Category Archives: Infectious Virus

Nurses Die, Doctors Fall Sick and Panic Rises on Virus Front Lines

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Nurses Die, Doctors Fall Sick and Panic Rises on Virus Front Lines ...

The pandemic has begun to sweep through New York City’s medical ranks, and anxiety is growing among normally dispassionate medical professionals.

A supervisor urged surgeons at Columbia University Irving Medical Center in Manhattan to volunteer for the front lines because half the intensive-care staff had already been sickened by coronavirus.

“ICU is EXPLODING,” she wrote in an email.

A doctor at Weill Cornell Medical Center in Manhattan described the unnerving experience of walking daily past an intubated, critically ill colleague in her 30s, wondering who would be next.

Another doctor at a major New York City hospital described it as “a petri dish,” where more than 200 workers had fallen sick.

Two nurses in city hospitals have died.

The coronavirus pandemic, which has infected more than 30,000 people in New York City, is beginning to take a toll on those who are most needed to combat it: the doctors, nurses and other workers at hospitals and clinics. In emergency rooms and intensive care units, typically dispassionate medical professionals are feeling panicked as increasing numbers of colleagues get sick.

“I feel like we’re all just being sent to slaughter,” said Thomas Riley, a nurse at Jacobi Medical Center in the Bronx, who has contracted the virus, along with his husband.

Medical workers are still showing up day after day to face overflowing emergency rooms, earning them praise as heroes. Thousands of volunteers have signed up to join their colleagues.

But doctors and nurses said they can look overseas for a dark glimpse of the risk they are facing, especially when protective gear has been in short supply.

In China, more than 3,000 doctors were infected, nearly half of them in Wuhan, where the pandemic began, according to Chinese government statistics. Li Wenliang, the Chinese doctor who first tried to raise the alarm about Covid-19, eventually died of it.

In Italy, the number of infected heath care workers is now twice the Chinese total, and the National Federation of Orders of Surgeons and Dentists has compiled a list of 50 who have died. Nearly 14 percent of Spain’s confirmed coronavirus cases are medical professionals.

New York City’s health care system is sprawling and disjointed, making precise infection rates among medical workers difficult to calculate. A spokesman for the Health and Hospitals Corporation, which runs New York City’s public hospitals, said the agency would not share data about sick medical workers “at this time.”

William P. Jaquis, president of the American College of Emergency Physicians, said the situation across the country was too fluid to begin tracking such data, but he said he expected the danger to intensify.

“Doctors are getting sick everywhere,” he said.

Last week, two nurses in New York, including Kious Kelly, a 48-year-old assistant nurse manager at Mount Sinai West, died from the disease; they are believed to be the first known victims among the city’s medical workers. Health care workers across the city said they feared many more would follow.

Mr. Riley, the nurse at Jacobi, said when he looked at the emergency room recently, he realized he and his colleagues would never avoid being infected. Patients struggling to breathe with lungs that sounded like sandpaper had crowded the hospital. Masks and protective gowns were in short supply.

“I’m swimming in this,” he said he thought. “I’m pretty sure I’m getting this.”

His symptoms began with a cough, then a fever, then nausea and diarrhea. Days later, his husband became ill. Mr. Riley said both he and his husband appear to be getting better, but are still experiencing symptoms.

Like generals steadying their troops before battle, hospital supervisors in New York have had to rally, cajole and sometimes threaten workers.

“Our health care systems are at war with a pandemic virus,” Craig R. Smith, the surgeon-in-chief at NewYork-Presbyterian Hospital, wrote in an email to staff on March 16, the day after New York City shut down its school system to contain the virus. “You are expected to keep fighting with whatever weapons you’re capable of working.”

“Sick is relative,” he wrote, adding that workers would not even be tested for the virus unless they were “unequivocally exposed and symptomatic to the point of needing admission to the hospital.”

“That means you come to work,” he wrote. “Period.”

Arriving to work each day, doctors and nurses are met with confusion and chaos.

At a branch of the Montefiore hospital system in the Bronx, nurses wear their winter coats in an unheated tent set up to triage patients with symptoms, while at Elmhurst Hospital Center in Queens, patients are sometimes dying before they can be moved into beds.

The inviolable rules that once gave a sense of rhythm and harmony to even the busiest emergency rooms have in some cases been cast aside. Few things have caused more anxiety than shifting protocols meant to preserve a dwindling supply of protective gear.

When the pandemic first hit New York, medical workers changed gowns and masks each time they visited an infected patient. Then, they were told to keep their protective gear on until the end of their shift. As supplies became even more scarce, one doctor working on an intensive care unit said he was asked to turn in his mask and face shield at the end of his shift to be sterilized for future use. Others are being told to store their masks in a paper bag between shifts.

“It puts us in danger, it puts our patients in danger. I can’t believe in the United States that’s what’s happening,” said Kelley Cabrera, an emergency room nurse at Jacobi Medical Center.

An emergency room doctor at Long Island Jewish Medical Center put it more bluntly: “It’s literally, wash your hands a lot, cross your fingers, pray.”

Doctors and nurses fear they could be transmitting the virus to their patients, compounding the crisis by transforming hospitals into incubators for the virus. That has happened in Italy, in part because infected doctors struggle through their shifts, according to an article published by physicians at a hospital in Bergamo, a city in one of the hardest-hit regions.

Frontline hospital workers in New York are now required to take their temperature every 12 hours, though many doctors and nurses fear they could contract the disease and spread it to patients before they become symptomatic.

They also say it is a challenge to know when to come back to work after being sick. All medical workers who show symptoms, even if they are not tested, must quarantine for at least seven days and must be asymptomatic for three days before coming back to work.

But some employers have been more demanding than others, workers said.

Lillian Udell, a nurse at Lincoln Medical Center, another public hospital in the Bronx, said she was still weak and experiencing symptoms when she was pressured to return to work. She powered through a long shift that was so chaotic she could not remember how many patients she attended. By the time she returned home, the chills and the cough had returned.

“I knew it was still in me,” she said. “I knew I wasn’t myself.”

Christopher Miller, a spokesman for the Health and Hospitals Corporation, said the agency could not comment on Ms. Udell’s claim, but said its hospitals had “never asked health care workers who are sick and have symptoms of Covid-19 to continue to work or to come back to work.”

There is also the fear of bringing the disease home to spouses and children. Some medical workers said they were sleeping in different rooms from their partners and even wearing surgical masks at home. Others have chosen to isolate themselves from their families completely, sending spouses and children to live outside the city, or moving into hotels.

“I come home, I strip naked, put clothes in a bag and put them in the washer and take a shower,” one New York City doctor at a large public hospital said.

Because the pathogen has spread so widely, even medical workers not assigned directly to work with infected patients risk contracting the disease.

A gynecologist who works for the Mount Sinai hospital system said she had begun seeing women in labor who were positive for the coronavirus. Because she is not considered a front-line worker, she said, restrictions on protective gear are even more stringent than on Covid-19 units. She said she was not aware of any patients who had tested positive after contact with doctors or nurses, but felt it was only a matter of time.

“We’re definitely contaminating pregnant mothers that we’re assessing and possibly discharging home,” said the doctor, who spoke on condition on anonymity because her hospital had not authorized her to speak.

Mount Sinai said in a statement that it had faced equipment shortages like other hospitals, but added the issues had been solved in part by a large shipment of masks that arrived from China over the weekend. The hospital “moved mountains” to get the shipment, the statement said.

This week, the Health and Hospitals Corporation recommended transferring doctors and nurses at higher risk of infection — such as those who are older or with underlying medical conditions — from jobs interacting with patients to more administrative positions.

But Kimberly Marsh, a nurse at Westchester Medical Center outside New York City, said she has no intention of leaving the fight, even though she is a 53-year-old smoker with multiple sclerosis and on a medication that warns against getting near people with infections.

“It almost feels selfish,” she said, though she acknowledged that with two years before retirement she could not afford leave if she wanted to.

Even so, she said, the fear is palpable each time she steps into the emergency room. A nurse on her unit has already contracted the virus and one doctor is so scared he affixes an N95 mask to his face with tape at the beginning of each shift. Ms. Marsh said she sweats profusely in her protective gear because she is going through menopause and suffers from hot flashes.

“We all think we’re screwed,” she said. “I know without any doubt that I’m going to lose colleagues. There’s just no way around it.”

 

 

 

Philadelphia Hospital to Stay Closed After Owner Requests Nearly $1 Million a Month

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Philadelphia Hospital to Stay Closed After Owner Requests Nearly ...

Hahnemann University Hospital could hold 500 patients with the coronavirus. But city officials said the cost was too steep.

A hospital with room for nearly 500 beds has been closed for months in the center of Philadelphia, a city bracing for the spread of the coronavirus and a crush of sick patients.

But the facility will remain empty, city officials said, because they cannot accept the owner’s offer: buy the hospital or lease it for almost $1 million a month, including utilities and other costs.

“We don’t have the need to own it nor the resources to buy it. So we are done and we are moving on,” Mayor Jim Kenney told reporters on Thursday during the city’s daily briefing.

The next day, he said that Temple University would let the city use a music and sports venue for free. The city would no longer pursue the closed facility, Hahnemann University Hospital.

The abrupt end of the dispute underscored the frantic search for more hospital beds as cities try to prepare for a crisis that is overwhelming medical facilities in New York, and highlighted the tensions between government officials and businesses in responding to the pandemic. This week, the Trump administration backed away from announcing a $1 billion deal with General Motors and Ventec Life Systems to produce ventilators, after officials said they needed more time to assess the estimated cost.

In Philadelphia, coronavirus infections are quickly rising. On Friday, the city health commissioner, Dr. Thomas Farley, reported 154 new cases, for a total of 637 cases across every ZIP code of the city, and three deaths. “This virus is everywhere in Philadelphia,” he said.

The owner of the hospital, Joel Freedman of Broad Street Healthcare Properties, a real estate company, said he had offered to sell the facility to the city well below market price, or to lease it for $60 a bed a day, far less than what two other hospitals in California agreed to charge to lease their facilities.

“Anyone looking at the apples-to-apples comparison can see that Mr. Freedman not only desired to be helpful to the city of Philadelphia and its leaders, but he was very reasonable,” said Sam Singer, a spokesman for Mr. Freedman, who is based in Los Angeles. “We’re disappointed that they didn’t accept what we offered, but we stand ready to be helpful to the city or the state if they want to reopen discussions.”

Hahnemann Hospital, which once served the city’s poorest patients, closed in September 2019. The hospital had been suffering millions of dollars in losses a month, Mr. Freedman told The Philadelphia Business Journal last June.

“We relentlessly pursued numerous strategic options to keep Hahnemann in operation, and have been uncompromising in our commitment to our staff, patients and community,” Mr. Freedman said at the time. “We are faced with the heartbreaking reality that Hahnemann cannot continue to lose millions of dollars each month and remain in business.”

The decision to close the hospital last year infuriated local leaders and led Senator Bernie Sanders, the Vermont independent running to be the Democratic nominee for president, to hold a rally outside the hospital. He described the closure as a consequence of greed, and an example of the need for a better health care system.

Mr. Singer said Mr. Freedman had been unfairly maligned throughout the recent dispute, and that his obligations included maintenance, compensating his staff and paying off the loan he took out to buy the property.

“They’ve wrongly been critical of Mr. Freedman,” Mr. Singer said of his detractors. “We understand that emotions are high. We don’t want in any way to hold that against them.”

He added, “Even with those harsh words, our doors, our ears, our minds are still open. We want to help.”

Since last fall, the hospital has sat empty and fallen into disrepair, Mayor Kenney said on Thursday. “It has no beds and would require extensive work to make it usable again,” he said.

Mr. Kenney said the city had offered to lease the hospital for a “nominal” amount and pay for its maintenance and expenses, a deal that would have meant “hundreds of thousands of dollars a month” for Mr. Freedman and made the property more marketable in the future.

“Yet the owner would not agree to our offer,” he said.

Instead, Mr. Freedman wanted the city to pay $400,000 a month in rent in addition to making improvements and paying for other expenses, Mr. Kenney said. “I’ll let others decide whether that’s reasonable or not,” Mr. Kenney said.

Mr. Singer said the city contacted Mr. Freedman around March 11 about leasing the property. “We responded immediately and said, ‘Yes, we would like to help in any manner,’” he said.

Mr. Freedman offered to sell the property below market price or lease it for $27 a bed a day. The city would have to pay an additional $33 a bed a day to cover the costs of utilities and taxes, he said. The full amount came to about $910,000 a month, Mr. Singer said.

“They just decided, ‘We’re not going to pursue Hahnemann,’” he said.

City officials had signaled that negotiations were breaking down earlier this week. On Tuesday, the city’s managing director, Brian Abernathy, told reporters that what Mr. Freedman wanted was “unreasonable.”

“I think he’s looking at this as a business transaction rather than providing an imminent and important aid to the city and our residents,” Mr. Abernathy said.

City Councilor Helen Gym said on Twitter that day that Philadelphia should not let “unconscionable greed to get in the way of saving lives,” and called for acquiring the property through eminent domain. Mr. Kenny said city officials had explored that option but determined it was too time-consuming and would require them to purchase the building at market price.

Mr. Kenney said in a news conference Friday that the city would use the Liacouras Center, a concert and sports venue at Temple University, for additional hospital space. The university will let the center be used for free and the space can fit up to 250 beds, officials said.

 

 

 

The Lost Month: How a Failure to Test Blinded the U.S. to Covid-19

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Coronavirus, Crisis, Crisis Management, Emergency Preparedness, Health Policy, Honesty, Infection Control, Infectious Virus, Integrity, Leadership, Pandemic, Public Health, Public Safety, Social Distancing, Trust, Truth, Ventilators • Leave a comment

The Lost Month: How a Failure to Test Blinded the U.S. to Covid-19 ...

Aggressive screening might have helped contain the virus in the United States. But technical flaws, regulatory hurdles and lapses in leadership let it spread undetected for weeks.

Early on, the dozen federal officials charged with defending America against the coronavirus gathered day after day in the White House Situation Room, consumed by crises. They grappled with how to evacuate the United States consulate in Wuhan, China, ban Chinese travelers and extract Americans from the Diamond Princess and other cruise ships.

The members of the coronavirus task force typically devoted only five or 10 minutes, often at the end of contentious meetings, to talk about testing, several participants recalled. The Centers for Disease Control and Prevention, its leaders assured the others, had developed a diagnostic model that would be rolled out quickly as a first step.

But as the deadly virus spread from China with ferocity across the United States between late January and early March, large-scale testing of people who might have been infected did not happen — because of technical flaws, regulatory hurdles, business-as-usual bureaucracies and lack of leadership at multiple levels, according to interviews with more than 50 current and former public health officials, administration officials, senior scientists and company executives.

The result was a lost month, when the world’s richest country — armed with some of the most highly trained scientists and infectious disease specialists — squandered its best chance of containing the virus’s spread. Instead, Americans were left largely blind to the scale of a looming public health catastrophe.

The absence of robust screening until it was “far too late” revealed failures across the government, said Dr. Thomas Frieden, the former C.D.C. director. Jennifer Nuzzo, an epidemiologist at Johns Hopkins, said the Trump administration had “incredibly limited” views of the pathogen’s potential impact. Dr. Margaret Hamburg, the former commissioner of the Food and Drug Administration, said the lapse enabled “exponential growth of cases.”

And Dr. Anthony S. Fauci, a top government scientist involved in the fight against the virus, told members of Congress that the early inability to test was “a failing” of the administration’s response to a deadly, global pandemic. “Why,” he asked later in a magazine interview, “were we not able to mobilize on a broader scale?”

Across the government, they said, three agencies responsible for detecting and combating threats like the coronavirus failed to prepare quickly enough. Even as scientists looked at China and sounded alarms, none of the agencies’ directors conveyed the urgency required to spur a no-holds-barred defense.

Dr. Robert R. Redfield, 68, a former military doctor and prominent AIDS researcher who directs the C.D.C., trusted his veteran scientists to create the world’s most precise test for the coronavirus and share it with state laboratories. When flaws in the test became apparent in February, he promised a quick fix, though it took weeks to settle on a solution.

The C.D.C. also tightly restricted who could get tested and was slow to conduct “community-based surveillance,” a standard screening practice to detect the virus’s reach. Had the United States been able to track its earliest movements and identify hidden hot spots, local quarantines might have confined the disease.

Dr. Stephen Hahn, 60, the commissioner of the Food and Drug Administration, enforced regulations that paradoxically made it tougher for hospitals, private clinics and companies to deploy diagnostic tests in an emergency. Other countries that had mobilized businesses were performing tens of thousands of tests daily, compared with fewer than 100 on average in the United States, frustrating local health officials, lawmakers and desperate Americans.

Alex M. Azar II, who led the Department of Health and Human Services, oversaw the two other agencies and coordinated the government’s public health response to the pandemic. While he grew frustrated as public criticism over the testing issues intensified, he was unable to push either agency to speed up or change course.

Mr. Azar, 52, who chaired the coronavirus task force until late February, when Vice President Mike Pence took charge, had been at odds for months with the White House over other issues. The task force’s chief liaison to the president was Mick Mulvaney, the acting White House chief of staff, who was being forced out by Mr. Trump. Without high-level interest — or demands for action — the testing issue festered.

At the start of that crucial lost month, when his government could have rallied, the president was distracted by impeachment and dismissive of the threat to the public’s health or the nation’s economy. By the end of the month, Mr. Trump claimed the virus was about to dissipate in the United States, saying: “It’s going to disappear. One day — it’s like a miracle — it will disappear.”

By early March, after federal officials finally announced changes to expand testing, it was too late. With the early lapses, containment was no longer an option. The tool kit of epidemiology would shift — lockdowns, social disruption, intensive medical treatment — in hopes of mitigating the harm.

Now, the United States has more than 100,000 coronavirus cases, the most of any country in the world. Deaths are rising, cities are shuttered, the economy is sputtering and everyday life is upended. And still, many Americans sickened by the virus cannot get tested.

In a statement, Judd Deere, a White House spokesman, said that “any suggestion that President Trump did not take the threat of Covid-19 seriously or that the United States was not prepared is false.” He added that at Mr. Trump’s direction, the administration had “expanded testing capacities.”

Dr. Bruce Aylward, a senior adviser at the World Health Organization, led an expert team to China last month to research the mysterious new virus. Testing, he said, was “absolutely vital” for understanding how to defeat a disease — what distinguishes it from others, the spectrum of illness and, most important, its path through populations.

“You want to know whether or not you have it,” Dr. Aylward said. “You want to know whether the people around you have it. Because you know what? Then you could stop it.”

“You can’t stop it,” he warned, “if you can’t see it.”

The first time Dr. Robert Redfield heard about the severity of the virus from his Chinese counterparts was around New Year’s Day, when he was on vacation with his family. He spent so much time on the phone that they barely saw him. And what he heard rattled him; in one grim conversation about the virus days later, George F. Gao, the director of the Chinese Center for Disease Control and Prevention, burst into tears.

Dr. Redfield, a longtime AIDS researcher, had never run a government agency before his appointment to lead the C.D.C. in 2018. Until then, his biggest priorities had been fighting the opioid epidemic and the spread of H.I.V. Suddenly, a man who preferred treating patients in Haiti or Africa to being in the public glare was facing a new pandemic threat.

At first, Dr. Redfield’s agency moved quickly.

On Jan. 7, the C.D.C. created an “incident management system” for the coronavirus and advised travelers to Wuhan to take precautions. By Jan. 20, just two weeks after Chinese scientists shared the genetic sequence of the virus, the C.D.C. had developed its own test, as usual, and deployed it to detect the country’s first coronavirus case.

“That’s our prime mission,” Dr. Redfield said later in an interview, “to get eyes on this thing.”

Assessing the virus would prove challenging. It was so new that scientists had little information to work with. China provided limited data, and rebuffed an early attempt by Mr. Azar and Dr. Redfield to send C.D.C. experts there to learn more. That the virus could cause no symptoms and still spread — something not initially known — made it all the more difficult to understand.

To identify the virus, the C.D.C. test used three small genetic sequences to match up with portions of a virus’s genome extracted from a swab. A German-developed test that the W.H.O. was distributing to other countries used just two, potentially making it less precise.

But soon after the F.D.A. cleared the C.D.C. to share its test kits with state health department labs, some discovered a problem. The third sequence, or “probe,” gave inconclusive results. While the C.D.C. explored the cause — contamination or a design issue — it told those state labs to stop testing.

The startling setback stalled the C.D.C.’s efforts to track the virus when it mattered most. By mid-February, the nation was testing only about 100 samples per day, according to the C.D.C.’s website.

Dr. Redfield played down the problem in task force meetings and conversations with Mr. Azar, assuring him it would be fixed quickly, several administration officials said.

With capacity so limited, the C.D.C.’s criteria for who was tested remained extremely narrow for weeks to come: only people who had recently traveled to China or had been in contact with someone who had the virus.

The lack of tests in the states also meant local public health officials could not use another essential epidemiological tool: surveillance testing. To see where the virus might be hiding, nasal swab samples from people screened for the common flu would also be checked for the coronavirus.

The C.D.C. announced a plan on Feb. 14 to perform the screening in five high-risk cities: New York, Chicago, Los Angeles, San Francisco and Seattle. An agency official said it could provide “an early warning signal to trigger a change in our response strategy.” But most of the cities could not carry it out.

“Had we had done more testing from the very beginning and caught cases earlier,” said Dr. Nuzzo, of Johns Hopkins, “we would be in a far different place.”

The consequences became clear by the end of February. For the first time, someone with no known exposure to the virus or history of travel tested positive, in the Seattle area, where the U.S.’s first case had been detected more than a month earlier. The virus had probably been spreading there and elsewhere for weeks, researchers later concluded. Without a more complete picture of who had been infected, public health workers could not do “contact tracing” — finding all those with whom any contagious people had interacted and then quarantining them to stop further transmission.

The C.D.C. gave little thought to adopting the test being used by the W.H.O. The C.D.C.’s test was working in its own lab — still processing samples from states — which gave agency officials confidence. Dr. Anne Schuchat, the agency’s principal deputy director, would later say that the C.D.C. did not think “we needed somebody else’s test.”

And the German-designed W.H.O. test had not been through the American regulatory approval process, which would take time.

Throughout February, Dr. Redfield shuttled between Atlanta, where the C.D.C. is based, and Washington, holding multiple calls every day with Mr. Azar and participating in the coronavirus task force.

Mr. Azar’s take-charge style contrasted with the more deliberative manner of Dr. Redfield, who lacked the kind of commanding television presence that impressed Mr. Trump. He was “a consensus person,” as one colleague described him, who sought to avoid conflict. He relied heavily on some of the C.D.C.’s career scientists, like Dr. Schuchat and Dr. Nancy Messonnier, the director of the agency’s National Center for Immunization and Respiratory Diseases.

Under scrutiny from Congress, Dr. Redfield offered reassurances. Responding on Feb. 24 to a letter from 49 members of Congress about the need for testing in the states, he wrote, “CDC’s aggressive response enables us to identify potential cases early and make sure that they are properly handled.”

Days later, his agency provided a workaround, telling state and local health department labs that they could finally begin testing. Rather than awaiting replacements, they should use their C.D.C. test kits and leave out the problematic third probe.

Meanwhile, the agency’s epidemiologists were growing more concerned as the virus spread in South Korea and Italy. On Feb. 25, Dr. Messonnier gave a briefing with a much blunter warning than usual. “Disruption to everyday life might be severe,” she said.

Mr. Trump, returning from a trip to India, was furious, according to senior administration officials. Later that day, Mr. Azar seemed to be tamping down the level of concern. All Dr. Messonnier had meant, he said at a news conference, was that people should “start thinking about, in their own lives, what that might involve.”

“Might,” Mr. Azar repeated emphatically. “Might involve.”

Dr. Stephen Hahn’s first day as F.D.A. commissioner came just six weeks before Mr. Azar declared a public health emergency on Jan. 31. A radiation oncologist and researcher who helped turn around MD Anderson in Houston, one of the nation’s leading cancer centers, Dr. Hahn had come to Washington to oversee a sprawling federal agency that regulates everything from lifesaving therapies to dog food.

But overnight, his mission — to manage 15,000 employees in a culture defined by precision and caution — was upended. A pathogen that Mr. Trump would later call the “invisible enemy” was hurtling toward the United States. It would fall to the newly arrived Dr. Hahn to help build a huge national capacity for testing by academic and private labs.

Instead, under his leadership, the F.D.A. became a significant roadblock, according to current and former officials as well as researchers and doctors at laboratories around the country.

Private-sector tests were supposed to be the next tier after the C.D.C. fulfilled its obligation to jump-start screening at public labs. In other countries hit hard by the coronavirus, governments acted quickly to speed tests to their populations. In South Korea, for example, regulators in early February summoned executives from 20 medical manufacturers, easing rules as they demanded tests.

But Dr. Hahn took a cautious approach. He was not proactive in reaching out to manufacturers, and instead deferred to his scientists, following the F.D.A.’s often cumbersome methods for approving medical screening.

Even the nation’s public health labs were looking for the F.D.A.’s help. “We are now many weeks into the response with still no diagnostic or surveillance test available outside of C.D.C. for the vast majority of our member laboratories,” Scott Becker, chief executive of the Association of Public Health Laboratories, wrote to Mr. Hahn in late February. “We believe a more expeditious route is needed at this time.”

Ironically, it was Mr. Azar’s emergency declaration that established the rules Dr. Hahn insisted on following. Designed to make it easier for drugmakers to pursue vaccines and other therapies during a crisis, such a declaration lets the F.D.A. speed approvals that could otherwise take a year or more.

But the emergency announcement created a new barrier for hospitals and laboratories that wanted to create their own tests to diagnose the coronavirus. Usually, they faced minimal federal regulation. But once Mr. Azar took action, they were subject to an F.D.A. process called an “emergency use authorization.”

Even though researchers around the country quickly began creating tests that could diagnose Covid-19, many said they were hindered by the F.D.A.’s approval process. The new tests sat unused at labs around the country.

Stanford was one of them. Researchers at the world-renowned university had a working test by February, based on protocols published by the W.H.O. The organization had already delivered more than 250,000 of the German-designed tests to 70 laboratories around the world, and doctors at the Stanford lab wanted to be prepared for a pandemic.

“Even if it didn’t come, it would be better to be ready than not to be ready,” said Dr. Benjamin Pinsky, the lab’s medical director.

But in the face of what he called “relatively tight” rules at the F.D.A., Dr. Pinsky and his colleagues decided against even trying to win permission. The Stanford clinical lab would not begin testing coronavirus samples until early March, when Dr. Hahn finally relaxed the rules.

Executives at bioMérieux, a French diagnostics company, had a similar experience. The company makes a countertop testing system, BioFire, that is routinely used to check for the flu and other respiratory illnesses in 1,700 hospitals around the country. It can provide results in about 45 minutes.

“A lot of us said, you know, your typical E.U.A. is just much too demanding,” said Dr. Mark Miller, the company’s chief medical officer, referring to the emergency approval. “It’s going to take much too much time. And can’t you do something to shorten that?”

Officials at the F.D.A. tried to be responsive, Dr. Miller said. But rather than throw out the rules, the agency only modified the regulatory requirements, still requiring weeks of discussions and negotiations.

After conversations with the F.D.A. in mid-February, the company received emergency approval for its BioFire test on March 24. (The company also began talking to the F.D.A. in January about another type of test, but decided not to pursue it in the United States for now.) Dr. Miller said that while he was ultimately satisfied with the F.D.A.’s actions, the overall response by the government was too slow, especially when it came to logistical questions like getting enough testing supplies to those who needed them.

“You’ve got other countries — and I’m sorry, unfortunately, the U.S. is one of those — where they’ve been slow, disorganized,” he said. “There are still not enough tests available there to test everybody who needs it.”

In an emailed statement, Dr. Hahn maintained that his agency had moved as quickly as it safely could to ensure that tests would be accurate. “Since the early days of this pandemic,” he said, “the F.D.A.’s doors have always been and still remain open to test developers.”

Alex Azar had sounded confident at the end of January. At a news conference in the hulking H.H.S. headquarters in Washington, he said he had the government’s response to the new coronavirus under control, pointing out high-ranking jobs he had held in the department during the 2003 SARS outbreak and other infectious threats.

“I know this playbook well,” he told reporters.

A Yale-trained lawyer who once served as the top attorney at the health department, Mr. Azar had spent a decade as a top executive at Eli Lilly, one of the world’s largest drug companies. But he caught Mr. Trump’s attention in part because of other credentials: After law school, Mr. Azar was a clerk for some of the nation’s most conservative judges, including Justice Antonin Scalia of the Supreme Court. And for two years, he worked as Ken Starr’s deputy on the Clinton Whitewater investigation.

As Mr. Trump’s second health secretary, confirmed at the beginning of 2018, Mr. Azar has been quick to compliment the president and focus on the issues he cares about: lowering drug prices and fighting opioid addiction. On Feb. 6 — even as the W.H.O. announced that there were more than 28,000 coronavirus cases around the globe — Mr. Azar was in the second row in the White House’s East Room, demonstrating his loyalty to the president as Mr. Trump claimed vindication from his impeachment acquittal the day before and lashed out at “evil” lawmakers and the F.B.I.’s “top scum.”

As public attention on the virus threat intensified in January and February, Mr. Azar grew increasingly frustrated about the harsh spotlight on his department and the leaders of agencies who reported to him, according to people familiar with the response to the virus inside the agencies.

Described as a prickly boss by some administration officials, Mr. Azar has had a longstanding feud with Seema Verma, the Medicare and Medicaid chief, who recently became a regular presence at Mr. Trump’s televised briefings on the pandemic. Mr. Azar did not include Dr. Hahn on the virus task force he led, though some of the F.D.A. commissioner’s aides participated in H.H.S. meetings on the subject.

And tensions grew between the secretary and Dr. Redfield as the testing issue persisted. Mr. Azar and Dr. Redfield have been on the phone as often as a half-dozen times a day. But throughout February, as the C.D.C. test faltered, Mr. Azar became convinced that Dr. Redfield’s agency was providing him with inaccurate information about testing that the secretary repeated publicly, according to several administration officials.

In one instance, Mr. Azar appeared on Sunday morning news programs and said that more than 3,600 people had been tested for the virus. In fact, the real number was much smaller because many patients were tested multiple times, an error the C.D.C. had to correct in congressional testimony that week. One health department official said Mr. Azar was repeatedly assured that the C.D.C.’s test would be widely available within a week or 10 days, only to be given the same promise a week later.

Asked about criticism of his agency’s response to the pandemic, Dr. Redfield said: “I’m personally not focused on whether they’re pointing fingers here or there. We’re focused on doing all we can to get through this outbreak as quickly as possible and keep America safe.”

For all Mr. Azar’s complaints, however, he continued to defer to the scientists at the two agencies, according to several administration officials. Mr. Azar’s allies said he was told by Dr. Redfield and Dr. Fauci that the C.D.C. had the resources it needed, that there was no reason to believe the virus was spreading through the country from person to person and that it was important to test only people who met certain criteria.

But even in the face of a crescendo of complaints from doctors and health care researchers around the country, Mr. Azar failed to push those under him to do the one thing that could have helped: broader testing.

In a statement, Caitlin Oakley, Mr. Azar’s spokeswoman, said that the secretary had “empowered and followed the guidance of world-renowned U.S. scientists” on the testing issue. “Any insinuation that Secretary Azar did not respond with needed urgency to the response or testing efforts,” she said, “are just plain wrong and disproven by the facts.”

By Feb. 26, Dr. Fauci was concerned that the stalled testing had become an urgent issue that needed to be addressed. He called Brian Harrison, Mr. Azar’s chief of staff, and asked him to gather the group of officials overseeing screening efforts.

Around noon on Feb. 27, Dr. Hahn, Dr. Redfield and top aides from the F.D.A. and H.H.S. dialed in to a conference call. Mr. Harrison began with an ultimatum: No one leaves until we resolve the lag in testing. We don’t have answers and we need them, one senior administration official recalled him saying. Get it done.

By the end of the day, the group agreed that the F.D.A. should loosen regulations so that hospitals and independent labs could move forward quickly with their own tests.

But the evening before, Mr. Azar had been effectively removed as the leader of the task force when Mr. Trump abruptly put Mr. Pence in charge, a decision so last-minute that even the top health officials in the White House learned of it while watching the announcement.

Previous presidents have moved quickly to confront disease threats from inside the White House by installing a “czar” to manage the effort.

During an outbreak of the Ebola virus in 2014, President Barack Obama tapped Ron Klain, his vice president’s former chief of staff, to direct the response from the West Wing. Mr. Obama later created an office of global health security inside the National Security Council to coordinate future crises.

“If you look historically in the United States when it is challenged with something like this — whether it’s H.I.V. crises, whether it’s pandemic, whether it’s whatever — man, they pull out all the stops across the system and they make it work,” said Dr. Aylward, the W.H.O. epidemiologist.

But faced with the coronavirus, Mr. Trump chose not to have the White House lead the planning until nearly two months after it began. Mr. Obama’s global health office had been disbanded a year earlier. And until Mr. Pence took charge, the task force lacked a single White House official with the power to compel action.

Since then, testing has ramped up quickly, with nearly 100 labs at hospitals and elsewhere performing it. On Friday, the health care giant Abbott said it had received emergency approval for a portable test that could detect the virus in five minutes.

The president boasted on Tuesday that the United States had “created a new system that now we are doing unbelievably big numbers” of tests for the virus. The U.S., he said, had done more testing for the coronavirus in the last eight days than South Korea had done in eight weeks.

Yet hospitals and clinics across the country still must deny tests to those with milder symptoms, trying to save them for the most serious cases, and they often wait a week for results. In tacit acknowledgment of the shortage, Mr. Trump asked South Korea’s president on Monday to send as many test kits as possible from the 100,000 produced there daily, more than the country needs.

Public health experts reacted positively to the increased capacity. But having the ability to diagnose the disease three months after it was first disclosed by China does little to address why the United States was unable to do so sooner, when it might have helped reduce the toll of the pandemic.

“Testing is the crack that split apart the rest of the response, when it should have tied everything together,” said Dr. Nahid Bhadelia, ​the medical director of the Special Pathogens Unit at Boston University School of Medicine.

“It seeps into every other aspect of our response, touches all of us,” she said. “The delay of the testing has impacted the response across the board.”

 

 

Public health expert: ‘We are still at the very beginning of this outbreak’

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Public health expert: 'We are still at the very beginning of this ...

Tom Inglesby, the director of the Johns Hopkins Center for Health Security, said on Sunday that the social-distancing measures taken in much of the U.S. to stem the spread of the novel coronavirus haven’t yet had time to fully take effect.

“We’re still at the very beginning of this outbreak,” Inglesby told Chris Wallace on “Fox News Sunday.” “We should expect it to continue for some time and focus on social distancing as one of the main interventions to stop it.”

Wallace asked Inglesby about the possibility of certain regions of the country with low case numbers reopening businesses and allowing public gatherings while maintaining restrictions longer in harder-hit areas.

Inglesby said such steps could be a possibility in the future, but not while numbers are still rising in just about every state across the country.

He added, “I don’t really have confidence that we really know where all the cases are,” and said more widespread testing and improved treatment ability is a prerequisite for lifting social distancing measures.

The U.S. last week became the country with the most coronavirus cases in the world. As of Sunday morning, it had recorded more than 124,000 cases, according to Johns Hopkins University.

Inglesby said the U.S. should look to other countries where aggressive measures have been successful in curbing the spread of COVID-19.

“What I think we need to do is really stick with what other countries who have had more success have done,” Inglesby said. “They’ve largely been in Asia, Singapore, Hong Kong, South Korea, China, Taiwan, and they have put in place social-distancing measures until they’ve gotten control of the epidemic convincingly and at that point begun to try experimenting with loosening it. And I do think we will get to that point.”

“But if we go back to work too quickly, this epidemic is going to spread widely and aggressively,” he added.

 

 

 

 

White House coronavirus coordinator: All governors and mayors need to ‘prepare like New York is preparing now’

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https://thehill.com/homenews/sunday-talk-shows/490052-white-house-coronavirus-coordinator-officials-are-asking-every

Deansboro, NY Coronavirus - News Break Deansboro, NY

The White House coronavirus task force coordinator said Sunday that the administration is “asking every single governor and every single mayor to prepare like New York is preparing now.”

Dr. Deborah Birx told NBC’s “Meet the Press” that state and city leaders need to know where each hospital in their jurisdiction is located, where the surgical centers are, where “every piece of equipment is in the state” and how to move equipment around the state “based on need.”

“So it’s not just what you have inside your doors today. It’s how you can surge and move things around,” she said. “We know this epidemic moves in waves. Each city will have its own epidemic curve. And so we can move between states, we can move within states, to meet the needs of everyone.”

But Birx emphasized that states and metro areas need to react because of the quickly increasing number of cases and deaths across the country.

“No state, no metro area will be spared, and the sooner we react and the sooner the states and the metro areas react and ensure that they put in full mitigation, at the same time understanding exactly what their hospitals need, then we’ll be able to move forward together and protect the most Americans,” she said.

Dr. Deborah Birx says “no metro area will be spared” of the coronavirus outbreak.

Dr. Birx: “The sooner we react and the sooner the states and the metro areas react and ensure that they have put in full mitigation … then we’ll be able to move forward.”

When NBC’s Chuck Todd questioned how states would go about obtaining new medical equipment, she said the federal government is “working very hard” to locate and place ventilators. 

“But we need states at the same time to look where all of their ventilators are, including outpatient surgical center,” she said.

New York Gov. Andrew Cuomo (D) has taken direct actions to combat the spread of the coronavirus initiating a stay-at-home order and working with the federal government to obtain more ventilators and temporary hospitals. The state has been hit hard by the pandemic with more than 52,300 cases and more than 880 deaths.

The president considered implementing a quarantine for New York’s tri-state area but ended up issuing a travel advisory for the area Saturday.

 

 

 

 

Fauci says US could have ‘millions’ of coronavirus cases and over 100,000 deaths

Posted on by • Posted in 2020 Election Issues, Coronavirus, Crisis, Crisis Management, Health Policy, Infection Control, Infectious Virus, Leadership, Pandemic, Public Health, Public Safety, Social Distancing, World Health Organization (WHO) • Leave a comment

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Fauci says coronavirus deaths in US could top 100,000 ...

Dr. Anthony Fauci, one of the faces of the Trump administration’s coronavirus task force, on Sunday warned that the novel coronavirus could infect millions of people in the United States and account for more than 100,000 deaths. 

Speaking on CNN’s “State of the Union,” Fauci said that, based on what he’s seeing, the U.S. could experience between 100,000 and 200,000 deaths from Covid-19.

“We’re going to have millions of cases,” Fauci, the head of the National Institute of Allergy and Infectious Diseases, said, noting that projections are subject to change, given that the disease’s outbreak is “such a moving target.”

The novel coronavirus, which first appeared in China in December, has infected more than 124,000 people in the U.S. and accounted for more than 2,000 deaths, according to a Johns Hopkins University database. The U.S. has reported the most confirmed cases of the virus worldwide.

Video of Dr. Fauci telling @jaketapper that “Looking at what we’re seeing now, I would say between 100,000 and 200,000 cases… excuse me, deaths. I mean, we’re going to have millions of cases.”

These next few weeks could be pretty rough.

The outbreak has upended everyday life, causing a mass closure of businesses and schools as federal and state officials enforce measures designed to slow the spread of the disease. Areas such as the New York metropolitan area have been hit particularly hard, producing concerns about a surge in patients overwhelming its health care system.

Fauci has continually called for social-distancing requirements to remain in place for an extended period of time. He said Sunday that lifting those restrictions would depend on the availability of testing kits that will be able to confirm a diagnosis within about 15 minutes.

“It’s going to be a matter of weeks. It’s not going to be tomorrow and it’s certainly not going to be next week,” he said.

Fauci added that he wanted to to see a substantial flattening of the curve in terms of cases before curbing social-distancing restrictions. 

“As I have said before, it’s true the virus itself determines that timetable. You can try and influence that timetable by mitigating against the virus, but, ultimately, it’s what the virus does,” he said.

 

 

 

 

Grocery workers are keeping Americans alive during the COVID-19 pandemic. Here’s what they need.

Posted on by • Posted in Centers for Disease Control & Prevention (CDC), Childcare, Coronavirus, Employee Benefits, Food Distribution, Hazard Pay, High Risk Employees, Human Resources, Infection Control, Infectious Virus, Labor Union, Pandemic, Personal Protective Equipment (PPE), Plexiglass Sneeze-Guard Barriers, Public Health, Public Safety, Sanitation, Sick Leave, Social Distancing, Supply Chain • Leave a comment

https://www.brookings.edu/blog/the-avenue/2020/03/25/grocery-workers-are-keeping-americans-alive-during-the-covid-19-pandemic-heres-what-they-need/?utm_campaign=Brookings%20Brief&utm_source=hs_email&utm_medium=email&utm_content=85335188

Grocery workers are keeping Americans alive during the COVID-19 ...

As worried Americans pack supermarket aisles in anticipation of quarantines and shelter-in-place orders, grocery workers like Courtney Meadows are working at a frantic pace to keep Americans fed and alive, and risking their own health in the process.

Meadows, a cashier at Kroger in Beckley, W.Va., said her store is the busiest she has seen it in 10 years on the job. “I have worked through snow scares, a blizzard, two derechos, holidays, anything that can impact a grocery store,” she told me. “This is the absolute worst I have seen it. It is a sea of people everywhere.”

Over the last week, I traveled to supermarkets across the Washington, D.C. region and interviewed workers from Virginia, Maryland, West Virginia and the District to hear—in their words—how COVID-19 is impacting them. These crowded stores I visited had few visible safeguards or protections for workers.

“We aren’t staying six feet away from the customers,” said Michelle Lee, a Safeway cashier in Alexandria, Va. “When we ring them up, they are like two feet away from us. We check out 200 customers a day. A doctor can wear a mask and protective gear. We don’t have all of that.”

Amber Stevens, a cashier at Shoppers in Prince George’s County, Md., expressed concern over social distancing as well. “I do still have a job to go to, but it isn’t helping me with social distancing because I am hands-on with customers,” she told me. “That is the scary part. Dealing with money, having to be so close to people.”

More than their own health, the grocery store employees I interviewed expressed the most concern about the safety of those around them: their loved ones at home, their elderly customers, their colleagues with underlying health conditions, and their neighbors in crowded apartment buildings. Several workers welled up with emotion as they described how hard it is to be unable to care for older relatives during the pandemic.

“All of that worry plus the stress of double the number of customers we normally have,” said Lisa Harris, a cashier at Kroger in Richmond, Va. “This isn’t just for one day. It is for weeks.”

As grocery workers put their lives on the line—often for low wages and few benefits—it is imperative that employers, policymakers, and even customers act with urgency to protect, support, and compensate them.

EMPLOYERS MUST KEEP GROCERY WORKERS HEALTHY

Employers need to implement immediate steps to reduce grocery workers’ exposure to COVID-19. First, employers should expand access to personal protective equipment (PPE) such as masks and gloves and end any restrictions on workers wearing them. While supplies of protective masks and gloves are extremely limited across the country, employers and policymakers should prioritize PPE for grocery workers as they become available. Employers should provide adequate cleaning supplies and hand sanitizer, regular opportunities for workers to wash their hands, and frequent equipment cleaning.

Second, stores should shorten hours and limit the number of customers at any given time. While several stores—including Trader Joe’s, Walmart, and Safeway—have limited store hours and introduced “senior only” hours, most stores are not following the CDC’s guidance of limiting gatherings to 50 people. Even tighter restrictions may be needed to keep workers safe as the virus spreads; for instance, some stores in China are checking customers’ temperatures before they enter the store.

Third, grocery stores should implement additional measures to protect workers and enforce safe spacing of customers. Albertsons, which owns Safeway and 19 other grocery chains, was the first major company to announce they will install plexiglass “sneeze-guard” barriers at checkouts in its 2,200 stores over the next two weeks. Walmart and Kroger have made similar commitments, and other grocery stores should follow.

Even in the absence of specific CDC guidelines for grocery workers, employers should act boldly and creatively to modify stores to keep workers safe, continuously adapt to evolving best practices, and respond to safety priorities identified by unions like the United Food and Commercial Workers International Union (UFCW), which represents over 1.2 million workers.

INCREASE COMPENSATION AND OFFER HAZARD PAY

The coronavirus pandemic has put a harsh spotlight on the low wages that grocery workers earn for their life-saving work. At Kroger, the country’s second-largest grocery chain with 453,000 workers, the average hourly wage of cashiers is just $9.94 per hour, according to estimates on Indeed.com.

Lisa Harris, a Kroger cashier, described the financial hardships she and her low-wage colleagues face: “I have coworkers who stand all day serving people, and then have to go pay for their own groceries with food stamps. I am very lucky that my boyfriend works in pizza because that is our survival food. If we can’t afford to buy food, he brings home a pizza.”

Even in “normal” times, grocery workers—like other service and low-wage workers—deserve better wages. In these extreme times, adequately compensating them is even more imperative. As grocery sales soar and their stock prices rise, employers should provide additional compensation and hazard pay to their workers on the front line.

“I think that some pay increase would be wonderful,” Kroger cashier Courtney Meadows told me. “I don’t think they understand the toll that comes through in our lives. They don’t see it. They don’t see the panic on people’s faces.”

In response to the pandemic, the two largest grocery employers, Kroger and Walmart, have offered workers one-time bonuses of $300. Responding to pressure from the UFCW, Safeway and Shoppers are now offering an additional $2 per hour of hazard pay, while Whole Foods and Target are also raising pay $2 per hour.

These pay increases are an important start, but they don’t go far enough. The raises should be permanent, and enough to provide a family-sustaining wage to workers.

ENSURE ACCESS TO HEALTH INSURANCE AND EXTEND PAID SICK LEAVE

Now more than ever, paid sick leave and health insurance are critical for grocery workers. Well before the COVID-19 pandemic, hundreds of thousands of grocery workers didn’t receive paid sick leave from their employers. Responding to public outrage and pressure from employees and unions, most large employers now have updated their sick leave policy to respond to COVID-19. However, their policies don’t go far enough: They are temporary, focus narrowly on COVID-19, and are insufficient to meet the needs of workers.

Companies including Safeway, Kroger, and Walmart are now offering 14 days paid sick leave for workers with a confirmed COVID-19 diagnosis. But COVID-19 tests are in extremely short supply and many workers with suspected cases will be unable to get tested. Employers should modify paid leave policies to allow flexibility for ill workers to access the benefits even without a confirmed test, at least until testing is more widely available.

Policies should cover paid leave for grocery workers to care for their immediate family members or people they live with if they become ill. Employers should also compensate workers for any coronavirus-related medical bills that are not covered by their health insurance.

Employers should provide extra support to grocery workers who are especially high-risk, such as older workers and the immunocompromised. The most vulnerable workers may need to simply stay home during the pandemic and not work for weeks or months. Employers should do their part to ensure those workers have extended paid leave or other forms of adequate compensation and benefits, including health insurance.

CUSTOMERS CAN HELP KEEP GROCERY WORKERS SAFE

A major concern for the workers I interviewed was the actions of individual customers that could jeopardize their health. Many workers noted that customers continue to come to their store even when they are sick.

“Some customers will come through the line and cough or sneeze in their hand,” said Safeway cashier Michelle Lee. “If you are sick, you should stay home or cough in their elbow.”

Customers should do their part by keeping a safe distance from workers at checkout and throughout the store, practicing proper hygiene when coughing or sneezing, and staying home when ill.

RIGHT NOW, GROCERY WORKERS ARE EMERGENCY PERSONNEL

On March 15, Minnesota Governor Tim Walz made grocery store employees and food distribution personnel eligible for free child care by designating them as emergency workers. Four days later, Vermont’s Department of Public Safety added grocery workers to its list of essential personnel, giving them free child care at school-based centers set up by the state.

Other states should follow the lead of Minnesota and Vermont and designate grocery workers as emergency personnel, granting them the same protections and benefits as first responders and health workers.

“If we had an opportunity to get free child care, people like me could go in,” Matt Milzman, a 29-year-old Safeway cashier in Washington, D.C. and father of two small children, told me. “They need all the people they can. I am low risk and healthy. I would much rather me work than someone who is older with a million health problems.”

Grocery workers are among the true heroes of the pandemic, providing basic necessities to keep Americans alive, but also human comfort for their customers during an anxious time.

“I choose to be happy and positive,” cashier Courtney Meadows told me. “If you can talk and make someone laugh, that might be the only positive thing in their life that day. That is what I choose to do.”

We owe them not only our gratitude, but the protection, support, and compensation they deserve.

 

 

 

U.S. leads world in confirmed coronavirus cases for first time

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Coronavirus dashboard: Catch up fast - Axios

The United States on Thursday reported the most coronavirus cases in the world for the first time, over China and Italy with at least 82,404 infections and more than 1,000 deaths, according to data from Johns Hopkins.

Why it matters: From the beginning, the U.S. — with a population of more than 325 million — has repeatedly underestimated and reacted slowly to the coronavirus, prolonging its economic pain and multiplying its toll on Americans’ health.

First, it happened with testing — a delay that allowed the virus to spread undetected, Axios’ Caitlin Owens reports.

  • Then we were caught flat-footed by the surge in demand for medical supplies in emerging hotspots.
  • And the Trump administration declined to issue a national shelter-in-place order. The resulting patchwork across the country left enough economic hubs closed to crash the economy, but enough places up and running to allow the virus to continue to spread rampantly.

What they’re saying: At a press conference Thursday, President Trump attributed the U.S. overtaking China to ramped up testing, before casting doubt on whether the Chinese government is reporting accurate numbers.

  • It is possible that China, which was the site of the original coronavirus outbreak, has been underreporting its cases.
  • The Chinese government covered up the outbreak in its first few weeks, likely allowing the virus to spread both domestically and throughout the rest of the world.

Flashback: Exactly one month ago on Feb. 26, President Trump said at a coronavirus press briefing that the U.S. has 15 reported cases and that “the 15 within a couple of days is going to be down to close to zero.”

 

 

 

 

U.S. now has more confirmed Coronavirus Cases than China and Italy

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These interactive maps show all reported coronavirus cases in the ...