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The swarm happening now south of the Salton Sea, near Westmoreland is over 30 km south of the end of the San Andreas. It is in the Brawley seismic zone, a common source of swarms. So far largest is M4.4. Too far from the San Andreas to change the probability of a quake on it.— Dr. Lucy Jones (@DrLucyJones) September 30, 2020 340

The United States and Mexico have reached an agreement to change parts of NAFTA, the trade deal that President Donald Trump has derided for years as unfair.Trump announced the agreement from the Oval Office Monday, with Mexican President Enrique Pe?a Nieto dialed in on a conference call.But the deal left open the question of whether Canada, the third country in NAFTA, would agree to the changes -- and Trump himself said he wanted to throw out the name NAFTA altogether."They used to call it NAFTA," Trump said. "We're going to call it the United States-Mexico trade agreement. We're going to get rid of NAFTA because it has a bad connotation."Negotiators for both countries agreed to a new rule that dictates where auto parts are made.Under the current law, about 62 percent of the parts in any car sold in North America must be produced in the region or automakers have to pay import taxes. The new preliminary agreement would require that 75 percent of auto parts be made in the United States and Mexico, according to the U.S. Trade Representative's office.Much of the business world has been worried about Trump's trade policies, and the stock market reacted positively to the news. The Dow rose more than 250 points and the S&P 500 and Nasdaq hit new highs on Monday.The agreement between the two countries could restart negotiations on NAFTA with all three parties -- the United States, Mexico and Canada.Despite Trump's signal that the deal could lead to a bilateral trade agreement between the United States and Mexico, Pe?a Nieto, through a translator, expressed his "desire that now Canada will also be able to be incorporated in this."Mexico and Canada have stood firm on the importance of maintaining the trilateral format of the NAFTA free trade deal, even as Trump has signaled a desire for individual deals with each country."Canada is encouraged by the continued optimism shown by our negotiating partners," said a spokesperson for Canadian Minister of Foreign Affairs Chrystia Freeland."Progress between Mexico and the United States is a necessary requirement for any renewed NAFTA agreement," he said.Negotiations on rewriting the three-country NAFTA agreement began about a year ago.The 24-year-old trade agreement generally prevents the three parties from imposing tariffs on imports from one another. But Trump has called the agreement "the worst deal maybe ever signed" and moved ahead with tariffs earlier this year.In May, the United States imposed steep tariffs on steel and aluminum from much of the world, including Mexico. In response, Mexico slapped tariffs on billion of U.S. goods, including steel, pork, apples, potatoes, bourbon and different types of cheese. Canada imposed tariffs on .5 billion of U.S. goods, including steel, toffee, maple syrup, coffee beans and strawberry jam. 2841

The Trump administration is taking steps to give telehealth a broader role under Medicare, with an executive order that serves as a call for Congress to make doctor visits via personal technology a permanent fixture of the program. The order President Donald Trump signed Monday applies to one segment of Medicare recipients — people living in rural communities. But administration officials say it’s intended as a signal to Congress that Trump is ready to sign more significant legislation that would permanently open up telehealth as an option for all people with Medicare. Trump says his administration is “taking action to make sure telehealth is here to stay.”"When the invisible enemy struck our shores, we took immediate action to eliminate regulatory barriers to telehealth, making it easier for patients to consult with doctors from safety and convenience and really, they have great safety and great convenience right from their homes," Trump said. While the CDC said in June it was working on expanding access to telehealth, it did list some drawbacks to the service:Situations in which in-person visits are more appropriate due to urgency, underlying health conditions, or inability to perform an adequate physical examThe need to address sensitive topics, especially if there is patient discomfort or concern for privacyLimited access to technological devices (e.g., smartphone, tablet, computer) needed for a telehealth visit or connectivity issuesLevel of comfort with technology for HCP and patientsCultural acceptance of conducting virtual visits in lieu of in-person visits by HCP and patientsInterstate licensure challenges and other regulatory issues that may vary by state 1701

The U.S. Surgeon General is talking about structural racism, saying it's partly why the coronavirus has disproportionately affected Black and Latino Americans.Surgeon General Jerome Adams plans to focus on two initiatives soon, high blood pressure and maternal mortality, which is women dying from pregnancy or childbirth issues.The office plans to put out science-based summaries designed to create urgent action on both issues that disproportionately affect communities of color.Earlier this month, the Institute for Health Metrics and Evaluation declared racism a public health crisis.“Racism is a public health issue,” said Dr. Ali Mokdad with the Institute for Health Metrics and Evaluation. “I’ve been on record saying it’s more dangerous than COVID-19, simply because we're going to find a vaccine for COVID-19.”They are currently working with the National Institutes of Health on providing data down to the county level of the burden of disease by race.Mokdad used life expectancy as an example. He says within a county there are high disparities, sometimes 15 years less based on where minorities or lower income people live.“Provide data in order to tell people this is what we see. These are the problems, keeping in mind you cannot change what you cannot measure,” said Mokdad.The CDC is also now requiring states to collect data about race, ethnicity, gender, and zip code for coronavirus cases.Racism in healthcare affects everyone, socially and economically.“What people don’t realize is we are paying for it one way or another and right now when you look at the United States, we spend more money on health than every other country,” said Mokdad.Mokdad and other health professionals we talked to all pointed to universal health care as another obvious solution to addressing structural racism. 1818

The White House is again rejecting calls for a national mask-wearing mandate.White House chief of staff Mark Meadows says in an appearance on “Fox and Friends” Monday morning that the president sees the issue as a “state-to-state” matter.He says that, “certainly a national mandate is not in order” and that “we’re allowing our local governors and our local mayors to weigh in on that.”New Jersey’s Democratic Gov. Phil Murphy has said he’d like to see a national strategy on the coronavirus, including a mask requirement. He says his state is seeing “small spikes in reinfection” from residents coming back from Florida, South Carolina and other virus hotspots, and the U.S. is “as strong as our weakest link right now.”Vice President Mike Pence has also rejected the idea of a national mandate, saying that’s up to governors and local health officials. 862

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