1
World
Ebola Reaches Capital of Guinea, Stirring Fears
With 13 Ebola cases in Conakry, Guinea’s densely populated capital, residents are on edge, with some carrying bottles of bleach and pharmacies selling out of hand sanitizer.Ebola virus disease, West Africa (Situation as of 5 April 2014)
The current number of clinical and confirmed cases and deaths by place of report is Conakry (18 cases, including 5 deaths), Guekedou (85 cases/59 deaths), Macenta (27 cases/14 deaths), Kissidougou (9 cases/5 deaths), and Dabola and Djingaraye combined (4 cases/3 deaths). Sixteen of the 18 clinical cases in Conakry have been laboratory confirmed for EVD. There has been no increase in the number of affected health care workers (HCW) from the 14 reported previously, including 8 deaths; 11 of the affected HCWs are laboratory confirmed cases. Sixteen of the 86 deaths overall are laboratory confirmed, 65 are classified as probable cases and 5 as suspected cases.
Case investigation and contact tracing are continuing, with 623 contacts requiring medical follow-up; this includes 74 new contacts identified on 3 April while 49 have been released from observation as they have remained well after the maximum incubation period for EVD of 21 days following the last exposure to a case. Laboratory support for the investigation is being provided by Institut Pasteur Dakar, Senegal, and the mobile laboratory in Guekedou. Reference laboratory functions have been provided by Institut Pasteur Lyon, France, the Bernhard-Nocht Institute of Tropical Medicine Hamburg, Germany, and the Centre International de Recherche en Infectiologie (CIRI) laboratory in Lyon, France.
WHO, in collaboration with technical partners in the Global Outbreak Alert and Response Network (GOARN) has deployed field laboratory support, and experts in anthropology, epidemiology, logistics, clinical case management and infection prevention and control and outbreak coordination to support the response in Guinea.
The Ministry of Health and Social Welfare (MOHSW) of Liberia has reported 18 suspected and 2 confirmed cases of EBV, including 7 deaths, since 24 March (CFR 31%); 7 patients are currently in an isolation unit while 2 suspected cases have been discharged. Four new clinically compatible cases were reported on 4 April. One of the suspected cases is in a health care worker. Both of the laboratory confirmed cases, sisters from Lofa County, have died. The suspected cases include a hunter treated at a hospital in Tapita, Nimba County, who died shortly after presenting to the health facility and a 3 year old boy with a clinically compatible illness who had travelled from Guinea. The deceased hunter gave no history of contact with known cases in Liberia or Guinea and his exposure is being investigated to exclude transmission from an animal source (bush meat). The laboratory results for both of these suspected cases are pending. The MOHSW has placed 46 contacts under medical observation, including those of the second confirmed case who travelled from Foyah, Lofa Country, to Monrovia, Montserrado Country, and then to Firestone in Margibi County. A total of 21 clinical samples have been sent to Conakry, Guinea, for laboratory testing. Counties of concern for EVD in Liberia include Lofa, Bong, Nimba, Margibi and Montserrado.
In response, Liberia has been scaling up activities to prevent the further spread of EVD. The National Task Force is conducting daily coordination meetings with response partners. WHO continues to provide technical expertise to the MOHSW, including public communications, providing a high level briefing on EVD prevention and control to the joint session of both houses of parliament and mobilising experts in epidemiology and infection prevention and control. The WHO Country Office in Liberia is working closely with the MOHSW to carry out needs assessments in areas such as procurement and the supply chain for critical materials and equipment need in the response to the outbreak. WHO is also working with the health information systems team at the MOHSW to further develop templates for case-based data collection and to track technical assistance. Additional deployments of regional experts, and partners in GOARN, are planned to support coordination activities, infection prevention and control, risk communications and social mobilisation. At the request of the MOHSW and WHO, the Metabiota Laboratory in Kenema, Sierra Leone, will install Real-Time Zaire ebolavirus-specific PCR, a pan-filo PCR, Lassa virus PCR, yellow fever and Marburg virus PCRs among other assays. This technology is being transferred from its laboratory in Kenema, Sierra Leone. Metabiota will also provide training to laboratory staff in Liberia.
Medical supplies and equipment have been provided by WHO, UNHCR, MSF, Save the Children and other partners, including personal protective equipment for health care facilities. Seven isolation units have been established in 5 counties. Médecins Sans Frontières (MSF) is conducting training for health care workers in the affected counties on case management, including on setting up isolation facilities. An additional 60 HCWs have been trained in Margibi County. Community education and social mobilisation activities have been strongly supported by the media and telecommunications sectors in Liberia. Local government officials, community and religious leaders and traditional healers have been approached to support the MOHSW in prevention and control activities; however, additional resources are needed to expand surveillance and health promotion and social mobilisation activities to schools, religious gatherings, market places and work places. Plans are also underway to mobilise the public through house-to-house visits.
The Ministry of Health of Mali has notified WHO of 4 patients suspected to have a viral haemorrhagic fever who presented for health care in Sibiribougou, Koulikoro Region of Mali. Two of the suspected cases had travelled from Guinea. The patients were placed in isolation pending epidemiological investigations and laboratory testing. Contact tracing is underway. Clinical samples have been sent to the Centers for Disease Control and Prevention (CDC), Atlanta, United States, for testing. Epidemiological surveillance is being enhanced on the ground and Rapid Response Teams are being mobilised to identify and treat suspected cases should others present. An isolation unit has been prepared in Bamako and units are also being installed in other locations. Information hotlines are being made available to the public.
There has been no change in the situation in Sierra Leone following the deaths of 2 probable cases of EVD in one family who died in Guinea and their bodies repatriated to Sierra Leone. The office of the Chief Medical Officer (CMO) is coordinating all operations involving suspected cases of Ebola as well as the follow-up investigations. Enhanced surveillance and public education activities are continuing. Senior officials from the Ministry of Health and Sanitation (MOHS) have visited border crossings between Sierra Leone and Guinea to sensitise border authorities about current prevention and response plans and public health medical officers are visiting border communities to support social mobilisation activities. Metabiota Laboratory in Kenema working under the MOHS and with the WHO Country Office in Sierra Leone, has established a full suite of ebolavirus-specific assays and differential diagnostics for other important viral haemorrhagic fevers that are locally endemic. The full range of assays is described in the section of this report for Metabiota activities in Liberia.
As this is a rapidly changing situation, the number of reported cases and deaths, contacts under medical observation and the number of laboratory results are subject to daily changes due to consolidation of case, contact and laboratory data, enhanced surveillance and contact tracing activities and ongoing laboratory investigations.
WHO does not recommend that any travel or trade restrictions be applied to Guinea, Liberia, Sierra Leone or Mali based on the current information available for this event."
2
N.Y. / Region
Rivals for New York Casino Licenses Must Pay Millions to Play
It will take a fortune just to open the doors of a full-scale casino resort in New York, starting with a $1 million nonrefundable application fee.
3
Automobiles
A Few Auto Industry April Fools’ Day Pranks
Every April 1, automakers and automotive publications crank out a few silly jokes and pranks in celebration of the world’s strangest celebration.
4
World
Religious Tensions Cloud Myanmar Census
The nationwide count has been criticized because the government has denied members of a long-persecuted Muslim minority the right to identify themselves as Rohingya."The census faces several challenges. In the past censuses of 1973 and 1983, the country's ongoing armed conflicts put many parts of the country out of reach. As a result, several thousands of people (many of whom were hill-tribe peoples) in border regions were never counted. Another challenge is to ensure that everyone, regardless of his or her citizenship, is counted. These include the Rohingya in northern Rakhine State, who are officially classified as stateless,[9] as well as hundreds of thousands of immigrants from China, who have illegally entered the country since the last census.[10] Other challenges include a systemic lack of expertise—most of the civil servants who worked on the 1973 and 1983 censuses are now retired, low levels of awareness among the population about the census, and the difficulty of reaching areas with active fighting such as Kachin State, Shan State and Kayin State.[4]
Burmese government is planning to count Burmese refugees living in Thailand, which is estimated to be around 130,000 people, and Burmese nationals living abroad in the 2014 census. Rohingya, described as Bengalis in Burma, will be counted under the other category on the census along with ethnic Chinese and Pakistani residents.[11] On 29 March 2014, the government banned the word Rohingya and asked muslims to register themselves as Bengalis despite UN assurances.[12][13][14]
5
N.Y. / Region
Holder, in New York City, Calls Terror Trials Safe
Attorney General Eric H. Holder Jr. said that last week’s conviction of Sulaiman Abu Ghaith had “proven beyond any doubt” that terrorism trials can “safely occur” in New York City.
6
Business Day
European Finance Ministers Approve New Loans for Greece
Pointing to signs that Greece is emerging from its economic crisis, euro zone finance ministers approved the release of 8.3 billion euros in rescue loans.
7
N.Y. / Region
Proposal Would Provide New York Police With Kits to Combat Overdoses
State Attorney General Eric T. Schneiderman on Thursday is expected to announce a push to have law enforcement officers carry a drug that is effectively an antidote to overdose.
8
Business Day
Fake Meats, Finally, Taste Like Chicken
Demand is growing from younger consumers seeking a more healthful or more ethical diet, but innovation is pushed by investors who see a potential solution to big problems.
9
Dining & Wine
Tavern on the Green Accepting Reservations
After two years of renovations, Tavern on the Green in Central Park will open for dinner on April 24.
10
Fashion & Style
Banking on My Future as a Father
A spate of reports on potential fertility problems among older men sends the author on a mission to the sperm bank.
11
U.S.
Law May Force Drilling on Balking Landowners
Houston-based Hilcorp seeks to use a 1961 Pennsylvania law to drill under the property of four holdout landowners in New Bedford.
12
World
Turkey Lifts Twitter Ban After Court Calls It Illegal
The social media site was unblocked after a two-week ban, following a ruling from the country’s highest court that the ban violated freedom of expression.
13
Fashion & Style
‘I Believe in the Valor of Pallor’
The writer Jill Kargman talks about staying out of the sun and why she wants to look like Veronica, the comics character.
14
U.S.
Chicago Mayor Seeks Alterations to Repair Badly Underfunded Pension Plan
Rahm Emanuel wants to raise property taxes and require some city workers and retirees to contribute more for their retirement benefits to repair a pension system at risk of insolvency.
15
Technology
Apple and Samsung Reprise Patent Fight (With Google a Shadow Presence)
The lawsuit is Apple’s second big patent action against Samsung Electronics, and the proceedings took on an air of something of a reunion bringing together a vastly dysfunctional family.
16
N.Y. / Region
Friends Without Words
Jaime Herrera, who has been deaf since he was a child, is a janitor at the main branch of the New York Public Library.
17
U.S.
Letter Tells of U.S. Searches for Emails and Calls
The letter, from the director of national intelligence to a senator, underscored that such activity was not just theoretical.Delays in Effort to Refocus C.I.A. From Drone War
WASHINGTON — In the skies above Yemen, the Pentagon’s armed drones
have stopped flying, a result of the ban on American military drone
strikes imposed by the government there after a number of botched
operations in recent years killed Yemeni civilians. But the Central Intelligence Agency’s drone war in Yemen continues.
In Pakistan, the C.I.A. remains in charge of drone operations, and may continue to be long after American troops have left Afghanistan.
And in Jordan,
it is the C.I.A. rather than the Pentagon that is running a program to
arm and train Syrian rebels — a concession to the Jordanian government,
which will not allow an overt military presence in the country.
Just over a year ago John O. Brennan,
the C.I.A.’s newly nominated director, said at his confirmation hearing
that it was time to refocus an agency that had become largely a
paramilitary organization after the Sept. 11 attacks toward more
traditional roles carrying out espionage, intelligence collection and
analysis. And in a speech last May in which he sought to redefine
American policy toward terrorism, President Obama
expanded on that theme, announcing new procedures for drone operations,
which White House officials said would gradually become the
responsibility of the Pentagon.
But change has come slowly to the C.I.A.
“Some
might want to get the C.I.A. out of the killing business, but that’s
not happening anytime soon,” said Michael A. Sheehan, who until last
year was the senior Pentagon official in charge of special operations
and now holds the distinguished chair at West Point’s Combating Terrorism Center.
A
number of factors — including bureaucratic turf fights, congressional
pressure and the demands of foreign governments — have contributed to
this delay. At the same time, Mr. Brennan is facing a reckoning for
other aspects of the C.I.A.’s role at the forefront of the secret wars
the United States has waged since 2001.
The
declassification of a scathing report by the Senate Intelligence
Committee about the agency’s detention and interrogation program will
once again cast a harsh light on a period of C.I.A. history Mr. Brennan
has publicly disavowed. The Justice Department has been drawn into a
dispute between the agency and the committee, and is looking into a
charge by Senator Dianne Feinstein, the committee’s chairwoman, that the
agency broke the law by monitoring computers of committee staff working
on the report.
Before
taking charge of the C.I.A. last March, Mr. Brennan had spent four
years as Mr. Obama’s top counterterrorism adviser, a job that put him in
charge of the targeted killing operations that became a signature of
the Obama administration’s approach to terrorism. It also made Mr.
Brennan — who before working for Mr. Obama had spent 25 years at the
C.I.A. — a powerful influence on a president with no experience in
intelligence.
American
officials said that in that role Mr. Brennan repeatedly cautioned Mr.
Obama that the C.I.A.’s counterterrorism mission threatened to attenuate
the agency’s other activities, most notably those of penetrating
foreign governments and analyzing global trends. During his confirmation
hearings, Mr. Brennan obliquely criticized the performance of American
spy agencies in providing intelligence and analysis of the Arab
revolutions that began in 2009, and said the C.I.A. needed to cede some
of its paramilitary role to the Pentagon.
“The C.I.A. should not be doing traditional military activities and operations,” he said.
But
now Mr. Brennan is in charge of a counterterrorism apparatus that has
steadily grown in budget, manpower and influence for more than a decade.
While officials said that Mr. Brennan has pushed for more resources to
counter traditional adversaries like Russia and China, as well as newer
threats like cyberwarfare, the agency’s Counterterrorism Center, known as the CTC, remains a powerful force both inside the agency and on Capitol Hill.
“I
think that most of the C.I.A. is behind the changes, but the CTC
community has grown dramatically since 9/11 and is fighting to keep its
turf,” Mr. Sheehan said. “And, they’ve been somewhat successful in that
regard, especially with the drone programs.”
Influential
lawmakers from both parties have fought to protect the C.I.A.’s role in
the drone wars and prevent the proposed shift of the bulk of drone
operations to the Pentagon.
Both
Ms. Feinstein and Representative Mike Rogers of Michigan, chairman of
the House Intelligence Committee, have urged Mr. Brennan to push back
against the White House policy announced last May, citing what they
regard as the Pentagon’s poor performance in lethal operations outside
of Iraq and Afghanistan.
A
number of bungled drone strikes carried out by the Joint Special
Operations Command in Yemen led the government there in recent months to
temporarily ban drone strikes by the military, which are launched from
an American base in Djibouti.
Officials
said that the ban, not previously reported, came after a military drone
strike in December killed a number of civilians who were part of a
wedding procession in a desolate region south of Yemen’s capital, Sana.
Meanwhile, the C.I.A. continues to wage its own drone war in Yemen, launching the unmanned planes from Saudi Arabia.
In
Pakistan, where the C.I.A. also is in charge of the drone program, the
pace of strikes has declined sharply, and there have been none since the
government in Islamabad formally entered peace talks with the Pakistani
Taliban, according to the Bureau of Investigative Journalism, a group that tracks drone strikes.
But
American officials said that the drone program there could continue for
years, and Pakistan’s government has long insisted that it be run by
the C.I.A., not the American military.
This
was one of the terms of the deal reached a decade ago between the Bush
administration and Pervez Musharraf, then the president of Pakistan, who
said he would allow armed drone strikes in the country’s tribal areas
only if they were conducted as a C.I.A. covert action and not
acknowledged by either country. For Pakistan to agree to any changes in
this arrangement, the United States would most likely have to agree to
integrating Pakistan’s military into the drone operations.
A
White House spokeswoman said there had been “no change in policy” since
President Obama’s speech last May announcing changes to the targeted
killing policy.
“The
plan is to transition to these standards and procedures over time, in a
careful, coordinated and deliberate manner,” said Caitlin Hayden, the
spokeswoman. “I’m not going to speculate on how long the transition will
take, but we’re going to ensure that it’s done right and not rushed.”
It
was during the string of revolts across the Arab world several years
ago that concerns first surfaced that the years of focus on targeting
terrorists had undermined the C.I.A.’s ability to forecast and analyze
global events. In Egypt, the agency had few sources beyond Omar Suleiman.
The country’s intelligence chief and one of the agency’s closest
partners in the Middle East, Mr. Suleiman was not about to give the
C.I.A. an honest assessment of the fragility of President Hosni
Mubarak’s government.
Responding
to a written question from the Senate Intelligence Committee during his
confirmation process, Mr. Brennan said that “with billions of dollars
invested in C.I.A. over the past decade, policy maker expectations of
C.I.A.’s ability to anticipate major geopolitical events should be
high.”
“Recent
events in the Arab world, however, indicate that C.I.A. needs to
improve its capabilities and its performance still further.”
The
previous year, a panel of advisers had warned Mr. Obama that American
spy agencies were overly focused on paramilitary operations, at the
expense of intelligence collection in the Middle East, China and other
locations.
Philip
D. Zelikow, a former member of the panel, called the report a “very
broad critique” of the C.I.A., and said the agency should not be
carrying out drone strikes.
“I
think these kind of military operations over the long haul are best
confined to the Department of Defense,” Mr. Zelikow said.
In
recent weeks, the heads of several intelligence agencies have faced
accusations from lawmakers that American spies and analysts were caught
by surprise when Russia swiftly annexed Crimea. Particular criticism has
been reserved for the Defense Intelligence Agency, responsible for
intelligence collection about foreign militaries, for concluding that
Russian troop movements near the Ukraine border were unlikely to lead to
an invasion of the Crimean Peninsula.
Even
if the C.I.A. eventually does give up the work of firing missiles and
dropping bombs in far-flung regions of the earth, Mr. Brennan insists
that its counterterrorism mission will endure.
“Despite
rampant rumors that the C.I.A. is getting out of the counterterrorism
business, nothing could be further from the truth,” the C.I.A. director
said during a speech last month at the Council on Foreign Relations.
The
agency’s covert action authorities and relationships with foreign spy
services, Mr. Brennan said, “will keep the C.I.A. on the front lines of
our counterterrorism efforts for many years to come.”"
18
Opinion
Albany’s Perilous Oil Boom
Tank cars are accidents waiting to happen, and regulators at all levels should take steps to reduce the risks.
19
World
Delays in Effort to Refocus C.I.A. From Drone War
Despite avowals about the need to refocus the agency on its original missions of analysis, intelligence collecting and espionage, the paramilitary operations have proven hard to give up.
20
U.S.
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