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News Brief: Afghan Crisis Talks, Biden To Survey Flood Area, ECMO Machines


How can Americans and others get out of Afghanistan now that U.S. troops are gone?


The Taliban, who now rule Afghanistan, have promised safe passage. Matching that promise to the reality is proving difficult, though. The U.S. says a few Americans have departed by land borders. Flights, though, are harder to arrange. Several private planes have been held up for days at an airport and a northern city in Afghanistan called Mazar-e-Sharif. That's one of the issues Secretary of State Antony Blinken faces when he visits Doha, Qatar, today.

INSKEEP: NPR's Michele Kelemen is traveling with the secretary of state. Hey there, Michele.


INSKEEP: What is the delay for these planes in the city called Mazar-e-Sharif?

KELEMEN: Well, veterans groups, activists and others that have been trying to evacuate hundreds of people that they say were left behind - these include some Americans and at-risk Afghans - have really been turning up the heat on the State Department, saying that they haven't been helpful with this. Now they say the Taliban isn't helpful with this. Secretary Blinken did address it today. Take a listen to what he had to say.


ANTONY BLINKEN: We're working around the clock to clear any roadblocks to make sure that charter flights carrying Americans or others to whom we have a special responsibility can depart Afghanistan safely. Without personnel on the ground, we can't verify the accuracy of manifests, the identities of passengers, flight plans or aviation security protocols.

KELEMEN: And you see - those are the real security risks at stake that Blinken was talking about there. And that's been one of the big issues that the State Department has been talking about - is that they don't know exactly who are on these planes. So they'd be responsible for them if they end up coming to other countries or to U.S. military bases.

INSKEEP: Yeah, I guess you don't know what kind of security protocols are really put in place by the Taliban in Mazar-e-Sharif, but what about the Taliban themselves? Are they being helpful or blocking things, as best you can tell?

KELEMEN: Well, Blinken said it's it's not a hostage situation. It's not that the Taliban are holding up all these planes. He said that they are letting people leave if they have the right travel documents or travel documents at all. In fact, he said the State Department got four Americans out on an overland route just yesterday. The Taliban knew about that and didn't impede it. So, you know, what he's focused on is trying to keep the Taliban committed to keep their commitment to letting people out, to giving people safe passage. And he's also working to try to get the airport in Kabul reopened with the help of Qatar and Turkey, where the U.S. would have a little bit - at least have allies and partners on the ground to help in this.

INSKEEP: I just want to think through what the Secretary of State would be doing in Doha, in Qatar, which is there on the Persian Gulf, south of us here in Pakistan and south of Afghanistan. There's a big U.S. military base there, I know. It would be the destination for some of these flights out of Afghanistan. Qatar is close to the Taliban, has friendly relations with the Taliban. And there's even a Taliban office there. So what is the secretary of state doing, and who's he meeting with?

KELEMEN: Well, as you say, it's really the hub for international diplomacy. The U.S. embassy staff that left Kabul are operating out of here. He's going to be meeting with them. He's talking do he's going to see where the refugees are - 58,000 of them have come through Qatar as the first stop before heading to the U.S. and Europe. But he's not planning to meet those Taliban delegation that has an office here that we know so far.

INSKEEP: Michele, thanks for your reporting. Safe travels to you.

KELEMEN: Thank you.

INSKEEP: NPR's Michele Kelemen is with the secretary of state in Doha, Qatar.


INSKEEP: OK, President Biden is also traveling, though not quite as far afield. He will be in New York and New Jersey today, two states where the remnants of Hurricane Ida killed more than 40 people.

MARTIN: His visit comes after a fairly tumultuous few weeks, for his administration anyway. The White House has been criticized for the chaotic withdrawal from Afghanistan, a summer COVID spike and the slow economic recovery. And in the midst of all this, the storm that ravaged both the Gulf Coast and the Northeast.

INSKEEP: NPR White House correspondent Tamara Keith joins us. Hey there, Tam.


INSKEEP: I'm sorry to say natural disasters have become so common that I could almost predict some of the things the president must say and would say. But is there anything special that the president will be able to deliver as he travels?

KEITH: Yeah, as you say, this is a most traditional presidential trip. And, of course, the main part of it will be surveying the damage, meeting with officials and people affected by the storm, just as he did last week in Louisiana. But an administration official tells me that the president will also make a larger case about climate change and the need for investments in resilient infrastructure. That's a tie back to the infrastructure legislation that Congress will be working on this month. You know, the frequency of these severe weather events gives him an opportunity to pitch improving infrastructure, from power grids to levees, storm water systems, all to hopefully be better able to handle extreme storms or heat waves.

INSKEEP: I guess we're in another of these periods that come from time to time where there are multiple huge news stories, all of which touch on the presidency and the president in some way. How's he managing that?

KEITH: And a president has to keep all the balls in the air at the same time. On Afghanistan, there are still Americans who want to get out, as we just heard. And that's now being worked through the State Department. That moves the main messenger on this outside of the White House and moves some of the bright political light off of President Biden because for President Biden, the less focus on Afghanistan, the better. He intends this month to move on to infrastructure. On COVID, the president said that he'll be announcing a plan this week to tackle the delta variant. The rise in new cases appears to be slowing slightly. This is, of course, a good thing.

But deaths are up at about 1,500 a day on average. And that's going to get worse before it gets better. That's just the grim reality of how COVID works. The president's speech is set for Wednesday, but it's not really clear what new tricks the administration has to battle the pandemic. There's only so far they can or are willing to go to mandate vaccines, for instance. And they've left vaccine verification up to the private sector. Looking forward, they've set the September 20 date to start opening up third doses to people to get sort of an immunity booster. But it's not clear right now whether those doses will be available to everyone.

INSKEEP: And as the delta variant goes up, it seems that job creation goes down.

KEITH: Yeah, the president is getting pressure from progressives to extend unemployment benefits, which expired yesterday. And that pressure mounted because one, they're expiring but two, the economic growth wasn't as strong, the jobs report simply wasn't as strong as many people had been hoping.

INSKEEP: NPR White House correspondent Tamara Keith, really appreciate it.

KEITH: You're welcome.


INSKEEP: COVID is again pushing hospitals to the brink.

MARTIN: Across the country, more than 100,000 hospital beds are occupied by COVID patients. In Tennessee, where rates are especially high, hospital executives are pleading with people to get shots and wear masks to avoid a breaking point.

INSKEEP: Blake Farmer of our member station WPLN is in Nashville. Blake, welcome.


INSKEEP: And I'm sorry to say we could mention - we could be talking about dozens of states now, but we're going to focus on Tennessee. How bad is it?

FARMER: Well, you know, hospitals have more COVID patients in them than they've ever had, including during the winter, when things were about as bad as anyone thought they could be. And the question is really what happens next.

INSKEEP: And there's a particular kind, as I understand it, of life support that is getting to be in considerably short supply. We've heard about ICUs that are completely full to capacity in numerous cities and numerous states over the past year and a half, but you've been reporting on a particular type of life support that would be used in ICU.

FARMER: Yeah, it's called ECMO, and this is a high-level life support. It stands for extracorporeal membrane oxygenation. It's essentially when the blood is pumped outside the body, and a machine does the work of the lungs, hopefully, you know, giving more time for the lungs to heal. And, you know, there was a time when we were all worried about having enough ventilators early in the pandemic, as you'll recall.


FARMER: And now it's really ECMO that seems to be the real pinch.

INSKEEP: And what makes it in such short supply? Is it both the technology and people who know how to use it?

MARTIN: Well, you know, most hospitals don't even offer ECMO. So in a way, there is that kind of shortage, but you also wouldn't want just any hospital trying it out. I was in a COVID ICU last week and saw this firsthand. I mean, you essentially have a big hose in your neck, piping out all your blood. And then after the blood's oxygenated, it's pumped back into your body. You know, so in one way, it's kind of simple, but there's so much that could go wrong. You know, you just think of, what if one of those hoses slips free?

INSKEEP: Yes, I mean, I'm cringing even thinking about it. You would want somebody who really knows what they're doing.

FARMER: Yeah. But, you know, even major medical centers that offer ECMO are limited by this huge staffing shortage we're talking about every week. Dr. Brett Campbell is a critical care physician at the Ascension Hospital System here in Nashville. And they only have enough staff to manage eight ECMO beds right now.

BRETT CAMPBELL: If somebody needs ECMO for COVID, you know, there's not a spot right now. Something has to open up before we get - and that's what we've been doing for the last two weeks - is as soon as we get an empty bed, it fills immediately.

FARMER: So there's literally a waiting line. And that's the same for big academic medical centers like Emory in Atlanta, who I've talked to. They're turning down ECMO transfers every day.

INSKEEP: Because of staffing, as well as the machine.

FARMER: Correct. And really, it's because of staffing because you need a one-on-one nurse for each of these patients. You know, I've talked to nurses who work with these patients, and it's all they can do just to work with this very one patient. And so that just means there are fewer patients they can care for in the ICU.

INSKEEP: Patient to nurse ratio of 1:1. Blake, thanks so much.

FARMER: You're welcome.

INSKEEP: Blake Farmer of WPLN in Nashville. Transcript provided by NPR, Copyright NPR.

Steve Inskeep is a host of NPR's Morning Edition, as well as NPR's morning news podcast Up First.
Rachel Martin is a host of Morning Edition, as well as NPR's morning news podcast Up First.