Coronavirus response: The Republican-led plan to force states to reopen is revealed

The lost months

The WHO was prepared

Contradicting Trump’s recent criticism of the World Health Organization (WHO) – saying they “minimized the threat” and “could have called it months earlier” – the Washington Post reported that Americans working with WHO provided real-time information about the virus when it first emerged last year:

More than a dozen U.S. researchers, physicians and public health experts, many of them from the Centers for Disease Control and Prevention, were working full time at the Geneva headquarters of the World Health Organization as the novel coronavirus emerged late last year and transmitted real-time information about its discovery and spread in China to the Trump administration, according to U.S. and international officials.

A number of CDC staff members are regularly detailed to work at the WHO in Geneva as part of a rotation that has operated for years. Senior Trump-appointed health officials also consulted regularly at the highest levels with the WHO as the crisis unfolded, the officials said.

…Caitlin B. Oakley, a spokeswoman for the Department of Health and Human Services, confirmed that in January, HHS had 17 staff members, including 16 from the CDC, at the WHO, “working on a variety of programs, including covid-19 and Ebola.”

Not only did the Trump administration have insiders within WHO, the chief of WHO Tedros Adhanom Ghebreyesus, held near-daily media briefings on the virus starting on Jan. 22, warning the world to take the threat seriously. Every day he repeated a mantra: “We have a window of opportunity to stop this virus. But that window is rapidly closing.”

But a close look at the record shows that the W.H.O. acted with greater foresight and speed than many national governments, and more than it had shown in previous epidemics. And while it made mistakes, there is little evidence that the W.H.O. is responsible for the disasters that have unfolded in Europe and then the United States. (NYT)

  • Further reading: “Why Trump Deserves More Blame for the U.S. Coronavirus Crisis Than the WHO or China,” an interview by NY Mag with Jeremy Konyndyk, a policy fellow at the Center for Global Development who previously served as the director of USAID’s Office of U.S. Foreign Disaster Assistance

Azar’s missteps

Conflicting reporting has emerged about the role Health and Human Services Secretary Alex Azar played in the early days of the coronavirus spread in the U.S. Previously, the New York Times reported that Azar directly warned President Trump of the possibility of a pandemic two different times in January, but Trump dismissed his concerns as “alarmist.”

This past week, the Wall Street Journal has painted a different picture of Azar’s performance:

…interviews with more than two dozen administration officials and others involved in the government’s coronavirus effort show that Mr. Azar waited for weeks to brief the president on the threat, oversold his agency’s progress in the early days and didn’t coordinate effectively across the health-care divisions under his purview.

This matches public statements Azar made at the time, such as a Jan. 21 appearance on Fox News when he bragged about the botched CDC test and assured viewers that America had “a playbook” for responding to pandemics. It would take the CDC and FDA (both under Azar’s purview) five and half weeks to fix the test kits and begin distributing them around the country.

Shortly after that appearance, Azar hired “a trusted aide with minimal public health experience to lead the agency’s day-to-day response to COVID-19.” That aide, Brian Harrison, worked as a dog breeder for six years before joining HHS.

Five sources say some officials in the White House derisively called him “the dog breeder.”

The following month, Dr. Nancy Messonnier, the director of the National Center for Immunization and Respiratory Diseases, publicly announced that the CDC was preparing for a pandemic to spread through communities in the U.S. Trump threatened to fire her in response.

On Feb. 25, Nancy Messonnier, a CDC official, said the agency was preparing for a potential pandemic and that community spread of the virus was likely. The stock market plunged. At a media briefing later that day, Mr. Azar sought to quell concerns, saying the virus was “contained.”

But it was too late. A furious Mr. Trump, flying back to Washington from India, called Mr. Azar and threatened to oust Dr. Messonnier. The next day, the president announced he was putting Vice President Pence in charge of the federal response—news Mr. Azar learned a few hours before the announcement. (emphasis mine)

  • Who is Trump listening to? The Washington Post reports that an internal White House “Covid Mail” email exists to receive queries and suggestions from “friends and family” as well as random individuals who have reached out to administration officials. Some inside the administration have privately worried these missives receive priority over expert advice.

Vaccine chief removed

Dr. Rick Bright, director of the Department of Health and Human Services’ Biomedical Advanced Research and Development Authority (BARDA), announced (non-paywalled) that he was removed from his position leading the development of a coronavirus vaccine for opposing the administration’s push to use hydroxychloroquine as a treatment for COVID-19.

“I believe this transfer was in response to my insistence that the government invest the billions of dollars allocated by Congress to address the Covid-19 pandemic into safe and scientifically vetted solutions, and not in drugs, vaccines and other technologies that lack scientific merit,” he said in his statement. “I am speaking out because to combat this deadly virus, science — not politics or cronyism — has to lead the way.”

Following Bright’s statement, five current and former administration officials came forward to accuse him of mismanagement of his office and failing to consult with his superiors on important decisions. These sources report that Bright’s ouster was over a year in the making.

Attorneys for Bright intend to file a whistleblower complaint with the Office of Special Counsel and the HHS Inspector General alleging retaliatory treatment by “HHS political leadership.”

Rep. Anna Eshoo, the chairwoman of the House’s Health subcommittee, plans to call in Dr. Rick Bright to testify before her panel: “”I think the American people deserve to hear Dr. Bright’s story.” Eshoo said she also wants to call Health and Human Services Secretary Alex Azar and Bob Kadlec, the assistant secretary for preparedness and response, to testify.


Hydroxychloroquine

After weeks of pushing anti-malarial drug hydroxychloroquine for treating COVID-19, both Trump and conservative media have suddenly gone silent on the matter.

From March 23 to April 6, Fox News personalities and guests mentioned hydroxychloroquine nearly 300 times. But that’s changed in recent days. Media Matters found that between April 16 to April 20 mentions of the drug dropped 77% compared to the previous five-day period.

In the past two weeks, numerous studies have been published that indicate the drug is not only ineffective for treating the virus, it is also dangerous.

  • A study of 368 male veterans hospitalized with confirmed coronavirus infection at Veterans Health Administration medical centers determined that patients treated with hydroxychloroquine received no health benefits. Additionally, there were more deaths among those given hydroxychloroquine versus standard care.
  • A panel of National Institutes of Health experts released new treatment guidelines advising medical personnel that hydroxychloroquine and azithromycin should not be used to treat COVID-19.
  • A French study reviewed the medical records of COVID-19 patients treated with hydroxychloroquine and compared their outcomes to those not treated with the drug. The team concluded that hydroxychloroquine didn’t help hospitalized patients with coronavirus and was associated with heart complications.
  • Earlier this month, a Brazil study was halted after 11 patients died of fatal arrhythmias or heart muscle damage resulting from a high chloroquine dosage.

Yesterday, when asked why he stopped promoting hydroxychloroquine, Trump falsely claimed that he “hasn’t at all.” The president continued: “We had some very good results and some results that perhaps aren’t so good, I don’t know.” Washington Post reporter Philip Rucker pressed him on if he has looked at the VA study showing more deaths occurred in patients treated with the drug, to which Trump responded that he has not seen it. (video)

More details from inside Trump’s hydroxychloroquine push

The night of April 4, following a briefing in which Trump touted the government’s collection of “millions and millions of doses” of hydroxychloroquine, a Trump official summarized a White House call in the following email:

“WH call. Really want to flood Ny and NJ with treatment courses. Hospitals have it. Sick out patients don’t. And can’t get. So go through distribution channels as we discussed. If we have 29 million perhaps send a few million ASAP? WH wants follow up in AM. We can get a lot more of this. Right Bob? Millions per week?”

In other words, ignoring expert advice, administration officials were willing to “flood”New York and New Jersey with a dangerous, unproven drug.

By the way, that email was sent by Brett Giroir, the assistant secretary for health in the Department of Health and Human Services, who is in charge of coronavirus testing in the country. He has been at many briefings, here is a picture of him.

Giroir claims he is the right person for the job because he has extensive experience working on vaccine development projects at Texas A&M University. However, Giroir was essentially fired from the position in 2015 – told he had to resign immediately or be terminated.

His annual performance evaluation at Texas A&M, the local newspaper reported, said he was “more interested in promoting yourself” than the health science center where he worked. He got low marks on being a “team player.”

…Robin Robinson, who as the director of the federal Biological Advanced Research and Development Authority oversaw a major grant for the Texas vaccine project, said in an interview that Giroir “over-promised and under-delivered.” He said, “I always had a good relationship with Brett. I know he has a temper and he sometimes has a very difficult time controlling it.”


Trump’s new miracle cure is more likely to kill you

In yesterday’s rally coronavirus task force briefing, Trump suggested that “we hit the body with a tremendous…ultraviolet or just a very powerful light” to treat COVID-19. The president asked HHS official Bill Bryan to test it, then went on to posit that HHS should also tes introducing “the light inside the body – which you can do, either through the skin or in some other way.”

“Then I see the disinfectant, where it knocks it out in a minute…and is there a way we can do something like that? By injection inside or-or almost a cleaning because you see it gets in the lungs and it does a tremendous number on the lungs. So it’d be interesting to check that.” (video)

Fact check: FDA Commissioner Stephen Hahn said on CNN: “I certainly wouldn’t recommend the internal ingestion of a disinfectant.” Dr. Vin Gupta, a pulmonologist and global health policy expert, told NBC News: “This notion of injecting or ingesting any type of cleansing product into the body is irresponsible, and it’s dangerous… even in small amounts. Small amounts are deadly.”

Trump’s suggestion followed a presentation by Bryan in which he spoke about an “emerging result” from HHS’s research tha UV light, heat, and humidity could have a detrimental effect on the virus on surfaces and in the air. In other words, to disinfect a living or working environment, not for use in or on living beings. However, even HHS’s research has been criticized:

Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University: “Everything that this scientist talked about from Homeland Security was basically incoherent, nonsensical, not really supported by evidence and really quite contrary to a lot of things we do know,” Redlener said.

Finishing out the unproven and dangerous pseudoscience segment, Trump offered a disclaimer: “I’m not a doctor. I’m like a person who has a good you-know-what.”

Washington Post reporter Philip Rucker pushed back. “Respectfully, sir, you’re the president, and people tuning into the briefings, they want to get information and guidance and want to know what to do. They’re not looking for rumor.”

“Hey Phil,” Trump replied. “I’m the president and you’re fake news.” (video)


McConnell the Grim Reaper

As Trump tweets calls to “liberate” states run by Democratic governors, Sen. Mitch McConnell has refused to assist states and local governments with additional funding. During an interview with radio host Hugh Hewitt on Wednesday, McConnell said he wants states to declare bankruptcy rather than receive federal assistance for coronavirus expenses and shortfalls.

“I would certainly be in favor of allowing states to use the bankruptcy route. It saves some cities. And there’s no good reason for it not to be available. My guess is their first choice would be for the federal government to borrow money from future generations to send it down to them now so they don’t have to do that. That’s not something I’m going to be in favor of,” McConnell said.

His comments faced bipartisan backlash, with Republican Rep. Pete King of New York deriding McConnell as the “Marie Antoinette of the Senate.”

McConnell didn’t stop there, however. Shortly after the interview, his office released a statement calling for an end to “blue state bailouts.” In response, New York Gov. Andrew Cuomo accurately captured the facts of the situation:

”This is one of the really dumb ideas of all time. …how do you not fund police, and fire, and teachers, and schools in the midst of this crisis? …If there was ever a time for you to put aside your pettiness and your partisanship and this political lens that you see the world through – Democrat and Republican, and we help Republicans but we don’t help Democrats – now is the time. (video)

In another clip, Cuomo pointed out that red states are more federally dependent than blue states: “New York puts in more money into the federal pot than it takes out. His state takes out more than it puts in. Sen. McConnell, who’s getting bailed out here? It’s your state that is living on the money that we generate. Your state is getting bailed out. Not my state.”


Forced reopening

McConnell’s statements have provided a fuller picture of the Trump administration’s strategy to “reopen” the country – no matter the cost.

Tactic 1: Task force to reopen the country filled with prominent business leaders to pressure governors to lift mitigation measures.

Tactic 2: Mobilization of protests to give the appearance of a public revolting against mitigation measures.

Tactic 3: Starve the states into reopening. Politico reports that the White House opposes aid to states because it believes “if Congress keeps cutting checks for state and local governments, they will be disincentivized to open up their economies.” As we know, the president cannot order states to magicall “reopen,” but he can fiscally “starve” states into doing so. McConnell and other Republican lawmakers will be key to this strategy’s success.

As a key corollary to the three-prong strategy, Trump can shift blame for an increase in sickness and death to the task force, to Republicans in Congress, and to the governors.


How to reopen

Until a vaccine or another protective measure emerges, there is no scenario, epidemiologists agreed, in which it is safe for that many people to suddenly come out of hiding. If Americans pour back out in force, all will appear quiet for perhaps three weeks.

Then the emergency rooms will get busy again.

…The next two years will proceed in fits and starts, experts said. As more immune people get back to work, more of the economy will recover. But if too many people get infected at once, new lockdowns will become inevitable. To avoid that, widespread testing will be imperative. (NYT)

Experts agree that the U.S. cannot open until we have tripled the number of tests performed each day. Regardless of Trump’s false boast that “we’ve tested more than every other country in the world even put together” (video), the facts are that the U.S. is far behind the per capita testing rates of other nations.

National Governors Association: “Currently, the U.S. is able to test approximately 12.1 per 1,000 people. Germany has tested 20.9 per 1,000 people, Italy is testing 23.6 per 1,000, and Iceland is testing 125.6 per 1,000.”

At the end of last week, VP Mike Pence and members of the coronavirus task force held a call with Senate Democrats that exploded onto social media. A source on the call said “almost every question is about testing and Dems not getting answers.” The normally mild-mannered Senator Angus King (I-Maine) called the lack of answers a “dereliction of duty,” adding “I have never been so mad about a phone call in my life.”

The call reportedly ended with Senators Schumer and Kaine asking Pence why the president was trying to incite division by tweeting “LIBERATE” Virginia, Minnesota, and Michigan. Pence defended Trump’s right to communicate with the people as he always has.

When asked about Sen. King’s recollection of the phone call, Trump said: “He’s not an independent, okay. Angus King is worse than any Democrat… that was totally staged.” (video)

Reminder: On March 21, the administration claimed that by the end of March “well over 28 million” tests would be available. In reality, it is nearing the end of April and Pence brags about 4 million tests having been conducted overall.


Other danger in reopening

Not only will reopening states too early put lives at danger, it will also push people afraid to work off unemployment, making them choose between their lives or their livelihood.

The Department of Labor’s website explicitly states that “voluntarily deciding to quit your job out of a general concern about exposure to COVID-19 does not make you eligible for [Pandemic Unemployment Assistance].” A Department of Labor spokesperson confirmed to VICE that employees cannot continue to collect pandemic unemployment insurance if they refuse to “return to work out of general safety concerns.”

Sen. Ron Wyden (D-OR) confirmed this is a major concern:

“Republican governors are casting public health aside and forcing their states to ‘reopen’. The effects of these reckless decisions will trickle down to vulnerable workers, making them ineligible for pandemic unemployment assistance even though businesses may remain closed and customers may stay home because they’re afraid of getting sick. Everyone wants to find a new normal and get back to our lives, but pretending the crisis is over when it’s not over will make it much harder to contain the virus and for workers to keep food on the table and a roof over their heads.”

When asked about the danger of employees and customers catching coronavirus from returning to work too early, White House Economic Adviser Larry Kudlow said he’s not worried about it but companies should not be held responsible for any sickness and/or death:

“Businesses, particularly small businesses that don’t have massive resources, should not be held liable — should not be held to trial lawyers putting on false lawsuits that will probably be thrown out of court,” Kudlow told CNBC. “You have to give the businesses some confidence here that if something happens, and it may not be their fault — I mean, the disease is an infectious disease.”


More supply problems

Trump and the coronavirus task force have spent weeks avoiding responsibility for medical supply shortages by saying it is up to hospitals and governors to obtain the equipment on their own. Behind the scenes, however, the federal government has been seizing orders placed by local entities, stymying attempts to protect their frontline workers.

I have covered these seizures in previous editions of this newsletter. To save time and space, I won’t recount those again. The following are instances of seizures and general difficulties obtaining medical supplies that we learned of in the past week:

  • USA Today: George Gianforcaro, owner of Delaware-based Indutex USA, told the Daily News that the Federal Emergency Management Agency confiscated 400,000 masks in two imported shipments meant for his U.S. customers. He said the masks, which arrived in separate shipments on April 6 and April 19, are still being held at JFK Airport, apparently stranded in limbo as federal officials work out what to do next. “The product is just sitting on a loading dock at JFK. They want to charge me $3,000 a day to store it there. I said, ‘I’ll just come pick it up then.’ They said, ‘No, it’s not released.’”
    • Why is it taking so long to get the product released? Perhaps a clue is where Gianforcaro is sending the PPE: Michigan, whose governor Trump has publicly criticized. Earlier this month, the president even suggested that he wouldn’t approve Michigan’s request for a state of emergency declaration – unlocking crucial funds – because Gov. Whitmer wasn’t grateful enough.
  • TPM As a shipment of millions of KN95 protective masks were on their way to [a hospital system in] New Jersey from China in early April, federal agents were hatching a plan. The government deemed the mask shipment to be “critical supplies,” necessary for treating the COVID-19 crisis that was rapidly approaching its peak. HHS officials worked to get a Defense Production Act order which would give the government the authority to take possession of the materials… It was only after a seven-hour visit to the importer’s facility that the feds backed off.
  • It is not confirmed, but the above shipment aligns with the account of Dr. Andrew Artenstein, the chief physician executive of Baystate Health in Massachusetts, who had the same masks seized in the same way: After paying five-times the normal price for a shipment of KN95 respirator masks from China, he and four others met a dealer at a small airport “in the mid-Atlantic region,” where they executed their plan. “Two semi-trailer trucks, cleverly marked as food-service vehicles, met us at the warehouse. When fully loaded, the trucks would take two distinct routes back to Massachusetts to minimize the chances that their contents would be detained or redirected.”
  • CNN: Even inside nursing homes — deemed a ground zero for the spread of coronavirus — health care workers still don’t have enough personal protective gear and the facilities can’t get testing done quickly enough to effectively fight the virus… elderly care facilities continue to be hit so hard because testing, among other things, wasn’t available. The entire state of Virginia had access to only 300 test kits at the start of March, he said.
  • WaPo: Nearly one-third of governors over the past week have said they lack sufficient coronavirus testing supplies to reopen their states… Among the testing supplies governors have said they are lacking are swabs and reagents. Some governors have called for the federal government to acquire and distribute testing supplies to the states amid a global shortage.
    • “We have the capacity to double or triple the number of tests that we are doing, but we need some of these supplies,” Michigan Gov. Gretchen Whitmer (D) said Sunday. “The reagents and the swabs are absolutely essential. … And so while our capabilities are there, these important supplies are not.”

The rightwing media

  • A new study from economists at the University of Chicago found that Sean Hannity helped spread the coronavirus: “Hannity’s viewers changed behavior in response to the virus later than other Fox News viewers… greater viewership of Hannity…is strongly associated with a greater number of COVID-19 cases and deaths in the early stages of the pandemic.”
  • Forbes: Conservative and right-wing voices play an outsized role in spreading mis- and disinformation online about the coronavirus pandemic worldwide… The report also highlights a substantial overlap between right-wing voices promoting conspiracy theories and health misinformation.
  • WaPo: Unknown activists have posted nearly 25,000 email addresses and passwords allegedly belonging to the National Institutes of Health, the World Health Organization, the Gates Foundation and other groups working to combat the coronavirus pandemic… unable to verify whether the email addresses and passwords were authentic… [the information was] almost immediately used to foment attempts at hacking and harassment by far-right extremists.
    • Vice News: [The information] is circulating within a network of neo-Nazi extremists… The data dump and circulation appears to be an attempt at intimidating several of the leading government and non-governmental groups currently leading the fight against the worldwide coronavirus pandemic

States and protests

  • WaPo: The states that Trump wants to ‘liberate’ don’t pass the benchmarks he himself set
    • Video of Gov. Inslee’s reaction: “To have a president of the United States basically encourage insubordination, to encourage illegal activity — these orders actually are the law of these states… It is dangerous because it can inspire people to ignore things that actually can save their lives. And I don’t know that there’s another way to characterize it.”
  • CNN: Georgia is reopening hair salons, gyms and bowling alleys despite a rise in coronavirus deaths statewide… Georgia should not even begin to reopen until June 22, according to the model by the Institute for Health Metrics and Evaluation at the University of Washington, which assumes states will implement aggressive testing, contact tracing, isolation and crowd-size limits to prevent more infections.
    • Trump originally agreed with Gov. Kemp’s decision to reopen Georgia immediately. Task force members, including Dr. Fauci, tried to convince Trump that it was too early for the state to lift mitigation measures, but Trump did not listen. They then sent Dr. Deborah Birx, the panel’s coordinator, to try to convince Trump to oppose Kemp’s move – which apparently was successful.
  • WaPo: On April 17, Florida reported a spike in new coronavirus cases: 1,413, the highest daily number yet, along with 58 deaths. That same day, Gov. Ron DeSantis told mayors and municipalities it was cool with him if they wanted to open a beach or two.
  • Milwaukee local news: Republican leaders of the Wisconsin Legislature asked the conservative-controlled Wisconsin Supreme Court on Tuesday to block an order from Democratic Gov. Tony Evers’ administration extending the safer-at-home order until May 26. Assembly Speaker Robin Vos and Senate Majority Leader Scott Fitzgerald…said the order is eroding the economy and liberty of people in the state.
    • Bloomberg: Liz Uihlein, who along with her husband rivals the Adelsons as GOP megadonors, emailed her employees to sign a petition to recall the governor of Wisconsin for violating their “constitutional right to work” with Covid-19 public health measures. The request bothered some staffers, in part because they consider Uihlein insufficiently supportive of work-from-home policies…The Uihleins, who are in their 70s, oppose unions and support small government…
  • ABC News: State health officials in Wisconsin said Tuesday that 19 people who have either voted in-person or worked at a polling site on election day have so far tested positive for COVID-19
  • WaPo: The anti-quarantine protests seem spontaneous. But behind the scenes, a powerful network is helping… it is also being amplified, and in some cases coordinated, by longtime conservative activists, whose robust operations were initially set up with help from Republican megadonors.
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