NOEL KING, HOST:
The first coronavirus vaccine in the U.S. could be approved in just a few days, but the next few months still look bleak.
DAVID GREENE, HOST:
Yeah, there's definitely a mix of good news and bad news here. The good news - case numbers have stabilized in parts of the Midwest, but now hospitals in the Sunbelt states are getting totally overwhelmed.
KING: Health reporter Will Stone is covering this one. Good morning, Will.
WILL STONE, BYLINE: Good morning.
KING: All right. So we have cases up in Arizona, in Texas, and now New Mexico's governor is warning that hospitals may have to ration care. That's the governor's words. What's going on in this region?
STONE: Yeah, the virus has just swept across the Southwest. And remember, this is where that summer surge was absolutely devastating. But in Arizona, you know, the state's now breaking records and cases are also higher in Texas than they've ever been. And in both states, hospitalizations are getting closer to that summer peak. New Mexico actually did pretty well until the fall. And the crisis there, I think, shows just how hard it is to get this virus under control once it takes off. That state went much further than others. Last month, the governor put in place a stay-at-home order. But still, doctors are facing down a nightmare scenario. Take a listen to Dr. Irene Agostini, who's at the University of New Mexico Hospital.
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IRENE AGOSTINI: All of our people want to help, and they want to be there for you. But please, please don't put us in that position to have to ration care. You know, if you're on the battlefield, that's one thing. But in a hospital in New Mexico, we never want to do that.
STONE: It may not come to that, and cases have come down, and it can take a while for these stay-at-home orders to really pay off. But hospitals have to be ready if they reach capacity.
KING: But if it does come to that, Will, what would rationing care mean in actual practice?
STONE: Yeah, it's not going to be an on or off switch. It will happen bit by bit. But doctors do describe it as a very fundamental shift. You go from doing everything possible for one patient to maximizing the benefits to save the most lives. And people tend to think about finite resources, who gets a bed or who gets a ventilator. But for COVID, it may come down to who gets the best care from doctors and nurses because that is the most limited resource. And this could be on the horizon not only in New Mexico but possibly Utah, Missouri, Idaho, to name just a few.
KING: That's a very scary thought. What about in the Midwest? David said there's some good news there.
STONE: Yeah, there has been some improvement in the past few weeks. It seems like parts of the Midwest and the West have at least stabilized. And a promising sign is that hospitalizations are slowing down, especially in Iowa, Wisconsin and Kansas and to a lesser extent in the Dakotas and Illinois. But experts say this is very tenuous because the Midwest is still inundated with the virus, and the rate of infections per capita is much higher than any other region.
KING: So what are we looking at over the next couple weeks?
STONE: Well, it's a very grim forecast. More than 105,000 people are in the hospital right now. And Dr. Peter Hotez at Baylor College of Medicine says just imagine what happens if that keeps climbing like it has been.
PETER HOTEZ: That's when mortality levels skyrocket is when it starts becoming difficult to take care of patients in an optimal way. We saw that in New York. We saw it in southern Europe. We're seeing it now in pockets across the country.
STONE: And what's really scary is that hospitals have not seen the impact of the Thanksgiving holidays fully yet. So the wave of sick patients that's expected to hit just ahead of the next round of holidays while people are out again traveling and being exposed is just going to create a whole nother stress on the health care system.
KING: Health reporter Will Stone. Thanks, Will.
STONE: Thank you.
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KING: All right. So President-elect Joe Biden will announce two more of his Cabinet nominations this morning.
GREENE: That's right, and one name is familiar. Tom Vilsack was secretary of agriculture in the Obama administration. And Joe Biden wants him to come back into that same job at Ag. Biden is nominating Ohio Congresswoman Marcia Fudge to be secretary of Housing and Urban Development. Curiously, though, a lot of people had been urging Biden to pick Fudge for the agriculture job but not HUD.
KING: NPR's Dan Charles covers food and agriculture. Hey, Dan.
DAN CHARLES, BYLINE: Hi, Noel.
KING: Why did so many people want Marcia Fudge to get the agriculture job instead of HUD?
CHARLES: Well, there is something that's useful to know about the U.S. Department of Agriculture. When it was set up, you know, 150-some years ago, the country was half farmers, and the department was set up to support them. And it still does a lot of that. The country has changed. And the biggest part of the USDA's budget is now for nutrition aid, the Supplemental Nutrition Assistance Program, SNAP, school lunches. Those programs reach something like a quarter of the people in the country. And Marcia Fudge has been a fierce defender of that nutrition part of the USDA. She represents a district that includes much of Cleveland, Akron, Ohio. She and her supporters felt it was high time for the top job at USDA to go to somebody who saw that as a top priority for the department. But we are not getting Marcia Fudge. He went for somebody much more traditional.
KING: And that somebody is Tom Vilsack, who's the former governor of Iowa, a very familiar name.
CHARLES: Yeah, he was secretary of agriculture for all eight years of the Obama administration. Apparently, that was not enough for him. He is kind of a middle-of-the-road figure, considered evenhanded, certainly knows the issues. But those anti-hunger groups and the environmental organizations who wanted change at the USDA really are not very happy about this choice. I mean, part of it is they wanted that new direction, you know, more focused on hunger and the environment. But also, Tom Vilsack, after he left the Obama administration, took a job as CEO of an industry group, the U.S. Dairy Export Council. And his critics say this is, you know, a signal of the problem. They say he's too cozy with the big companies that dominate agriculture.
KING: Oh, that's really interesting. Your reporting on this goes so deep. I wonder, do you expect that a Biden administration is going to make any big notable changes when it comes to farm or food policies?
CHARLES: There are some things that will change. One thing I think almost certainly will change - the astonishing thing over the last two years is just the sheer amount of money that the Department of Agriculture has doled out to farmers. This year, it's $46 billion in direct government payments. I don't think that can continue, not at that level. There's another interesting thing. There's been a lot of talk about the USDA playing a big role in actually responding to climate change. There's money for this. Rural development programs could help pay for clean energy in rural areas. There are plans to pay farmers for practices on the farm that reduce greenhouse emissions. It could also help do reforestation. People don't realize it, but the U.S. Forest Service is part of the Department of Agriculture.
KING: NPR's Dan Charles. Thanks, Dan.
CHARLES: Thank you.
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KING: Army Secretary Ryan McCarthy has fired or suspended 14 top leaders at Fort Hood after an investigation.
GREENE: It's amazing to think of what's been happening at Fort Hood. There were five homicides this year alone on the Texas Army base; also numerous cases of sexual assault that date back years.
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RYAN MCCARTHY: I am gravely disappointed that leaders failed to effectively create a climate that treated all soldiers with dignity and respect and that failed to reinforce everyone's obligation to prevent and properly respond to allegations of sexual harassment and sexual assault.
GREENE: That was Army Secretary McCarthy yesterday speaking at the Pentagon.
KING: With us now, Rose Thayer, who's a regional reporter for Stars and Stripes news. She's been covering the Fort Hood story from Austin, Texas. Hey, Rose.
ROSE THAYER: Hi. Good morning.
KING: What on Earth has been going on at Fort Hood? How did we get here?
THAYER: Yeah. It's been a tough year at Fort Hood. Over the summer, Secretary McCarthy convened this civilian panel to look at the rash of violent crimes that have taken place at the base. During a visit there, he said that the base has the highest numbers when it comes to violent felonies than any other Army formation. Back in April, Army Specialist Vanessa Guillen went missing from the base. And it was two months before we found out that she had been murdered by a fellow soldier during the workday on the Army base. So it really gained national attention, international attention. And during that, her family spoke that she had been sexually harassed while she was working at Fort Hood. And that inspired a number of soldiers and veterans to come forward on social media and tell their own stories and sort of expose this fear of retaliation. And so yesterday, this panel came back with findings that the Fort Hood command structure has created a permissive environment for sexual assault and sexual harassment. And it singled out this sexual harassment and assault response program known as SHARP. They found that there was a fear of retaliation, mostly among lower enlisted soldiers, and that they were significantly underreporting these crimes and harassment that was happening to them.
KING: OK. So it sounds like a significant number of people not doing their jobs well and a significant number of people suffering because of that. So then Army Secretary Ryan McCarthy is the one who responds to all of this. And what measures does he announce?
THAYER: Yesterday, Secretary McCarthy responded, and he said that he's relieved or suspended 14 leaders at the base. That includes relieving a two-star general. He put another two-star general on suspension pending another investigation. He also relieved the command team that oversaw Vanessa Guillen's unit. He said that of the 70 recommendations that came back from this committee, he's committed to implementing all 70 of them, which is - it's pretty impressive that he's willing to do that. And he set up this task force that has until March to tell him how this implementation process is going to happen.
KING: You were at Fort Hood yesterday. What was the reaction like?
THAYER: Yeah. Fort Hood commander General White held a press conference yesterday after Secretary McCarthy made the announcement. It was a very somber tone. He wanted people to know and his command teams at Fort Hood to know that this is something that's going to make changes, and he is going to take it very seriously. He then, you know, brought 2,000 soldiers together at an outdoor football stadium and he addressed them, quite frankly, about what was happening. You know, many of those soldiers had been at work all day. They didn't even know what had happened. They didn't know that some of their chain of command had been fired earlier in the day. But afterwards, I spoke to one female soldier who - she's been following this very closely. She's been working at Fort Hood for about a year now. And, you know, she has friends who are impacted by this, and she really wants to see these changes.
KING: Rose Thayer, a regional reporter for Stars and Stripes, thanks so much.
THAYER: Yep. Thank you. Transcript provided by NPR, Copyright NPR.