Tag: Death

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Health

‘Dying Doulas’ Present Help on the Finish of Life

‘Death Doulas’ Provide Aid at the End of Life

Since its inception in 2018, the National End-of-Life Doula Alliance, a professional organization of practitioners and trainers in the end of life, has grown to nearly 800 members; The number of members has almost doubled in the last year, said its President Angela Shook. There has been increased interest in training programs with the International End-of-Life Doula Association, Doulagivers, and the Doula Program to Accompany and Comfort, a nonprofit led by hospice social worker Amy L. Levine.

Much of the growing interest in these programs has come from artists, actors, youth and restaurant workers who were unemployed during the pandemic and realized they could still be of use.

“People of different ages, younger than we would normally see, because they realized that people in their age group were dying, which they usually don’t,” said Diane Button, 62, of San Francisco, a Doula Facilitator at UVM and a member the Bay Area End-of-Life Doula Alliance, a collective of death workers. “It made them more aware of their own mortality and really got them to plan and get their documents and living wills in order.”

Rebecca Ryskalczyk, 32, singer in Vergennes, Vt., Had always felt “pretty good” in death. When she was 12, she lost two cousins ​​in a plane crash and four years later a friend to suicide. When Covid paused her performance schedule, she enrolled with UVM. Its aim is to convey to people that they do not have to be afraid of death; you don’t have to do it alone either. “To be able to stand up for someone and share the last moments of their life with them and help them stick to their plan when they may not be able to express it is an honor,” she said.

Kate Primeau, 35, was also in the music industry before the pandemic. Last June, after her grandfather died of Covid-19, she began researching how to host a Zoom memorial and came across the concept of a death doula. “I felt a huge gap between the amount of grief everyone felt and the resources available,” she said. She was certified as an end-of-life doula by Alua Arthur’s company Going with Grace and is also volunteering in a hospice program. “I can’t believe how much I laugh at all this death education.”

Of course, during the pandemic, doulas had to change the way they work. That was one of the biggest challenges: you couldn’t interact in person. So, like the rest of the world, they used Zoom calls and FaceTime. Families often sought their own healing.

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Health

Brazil Reported One of many Highest Covid-19 Dying Tolls within the World

Brazil Reported One of the Highest Covid-19 Death Tolls in the World

The death toll of Covid-19 in Brazil has now exceeded 500,000, just behind the United States, which recorded 600,000 deaths last week, and India, where the death toll can range from 600,000 to 4.2 million.

Almost 18 million people have become infected so far, and the country is seeing an average of nearly 73,000 new cases and about 2,000 deaths per day, according to official figures. However, many experts believe the numbers underestimate the true scale of the country’s epidemic, as is the case in India.

Brazil’s President Jair Bolsonaro has been heavily criticized for dismissing the threat from the virus despite contracting himself last year. On Saturday, thousands of people protested his response to the pandemic, including his opposition to regulations on wearing masks and the slow adoption of vaccines, according to Reuters. It is believed that only 11 percent of residents are fully vaccinated.

A severe drought has also struck the country, the worst in at least 91 years, and experts say a terrible fire season could further complicate the country’s battle to fight the virus. The smoke could even make cases of Covid-19 worse by increasing inflammation in the lungs.

“It’s a dangerous situation,” said Dr. Aljerry Rêgo, professor and director of a Covid facility in the Amazon state of Amapá. “And, of course, the greatest risk is to further overwhelm the public health system, which is already precarious in the Amazon.”

In a recent testimony to a legislative committee, Brazil’s former Health Minister described Bolsonaros’ confusing belief that an anti-malaria drug would be effective against Covid-19, and a Pfizer executive said the company was offering millions of doses of its Covid-19 vaccine I went to Brazil last year – but received no response from the government for months.

Mr. Bolsonaro shrugged off the revelations. Last month, his government announced that Brazil would host the Copa America soccer tournament later this year after Argentina decided it would be irresponsible to do so while the virus continued to spread.

On Friday, officials reported that 82 people linked to the tournament had contracted Covid-19, according to The Associated Press. The Brazilian Ministry of Health said in a statement that 37 players and employees of the 10 tournament teams and 45 employees are infected.

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Health

Experiences of Extreme Covid or Demise After Vaccination Are Uncommon, however Not Surprising

Reports of Severe Covid or Death After Vaccination Are Rare, but Not Unexpected

In the past few months, a constant headline hit has highlighted the amazing effectiveness of Covid-19 vaccines in the field, particularly mRNA vaccines from Pfizer-BioNTech and Moderna. Studies have shown that the vaccines are more than 90 percent effective in preventing the worst outcomes, including hospitalization and death.

But alongside this good news, there have been rare reports of severe Covid in fully vaccinated people.

For example, on June 3, Napa County announced that a fully vaccinated woman who was more than a month after her second Moderna vaccination had died after being hospitalized with Covid. The over 65-year-old woman with previous illnesses had tested positive for the alpha variant identified for the first time in Great Britain.

While these cases are tragic, they are unusual – and not unexpected.

“I am very sad that she had such a serious illness that she actually died,” said Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases and vaccines expert at Vanderbilt University. But, he noted, “we expected the occasional breakthrough infection to occur.”

Such cases shouldn’t prevent people from getting vaccinated, scientists said. “There is no vaccine in history that has ever been 100 percent effective,” said Dr. Paul Offit, the director of the Vaccine Education Center at the Children’s Hospital of Philadelphia. “This is your best chance to avoid serious, critical illness. But as with everything in medicine, it is not perfect. “

Severe Covid is rare in fully vaccinated people. In a paper released last month, the Centers for Disease Control and Prevention said they had received reports of 10,262 breakthrough infections as of April 30. That’s only a tiny fraction of the 101 million Americans who have been vaccinated to that date, though the agency noted that these are likely to be a “significant minority” of breakthrough infections.

Of these groundbreaking cases, 10 percent of patients were hospitalized and 2 percent died – and in some of those cases, patients were hospitalized or died of something unrelated to Covid-19. The average age of the deceased was 82 years.

Updated

June 11, 2021, 2:36 p.m. ET

Older adults, who are at higher risk of Covid complications, are also more likely to develop breakthrough infections as they are known to build weaker immune responses to vaccines. People with compromised immune systems or other chronic health conditions may also be at increased risk.

Some of the variants – especially Beta, which was first identified in South Africa – may be more likely to evade vaccine-induced protection. But beta isn’t common in the United States right now, noted Dr. Conductor.

The alpha variant that infected the Napa County woman is highly contagious, but vaccines offer good protection against it – as well as against the original strain of the virus.

“Breakthrough infection stories, while exceptionally rare, can be confusing to the public,” said Dr. Napa County’s health officer Karen Relucio in an email. “We know that with stories like this one could be tempted to question the effectiveness of vaccines.”

But the vaccines are highly effective, she stressed. In Napa County, the breakthrough infection rate in fully vaccinated people is just 0.04 percent, she said.

Nationwide, the rate is even lower. According to the California Department of Health, there were 5,723 breakthrough cases in more than 17.5 million fully vaccinated residents as of June 2, a rate of 0.032 percent. Of these cases, only 7 percent are known to have been hospitalized and 0.8 percent to have died. In these cases, too, it is unclear whether Covid was the main cause of death.

Breakthrough infections are likely to decline as more people are vaccinated and community transmission rates decline. “The virus will find fewer and fewer people to become infected – it will be more difficult for the virus to get through the population,” said Dr. Conductor. “These are great vaccines. So that the vaccines work optimally – individually and collectively – as many people as possible must be vaccinated. “

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Health

Florida, Alabama not reporting every day Covid case and dying information

Florida, Alabama no longer reporting daily Covid case and death data

Florida and Alabama will no longer report daily Covid cases and deaths as vaccinations rise and states begin moving into the “next phase” of the pandemic.

Florida rolled out a weekly Covid data reporting plan on Friday, the state emergency management department said on its website.

“Florida is moving into the next phase of the COVID-19 response,” the Florida Department of Health wrote in a statement emailed Monday. “As vaccinations go up and the positivity rate of new cases declines, the Florida Department of Health has put in place a weekly reporting schedule.”

Alabama introduced a new schedule on Monday in which the state updates case and death dates three times a week and vaccination dates twice a week.

“In addition to decreasing COVID-19 cases, hospitalizations and deaths, the Alabama Department of Public Health (ADPH) will update its dashboard less frequently,” wrote Dr. Karen Landers, an Alabama health officer, in a news release on Friday.

The changes signal a shift in attitudes towards the pandemic, as the U.S. averaged around 16,000 new infections per day over the past week, a low number that has not been seen since the early days of the outbreak.

Florida reported an average of eight new cases per 100,000 residents last week and Alabama reported about 8.5 cases, well below their pandemic highs of 84 and 87 per 100,000, respectively, according to Johns Hopkins University.

Still, public health experts warn that relaxing data reporting guidelines could be risky as the nature of the outbreak has changed rapidly in various places over the past year.

“I think we have to learn from this pandemic that you can’t just imagine that there will be no change,” said Dr. Wafaa El-Sadr, professor of epidemiology and medicine at Columbia University, noted that infection rates were high in her hometown of New York were low last summer before skyrocketing again in winter.

“If you start to see a trend, even after a week, you can fly a red flag and be vigilant,” she added. “I think it’s a little premature to let our vigilance down.”

Of course, the last great wave of Covid infections in the US started over the winter before vaccines were available. In Alabama, however, only 36% of residents have had at least one injection, one of the lowest rates in the country, data from the Centers for Disease Control and Prevention shows. At 50%, the numbers in Florida are closer to the statewide rate of 52% of the population who are at least partially vaccinated, but still lagging behind.

Dr. Joseph Kanter, the chief medical officer in Louisiana, said his state started reporting Covid data five days a week about a month ago but has no plans to make any changes beyond that.

“I think the daily updates, at least Monday through Friday, are still relevant and helpful in informing the public,” he said.

“We’re still a long way from the woods,” added Kanter, despite encouraging trends in cases, hospitalizations and death rates. “We’re really fine, but the general feeling is that the health department is still out of the woods and I’m aware that I’m sending the wrong idea.”

Reporting on Covid data can be resource-intensive, and many state governments have struggled to build or upgrade technology systems that could handle the unprecedented demands last spring. The data is also “maintenance-intensive,” according to Kanter, who stated that his department, for example, needs to deduplicate multiple positive tests for a person in a recorded case in order to keep accurate records.

“It’s a long time, a big manpower investment, but we are still in a public health emergency,” he said.

Many states have ditched daily reporting over the course of the pandemic, with nearly 20 reporting dates five days a week, according to a list maintained by Johns Hopkins. However, Florida is the only state that currently reports both case and death data once a week, and according to Johns Hopkins, only Kansas and Alabama report three days a week.

The Alabama Department of Health was unable to be reached for comment.

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Health

When a Surgeon Grew to become a Covid-19 Affected person: ‘I Had By no means Confronted the Actuality of Demise’

When a Surgeon Became a Covid-19 Patient: ‘I Had Never Faced the Reality of Death’

“He brought his culture of innovation,” Dr. Emond said. “And his personal capability, his ability to work for long hours, never quitting, never giving up, no matter how difficult the situation, carrying out operations that many would deem impossible.”

In his first year at Columbia, Dr. Kato and his team operated successfully on a 7-year-old girl, Heather McNamara, whose family had been told by several other hospitals that her abdominal cancer was inoperable. The surgery, which involved removing six organs and then putting them back in, took 23 hours.

More and more patients from around the country, and around the world, began seeking out Dr. Kato for operations that other hospitals could not or would not perform. He had also begun making trips to Venezuela to perform liver transplants for children and teach the procedure to local surgeons, and he created a foundation to help support the work there as well as in other Latin American countries.

As Dr. Kato’s colleagues struggled to save him, a waiting list of surgical patients clung to hopes that he would soon be able to save them.

Gradually, Dr. Pereira said, there were signs of recovery.

“You come in early in the morning to see him,” he said. “The hospital hallways are empty and everybody’s looking at each other, scared and anxious. You go into the intensive care unit dreading bad news, and the team is giving you a sort of hopeful thumbs-up that maybe he’s looking better.”

Dr. Kato spent about a month on a ventilator, and a week on ECMO. Like many people with severe Covid, he was tormented by frightening and vivid hallucinations and delusions. In one, he was arrested at the Battle of Waterloo. In another, he had been deliberately infected with anthrax; only a hospital in Antwerp could save him, but he could not get there. He saw the white light that some people describe after near-death experiences. “I felt like I died,” he said.

He had spent much of his adult life in hospitals, but never as a patient.

“I never got sick,” he said. “I had never faced the reality of death.”

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Business

India Covid disaster: Loss of life toll surpasses 200,000

India Covid crisis: Death toll surpasses 200,000

A patient wearing an oxygen mask is taken to a COVID-19 hospital for treatment while coronavirus disease (COVID-19) spreads in Ahmedabad, India on April 26, 2021.

Amit Dave | Reuters

India reported a record daily death toll on Wednesday when the total number of Covid-19 deaths topped the 200,000 mark.

Government data showed that at least 3,293 people died within 24 hours. The total number of cases also rose by a record 360,960 reported infections. This was India’s seventh day in a row with over 300,000 new infections.

The total number of Covid cases in the country is just under 18 million while the death toll stands at 201,187. However, recent media reports suggest that the daily death toll may not be adequately reported.

In April alone, the South Asian nation reported more than 5.8 million new cases, marginalizing the country’s health system.

The international community responded with a promise to send urgently needed aid to India. The United States said it would send raw materials that the South Asian country needs to make AstraZeneca’s vaccine.

India has given more than 145 million doses of vaccine to date, according to the Ministry of Health. However, as of Tuesday, only around 23.9 million people had received their second dose.

India’s variant of Covid?

Experts fear that a mutated variant of the coronavirus is responsible for the dramatic increase in cases during the second wave. Before the resurgence, India reported an average of around 10,000 new cases per day.

The virus has mutated several times since last year. The World Health Organization classifies these variants either as “variant of interest” or as “variant of concern”. The affected variant typically refers to a variant that shows an increase in communicability and more severe illness, including a higher rate of hospitalizations or deaths.

The WHO classified the B1617 variant with several sublines with slightly different characteristic mutations as an interesting variant for their weekly epidemiological update of the pandemic. It was first spotted in India last October, but was represented in at least 17 countries as of Tuesday, including the US, UK and Singapore.

The international health agency said in its report that the B1617 variant is circulating in India along with other worrying variants as well as the B1618 variant discovered in some states. The WHO said these variants may collectively play a role in the current resuscitation.

Effects

The Indian government is increasingly criticized for gathering large crowds, mostly without mask, for religious festivals and election campaigns in different parts of the country.

The better-than-expected handling of the first wave last year created a feeling of complacency within the political class, and subsequent questionable decisions contributed to the rise, according to Akhil Bery, South Asia analyst with political risk advisory firm Eurasia Group.

Among those decisions, Bery noted that the government had allowed the week-long Kumbh Mela religious festival, which reportedly saw hundreds of thousands of people bathing in the Ganges. This has become a super-spreader event, as have electoral campaigns by various parties, including Prime Minister Narendra Modi’s Bharatiya Janata party in the eastern state of West Bengal.

“There have been some questionable decisions here and this is a major political challenge for Modi, at least in the short term,” Bery said on CNBC’s Squawk Box Asia on Wednesday.

“During last year’s boom, there was a general expectation that the Indian health system would collapse. Ultimately, it did not,” he said, adding, “This created a feeling of complacency within the political class, within the people … But ultimately that complacency fed into that mentality, and now we’re seeing the end results of that. “

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Business

The BBC coated Prince Philip’s dying for hours. Cue the complaints.

The BBC covered Prince Philip’s death for hours. Cue the complaints.

Shortly after Prince Philip, the Duke of Edinburgh and husband of Queen Elizabeth II passed away last Friday, the BBC cut its schedule to cover its television channels and radio stations all afternoon and night.

When popular shows went off the air – including the Friday episode of EastEnders, a soap opera that has aired since 1985, and the final episode of MasterChef, a cooking contest show – expressions of displeasure flooded the BBC. To be precise, 109,741 complaints were received, the BBC said on Thursday, making it the most complained moment in BBC history.

As a UK public broadcaster, the BBC has a prominent position in the UK media and it is difficult to fund it through a license fee. It is often attacked for being too liberal and too conservative, while its access to public funds is controlled by the government, which is currently a Conservative government.

The BBC tries to reflect the mood of the nation, but recently, after Oprah Winfrey’s interview with Prince Harry and his wife Meghan, the Duchess of Sussex, a heated debate erupted over the role of the royal family.

Too little coverage of tributes to the Duke and the BBC would have run the risk of not properly respecting his life. Even so, the station received so many online complaints that it set up a streamlined process on Friday – a special online form – that people could use to register their disappointment with the scope of their coverage.

The BBC said Thursday that the Duke of Edinburgh’s death “was a momentous event that generated great interest both nationally and internationally” and that the decision to change the schedule was made with careful consideration of what “the role of the BBC reflects “as a national broadcaster in moments of national importance. “

Two commercial broadcasters took different approaches. ITV, like the BBC, reportedly saw a sharp drop in viewership last Friday due to many hours of coverage of Prince Philip. Kanal 4 had special programming, but gave viewers a break by broadcasting a popular program called “Gogglebox” at 9pm, which broadcasts television viewers.

On Saturday, the BBC and ITV will broadcast the Duke of Edinburgh’s funeral, which will not be open to the public due to pandemic restrictions.

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Health

Covid was third main reason for dying in U.S. in 2020, behind coronary heart illness and most cancers, CDC says

Covid was third leading cause of death in U.S. in 2020, behind heart disease and cancer, CDC says

The body of a deceased patient is considered a health care worker treating individuals infected with coronavirus disease (COVID-19) on December 30, 2020 at the United Memorial Medical Center in Houston, Texas, United States.

Callaghan O’Hare | Reuters

Coronavirus was the third leading cause of death in the United States in 2020, after heart disease and cancer, according to a new study by the U.S. Centers for Disease Control and Prevention.

More than 3.3 million deaths were reported in the US last year, up 16% from 2019. This is according to early data released Wednesday by the National Vital Statistics System, which provides annual mortality statistics based on death certificates investigates and reports.

The deadliest weeks of last year were at the start of the pandemic and then in the middle of the holiday flood in the weeks leading up to April 11, with 78,917 deaths, and December 26, when 80,656 people died, the CDC found.

According to the study published on Wednesday, Covid-19 was listed as the root cause of 345,323 deaths. More Americans died in the process than accidental injuries, strokes, chronic lower respiratory diseases, Alzheimer’s, diabetes, influenza and pneumonia, and kidney disease.

Only heart disease and cancer killed more people than Covid-19 in the US in 2020 – heart disease killed 690,882 people and cancer killed 598,932.

Covid-19 replaced suicide in the top 10 leading causes of death in the United States, the study found. Overall, the annual death rate rose nearly 16% year over year in 2020, the first time since 2017, according to the CDC.

The highest annual death rates were reported among men, people age 85 and over, and people who are not Hispanic Black and Native American and Alaskan native, according to the CDC.

However, if you just look at Covid-19, Hispanic and Native American and Alaskan Native Americans, as well as those aged 85 and over, were more likely to die of the disease compared to any other group. Men died more often from Covid-19 than women.

CDC director Dr. Rochelle Walensky said after the study was published the results should “act as a catalyst” for Americans to reduce the spread of the virus and get vaccinated when it is their turn to get vaccinated.

“I know this is not easy and so many of us are frustrated with the disruption this pandemic has had in our daily lives, but we can do this as a nation that works together,” Walensky said during a White House press conference Covid-19

The agency’s first results were released months ahead of schedule as “freshness has improved and there is an urgent need for updated quality data during the global COVID-19 pandemic,” the researchers wrote.

Typically, it takes researchers 11 months after the end of the calendar year to “investigate specific causes of death and process and review data”. The daily Covid deaths reported by the CDC, while current, may underestimate the actual number of deaths due to “incomplete or late reports”.

“Preliminary death estimates provide an early indication of shifts in mortality trends and can guide public health policies and actions aimed at reducing the number of deaths directly or indirectly linked to the COVID-19 pandemic “write the researchers.

Some have tried to sow doubts about the real number of Covid-19 deaths, claiming they may have been overstated. However, in a separate CDC study released Wednesday, the agency found that the death certificates accurately reflected the number of reported coronavirus deaths.

The agency checked death certificates listing Covid-19 and at least one other concurrent illness. The CDC found that Covid-19 was reported in 97% of deaths alongside another condition that the virus might have caused, such as pneumonia or respiratory failure, or that contributed significantly to its severity, such as diabetes or high blood pressure.

A small fraction of them – 2.5% of the certificates – documented conditions not currently associated with Covid-19, the CDC noted.

“These results support the accuracy of COVID-19 mortality monitoring in the US using official death certificates,” the researchers said.

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World News

AstraZeneca Vaccine Beneath Extra Scrutiny After Denmark Demise

AstraZeneca Vaccine Under More Scrutiny After Denmark Death

Denmark reported on Saturday that after receiving the AstraZeneca Covid-19 vaccine, two people suffered cerebral haemorrhage, one of whom died. The Danish Medicines Agency said it was looking to see if the disease was a possible side effect.

A spokesman for the capital region of Denmark confirmed the death, and the Danish news agency Ritzau reported that the other person, a civil servant in her thirties, was seriously ill.

Millions of people in dozens of countries have received the AstraZeneca Covid-19 vaccine with few reports of side effects. However, the European Medicines Agency, the continent’s top medicines agency, carried out a review after several countries stopped using the vaccine. On Thursday, the agency said it thought the vaccine was safe, although it would continue to look out for links to blood disorders. It was determined that any threat would be very minor and that the gunfire would prevent far more deaths than they could cause.

Recent blood clots and abnormal bleeding in a small number of vaccine recipients in European countries raised safety issues and resulted in suspensions. This resulted in a disruptive pause in vaccination campaigns this week, although some European countries entered a third wave of infections.

“At the moment we are investigating whether this is exactly the same clinical picture with multiple blood clots, low platelet counts and bleeding,” said Tanja Erichsen, director of the Danish Medicines Agency, in a radio interview with the Danish national broadcaster DR.

“We prioritize reports of suspected serious side effects like these and investigate them thoroughly to determine whether there is a possible link to the vaccine,” Ms. Erichsen said on Twitter on Saturday. “We are in the process of dealing with the two specific cases.”

This is the second death in Denmark after a person received the AstraZeneca vaccine. Norway is investigating the deaths of two people who received the vaccine.

Denmark has suspended the use of AstraZeneca until Thursday, despite assurances from the European Medicines Agency. Other Scandinavian countries and Finland have made similar decisions. However, some European countries, including France and Germany, have resumed recording.

Part of the continued caution is due to preliminary results from medical experts in Norway and Germany, which suggest a possible link between the vaccine and the extremely rare blood disorders. The German experts said the sinus or cerebral vein thrombosis, which Germans suffered 13 days after receiving the vaccine, was caused by an immune system reaction they believe may be related to the shot. They did not publish detailed data, but planned to present their results to The Lancet.

AstraZeneca didn’t immediately comment on the claims on Friday.

Dr. James Bussel, an expert in platelet disorders and professor emeritus at Weill Cornell Medicine, said the occurrence of abnormal clotting and low platelets in people under the age of 50 was unusual. He found that researchers in Europe had identified antibodies produced by the immune system – possibly in a highly unusual response to the vaccine – that may have activated platelets and triggered a cascade of abnormal clotting and bleeding.

Researchers in Germany and Norway will continue their research. In Germany, where the vaccine is being re-administered, doctors are now warning anyone who receives an AstraZeneca shot to see a doctor immediately if they have a headache, dizziness, or blurred vision more than three days later. They said the problems could very likely be addressed if identified in time.

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Politics

Crushing Dissent: The Saudi Kill Workforce Behind Khashoggi’s Dying

Crushing Dissent: The Saudi Kill Team Behind Khashoggi’s Death

WASHINGTON – Seven Saudis who were involved in the murder of journalist Jamal Khashoggi were part of an elite unit tasked with protecting Crown Prince Mohammed bin Salman. This emerges from a released report on the attack published on Friday. The New York Times has linked the group with a brutal campaign to suppress disagreements at home and abroad, citing interviews with American officials who read intelligence reports on the campaign.

The role of activists from the so-called Rapid Intervention Force (RIF) in the assassination of Khashoggi helped bolster the case by American intelligence that Prince Mohammed approved the operation. “Members of the RIF would not have participated in the murder without the consent of the Crown Prince,” the report said.

The group “exists to defend the Crown Prince” and “only responds to him,” the report said, and on Friday the Treasury Department appointed the Rapid Intervention Force for economic sanctions for its role in the Khashoggi assassination.

Here’s something about what is known about the device:

The assassination of Mr Khashoggi was just one particularly monstrous operation that included members of the group. The Rapid Intervention Force appears to have begun its violent campaign in 2017, the year Prince Mohammed pushed his elder rival aside to become heir to the Saudi throne.

According to American officials, the group has carried out dozens of operations both inside and outside the kingdom – including the forcible repatriation of Saudis from other Arab countries. The group also appears to have been involved in the detention and abuse of prominent women rights activists who campaigned for the kingdom’s driving ban on women to be lifted. One of them, Loujain al-Hathloul, was arrested in 2018 and only released this month.

Another of the women arrested by the group, a university professor, attempted suicide after being subjected to American torture in 2018 after being subjected to psychological torture. Some of the inmates were temporarily held in an opulent palace owned by Prince Mohammed and his father, King Salman.

The group was so busy that in June 2018 their field commander asked an advisor to Prince Mohammed whether the Rapid Intervention Force could receive rewards for Eid al-Fitr, the holiday that marks the end of the holy month of Ramadan, according to American officials Read the intelligence report mentioning the request.

The group was overseen by Saud al-Qahtani, one of the Crown Prince’s best aides, who served as media tsar for the royal court. One of Mr. al-Qahtani’s jobs was to manage the kingdom’s “troll farms” – organizations that used legions of online bots and avatars to stifle the voices of prominent critics like Mr. Khashoggi. The intelligence report released on Friday referred to a quote from Mr. al-Qahtani in 2018 that he “did not make any decisions without the consent of the Crown Prince”.

American officials said the Rapid Intervention Force field commander was Maher Abdulaziz Mutreb, an intelligence officer who often traveled overseas with Prince Mohammed. Another member of the team, Thaar Ghaleb al-Harbi, was a member of the Saudi Royal Guard, who was promoted for valor in an attack on one of Prince Mohammed’s palaces in 2017.

In the released report on Friday, all three men were named as part of a group of 21 people who “participated in, ordered, or otherwise complicit in, or were responsible for the death of Jamal Khashoggi on behalf of the Crown Prince.”

The Saudi government has long denied that Prince Mohammed played a role in the assassination of Mr Khashoggi and has brought eight men to justice. The government never published the names of the defendants.

In September, a Saudi court announced that five of the men had been sentenced to 20 years in prison and three others had fewer sentences. Some of the accused had originally received death sentences, but those were overturned after one of Mr Khashoggi’s sons said publicly that he and his siblings pardoned the men who killed their father.

It was unclear whether members of the Rapid Intervention Force were tried or convicted, but Mr al-Qahtani was publicly exonerated by the Saudi government because prosecutors said there was not enough evidence to back him up in the murder of Mr Khashoggi Court.