The U.S. was beset by denial and dysfunction as the coronavirus raged

https://www.washingtonpost.com/national-security/2020/04/04/coronavirus-government-dysfunction/?arc404=true

America Wasn't a Democracy, Until Black Americans Made It One ...

From the Oval Office to the CDC, political and institutional failures cascaded through the system and opportunities to mitigate the pandemic were lost.

By the time Donald Trump proclaimed himself a wartime president — and the coronavirus the enemy — the United States was already on course to see more of its people die than in the wars of Korea, Vietnam, Afghanistan and Iraq combined.

The country has adopted an array of wartime measures never employed collectively in U.S. history — banning incoming travelers from two continents, bringing commerce to a near-halt, enlisting industry to make emergency medical gear, and confining 230 million Americans to their homes in a desperate bid to survive an attack by an unseen adversary.

Despite these and other extreme steps, the United States will likely go down as the country that was supposedly best prepared to fight a pandemic but ended up catastrophically overmatched by the novel coronavirus, sustaining heavier casualties than any other nation.

It did not have to happen this way. Though not perfectly prepared, the United States had more expertise, resources, plans and epidemiological experience than dozens of countries that ultimately fared far better in fending off the virus.

The failure has echoes of the period leading up to 9/11: Warnings were sounded, including at the highest levels of government, but the president was deaf to them until the enemy had already struck.

The Trump administration received its first formal notification of the outbreak of the coronavirus in China on Jan. 3. Within days, U.S. spy agencies were signaling the seriousness of the threat to Trump by including a warning about the coronavirus — the first of many — in the President’s Daily Brief.

And yet, it took 70 days from that initial notification for Trump to treat the coronavirus not as a distant threat or harmless flu strain well under control, but as a lethal force that had outflanked America’s defenses and was poised to kill tens of thousands of citizens. That more-than-two-month stretch now stands as critical time that was squandered.

Trump’s baseless assertions in those weeks, including his claim that it would all just “miraculously” go away, sowed significant public confusion and contradicted the urgent messages of public health experts.

“While the media would rather speculate about outrageous claims of palace intrigue, President Trump and this Administration remain completely focused on the health and safety of the American people with around the clock work to slow the spread of the virus, expand testing, and expedite vaccine development,” said Judd Deere, a spokesman for the president. “Because of the President’s leadership we will emerge from this challenge healthy, stronger, and with a prosperous and growing economy.”

The president’s behavior and combative statements were merely a visible layer on top of deeper levels of dysfunction.

The most consequential failure involved a breakdown in efforts to develop a diagnostic test that could be mass produced and distributed across the United States, enabling agencies to map early outbreaks of the disease, and impose quarantine measure to contain them. At one point, a Food and Drug Administration official tore into lab officials at the Centers for Disease Control and Prevention, telling them their lapses in protocol, including concerns that the lab did not meet the criteria for sterile conditions, were so serious that the FDA would “shut you down” if the CDC were a commercial, rather than government, entity.

Other failures cascaded through the system. The administration often seemed weeks behind the curve in reacting to the viral spread, closing doors that were already contaminated. Protracted arguments between the White House and public health agencies over funding, combined with a meager existing stockpile of emergency supplies, left vast stretches of the country’s health-care system without protective gear until the outbreak had become a pandemic. Infighting, turf wars and abrupt leadership changes hobbled the work of the coronavirus task force.

It may never be known how many thousands of deaths, or millions of infections, might have been prevented with a response that was more coherent, urgent and effective. But even now, there are many indications that the administration’s handling of the crisis had potentially devastating consequences.

Even the president’s base has begun to confront this reality. In mid-March, as Trump was rebranding himself a wartime president and belatedly urging the public to help slow the spread of the virus, Republican leaders were poring over grim polling data that suggested Trump was lulling his followers into a false sense of security in the face of a lethal threat.

The poll showed that far more Republicans than Democrats were being influenced by Trump’s dismissive depictions of the virus and the comparably scornful coverage on Fox News and other conservative networks. As a result, Republicans were in distressingly large numbers refusing to change travel plans, follow “social distancing” guidelines, stock up on supplies or otherwise take the coronavirus threat seriously.

“Denial is not likely to be a successful strategy for survival,” GOP pollster Neil Newhouse concluded in a document that was shared with GOP leaders on Capitol Hill and discussed widely at the White House. Trump’s most ardent supporters, it said, were “putting themselves and their loved ones in danger.”

Trump’s message was changing as the report swept through the GOP’s senior ranks. In recent days, Trump has bristled at reminders that he had once claimed the caseload would soon be “down to zero.”

More than 7,000 people have died of the coronavirus in the United States so far, with about 240,000 cases reported. But Trump has acknowledged that new models suggest that the eventual national death toll could be between 100,000 and 240,000.

Beyond the suffering in store for thousands of victims and their families, the outcome has altered the international standing of the United States, damaging and diminishing its reputation as a global leader in times of extraordinary adversity.

“This has been a real blow to the sense that America was competent,” said Gregory F. Treverton, a former chairman of the National Intelligence Council, the government’s senior-most provider of intelligence analysis. He stepped down from the NIC in January 2017 and now teaches at the University of Southern California. “That was part of our global role. Traditional friends and allies looked to us because they thought we could be competently called upon to work with them in a crisis. This has been the opposite of that.”

This article, which retraces the failures over the first 70 days of the coronavirus crisis, is based on 47 interviews with administration officials, public health experts, intelligence officers and others involved in fighting the pandemic. Many spoke on the condition of anonymity to discuss sensitive information and decisions.

Scanning the horizon

Public health authorities are part of a special breed of public servant — along with counterterrorism officials, military planners, aviation authorities and others — whose careers are consumed with contemplating worst-case scenarios.

The arsenal they wield against viral invaders is powerful, capable of smothering a new pathogen while scrambling for a cure, but easily overwhelmed if not mobilized in time. As a result, officials at the Department of Health and Human Services, the CDC and other agencies spend their days scanning the horizon for emerging dangers.

The CDC learned of a cluster of cases in China on Dec. 31 and began developing reports for HHS on Jan. 1. But the most unambiguous warning that U.S. officials received about the coronavirus came Jan. 3, when Robert Redfield, the CDC director, received a call from a counterpart in China. The official told Redfield that a mysterious respiratory illness was spreading in Wuhan, a congested commercial city of 11 million people in the communist country’s interior.

Redfield quickly relayed the disturbing news to Alex Azar, the secretary of HHS, the agency that oversees the CDC and other public health entities. Azar, in turn, ensured that the White House was notified, instructing his chief of staff to share the Chinese report with the National Security Council.

From that moment, the administration and the virus were locked in a race against a ticking clock, a competition for the upper hand between pathogen and prevention that would dictate the scale of the outbreak when it reached American shores, and determine how many would get sick or die.

The initial response was promising, but officials also immediately encountered obstacles.

On Jan. 6, Redfield sent a letter to the Chinese offering to send help, including a team of CDC scientists. China rebuffed the offer for weeks, turning away assistance and depriving U.S. authorities of an early chance to get a sample of the virus, critical for developing diagnostic tests and any potential vaccine.

China impeded the U.S. response in other ways, including by withholding accurate information about the outbreak. Beijing had a long track record of downplaying illnesses that emerged within its borders, an impulse that U.S. officials attribute to a desire by the country’s leaders to avoid embarrassment and accountability with China’s 1.3 billion people and other countries that find themselves in the pathogen’s path.

China stuck to this costly script in the case of the coronavirus, reporting Jan. 14 that it had seen “no clear evidence of human-to-human transmission.” U.S. officials treated the claim with skepticism that intensified when the first case surfaced outside China with a reported infection in Thailand.

A week earlier, senior officials at HHS had begun convening an intra-agency task force including Redfield, Azar and Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. The following week, there were also scattered meetings at the White House with officials from the National Security Council and State Department, focused mainly on when and whether to bring back government employees in China.

U.S. officials began taking preliminary steps to counter a potential outbreak. By mid-January, Robert Kadlec, an Air Force officer and physician who serves as assistant secretary for preparedness and response at HHS, had instructed subordinates to draw up contingency plans for enforcing the Defense Production Act, a measure that enables the government to compel private companies to produce equipment or devices critical to the country’s security. Aides were bitterly divided over whether to implement the act, and nothing happened for many weeks.

On Jan. 14, Kadlec scribbled a single word in a notebook he carries: “Coronavirus!!!”

Despite the flurry of activity at lower levels of his administration, Trump was not substantially briefed by health officials about the coronavirus until Jan.18, when, while spending the weekend at Mar-a-Lago, he took a call from Azar.

Even before the heath secretary could get a word in about the virus, Trump cut him off and began criticizing Azar for his handling of an aborted federal ban on vaping products, a matter that vexed the president.

At the time, Trump was in the throes of an impeachment battle over his alleged attempt to coerce political favors from the leader of Ukraine. Acquittal seemed certain by the GOP-controlled Senate, but Trump was preoccupied with the trial, calling lawmakers late at night to rant, and making lists of perceived enemies he would seek to punish when the case against him concluded.

In hindsight, officials said, Azar could have been more forceful in urging Trump to turn at least some of his attention to a threat that would soon pose an even graver test to his presidency, a crisis that would cost American lives and consume the final year of Trump’s first term.

But the secretary, who had a strained relationship with Trump and many others in the administration, assured the president that those responsible were working on and monitoring the issue. Azar told several associates that the president believed he was “alarmist” and Azar struggled to get Trump’s attention to focus on the issue, even asking one confidant for advice.

Within days, there were new causes for alarm.

On Jan. 21, a Seattle man who had recently traveled to Wuhan tested positive for the coronavirus, becoming the first known infection on U.S. soil. Then, two days later, Chinese authorities took the drastic step of shutting down Wuhan, turning the teeming metropolis into a ghost city of empty highways and shuttered skyscrapers, with millions of people marooned in their homes.

“That was like, whoa,” said a senior U.S. official involved in White House meetings on the crisis. “That was when the Richter scale hit 8.”

It was also when U.S. officials began to confront the failings of their own efforts to respond.

Azar, who had served in senior positions at HHS through crises including the 9/11 terrorist attacks and the outbreak of bird flu in 2005, was intimately familiar with the playbook for crisis management.

He instructed subordinates to move rapidly to establish a nationwide surveillance system to track the spread of the coronavirus — a stepped-up version of what the CDC does every year to monitor new strains of the ordinary flu.

But doing so would require assets that would elude U.S. officials for months — a diagnostic test that could accurately identify those infected with the new virus and be produced on a mass scale for rapid deployment across the United States, and money to implement the system.

Azar’s team also hit another obstacle. The Chinese were still refusing to share the viral samples they had collected and were using to develop their own tests. In frustration, U.S. officials looked for other possible routes.

A biocontainment lab at the University of Texas medical branch in Galveston had a research partnership with the Wuhan Institute of Virology.

Kadlec, who knew the Galveston lab director, hoped scientists could arrange a transaction on their own without government interference. At first, the lab in Wuhan agreed, but officials in Beijing intervened Jan. 24 and blocked any lab-to-lab transfer.

There is no indication that officials sought to escalate the matter or enlist Trump to intervene. In fact, Trump has consistently praised Chinese President Xi Jinping despite warnings from U.S. intelligence and health officials that Beijing was concealing the true scale of the outbreak and impeding cooperation on key fronts.

The CDC had issued its first public alert about the coronavirus Jan. 8, and by the 17th was monitoring major airports in Los Angeles, San Francisco and New York, where large numbers of passengers arrived each day from China.

In other ways, though, the situation was already spinning out of control, with multiplying cases in Seattle, intransigence by the Chinese, mounting questions from the public, and nothing in place to stop infected travelers from arriving from abroad.

Trump was out of the country for this critical stretch, taking part in the annual global economic forum in Davos, Switzerland. He was accompanied by a contingent of top officials including national security adviser Robert O’Brien, who took an anxious trans-Atlantic call from Azar.

Azar told O’Brien that it was “mayhem” at the White House, with HHS officials being pressed to provide nearly identical briefings to three audiences on the same day.

Azar urged O’Brien to have the NSC assert control over a matter with potential implications for air travel, immigration authorities, the State Department and the Pentagon. O’Brien seemed to grasp the urgency, and put his deputy, Matthew Pottinger, who had worked in China as a journalist for the Wall Street Journal, in charge of coordinating the still-nascent U.S. response.

But the rising anxiety within the administration appeared not to register with the president. On Jan. 22, Trump received his first question about the coronavirus in an interview on CNBC while in Davos. Asked whether he was worried about a potential pandemic, Trump said, “No. Not at all. And we have it totally under control. It’s one person coming in from China. . . . It’s going to be just fine.”

Spreading uncontrollably

The move by the NSC to seize control of the response marked an opportunity to reorient U.S. strategy around containing the virus where possible and procuring resources that hospitals would need in any U.S. outbreak, including such basic equipment as protective masks and ventilators.

But instead of mobilizing for what was coming, U.S. officials seemed more preoccupied with logistical problems, including how to evacuate Americans from China.

In Washington, then-acting chief of staff Mick Mulvaney and Pottinger began convening meetings at the White House with senior officials from HHS, the CDC and the State Department.

The group, which included Azar, Pottinger and Fauci, as well as nine others across the administration, formed the core of what would become the administration’s coronavirus task force. But it primarily focused on efforts to keep infected people in China from traveling to the United States even while evacuating thousands of U.S. citizens. The meetings did not seriously focus on testing or supplies, which have since become the administration’s most challenging problems.

The task force was formally announced on Jan. 29.

“The genesis of this group was around border control and repatriation,” said a senior official involved in the meetings. “It wasn’t a comprehensive, whole-of-government group to run everything.”

The State Department agenda dominated those early discussions, according to participants. Officials began making plans to charter aircraft to evacuate 6,000 Americans stranded in Wuhan. They also debated language for travel advisories that State could issue to discourage other travel in and out of China.

On Jan. 29, Mulvaney chaired a meeting in the White House Situation Room in which officials debated moving travel restrictions to “Level 4,” meaning a “do not travel” advisory from the State Department. Then, the next day, China took the draconian step of locking down the entire Hubei province, which encompasses Wuhan.

That move by Beijing finally prompted a commensurate action by the Trump administration. On Jan. 31, Azar announced restrictions barring any non-U.S. citizen who had been in China during the preceding two weeks from entering the United States.

Trump has, with some justification, pointed to the China-related restriction as evidence that he had responded aggressively and early to the outbreak. It was among the few intervention options throughout the crisis that played to the instincts of the president, who often seems fixated on erecting borders and keeping foreigners out of the country.

But by that point, 300,000 people had come into the United States from China over the previous month. There were only 7,818 confirmed cases around the world at the end of January, according to figures released by the World Health Organization — but it is now clear that the virus was spreading uncontrollably.

Pottinger was by then pushing for another travel ban, this time restricting the flow of travelers from Italy and other nations in the European Union that were rapidly emerging as major new nodes of the outbreak. Pottinger’s proposal was endorsed by key health-care officials, including Fauci, who argued that it was critical to close off any path the virus might take into the country.

This time, the plan met with resistance from Treasury Secretary Steven Mnuchin and others who worried about the impact on the U.S. economy. It was an early sign of tension in an area that would split the administration, pitting those who prioritized public health against those determined to avoid any disruption in an election year to the run of expansion and employment growth.

Those backing the economy prevailed with the president. And it was more than a month before the administration issued a belated and confusing ban on flights into the United States from Europe. Hundreds of thousands of people crossed the Atlantic during that interval.

A wall of resistance

While fights over air travel played out in the White House, public health officials began to panic over a startling shortage of critical medical equipment including protective masks for doctors and nurses, as well as a rapidly shrinking pool of money needed to pay for such things.

By early February, the administration was quickly draining a $105 million congressional fund to respond to infectious disease outbreaks. The coronavirus threat to the United States still seemed distant if not entirely hypothetical to much of the public. But to health officials charged with stockpiling supplies for worst-case-scenarios, disaster appeared increasingly inevitable.

A national stockpile of N95 protective masks, gowns, gloves and other supplies was already woefully inadequate after years of underfunding. The prospects for replenishing that store were suddenly threatened by the unfolding crisis in China, which disrupted offshore supply chains.

Much of the manufacturing of such equipment had long since migrated to China, where factories were now shuttered because workers were on order to stay in their households. At the same time, China was buying up masks and other gear to gird for its own coronavirus outbreak, driving up costs and monopolizing supplies.

In late January and early February, leaders at HHS sent two letters to the White House Office of Management and Budget asking to use its transfer authority to shift $136 million of department funds into pools that could be tapped for combating the coronavirus. Azar and his aides also began raising the need for a multibillion-dollar supplemental budget request to send to Congress.

Yet White House budget hawks argued that appropriating too much money at once when there were only a few U.S. cases would be viewed as alarmist.

Joe Grogan, head of the Domestic Policy Council, clashed with health officials over preparedness. He mistrusted how the money would be used and questioned how health officials had used previous preparedness funds.

Azar then spoke to Russell Vought, the acting director of the White House Office of Management and Budget, during Trump’s State of the Union speech on Feb. 4. Vought seemed amenable, and told Azar to submit a proposal.

Azar did so the next day, drafting a supplemental request for more than $4 billion, a sum that OMB officials and others at the White House greeted as an outrage. Azar arrived at the White House that day for a tense meeting in the Situation Room that erupted in a shouting match, according to three people familiar with the incident.

A deputy in the budget office accused Azar of preemptively lobbying Congress for a gigantic sum that White House officials had no interest in granting. Azar bristled at the criticism and defended the need for an emergency infusion. But his standing with White House officials, already shaky before the coronavirus crisis began, was damaged further.

White House officials relented to a degree weeks later as the feared coronavirus surge in the United States began to materialize. The OMB team whittled Azar’s demands down to $2.5 billion, money that would be available only in the current fiscal year. Congress ignored that figure, approving an $8 billion supplemental bill that Trump signed into law March 7.

But again, delays proved costly. The disputes meant that the United States missed a narrow window to stockpile ventilators, masks and other protective gear before the administration was bidding against many other desperate nations, and state officials fed up with federal failures began scouring for supplies themselves.

In late March, the administration ordered 10,000 ventilators — far short of what public health officials and governors said was needed. And many will not arrive until the summer or fall, when models expect the pandemic to be receding.

“It’s actually kind of a joke,” said one administration official involved in deliberations about the belated purchase.

Inconclusive tests

Although viruses travel unseen, public health officials have developed elaborate ways of mapping and tracking their movements. Stemming an outbreak or slowing a pandemic in many ways comes down to the ability to quickly divide the population into those who are infected and those who are not.

Doing so, however, hinges on having an accurate test to diagnose patients and deploy it rapidly to labs across the country. The time it took to accomplish that in the United States may have been more costly to American efforts than any other failing.

“If you had the testing, you could say, ‘Oh my god, there’s circulating virus in Seattle, let’s jump on it. There’s circulating virus in Chicago, let’s jump on it,’ ” said a senior administration official involved in battling the outbreak. “We didn’t have that visibility.”

The first setback came when China refused to share samples of the virus, depriving U.S. researchers of supplies to bombard with drugs and therapies in a search for ways to defeat it. But even when samples had been procured, the U.S. effort was hampered by systemic problems and institutional hubris.

Among the costliest errors was a misplaced assessment by top health officials that the outbreak would probably be limited in scale inside the United States — as had been the case with every other infection for decades — and that the CDC could be trusted on its own to develop a coronavirus diagnostic test.

The CDC, launched in the 1940s to contain an outbreak of malaria in the southern United States, had taken the lead on the development of diagnostic tests in major outbreaks including Ebola, zika and H1N1. But the CDC was not built to mass-produce tests.

The CDC’s success had fostered an institutional arrogance, a sense that even in the face of a potential crisis there was no pressing need to involve private labs, academic institutions, hospitals and global health organizations also capable of developing tests.

Yet some were concerned that the CDC test would not be enough. Stephen Hahn, the FDA commissioner, sought authority in early February to begin calling private diagnostic and pharmaceutical companies to enlist their help.

But when senior FDA officials consulted leaders at HHS, Hahn, who had led the agency for about two months, was told to stand down. There were concerns about him personally contacting companies regulated by his agency.

At that point, Azar, the HHS secretary, seemed committed to a plan he was pursuing that would keep his agency at the center of the response effort: securing a test from the CDC and then building a national coronavirus surveillance system by relying on an existing network of labs used to track the ordinary flu.

In task force meetings, Azar and Redfield pushed for $100 million to fund the plan, but were shot down because of the cost, according to a document outlining the testing strategy obtained by The Washington Post.

Relying so heavily on the CDC would have been problematic even if it had succeeded in quickly developing an effective test that could be distributed across the country. The scale of the epidemic, and the need for mass testing far beyond the capabilities of the flu network, would have overwhelmed Azar’s plan, which didn’t envision engaging commercial lab companies for up to six months.

The effort collapsed when the CDC failed its basic assignment to create a working test and the task force rejected Azar’s plan.

On Feb. 6, when the World Health Organization reported that it was shipping 250,000 test kits to labs around the world, the CDC began distributing 90 kits to a smattering of state-run health labs.

Almost immediately, the state facilities encountered problems. The results were inconclusive in trial runs at more than half the labs, meaning they couldn’t be relied upon to diagnose actual patients. The CDC issued a stopgap measure, instructing labs to send tests to its headquarters in Atlanta, a practice that would delay results for days.

The scarcity of effective tests led officials to impose constraints on when and how to use them, and delayed surveillance testing. Initial guidelines were so restrictive that states were discouraged from testing patients exhibiting symptoms unless they had traveled to China and come into contact with a confirmed case, when the pathogen had by that point almost certainly spread more broadly into the general population.

The limits left top officials largely blind to the true dimensions of the outbreak.

In a meeting in the Situation Room in mid-February, Fauci and Redfield told White House officials that there was no evidence yet of worrisome person-to-person transmission in the United States. In hindsight, it appears almost certain that the virus was taking hold in communities at that point. But even the country’s top experts had little meaningful data about the domestic dimensions of the threat. Fauci later conceded that as they learned more their views changed.

At the same time, the president’s subordinates were growing increasingly alarmed, Trump continued to exhibit little concern. On Feb. 10, he held a political rally in New Hampshire attended by thousands where he declared that “by April, you know, in theory, when it gets a little warmer, it miraculously goes away.”

The New Hampshire rally was one of eight that Trump held after he had been told by Azar about the coronavirus, a period when he also went to his golf courses six times.

A day earlier, on Feb. 9, a group of governors in town for a black-tie gala at the White House secured a private meeting with Fauci and Redfield. The briefing rattled many of the governors, bearing little resemblance to the words of the president. “The doctors and the scientists, they were telling us then exactly what they are saying now,” Maryland Gov. Larry Hogan (R) said.

That month, federal medical and public health officials were emailing increasingly dire forecasts among themselves, with one Veterans Affairs medical adviser warning, ‘We are flying blind,’” according to emails obtained by the watchdog group American Oversight.

Later in February, U.S. officials discovered indications that the CDC laboratory was failing to meet basic quality-control standards. On a Feb. 27 conference call with a range of health officials, a senior FDA official lashed out at the CDC for its repeated lapses.

Jeffrey Shuren, the FDA’s director for devices and radiological health, told the CDC that if it were subjected to the same scrutiny as a privately run lab, “I would shut you down.”

On Feb. 29, a Washington state man became the first American to die of a coronavirus infection. That same day, the FDA released guidance, signaling that private labs were free to proceed in developing their own diagnostics.

Another four-week stretch had been squandered.

Life and death

One week later, on March 6, Trump toured the facilities at the CDC wearing a red “Keep America Great” hat. He boasted that the CDC tests were nearly perfect and that “anybody who wants a test will get a test,” a promise that nearly a month later remains unmet.

He also professed to have a keen medical mind. “I like this stuff. I really get it,” he said. “People here are surprised that I understand it. Every one of these doctors said, ‘How do you know so much about this?’ ”

In reality, many of the failures to stem the coronavirus outbreak in the United States were either a result of, or exacerbated by, his leadership.

For weeks, he had barely uttered a word about the crisis that didn’t downplay its severity or propagate demonstrably false information. He dismissed the warnings of intelligence officials and top public health officials in his administration.

At times, he voiced far more authentic concern about the trajectory of the stock market than the spread of the virus in the United States, railing at the chairman of the Federal Reserve and others with an intensity that he never seemed to exhibit about the possible human toll of the outbreak.

In March, as state after state imposed sweeping new restrictions on their citizens’ daily lives to protect them — triggering severe shudders in the economy — Trump second-guessed the lockdowns.

The common flu kills tens of thousands each year and “nothing is shut down, life & the economy go on,” he tweeted March 9. A day later, he pledged that the virus would “go away. Just stay calm.”

Two days later, Trump finally ordered the halt to incoming travel from Europe that his deputy national security adviser had been advocating for weeks. But Trump botched the Oval Office announcement so badly that White House officials spent days trying to correct erroneous statements that triggered a stampede by U.S. citizens overseas to get home.

“There was some coming to grips with the problem and the true nature of it — the 13th of March is when I saw him really turn the corner. It took a while to realize you’re at war,” Sen. Lindsey O. Graham (R-S.C.) said. “That’s when he took decisive action that set in motion some real payoffs.”

Trump spent many weeks shuffling responsibility for leading his administration’s response to the crisis, putting Azar in charge of the task force at first, relying on Pottinger, the deputy national security adviser, for brief periods, before finally putting Vice President Pence in the role toward the end of February.

Other officials have emerged during the crisis to help right the United States’ course, and at times, the statements of the president. But even as Fauci, Azar and others sought to assert themselves, Trump was behind the scenes turning to others with no credentials, experience or discernible insight in navigating a pandemic.

Foremost among them was his adviser and son-in-law, Jared Kushner. A team reporting to Kushner commandeered space on the seventh floor of the HHS building to pursue a series of inchoate initiatives.

One plan involved having Google create a website to direct those with symptoms to testing facilities that were supposed to spring up in Walmart parking lots across the country, but which never materialized. Another centered an idea advanced by Oracle chairman Larry Ellison to use software to monitor the unproven use of anti-malaria drugs against the coronavirus pathogen.

So far, the plans have failed to come close to delivering on the promises made when they were touted in White House news conferences. The Kushner initiatives have, however, often interrupted the work of those under immense pressure to manage the U.S. response.

Current and former officials said that Kadlec, Fauci, Redfield and others have repeatedly had to divert their attentions from core operations to contend with ill-conceived requests from the White House they don’t believe they can ignore. And Azar, who once ran the response, has since been sidelined, with his agency disempowered in decision-making and his performance pilloried by a range of White House officials, including Kushner.

“Right now Fauci is trying to roll out the most ambitious clinical trial ever implemented” to hasten the development of a vaccine, said a former senior administration official in frequent touch with former colleagues. And yet, the nation’s top health officials “are getting calls from the White House or Jared’s team asking, ‘Wouldn’t it be nice to do this with Oracle?’ ”

If the coronavirus has exposed the country’s misplaced confidence in its ability to handle a crisis, it also has cast harsh light on the limits of Trump’s approach to the presidency — his disdain for facts, science and experience.

He has survived other challenges to his presidency — including the Russia investigation and impeachment — by fiercely contesting the facts arrayed against him and trying to control the public’s understanding of events with streams of falsehoods.

The coronavirus may be the first crisis Trump has faced in office where the facts — the thousands of mounting deaths and infections — are so devastatingly evident that they defy these tactics.

After months of dismissing the severity of the coronavirus, resisting calls for austere measures to contain it, and recasting himself as a wartime president, Trump seemed finally to succumb to the coronavirus reality. In a meeting with a Republican ally in the Oval Office last month, the president said his campaign no longer mattered because his reelection would hinge on his coronavirus response.

“It’s absolutely critical for the American people to follow the guidelines for the next 30 days,” he said at his March 31 news conference. “It’s a matter of life and death.”

 

 

 

 

It’s Official: CDC Recommends Public Wear Face Masks

https://www.medpagetoday.com/infectiousdisease/covid19/85800?xid=NL_breakingnewsalert_2020-04-04&eun=g885344d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=CDCMasksAlert_040420&utm_term=NL_Daily_Breaking_News_Active

A computer rendering of the coronavirus

Stresses use of cloth coverings, not medical grade, for ordinary people.

The CDC is now recommending that everyone should wear a cloth face covering when out in public places to protect others in case they are unknowingly infected with the virus.

Late Friday night, the agency updated its consumer-facing web page for COVID-19 self-protection as follows:

  • Cover your mouth and nose with a cloth face cover when around others.
  • You could spread COVID-19 to others even if you do not feel sick.
  • Everyone should wear a cloth face cover when they have to go out in public, for example to the grocery store or to pick up other necessities.
  • Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.
  • The cloth face cover is meant to protect other people in case you are infected.
  • Do NOT use a face mask meant for a healthcare worker.
  • Continue to keep about 6 feet between yourself and others. The cloth face cover is not a substitute for social distancing.

Because there is currently no vaccine nor approved treatment, the agency stressed that the best strategy for preventing illness is still to avoid exposure to the virus. Even asymptomatic people can spread coronavirus to others, the CDC stressed.

During a White House briefing on Friday evening, President Trump underscored the CDC’s advice to Americans who are not clinicians, that they not wear “medical-grade or surgical -grade” masks. These are now in shortage at many hospitals, forcing administrators to adopt last-ditch strategies to extend supplies.

But Trump said he has no plans to follow the recommendation himself to wear a mask in public. “I’m choosing not to do it,” he said at the Friday briefing.

The SARS-CoV-2 virus is transmitted primarily through person-to-person contact from people who are in close contact, meaning less than 6-feet apart; through respiratory droplets, projected in a sneeze or cough that land in the mouths and noses of people nearby and can be inhaled into their lungs, but importantly the virus can also be transmitted through talking.

Researchers reported earlier in the week that the coronavirus could be spread through normal breathing and speechLarge droplets remain one method of transmission, when they are inhaled by a person nearby or through contact with a contaminated surface and later touching one’s face. However, researchers noted that tiny particles in the air can also carry the virus.

Former FDA Commissioner Scott Gottlieb, MD, recommended last weekend that “everyone, including people without symptoms, should be encouraged to wear nonmedical fabric face masks while in public.”

While asymptomatic transmission of the virus outside of China was discovered in late January, White House officials had initially suggested that it was not an important driver of transmission. “You really need to just focus on the individuals that are symptomatic,” HHS Secretary Alex Azar told ABC News in March.

 

Decentralized leadership raises questions about Trump coronavirus response

https://thehill.com/homenews/administration/491093-decentralized-leadership-raises-questions-about-trump-coronavirus

The rotating cast of officials appearing behind President Trump to detail the government’s response to the coronavirus are leading to new criticisms that they reflect a scattered approach from the White House that too often leaves states fending for themselves.

Top Trump administration officials say the appearances by a broad range of administration officials shows the “all of government” undertaken to combat the coronavirus.

But some current and former government officials see a disconnected strategy where it can be unclear who’s in charge of what or whether there is a coordinated long-term plan.

 

The Navy Fired the Captain of the Theodore Roosevelt. See How the Crew Responded.

The Navy Fired Captain Crozier After His Letter on the Coronavirus ...

The rousing show of support provided another gripping scene to emerge from the coronavirus pandemic: the rank and file cheering a boss they viewed as putting their safety ahead of his career.

It was a send-off for the ages, with hundreds of sailors aboard the aircraft carrier Theodore Roosevelt cheering Capt. Brett E. Crozier, the commander who sacrificed his naval career by writing a letter to his superiors demanding more help as the novel coronavirus spread through the ship.

The rousing show of support provided the latest gripping scene to emerge from the coronavirus pandemic: the rank and file shouting their admiration for a boss they viewed as putting their safety ahead of his career.

The memes were quick to sprout on social media. On Reddit, one depicted Captain Crozier forced to choose between rescuing his career or his sailors from a burning building; he chooses his sailors. On Twitter, a slew of videos showed Captain Crozier’s walk down the gangway in Guam, most of them depicting him as a hero struck down by his superiors for trying to save the lives of his crew. “Wrongfully relieved of command but did right by sailors,” wrote Twitter user Dylan Castillo, alongside a video of Captain Crozier leaving his ship.

But in removing Captain Crozier from command, senior Navy officials said they were protecting the historic practice that complaints and requests have to go up a formal chain of command. They argued that by sending his concerns to 20 or 30 people in a message that eventually leaked to news organizations, Captain Crozier showed he was no longer fit to lead the fast-moving effort to treat the crew and clean the ship.

His removal from prestigious command of an aircraft carrier with almost 5,000 crew members has taken on an added significance, as his punishment is viewed by some in the military as indicative of the government’s handling of the entire pandemic, with public officials presenting upbeat pictures of the government’s response, while contrary voices are silenced.

The cheering by the sailors is the most public repudiation of military practices to battle the virus since the pandemic began. At the Pentagon, officials expressed concern about the public image of a Defense Department not doing enough to stay ahead of the curve on the virus.

Notably, the defense of the firing offered by senior Pentagon officials has centered around Captain Crozier not following the chain of command in writing his letter, which found its way to newspapers. In a circuitous explanation, Thomas B. Modly, the acting Navy secretary, said that Captain Crozier’s immediate superior did not know that the captain was going to write the letter, offering that act as an error in leadership and one of the reasons the Navy had lost confidence in the Roosevelt captain.

But a Navy official familiar with the situation but not authorized to speak publicly about it said that the captain had repeatedly asked his superiors for speedy action to evacuate the ship. His letter, the official said, came because the Navy was still minimizing the risk.

Mr. Modly insisted that his firing the captain for writing a letter asking for more help does not mean that subordinate officers are not allowed to raise criticisms and ask for assistance. “To our commanding officers,” Mr. Modly told reporters on Thursday, “it would be a mistake to view this decision as somehow not supportive of your duty to report problems, request help, protect your crews, challenge assumptions as you see fit.”

But the removal of Captain Crozier will likely have a chilling effect on the willingness of commanders to bring bad news to their superiors.

“There’s no question they had the authority to remove him,” Kathleen H. Hicks, a former top Pentagon official in the Obama administration, said in an email. “The issue is one of poor judgment in choosing to do so. They are fueling mistrust in leader transparency, among service members, families, and surrounding/hosting communities.”

 

 

 

Cartoon – Famous Last Words

Granlund cartoon: Famous last words - Opinion - Morning Sun ...

 

‘I just don’t understand why we’re not doing that’: Fauci calls for nationwide stay-at-home order, despite Trump’s resistance

https://www.washingtonpost.com/politics/2020/04/03/i-just-dont-understand-why-were-not-doing-that-fauci-calls-nationwide-stay-at-home-despite-trumps-resistance/?fbclid=IwAR0wkT53s_ATpUIp8aOHIU00KufxsoX8m5HgukQYwAtdZFMMhEJbmBsjTg0&utm_campaign=wp_main&utm_medium=social&utm_source=facebook

Fauci differs with Trump on nationwide stay-at-home orders - The ...

Trump has said certain states can treat the coronavirus outbreak differently. Fauci publicly disagreed Thursday night.

As certain states have continued to lag behind others in issuing stay-at-home orders, the White House has also resisted a more drastic step: demanding that states get with the program.

Vice President Pence made it clear Wednesday that President Trump has decided he doesn’t want to tell states what to do. “At the president’s direction, the White House coronavirus task force will continue to take the posture that we will defer to state and local health authorities on any measures that they deem appropriate,” Pence said.

Pressed again on Thursday after Georgia Gov. Brian Kemp (R) finally got on board with a stay-at-home order, Trump again signaled that the task force won’t seek to compel states. “I think it’s about 85 percent of the states have got the stay at home,” Trump said. “Brian’s a great governor; it’s his decision.”

The thing is, though, Trump is wrong. Eighty-five percent of states are not on board. A New York Times compilation shows that 12 states still have not taken this step. Localities within some of those state have, and the vast majority of the United States is under such orders, population-wise, but this is still not a blanket policy being applied across the country.

And for the first time, Anthony S. Fauci is signaling his frustration with that. After the White House had for days played off this question, the director of the National Institute of Allergy and Infectious Diseases appeared on CNN on Thursday night and for the first time made his position on that issue clear.

“If you look at what’s going on in this country, I just don’t understand why we’re not doing that,” he told Anderson Cooper. “We really should be.”

The question was about a federal mandate and not whether states should take this step themselves, and Fauci was careful to recognize valid questions about states’ rights. But he was also clear that he thinks this should be a nationwide policy, one way or another.

“I think so, Anderson,” Fauci added at another point. “I don’t understand why that’s not happening.”

Part of the reason it’s not happening is that this request has not been enunciated by the president like it was by Fauci on Thursday night. Florida Gov. Ron DeSantis (R) said earlier this week that he was waiting for Trump to tell him what to do. DeSantis eventually succumbed to the pressure himself, but in making his announcement, he cited Trump’s tone about the severity of the issue.

In other words, what the president says matters. And just like Florida and Georgia, all of the 12 remaining holdout states are run by Republican governors. Trump’s say-so would likely carry significant weight with them.

But Trump isn’t just declining to lean on them; he also continues to cling to the idea that certain areas of the country can treat the outbreak differently because they aren’t yet as hard-hit. Asked Wednesday why he wasn’t telling every state to do this, Trump said it was “because states are different.”

“There are some states that don’t have much of a problem,” Trump said. “There is some — well, they don’t have the problem. They don’t have thousands of people that are positive or thousands of people that even think they might have it, or hundreds of people in some cases.”

Trump added: “You have to give a little bit of flexibility. We have a state in the Midwest or if Alaska, as an example, doesn’t have a problem, it’s awfully tough to say close it down.”

About 24 hours later, Fauci offered a diametrically opposed view on this question, saying that every state should have a stay-at-home order. The statement both reinforced that there are certain disconnects between the president and his top health officials and added to pressure on everyone to fall in line.

Plenty of governors have resisted this step, only to succumb to the realities in their states. Fauci is essentially asking: Why are you waiting to be the next one?

 

 

 

 

HP unveils advanced security for remote workers — and shows how to disinfect your laptop

https://www.venture-med.com/hp-unveils-advanced-security-for-remote-workers-and-shows-how-to-disinfect-your-laptop/

HP has unveiled advanced security for businesses and their remote workforces and disclosed an extensive guide to disinfecting your laptop and other computer equipment.

The new offerings include HP Pro Security Edition, HP Proactive Security, and HP Sure Click Enterprise. These are aimed at the security threats that evolve and disrupt business every day.

With the recent surge of remote workers — due to work-from-home rules forced upon us by COVID-19 — HP said we must all be aware of the increased risks of working from home. Over 80% of home office routers have been found to be vulnerable to potential cyberattacks.

Emails also pose a significant risk to organizations, with over 90% of PC infections originating from attachments and 96% of security  breaches not discovered until months later. There are 5 billion new threats per month, based on HP’s estimates.

“Our HP Pro Security Edition takes Sure Sense and Sure Click and bundles [them] with our system,” said Andy Rhodes, global head of commercial PCs, in a press briefing. “Endpoints are still an enormous risk — 90% of infections originate with emails. Every user is at risk here.”

HP Pro Security for small businesses.

With public health concerns over COVID-19 spreading worldwide, HP wants customers to have the information they need to effectively clean HP devices and maintain a healthy work environment.

The Centers for Disease Control and Prevention (CDC) recommends cleaning surfaces, followed by disinfection, as a best practice for the prevention of COVID-19 and other viral respiratory illnesses in households and community settings.

In fact, HP has issued its own whitepaper for cleaning your devices.

“We get asked [about] this every day,” said Rhodes. “If you use the wrong disinfectant, you can actually damage the product.”

A CDC-recommended disinfectant that is also within HP’s cleaning guidelines is an alcohol solution consisting of 70% isopropyl alcohol and 30% water.

The steps below use the CDC-recommended alcohol solution to clean high-touch, external surfaces on HP products:

  1. Wear disposable gloves made of latex (or nitrile gloves if you are latex-sensitive) when cleaning and disinfecting surfaces.
  2. Turn off the device and disconnect AC power (printers should be unplugged from the outlet). Remove batteries from items like wireless keyboards. Never clean a product while it is powered on or plugged in.
  3. Disconnect any external devices.
  4. Moisten a microfiber cloth with a mixture of 70% isopropyl alcohol and 30% water. Do not use fibrous materials, such as paper towels or toilet paper. The cloth should be moist, but not dripping wet. (Isopropyl alcohol is sold in most stores, usually in a 70% isopropyl alcohol/30% water solution. It may also be marketed as rubbing alcohol.)
  5. Do not spray any liquids directly onto your device.
  6. Gently wipe the moistened cloth on the surfaces to be cleaned. Do not allow any moisture to drip into areas like keyboards, display panels, or USB ports located on the printer control panels, as moisture entering the inside of an electronic product can cause extensive damage to the product.
  7. Start with the display or printer control panel (if applicable) and end with any flexible cables, like power, keyboard, and USB cables.
  8. When cleaning a display screen or printer control panel, carefully wipe in one direction, moving from the top of the display to the bottom.
  9. Ensure surfaces have completely air-dried before turning the device on after cleaning. No moisture should be visible on the surfaces of the product before it is powered on.
  10. After disinfecting, copier/scanner glass should be cleaned again using an office glass cleaner sprayed onto a clean rag to remove streaking. Streaking on the copier/scanner glass from the CDC-recommended cleaning solution could cause copy quality defects.
  11. Gloves should be discarded after each cleaning. Clean hands immediately after gloves are removed.

 

 

 

Immigrants on the front lines

https://www.axios.com/newsletters/axios-vitals-b46e0485-d208-4360-bcd9-4d992ec54d95.html?utm_source=newsletter&utm_medium=email&utm_campaign=newsletter_axiosvitals&stream=top

Immigrants on the front lines in the coronavirus fight - Axios

 

New data provided to Axios spells out just how outsized a role immigrants play on the high- and low-skilled ends of the economy keeping Americans alive and fed during the coronavirus crisis, Axios’ Stef Kight reports.

By the numbers: Immigrants make up an estimated 17% of the overall U.S. workforce. But the analysis by New American Economy (NAE) shows they’re more than one in four doctors, nearly half the nation’s taxi drivers and chauffeurs and a clear majority of farm workers.

  • Reporting to work in hospitals, restaurant kitchens, cabs or the fields — for jobs deemed “essential” by the government — many documented and undocumented workers are putting themselves at higher risk of COVID-19 infections.

Be smart: The share of immigrants in some health care roles are higher in states that have been hit hardest by the virus.

  • More than a third of California nurses are immigrants, as well as 29% of nurses in New York and New Jersey, according to NAE data.

Between the lines: A large percentage of farm workers, who help maintain food supplies, are unauthorized immigrants, as the New York Times reported.

  • Immigrants make up a small percentage of delivery workers nationwide, but one-third of delivery workers in New York are unauthorized immigrants, NAE director of quantitative research Andrew Lim told Axios.
  • The $2 trillion aid package does not include assistance for unauthorized immigrants.

 

 

 

 

The Memo: Scale of economic crisis sends shudders through nation

The Memo: Scale of economic crisis sends shudders through nation

Pandemic derails resilient US economy | TheHill

New data released Thursday revealed the scale of the economic devastation wrought by the coronavirus crisis — and experts say there is no end in sight.

More than 6.6 million new unemployment claims were filed during the week ending March 28, according to the Department of Labor. The figure was double that of the previous week, which had itself been by far the highest since records began.

The stark reality is that roughly 10 million people have been dumped from their jobs in two weeks. A previously robust economy has been scythed down by the virus. A nation that had been enjoying its lowest unemployment rate for decades is now virtually certain to see jobless totals surpass those of the Great Recession a decade ago.

“The present economic situation is awful,” said Jason Furman, a Harvard University professor who served as chairman of President Obama’s Council of Economic Advisers. “The data is just telling us what we can see with our own eyes — there is very little business happening.”

Economists who had already been deeply worried about the immediate outlook are now wondering if their earlier projections were in fact too rosy.

“In our earlier scenario, we had expected 6.5 million job losses by May,” said Beth Ann Bovino, the chief U.S. economist at Standard & Poor’s. That figure will be exceeded, she now believes, given that there were “more lockdowns, more business closures and more businesses just trying to keep themselves alive” by laying off workers.

Heidi Shierholz, senior economist and director of policy at the Economic Policy Institute, said that even the 10 million figure for new unemployment claims was “likely a massive undercount” of actual losses because, during that period, self-employed people and workers in the so-called “gig economy” were generally not eligible to apply. This is changing as a consequence of the package recently passed by Congress that extends eligibility for unemployment benefits, as well as providing other aid for businesses and individuals.

“Our estimate is that by the end of June, 20 million people will have lost their jobs — and I am wondering if even that is optimistic,” Shierholz said.

The political ramifications of such a huge economic shock are unknowable.

President Trump had been looking forward to using the economy as his strongest card as he seeks a second term in November. That card has been shredded.

Trump has promised repeatedly during his White House briefings on the crisis that the nation can bounce back very fast once the public health dangers have receded.

Trump’s approval ratings have also ticked up modestly since the crisis began in many polls. He may be benefitting from the traditional “rallying around the flag” effect that has occurred in previous moments of crisis.

President George W. Bush, for example, hit 90 percent approval in a Gallup poll — the highest result for any president in the polling organization’s history — right after the terrorist attacks of Sept. 11, 2001.

In a statement on Thursday, probable Democratic nominee Joe Biden hit Trump for “failing to prepare our nation” for the ramifications of the coronavirus crisis. Biden called on Trump to allow open enrollment in the Affordable Care Act and also jabbed at Treasury Secretary Steven Mnuchin for having referred to previous unemployment figures as “not relevant.”

In response, Trump campaign communications director Tim Murtaugh blasted back at Biden for “ineffectively sniping from the sidelines, stumbling through television interviews, and hoping for relevance and political gain.”

Economic experts caution that Trump’s promises of a v-shaped recovery, in which the nation jolts itself back into strong economic shape quickly, are almost certainly unrealistic. It will not be a matter of the nation simply rolling the shutters back up and returning to business as usual.

“The economy is not symmetrical,” said Furman. “It is easier to separate someone from a job than to connect someone to a job. In recessions, the unemployment rate can go up very quickly and it comes down very slowly. The worry is that this will be like that.”

Several economic experts who spoke with The Hill made similar points, unprompted, as to the ways the federal government could ease the crisis.

One refrain was that huge assistance needs to be made available to states. States are generally required to balance their budgets. In a situation like the current one, where their tax revenue is cratering, this means they are obligated to severely cut spending — something that most economists believe would deepen and prolong the recession.

Another theme was the need to tie together financial assistance for businesses and the retention of employees.

The recently passed stimulus package makes some effort to do that, particularly in the case of small businesses. The Paycheck Protection Program extends loans to small businesses based upon eight weeks of payroll costs plus an additional 25 percent of the total.

The payroll portion of the loans would be forgiven — rendering them in effect a grant, not a loan — so long as the workforce was maintained at existing levels.

Economic experts praise the principle but worry that the total amount of money in the pot for these loans — $349 billion — may not be enough. 

“The small business subsidies will be critical,” said Steven Hamilton, an assistant professor of economics at The George Washington University. “The government needs to get the word out on those, and Congress will likely need to pass an expansion both to adequately fund the existing scheme and to make the scheme more generous to businesses to keep them from laying off workers.”

The public seems to share the view that the aid package, which also includes checks of up to $1,200 for individuals, is a move in the right direction — but unlikely to suffice.

A CBS News poll released late Thursday afternoon indicated 81 percent of Americans support the recent legislation but 57 percent also say it likely won’t be enough.

The same trepidation is shared by the experts, given the unprecedented nature of the coronavirus and the economic crisis it has created.

“It’s like nothing we have ever seen before,” said Shierholz.