anthrax Attacks Fast Facts | CNN



CNN
 — 

Here’s a look at the 2001 anthrax attacks, also referred to as Amerithrax.

There are four types of anthrax infection: cutaneous (through the skin), inhalation (through the lungs; the most deadly), gastrointestinal (through digestion) and injection anthrax. Injection anthrax is common in heroin-injecting users in northern Europe. This has never been reported in the United States.

Anthrax can be contracted by handling products from infected animals or by breathing in anthrax spores and by eating undercooked meat from infected animals.

It has been blamed for several plagues over the ages that killed both humans and livestock. It emerged in World War I as a biological weapon.

The Centers for Disease Control and Prevention categorizes anthrax as a Category A agent: one that poses the greatest possible threat for a negative impact on public health; one that may spread across a large area or need public awareness and requires planning to protect the public’s health.

Read more: America’s long and frightening history of attacks by mail

Five people died and 17 people were sickened during anthrax attacks in the fall of 2001; outbreak is often referred to as Amerithrax.

Anthrax was sent via anonymous letters to news agencies in Florida and New York and a congressional office building in Washington, DC.

Of the five victims who died of inhalation anthrax, two were postal workers. The other three victims were an elderly woman from rural Connecticut, a Manhattan hospital worker from the Bronx and an employee at a Florida tabloid magazine who may have contracted anthrax through cross-contamination.

The letters were sent to NBC anchor Tom Brokaw, Sen. Majority Leader Tom Daschle, Sen. Patrick Leahy, and the New York Post offices. The letters were postmarked Trenton, New Jersey.

No arrests were made in the attacks.

The FBI has interviewed more than 10,000 people and issued more than 6,000 subpoenas in the case.

4.8 million masks and 88 million gloves were purchased by the Postal Service for its employees, and 300 postal facilities were tested for anthrax.

Over 32,000 people took antibiotics after possible exposure to anthrax.

Stevens, Bob – photo editor at American Media Inc, died of inhalation anthrax, October 5, 2001

Morris, Thomas Jr. – DC postal worker, died of inhalation anthrax, October 21, 2001

Curseen, Joseph Jr. – DC area postal worker, died of inhalation anthrax, October 22, 2001

Nguyen, Kathy – employee at Manhattan hospital, died of inhalation anthrax, October 31, 2001

Lundgren, Ottilie – Connecticut woman, died of inhalation anthrax, November 22, 2001

October 5, 2001 – Sun photo editor Stevens dies of inhalation anthrax.

October 12, 2001 – NBC News announces that an employee has contracted anthrax.

October 15, 2001 – A letter postmarked Trenton, New Jersey, opened by an employee of Senate Majority Leader Daschle contains white powdery substance later found to be “weapons grade” strain of anthrax spores. More than two dozen people in Daschle’s office test positive for anthrax after the envelope is discovered.

October 19, 2001 – An unopened letter tainted with anthrax is found in the offices of the New York Post. One Post employee is confirmed to have a cutaneous infection and a second shows symptoms of the same infection.

October 21, 2001 – DC postal worker Morris Jr. dies of inhalation anthrax.

October 22, 2001 – DC postal worker Curseen dies of inhalation anthrax.

October 31, 2001 – Nguyen, a stockroom worker for the Manhattan Eye, Ear and Throat Hospital, dies of inhalation anthrax.

November 9, 2001 The FBI releases a behavioral profile of the suspect, who is probably a male loner and might work in a laboratory.

November 16, 2001 – A letter sent to Senator Leahy is found to contain anthrax. The letter is among those at the Capitol that has been quarantined. The letter contains at least 23,000 anthrax spores and is postmarked October 9, in Trenton, New Jersey.

November 22, 2001 – Lundgren, a 94-year-old Connecticut woman, dies of inhalation anthrax.

January 2002 – FBI agents interview former US Army bioweapons scientist Steven Hatfill as part of the anthrax investigation.

June 2002 – Bioweapons researcher Hatfill is named a “person of interest” by the FBI.

June 25, 2002 – The FBI searches Hatfill’s Maryland apartment and Florida storage locker with his consent.

June 27, 2002 The FBI says it is focusing on 30 biological weapons experts in its probe.

August 1, 2002 – The FBI uses a criminal search warrant to search Hatfill’s Maryland apartment and Florida storage locker a second time; anthrax swab tests come back negative.

August 6, 2002 Attorney General John Ashcroft refers to Hatfill as a “person of interest.”

August 11, 2002 – Hatfill holds a press conference declaring his innocence. He holds a second one on August 25, 2002.

September 11, 2002The FBI searches Hatfill’s former apartment in Maryland for the third time.

August 26, 2003 – Hatfill files a civil lawsuit against Attorney General John Ashcroft, the Justice Department and the FBI claiming his constitutional rights have been violated. The suit alleges violations of Hatfill’s Fifth Amendment rights by preventing him from earning a living, violations of his Fifth Amendment rights by retaliating against him after he sought to have his name cleared in the anthrax probe and the disclosure of information from his FBI file. The suit also seeks an undetermined amount of monetary damages.

July 11, 2004 – The former headquarters of American Media, Inc. in Boca Raton, Florida, where Stevens contracted the anthrax is pumped full of chlorine dioxide gas for decontamination. This was the last building exposed to anthrax in the fall of 2001.

June 27, 2008 – The Justice Department reaches a settlement with Hatfill. The settlement requires the Justice Department to pay Hatfill a one-time payment of $2.825 million and to buy a $3 million annuity that will pay Hatfill $150,000 a year for 20 years. In return, Hatfill drops his lawsuit, and the government admits no wrongdoing.

July 29, 2008Bruce Ivins, a former researcher at the Army’s bioweapons laboratory at Fort Detrick, Maryland, dies after overdosing during a suicide attempt on July 27.

August 6, 2008 – Judge unseals and releases hundreds of documents in the 2001 FBI Anthrax investigation that detail Ivins’ role in the attacks.

August 8, 2008The Justice Department formally exonerates Hatfill.

September 25, 2008 – The court releases more documents including emails that Ivins sent to himself.

February 19, 2010 – The Justice Department, FBI and US Postal Inspection Service announce its investigation into the 2001 anthrax mailings is at an end.

March 23, 2011 – A report, entitled The Amerithrax Case, is released through the Research Strategies Network, a non-profit think tank based in Virginia. According to the report, old mental health records suggest Ivins should have been prevented from holding a job at a US Army research facility in Maryland. The report was requested by the US Department of Justice.

October 9, 2011 – The New York Times reports indicate there are scientists questioning the FBI assertions regarding Ivins. Possibly Ivins, if he was involved, worked with a partner. Also, the scientists say the presence of tin in the dried anthrax warrants that the investigation be reopened.

November 23, 2011 – The Justice Department settles for $2.5 million with Stevens’ family. The family originally sued for $50 million in 2003, arguing that the military laboratory should have had tighter security.

December 19, 2014 – The Government Accountability Office releases a 77-page report reviewing the genetic testing used by the FBI during the investigation into the anthrax attacks.

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Concerned about the courts, some states and universities are stockpiling abortion drugs | CNN



CNN
 — 

With an eye on the courts, a growing number of Democratic-led states are stockpiling the pills that can be used for a medication abortion, the most common form of the procedure in the US.

The officials want to be prepared, in case US District Judge Matthew Kacsmaryk’s decision to suspend the US Food and Drug Administration’s approval of mifepristone goes through, so medication abortions would still be available in their states for some period of time. But they’re taking different approaches to the idea.

New York Gov. Kathy Hochul announced Tuesday that her state’s Department of Health would buy 150,000 doses of misoprostol, the other of the two drugs typically used in a medication abortion.

Misoprostol can be used off-label for an abortion, without mifepristone, but patients often have to use more of it. It would not be covered by the court case, and if Kacsmaryk’s decision stands, the New York City’s Health Department tweeted, it will change to using this medication only.

“Medication abortion continues to be available at our Sexual Health Clinics and NYC Health + Hospitals locations. Should mifepristone become unavailable, we will continue to make medication abortion accessible to all in NYC by shifting to a misoprostol-only treatment regimen,” the tweet said.

The state says the 150,000 doses should represent a five-year supply of pills.

“Anti-choice extremists have shown that they are not stopping at overturning Roe, and they are working to entirely dismantle our country’s reproductive health care system, including medication abortion and contraception,” Hochul said. “New York will always be a safe harbor for abortion care, and I am taking action to protect abortion access in our State and continue to lead the nation in defending the right to reproductive autonomy.”

California is also stocking up on misoprostol.

“While California still believes Mifepristone is central to the preferred regimen for medication abortion, the State negotiated and purchased an emergency stockpile of Misoprostol in anticipation of Friday’s ruling by far-right federal judge Matthew Kacsmaryk to ensure that California remains a safe haven for safe, affordable, and accessible reproductive care,” Gov. Gavin Newsom’s office said in a release Monday.

California plans to purchase up to 2 million pills through CalRx, a state initiative set up to make drugs more affordable.

The governor’s office said the state now has more than 250,000 pills on hand, which it purchased for about $100,000.

California said it shared the terms of its purchase agreement with other members of the Reproductive Freedom Alliance, a nonpartisan coalition of 21 governors who are committed to protecting reproductive rights, and who might also be interested in taking such action.

Another member of that alliance, Washington Gov. Jay Inslee, announced last week that his state bought a three year-supply of mifepristone, the drug at the center of Kacsmaryk’s ruling.

Inslee directed the state Department of Corrections – which has a pharmacy license and is legally able to buy medications – to buy the drug last month, he said, and the shipment was delivered March 31. The University of Washington also purchased 10,000 doses.

Lawmakers are introducing a bill to authorize officials to distribute or sell the medication to licensed providers throughout the state.

“This Texas lawsuit is a clear and present danger to patients and providers all across the country. Washington will not sit by idly and risk the devastating consequences of inaction,” Inslee said. “Washington is a pro-choice state, and no Texas judge will order us otherwise.”

In the meantime, its attorney general, Bob Ferguson, is helping lead a multistate lawsuit to protect access to mifepristone.

On Friday, the same day Kacsmaryk’s ruling came down, a federal judge in Washington ordered the US not to make any changes that would restrict access to mifepristone in the territories that brought the lawsuit: 17 states and the District of Columbia.

On Monday, Massachusetts Gov. Maura T. Healey announced that at her request, the University of Massachusetts and health care providers have also taken action to stockpile doses of mifepristone.

The governor’s office said last week that the university bought about 15,000 doses of mifepristone, enough to cover the commonwealth for about a year, and the pills are expected to arrive this week. Local health care providers have agreed to buy more, and the government agreed to set aside $1 million to pay for those doses.

The Massachusetts governor also signed an executive order confirming protections for medication abortion under existing law.

“Here in Massachusetts, we are not going to let one extremist judge in Texas turn back the clock on this proven medication and restrict access to care in our state,” Healey said. “The action we are taking today protects access to mifepristone in Massachusetts and protects patients and providers from liability. In Massachusetts, we stand for civil rights and freedom. We will always protect access to reproductive health care, including medication abortion.”

Danco Laboratories, the manufacturer of the brand-name version of mifepristone, says that orders for the drug have increased substantially in recent months and are significantly higher than they were at this time last year.

Demand for mifepristone is up across all types of customers, including clinics, pharmacies and individual providers, said Abby Long, Danco’s director of public affairs. But Massachusetts is the only state that has requested an especially large number of pills from the company.

Maine Gov. Janet Mills, who called the Texas decision “reckless” and a “fundamental assault on women’s rights,” said Monday that her administration is evaluating its options, “including procuring mifepristone if needed, to protect access to medication abortion for Maine women.”

The Connecticut governor’s office said Wednesday that it is also monitoring the situation.

Oregon Gov. Tina Kotek’s office said in an email Wednesday that she has directed the Oregon Health Authority to “explore all available avenues for ensuring Oregon is prepared should Mifepristone become less available. That includes evaluating the supply of Mifepristone and Misoprostol and consulting with providers to better understand the potential impact on the provision of abortion and reproductive health care and what additional support might be necessary.”



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Men with advanced prostate cancer going without life-prolonging medication amid shortage | CNN



CNN
 — 

Doctors across the United States who treat people with advanced prostate cancer can’t find supplies of a medicine that may help them live longer.

Pluvicto, a drug to treat metastatic castration-resistant prostate cancer, also known as mCRPC, is in such short supply that its maker, Novartis, said it cannot allow further supply to new patients until it can produce more of the drug. The company said it is working to produce enough doses to treat existing patients.

“We recognize that this situation is distressing for patients whether they are currently in the treatment process and being rescheduled, or waiting for their first dose of Pluvicto,” Novartis said in a statement to CNN. “Any interruption in the process, from unplanned manufacturing events to doses not arriving in time, may result in patient doses being rescheduled and can have a cascading effect on patients scheduled for future treatment.”

The Swiss company said it has been in touch with treatment centers and providers in the US and is “actively engaging with them to manage rescheduling of patient doses.”

The problem is that Novartis’ manufacturing facility in Ivrea, Italy, can’t keep up with demand for the drug. In May, it had to suspend production at the facility due to what it said was “an abundance of caution” related to potential quality issues. It also paused production at a New Jersey plant that makes the drug for the Canadian market.

Novartis resumed production at both plants in June.

The company hopes to get the New Jersey plant authorized to produce the drug for the US market, but it’s not clear when that might happen. Novartis said in early March that it had completed its filing for approval from the US Food and Drug Administration.

Someone who has a late-stage cancer that has spread to other parts of the body doesn’t have a lot of time to wait for the company to make more, doctors say, nor do they have many other treatment options. So even if Novartis got approval for the New Jersey plant quickly, the help will come too late for many people, according to Dr. Daniel Spratt, chair of the Department of Radiation Oncology at University Hospitals Seidman Cancer Center in Cleveland.

Novartis said it is prioritizing people who are currently being treated with Pluvicto, which is given in six cycles. But Spratt said the supply has recently been too low even for some of these patients.

“Many patients are missing months of therapy,” he said. “The real tragedy is the patients partially under treatment who have had great responses and we can’t get them the rest of their therapy in a timely fashion.”

Next to skin cancer, prostate cancer is the most common cancer in American men, according to the American Cancer Society. Most men do not die from prostate cancer, but about 34,700 people are expected to die from it this year. It’s the second leading cause of cancer death for American men, behind only lung cancer.

Pluvicto is a targeted radioligand therapy, meaning it uses radioactive atoms to deliver radiation to targeted cells, fighting cancer while limiting damage to the surrounding tissues.

There is no cure for this advanced stage of cancer, but Pluvicto can help people live longer. When the drug got FDA approval in March 2022, Spratt said, there was a lot of excitement about its potential. His patients who had heard about the trials have been asking about it for years.

One study from Novartis’ trials found that people who got the drug lived a median of about 15 months after diagnosis, four months longer than the median for people who didn’t get the treatment. For a handful of people, the recovery is even more dramatic.

“There are some patients that really do have those sort of miraculous responses, so it does occasionally give us one of those ‘wow’ moments,” said Dr. William Dahut, chief scientific officer at the American Cancer Society.

Dahut said doctors also like Pluvicto because, compared with other cancer treatments, it’s easy to administer and has relatively few side effects, other than dry mouth.

Another side effect of the shortage is that it’s slowing the progression of research. There is some indication that the drug could help people before their cancer reaches such a late stage.

“We’re anxious to have greater supply to study it in broader populations,” Dahut said.

Spratt said he is working closely with the medical oncologists in his health care system to try to find alternative treatment options, and he’s been looking to get people into clinical trials so they can get access to the therapy.

“But there’s really very few options available,” he said.

Novartis said that if the FDA approves its plant in Milburn, New Jersey, it could supply more Pluvicto as early as this summer.

The agency told CNN that it “is not able to discuss details regarding any possible communications or actions with companies due to commercial confidential information.”

“To be clear, FDA does not manufacture, produce, bottle, or ship drugs and cannot force companies to do so or make more of a drug. However, in general, the FDA works with firms making drugs in shortage to help them ramp up production if they are willing to do so. Often, they need new production lines approved or need new raw material sources approved to help increase supplies. FDA can and does expedite review of these to help resolve shortages of medically necessary drugs.”

Novartis is also building a plant in Indianapolis where the drug will be produced, but that won’t be up and running until the end of the year, the company said.

In the meantime, doctors will often have to tell their patients that they probably won’t be able to help get them this life-extending drug for some time.

“Some men and their physicians will feel that some hope was taken from them,” Spratt siad. “Cancer is the enemy here, not the company, but it’s unfortunate to have that excitement that your physician will be able to prescribe it to you and just not be able to give it to them.”

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One month later, people living near a toxic train derailment wonder if their lives will ever be back on track | CNN


East Palestine, Ohio
CNN
 — 

This had been a quiet little town of about 4,700 people nestled in the rolling hills of Northeast Ohio. A sign posted on State Road 14 welcomes visitors to East Palestine, “the place to be.”

But for the past month, ever since a freight train derailed and caught fire, the town has been bustling with responders and reporters. Residents say they’re grateful for the help, but the attention and uncertainty have begun to strain the town’s hospitality.

Town halls and news conferences have taken over the school auditoriums and municipal buildings and shut down its main street. A clinic opened to address worrisome health questions and symptoms, and government workers have been going door-to-door to survey residents about health impacts.

Gov. Mike DeWine has traveled to East Palestine four times since the derailment and US Environmental Protection Agency Administrator Michael Regan three times, each with entourages of aides and press wranglers. Some business owners near the downtown area are so tired of answering questions, they posted signs asking reporters to stay out.

The streets are busy with utility trucks for environmental clean-up companies TetraTech, Arcadis and AEComm. Plastic hoses snake into Leslie Run and Sulphur Run, two creeks that run through town that were contaminated by the accident. Large pieces of equipment that look like showerheads churn and bubble the water in these streams, hoping to speed the breakdown of chemicals in them.

Still, the floral, fruity odor of the chemical butyl acrylate still wafts up from the streams.

Many residents say they are angry.

Donna Reidy, 62, lives about a mile and a half away from the site in a white house on a hill that overlooks Leslie Run, one of the area waterways contaminated by the spill. On Thursday, she answered questions for a government health study that’s being conducted by the Agency for Toxic Substances and Disease Registry, a division of the US Centers for Disease Control and Prevention.

Reidy said that neither she or her husband – who has lung problems and requires supplemental oxygen – experienced any new or worsening physical symptoms since the derailment. However, her daughter, who also lives in East Palestine, had, she told investigators.

Reidy said her daughter had to gone to the hospital after vomiting and developing a rash. Donna said the stress of trying to protect her husband and worry for her daughter had worsened some anxiety she already struggled with, and she’s afraid of health problems that could arise later on.

“I’ve already had cancer, I don’t want to get it again,” she told Dr. Dallas Shi, an officer in the CDC’s Epidemic Intelligence Service, as they stood in the front yard outside her home.

For the study, called an assessment of chemical exposure, or ACE, Shi is working with a mapping specialist Ian Dunn, a geospatial health scientist and CDC contractor, to interview residents in some of the areas believed to be most impacted by the contamination.

After Reidy answered pages of required questions, Shi and Dunn ask her if there was anything else she wanted them to know.

“Yeah,” she said. “This stuff sucks.”

“We got roots here,” she told them. Five generations of her family lived in East Palestine. Her husband’s father saved money during World War II and sent it home to his wife so they could buy the home they live in today. Her children and grandchildren have gone to the local schools.

“They just ruined everything,” Reidy says, speaking of Norfolk Southern.

“My kids are moving, my grandkids are moving away. They just ruined everything,” she said as she started to cry.

“I’m so sorry,” Shi said, “Can I give you a hug?”

Shi, who was dressed in her dark blue public health service uniform and black work boots, put her arms around Reidy. “I can’t imagine,” she said.

“I’m so mad at them because they’re so cheap and all they cared about was money for themselves,” Reidy went on, speaking through tears. “They should have huge fines against them.”

Then Reidy apologized for getting upset.

On Thursday night, some area residents came to the local high school auditorium for a town hall meeting – their first chance to confront Norfolk Southern since the spill – and expressed similar anger and frustration.

The company was ordered to appear at the town hall by the EPA after declining to participate in earlier events.

“One thing I would like to say … is that we are sorry. We’re very sorry. We feel horrible about it,” said Darrell Wilson, who was representing the company.

The room erupted with shouts of “Buy us out!”

“Do the right thing,” one man shouted. “Tell Alan to buy us out,” referring to Norfolk Southern CEO Alan Shaw.

Several people said they believed staying in their homes was making them ill, but they couldn’t afford to go anywhere else. They want the railroad to buy their homes, which they feel have lost value since the spill.

“Get us out!” some yelled.

“We are going to do the right thing,” Wilson said, responding to the shouts.

Wilson said the company had leased office space in town and “and we signed a long lease. So we’re gonna be here for a long time,” he said..

But when asked whether there had been talk of the company relocating residents, he said there had not.

Some said they had experienced health problems since returning to their homes after the derailment. Others said they had lost their jobs or stopped going to work at jobs they felt were too close to the site. They are worried about their children or grandchildren potentially being exposed to toxins and having health problems down the road.

Some people say they continue to experience symptoms such as headaches, vomiting, dizziness and persistent coughs, and they feel puzzled by ongoing tests of the town’s air and water that have not detected chemicals at levels that are known to pose health risks.

“Why are people getting sick if there are no toxins?” East Palestine resident Jamie Cozza asked the panel answering questions at Thursday’s town hall.

“We do have a team here that is trying to collect health information so that we have a better understanding of the potential exposures and health effects,” said Capt. Jill Shugart, who is an associate director of emergency management at CDC’s Agency for Toxic Substances and Disease Registry, or ATSDR.

The agency is conducting a total of three Assessment of Chemical Exposure, or ACE, investigations – one for Ohio residents, one for people in Pennsylvania, and another for first responders to the accident scene.

Shugart said it would take about three weeks to collect enough information to get an understanding of the full picture, then the agency has to work with Pennsylvania and Ohio to present their findings to residents.

Data from some surveys are starting to come available. On Friday, the Ohio Department of Health released preliminary data from its ACE survey, and out of 168 completed, 74% of people said they experienced headaches, 64% reported anxiety, 61% reported coughing, 58% listed fatigue, and 52% said they had irritation, pain or burning of their skin. The health department is still collecting surveys through its health assessment clinic, which will be open again next week.

Many at the town hall said they felt that the evacuation order had been lifted too soon – less than a week after the derailment – and may have put them in harm’s way, before any potential dangers were fully assessed.

On Thursday, the EPA capitulated to demands from residents and said it would require Norfolk Southern to test for dioxins, cancer-causing chemicals that form during combustion. The EPA had previously declined to require testing for dioxins, saying that these chemicals are already present in the environment, so it’s hard to interpret what their levels mean. The EPA said it would require the railroad company to study background levels of dioxins in comparable areas in order to give some context to the test results.

Authorities have focused much of their concern on a 2-mile radius around the spill, but residents that live farther away, including some farmers in nearby Pennsylvania, say they’ve been impacted, too.

Dave Anderson raises grass fed beef 4 miles downwind of East Palestine, in nearby Darlington Township, Pennsylvania. After the derailment, fire and controlled burn of toxic chemicals, the thick black smoke drifted over his Echo Valley Farm.

“As far as the smoke, you could probably see 100 yards,” Anderson told CNN’s Miguel Marquez.

Anderson said his eyes, throat and mouth burned.

The cloud from the spill settled on his pastures and ponds. Anderson said now he’s not sure whether the grassfed cattle he’s raised for years are safe for human consumption.

So far, there’s been no testing of his water, soil or air on his farm.

Pennsylvania’s Department of Environment Protection, or DEP, just visited Anderson’s farm for the first time this week, nearly four weeks after the event.

In a written statement provided to CNN, the Pennsylvania Department of Agriculture said it launched a hotline encouraging those impacted to reach out if they have concerns about livestock or crops.

Also this week, Pennsylvania opened a community resource center in Darlington to help people who want to get their soil or wells tested. The center is also conducting medical exams for residents with health concerns. Adam Ortiz, regional administrator for EPA’s region 3 office, which includes Pennsylvania, said the center has seen about 100 people a day since it opened.

The crash occurred just feet from the Pennsylvania border. The winds typically blow east, toward Pennsylvania. The state is going house to house, testing soil and water in areas closest to the derailment. Anderson said officials are still trying to figure out if they should extend that testing to other areas.

Samuel Wenger and his wife Joyce had their fourth child, Jackson Hayes, a week ago. Wenger said the state’s response has been too slow and lacking in information to know whether Darlington is still a safe place to raise a family.

They only recently were able to get their well tested, and they were told it would take another three weeks to get the results of that testing. They said it was agonizing to bring their newborn son back to their house when they don’t have answers about contamination.

“I feel like I possibly regret the decision every day but here we live paycheck to paycheck, we live within our means, and we don’t have the financial luxury to pack up and move,” Samuel said. “It’s scary.”

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Ohio, Pennsylvania offer health services following train derailment, but some residents feel skeptical | CNN


Darlington Township, Pennsylvania
CNN
 — 

The municipal building in tiny Darlington Township, Pennsylvania, was buzzing with activity on Wednesday afternoon as a stream of locals arrived seeking information on health screenings, chemical exposures and well testing.

Darlington, home to about 1,800 people, sits just over the border from East Palestine, Ohio, the site of a catastrophic train derailment and controlled burn of toxic chemicals that sent black smoke billowing over the area for days in early February. Residents here say the wind blew acrid smoke into their homes and coated their cars with a fine ash. State and federal officials gave East Palestine residents the all-clear to return to their homes days later.

But residents in both places are now wondering whether their water is safe to drink and their air safe to breathe. The characteristic floral, fruity odor of butyl acrylate still permeates some homes and wafts up from some of the impacted streams that run through the town. Some say they’re experiencing symptoms – cough, headaches, rashes, watering eyes and dripping noses – that might be related to a chemical exposure.

Government-run community resource centers and health clinics have opened in East Palestine and Darlington to answer residents’ questions and connect them to any care they might need. More than 140 people have come to the clinic in East Palestine since it first opened on February 21, according to the Ohio Department of Health. The Darlington center opened February 28, and more than 200 people visited in its first two days, according to the Pennsylvania Department of Health.

Still, some residents are skeptical of the clinics, and the response overall. While many residents who live near the derailment site are following the testing for chemicals in the air and water, what they really want to know is whether they’ve had chemicals from the accident in their bodies, and whether those chemicals have impacted their health.

They’re swapping information online, and seeking out blood tests they hope will identify potential problems. Some are seeking out medical care so there’s a record of their symptoms.

On the advice of a lawyer, Ron Book and his wife came to the East Palestine Health Assessment Clinic on Wednesday afternoon to have their illnesses documented. Book says since the derailment, his nose has been running constantly. He has a sore throat, and he feels stuffy.

“It’s like I have a cold, but I don’t have a cold,” he said.

Book said he saw a doctor who took his vitals and advised him to keep up with the regular blood work that he needs for his ongoing treatment for prostate cancer. He was inside for about 45 minutes, and said the experience was helpful, and about what he expected.

“They can’t heal you,” Book says, “because nobody knows about this chemical.”

At the Darlington center, tables were staffed with experts to answer questions about the chemicals involved in the train derailment, free well and air testing for residents, and potential impacts to area farms.

There were pamphlets on how to manage stress following a disaster and mental health counselors, as well as Zuko, a 3-year-old Great Dane therapy dog.

Residents are also invited to take a nine-page questionnaire to contribute data to a newly launched Assessment of Chemical Exposure, or ACE, study, which is being conducted by the federal Agency for Toxic Substances and Disease Registry. Health investigators can use their data to inform a study into the health effects associated with the chemical exposures after the derailment.

People could see a doctor, or get referrals for a primary care physician.

“I think approximately 40% of people sought some sort of clinical evaluation,” said Nate Wardle, who is the special response project manager for the Pennsylvania Department of Health.

Wardle said when they opened the clinic, they weren’t sure what to expect – whether residents would be angry that it took more than three weeks to get them these services. So far, he said, people have been grateful and eager to get the help.

Jim Denes, who is 71, came to the health clinic in Darlington Township on Wednesday. He said he lives less than 2 miles from the accident site. On Friday of last week, Denes said he felt awful.

“I was just miserable. I was trying to cough up stuff, I couldn’t,” Denes said. “My eyes were all runny and watery.”

He said he took a Covid-19 test, but it was negative.

Denes said he’s extremely tired and had to drag himself to the clinic, but he’s glad he did. The doctor he saw diagnosed him with bronchitis and prescribed an antibiotic. The clinic was a lot closer than his regular doctor in Ellwood City, and he was able to walk in and be seen without a wait.

Denes said the doctor told him he couldn’t say whether it was related to the chemicals that were spilled or not.

Some residents said they have no interest in going to government-run health clinics.

“I honestly, at this point, don’t know who’s working with who and I really just don’t trust anything that has to do with the government right now,” said Giovanni Irizarry, whose family lives within a mile of the train derailment site.

In the evening hours of February 3, his wife Ashley Irizarry was driving to work when she noticed she could see thick black smoke hanging in the air, even though it was dark. Eventually, she saw the raging fire along the railroad tracks.

That night, Ashley had a red rash on her cheeks, her eyes were burning and red and a metallic chemical smell had burned her nose and throat. On Saturday, Giovanni said, his lips burned like he’d had scalding hot soup. Giovanni’s mother, who was living with them, developed a cough so severe she couldn’t catch her breath. The Irizarrys evacuated on Sunday to Boardman, Ohio, about 15 miles away.

They returned home on Saturday, February 11, in anticipation of school restarting on Monday.

As soon as they got close to town, Giovanni said, “I immediately felt my lips like start that burning sensation.”

He and his mom started coughing. His wife and kids developed debilitating and unrelenting headaches. After the kids came home from school on Monday, both started vomiting.

Ashley says she has taken the family to their primary care doctor, an urgent care and the hospital.

“It was not getting better,” she said.

Medical records reviewed by CNN show Ashley was prescribed a steroid and given a chest X-ray due to “toxic effects of gas exposure.” Her son was also diagnosed with chemical exposure.

When the doctors looked into her nose and throat they told her ” ‘Your mucous membranes are all pale. Like they were burned,’ but they didn’t know what to do at this time,” Ashley said in an interview with CNN on Wednesday.

On public Facebook groups, residents are sharing names of providers who will order blood testing for chemical exposures, which isn’t something either of the government-run clinics is doing currently. Some have even tried to do their own research to try to identify the medical codes needed to order tests for specific chemicals in the blood from large labs.

Instead of going to the government health clinic, on Wednesday, Ashley went to see their chiropractor, Richard Tsai, who has been ordering certain blood tests for existing patients who think they have having health problems connected to chemical exposures from the derailment.

Tsai’s practice, Blackhawk Chiropractic, is right next door to the Darlington Township community resource center and clinic that was opened by the Pennsylvania Department of Health and other state agencies this week.

The tests Tsai orders are general and standard in medical care – a test called a complete blood count, which measures levels of red cells, white cells, and clotting factors in the blood; and a test called a basic metabolic panel, which measures blood sugar, electrolytes, and kidney function. If his patients ask for it, he also orders a more specialized test that measure exposure to the chemical benzene. In the past two days, he estimates about 15 patients have asked him for blood testing.

Tsai, who lives in East Palestine, says he’s been frustrated by the government’s response.

“We shouldn’t be having to do this,” Tsai said, in an interview with CNN on Wednesday.

“Why are people having to figure this out on Facebook? These people need to know where to go and what’s available.”

Dr. Bruce Vanderhoff, director of the Ohio Department of Health, pushed back against the idea that the government wasn’t giving people enough information. He said that during the course of the medical assessment at the health clinic, the clinic physician might make recommendations for further testing, but that would be done by the person’s regular doctor.

If people don’t have a doctor that they see regularly, Vanderhoff said they are trying to help residents find one.

Vanderhoff said it would be important for the primary care providers to continue to monitor changes in a patient’s overall health.

“Because when we look at the chemicals involved, especially the primary chemical vinyl chloride, there is simply not a blood test that we can do or a urine test that we can do that would say ‘Aha! You had an exposure,’ ” Vanderhoff said. “That would be great, but that’s just not the case.”

Tsai, who lives in East Palestine, said that he’s legally able to order medical tests, so he does, within limits. “Why wouldn’t you do that?” he said.

Dr. Erin Haynes, the chairperson of the department of epidemiology and environmental health at the University of Kentucky, says she thinks it’s sound for residents to seek out common blood tests.

In an email to CNN, Haynes said in addition to a complete blood count and basic metabolic panel she would add a liver function test, since vinyl chloride, one chemical that was on the train, can damage the liver.

But Haynes says trying to test for specific chemicals may be a step too far.

“Testing for chemical exposure at this point is a difficult,” says Haynes, who has helped impacted communities investigate environmental exposures. “The high levels are now gone, and we aren’t exactly sure what to measure in blood or urine since we don’t know what chemicals formed during the fire. There are suspects, but not clear answers yet.”

Haynes said it would be ideal to collect blood and urine samples now, but store them for later testing, but this would be difficult for a local clinic to do.

Overall, Haynes says the government’s response to chemical spills like this one leaves something to be desired.

“The community is in dire need of an organized and coordinated health monitoring study that includes exposure assessment,” said Haynes, who hopes to bring such a study to the area soon.

Down the road, she says, there’s still a lot to learn about the health impacts of environmental exposures to toxins.

“We also need more research on what these chemicals do and methods for rapid testing,” Haynes said. “Communities with railroad must know what is moving through their community, when and how much. They also must receive training on how to safely respond when a disaster occurs.”

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Damar Hamlin could be released from a Buffalo hospital in the next day or two | CNN



CNN
 — 

A week after suffering a cardiac arrest while playing the Cincinnati Bengals, doctors are hoping Buffalo Bills safety Damar Hamlin is healthy enough to be released from a Buffalo hospital within 24 to 48 hours, Michael Hughes, senior vice president and chief administrative officer at Kaleida Health, told CNN on Tuesday.

Doctors are finishing tests and are identifying possible causes of the event, including whether there were any pre-existing conditions that played a role in Hamlin’s January 2 cardiac arrest.

“Hamlin is going through a series of testing and evaluation today,” Kaleida Health said in a statement Tuesday. The Buffalo General Medical Center team will also “potentially treat any pathology that may be found, as well as plan for his recovery, discharge and rehabilitation.”

Hamlin himself updated his fans Tuesday afternoon.

“Not home quite just yet,” Hamlin tweeted. “Still doing & passing a bunch of test. Special thank-you to Buffalo General it’s been nothing but love since arrival! Keep me in y’all prayers please!”

Hamlin was transferred from a Cincinnati hospital to the Buffalo hospital on Monday after doctors determined his critical condition had improved to good or fair – surpassing expectations.

“We felt that it was safe and proper to help get him back to the greater Buffalo area,” Dr. Timothy Pritts, chief of surgery at the University of Cincinnati Medical Center, said Monday.

Hamlin’s parents flew from Cincinnati back home to Pittsburgh but then flew to Buffalo. They were en route Tuesday from the Buffalo Bills’ practice facility and were expected to arrive at the hospital to see Hamlin soon.

Hamlin, a second-year NFL player, has been regaining strength over the past several days after his sudden collapse after a tackle against the Bengals in Cincinnati.

“He’s certainly on what we consider a very normal to even accelerated trajectory from the life-threatening event that he underwent,” Pritts said, “but he’s making great progress.”

Normal recovery from a cardiac arrest can be measured in weeks to months, Pritts explained. But Hamlin has been beating that timeline at each stage and is neurologically intact.

Still, Pritts said it’s too early to say when Hamlin could get back to normal life or what caused his heart to stop, saying more testing is needed.

Hamlin was sedated and on a ventilator for days after his cardiac arrest. On Friday morning, the breathing tube was removed, and Hamlin began walking with some help by that afternoon, his doctors said Monday.

The safety’s condition was upgraded Monday because his organ systems were stable and he no longer needed intensive nursing or respiratory therapy, doctors said.

“He walks normally,” said Dr. William Knight, a neurovascular critical care expert who treated Hamlin at UC Health. “He is admittedly a little weak. I don’t think that’s of any real surprise after what he went through, just regaining his strength. And that’s part of his recovery process.”

Hamlin’s release Monday meant he could return to Buffalo, which prompted even more encouragement and eagerness for some of his teammates to see him again.

“Super excited that he’s back in Buffalo and what a job that the team of docs and the medical team did out in Cincinnati, and now he’s in great care here in Buffalo. We’re happy to have him back,” Buffalo Bills head coach Sean McDermott told reporters Monday.

After seeing him Monday, McDermott said Hamlin was “tired” but seemed happy. “Happy to be back in Buffalo and around a familiar area to him. I know he’s taking it just one step at a time.”

The coach also said his team has grown since Hamlin was injured, saying such experiences nurture growth.

“We will all have grown as people, and as men in this case,” McDermott said, noting there’s a plan in place for the players and staff to visit Hamlin “at the proper time.”

“Having him nearby will give us more comfort” and inspire the team as it prepares for the postseason, McDermott said.

Although Hamlin was not with the team when they played Sunday against the New England Patriots, his support was definitely felt.

When his team scored a touchdown, Hamlin set off alarms in the ICU, Pritts said.

“When the opening kickoff was run back, he jumped up and down and got out of his chair and set – I think – every alarm off in the ICU in the process, but he was fine, it was just an appropriate reaction to a very exciting play. He very much enjoyed it,” Pritts said.

Hamlin was “beyond excited” Sunday and felt “very supported by the outpouring of love from across the league, especially from the Buffalo area. We’ve learned this week that the Bills mafia is a very real thing,” Pritts added.

The immediate medical response to Hamlin’s collapse helped save his life, and the Buffalo Bills are now encouraging people to learn how to administer CPR.

Assistant athletic trainer Denny Kellington is credited with performing CPR when Hamlin lost his pulse on the field and needed to be revived through resuscitation and defibrillation.

The medical response was part of an emergency action plan that “involves team, independent medical and athletic training staff, equipment and security personnel, and is reviewed prior to every game,” a Monday statement from the Bills read.

The team pledged support for resources including CPR certifications, automated external defibrillator units and guidance developing cardiac emergency response plans within the Buffalo community, according to the statement.

“We encourage all our fans to continue showing your support and take the next step by obtaining CPR certification,” the Bills said.

Clarification: This story has been updated to clarify Hughes’ remarks about Hamlin’s injury and recovery.



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