Testing for Trump, but not for us “warriors”

Welcome, dear readers, to my coronavirus roundup. I’m posting these every Friday in addition to Lost in the Sauce on Mondays (for non-coronavirus news).

There is so much to report from the past week. I will have to either do a separate post for the rest or roll it over into next week’s edition.

Scroll to the bottom for a summary if you’re short on time.

Housekeeping:

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Tests for Trump, not for us

Trump and Pence have notably been traveling the country without face masks, making a display of going back to normal. This is definitely a political decision; Trump has told advisors that he believes wearing a face mask would “send the wrong message,” because doing so would make it seem like he is preoccupied with health instead of focused on reopening the economy.

However, Trump and other White House officials benefit from a double standard: everyone Trump comes into contact with is tested for the virus, while the rest of us are expected to be “warriors,” in Trump’s words, and go back to work without that safety.

“As vice president of the United States, I’m tested for the coronavirus on a regular basis, and everyone who is around me is tested for the coronavirus,” Pence told reporters, amid a public backlash after he visited the Mayo Clinic in Rochester, Minn., and violated its rules requiring all visitors to wear a mask.

Yesterday, White House Press Secretary Kayleigh McEnany said that “as America reopens safely, the White House is continuing to operate safely.” However, only one of these entities has the ability to conduct contact testing: the White House. McEnany implicitly admits that rapid and regular testing is a prerequisite to operating safely, but the White House expects America to reopen without it. On Wednesday, McEnany said “the notion that everyone needs to be tested is simply nonsensical,” yet everyone in the White House is tested at least multiple times a week (video).

The White House system

Trump learned on Friday that his personal valet – who also serves him meals – tested positive for the coronavirus. According to NBC News, Trump became “lava level mad” at his staff and said he doesn’t feel it is doing all it can to protect him. Trump, Pence, and staff were all tested immediately; results were negative. We also found out that Pence aide Katie Miller – wife of Stephen Miller – tested positive, as did Ivanka Trump’s personal assistant. All officials in contact with them tested negative.

This is the system that would ultimately allow us to return to normal: early notification of symptoms, followed by quick contact tracing, followed by rapid testing with quickly turned-around results. But only the White House (and likely the richest Americans) have that ability right now.

  • Yesterday, Chief of Staff Mark Meadows made an “off the record” offer to reporters that they can get the same coronavirus testing as White House officials receive… however, the cameras were rolling when he said this.

More testing is “bad”

On March 6, Trump proclaimed to America that anyone who wanted a test could get one. That same week, Pence promised that there would be 4 million tests available. Later, a White House official said 27 million tests kits would be available to patients by the end of March. Now, over a month later, only 8 million tests have been conducted across the nation.

Why isn’t Trump concerned about the lack of testing for Americans? Well, first of all, he is safe because he has tests. But secondly, Trump admitted on Wednesday that more testing only reveals more infections and therefore increases the numbers. “In a way, by doing all this testing we make ourselves look bad,” he said. (video)

  • Reminder: In early March, Trump said (non-paywalled) that he didn’t want the Grand Princess cruise ship to dock in California because the infected passengers would add to the total confirmed cases in the U.S. “I’d rather have the people stay [on the ship],” Trump said, “because I like the numbers being where they are. I don’t need to have the numbers double because of one ship that wasn’t our fault. And it wasn’t the fault of the people on the ship either, okay? It wasn’t their fault either and they’re mostly Americans. So, I can live either way with it. I’d rather have them stay on, personally.”

Scaling up testing can be done

The U.S. is capable of scaling up the testing scheme that is already in place at the White House. A bipartisan team of experts convened by the Rockefeller Foundation has already drawn up plans to expand testing to 30 million per week. As Yale’s Zack Cooper – a member of the Rockefeller team – explains, the problem is money. So far, Congress has allocated only $33 billion to testing.

The rub is that because huge numbers of tests are needed over a short time, scaling up testing will cost hundreds of billions of dollars… As White House practices illustrate, the technology exists to return covid-19 test results in minutes. That technology needs to be scaled up. Many have pinned U.S. testing shortages on a lack of reagents and swabs, unused testing capacity and trouble linking existing labs to providers’ electronic medical records systems. At their core, these problems are attributable to inadequate funding. Framed differently, there are not many supply-chain or production problems that a congressional allocation of $250 billion couldn’t solve.

Ultimately, the United States faces a choice. We can reopen the economy without adequate testing, a move that raises the likelihood of a second wave of infections and places the costs of reopening squarely on the backs of essential workers. Alternatively, Congress could allocate more money for covid-19 testing and the White House could use those funds to test essential workers at the same rates White House staff are tested. This is both economically justifiable and our moral imperative.


Death toll

The influential model that the White House has relied on to forecast coronavirus deaths released a revised projection of nearly 135,000 U.S. deaths through the beginning of August. The source, the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, explains that the revisions reflect “rising mobility in most U.S. states as well as the easing of social distancing measures expected in 31 states by May 11, indicating that growing contacts among people will promote transmission of the coronavirus.”

A separate projection, based on FEMA modeling, forecasts up to about 3,000 daily deaths in the U.S. by June 1, almost doubling the current daily death rate. The White House said the model, not meant for the public, is a “preliminary result” and not a forecast.

”People should be aware that the risk of infection is still there,” [Dr. Christopher Murray, IHME Director] said in a Monday press conference. “Even in New York, 85 percent of the state is susceptible. In a place like Washington, 96-97 percent are susceptible. And so the risk of infection is there and people should take appropriate precautions.”

Note: The IHME model has come under criticism for wildly inaccurate death count projections prior to the most recent revision: “The model first estimated in late March that there’d be fewer than 161,000 deaths total in the US; in early April, it revised its projections to say the total death toll through August was ‘projected to be 60,415’ (though it acknowledged the range could be between 31,221 and 126,703).” Read this article for more on what goes into the model and why it was chosen by the White House.

Trump questions current death toll

It’s not just the models that Trump doesn’t accept: According to an Axios report, Trump has complained to advisers about the way coronavirus deaths are being calculated, suggesting the real numbers are actually lower. Some officials accuse hospitals of inflating the number of COVID-19 cases in order to rake in medicare payments.

One of these skeptical officials is Pence’s Chief of Staff Marc Short, who reportedly told the White House that the death toll would never reach 60,000 (it is now over 70,000):

He repeatedly questioned the data being shared with Trump, and in internal discussions said he did not believe the death toll would ever get to 60,000 and that the administration was overreacting, damaging the economy and the president’s chances for reelection, according to people who have heard his arguments. Day after day, Short pressed other officials to reopen the entire country, encouraging more risks to get the economy humming again.

Fact check: The official COVID-19 death count is actually under-reported (non-paywalled) due to inconsistent protocols, limited resources and a patchwork of decision making. For instance, until mid-April, a death was only attributed to coronavirus if it was confirmed with a laboratory test. Now, the CDC is including “probable [Covid-19] cases and deaths” in the totals because testing shortages hampered some states’ ability to test every patient suspected of having Covid-19.

  • A way to measure what the administration really thinks about the death projections: how many body bags the federal government has ordered (hint: 100,000 ordered on April 21).

Trump says deaths are okay

While touring a Honeywell factory that is producing face masks on Tuesday, Trump declared that the consequences of reopening the economy can be ignored:

“Will some people be affected? Yes,” Trump told reporters. “Will some people be affected badly? Yes. But we have to get our country open and we have to get it open soon.” (video)

The next day, Trump sat for an interview with ABC News and reiterated his sentiment, before then trying to project some empathy:

”It’s possible there with be some [deaths] because you won’t be locked into an apartment, or a house or whatever it is… (video)

Muir asks what the president wants to say to the families of coronavirus victims, to which he responded: “I want to say I love you. I want to say that we’re doing everything we can… we’re with you, we’re working with you. We’re supplying vast amounts of money like never before.”

Trump then predicted that the survivors will be “proud” of the economy he will build up next year, ending with: “To the people who have lost someone, there is nobody – I don’t sleep at night thinking about it – there is nobody that’s taken it harder than me. But at the same time, I have to get this enemy defeated. And that’s what we’re doing.” (video)

  • Note: Trump’s own administration is worried about the cost of reopening, as revealed in a May 1 recording of an interagency meeting between FEMA and HHS officials across the country. “If, at the end of stay-at-home orders, you were to lift everything and go back to normal business, and not have any community mitigation, you would expect to see in the second week in May we begin to increase again in ventilator uses,” the official said. “Which means cases increase, and by early June, we surpass the number of ventilators we currently have.”
  • Yale epidemiologist Gregg Gonsalves: “How many people will die this summer, before Election Day? What proportion of the deaths will be among African-Americans, Latinos, other people of color? This is getting awfully close to genocide by default. What else do you call mass death by public policy? …what is happening in the US is purposeful, considered negligence, omission, failure to act by our leaders.”

Trump’s moving the goalposts

On Jan. 30, Trump said: “We think we have it very well under control. We have very little problem in this country at this moment — five. And those people are all recuperating successfully.”

On Feb. 26, Trump said: “And again, when you have 15 people, and the 15 within a couple of days is going to be down to close to zero, that’s a pretty good job we’ve done.”

On March 5, he hailed the fact that there were about 3,000 deaths worldwide but only 11 in the United States.

By April 20, as the death count climbed above 42,000, Trump moved the goalposts to 60,000 deaths:

”But we’re going toward 50- or 60,000 people. That’s at the lower — as you know, the low number was supposed to be 100,000 people. We — we could end up at 50 to 60.”

On Sunday’s Fox News town hall, as nearly 70,000 Americans died from coronavirus, Trump again revised the “acceptable” total:

“That’s one of the reasons we’re successful, if you call losing 80 or 90,000 people successful. But it’s one of the reasons we’re not at the high end of that plane as opposed to the low end of the plane.” When pressed on his shifting estimate, Trump conceded, “I used to say 65,000 and now I’m saying 80 or 90 and it goes up and it goes up rapidly.” (video)

Five days later, in a rambling Friday morning Fox News interview, Trump pushed the total higher to 100,000-110,000 deaths:

If I didn’t [close the country] we would have lost two million – two and a half million, maybe more than that – people and we’ll be at a hundred thousand, a hundred and ten, higher than the lower level of what was projected if we did the shutdown, but still you’re talking about – I say two Yankee stadiums of people. It’s unacceptable. It’s unacceptable but I created, as president, we had the strongest economy in the history of the world… next year we’re going to have a phenomenal year. (video)

  • Fact check: By just about any important measure, the economy today is not doing as well as it did under Presidents Dwight D. Eisenhower, Lyndon B. Johnson and Bill Clinton — and Ulysses S. Grant. (WaPo)

Trevor Noah’s Daily Show made a great compilation of Trump’s ever-shifting goalposts. The reality is that Trump will declare victory no matter how many people die.


Kushner’s inexperience derailed response

…In other words, Jared Kushner holds at least some responsibility for the rising death count in the U.S..

Interviews with government officials by WaPo and NYT, in addition to a complaint filed by a volunteer, has filled in the details of Kushner’s “shadow” coronavirus task force in charge of managing and obtaining medical supplies for the nation. The group relied on a slew of volunteers from private sector industries that often had no relevant experience with their newfound roles in the medical supply chain:

The [complaint] document alleges that the team responsible for PPE had little success in helping the government secure such equipment, in part because none of the team members had significant experience in health care, procurement or supply-chain operations. In addition, none of the volunteers had relationships with manufacturers or a clear understanding of customs requirements or Food and Drug Administration rules, according to the complaint and two senior administration officials.

Because the team did not have existing relationships with vendors, they were instructed to “fast-track” recommendations for VIP’s, including Fox News hosts:

“Fox & Friends” host Brian Kilmeade, for example, called two people he knew in the administration to pass along a lead about PPE in an effort to be helpful, said two people familiar with the outreach. Fox News Channel host Jeanine Pirro also repeatedly lobbied the administration for a specific New York hospital to receive a large quantity of masks, one of the people said. (WaPo)

Many of the volunteers were told to prioritize tips from political allies and associates of President Trump, tracked on a spreadsheet called “V.I.P. Update”…among them were leads from Republican members of Congress, the Trump youth activist Charlie Kirk and a former “Apprentice” contestant who serves as the campaign chair of Women for Trump. (NYT)

A South Carolina doctor with longtime manufacturing contacts in China reached out to FEMA to help the agency procure masks. “Instead of encountering seasoned FEMA procurement officials, his information was diverted” to Kushner’s team, where it stalled.

You may recall from last week, that New York entered into a $69 million contract with a Silicon Valley engineer who tweeted to Trump that he could obtain ventilators. We now know that Kushner’s volunteers fielded the offer and passed the tip onto federal officials who then sent it to New York. Not a single ventilator was delivered.

New York officials said they were told by an official assigned to the Department of Health and Human Services that the federal government had vetted Mr. Oren-Pines, and that a consulting firm had conducted a video inspection of the ventilators in China.

Had Mr. Trump acted earlier than mid-March to assign FEMA to lead the federal government’s coronavirus response, the agency’s normal procedures might have been able to cope with the swelling demand. By the time Mr. Trump’s decision came, the Strategic National Stockpile was already running low on critical supplies. FEMA had no choice but to pursue every available lead, officials said, no matter how far-fetched. (NYT)


Whistleblower complaint

An official whistleblower complaint filed by Dr. Rick Bright, the ousted chief of the Biomedical Advanced Research and Development Agency, added to evidence that “VIPs” were given preferential treatment in the government’s coronavirus response:

Questionable contracts have gone to “companies with political connections to the administration,” the complaint said, including a drug company tied to a friend of Jared Kushner’s, President Trump’s son-in-law and senior adviser. It said Dr. Bright was retaliated against by his superiors, who pushed him out because of “his efforts to prioritize science and safety over political expediency.”

…The complaint says top Department of Health and Human Services officials, including Dr. Kadlec, who oversees the strategic national stockpile, overruled scientific experts while awarding contracts to firms represented by the consultant, John Clerici…“Dr. Bright was vocal about his concerns regarding the inappropriate and possibly illegal communications between Mr. Clerici, Dr. Kadlec, Mr. Shuy and Mr. Meekins,” the complaint stated, referring to Bryan Shuy and Chris Meekins, two other department officials.

Bright also describes incredible inaction from the administration:

On Jan. 23, he met with Mr. Azar and Dr. Kadlec to press “for urgent access to funding, personnel and clinical specimens, including viruses,” that would be necessary to develop treatments, the complaint said. But Mr. Azar and Dr. Kadlec “asserted that the United States would be able to contain the virus” through travel bans, the complaint said, adding that Dr. Bright was cut out of future department meetings related to Covid-19.

A separate recounting of the complaint:

One of Bright’s biggest frustrations was saved for procurement of masks, which he said he recognized early on would be a critical need in the coronavirus pandemic. Bright said that on January 21, 2020, Mike Bowen, co-owner and Executive Vice President of domestic surgical mask producer Prestige Ameritech, emailed him that the Department of Homeland Security had contacted him about procuring masks. Bright raised Bowen’s concerns internally about getting production of N95 masks up and going. But for a week nothing happened. Eventually, Bowen emailed again.

“I think we’re in deep shit,” he wrote.

…In a meeting with other health officials on February 7, he insisted that the federal government needed to place orders to ramp up production of N95 masks in order to protect healthcare workers and first responders. But an HHS supply chain team pushed back, saying there was “no indication of a supply chain shortage or of issues with masks,” according to the complaint.

Bright finally came forward when the administration began pushing hydroxychloroquine:

[An attorney for Bright told Rachel Maddow that] the administration thought “there would be a big political win to flood New York and New Jersey with drugs that were unproven and, in fact, could have had a very damaging effect to people who took those drugs, which is what prompted Dr. Bright to come forward.” (source)

Finally, yesterday the Office of Special Counsel – which is reviewing Bright’s complaint – determined that there are “reasonable grounds to believe” that Bright’s removal was retaliation. The office recommended that Bright be temporarily reinstated for 45 days while the investigation continues.

Coming up? Bright is reportedly scheduled to appear before the House Energy Committee’s Health subcommittee next week, perhaps on Thursday May 14.


In brief: Trump’s plan

Trump is pushing forward with his plan to reopen the economy, ignoring his own administration’s guidelines and discounting the projected death toll.

In short, Trump’s plan – aided by Republican lawmakers – is:

  1. Remove income support, forcing people to return to work. Officials across the country are not accepting “fear of the coronavirus” as an excuse not to return to work, meaning furloughed employees must accept an employer’s offer to return.
  2. Hide the facts about reopening and the human cost of doing so too early. The administration is burying a CDC document detailing how to safely reopen because the guidelines were “too specific,” setting a bar too high for many states to reach in a short period of time. The nationwide lack of testing also helps hide the facts, as we don’t know the true spread of the virus.
  3. Pretend that lifting mitigation measures is about freedom. For instance, Trump tweeted that citizens should “LIBERATE” states that are under lockdown, egging on protestors (who were armed, in some cases).
  4. Protect businesses against lawsuits for facilitating the spread of the coronavirus. The president has already signed an executive order forcing meat-processing plants to remain open, no matter the high rate of infection and death among employees. Sen. McConnell is insisting that the next pandemic relief bill must contain liability protection for corporations.

Trump has apparently given up on even trying to fight the virus, deciding that his main objective should be winning re-election:

Several Trump aides say their 2020 campaign will now be chiefly defined by two themes: Trump is the only candidate who can resurrect the economy and that Biden will not be as tough on China, a country Trump is blaming for the pandemic.

…Starting next week, messaging on China will be sent to Republican state party officials, accusing China of costing American lives and that “Joe Biden is good for China but bad for America,” one campaign aide said.


The effect of reopening

As the IHME model researchers stated, lifting mitigation measures will lead to increased coronavirus infections and deaths. Another model, out of the University of Pennsylvania, backs up this finding. The Penn Wharton Budget Model (PWBM) has a combination of different inputs that take both policy and behavior into account. With a partial reopening and reduced social distancing, the PWBM predicts over 350,000 deaths by the end of June 2020. I think this is too high, as a “partial” reopening includes reopening schools, which so far seems highly unlikely to occur in the last month and a half of the school year.

It seems a more likely number is the one projected for a partial reopening with maintained social distancing behavior, or 161,664 deaths by the end of June. This is 50,000 more deaths than projected if states do not open.


States reopening

To save time and space, I’ll just post some headlines and links to notable stories about states reopening.

  • By mid-April, the president said 29 states would be able to reopen “relatively soon.” An analysis of state data has found that at least 19 states still fail to meet the White House’s own reopening criteria. In some 22 states, rates of infection are still rising. Ten states are in particular danger: Idaho, Indiana, Iowa, Kansas, Maine, Mississippi, Nebraska, Oklahoma, Tennessee, and Utah. Note that South Dakota never issued a shelter-in-place order so is not “reopening.”
    • These early-reopening states have already seen a rapid increase in daily case totals relative to one month ago (graph).
  • “Here’s How Texas’ Reopening Is Going: 1,200 New Cases,” Daily Beast
    • “Reopened restaurant told workers: Don’t wear face masks — or don’t work,” CBS
  • “Two Days of Record COVID-19 Deaths Precede Mississippi Reopening,” Jackson Free Press
  • “Florida adds 113 coronavirus deaths, a new one-day record: The Sunshine State’s death toll grows to 1,536 as it begins to reopen,” Tampa Bay Times
  • “Georgia Coronavirus Deaths Surpass 1,000; Forecaster Says Will Double By August With Reopening,” Forbes
    • IHME revised its cumulative death toll figures upwards to nearly 5,000 by August, an increase of more than 140% percent.
  • “Missouri Governor Says Concerts Can Resume, Cities Keep Venues Closed,” Yahoo News

Meat-packing cases

  • “U.S. judge dismisses lawsuit over worker safety at Smithfield [South Dakota] pork plant,” Reuters
  • Supervisors at Cargill Inc.’s pork and beef processing plant in Hazleton, Pa., suppressed information about employees falling ill with the coronavirus and told workers not to discuss it. “By April 7, 130 of the plant’s 900 employees had tested positive,” but Cargill was not disclosing any numbers. One employee died from the virus after being ordered to remove his face mask “because it was creating unnecessary fears among plant employees.”
  • Management at JBS-USA’s beef plant in the Texas Panhandle town of Cactus did not tell employees that a co-worker had contracted COVID-19 for over a week, allowing multiple other individuals to be infected. One employee died from COVID-19 after working sick for almost two weeks “because his supervisors wouldn’t excuse him to see a doctor and insisted he keep working.”
  • “58 percent of workers at Tyson meat factory in Iowa test positive for coronavirus. An Iowa Public Health Department report showed that more than 700 workers contracted the virus at a meat plant in Perry,” NBC
  • “Public health officials in Grand Island, Nebraska, wanted the JBS meatpacking plant closed. But Gov. Pete Ricketts said no. Since then, cases have skyrocketed,” ProPublica

Summary

  • TESTING: Trump and other White House officials benefit from a double standard: everyone Trump comes into contact with is tested for the virus, while the rest of us are expected to be “warriors,” in Trump’s words, and go back to work without that safety.
    • McEnany said that “as America reopens safely, the White House is continuing to operate safely.” However, only one of these entities has the ability to conduct contact testing: the White House. McEnany implicitly admits that rapid and regular testing is a prerequisite to operating safely, but the White House expects America to reopen without it.
  • TESTING: Trump admitted on Wednesday that more testing only reveals more infections and therefore increases the numbers. “In a way, by doing all this testing we make ourselves look bad,” he said.
  • DEATHS: The influential model that the White House has relied on to forecast coronavirus deaths released a revised projection of nearly 135,000 U.S. deaths through the beginning of August. A separate projection, based on FEMA modeling, forecasts up to about 3,000 daily deaths in the U.S. by June 1.
  • DEATHS: Trump has complained to advisers about the way coronavirus deaths are being calculated, suggesting the real numbers are actually lower. Some officials accuse hospitals of inflating the number of COVID-19 cases in order to rake in medicare payments.
  • DEATHS: Trump declared that the consequences of reopening the economy can be ignored: “Will some people be affected badly? Yes. But we have to get our country open and we have to get it open soon.”
  • DEATHS: Trump has been continually revising his own predicted death count higher – from “close to zero” at the end of February to 70,000 on Sunday and, yesterday, 100,000 deaths.
  • INCOMPETENCE: Kushner’s shadow task force “had little success in helping the government secure” medical supplies, according to a complaint filed with the House Oversight Committee. The task force prioritized leads from VIP’s like Fox News hosts.
  • RETALIATION: The Office of Special Counsel found “reasonable grounds to believe” that Dr. Rick Bright’s removal was retaliation for pushing back against the administration’s politics-over-science approach.
  • REOPENING: Numerous states are reopening too early and death rates are increasing: at least 19 states still fail to meet the White House’s own reopening criteria. In some 22 states, rates of infection are still rising.
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