For One U.S. Bike-Maker, Tariffs Are A Mixed Bag

Zakary Pashak started Detroit Bikes when he moved to Detroit in 2011, at a time when the city was reeling.

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Courtesy of Melany Hallgren

Zakary Pashak is a rare breed. His company, Detroit Bikes, is one of the very few American bicycle makers. Most bikes come from China.

At times, Pashak endured ridicule at trade shows. “I’d get kind of surly bike mechanics coming up and telling me that my products stunk. There’s definitely a fair bit of attitude in my industry,” he says.

But last September, the industry’s tune abruptly changed. The first round of U.S. tariffs, or import taxes, upped the cost of Chinese-made bikes by 10%, and companies saw Detroit Bikes as a potential partner.

“All of a sudden I felt like the belle of the ball or something,” Pashak says.

Now a new round of tariffs set at 25% is hitting imports from China. Like many other American companies, Detroit Bikes is poring over the 194-page list of imported Chinese goods subject to the levies. Companies like Detroit Bikes rely on those goods, and now they face choices that will ultimately determine the prices consumers will pay.

Pashak started the company when he moved to Detroit in 2011, at a time when the city was reeling.

“What drew me to Detroit was the history, the music, the manufacturing,” he says. “But it was also the state that the city was in at the time.”

The financial crisis slammed automakers, laid off thousands of workers, many of whom abandoned their homes. Pashak envisioned an urban revival. Using those idle factories and workers, he wanted to build an American-made bicycle, which is how Detroit Bikes was born.

This month, the Trump administration upped the taxes it charges on Chinese imports by an additional 15%. Now, several companies seeking to avoid those added costs are considering hiring Detroit Bikes to manufacture bikes for their brands.

“If these tariffs are still in place next year at this time, I would anticipate that would probably be quite good for my business,” he says.

But the tariffs aren’t all good for Detroit Bikes. In fact, Pashak says the effects are so convoluted, he’s not sure yet whether they will ultimately help or hurt.

For one thing, his company relies on imported parts — rims, spokes, tires, cranks — most of which come from China. Tariffs on those also increased 25% since last fall, driving up Detroit Bikes’ expenses. To counteract that, Pashak is painstakingly evaluating each part, to see whether cheaper alternatives are available elsewhere.

He’s looking at parts made in Taiwan, which aren’t subject to tariffs. Or Cambodia, which he says is “the new hot country … that everyone’s trying to rush into.”

Businesses like Detroit Bikes react to tariffs in many ways, and one of the most significant is in finding alternate sources of goods. If Pashak succeeds in finding cheaper substitute parts, he keeps costs down on his bikes, which range from about $400 to $1,250. That then blunts the overall price increase for his customers.

Economists call this “substitution,” and say it affects how much consumers pay for tariffs.

“The impacts of these wars depend heavily on the substitution effect,” says Amit Khandelwal, a professor of international business at Columbia University.

Some substitutes are relatively easy to find. When China slapped retaliatory tariffs on American soybeans and corn, for example, buyers quickly turned to suppliers in South America.

But finding replacements for things like bike chains or software chips is considerably harder; factories can’t just be ginned up on demand. “Generally, the more specialized products often take longer to substitute,” Khandelwal says.

And timing is a key factor. It’s unclear whether the tariffs will remain for a week, a month, or years. Businesses, from farmers to retailers, are reluctant to make big changes when they can’t plan for the long haul.

That limits options for companies like Brooklyn Bicycle Co., which is based in its namesake city. It sources all its parts from 40 Asian countries, which are then assembled in China, before being shipped to the U.S. Ryan Zagata, the company’s president, says it would take about a year to rethink his supply chain and find options outside of China. And “it would be incredibly costly,” he says.

Detroit Bikes’ Pashak says he’s already mapped out some ingenious — if complicated — workarounds, if the tariffs stay put.

“I can bring in Chinese parts to Canada at no tariff code, bring in a Cambodian frame to Canada. Or ship my American frames up to Canada, put the parts on them, and then import them into the country,” he says. Doing so would relieve his tariff burden, but would take months. In the meantime, he says, tariffs might go away next week.

So the easiest solution for many companies, in the short run, is to raise prices. Many of Detroit Bikes’ rivals that rely on imported Chinese bikes, say they’ll have no choice. But Pashak says he’s not sure if his company will follow suit.

“It might be better for me strategically just to let all my competitors raise their prices because they have to,” he says. In the meantime, he’ll continue exploring options to try to make the tariffs work to his advantage.

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Saturday Sports: NBA, WNBA, Preakness, Ohio State

We have the latest on the NBA, the new commissioner leading the WNBA, and the investigation of an Ohio State University doctor’s sexual abuse of students.



SCOTT SIMON, HOST:

And now it’s time for sports.

(SOUNDBITE OF MUSIC)

SIMON: Fear the deer. The NBA finals almost set a new leader for the WNBA and sad news ahead of the Preakness. NPR’s Tom Goldman joins us. Good morning, Tom. How are you?

TOM GOLDMAN, BYLINE: Good morning (laughter). I feel like if you’re going to keep this fear the deer stuff up, I think I have to – into June, probably…

SIMON: Oh, sure.

GOLDMAN: I think I – I’ve got to have some response, maybe deer sound, like bleating or grunting or something. I’ll work on it.

SIMON: Yeah, yeah. I think you’d be good at deer grunting, if I’m not mistaken (laughter). I bet you would be. I’ll send you some of my old scripts. They’re all a bunch of deer grunts. In any event, the Bucks defeated the Toronto Raptors by 22 points last night. They take a 2-0 lead in the series, like the Warriors have over the Blazers, and they play tonight. Is it too early to ask if the deer can dethrone the team that is fleeing loyal Oakland?

GOLDMAN: Oh, yeah. No, it’s not. Milwaukee looks unbeatable with the normal caveats. As you mentioned, the Bucks only up 2-0. They’ve won two on their home court; same with Golden State. The playoff series, as you know, Scott, can flip in a game. Of course, I’m saying that as a Portland resident where Blazer fans are sure the script will start flipping tonight. But with those caveats out of the way, the Bucks – wow – playing so well on offense, defense, all other facets of the game, and they’re physically huge. Their starting lineup includes a guy 6’10”, 6’11”, 7 feet. The Warriors, during their run, have made small ball cool and very effective. But I don’t know how Golden State would deal with Milwaukee’s size if the two meet in the finals – if.

SIMON: The WNBA has a new commissioner, Cathy Engelbert. She is a business executive and a former college player. I’m very impressed by her.

GOLDMAN: Yeah. And the consensus is she’s a great choice. She has been the chief executive at Deloitte accounting firm – first woman to head the company. She’s also a good college basketball player, as you mentioned, at Lehigh under Muffet McGraw, now the legendary head coach at Notre Dame. Engelbert has had success in business, in sports. She understands both. She’s considered the perfect leader for the WNBA right now, which starts its 23rd season next week.

SIMON: And she’ll be commissioner, not president, right? That’s an important change.

GOLDMAN: You know, it’s significant they’re using that term. Up to now, it’s been president. The title has been president. But commissioner, you know, is a title with more heft, befitting a league that certainly wants to achieve more heft.

SIMON: Preakness this afternoon – terrible news from the track. Two great athletes died yesterday on racetracks – Congrats Gal at Pimlico, Commander Coil at Santa Anita, which courses had 24 deaths since December 26. I am a horse fan, if not always of horse racing. It’s just hard to root right now. What are these deaths doing to the sport?

GOLDMAN: Making it hard to root, as you say. I mean, you know, there’s still lots of people who show up at parks with money on their minds who explain away the deaths as, well, you know, that’s just part of horse racing, which, sadly, it is. But these deaths yesterday, on top of the cluster of 23 at Santa Anita before them and then the one at Pimlico, as you mentioned – the site of today’s Preakness, second leg of the Triple Crown – is just raising the criticism of the sport, increasing calls for reform. On top of that, Scott, you know, you’ve got the weird ending at the Kentucky Derby a couple of weeks ago where the winner was disqualified. Horse racing is a mess right now, I would say, which is what activists want it to be in order to trigger significant change.

SIMON: And let’s turn to what’s been happening at Ohio State. An investigation found former athletic department doctor Richard Strauss had sexually abused 177 male students. The university knew but took no real action for 15 years. Dr. Strauss took his own life in 2005. And the university says it is trying to revoke his emeritus professor status, even though, of course, he died a number of years ago. What’s that going to achieve?

GOLDMAN: Not clear beyond symbolism. This report confirms a very sordid and sad couple of decades at Ohio State. It should strengthen a number of pending lawsuits because as one plaintiff’s lawyer told The Columbus Dispatch, Ohio State cannot deny the abuse, and it’s not. The university president called the findings shocking and painful to comprehend. So, you know, along with what’s happened at Michigan State with the Larry Nassar case, just another sad, sad case of this.

SIMON: Yeah. NPR’s Tom Goldman, thanks very much for being with us. Talk to you soon.

GOLDMAN: OK. Thanks, Scott.

Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

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Ohio State Doctor Sexually Abused At Least 177 Male Students, Investigation Finds

Richard Strauss was employed as a doctor at Ohio State University from 1978 until he retired in 1998.

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For nearly two decades, a doctor at The Ohio State University sexually abused at least 177 male students, according to an exhaustive independent investigation commissioned by the university. Most of the doctor’s abuse happened under the auspices of providing the students with medical treatment.

Richard Strauss worked at OSU from September 1978 through March 1998, primarily as a doctor with the Athletic Department and the Student Health Center. The investigation found that university personnel became aware of Strauss’ abuse as early as 1979.

However, “despite the persistence, seriousness, and regularity of such complaints, no meaningful action was taken by the University to investigate such concerns until January 1996,” when they were first elevated to officials beyond Student Health or the Athletics Department, the report reads.

As a result, Strauss was suspended from working as a treating physician at OSU. The school eventually removed him from his departments, but it kept him on as a tenured faculty member. He voluntarily retired in 1998 with “emeritus” status from the university. Strauss took his own life in 2005.

“The findings are shocking and painful to comprehend,” current OSU President Michael Drake said in a message emailed to the OSU community.

“On behalf of the university, we offer our profound regret and sincere apologies to each person who endured Strauss’ abuse,” said Drake, who became the school’s president in 2014. “Our institution’s fundamental failure at the time to prevent this abuse was unacceptable — as were the inadequate efforts to thoroughly investigate complaints raised by students and staff members.”

Drake added that the university has started the process of revoking Strauss’ emeritus status and “will take additional action as appropriate.”

“Dreams were broken, relationships with loved ones were damaged, and the harm now carries over to our children as many of us have become so overprotective that it strains the relationship with our kids,” Kent Kilgore, a survivor of Strauss’ abuse, said in a statement to The Associated Press.

OSU said it launched the independent investigation last April, after a former student came forward with allegations of abuse and “indicated … that there may have been others who experienced sexual misconduct by Strauss.”

The investigation carried out by the law firm Perkins Coie was led by a former federal prosecutor and a former federal government ethics attorney. Both had experience in investigations involving male sexual abuse survivors.

They interviewed 520 people, among them the 177 men who said they had been abused by Strauss.

The report, which runs more than 230 pages, contains a litany of painful stories of abuse from former students who went to Strauss for medical care.

The instances of abuse often involved inappropriate touching of a students’ genitals during exams in ways that weren’t medically useful. A number of students said Strauss “would routinely touch their genitals at every visit, regardless of the medical ailment presented, including for a sore throat,” the report states.

The report also states that members of 15 university athletic teams were abused. Strauss most frequently targeted wrestlers — 48 of them, according to the report. And the abuse often became more explicit over multiple visits.

“We observed that, in many cases, a student’s most egregious experience of abuse did not occur during the student’s first encounter with Strauss; rather, the abuse escalated over time, in a series of examinations with the student,” the report states.

Other students reported that Strauss would frequently shower with teams, appearing to loiter and gawp at students as they were naked in locker rooms and making them uncomfortable.

A former soccer player told investigators that Strauss would sometimes run a single lap just as the team was finishing up practice. “The student noted that it was a commonly-held perception among the players that Strauss was exercising as a pretext to shower with the team, and the student-athletes would try to shower as quickly as possible,” the report reads.

Dozens of people who worked as coaches or athletic trainers told investigators that they had been aware of rumors and complaints against Strauss. The abuse was so widely known that it left some students with the idea that it was simply accepted by other university personnel.

“Many of the students felt that Strauss’ behavior was an ‘open secret,’ as it appeared to them that their coaches, trainers, and other team physicians were fully aware of Strauss’ activities, and yet few seemed inclined to do anything to stop it,” the report states. Students, it adds, said they had the impression the abuse was a form of hazing or a rite of passage.

The university took disciplinary action against Strauss only after a series of student complaints in the mid-1990s. Even after that, he opened an off-campus private men’s health clinic near the university — where he continued to abuse patients — and kept his title as a tenured faculty professor.

As Gabe Rosenberg and Adora Namigadde of member station WOSU reported:

“At least 50 students have filed lawsuits against Ohio State, arguing the university knew about and declined to act in response to complaints about Strauss. Their case is headed to mediation.

” ‘It’s what we’ve been saying—they’ve failed to act—investigate or act, and now we have validation,’ said Brian Garrett, one of the lead plaintiffs, in an interview Friday.

“The university has referred the report to Columbus Police, the Franklin County Prosecutor’s Office, and the Ohio Attorney General’s Office.”

The investigators and the university’s president thanked the survivors for coming forward to share their stories.

“This independent investigation was completed because of the strength and courage of survivors,” Drake said.

Read the investigative report here:

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Highly Potent Weed Has Swept The Market, Raising Concerns About Health Risks

Studies have shown that the levels of THC, the main psychoactive compound in pot, have risen dramatically in the U.S. from 1995 to 2017.

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As more states legalize marijuana, more people in the U.S. are buying and using weed — and the kind of weed they can buy has become much stronger.

That concerns scientists who study marijuana and its effects on the body, as well as emergency room doctors who say they’re starting to see more patients who come into the ER with weed-associated issues.

Some 26 million Americans ages 12 and older reported being current marijuana users in 2017, according to the National Survey on Drug Use and Health. It’s not clear how many users have had serious health issues from strong weed, and there’s a lot that’s still unknown about the potential risks. But scientists are starting to learn more about some of them.

The potency of weed depends on the amount of delta-9-tetrahydrocannabinol, or THC, the main compound responsible for the drug’s psychoactive effects. One study of pot products seized by the U.S. Drug Enforcement Administration found the potency increased from about 4% THC in 1995 to about 12% in 2014. By 2017, another study showed, the potency of illicit drug samples had gone up to 17.1% THC.

“That’s an increase of more than 300% from 1995 to about 2017,” says Staci Gruber, director of the Marijuana Investigations for Neuroscientific Discovery (MIND) program at the Harvard-affiliated McLean Hospital in Belmont, Mass. “I would say that’s a considerable increase.”

And some products with concentrated forms of cannabis, like hash and hash oil, can have as much as 80% to 90% THC, she adds.

“I think most people are aware of the phenomenon that ‘this is not your grand daddy’s weed,’ Gruber says. “I hear this all the time.”

But people might not be aware of the potential health risks of highly potent weed. “The negative effects of cannabis have primarily been isolated and localized to THC,” says Gruber. “So it stands to reason that higher levels of THC may in fact confer a greater risk for negative outcome.”

“In general, people think, ‘Oh, I don’t have to worry about marijuana. It’s a safe drug,’ ” says Nora Volkow, director of the National Institute on Drug Abuse. “The notion that it is completely safe drug is incorrect when you start to address the consequences of this very high content of 9THC.”

Pot’s paradoxical effects

THC can have opposite effects on our bodies at high and low doses, Volkow says. Take anxiety levels, for example.

“When someone takes marijuana at a low [THC] content to relax and to stone out, actually, it decreases your anxiety,” she says. But high concentrations can cause panic attacks, and if someone consumes high-enough levels of THC, “you become full-blown psychotic and paranoid.”

Weed can have a similar paradoxical effect on the vascular system. Volkow says: “If you take low-content THC it will increase your blood flow, but high content [THC] can produce massive vasoconstriction, it decreases the flow through the vessels.”

And at low concentrations, THC can be used to treat nausea in cancer patients undergoing chemotherapy. But Volkow says that “patients that consume high content THC chronically came to the emergency department with a syndrome where they couldn’t stop vomiting and with intense abdominal pain.”

It’s a condition called cannabinoid hyperemesis syndrome.

“The typical patient uses [inhales] about 10 times per day … and they come in with really difficult to treat nausea and vomiting,” says Andrew Monte, an associate professor of emergency medicine and medical toxicology at the University of Colorado’s school of medicine. “Some people have died from this … syndrome, so that is concerning.”

Scientists don’t know exactly how high levels of THC can trigger the syndrome, but the only known treatment is stopping cannabis use.

While the number of people who’ve had the syndrome is small, Monte says he and his colleagues have documented a rise in the number of cases at emergency rooms in Colorado since marijuana was legalized there five years ago. A study by Monte and his team found that cyclical vomiting cases made up about 18% of inhaled cannabis-related cases at his ER.

They also found that statewide, the overall number of ER cases associated with cannabis use has gone up. And Monte says his ER has “seen an approximately a three-fold increase in emergency department visits just by frequency. It doesn’t mean we’re getting overwhelmed by these visits due to cannabis, it’s just that means that there are more patients overall.”

Most people show up at his emergency department because of “intoxication” from too much pot, either straight or mixed with other drugs, Monte says. The bulk of these cases are due to inhaled cannabis, though edibles are associated with more psychiatric visits.

“We’re seeing an increase in psychosis and hallucinations, as well as anxiety and even depression and suicidality,” Monte says.

He thinks the increased potency of marijuana plays a role in all these cases. “Whenever you have a higher dose of one of these types of drugs, the patient is at a higher risk of having an adverse drug event. If the concentration is so much higher … it’s much easier to overshoot the low-level high that they’re looking for.”

Not everyone is at equal risk, Monte adds. “Many many people use cannabis safely,” he says. “The vast majority don’t end up in our emergency department.”

Different risks for users

Some people are more vulnerable than others to the potential negative effects of high THC cannabis.

Adolescent and young adults who use recreationally are especially susceptible because their brains are still developing and are sensitive to drugs in general, says Gruber of the MIND program. In a recent review of existing studies, she found that marijuana use among adolescents affects cognition — especially memory and executive functions, which determine mental flexibility and ability to change our behavior.

Medical marijuana users can face unexpected and unwelcome effects from potent weed. “It’s very important for people to understand that they may not get the response they anticipated,” Gruber notes.

Studies done on the medical benefits of pot usually involve very low doses of THC, says Monte, who adds that those doses “are far lower than what people are getting in a dispensary right now.”

David Dooks, a 51-year-old based in the Boston area turned to marijuana after an ankle surgery last year. “I thought that medical marijuana might be a good alternative to opioids for pain management,” he says.

Based on the advice at a dispensary, David began using a variety of weed with 56.5% THC and says it only “exacerbated the nerve pain.” After experimenting with a few other strains, he says, what worked for him was one with low (0.9%) THC, which eased his nerve pain.

‘Start low, go slow’

Whether people are using recreationally or medically, patients should educate themselves as much as possible and be cautious while using, Monte says.

Avoiding higher THC products and using infrequently can also help reduce risk, Volkow adds. “Anyone who has had a bad experience, whether it’s psychological or biological, they should stay away from this drug,” she notes.

Ask for as much information as possible before buying. “You have to know what’s in your weed,” Gruber says. “Whether or not it’s conventional flower that you’re smoking or vaping, an edible or tincture, it’s very important to know what’s in it.”

And the old saying “start low, go slow,” is a good rule of thumb, she adds. “You can always add, but you can never take it away. Once it’s in, it’s in.”

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Drugmaker Created To Reduce Shortages And Prices Unveils Its First Products

Pharmacy technician Peggy Gillespie fills a syringe with an antibiotic at ProMedica Toledo Hospital in Toledo, Ohio, in January.

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On Wednesday, Civica Rx, a nonprofit drug company founded last year by a consortium of hospitals and foundations, said it had entered an agreement with a Danish drugmaker to make available injected forms of vancomycin and daptomycin, two antibiotics that are often in short supply.

Civica Rx has plans to become an alternative source of generic drugs for hospitals and provide a steady supply of critical medicines at reasonable prices .

The company’s initial plan is to make 14 drugs and offer them to member health systems. The antibiotics are the first two that Civica Rx has publicly announced.

“Vancomycin is kind of the typical shortage drug because it’s generic and it’s an injectable and it’s critically needed,” says Erin Fox, a pharmacist who studies drug shortages at University of Utah Health, one of Civica Rx’s members. “But we just haven’t had a very good routine supply of it for a while now,” she explains. She also recently joined Civica Rx’s advisory board.

When the heavy-duty antibiotic vancomycin is in short supply, Dr. James Augustine, an emergency physician at Mercy Health hospitals in Cincinnati, gets worried.

“Vancomycin has been our last-ditch antibiotic for quite a few years,” Augustine says. “It is our go-to antibiotic for very, very sick people and those with resistant infections.”

Augustine collects information on drug shortages and shares it with other health care professional across the country. Shortages of key drug are a big and persistent problem for hospitals, he says.

“We have experienced shortages of most every drug,” he says. “It’s getting hard to keep track,” Augustine says. In a survey last year of emergency physicians, 9 in 10 had experienced a shortage in the previous month.

Shortages of vancomycin are a particular problem because it’s a powerful medicine that doesn’t have a good alternative, he says.

It’s unclear why vancomycin, which has been a generic for many years, has experienced shortages, says University of Utah’s Fox.

“Sometimes it’s just some kind of a supply constraint, or one company discontinuing production,” she says. “But we don’t always know the reasons for shortages. The companies won’t won’t tell us. In fact, pharma companies, while they’re required to report a shortage to the [Food and Drug Administration] FDA, they’re actually not required to provide the reason for that shortage to the FDA.”

Neither vancomycin, whose name comes from the same root as vanquish, nor daptomycin drug is on the FDA’s list of drugs in short supply, but they both are on another drug shortage list that Fox helps manage, along with the reasons why, if available. Drug giant Pfizer, for example, lists shortages for both drugs because of “manufacturing delays.”

Civica Rx won’t be making these drugs itself. Instead it has contracted with Danish drugmaker Xellia to make them with a Civica Rx label. Civica Rx’s member health systems currently include 800 hospitals across the country.

Fox says the real innovation here is a new kind of contract between drugmakers and hospitals.

“You can pretty much predict how much product you’re going to need at your hospital, and you can say, ‘Yep, I will purchase, say, 500 packages of this in a year,” she explains. “You would have to sign up for that and say, ‘I’m going to buy that,’ and if you don’t, the company still gets the money.”

That “guaranteed volume” for Civica Rx is supposed to help with the periodic shortages.

How much will the Civica Rx drugs cost? “Pricing will vary based on product,”company spokesperson Debbi Ford said in an email. She declined to provide specific prices.

Vancomycin “right now is a fairly reasonable price,” says Martin VanTrieste, Civica’s president and CEO. “However daptomycin is one of those high-priced drugs, and we’ll be able to bring [it at] a significantly lower price.”

VanTrieste says Civica’s pricing will be based on manufacturing costs, plus a “fair margin” for the drugmaker — in this case, Xellia. “Once we negotiate that price, we go back to our members and say, ‘I have vancomycin 1-gram vials I’m offering to you at “X” price. You want to opt in to purchase that product or opt out?’ “

Dr. James Augustine’s health system, Mercy Health, isn’t a Civica Rx member, although membership is open. It costs $300 per hospital bed to join, according to VanTrieste.

Augustine is encouraged by what Civica Rx is trying to do. “It’s a fabulous idea,” he says.

But the company’s existence underscores for him that up until now, generic drugmakers have failed patients and providers. “They have decided not to make a reliable source of these medicines available and where possible to jack up the prices to to incredible levels,” he said. “It’s disgusting.”

“We always support additional competition to the market,” said Rachel Schwartz, a spokesperson for the Association for Accessible Medicines, a trade group for generic drugmakers, in an email.

Civica Rx’s VanTrieste expects to be able to offer the two antibiotics to member health systems this summer.

That’s when the experiment to prevent drug shortages and bring down prices will be put to a real-world test.

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Facing Homelessness And Crushing Medical Debt, A Renowned Jazz Guitarist Reaches Out

Jazz guitarist Kenny Burrell, in an undated photo.

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One of the jazz world’s most enduring artists, the influential 87-year-old guitarist and composer Kenny Burrell, is facing financial ruin and homelessness.

His plight became public after his wife, Katherine Burrell, launched a GoFundMe page on May 9, in which she chronicled a number of overwhelming circumstances that the couple is currently navigating. In her telling, the couple has faced a cataclysmic series of misfortunes — including substantial ongoing medical expenses after a 2016 accident, identity theft and ongoing litigation involving the home owners association group in their community — that has brought them to the brink.

“We are facing possible foreclosure and homelessness,” Katherine Burrell wrote, adding: “It saddens and embarrasses me to desperately need and request help, but it is necessary at this point.” The page’s initial fundraising goal was $100,000; as of Tuesday morning, donations totaled almost $145,000.

Burrell, who was named an NEA Jazz Master in 2005, made his first professional recording in 1951 with Dizzy Gillespie, John Coltrane, Percy Heath and Milt Jackson. Since then, he has recorded hundreds of albums, including nearly one hundred as a bandleader in a discography that spans across the Blue Note, Prestige, Savoy, Columbia, Verve, Fantasy and Concord labels, among others.

Burrell first taught at UCLA in 1978 and in 1996, became the first director of the university’s jazz studies program, which he led for 20 years; the program’s graduates include the likes of saxophonist Kamasi Washington (who has since recorded with Burrell) and vocalist Gretchen Parlato. But in 2016, Burrell suffered an accident following a performance at UCLA’s Royce Hall that, according to his wife, necessitated a two-year recovery and partly triggered the couple’s misfortunes.

But as the Burrells’ dire stated needs became public last week, questions quickly arose in the jazz community about the veracity of the GoFundMe effort. On Friday, the Jazz Foundation of America (JFA) — a national nonprofit that exists in part to provide emergency funding to jazz, blues and roots artists struggling with housing or medical care — felt compelled to issue a statement regarding Katherine Burrell’s campaign.

“We would like to assure anyone concerned about Kenny that this campaign was indeed created by Katherine on his behalf,” the JFA wrote. “The Jazz Foundation has been in contact with Katherine for months. … Kenny and Katherine had been dealing with this situation alone for several years, because, as always, musicians are proud and self-reliant and do things on their own. They did not even contact us to ask for help but were referred by friends. The Jazz Foundation assessed the case, conferred with other helping organizations, and reviewed documents attesting to the financial need described in the GoFundMe post. We couldn’t possibly cover the full scope of the need, and other sources of funding were explored, including a GoFundMe campaign, given how successful and lifesaving they have proven for fellow musicians. As we can see in this outpouring of love for Kenny and Katherine, it has worked.”

The JFA also linked the Burrells’ situation to those being faced by other elder artists. “This is a painful but inspiring example of what we see every day at the Jazz Foundation,” the JFA wrote. “Many of our legends do not have a partner at home to help them. … This is why the organization exists, and we handle 30 emergency cases every day.”

Last September, UCLA’s Herb Alpert School of Music announced that it had received a gift of $1.2 million to create a Kenny Burrell Chair in Jazz Studies, which was funded by a group of over 150 donors. The timing was meant to celebrate Burrell’s 85th birthday, as well as his 20-year tenure as director of UCLA’s jazz studies program.

UCLA has issued a statement to NPR, saying: “UCLA was unaware of Katherine Burrell’s crowdfunding activity on behalf of herself and husband, Kenny. UCLA is concerned and is looking into the circumstances of this matter. Kenny Burrell is a Distinguished Professor of Music and Global Jazz Studies at UCLA’s Herb Alpert School of Music. Professor Burrell is currently on sabbatical, and is scheduled to return to UCLA for the Spring Quarter in March 2020. He remains a full-time faculty member with related compensation and health benefits.”

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It’s Not Just Measles. What You Should Know About Vaccines For Adults

Many people might not be aware of what types of vaccines they need as they get older. Here, an adult gets a flu shot in Jacksonville, Fla.

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Updated at 1 p.m. ET

Amid one of the largest measles outbreaks in the U.S. in recent history, vaccines are on the minds of many Americans.

The Centers for Disease Control and Prevention reported this week that the number of measles cases this year has climbed to 839 in 23 states, affecting mostly unvaccinated people. Most people in the U.S. are vaccinated against measles when they’re children as part of the routine immunizations they get in primary care.

We’re used to kids needing lots of shots to ward off lots of illnesses, but what about adults? The CDC recommends that adults get multiple vaccines for conditions ranging from tetanus to influenza to cervical cancer. The shots can be a bit trickier to keep track of, as many adults go to the doctor less frequently than kids do, but those vaccinations are equally important for staying healthy.

“Many adults are not aware of what vaccines they actually need,” says Dr. Pamela Rockwell, an associate professor of family medicine at the University of Michigan who works with the CDC’s Advisory Committee on Immunization Practices. “That is also balanced by physician unawareness of what vaccines they should be recommending. It’s gotten very complicated, and it is difficult to keep up with all the changes.”

So we’re here to answer some common questions about adult vaccines. Click on each topic to go to that section.

1. Measles 2. Shingles 3. Tetanus 4. Vaccines during pregnancy 5. Before meeting a newborn baby 6. Before visiting the elderly 7. Chickenpox 8. Hepatitis B, A and C 9. HPV

I was vaccinated against measles as a child, but the measles outbreak makes me worry that I’m no longer immune. Do I need to be revaccinated as an adult?

If you received the standard two doses of the modern measles, mumps and rubella (MMR) vaccine, you’re all set. You shouldn’t need to be revaccinated, because you’re considered immune for life.

And if you were born before 1957, doctors assume you were exposed to measles as a child and are already immune.

However, a version of the vaccine produced in the mid-to-late 1960s wasn’t as effective as the current regimen, so if you were vaccinated before 1968, you should talk to your doctor about whether you need another shot. If you were born after 1957 but for some reason never got immunized, you should also get the MMR vaccine.

I’ve heard there’s an effective vaccine for shingles, but my doctor’s office doesn’t have it and it’s out of stock at the pharmacy. What’s going on?

Shingrix is a two-dose vaccine that is upward of 95 percent effective at preventing shingles, a painful rash that tends to affect older adults and immunocompromised people. The vaccine was approved in 2017 and requires two injections. It’s more effective than Zostavax, an older shingles vaccine, so doctors will recommend Shingrix over Zostavax to most patients over age 50.

There has been a shortage of Shingrix for almost as long as it has been available because demand for the vaccine has outpaced the supply. Its manufacturer, GlaxoSmithKline, told the CDC that it’s working to step up its production schedule. But because every dose of Shingrix needs to undergo safety checks, GSK expects that shortages will continue at least through the end of the year.

“The demand was so great they literally couldn’t keep up,” Rockwell says.

If you get the first dose, do your best to get the second one within two to six months. If your local pharmacies don’t have Shingrix in stock, don’t worry — you can use the HealthMap Vaccine Finder to find out where it is available. If you wait more than six months to get the second dose, you don’t need to repeat the first one, but it’s possible the vaccine won’t be quite as effective in preventing shingles.

What’s the deal with tetanus shots? How often do I need them?

Tetanus is a life-threatening disease of the nervous system that’s caused by a toxin-producing bacterium usually found in soil. It can be prevented by a series of five childhood shots, including a booster between ages 11 and 12. Adults then need a booster shot every 10 years. It can be hard to keep track of this if you move or change doctors, so make a note in your calendar and don’t be afraid to ask about it. If you get it early or a year or two late, it isn’t harmful.

If you ever have an injury that might expose you to tetanus — such as stepping on a nail — your doctor will ask when your latest tetanus booster was and may give you another booster shot on the spot. If you’re not up to date on your tetanus vaccines, you may need additional treatment to prevent the disease.

Childhood tetanus shots are combined with a vaccine for diphtheria, a dangerous infection that can affect kids, and one for pertussis, which is known as whooping cough. Your every-10-year tetanus and diphtheria boosters won’t include pertussis, unless you’re pregnant. But when you turn 65, you should again get the shot that protects against all three, which is known as Tdap.

I’m thinking about having a baby. What vaccines do I need?

Make sure you and everyone around you is up to date on standard childhood and adolescent vaccines, including pertussis, since babies are vulnerable to this disease. You should also get a dose of Tdap during prenatal care, since it’s safe in pregnancy.

Everyone also should get an annual flu shot, because pregnant women, who have weakened immune systems, are particularly susceptible to influenza and can get very sick or die from an infection.

Even if you got all the recommended vaccines as a kid, it’s possible your immunity has waned when it comes to some of the vaccine-preventable diseases that can be passed from mom to baby. This is why prenatal doctors and midwives check to make sure pregnant women are immune to hepatitis B, varicella (chickenpox) and rubella.

If you find out you’re not immune before you get pregnant, you should get vaccinated again. The hepatitis B vaccine is safe during pregnancy. But the varicella and MMR (which includes rubella protection) vaccines are not safe for pregnant patients, so your doctor is likely to recommend that you get them after delivery.

I’m planning to visit my newborn nephew. What vaccines do I need?

If you’ve gotten all your recommended vaccines and boosters, you’re almost ready to meet the baby. Babies, like pregnant women, have weak immune systems, so an annual flu shot is important before interacting with a newborn. Adults over 65 should have gotten a pertussis booster (included in the Tdap shot).

What about if I’m visiting my hospitalized, elderly grandmother?

Older, hospitalized adults are similar to newborns in that their immune systems are weak and particularly vulnerable to infections. Follow the same advice as if you’re going to meet a new baby.

I was born before the varicella (chickenpox) vaccine existed. Do I need it now?

The varicella vaccine was approved in 1995, so if you were born before then, there’s a good chance you weren’t vaccinated.

But even if you weren’t vaccinated, you’re probably already immune because there’s a high likelihood you’ve had chickenpox. The CDC says adults born before 1980 don’t need the vaccine and don’t need testing to prove their immunity.

There are some occasions when doctors will want to order blood tests to make sure their patients are actually immune to varicella — for pregnant women and health care workers, for example. If you get tested and the blood test shows you’re still susceptible, your doctor will recommend that you get the vaccine. But because the vaccine is so effective and the blood test isn’t always accurate, getting tested isn’t necessary for everyone.

What do I need to know about all the different hepatitis shots?

Hepatitis means inflammation of the liver, but when we’re talking about vaccines, we’re referring to several types of viruses that infect liver cells and can cause lots of different and potentially life-threatening problems, ranging from diarrhea to liver failure to cancer. Routine childhood immunizations include vaccines for hepatitis A and hepatitis B, meaning virtually all kids in the U.S. are vaccinated against them.

Hepatitis B is transmitted through blood or sex. A vaccine for it has been available since the 1980s, but it’s common for immunity to hepatitis B to decrease over time. If you work in health care or are thinking about becoming pregnant, your doctor might order a blood test that shows if you’re still immune. If you’re not, your doctor may recommend you get revaccinated as an adult.

Hepatitis A is transmitted through the fecal-oral route, meaning that if you eat something that has been contaminated with the feces of an infected person, you can get it. The vaccine for hepatitis A was approved in 1995. If you’re not yet vaccinated and you fall into one of a few groups — including if you’re a man who has sex with other men, you’re traveling to a country where the virus is endemic, you live with a person who has had hepatitis A — you should get the shots.

Hepatitis C is another common viral infection that affects the liver. It’s so common, in fact, that doctors routinely test people born between 1945 and 1965 for the virus. Unfortunately, there’s no vaccine available for it, but it can be treated with an oral medication. If you haven’t been screened for it, ask your doctor if you need to be.

Who should get the HPV vaccine? What’s it for?

This is essentially a cancer vaccine.

The Food and Drug Administration initially approved the HPV vaccine for girls and young women in the early 2000s, but the range of people who should get it has since grown. The FDA recently approved its use for people up to age 45. FDA approval is different from CDC guidelines, however. The CDC still officially recommends that both boys and girls get their first shot by 11 or 12, up until age 26 for women and 21 for men. The CDC adds that men up to age 26 “may be vaccinated” based on a consult with a doctor. If you’re older than 26 and haven’t been vaccinated, again, talk to your doctor about whether you need it.

HPV stands for the human papillomaviruses, which cause a wide variety of conditions, ranging from common warts on hands and feet to cervical and anal cancer. The vaccine helps prevent infection from certain types of HPV, including the strains that are the most likely to cause cancer.

It’s a series of two shots, six to 12 months apart, which is a change from when the vaccine was first approved — it used to require three shots. Children who are late getting the HPV vaccine and receive their first dose after age 15 will still need three doses.

And there’s more.

You may also need vaccines for conditions such as pneumonia or meningitis. Ask your doctor. What your doctor recommends will depend on your medical history and your risk factors, so don’t be afraid to speak up at your next appointment. You can use this CDC quiz to see what might be right for you.

Mara Gordon is a family physician in Washington, D.C., and a health and media fellow at NPR and Georgetown University School of Medicine.

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Alabama Lawmakers Pass Bill Banning Nearly All Abortions

The Alabama Senate has passed an abortion ban that would be one of the most restrictive in the United States. The bill would make it a crime for doctors to perform abortions at any stage of a pregnancy unless a woman’s life is threatened or in case of lethal fetal anomaly.

Dave Martin/AP


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Dave Martin/AP

Updated Wednesday at 12:03 a.m. ET

The Alabama Senate passed a bill Tuesday evening to ban nearly all abortions. The state House had already overwhelmingly approved the legislation. It’s part of a broader anti-abortion strategy to prompt the U.S. Supreme Court to reconsider the right to abortion.

It would be one of the most restrictive abortion bans in the United States. The bill would make it a crime for doctors to perform abortions at any stage of a pregnancy, unless a woman’s life is threatened or in case of a lethal fetal anomaly.

The vote was 25-6, with one abstention.

Doctors in the state would face felony jail time up to 99 years if convicted. But a woman would not be held criminally liable for having an abortion.

Laura Stiller of Montgomery protests outside the Alabama State House as the Senate debates an abortion ban. Stiller calls the legislation political and an “affront to women’s rights.”

Debbie Elliott/NPR


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Debbie Elliott/NPR

There are no exceptions in the bill for cases of rape or incest, and that was a sticking point when the Alabama Senate first tried to debate the measure last Thursday. The Republican-majority chamber adjourned in dramatic fashion when leaders tried to strip a committee amendment that would have added an exception for cases of rape or incest.

Sponsors insist they want to limit exceptions because the bill is designed to push the idea that a fetus is a person with rights, in a direct challenge to the U.S. Supreme Court’s landmark Roe v. Wade decision that established a woman’s right to abortion.

“Human life has rights, and when someone takes those rights, that’s when we as government have to step in,” said Republican Clyde Chambliss, the Senate sponsor of the abortion ban.

The amendment has divided Republicans. Lt. Gov. Will Ainsworth, who presides over the Senate, posted on Twitter that his position is simple — “Abortion is murder.” But other Senate leaders have insisted that there be exceptions for rape and incest.

‘Abortion is murder,’ those three simple words sum up my position on an issue that many falsely claim is a complex one. #PassHB314 #NoAmendments pic.twitter.com/NjpYW2wu8T

— Will Ainsworth (@willainsworthAL) May 13, 2019

Democrats didn’t have the votes to stop the bill but tried to slow down proceedings during the debate.

Democratic Sen. Vivian Davis Figures questioned why supporters would not want victims of rape or incest to have an exception for a horrific act.

“To take that choice away from that person who had such a traumatic act committed against them, to be left with the residue of that person if you will, to have to bring that child into this world and be reminded of it every single day,” Figures said.

Republican Gov. Kay Ivey has not said whether she will sign it, and said she was waiting for a final version of the bill. She is considered a strong opponent of abortion.

The ACLU of Alabama says it will sue if the bill becomes law. “This bill will not take effect anytime in the near future, and abortion will remain a safe, legal medical procedure at all clinics in Alabama,” the organization tweeted Tuesday night, along with a map showing clinic locations in the state.

PLEASE REMEMBER: This bill will not take effect anytime in the near future, and abortion will remain a safe, legal medical procedure at all clinics in Alabama. #mybodymychoice #HB314 pic.twitter.com/vVohsiR5Md

— ACLU of Alabama (@ACLUAlabama) May 15, 2019

“Abortion is still legal in all 50 states,” the ACLU’s national organization wrote. “It’s true that states have passed laws trying to make abortion a crime, but we will sue in court to make sure none of those laws ever go into effect.”

Chipping away at abortion rights

In recent years, conservative states have passed laws that have chipped away at the right to abortion with stricter regulations, including time limits, waiting periods and medical requirements on doctors and clinics. This year state lawmakers are going even further now that there’s a conservative majority on the U.S. Supreme Court.

“The strategy here is that we will win,” says Alabama Pro-Life Coalition President Eric Johnston, who helped craft the Alabama abortion ban.

“There are a lot of factors and the main one is two new judges that may give the ability to have Roe reviewed,” Johnston said. “And Justice Ginsburg — no one knows about her health.”

So states are pushing the envelope. Several, including Alabama’s neighbors Georgia and Mississippi, have passed laws that prohibit abortion once a fetal heartbeat can be detected. But the drafters of the Alabama bill think by having no threshold other than if a woman is pregnant, their law might be the one ripe for Supreme Court review.

The National Organization for Women denounced the ban’s passage.

“This unconstitutional measure would send women in the state back to the dark days of policymakers having control over their bodies, health and lives,” the organization said in a statement. “NOW firmly believes that women have the constitutional right to safe, legal, affordable and accessible abortion care and we strongly oppose this bill and the other egregious pieces of legislation that extremist lawmakers are trying to pass in what they claim is an attempt to force the Supreme Court to overturn Roe.”

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Who Is Believed?

“They all needed Larry. Gymnastics is punishing. Spend enough hours hoisting your body up and over those wooden gymnastics bars, eventually the skin on your palms rips right open.”

That’s a quote from host Lindsey Smith in the first episode of the podcast Believed, from NPR and Michigan Radio.

In 2018, Nassar was convicted of criminal sexual conduct and federal child pornography charges.

He serially abused hundreds of young women. His victims included household names like Simone Biles and Aly Raisman, but they weren’t all famous. Vox reports that the majority “were students and young female athletes — gymnasts, dancers, and volleyball players.”

At the very minimum, isn’t it unsettling to think that because of Nassar’s expertise treating athletes, he was kept on despite suspicions he was abusing his patients? And that when girls and young women came forward with their stories, no one believed them?

But it happened. For decades.

The purpose of Believed is to discover “how Larry Nassar abused so many for so long.”

In one instance, the police just believed Nassar instead of what his victim reported. And local detectives never referred the case to a local prosecutor for review, to see if this report of Nassar’s behavior reflected an isolated incident, or something worse.

We reached out to USA Gymnastics, and they sent us this statement.

We will never forget the appalling acts of abuse that have forever impacted our athletes and the gymnastics community. We admire the survivors’ courage and strength in sharing their stories, and our goal is to do everything we can to prevent the opportunity for it to happen again. USA Gymnastics is further strengthening its athlete safety policies — including provisions on mandatory reporting and setting boundaries for athlete-adult interaction — to establish greater accountability and make reporting easier. Athletes are the heart and soul of our sport, their safety is of paramount importance to us, and we are focused on making our organization more athlete-centric.

We bring you the latest on what’s happened since Nassar’s conviction and speak with Lindsey Smith about her work.

Produced by Kathryn Fink.

This show will discuss sexual abuse and assault. If you or someone you know needs to speak to someone, the National Sexual Assault Hotline is 1-800-656-4673. You can also use the RAINN online hotline, which you can find here.

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