The United States is being ravaged by a deadly pandemic that is growing exponentially, overwhelming health care systems and costing thousands of lives, to say nothing of an economic recession that threatens to plague the nation for years to come.
But the American public seems to be over the pandemic, eager to get kids back in schools, ready to hit the bar scene and hungry for Major League Baseball to play its abbreviated season.
The startling divergence between the brutal reality of the SARS-CoV-2 virus and the fantasy land of a forthcoming return to normalcy has public health experts depressed and anxious about what is to come. The worst is not behind us, they say, by any stretch of the imagination.
“It’s an absolute disconnect between our perceived reality and our actual reality,” said Craig Spencer, a New York City emergency room doctor who directs global health in emergency medicine at New York Presbyterian/Columbia University Medical Center. “To look at the COVID case count and the surge in cases and to think that we can have these discussions as we have uncontrolled spread, to think we can have some national strategy for reopening schools when we don’t even have one for reopening the country, it’s just crazy.”
The number of dead from the virus in the United States alone, almost 136,000, is roughly equal to the populations of Charleston, S.C., or Gainesville, Fla. If everyone in America who had been infected lived in the same city, that city would be the third-largest in the country, behind only New York and Los Angeles. More people in the United States have tested positive for the coronavirus than live in the state of Utah. By the weekend, there are likely to be more confirmed coronavirus cases than there are residents of Connecticut.
There are signs that the outbreak is getting worse, not better. The 10 days with the highest number of new coronavirus infections in the United States have come in the past 11 days.
Case counts, hospitalizations and even deaths are on the rise across the nation, not only in Southern states that were slow to embrace lockdowns in March and April.
California, the first state to completely lock down, has reported more than 54,000 new cases over both of the last two weeks. Nevada, about one-thirteenth the size of California, reported 5,200 new cases last week. States where early lockdowns helped limit the initial peak like Pennsylvania, Illinois and Ohio are all seeing case counts grow and hospital beds fill up.
Only two states — Maine and New Jersey — have seen their case counts decline for two consecutive weeks.
“We are nearing the point where pretty much most of the gains we had achieved have been lost,” said Christine Petersen, an epidemiologist at the University of Iowa. “All of us are hoping we magically get our acts together and we can look like Europe in two months. But all the data shows we are not doing that right now.”
It is in that dismal context that schools are preparing some sort of return to learning, whether in person or remote. President Trump and Education Secretary Betsy DeVos have threatened schools that do not fully reopen.
But even though the coronavirus appears to have less severe consequences among children, sending them back to schools en masse does not carry zero risk. Children have died from the virus, and the more who are exposed mean more opportunities for the virus to kill again, even before considering the millions of teachers who may be vulnerable or the parents and grandparents asymptomatic children might be exposed to.
Already, school districts in Los Angeles and San Diego have delayed reopening plans as case counts rise.
“We do know that kids can get sick and they can even die. It’s definitely a much lower number,” Petersen said. “Even if they aren’t as infectious, if there are millions of them gathering in schools not having great hygiene, it’s a multiplier effect.”
The painful lockdowns that were supposed to reduce viral transmissions bought time to bolster testing and hospital capacity, to speed production of the equipment needed to test patients and protect front-line health care workers.
But that hasn’t happened; laboratories in the United States have tested as many as 823,000 people in a day, a record number but far shy of the millions a day necessary to wrestle the virus under control. Arizona and Los Angeles have canceled testing appointments for lack of supplies. Hospitals are reporting new shortages of protective gear and N95 masks.
The Trump administration used the Defense Production Act to order meat processing plants to stay open; it has only awarded contracts sufficient to produce 300 million N95 masks by the end of the year, far short of what health experts believe will be necessary to protect health care workers.
“A failure of national leadership has led us to a place where we are back where we were before, no national testing strategy, no national strategy for supply,” said Kelli Drenner, who teaches public health at the University of Houston. “States are still on their own to scramble for reagents and swabs and PPE and all of that, still competing against each other and against nations for those resources.”
There are troubling signs that the promise of a vaccine may not be the cure-all for which many had hoped. Early studies suggest that the immune system only retains coronavirus antibodies for a few months, or perhaps a year, raising the prospect that people could become reinfected even after they recover. A growing, if still fringe, movement of anti-vaccination activists may refuse a vaccine altogether, putting others at risk.
“A vaccine is not going to solve this. People die of vaccine-preventable diseases every day. All the failures with testing and diagnostics and all the inequities and access to care with those are going to be the same things that are going to be magnified with a vaccine,” said Nita Bharti, a biologist at Penn State’s Center for Infectious Disease Dynamics.
More than a dozen states hit hardest by the latest wave of disease have paused or reversed their reopening processes. But only 24 states and the District of Columbia have ordered residents to wear masks in public, and compliance varies widely by both geography and political affiliation.
“This is the critical time. If we are going to try to reverse this, we have to get back to the mental space and the resolute action we had in March. I’m not sure we have the energy and the wherewithal to do it,” Petersen said.
Without a dramatic recommitment to conquering the virus, health officials warn, the new normal in which the country exists will be one of serious and widespread illness, and a steady drumbeat of death.
“None of this was inevitable. None of this should be acceptable. There are ways we can do better,” Spencer said. “This will continue to be our reality for as long as we don’t take it seriously.”
But after months of repeating the same warnings — wear a mask, stay socially distant, stay home if possible, avoid places where people congregate in tight quarters — some health experts worry their message has been lost amid a sea of doubt, skepticism and mixed signals.
“It’s like a learned helplessness when we’re not helpless,” Drenner said. “There are some pretty effective strategies, but we don’t seem to have the political will to do it.”
https://www.cnn.com/2020/07/14/world/million-coronavirus-cases-five-days-intl/index.html
Coronavirus cases soared by more than a million globally in just five days as the numbers continue to accelerate from week to week, according to figures from Johns Hopkins University.
But for rash, foolish irresponsibility, I’d nominate the opposition research paper recently circulated by the White House in an attempt to discredit the National Institute of Allergy and Infectious Diseases’ Anthony S. Fauci. As reported by The Post, the document recounted a number of instances — on community transmission, asymptomatic transmission and mask wearing in particular — where Fauci’s views have shifted over time. As far as I know, this official record is unique: A White House attack on the government’s leading infectious-disease specialist during a raging pandemic. It indicates an administration so far gone in rage, bitterness and paranoia that it can no longer be trusted to preserve American lives.
From a purely political standpoint, it is understandable that the administration would want to divert attention from its covid-19 record. Trump’s policy of reopening at any cost is exacting a mounting cost. Five months into the greatest health crisis of modern U.S. history, there are still serious problems with supply chains for protective equipment. There are still long wait times for testing results in many places. The contact tracing process in many communities remains (as one health expert described it to me) “a joke.” More than 132,000 Americans have died.
Rather than addressing these failures, Trump has chosen to sabotage a public official who admits their existence. Rather than confronting these problems, Trump wants to ensure his whole administration lies about them in unison. The president has surveyed America’s massive spike in new infections and thinks the most urgent matter is . . . message discipline.
It is true that a number of Fauci’s views on the novel coronavirus have evolved (though some of the administration’s charges against him are distorted). But attacking a scientist for making such shifts is to willfully misunderstand the role of science in the fight against disease. We do not trust public health officials during an emerging pandemic because they have fully formed scientific views from the beginning. We trust them because 1) they are making judgments based on the best available information and 2) they have no other motive than the health of the public. If, say, health officials were initially mistaken about the possibility of asymptomatic transmission, it is not failure when they change their views according to better data. It is the nature of the scientific method and the definition of their duty.
In the inch-deep world of politics, amending your view based on new information is a flip-flop. In epidemiology, it is known as, well, epidemiology.
Meanwhile, the president is failing according to both requirements of public trust. Trump is not making judgments based on the best available information. And he clearly has political goals that compete with (and often override) his commitment to public health. The president is hoping against hope that the public will forget about the virus until November, or at least about the federal role in fighting it. To apply a veneer of normalcy, he is holding public events that endanger his staff and his audience and is planning a Republican convention that will double as a petri dish.
It now seems likely that the most decisive moment of the American pandemic took place in mid-April when new cases began to stabilize around 25,000 a day. Even four or six more weeks of firm presidential leadership — urging the tough, sacrificial application of stay-at-home orders — might have reduced the burden of disease to more sustainable levels, as happened in Western Europe. And this would have relieved stress on systems of testing, tracing and treatment.
But Trump’s nerve failed him. Instead of holding firm, he began siding with populist demands for immediate opening, pressuring governors to take precipitous steps and encouraging skepticism about basic public health information and measures. This may well have been the defining moment of the Trump presidency. And he was weak, weak, weak.
It is typical for Trump to shift blame. But in this case, the president has selected his fall guy poorly. Fauci has been an example of conscience and courage in an administration that values neither. When Trump encourages a contrast to his own selfishness and cravenness, he only damages himself.
Most U.S. parents say it would be risky to send their children back to school in the fall — including a slim majority of Republicans and a staggering nine in 10 Black Americans — in this week’s installment of the Axios-Ipsos Coronavirus Index, Axios’ Margaret Talev reports.
Why it matters: President Trump and Education Secretary Betsy DeVos have threatened to withhold federal funds from schools that don’t reopen. The new findings suggest that this pressure campaign could backfire with many of the voters to whom Trump is trying to appeal ahead of the election.
What they’re saying: “Americans at this point, and parents more specifically, can’t be force-fed policies that go against what they think,” says Cliff Young, president of Ipsos U.S. Public Affairs.
Driving the news: Officials on Monday began announcing decisions impacting schools in some major metro areas, erring on the side of caution in response to health concerns and parents’ anxieties.
As Florida recorded more than 15,000 new cases of COVID-19, the CEO of Altamonte Springs, Fla.-based AdventHealth said July 12 he would feel comfortable visiting Walt Disney World Resort, which has opened up two of its parks, according to CBS News.
In an interview on CBS’ “Face the Nation,” AdventHealth CEO Terry Shaw was asked about the resort’s reopening given that 48 Florida hospitals reached capacity as of July 10.
He told moderator Margaret Brennan: “So as a healthcare provider, my job is to help people do things safely. Whether it’s NASCAR or Disney, we have strategic alliances with those organizations. We work very closely with them to help them determine a way to reopen and do that safely.”
“I will tell you, based upon the way Disney is approaching this — with limiting people in, doing all the screenings that they’re doing, I’m — I personally am a Disney season ticket holder. I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” he said.
Mr. Shaw’s interview occurred the same day Florida reported 15,299 new COVID-19 cases, the largest daily case count set by any state since the beginning of the pandemic, according to NPR .
AdventHealth has about 30 hospitals in the state, and its physicians and sports medicine experts provide support to help racers who are part of runDisney races through Disney theme parks, according to the health system website. The organization has been providing this support for runDisney races for more than 25 years.
AdventHealth also confirmed health system employees are taking temperatures at the gates of the theme parks and the entrances to Disney Springs.
Access Mr. Shaw’s full interview here.
Tensions between the White House and Anthony Fauci, the government’s top infectious diseases expert, are spilling into the open as officials openly attack the doctor for his public health advice during the coronavirus pandemic.
Fauci’s advice has often run contrary to President Trump’s views, and the attacks on Fauci have begun to look like a traditional negative political campaign against an opponent. Yet this time, the opponent is a public health expert and career civil servant working within the administration.
Dan Scavino, deputy chief of staff for communications, shared a cartoon on his Facebook page late Sunday that depicted Fauci as a faucet flushing the U.S. economy down the drain with overzealous health guidance to slow the spread of the pandemic.
The cartoon, which shows Fauci declaring schools should remain closed and calling for “indefinite lockdowns,” did not accurately portray what Fauci has advised in public.
Adm. Brett Giroir, the administration’s testing czar, downplayed any riff within the White House coronavirus task force before offering some criticism of Fauci.
“I respect Dr. Fauci a lot, but Dr. Fauci is not 100 percent right and he also doesn’t necessarily, and he admits that, have the whole national interest in mind,” Giroir told “Meet the Press” on Sunday. “He looks at it from a very narrow public health point of view.”
There have been tensions between Trump and Fauci throughout the pandemic. The president has repeatedly downplayed the severity of the virus, broken with the advice of his own public health experts and painted rosy but at times misleading pictures of the U.S. response. Fauci, who has served four decades in his current post, has offered blunt talk on the dangers of the pandemic that has directly contradicted the president from time to time.
But the latest criticisms mark a shift as the White House has begun publicly undermining one of the leading public health voices in the administration at a time when multiple states are struggling to get new outbreaks under control.
White House trade adviser Peter Navarro, whom the president tapped to manage the use of the Defense Production Act, said he personally proceeds with caution before heeding Fauci’s advice.
Trump said last week that Fauci is a nice man but that he’s “made a lot of mistakes.”
A White House official this weekend sent media outlets a lengthy list of “mistakes” Fauci has made since the pandemic began, like his comment in March that there is no need for people to wear masks.
That comment came before scientists knew people could spread the virus without showing symptoms, and Fauci, the Centers for Disease Control and Prevention (CDC) and other experts now urge people to use face coverings in public.
Public health experts have leaped to Fauci’s defense on Twitter, noting that Fauci is one of the most respected health experts in the world, having worked for six presidents and researched HIV/AIDS, Ebola, Zika and a variety of other infectious diseases.
“When studies show that, opposite from SARS & MERS, COVID19 is most infectious soon after infection & less infectious later, we recognize asymptomatic transmission and importance of masks,” tweeted Tom Frieden, the former director of the CDC.
“That’s called science, not a mistake. The real, deadly mistake is not listening to science.”
Ashish Jha, director of the Harvard Global Health Institute, tweeted, “His track record isn’t perfect. It’s just better than anyone else I know. Sidelining Dr. Fauci makes the federal response worse. And it’s the American people who suffer.”
Polls still show the public trusts Fauci more than Trump for accurate information on the virus, with Democrats more likely than Republicans to believe the infectious diseases expert.
White House press secretary Kayleigh McEnany during a “Fox & Friends” interview Monday insisted Fauci’s recommendations were reaching Trump, while saying he represented only “one viewpoint” among many considered by the president.
“The point of the task force is to be a whole of government look at what is best for this country,” McEnany said when asked about the status of the relationship between Trump and Fauci. “Dr. Fauci is one member of a team, but rest assured, his viewpoint is represented and the information gets to the president through the task force.”
Still, Fauci’s public appearances became few and far between as his dire warnings about the state of the pandemic in the U.S. increasingly clashed from more hopeful messages coming from the White House.
Fauci also told the Financial Times last week that he hadn’t briefed Trump in two months, in which time a growing number of states have experienced significant surges in cases.
Fauci was not present at the White House coronavirus task force media briefing last week, events that have become rarer even as the COVID crisis grows worse.
And while he was a regular on cable news in the early days of the pandemic, his appearances have dwindled, a fact he said last week could be because of his “honesty.”
While Fauci has warned that the U.S. could hit 100,000 new COVID-19 cases per day if steps aren’t taken to alter the trajectory of the outbreaks, Trump has tied the rise in cases to increased testing.
While Fauci attributed outbreaks in some states to reopening too quickly after the spring lockdowns, Trump and his top allies have mostly stood by their decision to push governors to jump over checkpoints set by the White House.
Fauci has refuted the president’s claims that the rise in cases is solely tied to increased testing and that 99 percent of cases are “totally harmless.”
And as Trump touted a falling COVID-19 death rate, which is actually now increasing, Fauci has said the U.S. shouldn’t take comfort in the “false narrative,” noting the disease can cause other severe health outcomes.
Fauci’s warnings grew more urgent last week when he warned that the U.S. is “facing a serious problem” and the pandemic has become politicized.
“And you know from experience historically that when you don’t have unanimity in an approach to something, you’re not as effective in how you handle it,” Fauci said in an interview with FiveThirtyEight. “So I think you’d have to make the assumption that if there wasn’t such divisiveness, that we would have a more coordinated approach.”
https://www.axios.com/coronavirus-losing-war-b36632fb-33b0-4cb0-84b2-14000841d89c.html
By any standard, no matter how you look at it, the U.S. is losing its war against the coronavirus.
Why it matters: The pandemic is not an abstraction, and it is not something that’s simmering in the background. It is an ongoing emergency ravaging nearly the entire country, with a loss of life equivalent to a Sept. 11 every three days — for four months and counting.
The big picture: “The part that really baffles me is the complete lack of interest in doing anything to achieve the goals we all agree on,” said Ashish Jha, the director of the Global Health Institute at Harvard.
Seven times over the last two weeks, the U.S. has set a new record for the most cases in a single day. Cases are increasing in 33 states, and several of those states are seeing such staggering increases that they may soon overwhelm their hospitals.
Yes, but: Public health experts say they’re optimistic that we’ll get our act together.
It’s true — and it’s good — that the percentage of all coronavirus patients who die seems to be falling. And experts hope that will hold, as the pool of infected people is skewing younger.
What’s next: The optimistic view is that the pandemic just had to get worse before it gets better — that people outside of the New York region may not have taken it seriously enough in the early days when it was concentrated there, but that they will now.
The bottom line: “I think there’s a lot we can still do to turn around, and i’m still hopeful we are going to get more leadership to fight this thing,” Jha said. “I think we’re going to have to relearn the lessons of March and April and New York, without the ability to say, ‘Oh that was just New York.’ “It’s going to be a painful summer.”
The coronavirus is spreading at ever-faster rates in a broad array of states, putting the U.S. on the precipice of an explosion of illness that threatens to overwhelm the nation’s health care system.
The painful economic lockdowns imposed in March gave the country time to flatten the epidemiological curve and contain the virus. But that window of opportunity, which came at great economic cost, is quickly slamming shut. Health experts say all signs point to a deadly summer and fall unless government leaders implement a much more robust national strategy.
The breadth of the spread is staggering. Forty-three states have seen the number of cases confirmed on an average day increase in the last two weeks. The number of patients in hospitals has risen over the same period in 29 states. More than 80 percent of intensive care beds are occupied in Alabama, Arizona and Georgia.
The same models that predicted surges in Phoenix, Houston and Miami now show a new and broader round of cities as the likely next epicenters. The number of confirmed cases is likely to rise substantially in places like Atlanta, Kansas City, Mo., Tulsa, Okla., and Greenville, S.C.
The virus also appears to be traveling north along the I-95 corridor. Cities like Philadelphia and Baltimore, which struggled through earlier peaks of viral transmission, are now seeing early signs of a second wave. Transmissions even appear to be rising in New York City.
On the other side of the country, outbreaks in California have grown to unprecedented proportions. The Golden State is now averaging more than 7,900 new cases a day, substantially more than its seven-day average just two weeks ago.
Public health experts warn that the U.S. has only a fleeting window in which to wrestle the virus back under some form of control. Without a stronger national response, including restrictions on large gatherings and requirements that people wear masks in public, the risk of a second peak could bring new lockdowns and more economic harm, derail the beginning of the new school year and even overwhelm local health systems.
“Our projections show that without immediate actions to significantly reduce travel and social distancing nationwide, this virus will not only threaten our ability to reopen schools in the coming weeks, but our capacity to care for the sickest individuals,” said David Rubin, director of PolicyLab at the Children’s Hospital of Philadelphia whose models forecast higher case counts.
More than 3.1 million Americans have tested positive for the virus, though the Centers for Disease Control and Prevention estimate that as many as 25 million people in the U.S. may have contracted it. More than 133,000 people have died, almost twice as many victims as in Brazil, the second-hardest hit country.
Cities that successfully avoided early explosions of cases are now in the crosshairs after the loosening of restrictions in some states and regions that helped avoid what studies have suggested would have been tens of millions of infections.
“I would be lying if I didn’t say I was concerned,” Kansas City, Mo., Mayor Quintin Lucas said in an interview. “We have looked at the trends out of Texas, Arizona and Florida. Those states kind of reflect the political choices that were made statewide in Missouri, and that does give us concern.”
The Kansas City metropolitan area has confirmed more than 10,000 coronavirus cases. The PolicyLab model shows Jackson County, Mo., is likely to experience more than 200 new cases every day by the beginning of August.
Rubin warned that smaller cities are likely to experience significant outbreaks in the coming weeks, potentially straining health systems that are not as prepared to handle a high volume of patients in need of intensive care. College towns like South Bend, Ind., and Tuscaloosa, Ala., are beginning to see case counts rise even with most students gone.
“We’re starting to see a mild uptick,” said James Mueller, South Bend’s mayor. “We’re in a much better position now than we were for the first increase or the first peak.”
At other levels of government, some who have sought to downplay the severity of the American outbreak have pointed to an increasing number of tests being conducted across the country, which they say will naturally lead to identification of those who have only minor symptoms or asymptomatic cases. But the number of cases is rising faster than would be accounted for by the increase in testing; the share of tests coming back positive is rising in 38 states.
More than a quarter of tests conducted in Arizona are coming back positive, according to state data. More than 15 percent of tests are coming back positive in Alabama, Florida, Mississippi, South Carolina and Texas.
Governors in 23 states have ordered residents to wear masks in public, though President Trump has refused to order a nationwide mask mandate. Trump has instead focused on reopening the economy, insisting that schools operate as normal in the months before he faces voters in November.
But public health experts argue action is needed now to avoid a second peak of tsunami-like proportions.
“We never gave communities a real chance at success as we lacked a national strategy around masking and limiting gathering sizes to act as a buffer as places reopened,” Rubin and his colleagues Gregory Tasian and Jing Huang wrote.
“So, do we admit that we’ve failed and try to salvage the reopening of our schools in fall by quickly enacting a national approach to pause all reopenings and try to get our country back onto stable footing?” he asked. “It may not be what people want to hear, but the situation is that dire that we need to consider this.”
HENRY KOTULA 