“I can only say they have to stand down, let law enforcement do their work,” the President told reporters, before pivoting again by saying “the problem is on the left.”
His comments on the Proud Boys display how his instinct when cornered is to fight back harder, intensify personal attacks and aim the punches farther below the belt. Such an approach worked well in 2016, when he was an outsider who appreciated the potential for a populist, insurgent campaign when no one else did.
It is far from clear that an antagonistic approach is a good fit for 2020, when Trump is an incumbent President and the country is locked in multiple crises. Those aggressive reflexes are one reason why the President’s handling of the pandemic that has killed more than 200,000 people has been so poor. And they mean that any advice from Trump’s aides to torque back his demeanor ahead of the next debate in Miami on October 15 will either fall on deaf ears or be ignored in the heat of battle.
The next encounter also brings the added risk of a President not used to being challenged exploding at a member of the public in a town hall format on live TV.
Republican senators, suffering through one of hundreds of awkward on-the-spot moments of the Trump presidency, were particularly discomforted by questions about the President’s “stand back and stand by” order to the Proud Boys. Senate Majority Whip John Thune, R-South Dakota, suggested it was a statement the Trump team needed to “clear up.”
Even Donald Trump Jr. allowed on CBS News that his father’s comment at the debate could have been a “misspeak.” But the Proud Boys were in no doubt about where Trump stands, turning his comment into a new online logo.
Massive stakes for 2nd debate
The overwhelming consensus that Trump bombed in his first debate means the stakes for the second one are now even more astronomical than they were on Tuesday night. He will need a game-changer moment, with only three weeks left in the campaign. But he might have already missed his best chance.
Typically, the first debate garners the biggest TV audience. Further, by mid-October, millions more voters will have cast early ballots, and if current trends hold, a building new wave of Covid-19 infections will be having a demonstrably more serious impact on American life. Such a scenario will underscore the President’s failure on Tuesday night to offer any authentic plans to conquer the pandemic and may deepen his vulnerability on health care, which offered Biden a clear opening.
Debates are not always an accurate measure of who wins presidential elections. Democratic nominees John Kerry and Hillary Clinton were generally judged to have won their debates but they lost the elections. Trump’s destructive behavior likely appealed to those voters who prize him as a slayer of Washington elites and scourge of political correctness.
But if the misgivings inside his camp are on the button, the President probably did little in Cleveland to chip away at Biden’s advantage in most swing state polls. He might have even weakened his own position, as many voters saw in real time on their televisions the full extent of the boorish behavior that is familiar to Trump Cabinet members, foreign leaders and journalists who cover him.
If the President went into the evening needing to win back suburban voters and non-college-educated female voters, his tantrums and extreme rhetoric on race and refusals to guarantee ceding power, even if he loses the election, seem to have been guaranteed to secure exactly the opposite outcome.
Worse, from Trump’s point of view, his fury several times drowned out slips or uncertainty by Biden on the debate stage — including the former vice president’s inability to give a straight answer when asked whether he favored liberal demands for Supreme Court packing following Trump’s trio of picks to the nation’s top bench.
Compared with recent Democratic nominees, Biden wasn’t particularly impressive at the debate — albeit that he was trying to operate with constant haranguing from the man across the stage. But he didn’t have to be.
The President’s behavior meant that the sound bites from the debate being played on TV on Wednesday mostly referenced the President’s rage rather than Biden’s wobbly answers. Given that every day in the campaign is now crucial for a President who is behind, that was a small disaster in itself.
Biden was able to give the impression that he was the candidate with momentum heading out of the first clash, playing into what he saw as public distaste with the President’s performance.
“I kind of thought at one point, maybe I should’ve said this, but the President of the United States conducting himself the way he did — I think it was just a national embarrassment,” Biden told CNN’s Arlette Saenz on Wednesday.
Can Pence throw Trump a lifeline?
It’s going to be hard for the President’s political advisers to convince him that he has a problem. From the start of his presidency, Trump has existed in a bubble of praise from conservative news anchors and traded in the conspiracy theories that they amplify on shows he ravenously watches.
That helps to explain why the President came out with his normal rally punch lines in front of a far more diverse audience in the debate, mocking the use of masks, claiming he had saved millions of lives with his botched pandemic management and flinging unproven allegations about Biden’s son Hunter.
“I thought the debate last night was great. We got tremendous reviews on it,” the President told reporters on Wednesday. This may be typical Trump bravado. But it doesn’t suggest the kind of humility and the capacity for self-criticism that allowed Presidents Ronald Reagan and Barack Obama to bounce back from disastrous first debates in their own reelection races.
Trump has occasionally had teleprompter-driven moments in which he has behaved in a more statesmanlike manner. But such efforts have largely been confined to set-piece events like the State of the Union address. It is when the President gets off the teleprompter and his confrontational impulses are unrestrained — as in the debate situation on Tuesday — that he torches scripts and plans drawn up by aides.
The crucial point is that Trump doesn’t care. His actions show how he has long used the presidency as a channel for his personal grievances and to express how he feels, at any moment.
Pence, a smooth debater, is likely to make a far more conventional case for Trump’s second term than the President himself managed. Pence will detail what the administration sees as its main achievements: a conservative Supreme Court majority, multiple judges installed on lower benches, trade deals with Mexico and Canada, a reordering of US foreign policy and an economy that was prospering until the pandemic hit earlier this year.
The vice president will probably avoid unseemly personal attacks on Harris but will attempt to forensically exploit her liberal voting record to portray their ticket as the “Trojan horse” for the left that Trump believes it to be. The California Democrat is unlikely to be aiming her jabs at Pence and is expected to bring the inquisitorial skills that made her a renowned prosecutor to bear against the President himself.
If that’s the case, the President will go into his second debate with Biden under even more pressure than he faced in the first. He will need a Hail Mary moment to turn around the campaign with Election Day fast approaching. As Tuesday night shows, that’s not a scenario in which he seems to prosper.
In conversations with some senior Republican allies on the Hill, the White House is indicating that Barrett, a federal appellate judge and Notre Dame law professor, is the intended nominee, multiple sources said.
All sources cautioned that until it is announced by the President, there is always the possibility that Trump makes a last-minute change but the expectation is Barrett is the choice. He is scheduled to make the announcement on Saturday afternoon.
A former law clerk to the late right-wing beacon Justice Antonin Scalia, Barrett would tilt the balance of power on the court further to the right, possibly ahead of a consequential case on health care to be argued the week after Election Day. If her Senate confirmation is successful before the November election, the appointment would mark Trump’s third Supreme Court pick in one presidential term, cementing a conservative stronghold in the court for a generation.
Barrett was seen at her South Bend, Indiana, home on Friday. It was not clear if Barrett had been told she is the choice. Often that is done as late as possible to maintain secrecy around the announcement.
“The machinery is in motion,” one of the sources said. In previous nomination announcements, the White House had multiple rollouts planned in case the President made a last-minute decision to switch to another candidate. But one source said it would be surprising if there were a change since allies are already being told.
The White House declined to comment.
“She was the plan all along. She’s the most distinguished and qualified by traditional measures. She has the strongest support among the legal conservatives who have dedicated their lives to the court. She will contribute most to the court’s jurisprudence in the years and decades to come,” according to a former senior administration official familiar with the process.
The mother of seven children, Barrett, now 48, was confirmed in 2017 for her current judgeship on the 7th US Circuit Court of Appeals, which covers Indiana, Illinois and Wisconsin. Born in New Orleans in 1972 and a 1997 Notre Dame law graduate, Barrett worked in private practice and then became a law professor, settling at Notre Dame in 2002.
Advocates on the right have backed her possible nomination because of her writings on faith and the law. Religious conservatives were especially energized for Barrett when, during her 2017 confirmation, Democratic Sen. Dianne Feinstein of California suggested to her that the “dogma lives loudly within you.” Barrett supporters believed the nominee was being disparaged for her Catholicism.
The President indicated he has spoken to multiple candidates, but the White House has not been willing to say if other conversations were in person.
Barrett was at the White House on Monday and Tuesday of this week. She impressed the President and others during the initial meetings, two sources told CNN earlier this week.
This story has been updated with additional biographical details about Barrett.
Joan Biskupic and Maegan Vazquez contributed to this story.
But McConnell turned his back on his own made-up rule with a Republican in the White House. This Republican hypocrisy led to an absurd spectacle on Sunday talk shows of lawmakers and officials trying to explain away their own disingenuousness. The GOP will not care, however, since this pick will likely enshrine a decades-long conservative majority with the capacity to shape vast areas of American life — from voting and gender rights to environmental regulation and big business matters. The court could also become a thorn in the side of future Democratic presidents.
Trump reveled in his opportunity to nominate his third Supreme Court Justice at a rally in North Carolina on Saturday night. “It will be a woman, a very talented, very brilliant woman,” Trump said. “I haven’t chosen yet, but we have numerous women on the list.”
Biden seized on McConnell’s gall in an effort to make the case that Republicans who won the presidency despite losing the popular vote are embarked on an extreme power grab and must be reined in.
“Don’t go there,” Biden said Sunday, directly appealing to GOP senators. “Uphold your constitutional duty, your conscience, let the people speak. Cool the flames that have been engulfing our country. We can’t keep rewriting history.”
The exact dynamics inside the Senate GOP will become more clear later this week as the chamber returns to work and members gather for their policy lunch.
Worsening pandemic complicates Trump’s reelection push
The President pivoted forcefully to the new Supreme Court battle after a week when he became increasingly desperate to deflect from the pandemic, which included misleading and often false accounts, for example, of the speed with which Americans can expect to see a vaccine needed to end the disaster.
Trump’s hopes of talking about anything but the pandemic look slim given the worsening situation. The number of new Covid-19 cases has increased by at least 10% in 31 states over the last week, according to data Sunday from Johns Hopkins University. The test positivity rate — the percentage of new test results that are positive — is rising in 25 states, according to the Covid Tracking Project, fulfilling the fears of experts who warned of a post-Labor Day spike.
Republicans deny claims of hypocrisy
While large crowds of mourners gathered at the Supreme Court to pay tribute to Ginsburg, the White House was embarking on an aggressive plan to put her replacement — and a 6-3 conservative majority — in place.
“Today, we sit here 44 days out from election, so it’s certainly possible,” he said, referring to the chances of getting a new justice on the bench by November 3.”But I think that the President’s obligation is to make the nomination. We will leave the timetable to Leader McConnell.”
Republican senators blew past accusations of hypocrisy when asked about the tactics of McConnell, who has made reshaping the federal judiciary the priority of his leadership of the Senate.
If the Republicans cannot ram through a vote before the election, it could lead to a massive political conflagration should Democrats win the presidency and take back the Senate, then have to watch as a new justice is confirmed in a lame duck session by McConnell.
Such possibilities are making for some treacherous politics for both sides ahead of the election.
Trump, for example, is clearly hoping that a Supreme Court fight will supercharge his political base and send an overwhelming wave of conservatives into polling places. But there is also the chance that the Supreme Court battle could backfire on the President. It could boost liberal turnout among voters who fear, for example, that the new conservative majority will seek to limit or even outlaw the right to an abortion. A prolonged fight over this issue ahead of the election may further weaken Trump’s already compromised position among suburban women voters.
“You can’t keep a democracy if there’s one set of rules for one group and another set for everybody else,” Clinton said.
It was an unusual moment of exposure for a leader who demands constant public praise from his subordinates. On Tuesday night, audience members granted him the respect due to his office but none of the adulation he craves.
Answers that normally draw wild cheers at Trump’s packed campaign events fell flat when he was confronted by voters who appeared to want to cut through bluster and propaganda. And his responses did little to recognize the magnitude of the challenges facing the nation in a fearful year, suggesting that the President has yet to find the language or the appeals that might turn around an election he so far seems to be losing.
He said he did a “tremendous” job on the virus, insisted “it’s going to disappear” and that “a lot of people think masks are not good.” Asked who said masks aren’t good, Trump replied, “Waiters.” He bizarrely said “herd mentality” would make it go away, in an apparent reference to herd immunity that medical experts say could cost several million lives. The President has pounced on Biden’s verbal slips as evidence that he lacks the mental capacity to be President. But his own confusing answers after six months supposedly leading the national effort to fight the pandemic failed to inspire confidence that he fully understands the implications of the emergency even now.
He also illogically complained that Biden, who has no power, had not followed through on a national mask mandate and claimed falsely the US response to the crisis was the best in the world. And the President denied any blame for how the pandemic has turned out — placing the entire responsibility on China, where the virus first emerged, and several times complained he is not getting the credit he deserves.
At the end of the night, the President was asked by a voter named Ashley West to cite the most difficult part of his presidency and asked what he had learned from it — and in a way that seemed jarring given that the 200,000th American will soon die from the disease, the President reflected on his own personal sense of loss.
“I learned that life is very fragile. I knew people that were powerful people, strong people, good people, and they got knocked out by this, and died. Six people. It was five until about two weeks ago. Now, it’s six,” Trump said.
Trump defends himself
The President became most exercised when denying reports that he referred to US war dead as “losers” and “suckers,” calling them “fake.” He made halting attempts to show empathy to a new US citizen from the Dominican Republic who lost her mother to breast cancer complications a month ago and asked him a question about immigration. Trump responded by telling her that it was terrible that people died alone in hospital due to Covid-19 — and turned the answer into an infomercial for his pandemic leadership. Biden, who has buried a first wife and two children in a life marked by tragedy, is highlighting his own empathy as a balm for the country at a grief-wracked moment.
Trump shrugged off questioners who asked him if he agreed America needed to reexamine its painful history on race, again arguing that there were a few “bad apples” in the police force who “choked” in incidents in which unarmed Black Americans were killed.
The President also falsely claimed that Democrats wanted to remove protections for patients with pre-existing conditions introduced under Obamacare. His own administration is currently arguing a Supreme Court case trying to destroy the Affordable Care Act, while Democrats seek to preserve the law. While Trump says he would protect pre-existing conditions, he has offered no credible health plan.
The President’s appearance came in a crucial swing state at a moment when he is trailing Biden by nine points in the CNN Poll of Polls as the country faces concurrent crises: a pandemic, the consequent economic crash, a racial reckoning and historic fires in Western states.
Trump’s campaign insists untapped seams of pro-Trump voters who sat on the sidelines in 2016 are being ignored by pollsters and will embrace the President’s hardline culture war rhetoric to sweep him to a second term.
Trump again denies evidence of his own voice
The town hall event exactly seven weeks before Election Day was a reminder of the kind of chaos, falsehoods and divisiveness that is a selling point for the President’s most faithful voters but is the kind of behavior that may prompt an undecided voter to turn away.
The stream of lies and alternative realities that the President promoted recalled a statement attributed to former Director of National Intelligence Dan Coats in Woodward’s book “Rage” that was published on Tuesday.
“To him a lie is not a lie. It’s just what he thinks. He doesn’t know the difference between the truth and a lie,” Coats is quoted as saying to former Secretary of Defense James Mattis.
Such commentary was borne out when Trump responded to a question by a first time voter from Pittsburgh who asked why he was captured on tapes made by Woodward as downplaying the pandemic.
“Yeah, well, I didn’t downplay it. I, actually, in many ways, I up-played it, in terms of action,” he said.
In essence, the President is inviting voters to refuse to believe the evidence of their own ears on his early attitude to the worst domestic crisis since World War II that has now killed 195,000 Americans and pitched 30 million out of work.
He is implicitly arguing that not only does he not deserve any blame for a response that lags other industrialized nations — the US has 4% of the world’s population and more than 20% of the Covid-19 cases and deaths.
But such a view relies on an interpretation that distorts the traditional sense that the buck stops on the Oval Office desk and instead relies on voters to believe a flagrant act of salesmanship that defies the reality of their own lives.
After Trump told Fox News earlier Tuesday that he had read Woodward’s book on Monday night, and found it “boring,” Woodward said that the President was living in an “Orwellian world.”
“He was told, he knew, he told me about it,” the veteran reporter told CNN’s Anderson Cooper.
“I don’t know, to be honest, whether he’s got it straight in his head what is real and what is unreal.”
In one stunning moment, he said that if the Washington Post reporter, whose book “Rage” comes out Tuesday, was so concerned about what was said in their taped conversations, he should have gone to the “authorities” so they could prepare the country. Of course, under the Constitution, the President is the ultimate authority and whether Trump likes it, the buck stops with him for the pandemic and every other national crisis.
“I don’t want to jump up and down and start screaming death, death,” Trump said, after Vice President Mike Pence bizarrely suggested Trump’s negligence in fact typified a British propaganda campaign that was never widely used during the war and has become part of marketing kitsch in recent years: “Keep Calm and Carry On.”
At his Michigan rally, Trump jumped on the metaphor, comparing himself to the wartime prime minister.
“We have to be calm. We don’t want to be crazed lunatics. … When Hitler was bombing London, Churchill, a great leader, would oftentimes go to a roof in London and speak. And he always spoke with calmness,” Trump said, mangling the history of Churchill’s late night trips to view the raids with his separate radio addresses to the British people.
Trump’s meanderings were not just evidence of his slim grasp of history. They were the latest sign of how he has shirked his duty and minimized the current emergency. On Thursday, for instance, he urged New York City to go much faster after it announced that restaurants could soon begin serving food inside at 25% capacity after long and painful months slowly reducing the once out-of-control epidemic.
At his evening rally, he called on Michigan Gov. Gretchen Whitmer, a Democrat, to “open up” her state. He urged schools to reopen and called for Big Ten college football to come back, cherry picking science about the impact of the virus on kids and ignoring their potential to infect their elders who are more at risk of complications.
This was despite growing signs of the danger posed to teachers — three of whom recently died from Covid-19 complications. He disregarded 40,000 cases of Covid-19 already recorded in higher education with many institutions canceling football games and in-person classes. The administration has not furnished a national plan to help schools go back safely, other than US Centers for Disease Control and Prevention guidelines on reopening. It has also threatened to defund schools that don’t get kids back in class.
Flying to Michigan to greet several thousand maskless supporters packed together exemplified his defiance of his own government’s guidelines for battling the pandemic. And Trump’s admission to Woodward that he knew the virus was transmitted through the air back in February is training fresh scrutiny on his decision to hold a string of rallies through February and early March.
The President’s latest positions mirror those he took at the beginning of the summer when he goaded supportive state governors to open up their economies and mocked mask wearing, thereby helping set off a disaster in the Sun Belt.
The impression then was the same as it is now: the President is desperate to restore at least an illusion of normality and to juice up the economy to boost his chances of reelection — ignoring the human cost of his actions.
“This is the single largest public health failure in the modern history of the United States, certainly, in the last hundred years,” said Peter Hotez, dean of the National School of Tropical Medicine at Baylor University.
“And it happened because of the refusal by the White House to launch a national campaign and a national strategy against the virus. So it’s beyond upsetting,” Hotez told CNN’s “New Day.”
Trump’s explanation that he had not wanted to panic Americans by explaining the true threat from the virus also came under severe examination. “We could have had one-fifth the deaths we’ve have had, and part of this is a failure to communicate,” Tom Frieden, the former director of the CDC, told CNN’s Wolf Blitzer.
“We will pass 200,000 deaths in the beginning of October, by all estimates, and this is a number that is just almost inconceivable,” Frieden said.
“This is an enormous number of people dying and it’s tragic to recognize that if we just had a more organized, well-led response with clear communication, many of those deaths could have been avoided.”
Biden seizes chance to attack
The Woodward revelations, piled on top of previous evidence of Trump’s mishandling of the pandemic, are likely to have a devastating impact on the President’s legacy. What is less certain less than eight weeks from Election Day is how they will affect his immediate political fortunes.
There is little chance that after nearly four years of scandals, dramas and outrages, Trump’s bond with his loyal voter base will be hurt.
Texas Sen. John Cornyn declined to comment since he had no “personal knowledge” of the President’s remarks — even though they are on tape and have been playing on television for two days.
North Carolina Sen. Thom Tillis, who’s facing a tough reelection, told CNN, “When you’re in a crisis situation, you have to inform people for their public health but you also don’t want to create hysteria.”
“And look what’s happened. Again, 190,000 dead and climbing. And what’s he doing now? He still has not moved.”
The explosion over the Woodward books comes just two weeks after a Republican National Convention that made Trump’s campaign strategy clear — avoid discussion of the pandemic at all costs.
But the grim and looming milestone of 200,000 US deaths from Covid-19 is likely to drown out the President’s message within days.
And with the first debate with Biden on September 29 fast approaching, time is dwindling for the President to get the campaign back onto ground he prefers.
They nudged him awake and the conversation was calm for the first several minutes. Deputies told him they were just checking to see if he was all right. But the encounter ended with McKnight on life support after being injected with a high dose of a drug called ketamine.
“I was out cold for three days on life support,” he said. “My family didn’t know where I was.”
When McKnight finally woke up in an Aurora hospital, he couldn’t believe what he was seeing on the news. His eyes widened when he saw a story about another young Black man named Elijah. Elijah McClain was in a coma and near death after a police encounter that also involved a ketamine injection — the same drug McKnight had been given before everything went dark. The two incidents happened just 10 miles apart and within days of each other, but involved different law enforcement and EMT agencies.
“I’m thankful to be alive,” McKnight said. But he is convinced the use of ketamine in police calls is being abused when there is no medical need for it.
“They are being lazy. I guess they didn’t want to deal with a drunk asshole,” he said.
McKnight is not alone in questioning whether police are influencing paramedics to use the powerful tranquilizer that requires hospitalization for nonmedical reasons.
CNN has found ongoing investigations in multiple states regarding emergency responders’ use of the fast-acting drug to tranquilize people against their will. In some places, such as Colorado and Minneapolis, the use of the drug by paramedics rose sharply in recent years.
Outrage over its use has motivated a city council member in Aurora, Colorado, to propose a temporary ban on the administration of the drug by first responders. In Minneapolis, the police department decided to create a new policy for its officers in 2018.
Sidewalk to ICU
Body camera video shows Arapahoe County sheriff’s deputies approaching Elijah McKnight in 2019 to check on his welfare while he’s passed out on the sidewalk. The conversation is calm and cordial to start, even after McKnight admits unprompted that he has warrants out for his arrest.
Deputies and McKnight go back and forth with McKnight asking them to call his father and deputies taking down his dad’s number. But, eventually, the officers move to detain McKnight and he tries to run.
The video shows officers grabbing him and pulling him down in a struggle. He’s accused of kicking one of the officers in the face. McKnight denies that, but admits he was angry, scared and uncooperative.
The deputies warned him and then use a Taser on him. McKnight is lying face down in the dirt with his hands cuffed behind his back as the two deputies lean on his legs. He screams that his legs are in pain. So when paramedics arrive, he is relieved.
“When they first came on the scene, I was like, please help me,” McKnight told CNN. “Finally, I have witnesses, now the police can’t do something to me.”
The paramedics assess him. McKnight loudly asks to be lifted up.
Still on the ground, McKnight occasionally yells out but is able to give correct answers when asked what year it is and who is the president.
“You’re a little too hyped up right now, you gotta relax,” a medic from South Metro Fire Rescue says.
“I am being cooperative,” McKnight insists.
“You are. You are. And I appreciate it, man,” the paramedic says.
After about six minutes, paramedics determine McKnight does not need hospital treatment.
But then one of the deputies asks, “You can’t give him anything can you? Unless you go to the hospital, right?”
A paramedic responds, “We can give him ketamine. He’ll be sleeping like a baby, but he’ll have to go to the hospital.”
McKnight objects, yelling: “Don’t give me. Don’t inject anything into my veins.”
It is unclear whether a paramedic or deputy responds, saying, “Just give it to him. I mean he’s bucking the three of us. Just give it to him.”
And they do. After a 500-milligram shot, the paramedics’ post-incident report says McKnight is being “wildly combative.” On body camera video, they say he is still able to “lift” them.
The video shows McKnight cuffed and laying still, yelling out now and then. Paramedics call a physician and get permission to inject him with 250 more milligrams of ketamine — a total dose higher than the drug manufacturer and the state health department recommends for a man of his weight. And finally, McKnight passes out. On the paramedic logs, it says McKnight was suffering from “excited delirium,” a controversial medical diagnosis.
McKnight sees that as simply an excuse to knock him out because police didn’t want to deal with him. Once ketamine is given, the recipient has to be hospitalized.
“They said I didn’t need to be hospitalized. So they definitely wasn’t going to give me ketamine until the police asked for it,” McKnight said. “I definitely wasn’t experiencing excited delirium, I can tell you that.”
A powerful drug
Ketamine is often the strongest sedative in a paramedic’s kit in departments that allow its use. In Colorado, where McKnight lives, the crews need a waiver from the health department to use it. Doctors administer it for pain relief and it can even be a general anesthetic.
In Colorado in the spring of 2013, the state health department’s Emergency Medical Practice Advisory Council cleared the use of ketamine in the field to treat patients with “a presumptive diagnosis of excited delirium,” but EMS agencies need a waiver to use it.
Excited delirium is defined as a condition where a person is so violently agitated that they can essentially exercise themselves to death, two doctors told CNN.
This month, the state health department announced plans to review its ketamine waiver program.
Between 2018 and 2019, there was a 72% increase in ketamine waivers for excited delirium Issued by the Colorado Department of Public Health and Environment. Some 902 waivers were made from 2018 to June 2020, even though the department guidance says the condition is rare and ketamine should “not be considered the standard of care for the management of excited delirium or agitation.”
That increase in usage is “alarming,” said Dr. Mary Dale Peterson, president of the American Society of Anesthesiologists. “It can be fatal, as we have seen in a couple of cases without proper monitoring and attention to detail.”
“Ketamine, or any other drug, you know, should not be given for purely law enforcement purposes. We give drugs to treat medical problems,” Peterson said.
The syndrome of “excited delirium” is not recognized by major medical organizations such as the American Medical Association, the American Psychiatric Association or the World Health Organization. It is, however, recognized by smaller organizations that deal with emergency medicine, such as the American College of Emergency Physicians.
Dr. Walter Dunn, a psychiatrist and UCLA associate clinical professor, says the controversy over “excited delirium” doesn’t mean the syndrome does not exist — but it is tricky to diagnose.
“Even clinicians would have a difficult time diagnosing an excited delirium,” he said. “When you employ ketamine you better be darn sure that this is excited delirium and not something else.”
That is because, aside from being a powerful sedative, when coupled with other medications or substances, the drug can have unintended consequences, Dr. Peterson says.
Excited delirium is what authorities from two different EMT agencies said McKnight and McClain, who had no alcohol in his system, were experiencing when they were injected. Both received doses larger than the state medical guidelines for their size.
The Colorado health department recently determined medics’ actions on McKnight were “independent of police requests” and “warranted.”
His encounter with police ended with him being loaded on to a gurney to be taken to a hospital, where he was hooked up to a ventilator to keep him alive.
Peterson, the anesthesiologist, said that was a known side effect of the tranquilizer. “Depending on what study you look at, 30% to 57% of patients will require intubation,” she said.
That’s also what happened to McClain. But he never woke up.
McClain’s fatal encounter
A resident called Aurora police, saying McClain seemed suspicious because he was moving his hands around and wearing a ski mask in the summer. McClain’s family says he had a blood condition that would make him feel cold.
As police approached, the violin player and masseur was listening to music through headphones. When an officer touched him, he appears startled.
“Please respect the boundaries that I am speaking,” McClain says on body camera video.
Everything happens so fast. There is a struggle when officers decide to arrest him. The slight, 140-pound McClain is cuffed and on his stomach. He says he can’t breathe. Two officers are on him. He is put in a chokehold at least once. He vomits. At one point, an officer says, “Whatever he’s on, he has incredible strength … yeah, crazy strength.”
It turns out he was not “on” any illegal drugs. According to the autopsy, none were found in his system.
Paramedics are on the scene by now; they administer 500 milligrams of ketamine, nearly twice the recommended dose.
“I’ve been in practice 30 years and never given a dose that high,” Dr. Peterson said. She is not involved in McClain’s case.
Mari Newman, an attorney for the McClain family, told CNN: “‘Incredible strength’ is the buzz word police use. It’s an excuse that the person they are dealing with has superhuman strength. They get paramedics to use ketamine to cut corners and quickly sedate people they don’t want to deal with.”
McClain ends up having a heart attack in the ambulance on the way to the hospital. He was intubated and put on a ventilator. He died three days after his encounter with police and paramedics.
“He could not breathe. He was fighting for his life,” said his father, LaWayne Mosley. “I wish I was there to fight for him.”
The autopsy report said McClain died of “undetermined causes” but contributing factors were “intense physical exertion and a narrow coronary artery.” The coroner said an “unexpected reaction” to a therapeutic level of ketamine “cannot be excluded” as a factor in his death.
Aurora Fire Rescue determined last November that their paramedics’ actions were “consistent and aligned with our established protocol” and that McClain was showing signs of “excited delirium, a dangerous and often inexplicable condition.”
The district attorney’s office declined to press charges against the officers involved and they were later reinstated after being put on routine administrative leave.
Nearly a year after his death, the city, state and health department opened new investigations into his case.
The FBI and the Justice Department have been reviewing the case since 2019.
A spokesperson for the National Fraternal Order of Police said the idea that police are using excited delirium as an excuse to use excessive force by injecting ketamine on any subject is out of line.
“I push back on that,” Sherri Rowan, the national director for wellness services for the National Fraternal Order of Police, told CNN. “As soon as they respond and recognize what it is, medical personnel are summoned. EMTs and paramedics are called because of the risk that is possible when someone is recognized to be having that sort of condition. Police departments are looking to do the best job that they can.”
A paramedic’s story
There is no national database that tracks ketamine use by EMS workers across the US. CNN found several ongoing investigations into the use of ketamine by first responders across the country.
One completed investigation was in Minneapolis. Ketamine is also used by first responders in nearby communities, such as Woodbury, where Joseph Baker used to be a paramedic.
“I have been pressured by police to administer ketamine,” Baker told CNN, in his first media interview. In August, he filed suit against the city of Woodbury, where he worked until 2019.
Baker says he had to quit after suffering retaliation and being disciplined for exposing falsified EMS training attendance documents that allowed people to get or keep their certifications to be paramedics, and disciplinary action for refusing to bow to police pressure to use ketamine when he thought it was not medically necessary.
The fight over ketamine was one of the final straws, he said. In 2019, he says he was called to assist with someone having a mental health crisis. Before he even arrived, dispatch was telling him and his crew to “get the ketamine ready,” he said.
“I was met by multiple officers who asked, ‘Do you have your ketamine ready, do you have it drawn up?’ And I said, ‘No. I have it available, but I’d like to evaluate this patient,'” Baker told CNN.
That angered the police officers, he said. But, in the end, he said, talking to the patient worked and no drugs were required.
“The most powerful medication that we have on the ambulance is our ability to speak with patients. Ketamine takes that away.” Baker said. “I don’t believe it should be requested by police. I don’t tell them when to use their mace. They should not tell me to administer drugs.”
In a statement to CNN, the city of Woodbury said it “internally reviewed its Emergency Medical Services training records and protocols and determined the training and protocols were in compliance with all licensing requirements. Contrary to the allegations in the Complaint, no training records were falsified, and Mr. Baker’s complaints were properly addressed.”
It said with regard to the administration of any medications such as ketamine: “No employee of the City of Woodbury improperly administered any such medications.”
The city added, “Mr. Baker was never disciplined or subject to retaliation and we categorically deny the allegations in the complaint.”
Baker’s attorney, Kenneth Udoibok, disputes that and says not a month goes by at his small Minneapolis office without a call linked to administration of ketamine.
“People are not complaining that the paramedic injected them with ketamine. They are complaining that a police officer caused that to happen,” Udoibok told CNN.
Care or improper conduct?
That report also found in some cases, the person being detained was not only handcuffed, but strapped down on a stretcher in an ambulance before receiving ketamine.
Ryan Patrick, an attorney on the Minneapolis Office of Police Conduct Review, said during a public city council meeting that the full picture was complex.
“There is a wide range of involvement in those cases,” he said, “ranging from officers directly suggesting that ketamine in particular be administered to EMS professionals asking MPD officers if they believe they should be sedated.”
Attorney Udoibok calls ketamine use “the perfect crime against citizens.”
“If police are accused of abusing the use of ketamine, the police say it wasn’t their decision to administer it, that was the paramedics’ choice,” he said. “And paramedics are never going to admit they are liable, so they will say ketamine was necessary.”
Due to the McClain case, an Aurora City Council member is pushing for a temporary ban on the use of ketamine by first responders until the investigations in his case are complete.
McClain family attorney Newman said it should not have been used in the first place against Elijah.
“This is just another way to use excessive force against people, especially people of color.”
McKnight said he hopes they ban it all together.
“I woke up choking on a ventilator. This should not happen to anyone else ever again.”
CNN’s Josh Campbell contributed to this story.
Dismissing the notion that his appearance at a raw moment might increase violence, the President said, “it could also increase enthusiasm and it could increase love and respect for our country.”
“They want to destroy our country. They’re going to destroy our suburbs,” he said during an appearance in the White House briefing room mislabeled as a “news conference,” not even bothering to hide his goal to scare voters in affluent White areas around swing state cities into believing that Biden would bring political unrest that would shake America to its foundations.
Distracting from the pandemic
Trump’s day of fury reflects how he has now firmly settled on a campaign of demagoguery to save his presidency.
In a characteristic piece of projection, he accused Biden — who earlier condemned violence from all sources — of using Mafia talking points and Democrats of stirring disorder with “dangerous rhetoric.”
“It was a terrible, terrible thing to witness,” Trump said. His alarmism was expressed in a rant that resembled a highlight reel of conservative media buzz words and conspiracy theories including “radicals,” “maniacs,” “Antifa,” “looters,” “arsonists” and “fascism.”
In a classic authoritarian tactic, Trump also vastly over stated the extent of lawlessness and political violence, then promoted himself as the kind of strongman needed to restore order. And he tipped his hand over his new campaign tactic by opening his appearance with a boast about the stock market and a perfunctory mention of the pandemic that brought the country to its knees. Then it was on to his real topic: “left-wing political violence.”
In one sense, Trump’s gambit has already succeeded. He has moved the ground of the election away from the Covid-19 crisis and the multiple political corruption scandals that have clouded his term from day one. House Speaker Nancy Pelosi, however, made an attempt to wrest the conversation back to Covid-19, using an interview on MSNBC to accuse the President of saying to Americans “choose me over your child” as some kids go back to school without the testing infrastructure and needed safety precautions.
On Monday, Biden left his campaign-from-home bubble in Delaware to travel to Pittsburgh to parry Trump’s attacks amid increasing nervousness among Democrats that the President’s hardline approach could lift him back into a race in which he is trailing.
The Democratic nominee pointed out the flawed logic behind Trump’s approach, given that the unrest hitting cities in Minnesota, Oregon and Wisconsin is unfolding, after all, on the President’s watch.
“The violence you’re seeing in Donald Trump’s America. These are not images from some imagined ‘Joe Biden’s America’ in the future. These are images from Donald Trump’s America today,” Biden said.
In a sign that he intends to maintain his aggressive push back — and that he has no intention of being “swift boated” as happened to 2004 Democratic nominee John Kerry — Biden’s team said that he hoped to travel to Kenosha soon.
How Kenosha frames the stakes in the election
Biden also used his speech to move beyond the issue of violence in cities in an attempt to frustrate the President’s effort to make law and order the key issue in the election. While accusing Trump of “rooting for chaos and violence,” Biden said Trump’s failings on the pandemic, on foreign policy and even on Social Security had made Americans much more vulnerable.
“Do you feel safer and more secure now?” Biden asked in a repeating refrain.
A Biden trip to Wisconsin would bookend Trump’s own visit to the Badger State. The White House has said that it has tried to make contact with the family of Jacob Blake, the Black man shot seven times in the back by police in an incident that triggered unrest last week. Blake is still in hospital and local police have offered few explanations for the incident. The fact Trump and the family have not connected appears to indicate there is no desire to meet the President. Biden and his running mate, California Sen. Kamala Harris, have spoken at length with Blake’s family over the telephone.
The President plans to meet law enforcement officers in Kenosha and to survey damage from nights of unrest. He is claiming he ordered National Guard troops into the city to quell rioting and restore order. But in reality, Democratic Gov. Tony Evers had already activated the troops before Trump called for their intervention.
The political controversy over Kenosha is turning into a microcosm of the election in one of the most hotly contested districts in one of the most contested states.
“Once again, I urge the President to join me in saying that while peaceful protest is a right — a necessity — violence is wrong, period. No matter who does it, no matter what political affiliation they have. Period,” Biden said in a statement.
“If Donald Trump can’t say that, then he is unfit to be President, and his preference for more violence — not less — is clear.”
Hurricane Laura made landfall about an hour ago near Cameron, Louisiana.
The town is relatively low-lying, with only about 5 or 10 feet of elevation — meaning “It’s mostly completely underwater,” said CNN meteorologist Tom Sater.
“There will not be a chance to get to that area until late in the morning,” he added.
The eye of the storm is now moving over Lake Charles, lying further north. Already, the conditions have deteriorated severely; winds are howling, and storm chasers have reported glass being blown everywhere, and ears hurting from the low air pressure.
“Right now you can still hear the wind. It’s screaming through the cracks and crevasses of the building,” said CNN correspondent Martin Savidge from Lake Charles, where the CNN crew is taking refuge indoors.
“When you were outside, you literally felt the entire building as it was shuddering under the wind blow. So it’s taking a beating. And this is one of the strongest buildings in the area., it’s why we chose it.”
“All you hear is the roaring sound of a jet engine, and literally a world that is coming apart outside your windows,” he added.
The storm surge, heavy rainfall and powerful winds mean it’ll be near impossible to assess the damage until the morning — first responders won’t be able to travel in those conditions, and drones or aircraft won’t be able to get any aerial pictures. Roads will be submerged and power lines will have fallen, making transport or rescue efforts even harder.
“The presence of American troops in Poland enhances our deterrence potential because we are closer to the potential source of conflict,” Czaputowicz said in a joint appearance Saturday with US Secretary of State Mike Pompeo.
“It is important that they should be deployed in Poland, and not in Germany,” Poland’s top diplomat said. “The art of war assures us that the capability of deterrence is higher if the army is deployed in the right place.”
The boost for Poland is part of a Trump administration plan to pull some 12,000 US troops from Germany announced last month. While 1,000 of those will join 4,500 US troops already in Poland, others will move to Belgium or Italy or back to the US, available to be sent back to Europe or other world hotspots should the need arise.
As was the case in decades past, the potential source of conflict remains Russia — and the threat of possible incursion, as alluded to by Czaputowicz.
The head of the German Parliament’s foreign relations committee, Norbert Roettgen, tweeted: “Instead of strengthening #NATO it is going to weaken the alliance. The US’s military clout will not increase, but decrease in relation to Russia and the Near & Middle East.”
How could that “military clout” decrease? Deterrence is one example.
The last large US reduction of its troop presence in Germany occurred in 2012. Two years later, Russian troops moved into the Crimea and Moscow annexed the Ukrainian territory, spiking tensions with NATO.
US and European military experts tell CNN the new troop reduction plan would provide few benefits on any potential future battlefield, and certainly not enough to justify its enormous cost, estimated to be in the billions of dollars.
Specifically, the Trump administration plan pulls 11,900 troops from Germany, redeploying 5,400 of those elsewhere in Europe and sending the remaining ones back to the US with some of them rotating back to Europe at some point.
Key movements include command and control centers going from Germany to Belgium as well as Army airborne troops and Air Force F-16 fighters moving from Germany to Italy.
Where is the right place for US troops?
Nick Reynolds, a land warfare research analyst at the Royal United Services Institute (RUSI) in London, doesn’t see much benefit from the US plans.
“Moving ground troops to Belgium and Italy puts them farther away from areas in which they are likely to be needed,” Reynolds said. “Even if they went to northern Italy, and a crisis happened to occur in southeastern Europe, transport links would make moving them slightly more time consuming.”
Consider where the possible flashpoints are.
Getting ground forces in numbers to those spots from Italy means getting them through the mountains of the Alps, which would not be in the way of a move from Germany.
Even though Poland is closer to Russia, the potential Black Sea hotspots and another possible flashpoint along the border with the NATO allies in the Baltics, boosting troops in that country isn’t necessarily the answer, Reynolds said.
“If ground troops were moved to Poland then they would potentially be able to get to where they were needed faster, though they also start (depending where they are in Poland) to become vulnerable in the (unlikely) event of a Russian offensive that achieves operational surprise,” Reynolds said.
Bastian Giegerich, director of defense and military analysis at the International Institute of Strategic Studies in London, questioned the effectiveness of rotating troops back into Europe from the United States.
“Aside from being expensive, troops on rotational deployment will struggle to develop a similar degree of local knowledge and links to host nation armed forces,” Giegerich said.
And while rotational deployments would give the Pentagon some flexibility to respond to hotspots worldwide, there is a price to be paid in the European theater: Fewer boots on the ground mean less deterrence than if they were there, Giegerich said.
“It is a fine balance to strike — the ability to respond to contingencies around the globe with a bigger strategic reserve pool in the US might make it somewhat more likely that those contingencies arise in the first place,” he said.
Retired US Army Lt. Gen. Mark Hertling, now a CNN military analyst, has years of military experience in Europe, beginning in 1975 and continuing intermittently until 2011.
“Germany is key, because it is central to both the ‘old Europe’ to the west and the newer states to the east,” Hertling said.
“The rail and airports are terrific in Germany, and given its centralized position and ease in dealing with the government of Germany, we could fly anywhere, as well as bring allies into the training center at Grafenwoehr,” he said. The Trump administration’s German pullout sacrifices those efficiencies, Hertling said.
“The POTUS saying he’s going to put forces into Italy and Belgium makes no sense. Italy is south of the Alps, with challenges in the government, and Belgium is west — farther away from the eastern block of nations.”
And then there’s the cost. Hertling points out the US military has spent billions over the years to make Germany its central location in Europe. Pulling out of those bases means spending money on new infrastructure that’s already been paid for in Germany.
Numbers vs. location
But where US troops are in Europe may be missing a bigger point, said Reynolds, the RUSI analyst. “What is a more important issue is that the US does not keep adequate forces in Europe if the intention is to be able to quickly respond to a contingency involving Russian aggression,” he said.
And the NATO allies can’t do the job alone. “NATO forces are also working with too few units compared to the size of Russian forces that they would potentially face, at least until larger and heavier US forces could arrive from the continental US,” Reynolds said.
The Trump administration’s pullout from Germany doesn’t address another US/NATO deficiency in Europe — it doesn’t have enough runways that can handle alliance fighter aircraft.
“This is absolutely the issue that NATO faces in the air domain with being unable to adequately disperse its aircraft — particularly fighter and strike aircraft, which need longer and better-reinforced runways — to avoid having them concentrated on a few airfields that are therefore easier to target with long-range precision fires, either destroying the aircraft on the ground or negating their ability to use airfields by rendering the runway unserviceable,” Reynolds said.
In any event, the plan would take years execute and Congress would have to find the billions of dollars needed to make it happen. And with a US election less than three months away, new thinking could emerge with a possible new occupant of the White House.
The Germany pullout is far from a done deal.
CNN’s Ryan Browne, Zachary Cohen and Nic Robertson contributed to this report.
Overall, 50% of registered voters back the Biden-Harris ticket, while 46% say they support Trump and Pence, right at the poll’s margin of error of plus or minus 4 percentage points. Among the 72% of voters who say they are either extremely or very enthusiastic about voting this fall, Biden’s advantage over Trump widens to 53% to 46%. It is narrower, however, among those voters who live in the states that will have the most impact on the electoral college this fall.
Across 15 battleground states, the survey finds Biden has the backing of 49% of registered voters, while Trump lands at 48%.
The pool of battleground states in this poll includes more that Trump carried in 2016 (10) than were won by Hillary Clinton (5), reflecting the reality that the President’s campaign is more on defense than offense across the states. Taken together, though, they represent a more Republican-leaning playing field than the nation as a whole.
The movement in the poll among voters nationwide since June is concentrated among men (they split about evenly in June, but now 56% back Trump, 40% Biden), those between the ages of 35 and 64 (they tilt toward Trump now, but were Biden-leaning in June) and independents (in June, Biden held a 52% to 41% lead, but now it’s a near even 46% Biden to 45% Trump divide).
Trump has also solidified his partisans since June. While 8% of Republicans or Republican-leaning independents in June said they would back Biden, that figure now stands at just 4%. And the President has boosted his backing among conservatives from 76% to 85%.
But the survey suggests that Trump’s voters are a bit more likely to say that they could change their minds by November (12% say so) than are Biden’s backers (7%).
More voters say their choice of candidate is about Trump than say it is about Biden. Nearly 6 in 10 say they support the candidate they do because of their view of Trump (29% say their Biden vote is more to oppose Trump, 30% say they are casting a Trump vote in support of him), while only 32% say Biden is the deciding factor (19% are voting in favor of Biden, 13% casting a ballot to oppose him).
Overall, 54% disapprove of the way Trump is handling his job as president and 42% approve. That’s an uptick since June, and about on par with Trump’s ratings from earlier this year. It still lands the President near the bottom of a list of historical approval ratings for presidents seeking reelection just ahead of their nominating conventions. Trump lands ahead of Jimmy Carter (33% approval) and George H.W. Bush (35%), but below Barack Obama (48%), George W. Bush (49%), Bill Clinton (53%) and Ronald Reagan (54%).
Trump’s favorability rating remains underwater nationally (43% see him favorably, 55% unfavorably), a bit worse than Biden’s 46% favorable to 47% unfavorable even split. In the battleground states, though, voters’ views on the two candidates are almost even: 52% have an unfavorable opinion of Biden, 54% of Trump. Both candidates are viewed favorably by 45% in those states.
Kamala Harris seen as a good pick
Harris joins the ticket with a narrowly positive favorability rating (41% have a favorable view, 38% unfavorable), which is an improvement since May when 32% of Americans said they had a positive view of her and 33% a negative one.
Biden’s selection of Harris is rated as excellent or pretty good by most (52%), and 57% say it reflects favorably on Biden’s ability to make important presidential decisions. Most say she is qualified to be president should that be necessary (57%). And a majority, 62%, say her selection does not have much effect on their vote. People of color, though, are more likely than White people to say her selection makes them more likely to back Biden (28% among people of color, 18% among whites).
Compared with other recent Democratic running mates, Harris fares well. The 30% who call her selection excellent outpaces the share who said so in CNN polling on John Edwards in 2004, Biden in 2008, Joe Lieberman in 2000 or Tim Kaine in 2016. And the 57% who say she is qualified to serve as president if that becomes necessary is only topped by Biden (63%) and Al Gore in 1992 (64%).
On the issues
The poll suggests that supporters of the two candidates are living in alternate universes when it comes to the issues that matter to their vote. Overall, the economy, coronavirus, health care, gun policy and race relations are rated as extremely important by at least 40% of voters. But there are large gaps between Biden and Trump voters on the importance of these issues. Seventy percent of Biden voters say the coronavirus is critically important vs. 24% of Trump voters. Among Trump backers, 57% rate the economy as extremely important, while 37% of Biden voters agree. Majorities of Biden supporters (57% in each case) call health care and race relations extremely important, while only about 1 in 5 Trump backers agree (20% on health care, 22% on race relations).
Biden tops Trump as better able to handle most of the issues tested in the poll: Racial inequality in the US, the coronavirus outbreak, health care and foreign policy. Trump wins out on handling the economy. Voters are closely divided over which candidate would keep Americans safe from harm (50% say Biden would, 47% Trump). And more generally, Biden is more often seen as having “a clear plan for solving the country’s problems” (49% choose Biden to 43% Trump) and as better able to “manage the government effectively” (52% Biden to 44% Trump).
And when it comes to these top issues, nearly all Trump and Biden supporters think their man is the right one for the job. Just 1% of Biden backers say they would trust Trump over Biden to handle racial inequality in the US, and only 2% would trust Trump to handle the coronavirus outbreak. On the flip side, 2% of Trump voters say they would prefer Biden on the economy, and only 4% choose him on the coronavirus outbreak.
Overall, Biden holds the edge on a range of positive traits often seen as valuable in a run for the White House. Most say he cares about people like them (53% Biden, 42% Trump), shares their values (52% Biden to 43% Trump), and is honest and trustworthy (51% Biden to 40% Trump). More also say Biden will unite the country and not divide it (55% Biden to 35% Trump). But in this matchup between two septuagenarians, voters are split over which one has the stamina and sharpness to be president (48% say Trump, 46% Biden).
The CNN Poll was conducted by SSRS August 12 through 15 among a random national sample of 1,108 adults reached on landlines or cellphones by a live interviewer, including 987 registered voters. The survey also includes an oversample of residents of 15 battleground states for a total subsample of 636 adults and 569 registered voters from those states. That subset was weighted to its proper share of the overall adult population of the United States. Results for the full sample have a margin of sampling error of plus or minus 3.7 percentage points. It is 4.0 points among registered voters and 5.4 points for results for registered voters in the battleground states.