COVID-19 Update: Week 4

Ken AshfordEbola/Zika/COVID-19 Viruses, Trump & AdministrationLeave a Comment

World:

US:

NC and local:

In my country, Forsyth, we had another death reported this morning, bringing the total to four.

A new executive order will go into effect today that will require stricter social distancing guidelines for stores.

It goes into effect Monday at 5 p.m.

Under the new order, stores cannot exceed 20 percent of fire capacity or five people for every 1,000 square feet at any given time.

Stores must also have 6-foot markers at congregation areas like checkouts and must perform frequent cleaning and disinfection.

All these graphs, of course, don’t reflect the human cost, which is immeasurable for some:

Tension is growing as Trump’s demand for loyalty gets in the way.

Dr. Fauci said the federal government could have acted sooner to limit the spread of coronavirus on CNN Sunday morning.

President Donald Trump retweeted a tweet which called for the firing of Dr. Anthony Fauci Sunday evening (using the #FireFauci hashtag), raising concerns about the job security of the public health expert, while once again highlighting the precarious role of experts and the overall uncertainty that has plagued the Trump administration’s response to the coronavirus pandemic.

The retweet came following a spate of television appearances by Fauci — who is head of National Institute of Allergy and Infectious Diseases and a member of the White House coronavirus task force — including a Sunday morning CNN interview in which the doctor said earlier action could have limited Covid-19-related deaths in the US.

Fauci, of course, was only stating the obvious in broad language: an earlier response means less deaths.

While the president did not engage with the call to fire the official, he did once again push the unsubstantiated claim that he acted early and decisively to curb the spread of the virus.

When Fauci mentioned the “pushback” on CNN, he did not elaborate on who was pushing back.

But we do know from reports — including an investigation published Saturday by the New York Times — that much of the pushback came from Trump himself.

Among other things, the Times report details how Dr. Nancy Messonnier, the director of the National Center for Immunization and Respiratory Diseases and one of the few federal voices warning the public of the threat the coronavirus posed in February, was sidelined due to these warnings. It also documents how Trump’s anger over her messaging both led to a leadership vacuum at a moment when there was no time to waste, as well as the cancellation of an important presidential briefing on mitigation strategies scheduled for February 26:

On the 18-hour plane ride home [from a state visit to India], Mr. Trump fumed as he watched the stock market crash after Dr. Messonnier’s comments. Furious, he called Mr. Azar when he landed at around 6 a.m. on Feb. 26, raging that Dr. Messonnier had scared people unnecessarily. Already on thin ice with the president over a variety of issues and having overseen the failure to quickly produce an effective and widely available test, Mr. Azar would soon find his authority reduced.

The meeting that evening with Mr. Trump to advocate social distancing was canceled, replaced by a news conference in which the president announced that the White House response would be put under the command of Vice President Mike Pence.

Pence reportedly put a moratorium on messaging like Messonnier’s — which may explain Lorraine’s assertion that Fauci claimed everything was fine in late February. Fauci did in fact tell the public not to worry in February, but tempered that message by saying Americans needed to be prepared for a rapidly changing situation.

On February 29’s NBC’s Today, for instance, Fauci said: “At this moment, there is no need to change anything you’re doing on a day-by-day basis, right now the risk is still low, but this could change. … When you start to see community spread, this could change, and force you to become much more attentive to doing things that would protect you from spread.”

According to the Times’ report, Fauci and other public health experts on the coronavirus task force were more than convinced that not only “could” things change, but that they would — particularly after a February 21 meeting at which pandemic simulations were run, leading those present to believe “they would soon need to move toward aggressive social distancing, even at the risk of severe disruption to the nation’s economy and the daily lives of millions of Americans.”

Getting Trump to reach the same conclusion became a weeks-long struggle, and it wasn’t just the advice of his public health experts the president reportedly shrugged off.

White House trade adviser and Trump confidant Peter Navarro wrote memos in late February warning of the looming coronavirus crisis in America. Trump told reporters last week, “I didn’t see ’em, I didn’t look for ’em either.” The National Security Council recommended shutting down large cities based on intelligence it gathered in January. As Vox’s Aja Romano writes, “The security experts went dismissed even as an unfounded conspiracy theory about the virus’s origin spread among some government officials and economic advisers pushed back against taking drastic measures to thwart China.”

Although the president was eventually brought onboard with mitigation efforts beyond border closures in March, the administration’s refusal to heed the advice of experts bearing dire warnings led to well-documented delays in scaling up testing, acquiring needed equipment, and offering consistent federal messaging on what was needed to limit the spread of the virus.

But the response remains a fractured one, sometimes plagued by infighting and frustration over who has taken on what. And as the president considers when to encourage Americans to resume normal life, it is still uncertain how much weight Trump is giving expert advice. When asked Saturday on Fox News what will influence his decision-making on extending social distancing guidance past April 30, the president said, “a lot of facts and a lot of instincts.”

It’s clear that the Trump Administration never settled on a plan to deal with this.

Since anti-government conservatism swept into Washington, D.C. with the 2010 elections, cuts to public services have left the country unprepared to meet the pandemic now killing tens of thousands of Americans. John Auerbach, president of Trust for America’s Health, tells the Washington Post’s Dana Milbank that years of deep cuts to public health grants cost 60,000 jobs at state and local public health departments. Milbank believes it is not an exaggeration to call it “a deliberate strategy to sabotage government.”

Auerbach explains:

If the United States had more public health capacity, it “absolutely” would have been on par with Singapore, South Korea and Taiwan, which have far fewer cases, Auerbach said. South Korea has had 4 deaths per 1 million people, Singapore 1 death per million, and Taiwan 0.2 deaths per million. The United States: 39 per million — and rising fast.

“How Did the U.S. End Up with Nurses Wearing Garbage Bags?” encapsulates the federal failed response to the COVID-19 pandemic in its title. One almost need not read Susan Glasser’s latest New Yorker column. The Personal Protective Equipment (PPE) memes floating around ask the same question in images.

Eric Ries, author of a “The Lean Startup,” received a phone on March 21st from another Silicon Valley C.E.O. about setting up a website to match hospitals and suppliers. Donald Trump’s White House was recruiting tech executives to help with its coronavirus response.

Ries called the White House and asked about the coronavirus task force that recruiting Silicon Valley help. Someone at the White House asked, “Which one?” There was the group briefing reporters each day and then there was the group organized by presidential son-in-law, Jared Kushner. The latter was not yet public knowledge.

Ries had assumed the White House was taking charge because that is what the federal government is for. “I thought, Eventually somebody will lead,” Ries said. He thought he and his friends were there to backstop the federal response:

What they did not foresee was that the federal government might never come to the rescue. They did not realize this was a government failure by design—not a problem to be fixed but a policy choice by President Trump that either would not or could not be undone. “No one can believe it. That’s the No. 1 problem with the whole situation: the facts are known, but they are inconceivable,” Ries told me. “So we are just in denial.”

There were plans extant for dealing with the pandemic federal planners foresaw. The Pentagon had a 103-page pandemic influenza response plan in 2017. By federal mandate, the transition team from the outgoing administration briefs its replacements. Days before Trump’s inauguration, the outgoing administration of Barack Obama ran the incoming team through exercises for handling a series of worst-case scenarios including a global pandemic on the scale of 1918. Two thirds of those attending no longer work for Trump.

Those plans went unused. What exists instead is “a fragmented procurement system now descending into chaos.” Besides Kushner’s shadow task force and the public-facing group featured in daily televised briefings, the Washington Post reports there are the “Opening Our Country Council” (focused on restarting portions of the economy) and a “doctors group” that meets daily to review public health and medical issues. No one is in charge of centralizing and coordinating distribution of needed supplies to hot spots.

“[S]ome governors and lawmakers have watched in disbelief as they have sought to close deals on precious supplies, only to have the federal government swoop in to preempt the arrangements,” the Washington Post reports, adding:

Some of the states are seeking supplies, this official said, for items they say they might need in several weeks. Decisions are made by FEMA, but recommendations sometimes come from Trump, Vice President Pence, Kushner and others based on their interactions with states.

“FEMA makes the decision, but it’s not like FEMA is going to do the opposite of what the president tells them to do,” a second official said.

Colorado Gov. Jared Polis (D) struggled to find someone, anyone, to help meet Colorado’s equipment needs as demand for ventilators spiked (Politico):

So he made an official request for ventilators through the Federal Emergency Management System, which is managing the effort. That went nowhere. He wrote to Vice President Mike Pence, leader of the White House’s coronavirus task force. That didn’t work. He tried to purchase supplies himself. The federal government swooped in and bought them.

Then, on Tuesday, five weeks after the state’s first coronavirus case, the state’s Republican Sen. Cory Gardner called President Donald Trump. The federal government sent 100 ventilators to Colorado the next day, but still only a fraction of what the state wanted.

Gardner is in a tight race for reelection this fall. The Cook Political Report ranks the seat a toss-up.

And this lack of a federal response is why the United States as a whole is not flattening the curve when compared to other countries

This NY Times letter to the editor today sounds off on Trump’s slowness:

Oxford University has been ranking the stringency of government actions in response to Covid-19, comparing the efforts of six countries hard hit by the virus (China, South Korea, Italy, France, the United Kingdom and the United States). Its timeline shows that the United States was one of the slowest countries to respond and was late in ramping up its efforts. Its most recent data (as of April 5) puts the U.S. response in last place among the six nations. As a result, we are now first place in the number of Covid-19 deaths.

The United States may well have the best and most experienced cadre of pandemic expertise in the world, and we certainly have the resources to launch a robust effort in preventing the spread of novel diseases. Our poor response to Covid-19 reflects weaknesses in long-term preparation and planning as well as a failure of current leadership.

As additional waves of the virus work their way through the population, and as future diseases present themselves, we must either do a much better job of containment or be prepared to face even greater social disruption and an unprecedented loss of life.

And this:

There are multiple reasons that the virus has had such a different toll in different countries. But one of the reasons for the large toll in the United States is clearly President Trump. Over the weekend, The Times published a long story documenting the many warnings that he received throughout late January, February and much of March, about the likely severity of the virus and the need to take action.

He rejected those warnings, again and again. He chose a path of denial, rather than a path of aggressive response, as South Korea did.

In late January, several officials — including Alex Azar, the secretary of health and human services, and Peter Navarro, the trade adviser — told the president that the virus would likely do great damage unless the country responded. On Feb. 21, Trump administration officials conducted a meeting during which they discussed the need to close schools, cancel large gatherings and take other measures. On Feb. 25, a top disease expert in the government went so far as to make a public warning, only to be sidelined for doing so.

Each time, Trump’s response was a version of “stop panicking,” as The Times story explains.

He now conducts daily briefings where he tries to rewrite history, claiming that he knew it would be a serious problem all along. That is simply false. There is a long trail of evidence (including his own words) showing that he chose inaction over action, overruling the advice of scientists, public health experts and even some of his own advisers.

Hundreds more Americans are likely to die of the virus again today. For that, the president bears substantial blame.

In other COVID/Trump news… Trump is trying to kill the U.S. Postal Service. When members of Congress tried to include funding for the agency in the coronavirus stimulus, the White House made clear that it was a dealbreaker for Trump. Without additional funding, the USPS may not be able to operate past June, cutting off rural communities from deliveries and many people from their prescription medications as well as endangering the jobs of a 600,000-person workforce that includes many veterans and people of color.

Here’s something else about the Postal Service: It’s the most popular agency in the federal government, a 2019 Pew survey found. Nine out of 10 people have a favorable opinion of the Postal Service—and it’s bipartisan, with 87% favorability from Republicans. The National Park Service, NASA, and the CDC were the only other agencies at 80% or above. 

Killing off or privatizing the USPS is a longstanding Republican goal, but Trump brings something extra special and personal to it: his hatred of Amazon founder Jeff Bezos. Many Amazon packages are delivered by the Postal Service, and Trump thinks it should charge Amazon more money for that service, because Bezos owns The Washington Post, which has run reporting Trump doesn’t like.

But we need the Postal Service now more than ever, because we need vote-by-mail for the 2020 elections. Unfortunately, for Trump, that’s an additional reason to oppose funding the Postal Service, because democracy scares him. As he put it, “you’d never have a Republican elected in this country again.”

Trump is listening more to the economists than health officials — that is becoming obvious — as he talks about re-opening the country. Obviously this would be follow if we did it too soon.

Before I go on, let’s be clear that the rhetoric of “reopening” makes little sense. The economy never closed. It can’t therefore be “reopened.” To be sure, the Trump administration issued guidelines for implementing “social distancing” for the purpose of slowing the spread of the new coronavirus, which causes the disease COVID-19. But these public-health guidelines from the CDC are not the same thing as “closing” the economy. Easing them, or lifting them, is not the same thing as “reopening” the economy. If Trump had ordered a lock-down across all 50 states, there’d be substance behind the rhetoric of “reopening.” But he hasn’t done even that, to the dismay of governors from both parties, because getting reelected is his top priority, not you.

If the president had ordered a lock-down across all 50 states, he would have damaged the economy (for the right reasons), but he would also have been responsible for the damage (again, for the right reasons). If there’s one constant in this random, arbitrary and chaotic presidency, it’s that Donald Trump is never responsible for anything.

Fortunately, for him, our system of government was designed to divide authority (and therefore responsibility) between and among Washington and the states. That gives Trump a context in which he can make-believe presidenting without actually being presidential, all the while blaming governors for outcomes largely of his own creation.

Unfortunately, for us, Trump has as much disrespect for our federalist tradition as he does willingness to exploit it by whatever means necessary to maintain power. One means is getting the press corps to uncritically repeat news of his pending decision to “reopen” a national economy comprising 50 states with 50 governors from both parties, most of whom privilege public health over Trump’s reelection. In other words, by declaring, implicitly at first and then explicitly, powers he does not in fact have.

So that’s the controversy now. Who gets to “reopen”.

Ted Lieu is right.

The 10th Amendment of the U.S. Constitution says “The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.” As such, it’s quite questionable whether Trump has the power he claims to make states reopen their economies and force the country to resume normal functionality.

This being the case, loads of people responded to Trump with reminders about federalism and the concept of states’ rights.

Other news:

Humor still has a place as SNL experimented with a Live From Home version:

More news:

A sailor assigned to a coronavirus-stricken U.S. aircraft carrier has died of covid-19 complications, the Navy said Monday. There have been at least 585 confirmed infections among the crew of the USS Theodore Roosevelt, whose commander was removed after raising alarm about the Navy’s handling of the outbreak

Thinking on China more:

I noted news reports that claimed US military intelligence was warning as far back as late November of a possible new virus in China with a possible global impact. The problem is that these US intelligence reports would predate by weeks our earliest understanding of when the first cases emerged and well before the Chinese themselves knew they had a new disease on their hands. That chronology of the outbreak comes from news reports from major dailies in the United States and Hong Kong. But there’s another body of evidence which points to a similar and more definitive timeline. That’s hidden in the COVID-19 genome itself.

One of the great cinematic moments of future movies about the COVID-19 epidemic in the United States came on February 29th when Trevor Bedford, a virologist at the Fred Hutchinson Cancer Research Center in Seattle made a startling public announcement. A genomic analysis by Bedford and his colleagues showed that the COVID-19 samples from the assisted living facility in Kirkland, Washington were almost certainly an evolutionary descendent of the January 19th sample taken from a Snohomish County man who had been diagnosed with COVID-19 after returning from China. As Bedford put it in his late night Twitter thread, this finding had “some enormous implications.” The evidence strongly suggested that COVID-19 had been spreading in the Greater Seattle region for six weeks.

This was a first clue that limitations on testing had allowed COVID-19 to get a critical jump on public health authorities who had assumed the contagion had been bottled up with a handful of quarantined infections in travelers from China. But it is also a window into the science of viral genomics which gives researchers startling new insights into the life histories of pathogens.

As viruses replicate from host to host they pick up small (almost always inconsequential) mutations at an established frequency. By analyzing the number of mutations you can place the evolution and different branches of disease spread in time. Researchers have now mapped the genomes of numerous COVID-19 genetic lineages from across the world. In this way, they can pull each genetic thread back to a common starting point, placing it both in the stream of genetic evolution and in time. All the analyzed lineages lead back to an origin point in late November or early December 2019. As the NextStrain project puts it here, “The common ancestor of circulating viruses appears to have emerged in Wuhan, China, in late Nov or early Dec 2019.”

Trump has made much of the fact that China was not forthcoming. This is true for about two weeks. But two things can be true at the same time, and it is clear that the Trump Administration was slow to respond DESPITE whatever China’s delays were.

UPDATE:

The COVID-19 press conference mostly Trump defending his actions.

Wonder how that’s going to go over with the party of limited government.

Trump wants to be in the lead when re-opening comes. Except he wasn’t there for when the virus hit. So states are doing it themselves.