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Analysis: Fox News has been exposed as a dishonest organization terrified of its own audience

Analysis: Fox News has been exposed as a dishonest organization terrified of its own audience


New York
CNN
 — 

Fox News has been uncovered like in no way ahead of.

A trove of freshly-introduced textual content messages and emails have laid bare how the correct-wing media huge operated with minimal regard for truth in the weeks and months pursuing the 2020 presidential election. The correspondence reveals that the network’s senior-most executives and maximum-profile hosts selected not to disclose what they thought to be the truth of the election out of fear that that the information would alienate Fox News’ audience and toss the hugely successful business enterprise into damage.

The messages have been contained in a amazing authorized submitting manufactured community on Thursday as aspect of Dominion Voting Systems’ $1.6 billion lawsuit towards Fox Information, displaying the network’s executives and chat hosts privately trashing lies pushed by former President Donald Trump’s camp and his supporters asserting the 2020 election was rigged.

But, irrespective of privately acknowledging the realiity of the condition, the network allowed the lies to get hold on its air, in large portion since executives and hosts had been terrified that telling its sizable viewers the reality would prompt them to tune out.

Just after the election, an incensed Trump had attacked Fox News and encouraged his followers to change to Newsmax, a smaller sized correct-wing speak channel that was saturating its airwaves with election denialism.

Trump was enraged that Fox News was the 1st community to connect with the critical swing point out of Arizona for now-president Joe Biden. And he could not stand that the community, rightfully, declared Biden as the winner of the presidential contest.

In the days and months immediately after the presidential contest experienced been termed, Fox News’ audience listened to Trump and rebelled from the channel. Fox Information get rid of a chunk of its viewers whilst Newsmax acquired important viewership.

Driving the scenes, Fox Information executives and hosts were in stress. Jay Wallace, the Fox News president, described Newsmax’s surge as “troubling” and stated the community essential to be “on war footing.”

Rupert Murdoch, the Fox Corporation chairman, emailed Suzanne Scott, the Fox Information main government, telling her that Newsmax desired to be “watched.” Murdoch reported that he did not “want to antagonize Trump further” and stressed to her, “everything at stake listed here.”

The messages underscore that Fox News did not live up to the primary journalistic theory that news companies are supposed to deliver the news to viewers, with no dread or favor. In its place, the ideal-wing talk channel engineered its protection to attraction to its audience which was actively becoming lied to by Trump and his marketing campaign surrogates.

“Our viewers are good folks and they believe [the election fraud claims],” Tucker Carlson acknowledged in 1 concept to Laura Ingraham.

A 7 days right after the election had been referred to as, Sean Hannity informed Carlson and Ingraham, “In 1 week and one particular discussion they destroyed a manufacturer that took 25 years to build and the destruction is incalculable.”

“It’s vandalism,” Carlson responded.

Hannity then talked over the injury a competitor could really do to Fox Information, describing it as a perhaps “serious dilemma.”

“That could take place,” Carlson replied.

The hosts had been so alarmed by Newsmax’s increase, they have been enraged when their colleague, White House correspondent Jacqui Heinrich, tweeted a mere simple fact check out of Trump’s election lies.

“Please get her fired,” Carlson explained to Hannity. “Seriously What the f**k? I’m really shocked. It needs to cease promptly, like tonight. It is measurably hurting the corporation. The stock price tag is down. Not a joke.”

Hannity mentioned he experienced already spoken to Scott about the make any difference. He then proceeded to criticize two of his other colleagues, Fox News host Neil Cavuto and then-Fox Information anchor Chris Wallace, both of those of whom were crucial of Trump.

“I’m 3 strikes,” Hannity said. “Wallace s**t discussion[.] Election night time a catastrophe[.] Now this BS? Nope. Not gonna fly. Did I point out Cavuto?”

The fear that Fox News’ audience would abandon it for very good also appeared to push programming choices. In the times next the election, Alex Pfeiffer, a Carlson producer, advised the host, “Many viewers ended up upset tonight that we didn’t address election fraud …. It is all our viewers care about appropriate now.”

Carlson stated the determination was a “mistake,” incorporating, “I just despise this s**t.”

Executives at Fox had been so worried about their audience protesting the channel that Scott, the community chief govt, even made an overture to MyPillow CEO Mike Lindell, a notable Fox News advertiser and election conspiracy theorist.

When Lindell appeared on Newsmax and criticized Fox News, executives at Fox News “exchanged worried e-mails about alienating him,” the lawful filing mentioned. The submitting additional that Scott then sent him a handwritten note along with a reward.

In a statement Thursday evening, Fox Information argued that the court filing contained cherry-picked quotations missing context.

“There will be a ton of sounds and confusion produced by Dominion and their opportunistic personal fairness house owners, but the core of this circumstance stays about flexibility of the press and liberty of speech, which are elementary legal rights afforded by the Constitution and safeguarded by New York Instances v. Sullivan,” the community claimed.

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Analysis: This guy made $150,000 a day, because Corporate America is out of control

Analysis: This guy made $150,000 a day, because Corporate America is out of control

Editor’s Notice: A variation of this story appeared in CNN Business’ Nightcap e-newsletter. To get it in your inbox, sign up for no cost, in this article.


New York
CNN
 — 

Reporters typically joke that journalists are going to the “dark side” when they go into PR. Soon after looking at about Geoff Morrell, a hero I didn’t know I essential, I fully grasp the temptation.

Here’s the offer: A regulatory filing from Disney final 7 days, first documented by the Wall Street Journal, has set a spotlight on Morrell’s exceptionally transient but wildly rewarding tenure at the organization.

As the head of Disney’s head of PR for just three months, from January to April of past 12 months, Morrell built about $150,000 a working day, my colleague Chris Isidore stories.

That sum included income, bonuses and $537,438 for relocating his family from London to Los Angeles, as properly as an added $500,000 to “account for his unique circumstances” of acquiring relocating the family yet again on his departure.

On major of that, Disney is getting out the relaxation of Morrell’s contract. He’ll get an supplemental $4 million in the recent fiscal yr that ends October 1 to shell out out the relaxation of his deal, alongside with the target reward he would have obtained for 2022.

So, in complete, altering for an unvested effectiveness bonus and payments yet to arrive, Morrell is strolling absent with $10.3 million for precisely a person-quarter of a year’s do the job. And he’s already landed himself yet another gig as president of the global system and communications device of Teneo, a CEO advisory organization.

Morrell did not react to a request for comment on his Disney shell out offer, and Disney declined to comment past the specifics in the submitting.

Why the short tenure?

Morrell received handed a rather raw deal shortly soon after he begun, when Disney’s then-CEO Bob Chapek waded clumsily into the discussion about Florida’s laws that prohibits training about gender identity and sexual orientation via the 3rd quality — normally recognised as “Don’t Say Gay.”

Long story small, Disney, the state’s largest private employer, tried to continue to be silent on the invoice. Workforce had been furious. So Chapek spoke out towards it. Then Republican leaders were furious.

The business introduced Morrell’s departure inside of times of that PR nightmare.

(To be good, I really don’t think acquiring Olivia Pope on the payroll would have gotten Disney out of that scandal unscathed. But also…someone experienced to get the drop. Ultimately, Chapek also acquired the boot, cushioned by a $20 million severance that just barely usually takes the sting off the embarrassment of getting changed by his personal predecessor, Bob Iger.)

Base line: The tale of Geoff Morrell confirms my suspicion that govt titles are meaningless and Company The usa is all just a major activity that you can discover to participate in medium-well to medium-undesirable and nevertheless make out like a bandit.

Citadel is now the most prosperous hedge fund at any time following bringing in $16 billion past yr. The Miami-dependent fund, founded and run by Ken Griffin, topped the 2022 position of the world’s most effective-accomplishing hedge funds dependent on estimates from LCH Investments.

Citadel’s report-breaking performance very last 12 months took overall gains for the fund given that its inception to practically $66 billion. That knocked Ray Dalio’s Bridgewater — with gains of $58.4 billion — off the top rated place for the to start with time in seven a long time.

As I gaze into my 2023 crystal ball, I’m envisioning the organization and economics tales that will so dominate the news that you are going to all be unwell of them shortly. I’m seeing the phrases “recession,” “crypto,” “debt ceiling,” the “M&M’s spokescandy scandals…”

And nonetheless, I am bound my duty as a journalist not to shy absent from the difficult candy shell information. I know, I know, you’re all fatigued of the media’s relentless coverage of the M&M Spokescandy Saga, aka the Culture War Battle that is shaping social discourse in the Year of Our Lord 2023.

Here’s the matter: Following all the (manufactured?) drama surrounding the de-sexing of the Environmentally friendly M&M and the feminist-ing of her Purple counterpart, M&M is suspending the entire spokescandy campaign. For a little bit, anyway.

The corporation claims it did not believe everyone would detect when it introduced the modifications to the characters’ physical appearance. “We undoubtedly didn’t assume it would break the internet,” it said in a push release that frankly reeked of champagne and higher fives.

Oh you didn’t assume any one would detect, M&M advertising and marketing wizards? Properly, we did.

ICYMI: Very last yr, M&M’s unveiled a new search for its anthropomorphized sweet people.

Even though most of the updates were being delicate, the substitution of Green’s go-go boots for far more-practical-seeking white sneakers — “the variety that Melanie Griffith’s character in Working Lady variations into at her desk to sign she’s a Girlboss with a head for business and a bod for sin,” wrote EJ Dickson in a provocatively titled Rolling Stone short article that, frankly, I would like I’d created — did not escape the internet’s wrath.

“Give Inexperienced her boots back again,” cried a Washington Put up op-ed. A petition to “keep the green M&M sexy” garnered more than 20,000 signatures. M&Ms didn’t give in, but it did note in its statement on Monday that “even a candy’s sneakers can be polarizing.”

Then came an additional change: A new character, Purple, joined the lineup as part of a limited-edition package honoring Worldwide Women’s Working day.

Evidently the gender identification of — and I just cannot worry this plenty of — fictional representations of junk foods in human sort, is fodder for the Fox Information woke police.

“If this is what you want for validation, an M&M that is the shade that you feel is affiliated with feminism, then I’m apprehensive about you,” Fox Information anchor Martha MacCallum said, including that the transfer *checks notes*... emboldened China? “I consider that makes China say, ‘Oh, great, preserve concentrating on that. Preserve focusing on giving individuals their personal colour M&M’S when we consider above all of the mineral deposits in the whole entire world.’”

So somewhat than just, like, disregarding those people performatively pearl-clutchy reactions, M&M’s is having an “indefinite pause” from the spokescandy crew.

Comic Maya Rudolph (10/10, no notes) is stepping in to shill for the brand in the meantime, “allowing the vibrant cast of M&M’s spokescandies to phase away and embrace a new route to pursue other passions,” an M&M’S spokesperson advised CNN in an electronic mail.

My colleague Danielle Wiener-Bronner has more on this unsavory saga.

Experiencing Nightcap? Sign up and you will get all of this, additionally some other funny stuff we liked on the internet, in your inbox every evening. (Okay, most evenings — we believe that in a 4-working day get the job done week about listed here.)

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These US counties still have ‘high’ Covid-19 levels as their states lift mask mandates, CNN analysis shows

These US counties still have ‘high’ Covid-19 levels as their states lift mask mandates, CNN analysis shows

Florida’s Hillsborough County is one particular of them.

In that county on Wednesday, Gov. Ron DeSantis approached a group of pupils carrying masks who were being standing behind a podium at the University of South Florida, wherever the Republican governor was scheduled to hold a news conference. He instructed the college students, “You do not have to use these masks. I suggest, remember to choose them off.”

But in accordance to the CDC’s newest steerage, folks are suggested to nonetheless wear masks indoors in counties that have “superior” amounts of Covid-19, such as Hillsborough County.

The CDC stated Thursday that “far more than 90{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}” of US residents are now in a area with small or medium Covid-19 community ranges. A CNN analysis of the facts finds that 7{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of the US populace is in counties with “superior” Covid-19 group ranges, down from 28{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} previous week.

DeSantis called the students’ mask-donning “preposterous,” but they ended up following CDC suggestions. Dr. Georges Benjamin, government director of the American Public Wellbeing Association, said DeSantis was “bullying” the students for putting on masks.

“Gov. DeSantis has confirmed himself to be somebody who does not comply with excellent science advice, naturally for political factors,” Benjamin told CNN on Thursday. “I was horrified at what he did.”

On Twitter, DeSantis spokeswoman Christina Pushaw doubled down on the governor’s feedback: “I signify, an individual experienced to say it, just after 2 a long time of propaganda that terrified and manipulated youthful men and women. Breathe totally free, truly feel safe and sound and be satisfied.”

Throughout the United States, most of the counties that continue to have substantial Covid-19 degrees, dependent on the CDC’s current metrics, may be afflicted by many things, Benjamin reported: small Covid-19 vaccination fees, constrained entry to health and fitness assets or the continuing spread of the Omicron coronavirus variant.

“Some of these areas ended up spots wherever Omicron kind of hit later on. So like Maine. If you look at Maine proper now, you would think, ‘Maine is extremely vaccinated why is Maine getting hit so greatly? They continue to have an outbreak going on there,’ ” Benjamin explained. “Perfectly, it can be due to the fact they received hit by Omicron afterwards.”

In which Covid-19 is still ‘high’ but mask mandates are lifting

Some of the counties that nevertheless have “significant” degrees of Covid-19 are in states that either never ever experienced indoor mask mandates or lifted their mandates previously on in the pandemic.

New CDC Covid-19 metrics drop strong mask recommendations for most of the country
Last 7 days, California dropped its indoor mask mandate for unvaccinated persons. In that state, 11 counties have “large” degrees of Covid-19. Illinois also lifted its statewide indoor mask requirement and has six counties with “significant” concentrations of Covid-19.
Oregon and Washington prepare to lift their principles requiring masks in indoor community sites on March 11. There are four counties with “significant” levels of Covid-19 in Oregon and four counties with “high” amounts in the point out of Washington, in accordance to the CDC’s updated metrics.

Only 1 state and a single US territory — Hawaii and Puerto Rico — nevertheless have indoor mask mandates on the state or territorial level and have not introduced plans to raise individuals prerequisites.

Even in states the place indoor mask demands are lifted, counties can nonetheless require indoor mask-putting on on the nearby degree, Benjamin told CNN.

“The states are stating, ‘OK, we governors are no more time heading to manage it statewide. We’re now likely to lift a mandate from our point of view, and we are going to make it possible for you to customise this,’ ” he claimed.

With the updated county-level CDC metrics, “I feel the brilliance of what CDC did was, they were being able to pull the knowledge alongside one another at the neighborhood neighborhood degree — to allow neighborhood communities to make individuals decisions when to consider masks [off]. But it also presents them the capacity to re-mask, improve screening plan as they will need to, open and shut items,” Benjamin explained. “I would hope this not only puts it again in the fingers of regional elected officers but it also, I would hope, even a lot more powerfully, places it back in the fingers of neighborhood public health and fitness officials. That’s what I hope.”

As the CDC shifts masking guidance, Americans are split on path forward
The CDC’s “Covid-19 group amount” metrics are centered on 3 parts of info in a community: new Covid-19 hospitalizations, medical center capacity and new Covid-19 instances. The CDC’s internet site consists of a record of US counties and their current Covid-19 stages.

Beneath the CDC guidance, up to date last week, men and women in counties with very low or medium Covid-19 neighborhood stages no for a longer time have to have to wear masks indoors except they are immunocompromised or at “superior danger” for significant Covid-19 and if so, the CDC endorses to communicate to their wellbeing treatment company about sporting a mask.

In places with “superior” Covid-19 community levels, the CDC advises anyone to don a mask in public indoor options, like schools.

At all group concentrations, the CDC also endorses persons get vaccinated and boosted, and get tested if they have indicators.

The CDC’s new metrics are calculated at the county level to make it possible for for a “far more focused” being familiar with of the results of the coronavirus regionally and to inform own steps, these kinds of as mask carrying, as well as community policy decisions, Adriane Casalotti, chief of federal government and general public affairs at the National Association of County and Town Wellbeing Officials, wrote in an e mail to CNN on Thursday.

“Having said that, there are two difficulties for protecting masking specifications at a nearby plan stage. A single would be condition rules that prohibit this kind of action,” Casalotti wrote. “Yet another is less formal: the tension of taking further action. In particular as several in the community want to transfer further than the pandemic, it can be a challenge to proceed insurance policies like indoor masking necessities, even if it tends to make sense scientifically because of to community problems.”

Total, it can be tricky to keep track of regardless of whether there has been an overall shift in mask mandates currently being lifted in locations that continue to have “higher” Covid-19 degrees, Casalotti mentioned.

“This is more durable to observe as a lot of locations dropped — or ended up in the course of action of moving away from — formal masking specifications even right before the new, extra qualified metrics ended up launched,” she wrote.

“In some of all those locations, regional policy often shifted from indoor masking requirements to powerful recommendations for indoor masking or supporting enterprises to make individuals conclusions location by locale,” she additional. “In these areas, the burden is truly put on the unique to know the position of the virus in their local community, how to attain high-top quality masks, and when and wherever to use them to guard by themselves and their families.”

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Vedant Fashion IPO | Full Review | Vedant Fashion IPO GMP Today |Vedant Fashion IPO Detail Analysis| Oakland News Now

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More than 10,000 patients caught Covid-19 in a hospital, analysis shows. They never made it out

They left with covid-19 — if they left at all.

More than 10,000 patients were diagnosed with covid in a U.S. hospital last year after they were admitted for something else, according to federal and state records analyzed exclusively for KHN. The number is certainly an undercount, since it includes mostly patients 65 and older, plus California and Florida patients of all ages.

Yet in the scheme of things that can go wrong in a hospital, it is catastrophic: About 21{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of the patients who contracted covid in the hospital from April to September last year died, the data shows. In contrast, nearly 8{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of other Medicare patients died in the hospital at the time.

Steven Johnson, 66, was expecting to get an infection cut out of his hip flesh and bone at Blake Medical Center in Bradenton, Florida, last November. The retired pharmacist had survived colon cancer and was meticulous to avoid contracting covid. He could not have known that, from April through September, 8{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of that hospital’s Medicare covid patients were diagnosed with the virus after they were admitted for another concern.

Johnson had tested negative for covid two days before he was admitted. After 13 days in the hospital, he tested positive, said his wife, Cindy Johnson, also a retired pharmacist.

Soon he was struggling to clear a glue-like phlegm from his lungs. A medical team could hardly control his pain. They prompted Cindy to share his final wishes. She asked: “Honey, do you want to be intubated?” He responded with an emphatic “no.” He died three days later.

After her husband tested positive, Cindy Johnson, trained in contact tracing, quickly got a covid test. She tested negative. Then she thought about the large number of hospital staffers flowing into and out of his room — where he was often unmasked — and suspected a staff member had infected him. That the hospital, part of the HCA Healthcare chain, still has not mandated staff vaccinations is “appalling,” she said.

“I’m furious,” she said.

“How can they say on their website,” she asked, “that the safety precautions ‘we’ve put into place make our facilities among the safest possible places to receive healthcare at this time’?”

Blake Medical Center spokesperson Lisa Kirkland said the hospital is “strongly encouraging vaccination” and noted that it follows Centers for Disease Control and Prevention and federal and state guidelines to protect patients. President Joe Biden has called for all hospital employees to be vaccinated, but the requirement could face resistance in a dozen states, including Florida, that have banned vaccine mandates.
Cindy Johnson holds a pillow made from a shirt her husband, Steven, used to wear. Steven died of covid-19 in December 2020, and Cindy believes he contracted the virus at Blake Medical Center in Bradenton, Florida, where he was admitted for an infection in his hip. (Eve Edelheit for KHN)
Overall, the rate of in-hospital spread among Medicare and other patients was lower than in other countries, including the United Kingdom, which makes such data public and openly discusses it. On average, about 1.7{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of U.S. hospitalized covid patients were diagnosed with the virus in U.S. hospitals, according to an analysis of Medicare records from April 1 to Sept. 30, 2020, provided by Dr. James Kennedy, founder of CDIMD, a Nashville-based consulting and data analytics company.

Yet the rate of infection was far higher in 38 hospitals where 5{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} or more of the Medicare covid cases were documented as hospital-acquired. The data is from a challenging stretch last year when protective gear was in short supply and tests were scarce or slow to produce results. The Medicare data for the fourth quarter of 2020 and this year isn’t available yet, and the state data reflects April 1 through Dec. 31, 2020.

A KHN review of work-safety records, medical literature and interviews with staff at high-spread hospitals points to why the virus took hold: Hospital leaders were slow to appreciate its airborne nature, which made coughing patients hazardous to roommates and staff members, who often wore less-protective surgical masks instead of N95s. Hospitals failed to test every admitted patient, enabled by CDC guidance that leaves such testing to the “discretion of the facility.” Management often failed to inform workers when they’d been exposed to covid and so were at risk of spreading it themselves.
Spread among patients and staffers seemed to go hand in hand. At Beaumont Hospital, Taylor, in Michigan, 139 employee covid infections were logged between April 6 to Oct. 20 last year, a hospital inspection report shows. Nearly 7{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of the Medicare patients with covid tested positive after they were admitted to that hospital for something else, the federal data shows. A hospital spokesperson said tests were not available to screen all patients last year, resulting in some late diagnoses. He said all incoming patients are tested now.
Tracking covid inside health facilities is no new task to federal officials, who publicly report new staff and resident cases weekly for each U.S. nursing home. Yet the Department of Health and Human Services reports data on covid’s spread in hospitals only on a statewide basis, so patients are in the dark about which facilities have cases.
KHN commissioned analyses of hospital billing records, which are also used more broadly to spot various hospital-acquired infections. For covid, the data has limitations. It can pick up some community-acquired cases that were slow to show up, as it can take two to 14 days from exposure to the virus for symptoms to appear, with the average being four to five days. The records do not account for cases picked up in an emergency room or diagnosed after a hospital patient was discharged.
Linda Moore, pictured with her daughter Stacey Taylor, died of covid-19 in July 2020. Her daughter Trisha Tavolazzi says Moore tested positive after at least 15 days at Havasu Regional Medical Center in Lake Havasu City, Arizona. (Stacey Taylor)

Linda Moore, 71, tested positive at least 15 days into a hospital stay for spinal surgery, according to her daughter Trisha Tavolazzi. Her mother was at Havasu Regional Medical Center in Lake Havasu City, Arizona, which did not have a higher-than-average rate of internal spread last summer.

The hospital implemented “rigorous health and safety protocols to protect all of our patients” during the pandemic, said hospital spokesperson Corey Santoriello, who would not comment on Moore’s case, citing privacy laws.

Moore was airlifted to another hospital, where her condition only declined further, her daughter said. After the ventilator was removed, she clung to life fitfully for 5½ hours, as her daughter prayed for her mother to find her way to heaven.

“I asked her mom and her dad and her family and prayed to God, ‘Please just come show her the way,'” Tavolazzi said. “I relive it every day.”

When Tavolazzi sought answers from the hospital about where her mom got the virus, she said, she got none: “No one ever called me back.”

Two Negative Covid Tests, Then ‘Patient Zero’

As the second surge of covid subsided last September, doctors from the prestigious Brigham and Women’s Hospital published a reassuring study: With careful infection control, only two of 697 covid patients acquired the virus within the Boston hospital. That is about 0.3{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of patients ― about six times lower than the overall Medicare rate. Brigham tested every patient it admitted, exceeding CDC recommendations. It was transparent and open about safety concerns.
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But the study, published in the high-profile JAMA Network Open journal, conveyed the wrong message, according to Dr. Manoj Jain, an infectious-disease physician and adjunct professor at the Rollins School of Public Health at Emory University. Covid was spreading in hospitals, he said, and the study buried “the problem under the rug.”

Before the virtual ink on the study was dry, the virus began a stealthy streak through the elite hospital. It slipped in with a patient who tested negative twice ― but turned out to be positive. She was “patient zero” in an outbreak affecting 38 staffers and 14 patients, according to a study in Annals of Internal Medicine initially published Feb. 9.
That study’s authors sequenced the genome of the virus to confirm which cases were related ― and precisely how it traveled through the hospital.

As patients were moved from room to room in the early days of the outbreak, covid spread among roommates 8 out of 9 times, likely through aerosol transmission, the study says. A survey of staff members revealed that those caring for coughing patients were more likely to get sick.

The virus also appeared to have breached the CDC-OK’d protective gear. Two staff members who had close patient contact while wearing a surgical mask and face shield still wound up infected. The findings suggested that more-protective N95 respirators could help safeguard staff.

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Brigham and Women’s now tests every patient upon admission and again soon after. Nurses are encouraged to test again if they see a subtle sign of covid, said Dr. Erica Shenoy, associate chief of the Infection Control Unit at Massachusetts General Hospital, who helped craft policy at Brigham.

She said nurses and environmental services workers are at the table for policymaking: “I personally make it a point to say, ‘Tell me what you’re thinking,'” Shenoy said. “‘There’s no retribution because we need to know.'”

CDC guidelines, though, left wide latitude on protective gear and testing. To this day, Shenoy said, hospitals employ a wide range of policies.

The CDC said in a statement that its guidelines “provide a comprehensive and layered approach to preventing transmission of SARS-CoV-2 in healthcare settings,” and include testing patients with “even mild symptoms” or recent exposure to someone with covid.

Infection control policies are rarely apparent to patients or visitors, beyond whether they’re asked to wear a mask. But reviews of public records and interviews with more than a dozen people show that at hospitals with high rates of covid spread, staff members were often alarmed by the lack of safety practices.

Nurses Sound the Alarm on Covid Spread

As covid crept into Florida in spring 2020, nurse Victoria Holland clashed with managers at Blake Medical Center in Bradenton, where Steven Johnson died.

She said managers suspended her early in the pandemic after taking part in a protest and “having a hissy fit” when she was denied a new N95 respirator before an “aerosol-generating” procedure. The CDC warns that such procedures can spread the virus through the air. Before the pandemic, nurses were trained to dispose of an N95 after each patient encounter.

When the suspension was over, Holland said, she felt unsafe. “They told us nothing,” she said. “It was all a little whisper between the doctors. You had potential covids and you’d get a little surgical mask because [they didn’t] want to waste” an N95 unless they knew the patient was positive.

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Holland said she quit in mid-April. Her nursing colleagues lodged a complaint with the Occupational Safety and Health Administration in late June alleging that staff “working around possible Covid-19 positive cases” had been denied PPE. Staff members protested outside the hospital in July and filed another OSHA complaint that said the hospital was allowing covid-exposed employees to keep working.

Kirkland, the Blake spokesperson, said the hospital responded to OSHA and “no deficiencies were identified.”

The Medicare analysis shows that 22 of 273 patients with covid, or 8{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, were diagnosed with the virus after they were admitted to Blake. That’s about five times as high as the national average.

Kirkland said “there is no standard way for measuring COVID-19 hospital-associated transmissions” and “there is no evidence to suggest the risk of transmission at Blake Medical Center is different than what you would find at other hospitals.”

In Washington, D.C., 34 Medicare covid patients contracted the virus at MedStar Washington Hospital Center, or nearly 6{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of its total, the analysis shows.

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Unhappy with the safety practices ― which included gas sterilization and reuse of N95s — National Nurses United members protested on the hospital lawn in July 2020. At the protest, nurse Zoe Bendixen said one nurse had died of the virus and 50 had gotten sick: “[Nurses] can become a source for spreading the disease to other patients, co-workers and family members.”

Nurse Yuhana Gidey said she caught covid after treating a patient who turned out to be infected. Another nurse ― not managers doing contact tracing ― told her she’d been exposed, she said.

Nurse Kimberly Walsh said in an interview there was an outbreak in a geriatric unit where she worked in September 2020. She said management blamed nurses for bringing the virus into the unit. But Walsh pointed to another problem: The hospital wasn’t covid-testing patients coming in from nursing homes, where spread was rampant last year.

MedStar declined a request for an interview about its infection control practices and did not respond to specific questions.

While hospitals must track and publicly report rates of persistent infections like C. diff, antibiotic-resistant staph and surgical site infections, similar hospital-acquired covid rates are not reported.
KHN examined a different source of data that Congress required hospitals to document about “hospital-acquired conditions.” The Medicare data, which notes whether each covid case was “present on admission” or not, becomes available months after a hospitalization in obscure files that require a data-use agreement typically granted to researchers. KHN counted cases, as federal officials do, in some instances in which the documentation is deemed insufficient to categorize a case (see data methodology, below).

For this data, whether to deem a covid case hospital-acquired lies with medical coders who review doctors’ notes and discharge summaries and ask doctors questions if the status is unclear, said Sue Bowman, senior director of coding policy and compliance at American Health Information Management Association.

She said medical coders are aware that the data is used for hospital quality measures and would be careful to review the contract tracing or other information in the medical record.

If a case was in the data KHN used, “that would mean it was acquired during the hospital stay either from a health care worker or another patient or maybe if a hospital allowed visitors, from a visitor,” Bowman said. “That would be a fair interpretation of the data.”

The high death rate for those diagnosed with covid during a hospital stay — about 21{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} — mirrors the death rate for other Medicare covid patients last year, when doctors had few proven methods to help patients. It also highlights the hazard unvaccinated staffers pose to patients, said Jain, the infectious-disease doctor. The American Hospital Association estimates that about 42{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of U.S. hospitals have mandated that all staff members be vaccinated.

“We don’t need [unvaccinated staff] to be a threat to patients,” Jain said. “[Hospital] administration is too afraid to push the nursing staff, and the general public is clueless at what a threat a non-vaccinated person poses to a vulnerable population.”

Cindy Johnson believes her husband, Steven, caught covid-19 from staff at Blake Medical Center in Bradenton, Florida, in November 2020. After his death, she asked a doctor who sees patients at the hospital to take down the big "OPEN & SAFE" sign outside. (Cindy Johnson)
Cindy Johnson said the hospital where she believes her husband contracted covid faced minimal scrutiny in a state inspection, even after she said she reported that he caught covid there. She explored suing, but an attorney told her it would be nearly impossible to win such a case. A 2021 state law requires proof of “at least gross negligence” to prevail in court.

Johnson did ask a doctor who sees patients at the hospital for this: Please take down the big “OPEN & SAFE” sign outside.

Within days, the sign was gone.

KHN requested custom analyses of Medicare, California and Florida inpatient hospital data to examine the number of covid-19 cases diagnosed after a patient’s admission.

The Medicare and Medicare Advantage data, which includes patients who are mostly 65 or older, is from the Medicare Provider Analysis and Review (MedPAR) file and was analyzed by CDIMD, a Nashville-based medical code consulting and data analytics firm. The data is from April 1 through Sept. 30, 2020. The data for the fourth quarter of 2020 is not yet available.

That data shows the number of inpatient Medicare hospital stays in the U.S., including the number of people diagnosed with covid and the number of admissions for which the covid diagnosis was not “present on admission.” A condition not “present on admission” is presumed to be hospital-acquired. The data is for general acute-care hospitals, which may include a psychiatric floor, and not for other hospitals such as Veterans Affairs or stand-alone psychiatric hospitals.

KHN requested a similar analysis from California’s Department of Health Care Access and Information of its hospital inpatient data. That data was from April 1 through Dec. 31, 2020, and covered patients of all ages and payer types and in general, private psychiatric and long-term acute-care hospitals. Etienne Pracht, a University of South Florida researcher, provided the number of Florida covid patients who did not have the virus upon hospital admission for all ages at general and psychiatric hospitals from April 1 through Dec. 31, 2020. KHN subtracted the number of Medicare patients in the MedPAR data from the Florida and California all-payer datasets so they would not be counted twice.

To calculate the rate of Medicare patients who got covid or died, KHN relied on the MedPAR data for April through September. That data includes records for 6,629 seniors, 1,409 of whom, or 21{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, died. California data for all ages and payer types from April through December shows a similar rate: Of 2,115 who contracted covid after hospital admission, 435, or 21{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, died. The MedPAR data was also used to calculate the national nosocomial covid rate of 1.7{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, with 6,629 of 394,939 covid patients diagnosed with the virus that was deemed not present on admission.

Data on whether an inpatient hospital diagnosis was present on admission is used by Medicare for payment determinations and is intended to incentivize hospitals to prevent infections acquired during hospital care. It is also used by the U.S. Agency for Healthcare Research and Quality to “assist in identifying quality of care issues.”

Whether covid is acquired in a hospital or in the community is measured in different ways. Some nations assume the virus is hospital-acquired if it is diagnosed seven or more days after admission, while statewide U.S. data counts cases only after 14 days.

Medical coders who examine medical records for this inpatient billing data focus on the physician’s admission, progress and discharge notes to determine whether covid was present on admission. They do not have a set number of days they look for and are trained to query physicians if the case is unclear, according to Sue Bowman, senior director of coding policy and compliance at the American Health Information Management Association.

KHN tallied the cases in which covid was logged in the data as not “present on admission” to the hospital. Some covid cases are coded as “U” for having insufficient documentation to make a determination. Since Medicare and AHRQ consider the “U” to be an “N” (or not present on admission) for the purposes of payment decisions and quality indicators, KHN chose to count those cases in the grand total.

In 409 of 6,629 Medicare cases and in 70 of 2,185 California cases, the “present on admission” indicator was “U.” The Florida data did not include patients whose “present on admission” indicator was “U.” Medical coders have another code, “W,” for “clinically undetermined” cases, which consider a condition present on admission for billing or quality measures. Medical coders use the “U” (leaning toward “not present on admission”) and “W” (leaning toward “present on admission”) when there is some uncertainty about the case.

The Medicare MedPAR data includes about 2,500 U.S. hospitals that had at least a dozen covid cases from April through September 2020. Of those, 1,070 reported no cases of hospital-acquired covid in the Medicare records. Data was suppressed for privacy reasons for about 1,300 hospitals that had between one and 11 hospital-acquired covid cases. There were 126 hospitals reporting 12 or more cases of covid that were not present on admission or unknown. For those, we divided the number of hospital-acquired cases by the total number of patients with covid to arrive at the rate of hospital-acquired cases, as is standard in health care.