New U.S. health crisis looms as patients without COVID-19 delay care

By Sharon Bernstein

(Reuters) – A Texas man who waited until his brain tumor was softball-sized; a baby who suffered an ear infection for six days; a heart patient who died: The resurgence of COVID-19 is creating another health crisis as hospitals fill and patients are fearful or unable to get non-emergency care.

With U.S. coronavirus infections reaching new heights, doctors and hospitals say they are also seeing sharp declines in patients seeking routine medical care and screenings – and a rise in those who have delayed care for so long they are far sicker than they otherwise would be.

“I had one lady who had delayed for five days coming in with abdominal pain that was getting worse and worse,” said Dr. Diana Fite, who practices emergency medicine in Houston. “When she finally came in, she had a ruptured appendix.”

After the pandemic was declared a national emergency in March, many states banned non-essential medical procedures, and the number of patients seeking care for other ailments took a nosedive. Hospitals and medical practices were hit hard financially.

Emergency department use dropped by 42% during the first 10 weeks of the pandemic despite a rise in patients presenting with symptoms of the coronavirus, data from the U.S. Centers for Disease Control and Prevention show. In the same period, patients seeking care for heart attacks dropped by 23% and stroke care by 20%.

As the initial outbreak leveled off in the weeks that followed, healthcare experts planned to handle primary care differently should infections rise again, making sure minor procedures like cancer screenings were still allowed and assuring patients that hospitals and clinics were safe.

But the recent surge in cases has swamped hospitals in many states, including Texas, Arizona, Florida and parts of California.

CANCER MORTALITY RATES

Texas has again banned many non-emergency procedures, though cancer surgeries are still allowed, and a hospital in California’s San Joaquin Valley for several days admitted only COVID-19 patients.

Patients without COVID-19 – either out of fear, confusion or because of difficulty in obtaining the care they need – are again staying home.

The result is a healthcare crisis in the making, said Austin oncologist Dr. Debra Patt, who said she expects mortality rates from cancer to skyrocket in the years after the pandemic because patients have delayed their care.

“They’re scared to go in the hospital unless they absolutely have to,” said Patt. “And even when the patients are willing, it’s hard to get things done.”

Patt in recent days treated a man who waited to come in for headaches and dizziness until he had lost 35 pounds and had a softball-sized tumor in his head.

Fite, who is president of the Texas Medical Association, cared for a baby whose parents waited six days before bringing him in with a severe ear infection.

Patt said screening mammograms are down by 90% in Austin, where she specializes in breast cancer and serves as executive vice president of Texas Oncology. That means some tumors will be missed, and women who develop aggressive cancers might not know about it until the disease is more advanced and more likely to be deadly.

“It’s an impact we will see on cancer survival for years to come,” she said.

Dr. David Fleeger, a colorectal surgeon in Austin and a past president of the Texas Medical Association, said he has had numerous patients cancel colonoscopies in recent days.

“The delays in colonoscopies that are occurring right now ultimately will lead to more cancers and more deaths,” he said.

‘IN A HOLDING PATTERN’

Patt’s patient Helen Knost had to put off surgery for breast cancer in early spring because it was considered non-emergency in Texas and barred at the time, and she was treated instead with the medication Tamoxifen.

“It’s very strange to know you have cancer and you’re just hanging out with it, just in a holding pattern,” said Knost, who did ultimately undergo successful surgery.

In California, doctors at the 150-bed Adventist Lodi Memorial Hospital in the San Joaquin Valley were determined that a second surge in coronavirus cases would not bring a repeat of the pandemic’s early days, when emergency room visits dropped in half. Emergency medical technicians also reported a 45% rise in the number of heart patients who died before they could be brought to the hospital.

Hospital CEO Daniel Wolcott led a campaign to inform the community that the medical center was open and safe, even speaking to people about it in the grocery store.

But with new COVID-19 cases swamping the hospital, sickening nearly 30 staff members and forcing it to divert non-coronavirus cases to other facilities for several days, Wolcott fears that again patients with heart conditions and other illnesses will stay away.

“We won’t know for years how many people lost their lives or lost good years of their lives for fear of coronavirus,” he said.

(Reporting by Sharon Bernstein in Sacramento, California; editing by Bill Tarrant and Cynthia Osterman)

Trump declares coronavirus a national emergency

By Steve Holland and Jeff Mason

WASHINGTON (Reuters) – U.S. President Donald Trump on Friday declared a national emergency over the fast-spreading coronavirus, opening the door to providing what he said was about $50 billion in federal aid to fight the disease.

Trump made the announcement at a Rose Garden news conference.

Trump said he was declaring the national emergency in order to “unleash the full power of the federal government.” He urged every state to set up emergency centers to help fight the virus.

Pressure has been mounting for Trump to declare an infectious disease emergency under the 1988 law that would allow the Federal Emergency Management Agency (FEMA) to provide disaster funds to state and local governments and to deploy support teams. The power is rarely used. Former President Bill Clinton in 2000 declared such an emergency for West Nile virus.

(Reporting by Steve Holland; additional reporting by Lisa Lambert and Susan Heavey, Editing by Franklin Paul and Bill Berkrot)

Senate passes, sends Trump stopgap federal funding to November 21

WASHINGTON (Reuters) – The U.S. Senate on Thursday passed a bill that would extend federal funding through Nov. 21 and avert partial agency shutdowns when existing authorization expires on Oct. 1.

The Senate signed off by a vote of 82 to 15 on legislation that was approved by the House of Representatives on Sept. 19, sending it to President Donald Trump for signing into law.

The legislation is needed because Congress and the Trump administration so far have failed to agree on the one-dozen bills that would fund most government activities in the fiscal year that begins Oct. 1.

One of the biggest disagreements is over Trump’s demand for $12 billion in fiscal 2020 to build a wall along the U.S.-Mexico border, which most Democrats and some Republicans oppose.

A central promise of Trump’s presidency has been the construction of a wall to repel immigrants, many from Central America, from crossing into the United States.

In the face of congressional opposition, Trump early this year declared a national emergency, which he said allowed him to divert appropriated money from other programs to the border wall. On Wednesday, the Senate voted to end that emergency declaration, a move Trump likely would veto if the House of Representatives takes the same step.

There are also unresolved disagreements over funding for immigrant detention centers, public health facilities and other issues.

(Reporting by Richard Cowan; Editing by Dan Grebler)

Trump again threatens Mexico border closure, seeks Congress action

U.S. President Donald Trump speaks at the National Republican Congressional Committee Annual Spring Dinner in Washington, U.S., April 2, 2019. REUTERS/Joshua Roberts

WASHINGTON (Reuters) – President Donald Trump again threatened on Wednesday to close the U.S. border with Mexico, this time calling on Congress to take steps immediately to deal with immigration and security loopholes that he says are creating a national emergency.

“Congress must get together and immediately eliminate the loopholes at the Border!” Trump wrote in a Twitter post. “If no action, Border, or large sections of Border, will close. This is a National Emergency!”

Trump has repeatedly threatened to close the border to stem what he calls a tide of illegal immigration. On Friday, he said he would close the border this week unless Mexico took steps to stop illegal migration.

The threat drew an outcry from business leaders and others, who said the move could disrupt legal crossings and billions of dollars in trade. The U.S. Chamber of Commerce, the largest U.S. business lobbying group, said it contacted the White House to discuss the negative impact of a border closure.

Trump took a step back on Tuesday, saying action by Mexico in recent days had eased pressure on U.S. ports of entry. But he revived the closure warning on Wednesday in a bid to pressure Congress to act.

White House adviser Mercedes Schlapp said on Wednesday that progress is being made with Mexico on immigration issues but she declined to comment on whether the border would be closed this week.

“Our resources are being stretched thin. The system is overwhelmed,” she told reporters at the White House. “We are seeing our border patrol commissioner make it very clear that we are at a breaking point.”

Trump has made fighting illegal immigration from Mexico a key part of his agenda but shutting down one of the world’s most used borders might be a step too far even for many of his fellow Republicans.

Senate Republican leader Mitch McConnell said on Tuesday that closing the border could have devastating economic consequences, and joined his Democratic colleagues in warning Trump against such a move.

The White House is looking closely at ways to lessen the economic impact of a border shutdown, Trump economic adviser Larry Kudlow said on Wednesday.

(Reporting by David Alexander, Jeff Mason and Alexandra Alper; Writing by Doina Chiacu; Editing by David Gregorio and Alistair Bell)

Senate votes to terminate Trump national emergency

U.S. President Donald Trump walks down the U.S Capitol steps with Speaker of the House Nancy Pelosi (D-CA) after they both attended the 37th annual Friends of Ireland luncheon at the U.S. Capitol in Washington, U.S., March 14, 2019. REUTERS/Jonathan Ernst

WASHINGTON (Reuters) – The U.S. Senate on Thursday joined the House of Representatives in passing legislation that would defy President Donald Trump by terminating the national emergency on the southern border that he declared on Feb. 15.

Trump has vowed a veto – an act he has not yet taken as president. But enough Republicans in Congress are expected to block any veto override attempt. A two-thirds vote of the House and Senate are needed overturn a presidential veto.

The Senate voted 59-41 to end the emergency.

(Reporting by Doina Chiacu; Editing by Lisa Lambert)

House set to reject Trump’s border wall emergency declaration

U.S. House Speaker Nancy Pelosi (D-CA), flanked by Representative Joaquin Castro (D-TX) (L) and House Democrats hold a news conference about their proposed resolution to terminate U.S. President Trump's Emergency Declaration on the southern border with Mexico, at the U.S. Capitol in Washington, U.S. February 25, 2019. REUTERS/Jonathan Ernst

By Susan Cornwell and Richard Cowan

WASHINGTON (Reuters) – The U.S. House of Representatives was poised on Tuesday to vote for terminating President Donald Trump’s proclaimed national emergency at the U.S.-Mexico border, a first step toward what could be a stinging rejection of his proposed border wall.

If the Democratic-controlled House approves a resolution ending the president’s emergency, as expected, the measure would go to the Republican-controlled Senate where its chances of passage were slimmer, but seemed to be improving.

Trump has vowed to issue a veto, which would be the first of his presidency, against any resolution approved by both chambers targeting the emergency that he single-handedly declared on Feb. 15 as a way to fund his wall by circumventing Congress.

Overriding such a veto in Congress would require two-thirds majorities in both chambers, making it highly unlikely, said lawmakers.

“When you see the vote today, there will be nowhere near the votes to override a veto,” U.S. Representative Steve Scalise, the No. 2 House Republican, told reporters on Capitol Hill on Tuesday.

The battle in Congress is the latest chapter in a long-running war between Trump and Democrats over border security, immigration policy and the “great, great wall” that Trump has pledged to build since becoming a presidential candidate.

He originally promised that Mexico would pay for it, but after Mexico refused, he asked U.S. taxpayers to foot the bill for the project, which Democrats call unneeded and ineffective.

In his first two years in office, Trump’s Republicans controlled both chambers of Congress, which under the U.S. Constitution holds the national purse strings, but lawmakers failed to provide the funding Trump wanted for his border barrier.

When Congress, with the House now controlled by Democrats, refused in recent weeks to provide the money he wants, Trump declared an emergency and vowed to divert funds toward the wall from accounts already committed by Congress for other purposes.

That set up a test of the constitutional separation of powers between Congress and the presidency that will likely lead to a court challenge after lawmakers deal with the resolution.

A coalition of 16 U.S. states led by California has already sued Trump and top members of his administration in an attempt to block his emergency declaration.

Writing on Twitter on Monday, Trump, who says the wall is needed to stop illegal immigration and drugs, warned Republicans not to “fall into the Democrats ‘trap’ of Open Borders and Crime!”

Republican Representative Justin Amash is co-sponsoring the resolution in the House, along with more than 230 House Democrats, and Amash is urging his colleagues to support it.

“The same congressional Republicans who joined me in blasting Pres. Obama’s executive overreach now cry out for a king to usurp legislative powers,” Amash wrote on Twitter.

“If your faithfulness to the Constitution depends on which party controls the White House, then you are not faithful to it,” he wrote over the weekend.

The White House was working to limit Republican support for the measure, especially in the Senate. Vice President Mike Pence was scheduled to attend a Senate Republican luncheon on Tuesday, where the resolution was expected to be a key topic.

Republican Senator Thom Tillis, in an opinion article published in the Washington Post, said he backed Trump on border security, but would vote for the resolution because he “cannot justify providing the executive with more ways to bypass Congress.”

At least two other Republican senators, Susan Collins and Lisa Murkowski, have said they will likely support the measure, too. For it to pass the Senate, at least one more Republican vote would be needed, assuming all Democrats and two independents back it.

Trump declared the emergency after Congress declined his request for $5.7 billion to help build the wall.

Congress this month appropriated $1.37 billion for building border barriers following a battle with Trump, which included a 35-day partial government shutdown – the longest in U.S. history – when agency funding lapsed on Dec. 22.

(Reporting by Susan Cornwell and Richard Cowan; editing by Kevin Drawbaugh and Jonathan Oatis)

U.S. states sue Trump administration in showdown over border wall funds

A view shows a new section of the border fence in El Paso, Texas, U.S., as seen from Ciudad Juarez, Mexico February 15, 2019. REUTERS/Jose Luis Gonzalez

By Jeff Mason and Sarah N. Lynch

WASHINGTON (Reuters) – A coalition of 16 U.S. states led by California sued President Donald Trump and top members of his administration on Monday to block his decision to declare a national emergency to obtain funds for building a wall along the U.S.-Mexico border.

The lawsuit filed in U.S. District Court for the Northern District of California came after Trump invoked emergency powers on Friday to help build the wall that was his signature 2016 campaign promise.

Trump’s order would allow him to spend on the wall money that Congress appropriated for other purposes. Congress declined to fulfill his request for $5.7 billion to help build the wall this year..

“Today, on Presidents Day, we take President Trump to court to block his misuse of presidential power,” California Attorney General Xavier Becerra said in a statement.

“We’re suing President Trump to stop him from unilaterally robbing taxpayer funds lawfully set aside by Congress for the people of our states. For most of us, the office of the presidency is not a place for theater,” added Becerra, a Democrat.

The White House declined to comment on the filing.

In a budget deal passed by Congress to avert a second government shutdown, nearly $1.4 billion was allocated toward border fencing. Trump’s emergency order would give him an additional $6.7 billion beyond what lawmakers authorized.

Three Texas landowners and an environmental group filed the first lawsuit against Trump’s move on Friday, saying it violated the Constitution and would infringe on their property rights.

The legal challenges could slow Trump’s efforts to build the wall, which he says is needed to curb illegal immigration and drug trafficking. The lawsuits could end up at the conservative-leaning U.S. Supreme Court.

Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Virginia, and Michigan joined California in the lawsuit.

The states said Trump’s order would cause them to lose millions of dollars in federal funding for national guard units dealing with counter-drug activities and redirection of funds from authorized military construction projects would damage their economies.

In television interviews on Sunday and Monday, Becerra said the lawsuit would use Trump’s own words against him as evidence that there was no national emergency to declare.

Trump said on Friday he did not need to make the emergency declaration but wanted to speed the process of building the wall. That comment could undercut the government’s legal argument.

“By the president’s own admission, an emergency declaration is not necessary,” the states said in the lawsuit. “The federal government’s own data prove there is no national emergency at the southern border that warrants construction of a wall.”

(Reporting by Jeff Mason and Sarah N. Lynch; Editing by Clarence Fernandez)

California tells Trump that lawsuit over border wall is ‘imminent’

FILE PHOTO: The prototypes for U.S. President Donald Trump's border wall are seen behind the border fence between Mexico and the United States, in Tijuana, Mexico January 7, 2019. REUTERS/Jorge Duenes/File Photo

By David Morgan and David Lawder

WASHINGTON (Reuters) – California will “imminently” challenge President Donald Trump’s declaration of a national emergency to obtain funds for a U.S.-Mexico border wall, state Attorney General Xavier Becerra said on Sunday.

“Definitely and imminently,” Becerra told ABC’s “This Week” program when asked whether and when California would sue the Trump administration in federal court. Other states controlled by Democrats are expected to join the effort.

“We are prepared, we knew something like this might happen. And with our sister state partners, we are ready to go,” he said.

Trump invoked the emergency powers on Friday under a 1976 law after Congress rebuffed his request for $5.7 billion to help build the wall that was a signature 2016 campaign promise.

The move is intended to allow him to redirect money appropriated by Congress for other purposes to wall construction.

The White House says Trump will have access to about $8 billion. Nearly $1.4 billion was allocated for border fencing under a spending measure approved by Congress last week, and Trump’s emergency declaration is aimed at giving him another $6.7 billion for the wall.

Becerra cited Trump’s own comment on Friday that he “didn’t need to do this” as evidence that the emergency declaration is legally vulnerable.

“It’s become clear that this is not an emergency, not only because no one believes it is but because Donald Trump himself has said it’s not,” he said.

Becerra and California Governor Gavin Newsom, both Democrats, have been expected to sue to block Trump’s move.

Becerra told ABC that California and other states are waiting to learn which federal programs will lose money to determine what kind of harm the states could face from the declaration.

He said California may be harmed by less federal funding for emergency response services, the military and stopping drug trafficking.

“We’re confident there are at least 8 billion ways that we can prove harm,” Becerra said.

Three Texas landowners and an environmental group filed the first lawsuit against Trump’s move on Friday, saying it violates the Constitution and would infringe on their property rights.

The legal challenges could at least slow down Trump’s efforts to build the wall but would likely end up at the conservative-leaning U.S. Supreme Court.

Congress never defined a national emergency in the National Emergencies Act of 1976, which has been invoked dozens of times without a single successful legal challenge.

Democrats in Congress have vowed to challenge Trump’s declaration and several Republican lawmakers have said they are not certain whether they would support the president.

“I think many of us are concerned about this,” Republican Senator Ron Johnson of Wisconsin, who chairs the Senate Homeland Security Committee, told NBC’s “Meet the Press.”

Trump could, however, veto any resolution of disapproval from Congress.

White House senior adviser Stephen Miller told Fox News on Sunday that Trump’s declaration would allow the administration to build “hundreds of miles” of border wall by September 2020.

“We have 120-odd miles that are already under construction or are already obligated plus the additional funds we have and then we’re going to outlay; we’re going to look at a few hundred miles.”

Trump’s proposed wall and wider immigration policies are likely to be a major campaign issue ahead of the next presidential election in November 2020, where he will seek a second four-year term.

(Reporting by David Morgan and David Lawder; Editing by Lisa Shumaker)

Trump says he’ll declare emergency on U.S.-Mexico border

A U.S. Border Patrol agent listens from the front row as President Donald Trump declares a national emergency at the U.S.-Mexico border during remarks about border security in the Rose Garden of the White House in Washington, U.S., February 15, 2019. REUTERS/Carlos Barria

By Roberta Rampton and Richard Cowan

WASHINGTON (Reuters) – President Donald Trump on Friday announced he would declare a national emergency at the U.S.-Mexico border, a move Democrats vowed to challenge as an unconstitutional attempt to fund his promised border wall without approval from Congress.

“I’m going to be signing a national emergency,” Trump said from the Rose Garden of the White House.

“We have an invasion of drugs, invasion of gangs, invasion of people, and it’s unacceptable,” he said.

The president said he would sign the authorizing paperwork later in the day in the Oval Office.

Trump was also expected on Friday to sign a bipartisan government spending bill approved by Congress on Thursday that would prevent another partial federal government shutdown by funding several agencies that otherwise would have closed on Saturday morning.

The bill, which contains no money for his wall, is a defeat for Trump in Congress, where his demand for $5.7 billion in barrier funding yielded no results, other than a record-long, 35-day December-January partial government shutdown that damaged the U.S. economy and his opinion poll numbers.

Reorienting his wall-funding quest toward a legally uncertain strategy based on declaring a national emergency could plunge Trump into a lengthy battle with Democrats – and divide his fellow Republicans.

Fifteen Democrats in the Republican-controlled Senate introduced legislation on Thursday to prevent the transfer of funds from accounts Trump likely would target to pay for his wall.

Nancy Pelosi, the Democratic Speaker of the House of Representatives, and Chuck Schumer, the Senate’s top Democrat, swiftly responded to Trump’s declaration.

“The president’s actions clearly violate the Congress’s exclusive power of the purse, which our Founders enshrined in the Constitution,” they said in a statement. “The Congress will defend our constitutional authorities in the Congress, in the courts, and in the public, using every remedy available.”

The president acknowledged that his order would face a lengthy legal challenge. “We’ll win in the Supreme Court,” Trump said.

Trump has argued the wall is needed to curb illegal immigrants and illicit drugs streaming across the southern border despite statistics that show illegal immigration there is at a 20-year low and that many drug shipments are likely smuggled through legal ports of entry.

At Friday’s White House event, a half-dozen women holding poster-sized pictures of family members killed by illegal immigrants preceded Trump into the Rose Garden. He cited their presence in announcing the emergency declaration.

A senior White House official, speaking on condition of anonymity, said the administration had found nearly $7 billion to reallocate to the wall, including $600 million from a Treasury Department forfeiture fund, $2.5 billion from a Defense Department drug interdiction fund and $3.5 billion from a military construction budget.

Trump on Friday estimated the order could free up as much as $8 billion to construct the wall.

The funds would cover just part of the estimated $23 billion cost of the wall promised by Trump along the nearly 2,000-mile (3,200-km) border with Mexico.

The Senate Democrats’ bill also would stop Trump from using appropriated money to acquire lands to build the wall unless specifically authorized by Congress.

(Reporting by Richard Cowan and Roberta Rampton Morgan; additional reporting by David Morgan, Steve Holland, Susan Cornwell, Makini Brice and Eric Beech; Writing by James Oliphant, Kevin Drawbaugh and Peter Cooney; editing by Jeffrey Benkoe and Jonathan Oatis)

Trump says may declare an emergency for wall as little headway in talks

U.S. President Donald Trump speaks during a meeting to "discuss fighting human trafficking on the southern border" in the Cabinet Room of the White House in Washington, U.S., February 1, 2019. REUTERS/Jim Young

WASHINGTON (Reuters) – President Donald Trump said on Friday he might declare a national emergency to obtain funding to build a wall along the U.S. border with Mexico because it did not appear Democrats were moving toward a deal that would provide the money.

“We’re not getting anywhere with them,” Trump said during an event at the White House.

“I think there’s a good chance that we’ll have to do that,” he added, referring to the possibility of an emergency declaration that could allow him to use funds that Congress has approved for other purposes.

His comments came a day after Nancy Pelosi, the Democratic speaker of the House of Representatives, told reporters, “There’s not going to be any wall money” in legislation to fund border security for the rest of this year.

Pelosi said funding for more ports of entry or additional border security technology was open for negotiation. She added that the 17 House and Senate negotiators working on legislation to fund homeland security for the year should decide the components of the nation’s border security.

Democratic negotiators unveiled a detailed opening position containing no money for any type of additional physical barriers on the border to control the flow of undocumented immigrants and illegal drugs. Previously they had supported $1.3 billion for new fencing and improvements to existing barriers.

Trump has said he has to have a wall for border security.

(Reporting by Steve Holland; Writing by David Alexander; Editing by Tim Ahmann)