Here & Now

Here & Now for January 21, 2022

Announcer:

The following program is a PBS Wisconsin original production.

Frederica Freyberg:

COVID-19 cases are through the roof, and Wisconsin has not yet seen the peak of omicron infections. Cases and hospitalizations in children are on the rise, prompting public health doctors to double down on prevention and safety.

Woman:

Getting your child vaccinated against COVID-19 and getting them boosted if they’re eligible not only protects them from the short-term impact of COVID-19, but also from some of the long-term symptoms as well.

Frederica Freyberg:

I’m Frederica Freyberg. Tonight on “Here & Now,” with COVID-19 cases not yet at their peak but hugely spiking, what are UW campuses looking ahead to as students return for spring semester? A bioethicist explains how decisions are made about who to give priority COVID care and Wisconsin described as a microcosm of efforts nationwide to upset election procedures in the aftermath of 2020. It’s “Here & Now” for January 21.

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Funding for “Here & Now” is provided by the Focus Fund for Journalism and Friends of PBS Wisconsin.

Frederica Freyberg:

Next week marks the start of the spring semester on the flagship campus of the UW. Madison welcomes students back to class in the midst of a massive spike in COVID-19 cases statewide, including with beefed-up testing availabilities and new vaccine clinics. Other system campuses also prepared with updated guidance and mitigation strategies. Our next guest is the point person for all of this at UW-Madison. Jake Baggott is associate vice-chancellor and executive director of University Health Services. He joins us now and thanks very much for being here.

Jake Baggott:

Good afternoon. It’s good to be here. Thank you.

Frederica Freyberg:

So what kind of trepidation do you have with students returning from all corners in the midst of this fast-spreading omicron variant?

Jake Baggott:

Obviously, we’re giving a lot of thought to that and giving advice to our students about how to prepare to travel here and then what to do when they arrive. We’ve given them instructions that when they’re ready to travel here, before they do that to go ahead and get tested at home. And if they end up with a positive result, to stay there until those symptoms resolve and they’re cleared to travel. But even after they get here, we’re ready for them to get tested whether they live in the residence hall or live off campus, we’ll have testing capacity available for them. So we can help identify any cases that might have been missed earlier on. We think that will do a lot to prepare our students. On top of that, we have a high level of vaccination within our population. Our students have really responded very, very strongly so we have a high level of protection already in place.

Frederica Freyberg:

If students in dorms when they get back get a positive result, are there additional isolation or quarantine living spaces for students?

Jake Baggott:

Right. So we’re in our fifth semester of working through this kind of thing, so we’ve got a fair amount of experience. So we’re already prepared with on-campus housing capacity to support that need should it, when it arises and we also have additional capacity in the community through hotels. If we have a need, we can expand that capacity. But I feel like we’re well prepared to respond when that need develops.

Frederica Freyberg:

I know that masks continue to be required in university buildings, and now N95s are recommended. UW-Madison has a large stock of those. I should say that we were able to get some from UW-Madison. Thank you. But can students get them?

Jake Baggott:

So yes. We have a large supply of both those kinds of masks as well as high-grade surgical masks available for our students and our population, our campus population in general. And so those will be available to students. When they arrive they can get those when they pick up their test kits at the sites here on campus. What’s really important about the masks is to make sure you have one that’s good-fitting. Make sure it’s providing the level of protection that it’s designed to do so. And whether it’s a surgical mask or a KN95 or N95.

Frederica Freyberg:

So I know that there are high rates of vaccination among students and staff at UW-Madison. What about boosters? What is your guidance around boosters for the entire population?

Jake Baggott:

So the guidance from us and CDC and DHS has been if you’re eligible to get boosted, go ahead and get boosted and we’ve been encouraging students, and staff and employees to go ahead and do that. And many have responded in very strong numbers. We know that that happened starting before they left for the break and we are set up to support that need when students arrive. We’ll have added capacity to do that. But we also know that many individuals have already done that over the break. They’re sharing that information with us and we’re seeing a very strong response. We’re going to continue to encourage folks to do that as soon as they’re eligible. We think that’s an important level of protection as well.

Frederica Freyberg:

As students are returning really across the state, what is your overall message to students newly returning to campus?

Jake Baggott:

Sure. The things that they’ve been doing all along to protect themselves, those good health practices, to be thoughtful about how you spend your time, wear face coverings when inside, in particular when you’re not sure if you’re around fully vaccinated individuals. Take advantage of the testing capacity. It’s available here on campus, in our communities and even the federal government is starting to roll out in larger numbers. Those things will help you kind of pay attention to what’s going on, follow health protocols and we feel like we’ll be in a strong position going into the start of the semester. And I think that will serve students well in general.

Frederica Freyberg:

All right. We will leave it there. Thanks very much for your work and we’ll see how this goes as the throngs return. Jake Baggott, thanks very much.

Jake Baggott:

Thank you.

Frederica Freyberg:

One person who will contend with the pandemic at the university is the new system president. Today the UW Board of Regents unanimously voted to name Jay Rothman as the president of the university system. He’s the chairman and CEO of the Milwaukee-based law firm Foley & Lardner. A graduate of Marquette and Harvard Law, he also previously served as chairman of the board of Children’s Wisconsin. In a statement after the vote, Rothman said he is “humbled by the opportunity to lead the UW system.” He will start in his role June first and this reminder, PBS Wisconsin is part of UW-Madison.

This week some 80 National Guard members took part in nurse training, a step the state is taking to provide help to the strained health care system in Wisconsin. The guard troops will have spent ten days training at Madison College and will be deployed around the state.

Lisa Marie Greenwood:

There is a tremendous need for health care providers at this point in time. We see that our hospitals are full, our long-term care facilities are full. We have just reached our two-year anniversary with COVID. And our health care providers are beyond exhausted. And they desperately need our help. When they are deployed across Wisconsin communities in greatest need, they will have those skills in hand that they can then be immediately providing hands-on care to our communities that are in need.

Andrew Moen:

I have some family members that are in nursing or work at hospitals that– they are struggling a little bit, at least from what they’ve told me, and I think it’s going to be cool to go have an impact on our state and the people.

Frederica Freyberg:

Officials at Madison College say there could be another class of 80 guard members receiving training by the end of January.

COVID-19 cases persist in Wisconsin. A new seven-day average of 17,586 positive infections were reported and the state epidemiologist says we have not hit the peak of the omicron surge. “Here & Now” reporter Will Cushman, author of our online “COVID-19 Condition” series joins us now with more. Thanks for being here.

Will Cushman:

Hey, Fred.

Frederica Freyberg:

Last week we learned that a data dump of positive cases contributed to these huge numbers and even later this week a daily count was more than 15,000. Are we kind of just in the real number now or what’s going on with all that?

Will Cushman:

Yeah. Great question. And we are back to kind of new daily case numbers that do reflect the daily reality. The state Department of Health Services did, as you say, kind of dump some data at the end of last week and early this week that resulted in some really high daily case counts, including on Monday. There were over 35,000 new cases reported on just that day. But that was a result of DHS updating its system, automating part of its system due to actually a backlog of cases that had been in the system kind of piling up for a couple of weeks just because of the crush of the omicron surge. But that backlog was cleared early this week, so the case numbers are kind of back to reflecting daily reality.

Frederica Freyberg:

All right. So a lot of people are asking has Wisconsin yet hit this peak. And the state health officials are saying we haven’t. What else are they saying about that?

Will Cushman:

Yeah. They’re saying that the evidence is not there yet that we have hit or are imminently going to hit the omicron peak. They noted that some places around the U.S. probably are a little bit beyond the peak. Those would be the places that got hit first by omicron, places like New York City. They said in a briefing yesterday, on Thursday, that, yeah, we’re not quite there yet. The evidence isn’t quite there yet. They also reminded us that once we do hit that peak, there will be just as many infections on the downside from that peak as there were leading up to it, so we will by no means be out of the woods just because we hit the peak.

Frederica Freyberg:

Good point. The state is putting on the push to protect children to both keep them from getting sick and keep them in school. What do pediatric case counts and hospitalizations look like?

Will Cushman:

Children have accounted for a large part of the cases during the omicron surge. Cases have actually risen most sharply among children of all age groups. There have been about 50,000 new cases among children 18 and younger since the beginning of the year. So that’s just a few weeks. That’s really a very high number of cases. Very few of those actually result in symptoms that are so severe that children are being hospitalized at high rates, but there are children being hospitalized all around the state, including just this last week in Milwaukee County alone 75 children were hospitalized with COVID.

Frederica Freyberg:

And yet as we’re suggesting, it’s still true, is it not, that those cases are not necessarily as severe?

Will Cushman:

Yes. That is true. And I should also add that it’s not totally clear all the time whether children or anyone for that matter, based on the data that we have, are hospitalized because of the symptoms they are experiencing due to COVID or if they’re hospitalized perhaps for another reason and also are testing positive for COVID while they’re in the hospital. Although there are definitely a lot of people in the hospital right now specifically for COVID.

Frederica Freyberg:

Yeah. Very scary. Thank you so much for your information and your reporting on this, Will Cushman.

Will Cushman:

You’re welcome, Fred.

Frederica Freyberg:

For more coverage on the COVID condition in Wisconsin and Will’s reporting, visit PBSwisconsin.org and then click on the news page.

Which patients are getting priority treatment for COVID-19? The unvaccinated or the fully vaxxed, even if patients in that latter category might be at high risk? And are the decisions fair or right? These are questions for a medical ethicist. We are joined by one now. Karola Kreitmair is an assistant professor of bioethics at UW-Madison. She joins us. Thanks for being here.

Karola Kreitmair:

Thanks for having me.

Frederica Freyberg:

Are there priorities hierarchies for who gets treatment even aside from COVID?

Karola Kreitmair:

Well, yeah. Sure. And if you’re in the ER and you’re taking care of someone with a scraped knee and then suddenly a trauma casualty comes in, it makes no sense to continue taking care of the scraped knee when someone is in sort of life-threatening condition. Or with organ allocations for organ transplantation, there are priorities given to those who are likely to die without the organ over those who have more of a chance of surviving for longer without. So we generally tend to prioritize individuals who have the greatest need even outside of COVID.

Frederica Freyberg:

So in a perfect world, anyone who needed it would get the treatment they need, like an ICU bed. But in the COVID-19 reality right now, who is getting ICU care?

Karola Kreitmair:

Well, in the COVID-19 reality, the first thing that has happened is that ICU beds are sort of — the pressure on ICU beds is reduced by cancelling operations, not accepting transfers in, treating patients on the floor rather than in the ICU. And so that all comes with costs. Obviously when an operation is cancelled, over time a condition that might not have been life-threatening could end up being life-threatening. So this is sort of the first stage of what to do about ICU beds in the COVID-19 world. And then the second stage is really when these crisis standards of care are implemented. This is when hospitals implement specific policies where they decide how to prioritize patients for things like ventilators and ICU beds. I think every bioethicist in the country has been thinking about these issues over the last two years and has come up with a — helped to come up with a policy for a hospital. And the two principles that we’ve really found are most important here are save the most lives, so generate the most benefit from the resources that you have, and don’t exacerbate existing social inequalities.

Frederica Freyberg:

So as to COVID patients, are there or should there be given priority to patients who “did the right thing” and got vaccinated and boosted?

Karola Kreitmair:

No, because medicine is not, nor should it be, the moral arbiter of deservingness, right? If someone comes in with a heart attack because they didn’t listen to advice and continued to eat cheeseburgers or didn’t run on the treadmill, we don’t say, “Well, tough, that was your own fault.” No, we treat people based on what they need. Same with addiction. We’ve learned that addiction is better conceptualized as a disease rather than people making really stupid decisions for no reason. So it’s the same with vaccination status. We shouldn’t be blaming people for their lack of vaccination status or their lack of vaccination. If we want to blame someone, we should be blaming those people who are spreading lies and misinformation that is causing people to think that they are better off if they’re unvaccinated.

Frederica Freyberg:

So similar to that, why would unvaccinated patients be in line for new treatments, the pill that’s just out, over vaccinated patients?

Karola Kreitmair:

Yeah. So like I said with the allocation of critical care resources, we want to give the resources to individuals where they can have the most benefit. And if someone is going to get very sick from COVID, they’re likely to take up a lot of our resources, maybe take up an ICU bed and that would be bad for everyone. So prioritizing unvaccinated individuals in some cases means that those people who are most likely to get sick, most likely to take up resources don’t end up taking that resource and then it ends up being better for everyone. So in a sense it makes sense from a societal level perspective.

Frederica Freyberg:

Things are happening so fast obviously in health care right now with this pandemic. So these kinds of triage decisions are being made on the spot, I imagine. Would you suggest changing that?

Karola Kreitmair:

Well, it’s hard because talking about triage makes it sound like there’s a point when we don’t do triage and then we step over into the realm of triage. But triage occurs kind of all the time. And when we don’t have these explicit policies that give providers the guidelines on how to be making these decisions and kind of take some of these decisions out of their hands, we’re really forcing the bedside nurses and doctors to make some of these decisions and they’re not in the best place to make these decisions, nor should they. That’s not part of what it means to act as a nurse or a doctor. So I do believe that if there were more leadership from central places, state or federally, on what the protocols should be that should be implemented in these situations, we would have more ethical outcomes.

Frederica Freyberg:

All right. Very interesting stuff. We could speak a lot longer. But, professor, thanks very much.

Karola Kreitmair:

Thanks. Thanks again.

Frederica Freyberg:

At the Capitol, the State Supreme Court heard arguments this week in a suit to decide the next voting maps for Wisconsin. The court previously announced it would try to make as few changes as possible to the current maps, which some argue lock in Republican majorities in the legislature. The court must also consider changes to the state’s minority communities. Under the federal Voting Rights Act, minority communities cannot be gerrymandered out of political voice. Here’s Justice Pat Roggensack on that point.

Pat Roggensack:

I’m looking at what’s happened in the Milwaukee community and I go back and I look at how African-Americans have fared in elections there. And I have some very specific questions, particularly, you know, the fact that Lieutenant Governor Mandela Barnes was elected to be the candidate to run with the governor with 67.86% of the vote in the primary defeating a white candidate. So to me that appears in a statewide contest you have — you have African-American candidates being supported by white voters which one would think we should. But that certainly doesn’t show a block voting, okay, by white voters to knock out an African-American candidate.

Frederica Freyberg:

The redistricting process in Wisconsin is going about as expected, landing before the State Supreme Court. What might be considered unexpected, infighting among legislative Republicans over allegations of fraud in the 2020 elections. Infighting that caused Speaker Robin Vos to strip a member of his caucus of his staff.

Robin Vos:

There are some who believe – one who believes – that we somehow have the right, even though every lawyer that we have worked with in Wisconsin says we cannot undo the 2020 elections. You know, Representative Ramthun has that belief. That’s his right.

Frederica Freyberg:

All of what is happening in this state with elections is what our next guest calls “exceptional and dangerous.” UW-Madison Professor Barry Burden is the director of the Elections Research Center and thanks very much for being here.

Barry Burden:

Glad to be here.

Frederica Freyberg:

Specify why you call how the last election is being treated right now in Wisconsin “exceptional and dangerous”?

Barry Burden:

The exceptional part is probably more obvious. We’ve seen a series of things happen since the election we’ve never seen before in modern history. Not only did we have the normal audits and canvass that happen after the election, but there was a recount in the state’s two biggest counties, Dane and Milwaukee. And then a series of investigations, audits, hearings that were based not in fact and not drawing on the expertise of people who actually run elections or know how these things work and seem to have a kind of open-ended quality to them, with no clear resolution in sight. All of these efforts, particularly the Gableman investigation, are not likely to resolve people’s questions or build confidence. They’re likely to further undermine it and keep those suspicions on the table. And I say that’s dangerous because support for the outcome of elections is an essential part of a democracy. Voters have to be willing to accept the results once the courts have done their business and decided they are finalized and move on and try to win the next election. Instead, these efforts I think are keeping those suspicions alive and relitigating the 2020 election.

Frederica Freyberg:

These efforts seem to have hit a fevered pitch with subpoenas flying and threats of jailing big city mayors and on and on. But does the Gableman investigation stand out even among other states’ efforts in this way?

Barry Burden:

Absolutely. I think the only parallel would be the Cyber Ninjas investigation that took place in Arizona. That was funded mostly by private dollars rather than state dollars the way the Gableman investigation is. But both of them were run by people with no expertise in the field, staffed mostly by either Trump supporters, Trump loyalists or people who were election skeptics and deniers and have no endpoint, no limitation of scope, no clear questions defined. Both the Cyber Ninjas project and the Gableman investigation have kind of hopped from one topic to another. Sometimes it’s voting machines. Sometimes it’s purging of voters. Sometimes it’s private contracts. Sometimes it’s drop boxes. So it’s unclear how a project like that ever reaches something convincing at the end of the work.

Frederica Freyberg:

So the slate of Republican electors in Wisconsin called “fraudulent electors” who sent their votes for Trump to Washington are described as part of a national coordinated campaign that the January 6 committee is now investigating. What is your response to the ten Republican false electors in this state?

Barry Burden:

It’s bizarre. You know, those fake electors signed the certificates after all of the legal challenges had been concluded. It was not as though there was still a question about who had won the state and the courts were working their way through the system. It was time for the electors to vote in the state Capitol. It was more than a month since Election Day and the final decision from the State Supreme Court had been rendered just a couple hours, I think, before those electors met at the state Capitol. It wasn’t based on facts on the ground in Wisconsin. A real specific knowledge of things that had gone wrong here because it was the same effort in Arizona and other competitive battleground states. It was a national campaign, as we’re learning, led by folks inside the Trump operation to try to set the stage for overturning the election on January 6.

Frederica Freyberg:

In fact, one of those Republican electors who signed that paperwork that was sent along to Washington is actually a commissioner on the Wisconsin Elections Commission. What’s your response to that?

Barry Burden:

It seems unconscionable to me that someone who is responsible for overseeing elections at the statewide level is also so closely attached to one of the national campaigns and so committed to it that the person would sign a fake electoral certificate. I don’t know how that’s possible. It’s certainly not ethical and not helpful.

Frederica Freyberg:

You say that you would welcome an actual review of the 2020 pandemic election, but you call this one and I’m quoting, “secretive, bumbling and lacking credibility.” But what would you want to learn in an actual review?

Barry Burden:

I think there are good questions to be raised about areas of state law that should be clarified after the election, particularly around absentee voting with so many people voting by mail or voting early for the first time. What should be done about nursing homes and drop boxes and all of the issues that became a part of the election infrastructure in a way they had not been before? Some of those are just not well specified in the law because they weren’t anticipated for good reasons. You can imagine state legislators were not anticipating a public health crisis that would cause the system to have to change as radically as it did. So I think some serious consideration for how to tweak the laws is warranted.

Frederica Freyberg:

Does it suggest in tweaking the laws that there was anything going on that was wrong or fraudulent?

Barry Burden:

I think the courts have already concluded that there was nothing wrong or fraudulent that had gone on. The Legislative Audit Bureau’s report indicated that there were areas of state law that should be clarified. And there were some practices that were a little sloppy or uneven across the state but that’s true in every election. It’s a human process. It’s an imperfect one and I think trying to perfect it ought to be the job of the state legislature.

Frederica Freyberg:

Barry Burden, thanks very much for joining us with your perspective on this.

Barry Burden:

Glad to be here.

Frederica Freyberg:

That is our program for tonight. I’m Frederica Freyberg. Have a good weekend.

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Funding for “Here & Now” is provided by the Focus Fund for Journalism and Friends of PBS Wisconsin.