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News brief:Ukraine defense, COVID treatments, prisoners' early release

RACHEL MARTIN, HOST:

When you hear President Biden talk about Vladimir Putin's possible action in Ukraine, it is clear Biden is planning for the worst.

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PRESIDENT JOE BIDEN: If he were to move in with all those forces, it'd be the largest invasion since World War II. It would change the world.

STEVE INSKEEP, HOST:

U.S. warnings have focused on that threat, telling Russia that it will face massive sanctions if any unit of Russian soldiers should cross the Ukrainian border. But modern technology offers more than one way to attack a country, and that leaves analysts wondering what else Russia might do. And the analysts include people in the Ukrainian capital that is seemingly menaced by Russian troops just across the border.

MARTIN: NPR correspondent Rob Schmitz was just in Kyiv, and he joins us now. Rob, so on this reporting trip, you got a chance to talk with a former defense official in Ukraine. What did he tell you?

ROB SCHMITZ, BYLINE: Yeah, his name is Andriy Zagorodnyuk, and he was defense minister under President Zelenskyy from 2019 to 2020. He has a civilian background, and he now heads a defense strategies think tank. He does not expect the Russians to mount a full-scale invasion and occupation of Ukraine with the force that they have now massed on Ukraine's borders, which he estimates at around 127,000 troops. Here's what he told me.

ANDRIJ ZAGORODNIUK: One hundred and twenty-seven thousand is not even close to what you need to occupy Ukraine or even half of Ukraine. So we need, like, at least 300,000, perhaps even more. Potentially, we may see the increase of troops, but we don't see this at the moment.

SCHMITZ: Another thing Zagorodnyuk told me he's not seeing yet - enough Russian mobile hospital units and medical personnel near the borders to indicate that a Russian invasion is imminent. And he doesn't think that the Russians will make a move until after the Beijing Olympics, which end on February 20, so as not to distract attention from China's moment of glory.

MARTIN: So, I mean, this is fascinating. He's saying there just isn't the Russian presence yet...

SCHMITZ: Right.

MARTIN: ...To wage a full-scale invasion. But that's not the only play that Russia has here, right?

SCHMITZ: Yeah, he lays out a bunch of what he calls likely scenarios. And the first one is something that's already happening - Russia's so-called hybrid warfare. These are things like cyberattacks, which we've already seen on Ukraine's government. There are also efforts to weaken or distract police and military. Last Friday, dozens of schools in Kyiv sent students home because of a series of bomb threats that were suspected to be a Russian hybrid attack. He also said it was highly likely that Russia would escalate tensions in Ukraine's eastern border, where Ukrainian troops have been fighting Russian-backed insurgents for eight years.

MARTIN: I mean, that's been a long time, right? But the threat isn't isolated to the east, though, is it? I mean, Russia could approach from other directions.

SCHMITZ: Yeah, he also expects that - the Russian navy to block Ukrainian access to the Black and Azov seas along Ukraine's southern coast, which would disrupt important shipping routes to and from the country. The Russian navy is much bigger than the Ukrainian navy, and it's got a base in Crimea.

MARTIN: All right, NPR Berlin correspondent Rob Schmitz. He was just in Kyiv, Ukraine, on a reporting trip. Thanks so much, Rob. We appreciate it.

SCHMITZ: Thank you.

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MARTIN: OK, even though coronavirus cases are dropping rapidly across the country, a lot of hospitals are still under extreme stress.

INSKEEP: Because they're caring for more COVID patients than at any other time in the pandemic. Remember; even after cases start to go down, hospitalizations will remain high for a while. There are early treatments designed to help keep high-risk COVID patients out of hospitals, but the medicines are in short supply.

MARTIN: For more, we've got NPR's Pien Huang with us this morning. Hi, Pien.

PIEN HUANG, BYLINE: Hi, Rachel.

MARTIN: So this week, the FDA actually restricted the use of two of the first drugs that were authorized to treat COVID. Explain why they would do that.

HUANG: Right. So on Monday, the FDA curbed the use of two out of three monoclonal antibody treatments. Now, these two drugs, made by Regeneron and Eli Lilly, worked well earlier in the pandemic, but recent lab studies show that they're highly unlikely to work against the omicron variant. And remember; omicron now accounts for around 99% of U.S. cases. Erin Fox, a pharmacy director at University of Utah Health, says the FDA is following the science.

ERIN FOX: Honestly, I'm shocked that it took them this long to do it because things are bad enough without wasting valuable health care provider time infusing a medicine that is not going to be effective.

HUANG: Omicron has dominated since Christmas, but every state has continued to get these two treatments. Now the Department of Health and Human Services, which distributes these drugs, has stopped sending them out.

MARTIN: So how have states reacted to that?

HUANG: Well, some state officials are not happy. The FDA's move prompted Florida's health department to shut down all of its state-run antibody treatment sites. Governor Ron DeSantis called for the Biden administration to reverse the decision, accused the president of, quote, "medical authoritarianism." But even the makers of the drug acknowledge that they don't work well against omicron. Now, there is one antibody drug left called sotrovimab that does work against omicron, but it's in very short supply. Each week there are only about 50,000 doses available for the whole country. So that's not nearly enough to go around.

MARTIN: What about remdesivir, Pien? The FDA recently expanded the use of that drug, no?

HUANG: That's right. Remdesivir was the first antiviral COVID drug to get FDA approval back in 2020, but at the time, it was only for very sick patients in the hospital. Recently, the FDA broadened that approval to include patients not sick enough to be hospitalized. Dr. Raymund Razonable at Mayo Clinic in Minnesota says recent research shows, for high-risk patients, remdesivir reduce the risk of getting hospitalized by 87%.

RAYMUND RAZONABLE: And it confirms what people - what I, as an infectious disease provider - have assumed from the very beginning, that for antivirals to work, it has to be given early.

HUANG: Razonable calls it a blessing that the evidence for remdesivir came out right as omicron was coming in. And there's plenty of this drug available, but it's not easy to administer. A patient has to go to a clinic and get IV infusions over three consecutive days.

MARTIN: Which is a commitment, right? I thought there were supposed to be pills that you could take at home, though.

HUANG: That's true. There are two pills, Paxlovid from Pfizer and molnupiravir from Merck. Out of those two pills, doctors are more inclined to prescribe Paxlovid. It works more than twice as well as molnupiravir at keeping patients out of the hospital. But these pills are not easy to get, either. For the past two weeks, 500,000 courses of both drugs went out at a time when 10 million people tested positive. Carl Dieffenbach with NIH says the situation with treatments is starting to get better.

CARL DIEFFENBACH: So as the omicron surge wanes, demand will go down. At the same time, supply is going up.

HUANG: He says drug companies are coming up with new monoclonal antibodies, which could also be available soon.

MARTIN: All right. NPR's Pien Huang. Thank you so much. We appreciate it.

HUANG: Thanks for having me.

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MARTIN: All right, thousands of people are leaving federal prison this month because of a law called the First Step Act.

INSKEEP: President Trump signed this bipartisan measure back in 2018, and it's designed in part to reduce the federal prison population. Leaders of both parties agreed that too many Americans are behind bars. The Justice Department is using computers to determine who deserves early release, but it turns out the algorithm appears to give biased results, treating people of different races differently.

MARTIN: NPR's Carrie Johnson has been looking into this, and she joins us now. Good morning, Carrie.

CARRIE JOHNSON, BYLINE: Good morning, Rachel.

MARTIN: So before we talk about the inequities of this supposed fix (laughter) to this problem, let's talk about the law itself. Remind us how this came to be.

JOHNSON: Yeah, a huge bipartisan majority in Congress passed this law about three years ago - almost four now. It was supposed to create a way for people to leave prison early if they work or take classes to help prepare for their release. But the key is people in prison have to be considered a low or minimum risk of a return to crime to be eligible, and the law says the prison system should decide that central question based on a new algorithm called Pattern. Here's how David Patton, the federal public defender in New York, described the issue to Congress.

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DAVID PATTON: That score that people receive will directly impact how much time they spend in prison. It is vital.

JOHNSON: But that's where the problems come in.

MARTIN: All right, so say more. What are the problems?

JOHNSON: (Laughter) These kinds of risk tools are common in the criminal justice system in many states, but critics say Pattern is the first time the federal government has been using an algorithm with such high stakes. The Justice Department finished the first version in a rush and said it suffered from math problems and human error. So it made some tweaks. But about 14,000 men and women in prison still wound up in the wrong risk categories. And there were big disparities for people of color in how this tool worked. Aamra Ahmad is senior policy counsel at the ACLU.

AAMRA AHMAD: The Justice Department found that only 7% of Black people in the sample were classified as minimum level risk, compared to 21% of white people. This indicator alone should give the Department of Justice great pause in moving forward.

JOHNSON: DOJ's own data says Pattern overpredicted the risk that Black, Hispanic and Asian people in prison would commit new crimes or violate rules, but it underpredicted the risk for some inmates of color when it came to possible return to violent crime. Melissa Hamilton is a professor of law and criminal justice at the University of Surrey. She says despite all these problems, Pattern may be worth saving.

MELISSA HAMILTON: So that's the unfortunate thing - is it's better than gut instinct of very flawed humans that we all are. And can we improve it more than marginally? And that's what we're working on.

MARTIN: So what is the Justice Department saying about the program and these problems?

JOHNSON: Yeah, the Justice Department said in a written statement that Attorney General Merrick Garland has directed people to try to address racial bias in this tool, to make it more transparent. All of a sudden, there's going to be an overhaul underway at some point. And all of this is really technical stuff. It could take a while to fix. Even if the Justice Department moves ahead here, it's not clear they can find a way to eliminate all the racial bias in this algorithm. That's why some advocates want to see the Justice Department and Congress just drop this thing altogether.

MARTIN: NPR's justice correspondent Carrie Johnson. Carrie, thank you.

JOHNSON: My pleasure. Transcript provided by NPR, Copyright NPR.

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