Category Archives: Transparency

White House goes public with attacks on Fauci

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy Reopening, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Expert, Expert Opinion, False Hope, False Narrative, Health Policy, Honesty, Infection Control, Infection Control Plan, Infectious Virus, Integrity, Mislead, Misleading, Mortality, National Strategy, Pandemic, Partisanship, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Scientists, Social Distancing, Transparency, Trust, Truth • Leave a comment

White House goes public with attacks on Fauci

Dr. Anthony Fauci describes his 'very different' relationships ...

Tensions between the White House and Anthony Fauci, the government’s top infectious diseases expert, are spilling into the open as officials openly attack the doctor for his public health advice during the coronavirus pandemic. 

Fauci’s advice has often run contrary to President Trump’s views, and the attacks on Fauci have begun to look like a traditional negative political campaign against an opponent. Yet this time, the opponent is a public health expert and career civil servant working within the administration. 

Dan Scavino, deputy chief of staff for communications, shared a cartoon on his Facebook page late Sunday that depicted Fauci as a faucet flushing the U.S. economy down the drain with overzealous health guidance to slow the spread of the pandemic.

The cartoon, which shows Fauci declaring schools should remain closed and calling for “indefinite lockdowns,” did not accurately portray what Fauci has advised in public.

Adm. Brett Giroir, the administration’s testing czar, downplayed any riff within the White House coronavirus task force before offering some criticism of Fauci.

“I respect Dr. Fauci a lot, but Dr. Fauci is not 100 percent right and he also doesn’t necessarily, and he admits that, have the whole national interest in mind,” Giroir told “Meet the Press” on Sunday. “He looks at it from a very narrow public health point of view.”

There have been tensions between Trump and Fauci throughout the pandemic. The president has repeatedly downplayed the severity of the virus, broken with the advice of his own public health experts and painted rosy but at times misleading pictures of the U.S. response. Fauci, who has served four decades in his current post, has offered blunt talk on the dangers of the pandemic that has directly contradicted the president from time to time.

But the latest criticisms mark a shift as the White House has begun publicly undermining one of the leading public health voices in the administration at a time when multiple states are struggling to get new outbreaks under control.

White House trade adviser Peter Navarro, whom the president tapped to manage the use of the Defense Production Act, said he personally proceeds with caution before heeding Fauci’s advice.

Trump said last week that Fauci is a nice man but that he’s “made a lot of mistakes.”

A White House official this weekend sent media outlets a lengthy list of “mistakes” Fauci has made since the pandemic began, like his comment in March that there is no need for people to wear masks.

That comment came before scientists knew people could spread the virus without showing symptoms, and Fauci, the Centers for Disease Control and Prevention (CDC) and other experts now urge people to use face coverings in public.

Public health experts have leaped to Fauci’s defense on Twitter, noting that Fauci is one of the most respected health experts in the world, having worked for six presidents and researched HIV/AIDS, Ebola, Zika and a variety of other infectious diseases.

“When studies show that, opposite from SARS & MERS, COVID19 is most infectious soon after infection & less infectious later, we recognize asymptomatic transmission and importance of masks,” tweeted Tom Frieden, the former director of the CDC.

“That’s called science, not a mistake. The real, deadly mistake is not listening to science.” 

Ashish Jha, director of the Harvard Global Health Institute, tweeted, “His track record isn’t perfect. It’s just better than anyone else I know. Sidelining Dr. Fauci makes the federal response worse. And it’s the American people who suffer.”

Polls still show the public trusts Fauci more than Trump for accurate information on the virus, with Democrats more likely than Republicans to believe the infectious diseases expert.

White House press secretary Kayleigh McEnany during a “Fox & Friends” interview Monday insisted Fauci’s recommendations were reaching Trump, while saying he represented only “one viewpoint” among many considered by the president.

“The point of the task force is to be a whole of government look at what is best for this country,” McEnany said when asked about the status of the relationship between Trump and Fauci. “Dr. Fauci is one member of a team, but rest assured, his viewpoint is represented and the information gets to the president through the task force.”

Still, Fauci’s public appearances became few and far between as his dire warnings about the state of the pandemic in the U.S. increasingly clashed from more hopeful messages coming from the White House. 

Fauci also told the Financial Times last week that he hadn’t briefed Trump in two months, in which time a growing number of states have experienced significant surges in cases.

Fauci was not present at the White House coronavirus task force media briefing last week, events that have become rarer even as the COVID crisis grows worse.

And while he was a regular on cable news in the early days of the pandemic, his appearances have dwindled, a fact he said last week could be because of his “honesty.” 

While Fauci has warned that the U.S. could hit 100,000 new COVID-19 cases per day if steps aren’t taken to alter the trajectory of the outbreaks, Trump has tied the rise in cases to increased testing. 

While Fauci attributed outbreaks in some states to reopening too quickly after the spring lockdowns, Trump and his top allies have mostly stood by their decision to push governors to jump over checkpoints set by the White House.

Fauci has refuted the president’s claims that the rise in cases is solely tied to increased testing and that 99 percent of cases are “totally harmless.” 

And as Trump touted a falling COVID-19 death rate, which is actually now increasing, Fauci has said the U.S. shouldn’t take comfort in the “false narrative,” noting the disease can cause other severe health outcomes. 

Fauci’s warnings grew more urgent last week when he warned that the U.S. is “facing a serious problem” and the pandemic has become politicized. 

“And you know from experience historically that when you don’t have unanimity in an approach to something, you’re not as effective in how you handle it,” Fauci said in an interview with FiveThirtyEight. “So I think you’d have to make the assumption that if there wasn’t such divisiveness, that we would have a more coordinated approach.”

 

 

 

 

Trump sidelines public health advisers in growing rift over coronavirus response

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Coronavirus, Data Integrity, Dept of Health and Human Services (HHS), Economic Crisis, Economy Reopening, Evidence-Based Care, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, False Hope, False Narrative, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Integrity, Intimidation, Leadership Culture, Leadership Decentralized, Mislead, Misleading, Mortality, National Strategy, Pandemic, Personal Protective Equipment (PPE), Physician, Public Health, Public Safety, Retaliation, Scientists, Transparency, Trust, Truth, Womens Health • Leave a comment

https://www.washingtonpost.com/health/trump-sidelines-public-health-advisers-in-growing-rift-over-coronavirus-response/2020/07/09/ad803218-c12a-11ea-9fdd-b7ac6b051dc8_story.html?fbclid=IwAR0MI5VGiJQmUsyEpzYDj09Q0VVxxYMlHwx-UjfHdmMu1PdGD6uIzv8R2fM&utm_campaign=wp_main&utm_medium=social&utm_source=facebook

The Health 202: Health officials promise to ramp up pandemic ...

The June 28 email to the director of the Centers for Disease Control and Prevention was ominous: A senior adviser to a top Health and Human Services Department official accused the CDC of “undermining the President” by putting out a report about the potential risks of the coronavirus to pregnant women.

The adviser, Paul Alexander, criticized the agency’s methods, and said its warning to pregnant women “reads in a way to frighten women . . . as if the President and his administration can’t fix this and it is getting worse.”

As the country enters a frightening phase of the pandemic with new daily cases surpassing 62,000 on Wednesday, the CDC, the nation’s top public health agency, is coming under intense pressure from President Trump and his allies, who are downplaying the dangers in a bid to revive the economy ahead of the Nov. 3 election. In a White House guided by the president’s instincts, rather than by evidence-based policy, the CDC finds itself forced constantly to backtrack or sidelined from pivotal decisions.

The latest clash between the White House and its top public health advisers erupted Wednesday, when the president slammed the agency’s recommendation that schools planning to reopen should keep students’ desks six feet apart, among other steps to reduce infection risks. In a tweet, Trump — who has demanded schools at all levels hold in-person classes this fall — called the advice “very tough & expensive.”

“While they want them open, they are asking schools to do very impractical things. I will be meeting with them!!!” Trump tweeted Wednesday. Within hours, Vice President Pence had asserted the agency would release new guidance next week.

“The president said today we just don’t want the guidance to be too tough,” Pence told reporters. “And that’s the reason next week the CDC is going to be issuing a new set of tools.”

Analysts say the deepening divide is undermining the authority of one of the world’s premier public health agencies, which previously led fights against malaria, smallpox and HIV/AIDS. Amid the worst public health crisis in a century, the CDC has in recent months altered or rescinded recommendations on topics including wearing masks and safely reopening restaurants and houses of worship as a result of conflicts with top administration officials.

“At a time when our country needs an orchestrated, all-hands-on deck response, there is simply no hand on the tiller,” said Beth Cameron, former senior director for global health security and biodefense on the White House National Security Council.

In the absence of strong federal leadership, state and local officials have been left to figure things out for themselves, leading to conflicting messaging and chaotic responses. Trump’s decision to pull the U.S. out of the World Health Organization further undermined efforts to influence global strategies against the coronavirus, including how vaccines will be distributed.

The CDC, meanwhile, is increasingly isolated — a function both of its growing differences with the White House and of its own significant missteps earlier in the outbreak.

Those stumbles include the botched rollout of test kits likely contaminated at a CDC lab in late January, which led to critical delays in states’ ability to know where the virus was circulating. And the CDC’s initial decision to test only a narrow set of people gave the virus a head start spreading undetected across the country.

During a May lunch with Senate Republicans, Trump told the group the CDC “blew it” on the coronavirus test and that he’d installed a team of “geniuses” led by his son-in-law Jared Kushner to handle much of the response,” according to two people familiar with the lunch who spoke on the condition of anonymity.

“There is a view the CDC is staffed with deep state Democrats that are trying to tweak the administration,” said one adviser who also spoke on the condition of anonymity to reveal private conversations.

White House officials, who see the president’s reelection prospects tied to economic recovery, also say they’ve been deeply frustrated by what they view as career staffers at the agency determined “to keep things closed,” according to a senior administration official who spoke on the condition of anonymity to reveal internal deliberations.

Trump believes the CDC is “ineffective” and a “waste of time,” but doesn’t blame CDC Director Robert Redfield and generally likes him, said another official speaking on the condition of anonymity. “He just thinks he is a poor communicator,” the official added.

Joe Grogan, former head of the White House Domestic Policy Council, said Redfield had fans inside the White House who work on “addiction issues, on life issues, on HIV issues,” among other topics.

But he said Redfield has few political appointees to help him run a complex agency. “How do you run a place like that with … [few] appointees?” Grogan asked.

HHS Secretary Alex Azar called the director “a key scientific guide for the President and his administration, a trusted source for the American people, and a closely engaged partner of state and local governments.”

But Redfield is not a voice in coronavirus task force meetings, and “is never really in the Oval [Office] with the president,” said another senior administration official, who also spoke on the condition of anonymity to discuss the internal dynamics.

Even Redfield’s supporters say he has failed to be an effective advocate for the agency.

“Bob Redfield’s commitment to public health is completely strong,” said William Schaffner, a veteran infectious-disease specialist at Vanderbilt University. But he said Redfield lacks the standing, deftness, and communication capacity to persuade skeptical audiences, including those in the White House, that protecting public health and fostering economic recovery are not opposing goals.

Redfield, for his part, downplayed Trump’s criticism of the CDC school reopeniing guidelines after a coronavirus task force briefing Wednesday, saying the agency and the president were “totally aligned.”

“We’re both trying to open the schools,” he said.

White House spokesman Judd Deere also disputed big differences, saying in a statement the White House and the CDC “have been working together in partnership since the very beginning of this pandemic to carry out the President’s highest priority: the health and safety of the American public.

“The CDC is the nation’s trusted health protection agency and its infectious disease and public health experts have helped deliver critical solutions to save lives. We encourage all Americans to continue to follow the CDC’s guidelines and use best-practices they have learned, such as social distancing, face coverings, and good hygiene, to maintain public health and continue our Transition to Greatness.”

But some health experts were indignant the agency had been ordered to rewrite guidance to reopen schools to “make it easier and cost less” — a demand that effectively “turns science on its head,” said Tom Inglesby, director of Johns Hopkins University’s Center for Health Security.

“CDC should be giving their best judgments on how to lower risks to make schools safer,” he said. “That’s their job. If they aren’t allowed to do that, the public will lose confidence in the guidance.”

Why are they ‘not shouting “fire”?’

The diminished role of the 74-year-old agency has bewildered infectious-disease experts, as well as members of the public seeking guidance.

After six states set one-day case records on July 3, Carlos del Rio, executive associate dean at Emory University’s School of Medicine, tweeted at Tom Frieden, a former CDC director, “Tom, where is @CDCgov ? Why are they not out there shouting ‘fire’?”

Frieden shot back: “They are still there, still doing great work, just not being allowed to talk about it, not being allowed to guide policy, not being allowed to develop, standardize, and post information that would give, by state and county, the status of the epidemic and of our control measures.”

Jeffrey Duchin, the health officer at Seattle and King County health department, added: “Agree. Muzzled, neutered and exiled.”

The agency has been largely invisible. After more than three months of silence, it resumed briefings for the public last month. There have been two.

By comparison, when the H1N1 swine flu pandemic hit the United States in the spring of 2009, the CDC held briefings almost every day for six consecutive weeks.

During this outbreak, the agency’s regular briefings ended abruptly after White House officials were angered when a top CDC leader warned that Americans could face “significant disruption” to their lives as a result of the virus’s spread to the United States.

CDC officials say they are still getting their message out, pointing to more than 2,000 documents providing pandemic-related information about reopening and staying safe for dozens of groups and venues, including funeral home directors, amusement parks, and pet owners. Each Friday, the CDC also posts CovidView, a weekly report of selected data and trends on testing, hospitalizations, and reported deaths.

But the information is posted without additional explanation or analysis.

“I want to hear a real person give me three minutes based on these findings,” said del Rio, also a global health and infectious-disease professor at Emory. “I want to see them in the news, being interviewed, giving us the data.”

Scientists at the CDC and former colleagues speak of deep frustration and low morale over its inability to fully share and explain scientific and medical information.

Researchers are fearful for their jobs and want to protect the integrity of the data they release. “If you want to say something, you’re thinking, ‘what’s the White House going to say and how are they going to use it,’ ” said one longtime scientist who spoke on the condition of anonymity for fear of retaliation.

The lack of briefings has fostered misunderstandings at times. In early April, for instance, when the agency reversed its position and recommended the use of cloth face coverings, CDC scientists gave no public briefings explaining why they made the change.

“It’s not rocket science,” said Nancy Cox, a virologist and former CDC official who led the influenza program for 22 years and was part of the agency’s response during the 2009 H1N1 swine flu pandemic. “But the reasoning behind those changes should be explained as clearly as possible and then you can get everyone on board.”

In the CDC’s absence, academic medical centers, public health and professional disease groups have filled the void by holding coronavirus briefings and providing analysis of key issues, data and research studies. Frieden, the president of Resolve to Save Lives, a New York nonprofit, has also been posting long Twitter threads analyzing the weekly CDC data released on Fridays.

Speaking ‘with an unfettered voice’

Alarmed at the agency’s diminished role, nearly 350 public health organizations sent a letter Tuesday to Azar urging him to advocate for the CDC. The agency must be allowed to speak based on the best available science “and with an unfettered voice,” said John Auerbach, president and chief executive of Trust for America’s Health, a public health nonprofit that led the effort.

House Democrats echoed those concerns in a separate letter to Azar last month. Reps. Diana DeGette of Colorado and Frank Pallone Jr. of New Jersey, who chairs the House Energy and Commerce Committee, said they were troubled by reports that administration officials are considering narrowing the CDC’s mission and embedding more political appointees at the Atlanta-based agency.

Traditionally the CDC has one political appointee, the director. Now it has Redfield and five other political appointees, including two advisers who were added in recent weeks.

“Now more than ever, the American people need a robust and effective CDC that is not repeatedly undermined by others in the administration, including the President and the Vice President,” the letter said.

White House Chief of Staff Mark Meadows views the agency as a problem and has criticized the CDC repeatedly to other administration officials, said a senior administration official.

White House and HHS officials are discussing what the CDC’s “core mission needs to be,” said one adviser familiar with the talks who spoke on the condition of anonymity to comment on policy deliberations. The discussions were first reported by Politico.

Over the years, the agency that was founded to fight malaria now works on virtually every aspect of public health. “It has tried to be everything to everyone,” the adviser said, suggesting the agency might need to refocus more narrowly.

On the global front, administration officials are also weighing a $2.5 billion initiative called the President’s Response to Outbreaks that would move a significant portion of national and international pandemic responses to the State Department, according to a draft obtained by The Post. Details were first reported by Devex.

“There is no clear leadership role for CDC” in this plan, said Jennifer Kates, a senior vice president for global health and HIV policy at the Kaiser Family Foundation. “In global health, you need an engaged CDC.”

Taken together, the administration efforts seem “designed to position CDC to the margins,” said one federal health official who spoke on the condition of anonymity for fear of retaliation.

‘Boogeyman where there aren’t any’

The report that drew the email attack, accusing the agency of undermining the president, had provided detailed but incomplete information about pregnancy risks related to the coronavirus. It found pregnant women with covid-19 were more likely to be hospitalized, admitted to an intensive care unit, and to need ventilator support than infected women who are not pregnant.

The sender, Alexander, a specialist in health research methods, is a senior adviser to Michael Caputo, a longtime Trump ally who was recently appointed assistant HHS secretary for public affairs , which includes the CDC.

The email was directed to Redfield and Caputo.

Even amid the intense criticism of the agency, the email “crosses the line,” said the official, who was aware of the content.

Like all of the CDC’s reports, the analysis itself noted several limitations. One key one that researchers acknowledged was that they did not have data to indicate whether the pregnant women were hospitalized because of labor and delivery, or because they had covid-19.

Administration officials are “seeing political boogeymen where there aren’t any,” the federal health official said, adding that such narratives could further hamper the U.S. response.

“It could feed the fire to limit the flow of scientific data and communication to the general population,” the official said. “People are getting sick and dying. Can we just focus on the science?”

Alexander said in his email that the lack of data about why women were hospitalized was a “key issue.”

“The CDC is undermining the President by what they put out, this is my opinion and sense, and I am reading it and can see the subtle and direct hits,” he wrote.

Alexander, also a part-time assistant professor at McMaster University in Hamilton, Ontario, did not respond to emails and telephone calls seeking comment.

Caputo said in an interview that he agreed with Alexander. The CDC represents itself as the gold standard for public health agencies, he said, “but in the case of pregnancy analysis, it wasn’t even bronze.”

He called CDC’s track record “spotty” and “questionable,” pointing to Zika diagnostic testing errors in 2016.

“In many cases over the years, regardless of administration, the CDC has undermined presidents and themselves,” Caputo said, referring to leaked drafts of CDC guidances. “Who says the CDC is the sole font of wisdom when it comes to detecting and fighting deadly pathogens?”

Experts say that even with some big unanswered questions, the pregnancy findings represent the best available evidence and are important. The lack of data reflects decades of long-neglected national surveillance on pregnancy.

“I don’t think this is frightening women,” said Denise Jamieson, who heads the obstetrics and gynecology department at Emory University and Emory Healthcare. True, the report “suffers from completeness of data,” she said. But now doctors can be more confident that pregnant women are more likely to have severe disease and use “this really important information” to counsel patients, she said.

 

 

Merkel says pandemic reveals limits of ‘fact-denying populism’

Posted on by • Posted in 2020 Election Issues, Accountability, Compromise, Coronavirus, Crisis, Crisis Management, Democracy, Democratic Institutions, Disinformation, Economic Crisis, Economic Recovery, Economy Reopening, Fact-Denying Populism, False, False Hope, False Narrative, Governance, Infection Control, Infection Control Plan, Infectious Virus, Leadership, Leadership Trust, Lies, Misinformation, Misleading, Mortality, National Strategy, Pandemic, Public Good, Public Health, Public Safety, Quarantine, Readiness, Responsibility, Social Distancing, Transparency, Trust, Truth • Leave a comment

Merkel says pandemic reveals limits of ‘fact-denying populism’

Covid-19 has exposed the limits of 'fact-denying populism', Merkel ...

German Chancellor Angela Merkel told European Union (EU) countries Wednesday that the coronavirus pandemic is showing the limits of “fact-denying populism” as she urged the bloc to reach an agreement on an economic recovery package.

Merkel said that the EU “must show that a return to nationalism means not more, but less control,” according to France 24.

Without naming any specific nations, Merkel said: “We are seeing at the moment that the pandemic can’t be fought with lies and disinformation, and neither can it be with hatred and agitation.”

“Fact-denying populism is being shown its limits,” she added. “In a democracy, facts and transparency are needed. That distinguishes Europe, and Germany will stand up for it during its presidency.”

The pandemic has killed more than 100,000 people in the 27 EU nations and sparked what is expected to be the largest recession the continent has experienced in decades.

On Tuesday the EU released a report predicting the bloc’s economy will contract more than initially expected due to coronavirus-related lockdowns.

Merkel on Wednesday joined EU Economy Commissioner Paolo Gentiloni in urging the commission to quickly reach an agreement on the 750 billion-euro stimulus package proposed earlier this year.

“The depth of the economic decline demands that we hurry,” Merkel told lawmakers, according to The Associated Press. “We must waste no time — only the weakest would suffer from that. I very much hope that we can reach an agreement this summer. That will require a lot of readiness to compromise from all sides — and from you too.”

 

 

 

 

Trump says Covid-19 is ‘dying out.’ Experts fear his dismissiveness could prolong the crisis

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Credibility, Crisis, Crisis Management, Economic Crisis, Economy Reopening, False Hope, False Narrative, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Mislead, Misleading, Mixed Message, Mortality, National Strategy, Pandemic, Public Health, Public Safety, Quarantine, Scientists, Social Distancing, Transparency, Trust, Truth • Leave a comment

Trump says Covid-19 is ‘dying out.’ Experts fear his dismissiveness could prolong the crisis

The Trump Administration Paid Millions for Test Tubes — and Got ...

The White House is taking a new position on the coronavirus pandemic: a daily count of 750 deaths is a testament to the federal government’s successful pandemic response.

On Wednesday, when U.S. health officials reported nearly 27,000 new Covid-19 cases, President Trump said in a television interview that the virus was “dying out.” He brushed off concerns about an upcoming rally in Tulsa, Okla., because the number of cases there is “very miniscule,” despite the state’s surging infection rate. In a Wall Street Journal interview Wednesday, Trump argued coronavirus testing was “overrated” because it reveals large numbers of new Covid-19 cases, which in turn “makes us look bad,” and suggested that some Americans who wear masks do so not only to guard against the virus, but perhaps to display their anti-Trump animus.

But a range of public health experts told STAT that this messaging not only diverts attention from a pandemic that has already caused 120,000 U.S. deaths, but has more practical implications: It could make it difficult for local governments to enlist the public in the mitigation measures necessary to reduce the continued spread of the virus.

“The science behind how people process public warnings in a crisis supports this: You have to have people speaking with one voice,” said Monica Schoch-Spana, a medical anthropologist at the Johns Hopkins Center for Health Security. “You need a chorus.”

Conflicting directives can make it more difficult for recommendations coming from state and local leaders to have an impact, said Sara Bleich, a professor of public health policy at Harvard’s T.H. Chan School of Public Health.

“It sends a mixed message, which is confusing, particularly because while many people will get infected, most will not get severely sick, so it’s easy to say this won’t happen to me,” she said. “And it’s that sort of attitude that will keep us in this situation for a very long time.”

While the president has for weeks, if not months, underplayed the pandemic, his sharp and repeated remarks this week represent a remarkable attempt from the leader of American government to effectively declare the U.S. Covid-19 epidemic over.

The president’s rhetoric comes at a time that his coronavirus task force, which once conducted daily briefings, has not addressed the public since May. The president’s resumption of campaign rallies flouts federal guidance that encourages mask use (Trump’s campaign will hand out masks and hand sanitizer at the rally, but has not said it will require attendees to use them) and discourages large indoor gatherings. And the president has repeatedly claimed, misleadingly, that persistently high U.S. case totals are simply the result of increased testing.

Health experts say that political leaders preaching caution and modeling proper behavior — such as wearing a mask and demonstrating proper hand hygiene — can send a powerful signal to people that these steps can not only protect them, but their communities. They say that, essentially, national and state leaders need to walk the walk in a situation when individual behavior, like staying home when sick and cooperating with contact tracing, can make a large impact in curbing contagion.

Trump’s counterproductive behavior, Schoch-Spana said, extends far beyond the consistently dismissive tone he has taken toward the health risks of Covid-19. With few exceptions, the president has refused to wear a mask in public, and has insisted on continuing in-person briefings and White House events that effectively defy federal health guidance about gathering indoors in large groups.

“It’s not just words, it’s actions,” she said. “So when you have the nation’s top executive refusing to wear a mask, holding meetings where people are shoulder to shoulder, where he’s signing executive orders — that is also a form of communication.”

Experts also say continued federal commitments to combating the virus are crucial as the public grows tired of abatement measures. Instead, Trump has only elevated his monthslong campaign of downplaying the virus.

And Vice President Mike Pence, in a Wall Street Journal op-ed, framed the declines in cases and deaths since April as “testament to the leadership of President Trump” — even as hundreds of Americans are still dying every day and cases are not dropping further.

Rep. Donna Shalala (D-Fla.), who served as health secretary during the Clinton administration, said she hoped Americans would listen to public health guidance from local officials, not Trump and Pence.

“The president of the United States is dangerous to the health of the people of my district, because he’s giving out misinformation and false hope,” she said. “For those that believe him, they’re putting themselves and their families at risk.”

Public health experts have raised a number of issues with the administration’s messaging.

For one, a plateau of cases and deaths should not be celebrated, they say. While some countries in Europe and Asia have not only flattened their curve but driven them down, that hasn’t happened in the United States. Daily cases and deaths dipped from the peak in April, but have averaged about 20,000 and 800, respectively, for weeks.

Beyond those numbers representing real people getting sick and dying, there are other problems with sustained high levels of spread. The more cases there are, the more difficult it is for the surveillance system, including contact tracing, to keep up. It’s also more likely that some of the cases will spiral into explosive spread; 20,000 cases can turn into 40,000 a lot faster than one case can turn into 20,000.

Plus, a failure to suppress spread now could lead to more prolonged disruptions to daily life. If transmission rates come fall are still what they are now in certain communities, that makes it harder to reopen schools, for example.

Experts also point to evidence suggesting that the daily case and death numbers won’t stay flat for long. While new cases in the Northeast and Midwest are declining, a number of states in the West and South — Arizona, Texas, Florida, California, and Oregon among them — have reported record number of new cases this week. What worries public health officials is that, without measures to stem those increases, those outbreaks could keep growing. Those thousands of new cases also signal that, in a week or two, some portion of those people will show up in the hospital, and, about a week after that, a number of them will be dead, even as clinicians have learned more about treating severe Covid-19.

Some states in the South and West are already reporting record hospitalizations from Covid-19.

The White House’s shrug has been echoed by some governors, who insist, like Pence and Trump, that increased testing explains away the rise in cases. That is certainly one reason; testing has become more widespread, so states are capturing a more accurate reading of their true case burden.

But experts say increased testing can only account for some of the data states are reporting. Other metrics — including rising hospitalizations, filling ICUs, and the increasing rate of tests that are positive for the virus — signal broader spread.

Until Wednesday, leaders of Texas and Arizona also bristled at efforts from city and county officials to institute mask requirements, but acceded to growing pressure even as they have not ordered statewide mandates.

Cameron Wolfe, an infectious disease expert at Duke University, said he was seeing a growing “fatigue” among the public to keep up with precautionary steps like physical distancing and mask wearing. People letting down their guard was coinciding with an increase of cases in states, including North Carolina.

He said medical experts and health workers needed to model proper behavior to show others that the coronavirus epidemic was still something that required action. But, he added, “that also comes from political leaders buying into this.”

Federal and state authorities, he said, need to be “taking this to heart. That has not yet happened. That needs to change if we’re going to get people to buy into this.”

 

 

 

 

Cartoon – Coronavirus Leadership

Posted on by • Posted in 2020 Election Issues, Absenteeism, Accountability, Cartoon, Coronavirus, Coronavirus Treatment, Credibility, Crisis, Crisis Management, Economic Crisis, Economic Stimulus, Economy Reopening, False Hope, False Narrative, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Mortality, Pandemic, Public Health, Public Safety, Quarantine, Responsibility, Social Distancing, Transparency, Trust, Truth, Wishful Thinking • Leave a comment

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Federal Reserve – Semiannual Monetary Policy Report to the Congress

Posted on by • Posted in 2020 Election Issues, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economic Recovery, Economic Stimulus, Fiscal Policy, Gross Domestic Product (GDP), Job, Job Growth, Job Market, Mission, Monetary Policy, Paycheck Protection Program, Responsibility, The CARES Act, Transparency • Leave a comment

https://www.federalreserve.gov/newsevents/testimony/powell20200616a.htm

Federal Reserve Board - Structure of the Federal Reserve System

Chair Powell submitted identical remarks to the Committee on Financial Services, U.S. House of Representatives, Washington, D.C., on June 17, 2020.

Chairman Crapo, Ranking Member Brown, and other members of the Committee, thank you for the opportunity to present the Federal Reserve’s semiannual Monetary Policy Report.

Our country continues to face a difficult and challenging time, as the pandemic is causing tremendous hardship here in the United States and around the world. The coronavirus outbreak is, first and foremost, a public health crisis. The most important response has come from our health-care workers. On behalf of the Federal Reserve, I want to express our sincere gratitude to these dedicated individuals who put themselves at risk, day after day, in service to others and to our nation.

Current Economic Situation and Outlook
Beginning in mid-March, economic activity fell at an unprecedented speed in response to the outbreak of the virus and the measures taken to control its spread. Even after the unexpectedly positive May employment report, nearly 20 million jobs have been lost on net since February, and the reported unemployment rate has risen about 10 percentage points, to 13.3 percent. The decline in real gross domestic product (GDP) this quarter is likely to be the most severe on record. The burden of the downturn has not fallen equally on all Americans. Instead, those least able to withstand the downturn have been affected most. As discussed in the June Monetary Policy Report, low-income households have experienced, by far, the sharpest drop in employment, while job losses of African Americans, Hispanics, and women have been greater than that of other groups. If not contained and reversed, the downturn could further widen gaps in economic well-being that the long expansion had made some progress in closing.

Recently, some indicators have pointed to a stabilization, and in some areas a modest rebound, in economic activity. With an easing of restrictions on mobility and commerce and the extension of federal loans and grants, some businesses are opening up, while stimulus checks and unemployment benefits are supporting household incomes and spending. As a result, employment moved higher in May. That said, the levels of output and employment remain far below their pre-pandemic levels, and significant uncertainty remains about the timing and strength of the recovery. Much of that economic uncertainty comes from uncertainty about the path of the disease and the effects of measures to contain it. Until the public is confident that the disease is contained, a full recovery is unlikely.

Moreover, the longer the downturn lasts, the greater the potential for longer-term damage from permanent job loss and business closures. Long periods of unemployment can erode workers’ skills and hurt their future job prospects. Persistent unemployment can also negate the gains made by many disadvantaged Americans during the long expansion and described to us at our Fed Listens events. The pandemic is presenting acute risks to small businesses, as discussed in the Monetary Policy Report. If a small or medium-sized business becomes insolvent because the economy recovers too slowly, we lose more than just that business. These businesses are the heart of our economy and often embody the work of generations.

With weak demand and large price declines for some goods and services—such as apparel, gasoline, air travel, and hotels—consumer price inflation has dropped noticeably in recent months. But indicators of longer-term inflation expectations have been fairly steady. As output stabilizes and the recovery moves ahead, inflation should stabilize and then gradually move back up over time closer to our symmetric 2 percent objective. Inflation is nonetheless likely to remain below our objective for some time.

Monetary Policy and Federal Reserve Actions to Support the Flow of Credit
The Federal Reserve’s response to this extraordinary period is guided by our mandate to promote maximum employment and stable prices for the American people, along with our responsibilities to promote the stability of the financial system. We are committed to using our full range of tools to support the economy in this challenging time.

In March, we quickly lowered our policy interest rate to near zero, reflecting the effects of COVID-19 on economic activity, employment, and inflation, and the heightened risks to the outlook. We expect to maintain interest rates at this level until we are confident that the economy has weathered recent events and is on track to achieve our maximum-employment and price-stability goals.

We have also been taking broad and forceful actions to support the flow of credit in the economy. Since March, we have been purchasing sizable quantities of Treasury securities and agency mortgage-backed securities in order to support the smooth functioning of these markets, which are vital to the flow of credit in the economy. As described in the June Monetary Policy Report, these purchases have helped restore orderly market conditions and have fostered more accommodative financial conditions. As market functioning has improved since the strains experienced in March, we have gradually reduced the pace of these purchases. To sustain smooth market functioning and thereby foster the effective transmission of monetary policy to broader financial conditions, we will increase our holdings of Treasury securities and agency mortgage-backed securities over coming months at least at the current pace. We will closely monitor developments and are prepared to adjust our plans as appropriate to support our goals.

To provide stability to the financial system and support the flow of credit to households, businesses, and state and local governments, the Federal Reserve, with the approval of the Secretary of the Treasury, established 11 credit and liquidity facilities under section 13(3) of the Federal Reserve Act. The June Monetary Policy Report provides details on these facilities, which fall into two categories: stabilizing short-term funding markets and providing more-direct support for credit across the economy.

To help stabilize short-term funding markets, the Federal Reserve set up the Commercial Paper Funding Facility and the Money Market Liquidity Facility to stem rapid outflows from prime money market funds. The Fed also established the Primary Dealer Credit Facility, which provides loans against good collateral to primary dealers that are critical intermediaries in short-term funding markets.

To more directly support the flow of credit to households, businesses, and state and local governments, the Federal Reserve established a number of facilities. To support the small business sector, we established the Paycheck Protection Program Liquidity Facility to bolster the effectiveness of the Coronavirus Aid, Relief, and Economic Security Act’s (CARES Act) Paycheck Protection Program. Our Main Street Lending Program, which we are in the process of launching, supports lending to both small and midsized businesses. The Term Asset-Backed Securities Loan Facility supports lending to both businesses and consumers. To support the employment and spending of investment-grade businesses, we established two corporate credit facilities. And to help U.S. state and local governments manage cash flow pressures and serve their communities, we set up the Municipal Liquidity Facility.

The tools that the Federal Reserve is using under its 13(3) authority are appropriately reserved for times of emergency. When this crisis is behind us, we will put them away. The June Monetary Policy Report reviews the implications of these tools for the Federal Reserve’s balance sheet.

Many of these facilities have been supported by funding from the CARES Act. We will be disclosing, on a monthly basis, names and details of participants in each such facility; amounts borrowed and interest rate charged; and overall costs, revenues, and fees for each facility. We embrace our responsibility to the American people to be as transparent as possible, and we appreciate that the need for transparency is heightened when we are called upon to use our emergency powers.

We recognize that our actions are only part of a broader public-sector response. Congress’s passage of the CARES Act was critical in enabling the Federal Reserve and the Treasury Department to establish many of the lending programs. The CARES Act and other legislation provide direct help to people, businesses, and communities. This direct support can make a critical difference not just in helping families and businesses in a time of need, but also in limiting long-lasting damage to our economy.

I want to end by acknowledging the tragic events that have again put a spotlight on the pain of racial injustice in this country. The Federal Reserve serves the entire nation. We operate in, and are part of, many of the communities across the country where Americans are grappling with and expressing themselves on issues of racial equality. I speak for my colleagues throughout the Federal Reserve System when I say, there is no place at the Federal Reserve for racism and there should be no place for it in our society. Everyone deserves the opportunity to participate fully in our society and in our economy.

We understand that the work of the Federal Reserve touches communities, families, and businesses across the country. Everything we do is in service to our public mission. We are committed to using our full range of tools to support the economy and to help assure that the recovery from this difficult period will be as robust as possible.

Thank you. I am happy to take your questions.

 

 

 

 

Scientists caught between pandemic and protests

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Credibility, Crisis, Crisis Management, Free Speech, Freedom, Freedom of the Press, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Mortality, National Strategy, Pandemic, Partisanship, Protest, Public Debate, Public Discourse, Public Good, Public Health, Public Safety, Scientists, Transparency, Trust, Truth • Leave a comment

https://www.axios.com/black-lives-matter-protests-coronavirus-science-15acc619-633d-47c2-9c76-df91f826a73c.html

Scientists accused of double standards on coronavirus and Black ...

When protests broke out against the coronavirus lockdown, many public health experts were quick to warn about spreading the virus. When protests broke out after George Floyd’s death, some of the same experts embraced the protests. That’s led to charges of double standards among scientists.

Why it matters: Scientists who are seen as changing recommendations based on political and social priorities, however important, risk losing public trust. That could cause people to disregard their advice should the pandemic require stricter lockdown policies.

What’s happening: Many public health experts came out against public gatherings of almost any sort this spring — including protests over lockdown policies and large religious gatherings.

  • But some of the same experts are supporting the Black Lives Matter protests, arguing that addressing racial inequality is key to tackling the coronavirus epidemic.
  • The systemic racism that protesters are decrying contributes to massive health disparities that can be seen in this pandemic — black Americans comprise 13% of the U.S. population, but make up around a quarter of deaths from COVID-19. Floyd himself survived COVID-19 before he was killed by a now former police officer in Minneapolis.
  • “While everyone is concerned about the risk of COVID, there are risks with just being black in this country that almost outweigh that sometimes,” Abby Hussein, an infectious disease fellow at the University of Washington, told CNN last week.

Yes, but: Spending time in a large group, even outdoors and wearing masks — as many of the protesters are — does raise the risk of coronavirus transmission, says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

  • In a Twitter thread over the weekend, coronavirus expert Trevor Bedford estimated that each day of protests would result in some 3,000 additional infections, which over time could lead to hundreds of additional deaths each day.
  • Public health experts who work in the government have struck a cautionary note. Mass, in-person protests are a “perfect setup” for transmission of the virus, Anthony Fauci told radio station WTOP last week. “It’s a delicate balance because the reasons for demonstrating are valid, but the demonstration puts one at additional risk.”

The difference in tone between how some public health experts are viewing the current protests and earlier ones focused on the lockdowns themselves was seized upon by a number of critics, as well as the Trump campaign.

  • “It will deepen the idea that the intellectual classes are picking winners and losers among political causes,” says Tom Nichols, author of the “The Death of Expertise.”
  • Politico reported that the Trump campaign plans to restart campaign rallies in the next two weeks, with advisers arguing that “recent massive protests in metropolitan areas will make it harder for liberals to criticize him” despite the ongoing pandemic.

The current debate underscores a larger question: What role should scientists play in policymaking?

  • “We should never try to harness the credibility of public health on behalf of our judgments as citizens,” writes Peter Sandman, a retired professor of environmental journalism. He tells Axios some scientists who supported one protest versus others “clearly damaged the credibility of public health as a scientific enterprise that struggles to be politically neutral.“
  • But some are pushing back against the very idea of scientific neutrality. “Science is part of how we got to our racist system in the first place,” Susan Matthews wrote in Slate.
  • Medical science has often betrayed the trust of black Americans, who receive less, and often worse, care than white Americans. That means — as Uché Blackstock, a physician and CEO of Advancing Health Equity, told NPR — that the pandemic presents “a crisis within a crisis.”

The big picture: The debate risks exacerbating a partisan divide among Americans in their reported trust in scientists.

  • 53% of Democrats polled in late April — about a month before Floyd’s death — reported a “great deal of confidence in medical scientists to act in the public interests” versus 31% of Republicans.
  • If science-driven policymaking continues to be seen as biased, it will have repercussions for public trust in issues beyond the pandemic, including climate change, AI and genetic engineering.

What to watch: If there is a rise in new cases in the coming weeks, there will be pressure to trace them — to protests, rallies and the reopening of states. How experts weigh in could affect how their recommendations will be viewed in the future — and whether the public, whatever their political leanings, will follow them again.

 

 

 

 

White House goes quiet on coronavirus as outbreak spikes again across the U.S.

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Credibility, Crisis, Crisis Management, Dept of Health and Human Services (HHS), Economic Crisis, Economic Stimulus, Economy Reopening, Employee Benefits, Employee Furlough, Employee Hiring Freeze, Employee Layoffs, Employee Pay Cuts, Employee Protections, Expert, Expert Opinion, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Mortality, National Strategy, Pandemic, Public Health, Public Safety, Quarantine, Scientists, Social Distancing, Transparency, Trust, Truth • Leave a comment

https://www.politico.com/news/2020/06/10/white-house-stops-talking-about-coronavirus-309993?utm_source=ActiveCampaign&utm_medium=email&utm_content=Mnuchin%3A+More+Stimulus++Definitely++Needed&utm_campaign=TFT+Newsletter+06102020

White House goes quiet on coronavirus as outbreak spikes again ...

The coronavirus is still killing as many as 1,000 Americans per day — but the Trump administration isn’t saying much about it.

It’s been more than a month since the White House halted its daily coronavirus task force briefings. Top officials like infectious disease expert Anthony Fauci have largely disappeared from national television — with Fauci making just four cable TV appearances in May after being a near fixture on Sunday shows across March and April — and are frequently restricted from testifying before Congress. Meanwhile, President Donald Trump is preparing to resume his campaign rallies after a three-month hiatus, an attempted signal to voters that normalcy is returning ahead of November’s election, and that he’s all but put the pandemic behind him.

“We’ve made every decision correctly,” Trump claimed in remarks in the Rose Garden Friday morning. “We may have some embers or some ashes or we may have some flames coming, but we’ll put them out. We’ll stomp them out.”

Inside the White House, top advisers like Jared Kushner privately assured colleagues last month that the outbreak was well in hand — citing data on declines in community spread — and that the long-feared “second wave” may have even been averted, according to three current and former officials.

However, new data from states like Florida and mass protests across the country are renewing concerns about the virus’s spread. Texas, for instance, has reported two straight days of record-breaking coronavirus hospitalizations — highs that come shortly after the state kicked off the third stage of its reopening plan.

Those officials also acknowledge that the Covid-19 task force has scaled back its once-daily internal meetings — the task force now meets twice per week — but insist that the pandemic response remains a priority. One official with direct knowledge of the administration’s strategy cited efforts to scale up testing, accelerate the development of treatments and vaccines and perform other behind-the-scenes work to get ready for a potential fall surge.

“We’re delivering the supplies and resources that states asked for,” said the official. “This doesn’t need to be the public ‘coronavirus show’ every day anymore.”

“You can’t win,” said a senior administration official. “Some people complained for weeks that ‘we don’t want so much White House involvement,’ and that ‘the President should stop doing daily briefings,’ and then they turn around and complain that there aren’t enough or as many briefings.”

But the White House’s apparent eagerness to change the subject comes as new coronavirus clusters — centered around meatpacking plants, prisons and other facilities — drive spikes in disparate states like Utah and Arkansas. Meanwhile, states and major cities are lifting lockdowns and reopening their economies, prompting public health experts to fret that additional outbreaks are imminent. And several Democratic governors also have defied their own states’ social distancing restrictions to join mass protests over police brutality, where hundreds of thousands of Americans have spilled into the streets, further raising public health risks.

The fear is that all the mixed signals will only confuse people, stoke public skepticism over the health threat and promote the belief the worst is over just as the outbreak enters a dangerous new phase.

“Cases are rising, including from cases in congregate settings,” said Luciana Borio, who led pandemic preparedness for the National Security Council between 2017 and 2019. “We still have a pandemic.”

Nine current and former administration officials, as well as outside experts, further detailed how the White House is steadily ramping down the urgency to fight a threat that continues to sicken more than 100,000 Americans per week and is spiking in more than 20 states.

For instance, the administration in recent days told state health officials that it planned to reorganize its pandemic response, with HHS and its agencies taking over the bulk of the day-to-day responsibilities from the Federal Emergency Management Agency.

“The acuity of the response is not what it was, so they’re trying to go back to a little more of a normal ongoing presence,” said Marcus Plescia, the chief medical officer of the Association of State and Territorial Health Officials.

The coronavirus task force, which used to send daily updates to state officials, has done so with less regularity over the last several weeks, Plescia said. And the CDC has restructured its daily conference calls with states, moving away from the practice of giving top-down briefings to encouraging state officials to offer updates on what they’re seeing in their parts of the country.

One current and one former FEMA official also said they’re keen to have HHS resume its leadership role in containing the coronavirus so FEMA can make contingencies for a summer of hurricanes, floods and other natural disasters.

“Given the likelihood that we will soon see both hurricanes and coronavirus, HHS should manage the ongoing pandemic response so FEMA can prepare for coming ‘coronacanes,’” Daniel Kaniewski, who served as the top deputy at FEMA through January, wrote last week. “But they need to act soon. Coronacanes are in the forecast.”

Meanwhile, officials in at least 19 states have recorded two-week trends of increasing coronavirus cases, including spikes of more than 200 percent in Arizona and more than 180 percent in Kentucky. Two months after the White House issued so-called gating criteria that it recommended states hit before resuming business and social activities, only a handful of states — like Connecticut, New Jersey, New York and South Dakota — currently meet all of those benchmarks, according to CovidExitStrategy.org.

Officials within Trump’s health department are strategizing over how to convey the current level of risk, given data that Americans have put off emergency care and other potential medical needs, fearful of contracting Covid-19. “Our message now is that people should start returning to their health care providers to get the screenings, vaccines, care, or emergency services that they need,” Laura Trueman, the HHS official in charge of external affairs, wrote in an office-wide email to colleagues and shared with external groups on June 3, which was obtained by POLITICO.

Dan Abel, a longtime Coast Guard vice admiral, also has been installed at HHS with a small team, where he’s coordinating daily Covid-19 calls with HHS Secretary Alex Azar and the department’s division leaders, according to four officials with knowledge of the calls — an arrangement that’s raised some questions.

“Why is a Coast Guard admiral leading meetings between the HHS secretary and his senior staff?” asked one senior official, suggesting it created an unnecessary layer of management.

Meanwhile, the department is steadily turning back to its many pre-Covid-19 priorities. At the Food and Drug Administration, officials are returning to hot-button issues like tobacco and CBD regulations. Some staff in the health department’s emergency response arm are pivoting away from Covid-19 and back toward natural disasters as hurricane season begins.

At the same time, the Centers for Disease Control — traditionally the beating heart of the nation’s infectious disease response — remains largely demoralized and often sidelined in fighting what CDC director Robert Redfield last week acknowledged as the nation’s biggest health challenge in more than a century, and one he said is “moving through our social consciousness, our outward expression, and our grief.” That grim message has conflicted with Trump’s frequent vows of victory over the coronavirus.

“We were able to close our country, save millions of lives, open,” Trump said in Friday’s Rose Garden remarks. “And now the trajectory is great.”

“I fully recognize the anguish our Nation is experiencing & am deeply saddened by the many lives lost to COVID19,” Redfield tweeted just minutes later. “I call upon the American people to remain vigilant in protecting the vulnerable – protect your community, grandparents and loved ones from COVID-19.”

Redfield and other top officials also have spent the past week reckoning with the implications of widespread protests over police brutality, from meeting with staff to discuss longstanding concerns about systemic racism in health care to acknowledging the probability that those protests will spark new outbreaks.

HHS also on Monday sent members of Congress a fact sheet on its response to racial disparities in Covid-19 care — a much scrutinized issue in public health, with African Americans contracting and dying from the virus at much higher rates.

But on Capitol Hill, watchdogs say that fact sheets don’t cut it, and they’re frustrated by the lack of access to experts and insight into how the administration is handling a historic pandemic.

“Some are acting like the battle has been won when in reality it’s just beginning,” said a senior Democratic staffer. “The White House still won’t let task force members testify at hearings in June even though they have disappeared from TV and it’s not clear how often they are meeting.”

Fauci, meanwhile, has continued to issue a string of dire warnings in his lower-profile media appearances and at an industry conference on Tuesday.

“We have something that turned out to be my worst nightmare,” Fauci said in virtual remarks aired at a conference of the biotech industry’s Washington trade group, recounting how quickly the virus spread around the globe, outpacing Ebola and HIV. “And it isn’t over yet.”

The White House has maintained that chief of staff Mark Meadows has needed to clear officials like Fauci to testify, so they can stay focused on other priorities, and a spokesperson insisted that Trump has still prioritized the coronavirus fight even as the White House shifts toward focusing on revitalizing the economy.

Several officials have suggested that the task force’s lower profile has been helpful for the response, especially because the daily Covid-19 press briefings were often hijacked by Trump’s meandering remarks or the day’s other political news.

“In some ways, it actually has been easier to get Covid-related work done,” said one HHS staffer who’s helped support the Covid-19 response. “The task force briefings and the prep sessions for them took up a lot of principals’ time, and staff would sometimes have to crash on putting together materials for them.”

But the white-hot spotlight on the coronavirus also brought urgency and intensity, and the increasingly scattered nature of the current response could present new challenges if there’s an uptick in cases.

“This is when a one-government approach is needed more now than ever,” said Howard Koh, who served as President Barack Obama’s HHS assistant secretary for health. “Get all those people together in one room every day at the highest level and track outcomes and address all the questions and try to maximize coordination as much as possible.”