Category Archives: Misleading

US coronavirus data will now go straight to the White House. Here’s what this means for the world

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Credibility, Crisis, Crisis Management, Data, Data Analytics, Data Control, Data Gathering, Data Governance, Data Integrity, Data Interpretation, Data Ownership, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Expert, Expert Opinion, False Hope, False Narrative, Honesty, Infection Control, Infection Control Plan, Infectious Virus, Integrity, Misinformation, Misinterpret, Mislead, Misleading, Mistrust, Mixed Message, Pandemic, Public Good, Public Health, Public Safety, Quarantine, Scientists, Silence, Silencing, Silencing Speech, Social Distancing, Transparency, Trust, Truth • Leave a comment

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US coronavirus data will now go straight to the White House ...

Led by physicians, scientists and epidemiologists, the US Centers for Disease Control and Prevention (CDC) is one of the most reliable sources of knowledge during disease outbreaks. But now, with the world in desperate need of authoritative information, one of the foremost agencies for fighting infectious disease has gone conspicuously silent.

For the first time since 1946, when the CDC came to life in a cramped Atlanta office to fight malaria, the agency is not at the front line of a public health emergency.

On April 22, CDC director Robert Redfield stood at the White House briefing room lectern and conceded that the coronavirus pandemic had “overwhelmed” the United States. Following Redfield at the podium, President Donald Trump said the CDC director had been “totally misquoted” in his warning that COVID-19 would continue to pose serious difficulties as the US moved into its winter ‘flu season in late 2020.

Invited to clarify, Redfield confirmed he had been quoted correctly in giving his opinion that there were potentially “difficult and complicated” times ahead.

Trump tried a different tack. “You may not even have corona coming back,” the president said, once again contradicting the career virologist. “Just so you understand.”

The exchange was interpreted by some pundits as confirmation that the CDC’s venerated expertise had been sidelined as the coronavirus continued to ravage the US.

In the latest development, the New York Times reported this week the CDC has even been bypassed in its data collection, with the Trump administration ordering hospitals to send COVID-19 data directly to the White House.

Diminished role

When facing previous public health emergencies the CDC was a hive of activity, holding regular press briefings and developing guidance that was followed by governments around the world. But during the greatest public health emergency in a century, it appears the CDC has been almost entirely erased by the White House as the public face of the COVID-19 pandemic response.

This diminished role is obvious to former leaders of the CDC, who say their scientific advice has never before been politicised to this extent.

As the COVID-19 crisis was unfolding, several CDC officials issued warnings, only to promptly disappear from public view. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, predicted on February 25 that the virus was not contained and would grow into a pandemic.

The stock market plunged and Messonnier was removed from future White House press briefings. Between March 9 and June 12 there was no CDC presence at White House press briefings on COVID-19.

The CDC has erred during the pandemic, most significantly in its initial efforts to develop a test for COVID-19. The testing kits proved to be faulty – a problem compounded by sluggish efforts to rectify the situation – and then by severe delays in distributing enough tests to the public.

But many public health specialists are nevertheless baffled by the CDC’s low profile as the pandemic continues to sweep the globe.

“They have been sidelined,” said Howard Koh, former US assistant secretary for health. “We need their scientific leadership right now.”

What does it mean for the world?

The CDC being bypassed in the collection of COVID-19 data is another body blow to the agency’s standing.

Hospitals have instead been ordered to send all COVID-19 patient information to a central database in Washington DC.

This will have a range of likely knock-on effects. For starters, the new database will not be available to the public, prompting inevitable questions over the accuracy and transparency of data which will now be interpreted and shared by the White House.

The Department of Health and Human Services, which issued the new order, says the change will help the White House’s coronavirus task force allocate resources. But epidemiologists and public health experts around the world fear the new system will make it harder for people outside the White House to track the pandemic or access information.

This affects all nations, because one of the CDC’s roles is to provide sound, independent public health guidance on issues such as infectious diseases, healthy living, travel health, emergency and disaster preparedness, and drug efficacy. Other jurisdictions can then adapt this information to their local context — expertise that has become even more essential during a pandemic, when uncertainty is the norm.

It is difficult to recall a previous public health emergency when political pressure led to a change in the interpretation of scientific evidence.

What happens next?

Despite the inevitable challenges that come with tackling a pandemic in real time, the CDC remains the best-positioned agency – not just in the US but the entire world – to help us manage this crisis as safely as possible.

In the absence of US leadership, nations should start thinking about developing their own national centres for disease control. In Australia’s case, these discussions have been ongoing since the 1990s, stymied by cost and lack of political will.

COVID-19, and the current sidelining of the CDC, may be the impetus needed to finally dust off those plans and make them a reality.

 

 

 

One question still dogs Administration: Why not try harder to solve the coronavirus crisis?

Posted on by • Posted in 2020 Election Issues, Accountability, Blame, Centers for Disease Control & Prevention (CDC), Clinical Testing, Competency, Contact Tracing, Coronavirus, Crisis, Crisis Management, Data, Data Analytics, Data Integrity, Data Interpretation, Data Ownership, Economic Crisis, Economic Recovery, Employer-Based Health Insurance, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Expert, Expert Opinion, False Hope, False Narrative, Health Insurance Coverage Adequacy, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Job, Job Loss, Job Market, Job Search, Job Security, Judgement, Leadership Decentralized, Mislead, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Out of Control, Out of Pocket Expenses, Pandemic, Preexisting Conditions, Public Health, Public Safety, Public Trust, Quarantine, Scapegoat, School Reopening, Scientists, Social Distancing, Trust, Truth, Underinsured, Unemployment, Unemployment Insurance, Uninsured, Wishful Thinking • Leave a comment

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Questions to ask students in class to help them deal with the ...

Both President Trump’s advisers and operatives laboring to defeat him increasingly agree on one thing: The best way for him to regain his political footing is to wrest control of the novel coronavirus.

In the six months since the deadly contagion was first reported in the United States, Trump has demanded the economy reopen and children return to school, all while scrambling to salvage his reelection campaign.

But allies and opponents agree he has failed at the one task that could help him achieve all his goals — confronting the pandemic with a clear strategy and consistent leadership.

Trump’s shortcomings have perplexed even some of his most loyal allies, who increasingly have wondered why the president has not at least pantomimed a sense of command over the crisis or conveyed compassion for the millions of Americans hurt by it.

People close to Trump, many speaking on the condition of anonymity to share candid discussions and impressions, say the president’s inability to wholly address the crisis is due to his almost pathological unwillingness to admit error; a positive feedback loop of overly rosy assessments and data from advisers and Fox News; and a penchant for magical thinking that prevented him from fully engaging with the pandemic.

In recent weeks, with more than 145,000 Americans now dead from the virus, the White House has attempted to overhaul — or at least rejigger — its approach. The administration has revived news briefings led by Trump and presented the president with projections showing how the virus is now decimating Republican states full of his voters. Officials have also set up a separate, smaller coronavirus working group led by Deborah Birx, the White House coronavirus response coordinator, along with Trump son-in-law and senior adviser Jared Kushner.

For many, however, the question is why Trump did not adjust sooner, realizing that the path to nearly all his goals — from an economic recovery to an electoral victory in November — runs directly through a healthy nation in control of the virus.

“The irony is that if he’d just performed with minimal competence and just mouthed words about national unity, he actually could be in a pretty strong position right now, where the economy is reopening, where jobs are coming back,” said Ben Rhodes, a deputy national security adviser to former president Barack Obama. “And he just could not do it.”

Many public health experts agree.

“The best thing that we can do to set our economy up for success and rebounding from the last few months is making sure our outbreak is in a good place,” said Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security. “People are not going to feel comfortable returning to activities in the community — even if it’s allowed from a policy perspective — if they don’t feel the outbreak is under control.”

Some aides and outside advisers have tried to stress to Trump and others in his orbit that before he could move on to reopening the economy and getting the country back to work — and life — he needed to grapple with the reality of the virus.

But until recently, the president was largely unreceptive to that message, they said, not fully grasping the magnitude of the pandemic — and overly preoccupied with his own sense of grievance, beginning many conversations casting himself as the blameless victim of the crisis.

In the past couple of weeks, senior advisers began presenting Trump with maps and data showing spikes in coronavirus cases among “our people” in Republican states, a senior administration official said. They also shared projections predicting that virus surges could soon hit politically important states in the Midwest — including Michigan, Minnesota and Wisconsin, the official said.

This new approach seemed to resonate, as he hewed closely to pre-scripted remarks in a trio of coronavirus briefings last week.

“This could have been stopped. It could have been stopped quickly and easily. But for some reason, it wasn’t, and we’ll figure out what that reason was,” Trump said Thursday, seeming to simultaneously acknowledge his predicament while trying to assign blame elsewhere.

In addition to Birx and Kushner, the new coronavirus group guiding Trump includes Kushner advisers Adam Boehler and Brad Smith, according to two administration officials. Marc Short, chief of staff to Vice President Pence, also attends, along with Alyssa Farah, the White House director of strategic communications, and Stephen Miller, Trump’s senior policy adviser.

The working group’s goal is to meet every day, for no more than 30 minutes. It views its mission as half focused on the government’s response to the pandemic and half focused on the White House’s public message, the officials said.

White House spokeswoman Sarah Matthews defended the president’s handling of the crisis, saying he acted “early and decisively.”

“The president has also led an historic, whole-of-America coronavirus response — resulting in 100,000 ventilators procured, sourcing critical PPE for our front-line heroes, and a robust testing regime resulting in more than double the number of tests than any other country in the world,” Matthews said in an email statement. “His message has been consistent and his strong leadership will continue as we safely reopen the economy, expedite vaccine and therapeutics developments, and continue to see an encouraging decline in the U.S. mortality rate.”

For some, however, the additional effort is too little and far too late.

“This is a situation where if Trump did his job and put in the work to combat the health crisis, it would solve the economic crisis, and it’s an instance where the correct governing move is also the correct political move, and Trump is doing the opposite,” said Josh Schwerin, a senior strategist for Priorities USA, a super PAC supporting former vice president Joe Biden, the presumptive Democratic nominee.

Other anti-Trump operatives agree, saying he could make up lost ground and make his race with Biden far more competitive with a simple course correction.

“He’s staring in the mirror at night: That’s who can fix his political problem,” said John Weaver, one of the Republican strategists leading the Lincoln Project, a group known for its anti-Trump ads.

One of Trump’s biggest obstacles is his refusal to take responsibility and admit error.

In mid-March, as many of the nation’s businesses were shuttering early in the pandemic, Trump proclaimed in the Rose Garden, “I don’t take responsibility at all.” Those six words have neatly summed up Trump’s approach not only to the pandemic, but also to many of the other crises he has faced during his presidency.

“His operating style is to double- and triple-down on positions and to never, ever admit he’s wrong about anything,” said Anthony Scaramucci, a longtime Trump associate who briefly served as White House communications director and is now a critic of the president. “His 50-year track record is to bulldog through whatever he’s doing, whether it’s Atlantic City, which was a failure, or the Plaza Hotel, which was a failure, or Eastern Airlines, which was a failure. He can never just say, ‘I got it wrong and let’s try over again.’ ”

Another self-imposed hurdle for Trump has been his reliance on a positive feedback loop. Rather than sit for briefings by infectious-disease director Anthony S. Fauci and other medical experts, the president consumes much of his information about the virus from Fox News and other conservative media sources, where his on-air boosters put a positive spin on developments.

Consider one example from last week. About 6:15 a.m. that Tuesday on “Fox & Friends,” co-host Steve Doocy told viewers, “There is a lot of good news out there regarding the development of vaccines and therapeutics.” The president appears to have been watching because, 16 minutes later, he tweeted from his iPhone, “Tremendous progress being made on Vaccines and Therapeutics!!!”

It is not just pro-Trump media figures feeding Trump positive information. White House staffers have long made upbeat assessments and projections in an effort to satisfy the president. This, in turn, makes Trump further distrustful of the presentations of scientists and reports in the mainstream news media, according to his advisers and other people familiar with the president’s approach.

This dynamic was on display during an in-depth interview with “Fox News Sunday” anchor Chris Wallace that aired July 19. After the president claimed the United States had one of the lowest coronavirus mortality rates in the world, Wallace interjected to fact-check him: “It’s not true, sir.”

Agitated by Wallace’s persistence, Trump turned off-camera to call for White House press secretary Kayleigh McEnany. “Can you please get me the mortality rates?” he asked. Turning to Wallace, he said, “Kayleigh’s right here. I heard we have one of the lowest, maybe the lowest mortality rate anywhere in the world.”

Trump, relying on cherry-picked White House data, insisted that the United States was “number one low mortality fatality rates.”

Fox then interrupted the taped interview to air a voice-over from Wallace explaining that the White House chart showed Italy and Spain doing worse than the United States but countries like Brazil and South Korea doing better — and other countries that are doing better, including Russia, were not included on the White House chart. By contrast, worldwide data compiled by Johns Hopkins University shows the U.S. mortality rate is far from the lowest.

Trump is also predisposed to magical thinking — an unerring belief, at an almost elemental level, that he can will his goals into existence, through sheer force of personality, according to outside advisers and former White House officials.

The trait is one he shares with his late father and family patriarch, Fred Trump. In her best-selling memoir, “Too Much and Never Enough,” the president’s niece, Mary L. Trump, writes that Fred Trump was instantly taken by the “shallow message of self-sufficiency” he encountered in Norman Vincent Peale’s 1952 bestseller, “The Power of Positive Thinking.”

Some close to the president say that when Trump claims, as he did twice last week, that the virus will simply “disappear,” there is a part of him that actually believes the assessment, making him more reluctant to take the practical steps required to combat the pandemic.

Until recently, Trump also refused to fully engage with the magnitude of the crisis. After appointing Pence head of the coronavirus task force, the president gradually stopped attending task force briefings and was lulled into a false sense of assurance that the group had the virus under control, according to one person familiar with the dynamic.

Trump also maintained such a sense of grievance — about how the virus was personally hurting him, his presidency and his reelection prospects — that aides recount spending valuable time listening to his gripes, rather than focusing on crafting a national strategy to fight the pandemic.

Nonetheless, some White House aides insist the president has always been focused on aggressively responding to the virus. And some advisers are still optimistic that if Trump — who trails Biden in national polls — can sustain at least a modicum of self-discipline and demonstrate real focus on the pandemic, he can still prevail on Election Day.

Others are less certain, including critics who say Trump squandered an obvious solution — good governance and leadership — as the simplest means of achieving his other goals.

“There is quite a high likelihood where people look back and think between February and April was when Trump burned down his own presidency, and he can’t recover from it,” Rhodes said. “The decisions he made then ensured he’d be in his endless cycle of covid spikes and economic disruption because he couldn’t exhibit any medium- or long-term thinking.”

 

 

 

‘That’s Ridiculous.’ How America’s Coronavirus Response Looks Abroad.

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Credibility, Crisis, Crisis Management, Economic Crisis, Economic Recovery, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Expert, Expert Opinion, False Hope, False Narrative, Infection Control, Infection Control Plan, Infectious Virus, Job, Job Loss, Job Market, Job Search, Job Security, Leadership Decentralized, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Pandemic, Partisanship, Public Health, Public Safety, Quarantine, Scientists, Social Distancing, Underinsured, Undocumented Immigrants, Unemployment, Uninsured • Leave a comment

WATCH THE VIDEO

Video -'That's Ridiculous.' How America's Coronavirus Response ...

From lockdowns to testing, we showed people around the world the facts and figures on how the U.S. has handled the pandemic.

The United States leads the world in Covid-19 deaths, nearing 150,000 lost lives. The unemployment figures brought on by the pandemic are mind-boggling. The Trump administration’s slow and haphazard response has been widely criticized. But what does it look like to young people around the world, whose governments moved quickly and aggressively to contain the coronavirus?

We wanted to know, so we reached out to quite a few and showed them charts, facts, photos and videos illustrating the U.S. response. Spoiler: They were not impressed.

Many advanced economies, from Germany to Singapore, directly supplemented salaries to save jobs. Other nations with fewer resources started mass testing at the first sign of an outbreak. Many countries mandated universal lockdowns — and successfully flattened the curve. In some parts of Europe, you could be fined for straying too far from your home. And Vietnam, a nation of 95 million people, has not seen a single Covid-19 death.

This Opinion video is a follow-up to a popular video we produced last year, which asked young Europeans to respond to American policies such as health care and parental leave. Many comments suggested we produce a sequel. Well, here it is — the Covid-19 edition.

 

 

 

 

I’m a doctor in Miami. Here’s how I know Florida’s covid-19 outbreak won’t improve anytime soon.

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy Reopening, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Infection Control, Infection Control Plan, Infectious Virus, Misleading, Mixed Message, Mortality, Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Social Distancing • Leave a comment

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July 26: Tracking Florida COVID-19 Cases, Hospitalizations, and ...

I knew something was amiss when I had my car repaired in early June, shortly after Miami began relaxing its coronavirus restrictions. At first glance, the dealership looked as if it was following the recommended precautions: Every other seat was blocked off with tape, and customers and workers were wearing face coverings.

On closer inspection, many of the customers’ nostrils protruded above their masks. Staff members wore masks with one-way valves, allowing their breath to escape as they told customers the cost of fixing their clunkers. And no one was enforcing limits on the number of customers who could enter the reception area while waiting for their repairs.

It wasn’t just the repair shop. As I walked around my neighborhood in the early evenings, I’d pass houses with cars packed into their driveways. The sounds of Pitbull and J Balvin blared through the tropical shrubbery — a sure sign of a Miami house party.

A month later, Miami has become the pandemic’s epicenter. Miami-Dade County’s intensive-care units and emergency departments are jammed. Specialists unaccustomed to managing critically ill patients are being called into action. The state has sent 100 additional health workers, mostly nurses, to the county’s large public hospital to help its exhausted staff.

I see patients in one of the hospital’s primary-care clinics. Recently, a colleague started her week as ward attending by being called to a code, one of several occurring simultaneously in different parts of the hospital; a middle-aged woman recovering from the coronavirus had suddenly gone into cardiac arrest. Other colleagues have been intubating physically fit young people who precipitously went into respiratory failure.

This is what happens when your state becomes a national embarrassment. And the reason is clear: We have suffered from failures of political leadership at every level.

Florida’s challenges are similar to those that New York and other northern states faced months ago. But while leaders in those states took aggressive action and modeled good behavior, our state has been significantly more laissez-faire and chaotic. Bars and restaurants closed for indoor service in March but reopened in June; now, Miami-Dade County’s mayor has shut them down again. Opening business might have worked if our state and local officials had enforced the correct wearing of appropriate masks, or modeled good mask-wearing behavior themselves, or provided businesses with instructions on maintaining proper ventilation. But they didn’t.

Covid-19 testing is woefully inadequate, and the lucky folks who can actually score an appointment at one of the state’s free testing sites, such as Marlins Park, are waiting more than a week to receive their results. The perpetually underfunded and politically influenced Florida Department of Health lacks enough staff to adequately trace all the people who test positive. Our leaders should have developed a robust public-health infrastructure capable of supporting contact tracing and quarantine enforcement long ago. They didn’t, and scrambling to assemble these systems in the midst of a pandemic is too little, too late.

Ironically, I feel safer at work, where everyone wears masks correctly and takes proper precautions, than I do out in public. We still have adequate personal protective equipment — for now — and are not yet forced to wear garbage bags and rain ponchos like our colleagues in New York. But many staff are already calling in sick, and we worry we won’t have enough nurses, respiratory therapists and doctors to manage the continuing deluge. And still young medical trainees tell me they see crowds of people, many without masks, congregating in the trendy areas of Miami Beach and in Miami’s Brickell neighborhood.

Meanwhile, Florida Gov. Ron DeSantis (R), who only recently began reliably sporting a mask, has thrown up his hands and proclaimed that younger adults are “going to do what they’re going to do,” arguing that he’s powerless to stop them. At the same time, he’s been bullying local school districts to offer in-person classes next month. Unfortunately, many public schools are housed in environmentally unhealthy buildings with lousy ventilation. Several classrooms in my daughter’s public high school lack windows; in other rooms, the windows that do exist don’t open. For years, the building’s outdated air-conditioning system has emitted a musty smell.

In a rational world, the federal government would help us test more people, faster; state and federal leaders would set an example by wearing masks correctly and consistently; local officials would strictly enforce quarantine rules; someone would slap warning labels on those awful ubiquitous online ads for valved masks; and our public health departments would be guided by health experts, not politicians. But this is Florida, a state with a well-established history of being anything but rational.

So for now, the state’s citizens continue to muddle through. My fellow physicians and I are trying to stay on top of a fast-changing situation, while also keeping an eye on hurricane season. In the absence of responsible leadership, we doubt Florida will stop setting records — of the wrong kind — anytime soon.

 

 

 

 

Cartoon – It’s all about Re-Branding in this Economy

Posted on by • Posted in 2020 Election Issues, Branding, Coronavirus, Crisis, Crisis Management, False Hope, False Narrative, Infection Control, Infection Control Plan, Infectious Virus, Misleading, Mistrust, Mixed Message, Mortality, Pandemic, Public Health, Public Safety, Quarantine, Social Distancing, Trust, Truth, Wishful Thinking • Leave a comment

Cartoon – It's all about Re-Branding in this economy | HENRY KOTULA

Cartoon – Under Control

Posted on by • Posted in 2020 Election Issues, Blame, Cartoon, Centers for Disease Control & Prevention (CDC), Communication, Control, Coronavirus, Credibility, Data Control, Data Integrity, Data Interpretation, Data Management, Denial, Economic Crisis, Economic Recovery, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, False Hope, False Narrative, Free Speech, Freedom, Freedom of the Press, Infection Control, Infection Control Plan, Infectious Virus, Misleading, Mistrust, Mixed Message, Mortality, National Strategy, Pandemic, Partisanship, Public Good, Public Health, Public Safety, Quarantine, Scapegoat, Scientists, Social Distancing, Transparency, Trust, Truth, Wishful Thinking • Leave a comment

Coronavirus | The Manchester Journal | Manchester Breaking News ...

EXCLUSIVE: WHITE HOUSE PRIVATELY WARNS 11 CITIES MUST TAKE “AGGRESSIVE” ACTION AGAINST CORONAVIRUS

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Credibility, Crisis, Crisis Management, Decision Making, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, False Hope, False Narrative, Freedom of the Press, Honesty, Infection Control, Infection Control Plan, Infectious Virus, Misleading, Mistrust, Mixed Message, Out of Control, Pandemic, Partisanship, Public Health, Public Safety, Quarantine, Scientists, Social Distancing, Transparency, Trust, Truth, Uncertainty, Wishful Thinking • Leave a comment

Exclusive: White House privately warns 11 cities must take ‘aggressive’ action against coronavirus

New red flags about the severity of the coronavirus outbreak come after Trump focused on upsides in televised briefing.

Dr. Deborah Birx, a leader of the White House Coronavirus Task Force, warned state and local leaders in a private phone call Wednesday that 11 major cities are seeing increases in the percentage of tests coming back positive for COVID-19 and should take “aggressive” steps to mitigate their outbreaks. 

The cities she identified were Baltimore, Cleveland, Columbus, Indianapolis, Las Vegas, Miami, Minneapolis, Nashville, New Orleans, Pittsburgh and St. Louis.

The call was yet another private warning about the seriousness of the coronavirus outbreaks given to local officials but not the public at large. It came less than a week after the Center for Public Integrity revealed that the White House compiled a detailed report showing 18 states were in the “red zone” for coronavirus cases but did not release it publicly.

Increasing test positivity — an indicator that a community does not have an outbreak under control — should be expected in areas that reopened and grew more relaxed about social distancing measures, said Harvard epidemiologist Bill Hanage. He said the warnings and data from the White House should be made public.

“This is a pandemic. You cannot hide it under the carpet,” he said. “The best way to deal with a crisis or a natural disaster is to be straight with people, to earn their trust and to give the information they need to make decisions for themselves and their communities.”

Birx told hundreds of emergency managers and other state and local leaders that they should act quickly to stem the outbreaks. Among her recommendations were to trace the contacts of patients testing positive for COVID-19 in areas where test positivity is going up.

“When you first see that increase in test positivity, that is when to start the mitigation efforts,” she said in a recording obtained by Public Integrity. “I know it may look small and you may say, ‘That only went from 5 to 5-and-a-half [percent], and we’re gonna wait and see what happens.’ If you wait another three or four or even five days, you’ll start to see a dramatic increase in cases.”

Birx said the federal government was seeing encouraging declines in test positivity in places like Phoenix and San Antonio but warned that the outbreak in the Sunbelt was moving north.

“What started out very much as a southern and western epidemic is starting to move up the East Coast into Tennessee, Arkansas, up into Missouri, up across Colorado, and obviously we’re talking about increases now in Baltimore,” she said. “So this is really critical that everybody is following this and making sure they’re being aggressive about mitigation efforts.”

It’s unclear who heard the warnings and was invited to the call, which was hosted by the White House Office of Intergovernmental Affairs and closed to the press. Baltimore and Cleveland were two of the cities Birx warned were facing rising test positivity, but a spokeswoman for the Cleveland mayor’s office, Nancy Kelsey-Carroll, said they did not participate in the call. And Baltimore health department leaders didn’t know about it, agency spokesman Adam Abadir said in an email. That city today announced a mask mandate and new restrictions on indoor dining.

The test positivity rates may not have been news to some elected officials. For example, Pennsylvania already publicly reports that data by county.

Birx’s warning came a day after President Donald Trump resumed his televised coronavirus briefings. The president offered a rosier picture of the pandemic than Birx, focusing on examples of improvements in the fight against the virus, such as better treatment with the drug remdesivir.

Her call also came the same day that Democratic Senate Minority Leader Sen. Chuck Schumer said on the Senate floor that he and House Majority Leader Nancy Pelosi had insisted on greater data transparency in a meeting with White House Chief of Staff Mark Meadows. Schumer said they would push for legislation to “ensure that COVID-19 data is fully transparent and accessible without any interference from the administration.”   

And on Tuesday, former CDC Director Tom Frieden and colleagues released a list of data points they would like states to publish in real-time, standardized, to give officials and residents better information.

“It’s not just people who are holding office who need to make decisions,” said Caitlin Rivers, an epidemiologist at Johns Hopkins University, on a call with reporters. “The more that we can provide information to people to keep themselves and their families safe, the better off we’ll be.”

The White House did not immediately respond to a request for comment on Birx’s warnings, nor did it answer repeated questions over several days from Public Integrity on why it had not made the “red zone” report public. Birx said on the call that the weekly report had been sent to governors for four weeks. One staffer for a governor said his boss received only the section of the report related to his state, not the entire report.

 

Photo of COVID-19 victim in Indonesia sparks fascination—and denial

Posted on by • Posted in Coronavirus, Denial, Economic Crisis, Economic Recovery, Economy Reopening, False Hope, False Narrative, Front Lines, Healthcare Providers, Infection Control, Infection Control Plan, Infectious Virus, Misinformation, Mislead, Misleading, Mistake, Mistrust, Mixed Message, Mortality, Nurses, Pandemic, Physician, Public Health, Public Opinion, Public Safety, Quarantine, School Reopening, Social Distancing, Wishful Thinking, World Health Organization (WHO) • Leave a comment

https://www.nationalgeographic.com/photography/2020/07/covid-victim-photograph-sparks-fascination-and-denial-indonesia/?cmpid=org=ngp::mc=crm-email::src=ngp::cmp=editorial::add=SpecialEdition_20200724&rid=C1D3D2601560EDF454552B245D039020

Photo of COVID-19 victim in Indonesia sparks fascination—and denial

Coronavirus victim wrapped in plastic shows what many didn’t want the populace to see.

Photojournalist Joshua Irwandi shadowed hospital workers in Indonesia, taking a striking image of a plastic-wrapped body of a COVID-19 victim while making sure not to reveal distinguishing characteristics, or even gender.

The image, taken for Nat Geo as part of a National Geographic Society grant, struck a chord in the nation of 270 million people. Indonesia had been slow to fight the global pandemic, with President Joko “Jokowi” Widodo touting an unproven herbal remedy in March. Some of the reactions to Irwandi’s image, which humanized the suffering from the virus, have been hostile.

Irwandi’s photograph has been displayed on television news and shared by the spokesperson for the nation’s coronavirus response team. The image was widely screen-grabbed and republished without Irwandi’s consent by Indonesian media. More than 340,000 people have “liked” the image on his Instagram page, which he posted after the Nat Geo story published on July 14. More than 1 million people also liked it in its first few hours on Nat Geo’s Instagram.

“It’s clear that the power of this image has galvanized discussion about coronavirus,” Irwandi said from his home in Indonesia. “We have to recognize the sacrifice, and the risk, that the doctors and nurses are making.”

There’s no question the photograph broke through, agreed Fred Ritchin, dean emeritus of the International Center of Photography: “Here we have a mummified person. It makes you look at it, feel terror.”

At the same time, there is distance, Ritchin said. “To me, the image was of someone being thrown out, discarded, wrapped in cellophane, sprayed with disinfectant, mummified, dehumanized, othered … It makes sense in a way. People have othered people with the virus because they don’t want to be anywhere near the virus.”

After Irwandi posted the photograph, a popular singer with a massive following accused the photographer of fabricating the news, said COVID-19 wasn’t so dangerous, and opined that a photojournalist shouldn’t be allowed to take a photograph in a hospital if the family could not see the victim. The singer’s followers erroneously charged Irwandi with setting up the photo with a mannequin, and called him “a slave” of the World Health Organization. The 28-year-old photographer’s ethics were questioned by the government this week, which also suggested the name of the hospital, which was not disclosed in the photograph, should be revealed, CNN Indonesia reported.

”Details of my private life have been published without my permission,“ Irwandi said. ”We’ve gone really astray from the photojournalistic intent of my photograph.“

However, he has gotten support from the nation’s association of photojournalists. They countered that the image met journalistic standards—and demanded the singer apologize, which he subsequently did.

Irwandi says some government officials have said the nation should take COVID-19 more seriously. As of Tuesday, the Johns Hopkins University Coronavirus Tracker had reported 4,320 COVID-19 deaths and 89,869 cases from Indonesia, although the count is believed to be vastly underreported. Many people aren’t practicing social distancing, and hordes have not been wearing masks. Large-scale social restrictions began fading last month.

His hope is that the image encourages Indonesians to take precautions—and save lives. He cited a challenge to photojournalists given in May by Harvard professor Sarah Elizabeth Lewis: to move beyond statistics and show how COVID-19 is affecting people. Other photographers, such as Lynsey Addario, have been motivated to do the same thing. (Addario also has been supported by a National Geographic Society fund for COVID-19 reporting.)

So, what are Irwandi’s next steps?

He paused a moment.

“I think I’m going to stay low for a time,” he said.

 

 

 

 

U.S. passes 4 million coronavirus cases as pace of new infections roughly doubles

Posted on by • Posted in 2020 Election Issues, Asymptomatic Transmission, Blame, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Credibility, Crisis, Crisis Management, Economic Crisis, Economic Recovery, Economy Reopening, Employee Benefits, Employee Furlough, Employee Hiring Freeze, Employee Layoffs, Employee Pay Cuts, Employer-Based Health Insurance, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, False Hope, False Narrative, Financial Pressure, Financial Viability, Financially Distressed, Health Insurance Coverage Adequacy, Health Policy, Honesty, Infection Control, Infection Control Plan, Infectious Virus, Integrity, Job, Job Loss, Job Market, Job Search, Job Security, Leadership Decentralized, Misinformation, Mislead, Misleading, Mistrust, Mixed Message, Mortality, National Strategy, Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Recession, School Reopening, Scientists, Social Distancing, Trust, Truth, Underinsured, Unemployment, Unemployment Insurance, Uninsured, Wishful Thinking • Leave a comment

https://www.washingtonpost.com/politics/us-passes-4-million-coronavirus-cases-as-pace-of-new-infections-roughly-doubles/2020/07/23/d0125192-cd02-11ea-b0e3-d55bda07d66a_story.html?utm_campaign=wp_main&utm_medium=social&utm_source=facebook&fbclid=IwAR3Ve5MnHiStJnPO_mzkc1c2sHE2EM6QOG-2HochFPBmJe6hnyvcmqEVQ4U

The United States on Thursday passed the grim milestone of 4 million confirmed coronavirus infections, and President Trump announced he was canceling the public celebration of his nomination for a second term, as institutions from schools to airlines to Major League Baseball wrestled with the consequences of a pandemic still far from under control.

The rapid spread of the virus this summer is striking, taking just 15 days to go from 3 million confirmed cases to 4 million. By comparison, the increase from 1 million cases to 2 million spanned 45 days from April 28 to June 11, and the leap to 3 million then took 27 days.

Trump’s cancellation of the in-person portion of the Republican National Convention planned for next month in Jacksonville, Fla., represented a remarkable reversal. He had insisted for months on a made-for-television spectacle that would have packed people close together in a state that is now an epicenter of the resurgent pandemic.

On Thursday, he conceded that was not going to work. “The timing for this event is not right,” Trump said during the latest of somber, solo White House briefings this week. “It’s just not right with what’s been happening.”

Florida reported 173 deaths on Thursday, its highest single-day count of new deaths, and also reported more than 10,200 new coronavirus cases.

In a scathing statement blaming the surge of new cases on Trump’s “failure to care,” presumptive Democratic nominee Joe Biden said the president “quit on this country and waved the white flag of surrender.”

Meanwhile, nearly every public health metric suggests America is badly losing its fight against the virus.

Positivity rates have reached alarming levels in numerous states, hospitalizations are soaring, and more than 1,100 new coronavirus deaths were reported across the United States on Wednesday, marking the first time since May 29 that the daily count exceeded that number, according to Washington Post tracking.

The rolling seven-day average of infections has doubled in less than a month, reaching more than 66,000 new cases per day Wednesday. The U.S. death toll now exceeds 141,000.

As a result, many businesses appear to be pulling back after their attempts to resume more normal operations proved premature, and an additional 1.4 million American workers filed for unemployment benefits last week. It was the first time since March that new claims rose. Another 980,000 new Pandemic Unemployment Assistance claims — the benefits offered to self-employed and gig workers — were also filed.

Congress, meanwhile, struggled to confront the crisis. Senate Republicans killed Trump’s payroll tax cut proposal on Thursday, widening an unusual rift with the White House over the cost and contents of the latest national coronavirus relief package.

Senate Majority Leader Mitch McConnell (R-Ky.) had planned to roll out a $1 trillion GOP bill Thursday morning, but that was canceled amid the intraparty conflicts.

Administration officials then floated a piecemeal approach, involving several different aid bills, but ran into opposition from lawmakers in both parties.

Trump’s briefing Thursday afternoon, his third of the week, reflected an effort to increase popular support for his management of the coronavirus outbreak, which even many of his allies have criticized. About 2 out of 3 Americans disapprove of Trump’s handling of the pandemic, a new poll found.

Trump dismissed or played down the risk of the virus for months after it had begun spreading in the United States and has been a self-described cheerleader for rapid reopening of businesses and schools shuttered to help slow its spread.

The survey of 1,057 adults in the United States, conducted by the Associated Press-NORC Center for Public Affairs Research, also showed that 3 out of 4 Americans, including a majority of Republicans, support mandatory face coverings when people are outside their own homes.

Democrats overwhelmingly favor mask mandates, at 89 percent. The majority of Republicans — 59 percent — also support them.

Ninety-five percent of Democrats and 75 percent of Republicans say they wear face coverings when leaving home. Overall, more Americans — 86 percent — are wearing masks compared with in May, when 73 percent were doing so.

Trump resisted wearing a mask in public until earlier this month, despite calls to set a good example from the top. He now calls it patriotic to wear a mask, though he still does not wear one consistently and says people should decide for themselves. Trump carries a black-cloth version in his pocket, which he says is sufficient for those instances when he is close to people who have not been screened for the virus.

Trump’s shift may reflect a growing consensus in favor of masks, although it is not clear that opposition to them has ebbed among some of the president’s strongest political supporters.

The business community is struggling, too. American Airlines and Southwest Airlines posted big quarterly losses between April and July in their earnings reports released Thursday, projecting that travel demand will not rebound anytime soon.

In American’s second quarter, revenue dropped more than 86 percent, to $1.6 billion, from nearly $12 billion a year ago, according to a Securities and Exchange Commission filing. The company posted a net loss of nearly $2.1 billion, attributing it to stay-at-home orders, border closures and travel restrictions.

“As a result, we have experienced an unprecedented decline in the demand for air travel, which has resulted in a material deterioration in our revenues,” the company said in the earnings report. “While the length and severity of the reduction in demand due to Covid-19 is uncertain, we expect our results of operations for the remainder of 2020 to be severely impacted.”

Southwest posted revenue of $1 billion in its second quarter, an almost 83 percent dip compared with a year ago. The company also posted a net loss of $915 million.

Trump also took a small step back from his insistence that schools should open on time this fall, conceding instead that some schools might need to delay in-person learning. Many school districts have already announced that decision.

Trump has been critical of guidance from the Centers for Disease Control and Prevention, saying it made it too tough for schools to reopen, and promised new guidelines would be issued. On Thursday, the CDC released several documents emphasizing the benefits of in-person school, in line with Trump’s messaging. Some of the guidance was written by White House officials rather than experts at the CDC, people familiar with the process said. They spoke on the condition of anonymity to discuss internal decision-making.

The new guidelines for school administrators mention precautions outlined in previous documents, but they appear to drop specific reference to keeping students six feet apart — something many schools find almost impossible to do if they are fully reopened. This document also suggests that schools consider closing only if there is “substantial, uncontrolled transmission” of the virus, and not necessarily even then.

Florida Gov. Ron DeSantis (R) echoed Trump in making a case for students to return to classrooms, despite the state’s teachers union suing over an order forcing schools to fully reopen. Meanwhile, a new poll showed that most parents would prefer to delay the start of in-person school.

During an appearance on “Fox & Friends,” DeSantis said that schoolchildren are “by far at the least risk for coronavirus, thankfully.”

“We also know they play the smallest role by far in transmission of the virus, and yet they’ve really been asked to shoulder the brunt of our control measures,” said DeSantis, a close Trump ally who had volunteered his state for the Republican convention next month.

DeSantis said that the “evidence-based decision” is for all parents to have the option of in-class instruction for their children if they choose. He said those who are not comfortable with sending their children back to school could continue distance learning.

The role children play in spreading the virus is still being studied, with experts saying that results are not definitive. A South Korean study found that children over the age of 10 were as likely to transmit the virus as adults, while those under 10 were less likely to spread it.

Deborah Birx, the White House coronavirus response coordinator, said Wednesday on Fox News that the United States is launching a study of its own, adding that the data “really needs to be confirmed here.”

Among the most visible American institutions searching for a path forward is the sports industry. Major League Baseball began a pandemic-shortened season on Thursday, playing in empty stadiums amid questions about whether the sport can make it through October without having to abort. It is as much a science experiment as a championship pursuit.

Players are prohibited from spitting or high-fiving. Foul balls that wind up in the stands will remain there.

Anthony S. Fauci, the nation’s leading infectious-disease expert, threw out the first pitch for the Washington Nationals home opener against the New York Yankees. Nationals star outfielder Juan Soto tested positive for the coronavirus on Thursday and missed the game.

Meanwhile, Japan marked a year’s delay of the Olympic Games on Thursday. Tokyo was to host the 2020 Summer Olympics starting Friday. A 15-minute ceremony in Tokyo’s newly built $1.4 billion Olympic Stadium started the countdown to the delayed games, now set to begin on July 23, 2021. The city also marked a new daily record in reported cases on Thursday, with 366.

A poll this week by Japan’s Kyodo News Agency found that fewer than 1 in 4 people in Japan even want to host the games anymore. One-third of respondents said the games should be canceled, while 36 percent expressed interest in postponing them for more than a year.

 

 

 

‘The virus doesn’t care about excuses’: US faces terrifying autumn as Covid-19 surges

Posted on by • Posted in 2020 Election Issues, Asymptomatic Transmission, Blame, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Credibility, Crisis, Crisis Management, Economic Crisis, Economy Reopening, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Expert Opinion, False Hope, False Narrative, False Reassurance, Health Policy, Health System, Herd Immunity, Hospital, Hospital Industry, Infection Control, Infection Control Plan, Infectious Virus, Job, Job Loss, Job Market, Job Search, Job Security, Leadership Decentralized, Misinformation, Mislead, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Pandemic, Partisanship, Personal Protective Equipment (PPE), Preexisting Conditions, Public Health, Public Safety, Quarantine, School Reopening, Scientists, Social Distancing, Trust, Truth, Uncertainty, Underinsured, Unemployment, Unemployment Insurance, Uninsured, Vulnerable Populations, Wishful Thinking • Leave a comment

https://www.theguardian.com/world/2020/jul/18/us-coronavirus-fall-second-wave-autumn

The breathing space afforded by lockdowns in the spring has been squandered, with new cases running at five times the rate of the whole of Europe. Things will only get worse, experts warn.

In early June, the United States awoke from a months-long nightmare.

Coronavirus had brutalized the north-east, with New York City alone recording more than 20,000 deaths, the bodies piling up in refrigerated trucks. Thousands sheltered at home. Rice, flour and toilet paper ran out. Millions of jobs disappeared.

But then the national curve flattened, governors declared success and patrons returned to restaurants, bars and beaches. “We are winning the fight against the invisible enemy,” vice-president Mike Pence wrote in a 16 June op-ed, titled, “There isn’t a coronavirus ‘second wave’.”

Except, in truth, the nightmare was not over – the country was not awake – and a new wave of cases was gathering with terrifying force.

As Pence was writing, the virus was spreading across the American south and interior, finding thousands of untouched communities and infecting millions of new bodies. Except for the precipitous drop in New York cases, the curve was not flat at all. It was surging, in line with epidemiological predictions.

Now, four months into the pandemic, with test results delayed, contact tracing scarce, protective equipment dwindling and emergency rooms once again filling, the United States finds itself in a fight for its life: swamped by partisanship, mistrustful of science, engulfed in mask wars and led by a president whose incompetence is rivaled only by his indifference to Americans’ suffering.

With flu season on the horizon and Donald Trump demanding that millions of students return to school in the fall – not to mention a presidential election quickly approaching – the country appears at risk of being torn apart.

“I feel like it’s March all over again,” said William Hanage, a professor of epidemiology at the Harvard TH Chan School of Public Health. “There is no way in which a large number of cases of disease, and indeed a large number of deaths, are going to be avoided.”

The problem facing the United States is plain. New cases nationally are up a remarkable 50% over the last two weeks and the daily death toll is up 42% over the same period. Cases are on the rise in 40 out of 50 states, Washington DC and Puerto Rico. Last week America recorded more than 75,000 new cases daily – five times the rate of all Europe.

“We are unfortunately seeing more higher daily case numbers than we’ve ever seen, even exceeding pre-lockdown times,” said Jennifer Nuzzo, an epidemiologist at the Johns Hopkins Center for Health Security. “The number of new cases that occur each day in the US are greater than we’ve yet experienced. So this is obviously a very worrisome direction that we’re headed in.”

The mayor of Houston, Texas, proposed a “two-week shutdown” last week after cases in the state climbed by tens of thousands. The governor of California reclosed restaurants, churches and bars, while the governors of Louisiana, Alabama and Montana made mask-wearing in public compulsory.

“Today I am sounding the alarm,” Governor Kate Brown said. “We are at risk of Covid-19 getting out of control in Oregon.”

As dire as the current position seems, the months ahead look even worse. The country anticipates hundred of thousands of hospitalizations, if the annual averages hold, during the upcoming flu season. Those hospitalizations will further strain the capacity of overstretched clinics.

But a flu outbreak could also hamper the country’s ability to fight coronavirus in other ways. Because the two viruses have similar symptoms – fever, chills, diarrhea, fatigue – mistaken diagnoses could delay care for some patients until it’s too late, and make outbreaks harder to catch, one of the country’s top health officials has warned.

“I am worried,” Dr Robert Redfield, the director of the Centers for Disease Control (CDC), said last week. “I do think the fall and the winter of 2020 and 2021 are probably going to be one of the most difficult times that we have experienced in American public health because of … the co-occurrence of Covid and influenza.”

Other factors will be in play. A precipitous reopening of schools in the fall, as demanded by Trump and the education secretary, Betsy DeVos, without safety measures recommended by the CDC, could create new superspreader events, with unknown consequences for children.

“We would expect that to be throwing fuel on the fire,” said Hanage of blanket school reopenings. “So it’s going to be bad over the next month or so. You can pretty much expect it to be getting worse in the fall.”

The list of aggravating circumstances goes on and on. A federal unemployment assistance program that gave each claimant an extra $600 a week is set to expire at the end of July. A new coronavirus relief package is being held up in Congress by Republicans’ accusations that states are wasting money, and their insistence that any new legislation include liability protections for businesses that reopen during the pandemic.

Cable broadcasts and social media have been filled, meanwhile, with video clips of furious confrontations on sidewalks, in stores and streets over wearing facial masks. In Michigan, a sheriff’s deputy shot dead a man who had stabbed another man for challenging him about not wearing a mask at a convenience store. In Georgia, the Republican governor sued the Democratic mayor of Atlanta for issuing a city-wide mask mandate.

The partisan divide on masks is slowly closing as the outbreaks intensify. The share of Republicans saying they wear masks whenever they leave home rose 10 points to 45% in the first two weeks of July, while 78% of Democrats reported doing so, according to an Axios-Ipsos poll.

Another divide has proven tragically resilient. As hotspots have shifted south, the virus continues to affect Black and Latinx communities disproportionately. Members of those communities are three times as likely to become infected and twice as likely to die from the virus as white people, according to data from early July.

The raging virus has prompted speculation in some corners that the only way out for the United States is through some kind of “herd immunity” achieved by simply giving up. But that grossly underestimates the human tragedy such a scenario would involve, epidemiologists say, in the form of tens of millions of new cases and unknown thousands of deaths.

“I think that every single serology study that’s been done to date suggests that the vast majority of Americans have not yet been exposed to this virus,” Nuzzo said. “So we’re still very much in the early stages.

“Which is good, that’s actually really good news. I don’t want to strive for herd immunity, because that means the vast majority of us will get sick and that will mean many, many more deaths. The point is to slow the spread as much as possible, protect ourselves as much as possible, until we have other tools.”

But the ability of the US to take that basic step – to slow the spread, as dozens of other countries have done – is in perilous doubt. After half a year, the Trump administration has made no effort to establish a national protocol for testing, contact tracing and supported isolation – the same proven three-pronged strategy by which other countries control their outbreaks.

Critics say that instead, Trump has dithered and denied as the national death toll climbed to almost 140,000. The Democratic presidential candidate, Joe Biden, who is hoping to unseat Trump in November, blasted the president for refusing until recently to wear a mask in public.

“He wasted four months that Americans have been making sacrifices by stoking divisions and actively discouraging people from taking a very basic step to protect each other,” Biden said in a statement last weekend.

Meanwhile the White House has attacked Dr Anthony Fauci, the country’s foremost expert on infectious diseases whose refusal to lie to the public has enraged Trump, by publishing an op-ed signed by one of the president’s top aides titled “Anthony Fauci has been wrong about everything I have interacted with him on” and by releasing a file of opposition research to the Washington Post.

Trump claimed the number of cases was a function of unusually robust testing, though experts said that positivity rates of 20% in multiple states suggested that the United States is testing too little – and that in any case closing one’s eyes to the problem by testing less would not make it go away.

“We’ve done 45 million tests,” Trump said this week, padding the figure only slightly. “If we did half that number, you’d have half the cases, probably around that number. If we did another half of that, you’d have half the numbers. Everyone would be saying we’re doing well on cases.”

Such statements by Trump have encouraged unfavorable comparisons of the US pandemic response with those in countries such as Italy, which recorded just 169 new cases on Monday after a horrific spring, and South Korea, which has kept cases in the low double-digits since April.

But the United States could also look to many African countries for lessons in pandemic response, said Amanda McClelland, who runs a global epidemic prevention program at Resolve to Save Lives.

“We’ve seen some good success in countries like Ghana, who have really focused on contact tracing, and being able to follow up superspreading events,” said McClelland. “We see Ethiopia: they kept their borders open for a lot longer than other countries, but they have really aggressive testing and active case-finding to make sure that they’re not missing cases.

“I think what we’ve seen is that you need not just a strong health system but strong leadership and governance to be able to manage the outbreak, and we’ve seen countries that have all three do well.”

But in America, the large laboratories that process Covid-19 tests are unable to keep up with demand. Quest Diagnostics announced on Tuesday that the turnaround time for most non-emergency test results was at least seven days.

“We want patients and healthcare providers to know that we will not be in a position to reduce our turnaround times as long as cases of Covid-19 continue to increase dramatically,” the lab said.

“You can’t have unlimited lab capacity, and what we’ve done is allow, to some extent, cases to go beyond our capacity,” said McClelland. “We’re never going to be able to treat and track and trace uncontrolled transmission. This outbreak is just too infectious.”

Public health experts emphasize that the United States does not have to accept as its fate a cascade of tens of millions of new cases, and tens of thousands of deaths, in the months ahead. Focused leadership and individual resolve could yet help the country follow in the footsteps of other nations that have successfully faced serious outbreaks – and brought them under control.

But it is clear that the most vulnerable Americans, including the elderly and those with pre-existing conditions, face grave danger. Republicans have argued in recent weeks that while cases in the US have soared, death rates are not climbing so quickly, because the new cases are disproportionately affecting younger adults.

That is a false reassurance, health experts say, because deaths are a lagging indicator – cases necessarily rise before deaths do – and because large outbreaks among any demographic group speeds the virus’s ability to get inside nursing homes, care facilities and other places where residents are most vulnerable.

“If we don’t do anything to stop the virus, it’s going to be very difficult to prevent it from getting to people who will die,” said Nuzzo.

There is a question of whether the United States, for all its wealth and expertise – and its self-regard as an exceptional actor on the world stage – can summon the will to keep up the fight. People are tired of fighting the virus, and of fighting each other.

“I think unfortunately people are emotionally exhausted from having to think about and worry about this virus,” said Nuzzo. “They feel like they’ve already sacrificed a lot. So the worry that I have is, what willingness is there left, to do what it takes?”

It is as if the country is “treading water in the middle of the ocean”, Hanage said.

“People tend to be shuffling very quickly between denial and fatalism,” he said. “That’s really not helpful. There are a number of things that can be done.

“What I would hope is that this marks a point when the United States finally wakes up and realizes that this is a pandemic and starts taking it seriously.

“Folks tend to look at what has happened elsewhere and then they make up some kind of magical reason why it’s not going to happen to them.

“People keep making these excuses, and the virus doesn’t care about the excuses. The virus just keeps going. If you give it the opportunity, it will take it.”