Coronavirus: No testing + undercounting deaths = artificial success

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).

I’m going to do a separate post on PPE, ventilators, and the DPA early next week. There is just too much to fit into this recap.

Housekeeping:

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Hide the true toll

If you’ll remember last week, I briefly went over Trump’s apparent plan to get the country reopened: (1) Remove income support, forcing people to return to work. (2) Hide the facts about reopening and the human cost of doing so too early. (3) Pretend that lifting mitigation measures is about freedom and preserving Republicans’ chances in the election. (4) Protect businesses against lawsuits for facilitating the spread of the coronavirus.

This week, we’ve seen the second step in that plan kick into full gear, with the administration trying to suppress any information that reveals the truth about the crisis we’re in.

Trump and some on the coronavirus task force are pressuring the CDC to change how COVID-19 deaths are counted so that far fewer deaths make it into the official total. Specifically, these officials believe that only those individuals with confirmed positive test results should be included.

[In a task-force meeting last week,] a heated discussion broke out between Deborah Birx, the physician who oversees the administration’s coronavirus response, and Robert Redfield, the director of the Centers for Disease Control and Prevention. Birx and others were frustrated with the CDC’s antiquated system for tracking virus data, which they worried was inflating some statistics — such as mortality rate and case count — by as much as 25 percent… (WaPo)

However, numerous public health experts have said that coronavirus deaths are actually significantly undercounted. Most recently, Dr. Fauci told the Senate Health subcommittee (HELP) that “there’s more of a chance of missing some that are really coronavirus deaths that are not being counted.”

“The official statistic, Dr. Fauci, is that 80,000 Americans have died from the pandemic,” Sen. Bernie Sanders (I-Vt.) said, referring to the current death toll. “There are some epidemiologists who suggest the number may be 50 percent higher than that. What do you think?”

“I’m not sure, Senator Sanders, if it’s going to be 50 percent higher,” Fauci replied. “But most of us feel that the number of deaths are likely higher than that number.” (video)

One way to estimate the true death toll from the pandemic is by evaluating excess mortality, or the difference between observed numbers of deaths and expected numbers (usually based on the weekly average from previous years). An analysis by the New York Times using this method found that “around 100,000 to 110,000 Americans have already died as a result of the pandemic,” which is an undercount of at least 20,000 deaths.

One-two-punch

If the Trump administration gets its way, only deaths with confirmed-positive test results will be counted in the coronavirus total. However, tests are still hard to come by. In a near perfect one-two-punch strategy, the federal government is limiting the availability of the key element they require to count cases, resulting in an artificially low death count.

Trump himself has admitted on numerous occasions that he dislikes testing for the virus because it leads to a higher (more accurate) total. In fact, he said it again yesterday:

“When you test, you have a case. When you test, you find something is wrong with people. If we didn’t do any testing we would have very few cases.” (video)

Last week, Trump said, “in a way, by doing all this testing we make ourselves look bad” (video). In early March, Trump 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.”

Where did this view come from? Perhaps Jared Kushner, according to the Financial Times (non-paywalled):

“Jared [Kushner] had been arguing that testing too many people, or ordering too many ventilators, would spook the markets and so we just shouldn’t do it,” the source told the Times. “That advice worked far more powerfully on him than what the scientists were saying. He thinks they always exaggerate.”

The conservative pipeline

Trump’s questioning of the death toll started in conservative media, with conspiracy theories about deep state actors artificially inflating the number of deaths to make Trump look bad. Reacting to a fake tweet about the CDC misreporting fatality data, former White House adviser Sebastian Gorka said:

“Not only does this prove that the Chinese virus is not nearly as deadly as originally believed, but it also most likely confirms that many of the deaths previously attributed to the Coronavirus were actually caused by other underlying factors, such as pre-existing conditions, or even deaths falsely attributed to the virus when said victims were not proven to have had the virus in the first place.”

Fox News is also questioning whether the numbers we’re seeing are really so bad. “There may be reasons people seek an inaccurate death count,” Tucker Carlson said last month. “When journalists work with numbers, there sometimes is an agenda.” Likewise, Brit Hume tweeted that New York City’s coronavirus “fatality numbers are inflated.”

Dr. Bright’s testimony

While the Trump administration seems to have a plan for downplaying pandemic, it has been clear for months that there is no federal plan to mitigate the impact of the virus.

Yesterday, vaccine expert and whistleblower Dr. Rick Bright testified before the House Energy and Commerce Committee that “we don’t have a single point of leadership right now for this response, and we don’t have a master plan for this response” (video). Bright warned that without a comprehensive national plan the coronavirus outbreak could combine with the seasonal flu later this year to create “the darkest winter in modern history” (video:

“Without better planning, 2020 could be the darkest winter in modern history. First and foremost, we need to be truthful with the American people. … we have the world’s greatest scientists. Let us lead. Let us speak without fear of retribution. We must listen…

While waiting for a cure and a vaccine – which I believe will come – there are things we must do immediately. We must increase the public education about the basics: washing hands, social distancing, appropriate face coverings. These are simple but critical steps that buy valuable time until there’s a vaccine. We need to ramp up production of essential equipment and supplies, including raw materials and critical components… We need to facilitate equitable distribution of essential equipment and supplies.

”Finally, we need a national testing strategy. The virus is here. It’s everywhere. We need to be able to find it, isolate it, and stop it. We need to have the right testing for everyone who needs it. We need to be able to trace contacts, isolate, and quarantine appropriately while striving to develop a cure.”

Other takeaways

The main point of Dr. Bright’s testimony was that we never had a plan, we don’t currently have a plan, and we need a plan! Other key points he made include:

  • “Lives were endangered, and I believe lives were lost” as a result of the delayed and inadequate government response. Bright described urging the Dept. of Health and Human Services (HHS) to focus on securing N95 masks, but was told that officials did not believe there was a critical urgency. HHS leadership “indicated if we noticed there is a shortage that we will simply change the CDC guidelines to better inform people who should not be wearing those masks to save those masks for our healthcare workers. My response was, ‘I cannot believe you can sit and say that with a straight face.’ It was absurd.” (video
  • “There were some attempts to bypass” the standard process to prove hydroxychloroquine was effective and safe for use to treat COVID-19, according to Bright. (video)
  • The country is not prepared to manufacture and distribute a vaccine, when one is found. “There’s no one company that can produce enough for our country or for the world, it’s going to be limited supplies. We need to have a strategy and plan in place now to make sure that we can not only fill that vaccine, make it, distribute it, administer it in a fair and equitable plan… We don’t have that yet and it is a significant concern,” Bright said. (video)
  • Republicans in the hearing spent an inordinate amount of time defending Trump’s promotion of hydroxychloroquine. Ranking member on the subcommittee, Rep. Michael Burgess (R-TX) used his time to proclaim that he’s “hearing from a lot of doctors” that there is “significant benefit” to using hydroxychloroquine to treat COVID-19 (video). Rep. Gus Bilirakis (R-FL) also cited unnamed “experts” who have supposedly reported benefits to using the drug that outweigh the risks (video).

Fact check: Two new studies published last week found that patients treated with hydroxychloroquine experienced no noticeable benefit, adding to the previous research with the same conclusions. The first was published in the New England Journal of Medicine and the second in the Journal of the American Medical Association.

Mike Bowen

Also present at the hearing was Prestige Ameritech CEO Mike Bowen, who testified that his company tried to warn federal officials that there was a need to stockpile N-95 masks earlier this year in response to the pandemic.

In fact, Bowen has been arguing for years that the U.S. needs to maintain domestic production of critical equipment like masks. Two years ago, he told local Dallas news that the Trump administration did not heed his warnings, instead awarding a contract to make masks to a company in Mexico.

Bowen sent an email to Bright early in the pandemic, warning that the supply of N95 masks was low and offering increased capacity to make more. He noted that if his lines were activated “we could be making about 7 million N95 respirators a month.”

“So my email to Rick Bright, in that email, I said, ‘I think we’re in trouble. We have these machines, it would be expensive and hard to get them going. But if we’re going, if this is going to be bad, that could happen.’ So that was my offer.”

Eshoo then asked Bowen if the reason the offer wasn’t accepted was to save money.

“It’s — I call it chasing pennies to China,” Bowen said.

“And look what it has cost us,” Eshoo said.

“It’s cost us lives,” Bowen replied. (video)

Vaccines

As Dr. Bright warned, a vaccine is likely a year and a half away at minimum. But Trump apparently doesn’t think we’ll need it – continuing the same magical thinking that he’s employed during the crisis, Trump said: “I feel about vaccines like I feel about tests: This is going to go away without a vaccine…It’s going to go away, and we’re not going to see it again, hopefully, after a period of time.” (video)

  • Dr. Fauci rebutted Trump at a congressional hearing on Tuesday,, saying: “When you talk about ‘will this virus just disappear’ — and I’ve said publicly many times, that is just not gonna happen because it’s such a highly transmissible virus.”

Back to Dr. Bright’s point, though, we need to ramp up capabilities to manufacture, package, store, deliver, and administer a vaccine while we figure out the science, so the nation is prepared when one is eventually found.

The nation is already grappling with a shortage of the specialized glass used to make the vials that will store any vaccine. Producing and distributing hundreds of millions of vaccine doses will also require huge quantities of stoppers — which are made by just a handful of companies — as well as needles and refrigeration units. Low stocks of any one of these components could slow future vaccination efforts, much as shortfalls of key chemicals delayed widespread coronavirus testing.

A key concern about distributing a potential vaccine is accessibility. As we’ve seen with PPE and testing kits, existing systematic disparities have been magnified during the pandemic. Low-income and minority communities have suffered the most.

Sen. Bernie Sanders highlighted this fact during Tuesday’s hearing and tried to get the government witnesses to guarantee that a vaccine “will be available to all people, regardless of their income.” None of the officials agreed to that guarantee. Admiral Brett Giroir, for instance, said he will “advocate” for it but could not commit HHS to such a promise. (video)

America last?

Last week, countries around the world pledged money to a joint effort to fund a coronavirus vaccine. The money will be distributed to laboratories with the ultimate goal of delivering universal and affordable medication to giht COVID-19. Trump, however, did not contribute to the fund because his administration prefers America spend its money funding its own search for a vaccine.

“The United States is led by a president who embodies the U.S.’s most basic instincts — sovereignty above all,” said Robin Niblett, director of the London-based think tank Chatham House. “Any international cooperation he engages in needs to be very firmly in the interest of the United States.”

World leaders who pledged money expressed a willingness to help the world beat the virus, not just their own country: “We will not be safe until we can share it with the rest of the world,” said Prime Minister Justin Trudeau of Canada, referring to a vaccine.

The risk here is obvious: If there is a breakthrough, the US could find itself at the end of the line. America first could become America last and America alone.

Other nations have noted Trump’s selfishness and worry that the U.S. president will promote a global contest for a vaccine, one in which poorer countries are left behind to experience unnecessary suffering and death.

“The worst situation would be, if when these tools are available, they go to the highest bidder — that would be terrible for the world,” said Melinda Gates…

“You would think that, based on the past, that the U.S. would be a galvanizing, lead element in pushing for transparency and early planning” on the vaccine front, said Stephen Morrison, who runs a global health program at the Center for Strategic and International Studies. “I don’t think that’s true in this administration.”

In fact, we already have evidence that Trump is willing to throw everyone else under the coronavirus-bus for profit. You may remember in March Trump offered a German company “large sums of money” to get exclusive access to a coronavirus vaccine in development.

Trump was trying to get the Tübingen-based CureVac company — which also has sites in Frankfurt and Boston — to move its research wing to the United States and develop the vaccine “for the U.S. only.”

Reopening

  • Based on the CDC guidelines that were shelved by the Trump administration, “no one who is reopening meets the criteria for reopening,” said a senior CDC official. “Ultimately members of the task force felt it was too specific and might not be helpful as nationwide guidance.” However, the White House guidance has been criticized for being vague, without details of how to achieve goals.
    • AP: A former chemical industry executive [Nancy Beck] nominated to be the nation’s top consumer safety watchdog was involved in sidelining detailed guidelines to help communities reopen during the coronavirus pandemic, internal government emails show.
  • Michigan Gov. Gretchen Whitmer: “These protests, in a perverse way, make it likelier that we’re going to have to stay in a stay-at-home posture,” “This is not appropriate in a global pandemic … This is calls to violence. This is racist and misogynistic. This is racist and misogynistic.”
  • Whitmer is right, the stay-at-home order is working as cases and deaths plummet, Metro Times
  • Michigan Barber Has Licenses Suspended After Defying Shutdown Orders: State officials said Karl Manke’s decision to reopen his shop during the coronavirus pandemic jeopardized public health and safety, NYT
    • A Michigan Barbershop Used Armed Militia To Stop Police From Shutting Them Down, Yahoo
  • Wisconsin Supreme Court Overturns The State’s Stay-At-Home Orders, NPR
    • Gov. Tony Evers: “We’re the Wild West. There are no restrictions at all across the state of Wisconsin. … So at this point in time … there is nothing that’s compelling people to do anything other than having chaos here.” (video)
  • Wisconsin bars packed with patrons almost immediately after court strikes down stay-at-home order, CBS
  • 60,000 people headed to Georgia after it allowed some businesses to open — and it led to the exact scenario researchers warned could make matters worse, Business Insider
  • South Dakota will take Native American tribes to court over coronavirus checkpoints, The Hill
  • Coronavirus case cluster tied to Pasadena party and ‘selfish behavior,’ officials say, LA Times
  • Coronavirus ‘parties’ in a Washington county linked to a rise in cases, officials say, NBC

SUMMARY

  • Trump is pressuring the CDC to change how COVID-19 deaths are counted so that far fewer deaths make it into the official total. Specifically, these officials believe that only those individuals with confirmed positive test results should be included.
  • If the Trump administration gets its way, only deaths with confirmed-positive test results will be counted in the coronavirus total. However, tests are still hard to come by. In a near-perfect one-two-punch strategy, the federal government is limiting the availability of the key element they require to count cases, resulting in an artificially low death count.
  • Jared Kushner has been arguing since early in the pandemic that testing people for the virus (and thus finding cases) would spook the stock market.
  • Dr. Rick Bright testified before the House Energy and Commerce Committee that “we don’t have a single point of leadership right now for this response, and we don’t have a master plan for this response.”
  • Bright: “Lives were endangered, and I believe lives were lost” as a result of the delayed and inadequate government response.
  • Trump: “I feel about vaccines like I feel about tests: This is going to go away without a vaccine.”
  • The US did not contribute to a global effort to find a vaccine.
  • Based on the CDC guidelines that were shelved by the Trump administration, “no one who is reopening meets the criteria for reopening,” said a senior CDC official
  • Wisconsin Supreme Court Overturns The State’s Stay-At-Home Orders