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California AG Calls For Coronavirus Drug Supply, County Exploring Outsourcing Jail Health Care, Veteran Voices, Mexico’s Violence Hits All-Time High, SD Writers Festival Wraps Up

 August 5, 2020 at 11:37 AM PDT

Speaker 1: 00:00 California's attorney general goes to bat for a lifesaving Speaker 2: 00:03 Drug. Please take the actions you can under federal law to try to boost the supply and the availability and the affordability of from deciview right. Speaker 1: 00:11 I'm Alison st. John, along with Maureen kavanah. This is KPBS Monday, Speaker 2: 00:24 [inaudible] Speaker 1: 00:24 San Diego wrestles with how to provide decent health care to inmates of the County. Jails Speaker 2: 00:30 Is, um, more ideological than just who's going to be delivering the services Speaker 1: 00:35 Homicides in Mexico, arising and Tijuana has the highest count. And the San Diego writer's festival has been a page Turner. We'll hear what publishers are looking for from new storytellers. That's sort of the head on midair. Yeah. Speaker 1: 01:01 Our top story on mid day edition California's attorney general heavy of is Sarah is calling on the federal government to increase the availability and decrease the price of desert. It's the only drug given FDA authorization to treat COVID-19, but because of limited supplies, a national institutes of health panel recommends prioritizing the drug for hospitalized patients who require supplemental oxygen, but are not on ventilators. Ram does severes, California based manufacturer Gilead sciences priced around of treatment at $3,000. According to news reports, generic versions of the drug are being priced below $100, but are not available in the U S but Sarah and other attorneys general sent a letter to federal agencies, asking them to license out the drug to other producers since it was developed in part with taxpayer dollars. But Sarah spoke to KPBS health reporter, Taran mento hours after he sent the letter, why are you taking this step as part of this? Speaker 2: 02:05 Well, we haven't seen the federal government take the actions that it can. And for many of us are watching too many of our, our fellow Californians fellow Americans, uh, either pass on or become ill. And when you've got some treatment that has shown some level of success in helping fight off the virus, you gotta do what you can. And when the federal government has the tools in place, the laws that allow them to, and we haven't seen them do it yet, but we think it's time. And it's a bipartisan letter that is going out from the majority of States in this country saying, please take the actions you can under federal law to try to boost the supply and the availability and the affordability of from deciview, which is a medication that has proven fairly successful in helping people combat COVID-19. Speaker 1: 02:54 You know, and I know there's a number of attorneys general that are involved in this, but California, doesn't the best relationship Speaker 3: 03:00 With, um, you know, the federal government. So I'm curious to know why you believe being one of the leaders of this is going to Speaker 2: 03:08 Work. Listen, I, I think we take these issues as they come our way. And we're of the, of the belief that the health and human services department at, uh, in Washington, DC, is going to try to do everything it can to preserve life and, and keep people safe and protected against COVID-19. If that's the case, then we hope they'll look closely at their powers to actually increase the supply of rim to severe now. And it's a request that's being made, not just by California, uh, ag Landry, Jeff Landry from Louisiana who joined me in co-leading this letter, uh, we were joined by 30, some odd other attorneys general from throughout the country, bipartisan partisanly to make this request because we've got the power. And for many of us in our States, we know that anything that helps us combat COVID-19, especially at the individual level, uh, at the patient level is crucial. Speaker 3: 04:06 Why do you feel the need to take this step? This would be forcing a company to, to do something why not work with the company Speaker 2: 04:14 Because we're living in extraordinary times. Uh, this is not just a, uh, a simple ordinary request, uh, when almost 5 million Americans have now contracted the virus, when more than 150,000 Americans have died as a result of it, uh, extraordinary times they require extraordinary measures. And we believe that one of those extraordinary, extraordinary measures, which the federal government has the tools to implement is to increase the supply, make a drug more affordable and accessible because taxpayers actually invested in this drug to make it possible. Juliet. The manufacturer of rum, DESA vere certainly deserves credit for having produced this medication, but without taxpayer support, there's a very strong chance that [inaudible] wouldn't be around or at least wouldn't have been around as long. And so, uh, taxpayers are invested in this drug in more way than one, and we should make sure that if it shows some, uh, positive prospects, uh, for helping people fight off the virus, we should be doing everything possible to make it available. And so far Gilliad has made it very clear. They're only making it very small supply of this, and certainly they're selling it for outrageously high, high prices compared to what it costs them to produce. Speaker 3: 05:32 Have you had conversations with Gilliad, um, about this and if so, what, what have they said Speaker 2: 05:38 We've reached out? Um, you know, we always reach out, we reached out to the federal government in the past to talk about COVID-19 and what we're all doing. Uh, uh, these are different times and I hope that [inaudible] recognizes that this is not a time for it to horde a or to, to be greedy with what it's got. Um, Scrooge is not, does not have a role to play in solving COVID-19. And so we need people to step forward and we can ask kindly politely, but we also have tools in our legal arsenal to move forward. If we have recalcitrant stakeholders. And I would hope that Juliet would be a willing partner and that they would recognize the value in helping save human life and that they would join along with the federal government to do this. And if the federal government isn't willing to push that along, that we hope that the federal government would give States, the authority would give us the agency to do what they can do and assign that agency to us so that we in our particular States can take that action. Maybe some States won't ask, but I know some of us will Speaker 3: 06:54 Literally just before this call, I had reached out to Galiad earlier today, and they just got back to me for a comment in response to your letter. And they, um, raise a couple of concerns about what they call inaccuracies. They, a couple of them, there's the one I want to read to you is, um, they claim that not all COVID-19 patients, um, should even be treated, um, with rum does severe because they're not all eligible to be treated for it cause they, um, you know, would recover before hospitalization and ever even need it. And then, um, they also say that, um, the w the actions you're calling for wouldn't increase, um, the speed or access to rum death severe, um, because it takes six to 12 months to manufacture. Um, and it wouldn't produce additional doses, uh, this year. Speaker 2: 07:38 Does it strike, strike you, uh, uh, strange that I'm very suspicious of what they've just said. Listen, uh, we've been fighting COVID-19 now for five, six months. We've known about it for longer. Uh, we've known for a good portion of that time that prim disappeared has shown some, uh, positive results for people who are trying to fight off COVID-19. Um, Juliet is selling this drug for extremely high prices. They know it's in demand. I guarantee you, if you believe in the capitalist markets, that when there is a major demand, you increase your supply. Now, Gilliad could certainly increase it supply. We can bicker about how much it could increase it and how quickly, but I'm not falling for that. They can do much more than what they're doing. And I'm hoping what the federal government do will call their bluff and require them to do more, or at least that the federal government then license others who could produce the medication to make it more available Gil. Yet Speaker 4: 08:56 Doesn't have to make all its profits on the taxpayer's dime and at the expense of the lives of millions of Americans. And we hope that there'll be a good partner here, as I said, but one way or the other it's time in these extraordinary times for us to add in the federal government has tools to act. And if they won't take them, we hope that they'll recognize that there's some of us in, in various States, we're prepared to try to take advantage of those tools and work with Gilliad and our federal partners where possible Speaker 5: 09:27 Very much for your time attorney Genova, Sarah, I really do appreciate it. Thank you very much. The hospital association of San Diego and Imperial counties, as it has not seen a shortage in the region, but appreciates any advocacy efforts to boost supply. Speaker 5: 09:52 The San Diego Sheriff's spends $90 million a year on healthcare services for inmates of the counties jails. Meanwhile, the County has also spent about 8 million over the past decade on legal claims from jail inmates and their advocates often tied to inadequate care this week at the Sheriff's request and Eagle County supervisors decided to explore whether to shift the responsibility for jail inmates, mental and physical health, to private contractors, San Diego union Tribune, investigative reporter, Jeff McDonald has followed this issue for months leading up to yesterday's vote and joins us. Now, Jeff, thanks for being with us. Hello. Thanks for having me. Okay. So yesterday the supervisors acknowledged that there is a problem. What is the problem? Is it the quality of the healthcare and the jails or the cost of healthcare in the jails? Speaker 4: 10:37 Well, I think the, uh, the sheriff would say the cost and some of the advocates would say the quality of service that the inmates receive. Uh, there've been a number of cases where inmates have died and been injured due to lapses in medical or mental health care in San Diego County jails. Some of those inmates in their families have filed lawsuits against the County and recovered damages as a result of their injuries or death Speaker 5: 11:02 Reporting. In fact has shown that the death rate of the County jails is the highest in California. How, how would you say the current medical and mental health care is contributing to the deaths of inmates? Speaker 4: 11:13 Totally Davidson. I spent six months looking at the jail deaths last year. And, and, uh, even though a number of the, they have a high suicide rate, a inmates die, they die of natural causes. They die of accidents, uh, accidental deaths, uh, San Diego has, as you said, the highest rate among the largest counties in California, that we examined a lot of the deaths are natural. Uh, but the problem with that is that they, uh, they're classified as natural, even though they're succumbing to diseases that are often treatable. And so the problem is that they're not getting adequate medical and mental health care in jail. And that leads to the inmates deaths in many cases who provides mental health Speaker 5: 11:54 Care and medical services to the inmates now. And how could that change if, uh, what the supervisors are exploring takes place. Speaker 4: 12:02 It's state law, that when you take someone into custody, you have to provide for their food and housing and medical, uh, health care. Uh, so the sheriff is responsible for that when he books people into the County jail. Uh, right now there's a patchwork of about 300 nurses and other administrative staff who worked for the County of San Diego and work inside the jails, uh, on the medical services Bureau. They also have a couple of dozen, more than two dozen, uh, contractors that provide specialty services like, uh, physicians, dentists, pharmacists, uh, experts like that. So right now they have a combination of private contractors and public sector employees who deliver the services to the counties, inmates, what the Sheriff's trying to do now, or what he's exploring is the idea of bringing in one general contractor who would run the whole, um, the whole, uh, division and be responsible for all medical services. Now, the unions don't like it because it would cost the County several hundred jobs, about 300 personnel. Many of whom testified yesterday against the, uh, uh, the idea of moving forward with the outsourcing. Speaker 5: 13:17 Well, let's talk about how County employees in the union that represents them, are reacting to this proposal to, to outsource these jobs. Here's FCIU local number two 20 ones. President David Garcia, Speaker 4: 13:28 Contracting out essential healthcare services will lead to worse care. And the loss of our skilled workforce outsourcing has led more liability lawsuits and large settlements around the country. This is more expensive, not less now here, of course, proposing they're bringing the model to San Diego while the rest of the country moves away from it. Speaker 5: 13:54 The suggestion, the board agreed to also ask the counties health and human services department to bid on providing the jails with medical and mental health care. Uh, I remember when the county's waste disposal services open to bids from the private sector and the County employees bed came in lower. So might that happen again here? Speaker 4: 14:13 Uh, yes, that might happen again, but the dispute is, um, more ideological than just who's gonna be delivering the services. Uh, what Nathan Fletcher wants to do is to take the medical and mental health services responsibility away from the sheriff, because he doesn't believe the sheriff is being diligent enough in delivering those services. He wants to put it under the purview of the health and human services agency. So maybe health and human services could deliver those services cheaper. But the dispute between the sheriff and the supervisor also extends to who would control those, uh, those folks, the sheriff of course, wants to retain authority over who's ever in charge of healthcare for his inmates. Uh, Nathan is saying that that obligation and responsibility should be taken away from the sheriff and given to the social workers who do that kind of work every day, all day. Speaker 5: 15:00 What's the Sheriff's reaction to that. Speaker 4: 15:02 His answer to that is that state law dictates that the Sheriff's department is responsible for the inmates, all the care and, uh, and, uh, practices within the jail. So he's not willing to give up that responsibility. So that's something of a loggerheads that we'll have to see how that unfolds Speaker 5: 15:19 In your reporting so far. Jeff, would you say it's the mental or the physical health care that's the most problematic at this point? Speaker 4: 15:25 Oh, that's a difficult question. Uh, there, I would say equally, so we've seen cases where, you know, simple diseases, very easily treatable diseases result in deaths. And then the medical examiner will say, well, this person died from diabetes. It'll get recorded as a natural death, but most people don't die from diabetes. Uh, so that's, that's a pretty pervasive problem among the deaths that we examined over the 10 years between, uh, 2009 and 2019, that in a series of published last fall, that said you had the Sheriff's department is the biggest provider of mental health services in the region, a point which he made before the board of supervisors or in his argument yesterday. So clearly that's a pervasive issue as well. Speaker 5: 16:09 So when will the bids come in and a decision to be made on whether to contract out the health services in the jails? Speaker 4: 16:15 Well, they were a little, um, should I on specific timelines, Nathan Fletcher had asked for, uh, arresting this process for three days to give health and human services time to put together a proposal. Sheriff didn't like that. Of course the expectation is that he'll move forward straight away with, um, soliciting that the potential bids, and then using that information to write up a request for proposals, which is a more formalized, uh, basically a contract, a solicitation, uh, that could happen as soon as this year. It's interesting that the board of supervisors just scheduled to change, uh, two seats, this, this, uh, this November. So maybe this year, if wants to get this done before the board changes. And maybe not that didn't come up in the discussion, but it's certainly a open political consideration, Speaker 5: 17:03 Thanks as always for your reporting. Well, thank you. Have a great day. That's Jeff McDonald, investigative reporter with the San Diego union Tribune. Speaker 1: 17:17 This is KPBS mid day edition. I'm Maureen Cavenaugh with Alison st. John KPBS partner. I new sources launching a series today called veterans voices. It will follow veterans as the San Diego VA removes them from a drug treatment that's been effective in relieving their depression and suicidal thoughts. I news source investigative reporter, Brad Racino kicks off the series with a local Marines story. And as a warning to our listeners, this story discusses, suicidal thoughts and fears. Speaker 6: 17:50 This was Henry Henry, but Henry was the beginning of my plan. I'm sorry. Speaker 7: 17:57 Kaia bender is a 29 year old Marine veteran with a history of major depression and suicidal thoughts, Speaker 6: 18:04 Parsley Bazell mint oregano. Speaker 7: 18:09 He recently gave us a tour of the garden outside his Vista apartment. I have like these crazy, Speaker 6: 18:15 Your dreams of like what it would look like, like this big old food forest. It's just like a bunch of fruit trees and like, uh, other food plants, Speaker 7: 18:24 Just the assumption that he'll be alive to see that happen is proof to bender that his ketamine drug treatments are working Speaker 6: 18:30 Suicidal. Thoughts are just like, kind of gone. Like I don't, it's really like free Speaker 7: 18:35 Ketamine began in the 1960s as a veterinary anesthetic, but in the early two thousands scientists began to notice its tremendous effect on patients with treatment resistant depression. They also recognized ketamine's ability to rapidly reduce suicidal impulses as it did with bender. Right. Speaker 6: 18:52 You know, and I couldn't have imagined being able, being capable of doing the things that I'm doing now every single day Speaker 7: 19:02 For years, the San Diego VA has referred patients like bender for ketamine treatment at the Kadima neuropsychiatry Institute in LA Jolla to great success. Kadima is run by dr. David Pfeifle a former UC San Diego and VA psychiatrist Pfeifle is an expert in ketamine having administered it for over a decade. Speaker 6: 19:21 But I recognized that this was really something like I've never seen in my, uh, years, uh, in the field of psychiatry had trauma, had it had limitations for sure, but it also had, um, had characteristics that, uh, we had not seen in terms of the ability to improve people's, uh, major depression, uh, when nothing else did. And also many times to do it very, very rapidly. Speaker 7: 19:50 Despite San Diego VA psychiatrist lauding Pfeifle success with their vets in may. The agency began telling patients that their time at Kadima would soon end Speaker 6: 20:00 Terrified. I was absolutely terrified. Speaker 7: 20:02 The agency plan to bring vets back in house for an alternative drug treatment called provato. Speaker 6: 20:08 I'm scared that, you know, they they're what they're doing, won't be enough. And that I'll end up feeling like I did before Academy. And then I, that that's, that's terrifying for me cause I don't know if I would make it through it again. Speaker 7: 20:24 Now Kadima vets are pleading with VA leadership not to stop a treatment that for the first time gave them hope. Some are reaching out to politicians, including San Diego, Congressman Scott Peters, whose office is working directly with some of the vets affected. So our job now is to make sure that the mental health professionals at the VA are looking at each case individually and giving each individual works for them because it works now because it's what's convenient for the VA. There are a few dozen vets caught up in this ongoing situation. That's why I knew source created this series veterans voices to let them share their stories. It will provide a firsthand look at how local veterans are grappling with mental illness and fighting for their own health care within the VA system. Speaker 1: 21:10 Joining me is I knew source investigative reporter Brad Racino Brad. Welcome. Speaker 7: 21:16 Thanks for having me. Speaker 1: 21:17 Is this switch from ketamine to the other drug happening in VA treatment all over the country or is it only here? Speaker 7: 21:26 So we still don't know the full scope of what's happening outside of San Diego, but that's not for lack of trying. It's just that the VA's office in DC has refused to answer questions about this. What we've been able to piece together is that last year after president Trump touted bravado as a game changer in combating veteran suicides, a small number of BAS began adopting the drug and San Diego was one of those. Speaker 1: 21:51 Is there just anecdotal evidence that ketamine works in helping depression and suicidal thoughts or has that drug been clinically proven? Speaker 7: 22:01 It has been clinically proven, but it hasn't gone through FDA approval for this specific use. So experts have told me that's because ketamine is old and off patent. And that means any pharmaceutical company that would spend the tens of millions of dollars required to go through FDA approval. Wouldn't then be able to recoup those costs afterward by doing what drug companies normally do, which is patent their drug. Speaker 1: 22:27 Have you gotten any answers about why the VA is ending the ketamine treatment and moving to [inaudible]? Speaker 7: 22:35 So we've heard lots of explanations from the San Diego VA. Um, but none of them make any sense. So bear with me, I'll go through them real quick. So for example, first the VA said it was removing that's from Kadima because the agency could provide the same type of ketamine treatment in house, but that wasn't true. Then they cited patient safety concerns. They said because Kadima was providing a non FDA approved treatment. It's safer to have these bets on [inaudible], which is FDA approved, which makes sense. Except every veteran who has been pulled from Kadima, put on bravado at the VA and failed, the drug has been put right back on ketamine at the VA, which is not FDA approved. And then one last thing the VA also said they only recently learned Kadima was providing ketamine through an injection and not an IB and that that's not standard practice and therefore it's dangerous. Speaker 7: 23:25 However, I have notes from VA psychiatrist showing that they've known that was the case for years and administrators approved it. So it's a confusing mess of lies that we're still trying to sort out, but even the vets, aren't getting a straight answer. Here's Joel Andrews and army that we profiled, who talked about the lack of explanation from VA doctors. It's like, just let down, you know, you gotta learn that you can't rely on other people. You got to take action yourself or you can't get what you want in this world. And it's frustrating because nobody has a definitive answer as to what the hell is going on with all of this. It's like they're playing some game and they're trying to keep it a secret. Speaker 1: 24:09 Now it seems like the rate of suicide among veterans was very much in the news. Let's say a couple of years ago, how big a problem does depression and suicide remain among veterans? Speaker 7: 24:21 Sadly, it's still a very big problem that has actually only gotten worse over time. In 2017, the suicide rate among veterans was about one and a half times higher than non veterans in the U S and last year, president Trump called on a number of federal agencies, including the VA to develop a strategy for ending veterans suicide that is now called prevents. But it's obviously a complicated thing to tackle because there is no single medical cause for suicide and no single treatment or prevention strategy. Here's Navy vet, Larry McMinn, another local veteran we're profiling, and he's explaining his depression. It's debilitating disease for people. And unfortunately it isn't discussed enough. And every single day suicide crossed my mind multiple times Speaker 1: 25:15 As this switch off ketamine started yet at the San Diego VA. Speaker 7: 25:19 Yes and different veterans are at different stages of that transition. So those I've interviewed who were removed from ketamine and put on, [inaudible] said, provato, isn't working for them. They were then put back on ketamine at the BA, but at a much lower dose than they were used to. And they're very unhappy and scared. A lot of them are scared that they'll regress to the place they were before they started ketamine treatments. Speaker 1: 25:44 How much help have vets who want to stay on ketamine treatment, gotten from let's say experts and politicians. Speaker 7: 25:51 So they've gotten some San Diego Congressman Scott Peters. His office is working on this with the VA the house veteran's affairs committee is looking into the situation. And I'm told there may be other investigations just starting up, uh, among one or more federal agencies. Speaker 1: 26:07 And can you give us an idea, Brad, about the other vet voices that we'll be hearing from in this series? Speaker 7: 26:14 So we've got veterans from the army Navy air force and Marines lined up who want to share their stories. So these are men and women with very different backgrounds and experiences who are all eager to bring this issue to light and let the public know what's happening here. So they'll all be featured at [inaudible] dot org slash veterans voices. Speaker 1: 26:35 And I've been speaking with our new source, investigative reporter, Brad Racino Brad. Thank you. Thank you. If you or someone, you know, is considering suicide call the national suicide prevention hotline at +1 800-273-8255. Speaker 1: 26:58 The number of homicides in Mexico hit an all time high last year and major drug cartels are diversifying into international criminal enterprises. Those are two of the disturbing findings in the latest justice in Mexico report, compiled by researchers at the university of San Diego. The report also finds that the city of Tijuana has the highest number of homicides in Mexico. Joining me is David shirk, co author of the report and director of the justice and Mexico project at the university of San Diego. David, welcome. Thanks so much for having me looking at some of the figures. There were more than 29,000 homicide cases in Mexico last year, more than 34,000 victims. Are these homicides mostly to do with drug cartel violence? Speaker 8: 27:47 It's difficult to say. Um, we know that a significant share are related to, um, organized crime. Uh, it's very difficult to say that what the precise proportion is in part, because there's not really a way to, um, measure what is an organized crime killing. I mean, you find a body on the side of the road, it's got multiple gunshot wounds, it's got a message from, um, the new generation cartel. Um, and you can Mark that one as, as probably related to organized crime, but there's no official accounting of the number of organized crime killing. So, uh, we use estimates that are generated by Mexican newspapers and other sources to try to, uh, roughly guests the approximate number and that ranges, unfortunately between 40 and 60% of homicides. So we don't know if it's most, but it's a big chunk. Speaker 1: 28:38 How does the rate of homicide last year compare with previous Speaker 8: 28:42 Last year's rate was the highest on record that translates into a rate of about 27.4 27.5 per a hundred thousand. The problem of, of course, you know, that's a very high rate, but it's only marginally higher than the year before 2019 was very, very violent. Uh, but 2018 was also very, very violent. Um, and those two years are roughly on par. We can't say that the violence is icing rapidly, but we can't say that it is, it has sort of stabilized at a very high level. Speaker 1: 29:18 Well, when you look specifically at Tijuana on one hand, it recorded the highest number of homicides in all of Mexico, but for the first time in five years, it was not one of the top five cities for assault and robbery cases. What do you think is going on? Speaker 8: 29:33 That's really interesting. And if you look at the data on homicides and assaults specifically in Tijuana, they're almost inversely, which means they're going in opposite directions. As homicides have risen, we've seen the number of assaults go down. And I think a cynical conclusion, uh, looking at those data might be that the people who are trying to kill other people are becoming better shots, right? Um, that effectively, um, they're less likely to injure someone in an attack and more likely to kill them. Uh, and that's, that's partly because of the lethality of, uh, the violence, I should say. That is an illustration of the lethality of the violence and the fact that so many of these homicides over 90% of them are, uh, committed with high powered, uh, weapons, firearms, including, you know, uh, assault type weapons, especially important from the United States. Uh, but, but a whole variety of firearms that are not available for retail purchase in Mexico, uh, and have to be smuggled across the bar. Speaker 1: 30:34 Now, one of the statistics in this report that jumped out at me, it was that almost half the women in Mexico reported to have been victims of violence by their partners. Can you tell us more about that? Speaker 8: 30:46 If anything jumped out, uh, as, as distinct about the last year, it is the growing attention to the longstanding problem of violence against women. Um, and this is not violence perpetrated by Chapo Guzman, uh, and, and high profile drug traffickers. Uh, this is widespread, um, sort of societal, uh, violence, uh, targeting women in instances of domestic violence, but also, you know, high profile cases that, that, uh, showed up in the media of women being targeted by boyfriend's former boyfriends by random people, uh, a seven year old girl abducted, uh, in Mexico city and found dead, uh, days later. Uh, but the past year, we've just seen numerous cases of that nature that have drawn public attention and generated enormous public protest in Mexico. It's not clear to me exactly whether the actual number of cases of femicide as it's called or violence targeting women has increased, or whether we're seeing, um, does greater scrutiny, uh, public scrutiny and also law enforcement scrutiny of those kinds of cases. Um, either way it's a serious problem that, um, that Mexico needs to address. And that unfortunately, uh, the current federal government in Mexico has not really taken very seriously. Speaker 1: 32:12 This year. Mexico has been struggling with the coronavirus pandemic, just like most of the rest of the world. Now isn't there any indication that the virus has made an impact on crime in Mexico Speaker 8: 32:23 So far, we're not seeing reductions in violence. In other words, uh, the, uh, criminal groups continue to engage in violent behavior that has led to a sort of steady level of homicides over the last few months. One thing that we think is going on is that the closures in China have led to some supply chain interruptions that have made it more difficult for drug cartels, and that led perhaps to increase fighting among them, uh, for access to and control over the movement of, of drugs. Uh, but at the end of the day, all it means is higher prices for drug users in the United States. Um, it does, it has not substantially reduced, uh, demand if anything, uh, people, uh, who, who are addicted to drugs are have more time, uh, and more anxiety. Uh, right now Speaker 1: 33:15 President Andres Manuel Lopez Obrador was elected in 2018 in the hopes of maybe ending some of this crime, the security problems in Mexico. How would you say he's doing Speaker 8: 33:28 Andres Manuel Lopez Obrador when he came into office, believed that the, the central, uh, the, the roots of Mexico's violent crime really stemmed from broader socioeconomic problems like poverty, inequality, lack of education, unemployment. And, and he said about trying to generate social welfare policies that would help to address those problems. Um, now even if we assume that he had been totally successful in, uh, that his social welfare policies are designed extremely well and will have a real impact on those socioeconomic problems, which I think is doubtful. Those are longterm ventures, longterm investments that are not going to show up, uh, in a year or two while Lopez Obrador has said, I'm not going to go after the drug cartel leaders, I'm going to leave them alone so that they can stop fighting. He's moved away from that strategy from time to time, he's not being consistent. Um, he lets go Chapo Guzman son, but then, uh, just days ago, uh, he captured a, um, well known, uh, criminal actor from the Sentara Rosalia Lima cartel, uh, whose nickname is El mortal. So, you know, the, the Lopez Obrador administration has not identified a strategy stuck by that strategy. And doesn't really have a plan for diminishing violence in the short term. That is the next three to five years. Speaker 1: 34:56 David shirk is coauthor of the report and director of the justice and Mexico project at the university of San Diego. David, thank you, sir. Speaker 8: 35:06 Oh, it was my pleasure. Thank you so much for sharing. You are listening to KPBS Monday edition. Speaker 1: 35:21 I was in st. John with Maureen Kavanaugh. Writing is such a powerful thing to do. It can change your space, take you deeper, help you connect with yourself. The San Diego writers festival is bringing writers together to talk about storytelling of all sorts. It's the second Speaker 5: 35:38 Year they've done this last year. Thousands of writers showed up to the first festival at the San Diego library, downtown creating a great sense of inspiration and community this year. It's different, it's online, but it's just as inspirational. And the upside is that even if you miss the early sessions, you can go back and watch them joining me as the founder of the San Diego writers festival, Marty Friedman, thanks for being Speaker 9: 36:00 Your money. Thank you for having me Speaker 5: 36:03 And at least Capron who works with San Diego's premier literary agency, the Sandy Dykstra agency, which describes itself as the premier agency for authors to find and sell books that make a difference. Thank you for having me now. The writer's festival has taken place over four Saturdays and the final Saturday is this coming weekend. So what is the focus of this coming session? Speaker 9: 36:25 Um, the focus of this session, I'm really excited about this one is publishing and platform building, um, my co founder, uh, Jennifer Thompson, shout out to her. She's awesome. She's going to be doing a really cool session on author branding, um, and platform building the most amazing agent. I know at least prawns, she's going to be doing two sessions. So one is I'm avoiding the slush pile. People love that one. And if you're wondering what an agent does, or you're wondering what an agent, you know, um, how to not end up in the circular file, as they say the garbage, and then we're going to be doing publishing one Oh one, what every author needs to know about publicity, we're doing an agent pitch Fest, um, at this moment that you're hearing it. You can still sign up to be on the wait list. There all the spots are filled up, but in case there are some people that drop out. You might want to put your name on the wait list. What is a pitch Fest? Every author gets seven minutes. So you have to summarize your book and why it's something that the agent should pick up in like three to four minutes. So this time we're going to be doing it through zoom sessions and breakout sessions. So the public itself won't get to see the pitch sessions. Um, cause I think that the writers would be too nervous, but people are signed up beforehand and then they get to pitch three different San Diego agents. Speaker 5: 37:49 That's quite an opportunity for a budding writer. Now, at least you were working with authors who want to get published. Are San Diego authors getting published much these days? Speaker 9: 38:00 Oh, certainly. I mean, why we'll say as an agency, we work with writers all around the world, not just in California or San Diego, but, um, but absolutely. I mean, there are one thing that's nice is that even, you know, during the pandemic, when we're all stuck at home, we need entertainment. We need books to read. And so very, very fortunately book publishing has remained, um, you know, a few hookups at first when all the shutdown was happening, but overall has remained a pretty vibrant industry. Um, and it's the time to really focus on if you have the energy to do it really focus on writing as healing and working on projects, if you can. And you know, using this time to maybe come out with a marketable project at the end of all this a lot of time in front of our computers right now. Yeah. Speaker 5: 38:47 Yes. So this weekend, you're going to be talking about how to avoid that dreaded slush pile, you know, the pile of rejects or literary agency, how many books a week do you get pitched and how many actually make it? Speaker 9: 39:00 Um, yeah, so most agents and of course us included are getting hundreds of queries every single week. And those are hundreds of unsolicited queries. So one of the best things any writer can do is to learn how to make some direct connections with whichever agent they are approaching and learn how to bypass that, you know, dreaded slush cycle. Um, because it is tough. Publishing is a difficult, difficult business. It's hard to really figure out the tricks of the trade and to learn how to make those valuable connections and get to the next step. So everything that I'll be talking about and the focus of really everything that Marnie has organized on Saturday will be about understanding the landscape of this industry that all the writers want to be a part of. Speaker 5: 39:51 And what are you looking for when you read a manuscript at least? Speaker 9: 39:55 Oh my goodness. Um, so I mean, of course it depends on what any particular agent is specifically focused on, but I'm looking for stories I have never heard before. And I'm looking for voices that feel fresh and new. And I think that's probably a key question that any writer should ask him or herself is what is your perspective or approach contributing to that? No one else is quite doing. What is truly new about your work? Speaker 5: 40:26 Does it make a difference how willing an author is to work with you to make those painful changes that you know, will be needed to get a book published? Speaker 9: 40:33 Absolutely. We are looking for a partnership with an author. We are hoping to have a team player who can be, we can go on this publishing journey together for hopefully many years and many books to come. We look to develop careers and long lasting relationships. So yes, it is vitally important. Not that an author just listened to everything we say, but that we can communicate clearly with each other and be on the same page about the priorities for, for a particular book project and get to a finish line where it really works well on all levels. Speaker 5: 41:08 Hmm. And are you expecting that this pandemic quarantine will produce any good books? So you're getting some already. Speaker 9: 41:14 I was a little bit worried when the pandemic started about everybody's mental space and things just getting very slowed down and they were for a little while at the beginning. Um, but now we are seeing that lots of exciting stuff is happening. There's also a wonderful, um, sense of inclusivity right now, more than ever in publishing, which Marnie has been a huge part of what this festival as well is making it accessible and inclusive for all types of writers and all types of people. And I think that is, we're seeing that in the industry as a whole right now. So this is a great time for all voices and all types of writers and human beings. And I really love that Speaker 5: 41:54 You are also a great motivator of writers in this time. Speaker 9: 41:59 Right now, my, my specific, uh, passion is community. Cause I know so many people are struggling and, and the writing to heal. I think, um, you know, it's been such a healing force in my life and I've watched it, I'm a memoir teacher. And so that I didn't expect it to have such a healing, um, impact on the writers that I work with. So that's my big passion right now. Speaker 5: 42:24 Can you give us a couple of ideas that you've learned about why writing is so healing, Speaker 9: 42:30 Expressive writing has finally been studied and been over about 300 research studies to show it that it's effective. And I think one of the first reasons why it's so effective is we walk around all day and we, we deny our feelings and we put on a mask and we say, everything's okay. And we just, you know, buck up and keep going and expressive writing can really help you tap into this is how I feel. And it's okay that I feel this way to not approach it with any shame or blame, uh, to accept where you're at and doing that actually allows you to move through it to a more creative place. Um, so that's just one, you know, really simple secret. If you can do it at least four days a week, um, they recommend 20 minutes, but you can do two minutes, three minutes and just write, you know, today, I feel you don't have to moderate or pretend you just get to say how you truly feel Speaker 5: 43:30 Well. That's how it's helping the individuals. You were talking earlier about community. Do you have a sense of how San Diego is growing as a writing community? Speaker 9: 43:38 I feel it's really growing right now, also the kids, right? But I'm so blown away by what's happening with kids, right. You know, so much is going on in our world right now. And kids are really wanting to have a voice. And so we started the kids right contest. And just watching that start to blossom. We've been shocked at how much people are craving this community and wanting it to grow. So if anyone that is hearing this that doesn't know about us, please join us on Saturday. We'll hopefully walk away feeling inspired and you'll have more tools in your tool belt. Speaker 5: 44:14 And for people who want to go back and perhaps watch one of the sessions that have already happened. Do you have any tips about ones that might be particularly relevant for, for new writers? Speaker 9: 44:25 So the screenwriting panels, people are really interested in, but go back and look at all the offerings. Uh, John Vorhaus spoke about how to have a, create a process, especially when you are under stress, how to connect to your creative process. Speaker 5: 44:41 Okay. And this Saturday, the session starts at 10 o'clock and runs till after six o'clock. All you have to do is go to San Diego writers, festival.com and sign up and it's free, right free 100% Marni Freedman, the founder of the San Diego writers festival. Thank you so much for joining. Speaker 9: 44:57 Yes. Thank you. We really appreciate it. Speaker 5: 44:59 And at least Capron from the Sandy Dykstra agency. Thank you. Thank you. Thank you so much.

California's Attorney General Xavier Becerra and other attorneys general sent a letter asking the federal government to step in to increase the supply and decrease the cost of the COVID-19 drug remdesivir. Plus, the county is exploring outsourcing health care of jail inmates to private contractors. Also, KPBS partner inewsource is launching a series today called Veterans Voices. It will follow veterans as the San Diego VA removes them from a drug treatment they say has been effective in relieving their depression and suicidal thoughts. And, violence in Mexico hit an all-time high last year and major drug cartels are diversifying into international criminal enterprises — two disturbing findings in a report by University of San Diego. Finally, the San Diego Writers Festival wraps up with a focus on how to get published.