'Doctor to Congress and Supreme Court Toils to Sidestep Politics Amid Pandemic' diff viewer (4/5)

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Doctor to Congress and Supreme Court Toils to Sidestep Politics Amid Pandemic	Doctor to Congress and Supreme Court Toils to Sidestep Politics Amid Pandemic
2020-06-10 06:22:38 UTC	2020-06-13 12:10:37 UTC (3 days later)
WASHINGTON — When Senator John Barrasso, Republican of Wyoming, sought guidance on how to protect his family, including his 94-year-old father-in-law, when he returned home from the nation’s capital amid the coronavirus pandemic, a doctor offered him some blunt advice.	WASHINGTON — When Senator John Barrasso, Republican of Wyoming, sought guidance on how to protect his family, including his 94-year-old father-in-law, when he returned home from the nation’s capital amid the coronavirus pandemic, a doctor offered him some blunt advice.
Don’t go home just yet, Dr. Brian P. Monahan, the attending physician of Congress, told Mr. Barrasso, directing him to quarantine for 14 days before rejoining his family. “You’re a visitor,” Dr. Monahan said.	Don’t go home just yet, Dr. Brian P. Monahan, the attending physician of Congress, told Mr. Barrasso, directing him to quarantine for 14 days before rejoining his family. “You’re a visitor,” Dr. Monahan said.
But when House Democratic leaders wanted counsel on whether they could safely reconvene in the Capitol with Covid-19 still spreading — a debate with political dimensions as a partisan divide was emerging across the country over how quickly to reopen — Dr. Monahan was less absolute. Returning to Washington carried health risks he would not recommend taking, he told Speaker Nancy Pelosi of California and Representative Steny H. Hoyer of Maryland, the majority leader. But it was up to them to decide what to do.	But when House Democratic leaders wanted counsel on whether they could safely reconvene in the Capitol with Covid-19 still spreading — a debate with political dimensions as a partisan divide was emerging across the country over how quickly to reopen — Dr. Monahan was less absolute. Returning to Washington carried health risks he would not recommend taking, he told Speaker Nancy Pelosi of California and Representative Steny H. Hoyer of Maryland, the majority leader. But it was up to them to decide what to do.
They opted to delay their return, and on Friday, partly because of Dr. Monahan’s warnings, moved forward with plans to institute remote voting in the future.	They opted to delay their return, and on Friday, partly because of Dr. Monahan’s warnings, moved forward with plans to institute remote voting in the future.
It was typical of Dr. Monahan, the 59-year-old Navy rear admiral who is known in the halls of the Capitol as much for his meticulous attention to medical detail as he is for his efforts to stay completely out of politics.	It was typical of Dr. Monahan, the 59-year-old Navy rear admiral who is known in the halls of the Capitol as much for his meticulous attention to medical detail as he is for his efforts to stay completely out of politics.
“He is both an executive with lots of health care responsibilities — particularly now — and also has the unique relationship with members that a small-town doctor would have with the patients he knows and sees,” said Senator Roy Blunt, Republican of Missouri and chairman of the Senate Rules Committee. “He’s in a unique role at a unique time”	“He is both an executive with lots of health care responsibilities — particularly now — and also has the unique relationship with members that a small-town doctor would have with the patients he knows and sees,” said Senator Roy Blunt, Republican of Missouri and chairman of the Senate Rules Committee. “He’s in a unique role at a unique time”
As government doctors have emerged as trusted public voices and political figures in the face of a fearsome pandemic — appearing in White House news conferences and as witnesses at marquee hearings — Dr. Monahan has maintained an uncommonly low profile.	As government doctors have emerged as trusted public voices and political figures in the face of a fearsome pandemic — appearing in White House news conferences and as witnesses at marquee hearings — Dr. Monahan has maintained an uncommonly low profile.
He never issued a public statement offering his opinion on whether Congress should reconvene, although he shared his warnings with House leaders and privately told senior Republican officials that his office did not have the capacity to screen all 100 senators for the coronavirus when they returned to work. When Alex M. Azar II, the health secretary, said he would send 1,000 tests to Capitol Hill to accommodate them, Ms. Pelosi and Senator Mitch McConnell, Republican of Kentucky and the majority leader, turned down the offer, wary of the optics of receiving special treatment at a time when testing was scarce — and prompting President Trump to suggest on Twitter that “maybe you need a new Doctor over there.”	He never issued a public statement offering his opinion on whether Congress should reconvene, although he shared his warnings with House leaders and privately told senior Republican officials that his office did not have the capacity to screen all 100 senators for the coronavirus when they returned to work. When Alex M. Azar II, the health secretary, said he would send 1,000 tests to Capitol Hill to accommodate them, Ms. Pelosi and Senator Mitch McConnell, Republican of Kentucky and the majority leader, turned down the offer, wary of the optics of receiving special treatment at a time when testing was scarce — and prompting President Trump to suggest on Twitter that “maybe you need a new Doctor over there.”
Dr. Monahan, who declined to be interviewed, has been a calm and professional voice of reason during the pandemic, according to interviews with more than two dozen lawmakers, Capitol officials and medical professionals who know him. They say he has taken a personal interest in his influential clientele, which also includes the nine Supreme Court justices, even as he fields politically charged questions about reopening, testing and precautionary measures.	Dr. Monahan, who declined to be interviewed, has been a calm and professional voice of reason during the pandemic, according to interviews with more than two dozen lawmakers, Capitol officials and medical professionals who know him. They say he has taken a personal interest in his influential clientele, which also includes the nine Supreme Court justices, even as he fields politically charged questions about reopening, testing and precautionary measures.
Operating out of a nondescript clinic tucked away in the heart of the Capitol, Dr. Monahan and a small staff have been exceedingly busy since the pandemic took hold, consulting with lawmakers who have contracted Covid-19 or exposed to someone infected with it, doling out health recommendations in detailed memos ahead of votes, and producing a series of videos released on an internal website to educate lawmakers and their staff on how to protect themselves.	Operating out of a nondescript clinic tucked away in the heart of the Capitol, Dr. Monahan and a small staff have been exceedingly busy since the pandemic took hold, consulting with lawmakers who have contracted Covid-19 or exposed to someone infected with it, doling out health recommendations in detailed memos ahead of votes, and producing a series of videos released on an internal website to educate lawmakers and their staff on how to protect themselves.
Dr. Monahan has filmed and produced the videos by himself in his office, often seated next to an elaborate bouquet of white flowers and a tiny plastic model of a pangolin, the scaly mammal that may have been an intermediary carrier of the virus.	Dr. Monahan has filmed and produced the videos by himself in his office, often seated next to an elaborate bouquet of white flowers and a tiny plastic model of a pangolin, the scaly mammal that may have been an intermediary carrier of the virus.
In the videos, he typically walks through the most recent recommendations offered by the Centers for Disease Control and Prevention and demonstrates medical equipment, such as a thermometer and a variety of masks (including one made by his wife, using a black shopping bag and a sewing machine).	In the videos, he typically walks through the most recent recommendations offered by the Centers for Disease Control and Prevention and demonstrates medical equipment, such as a thermometer and a variety of masks (including one made by his wife, using a black shopping bag and a sewing machine).
“He has a big job — two houses of Congress, two parties to deal with — but he’s not political in any way,” Ms. Pelosi said. “He treats us all with respect, and we respect his judgment in return.”	“He has a big job — two houses of Congress, two parties to deal with — but he’s not political in any way,” Ms. Pelosi said. “He treats us all with respect, and we respect his judgment in return.”
Dr. Monahan in 2009 became the seventh man to serve as attending physician, taking up a position that has always been held by a Navy doctor. The House first approved a Navy officer to work out of the Democratic cloakroom in 1928 after one lawmaker died and two collapsed, with several hours passing before a doctor could arrive in each case. Two years later, the Senate extended that doctor’s jurisdiction to include its own members, leading to the establishment of the Office of the Attending Physician.	Dr. Monahan in 2009 became the seventh man to serve as attending physician, taking up a position that has always been held by a Navy doctor. The House first approved a Navy officer to work out of the Democratic cloakroom in 1928 after one lawmaker died and two collapsed, with several hours passing before a doctor could arrive in each case. Two years later, the Senate extended that doctor’s jurisdiction to include its own members, leading to the establishment of the Office of the Attending Physician.
The office provides care to lawmakers for a fee, as well as offering some services and emergency care to staff and tourists. The first physician, Dr. George W. Calver, who began his work just before the start of the Great Depression, displayed placards in cloakrooms and elevators across the Capitol with his nine “Commandments of Health,” including “Accept Inevitables (don’t worry)” and “Relax Completely.”	The office provides care to lawmakers for a fee, as well as offering some services and emergency care to staff and tourists. The first physician, Dr. George W. Calver, who began his work just before the start of the Great Depression, displayed placards in cloakrooms and elevators across the Capitol with his nine “Commandments of Health,” including “Accept Inevitables (don’t worry)” and “Relax Completely.”
Dr. Monahan was born in Connecticut, the son of Irish immigrants who came to the United States in the 1950s. His mother grew up in Kilkee, while his father grew up in a house with a thatched roof without running water or electricity in Lissycasey. The first in his family to attend college, he worked full-time at a supermarket while commuting in a yellow Volkswagen Beetle to Fairfield University, a Jesuit college — an education, he would tell graduates in 2011, that meant, “you are called to be ‘men and women for others.’”	Dr. Monahan was born in Connecticut, the son of Irish immigrants who came to the United States in the 1950s. His mother grew up in Kilkee, while his father grew up in a house with a thatched roof without running water or electricity in Lissycasey. The first in his family to attend college, he worked full-time at a supermarket while commuting in a yellow Volkswagen Beetle to Fairfield University, a Jesuit college — an education, he would tell graduates in 2011, that meant, “you are called to be ‘men and women for others.’”
He studied biology and chemistry, and after graduating, joined the Navy through its Health Professions Scholarship Program, enticed in part by the offer of free tuition and a living allowance in exchange for a commitment to three years of service.	He studied biology and chemistry, and after graduating, joined the Navy through its Health Professions Scholarship Program, enticed in part by the offer of free tuition and a living allowance in exchange for a commitment to three years of service.
“Brian was always the smartest kid in the class,” said Dr. William Dahut, a medical oncologist who spent time with him in both medical school and the Navy. “If there was a publication or data, Brian knew that data and knew that well.”	“Brian was always the smartest kid in the class,” said Dr. William Dahut, a medical oncologist who spent time with him in both medical school and the Navy. “If there was a publication or data, Brian knew that data and knew that well.”
~~Updated June 5, 2020~~	Updated June 12, 2020
	Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.	So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.	A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.	The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.	Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.	Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.	States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.	Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)	If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.	Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.	The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.	If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.	If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
In 1989, as a resident in the cardiology ward in what was then the National Naval Medical Center in Bethesda, Md., he treated a 39-year-old woman for potentially fatal cardiac arrhythmias. The patient had taken the popular antihistamine Seldane, and his contribution to research on that medicine — and its connection to the arrhythmias — later helped lead to its removal from the market.	In 1989, as a resident in the cardiology ward in what was then the National Naval Medical Center in Bethesda, Md., he treated a 39-year-old woman for potentially fatal cardiac arrhythmias. The patient had taken the popular antihistamine Seldane, and his contribution to research on that medicine — and its connection to the arrhythmias — later helped lead to its removal from the market.
Dr. Monahan rose through the ranks of the Navy, becoming a professor of medicine and pathology at the Uniformed Services University of the Health Sciences in Maryland, as well as participating in a number of national organizations related to cancer, oncology and hematology.	Dr. Monahan rose through the ranks of the Navy, becoming a professor of medicine and pathology at the Uniformed Services University of the Health Sciences in Maryland, as well as participating in a number of national organizations related to cancer, oncology and hematology.
While serving as the Chairman of the Department of Medicine at the university, he received a call for a meeting in which officials with congressional leadership asked him to become the attending physician on Capitol Hill when his predecessor retired.	While serving as the Chairman of the Department of Medicine at the university, he received a call for a meeting in which officials with congressional leadership asked him to become the attending physician on Capitol Hill when his predecessor retired.
He has since become a fixture on Capitol Hill, participating in congressional trips and functions and releasing health assessments for presidential and vice-presidential contenders, including Senators Bernie Sanders, the Vermont independent, and Tim Kaine, Democrat of Virginia. (Mr. Kaine also asked him for “a tuneup” before hiking the Virginia section of the Appalachian Trail.)	He has since become a fixture on Capitol Hill, participating in congressional trips and functions and releasing health assessments for presidential and vice-presidential contenders, including Senators Bernie Sanders, the Vermont independent, and Tim Kaine, Democrat of Virginia. (Mr. Kaine also asked him for “a tuneup” before hiking the Virginia section of the Appalachian Trail.)
In 2016, it was Dr. Monahan’s assessment of Justice Antonin Scalia’s health at the time of his death — including sleep apnea, coronary artery disease, obesity and diabetes — that influenced the decision to decline an autopsy of the justice, The Associated Press reported at the time.	In 2016, it was Dr. Monahan’s assessment of Justice Antonin Scalia’s health at the time of his death — including sleep apnea, coronary artery disease, obesity and diabetes — that influenced the decision to decline an autopsy of the justice, The Associated Press reported at the time.