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Did anyone ever warn that we were unprepared for a pandemic? Here is what the editorial board of the Washington Post says:


“CAME OUT of nowhere,” President Trump said March 6 of the coronavirus pandemic. “I just think this is something . . . that you can never really think is going to happen.” A few weeks later, he added, “I would view it as something that just surprised the whole world.” Mr. Trump also said, “Nobody knew there would be a pandemic or epidemic of this proportion.”

Of course, no one can pinpoint the exact moment that lightning will strike. But a global pandemic? Experts have predicted it, warned about the preparedness gaps and urged action. Again and again and again.

Just look at 2019. In January, the U.S. intelligence community issued its annual global threat assessment. It declared, “We assess that the United States and the world will remain vulnerable to the next flu pandemic or large-scale outbreak of a contagious disease that could lead to massive rates of death and disability, severely affect the world economy, strain international resources, and increase calls on the United States for support. . . . The growing proximity of humans and animals has increased the risk of disease transmission. The number of outbreaks has increased in part because pathogens originally found in animals have spread to human populations.”

In September, the Johns Hopkins Center for Health Security issued a report titled “Preparedness for a High-Impact Respiratory Pathogen Pandemic.” The report found that if such a pathogen emerged, “it would likely have significant public health, economic, social, and political consequences. . . . The combined possibilities of short incubation periods and asymptomatic spread can result in very small windows for interrupting transmission, making such an outbreak difficult to contain.” The report pointed to “large national and international readiness gaps.”

In October, the Nuclear Threat Initiative, working with the Johns Hopkins center and the Economist Intelligence Unit, published its latest Global Health Security Index, examining open-source information about the state of health security across 195 nations, and scoring them. The report warned, “No country is fully prepared for epidemics or pandemics, and every country has important gaps to address.” The report found that “Fewer than 5 percent of countries scored in the highest tier for their ability to rapidly respond to and mitigate the spread of an epidemic.”

In November, the Center for Strategic and International Studies published a study by its Commission on Strengthening America’s Health Security. It warned, “The American people are far from safe. To the contrary, the United States remains woefully ill-prepared to respond to global health security threats. This kind of vulnerability should not be acceptable to anyone. At the extreme, it is a matter of life and death. . . . Outbreaks proliferate that can spread swiftly across the globe and become pandemics, disrupting supply chains, trade, transport, and ultimately entire societies and economies.” The report recommended: “Restore health security leadership at the White House National Security Council.”

Came out of nowhere? Not even close. The question that must be addressed in future postmortems is why all this expertise and warning was ignored.

Blogger “Like a Renegade” observes that Arkansas Governor Asa Hutchinson is indifferent to the presence of COVID 19 in the prison population.

The blogger reminds the governor that prisoners interact with a large number of staff who then go out into the general population and may spread the disease.

She also points out that most inmates are in jail for a term, or for a death sentence.

The virus is no respecter of boundaries. It can be carried by cafeteria workers, guards, medical staff, police, or inmates on work release. She suggests that the indifferent, inhumane Governor Hutchinson pay attention.

Governor Hutchinson is one of those conservatives who is pro-life so long as it’s unborn.

Trump, who is not a medical doctor, suggested at his daily campaign rally yesterday, that his experts should study the effects of ingesting disinfectants, since they are known to kill coronavirus. Or inserting ultraviolet light inside the body or staying in bright sunshine.

The manufacturer of Lysol, a leading disinfectant, released a warning to the public: Do not ingest Lysol.

Anderson Cooper asked two doctors on CNN, including Dr. Sanjay Gupta, about Trump’s recommendations, and they said no responsible doctor would consider Trump’s recommendations. COVID affects people in hot and sunny climates. Disinfectants should not be ingested.

Perhaps his cabinet or Mitch McConnell should offer themselves as subjects for a trial recommended by the man they adore.

The New York Times reported that Alex Azar, the head of Health and Human Services, had chosen a former labradoodle breeder to lead the federal government’s response to the coronavirus pandemic. No, this is not a story from the Onion.

This one takes the cake. Lincoln, said historian Doris Kearns, was surrounded by a “team of rivals.” Trump has surrounded himself with a team of incompetents.

WASHINGTON — On January 21, the day the first U.S. case of coronavirus was reported, the secretary of the Department of Health and Human Services appeared on Fox News to report the latest on the disease as it ravaged China. Alex Azar, a 52-year-old lawyer and former drug industry executive, assured Americans the U.S. government was prepared.

“We developed a diagnostic test at the CDC, so we can confirm if somebody has this,” Azar said. “We will be spreading that diagnostic around the country so that we are able to do rapid testing on site.”

While coronavirus in Wuhan, China, was “potentially serious,” Azar assured viewers in America, it “was one for which we have a playbook.”
Azar’s initial comments misfired on two fronts. Like many U.S. officials, from President Donald Trump on down, he underestimated the pandemic’s severity. He also overestimated his agency’s preparedness.

As is now widely known, two agencies Azar oversaw as HHS secretary, the Centers for Disease Control and Prevention and the Food and Drug Administration, wouldn’t come up with viable tests for five and half weeks, even as other countries and the World Health Organization had already prepared their own.

Shortly after his televised comments, Azar tapped a trusted aide with minimal public health experience to lead the agency’s day-to-day response to COVID-19. The aide, Brian Harrison, had joined the department after running a dog-breeding business for six years. Five sources say some officials in the White House derisively called him “the dog breeder.”

Azar’s optimistic public pronouncement and choice of an inexperienced manager are emblematic of his agency’s oft-troubled response to the crisis. His HHS is a behemoth department, overseeing almost every federal public health agency in the country, with a $1.3 trillion budget that exceeds the gross national product of most countries.

Azar and his top deputies oversaw health agencies that were slow to alert the public to the magnitude of the crisis, to produce a test to tell patients if they were sick, and to provide protective masks to hospitals even as physicians pleaded for them.

The first test created by the CDC, meant to be used by other labs, was plagued by a glitch that rendered it useless and wasn’t fixed for weeks. It wasn’t until March that tests by other labs went into production. The lack of tests “limited hospitals’ ability to monitor the health of patients.

A promised virus surveillance program failed to take root, despite assurances Azar gave to Congress. Rather than share information, three current and three former government officials told Reuters, Azar and top staff sidelined key agencies that could have played a higher-profile role in addressing the pandemic. “It was a mess,” said a White House official who worked with HHS.
Officials across the government, from President Trump on down, have been blasted for America’s halting response to the pandemic. Critics inside and outside the administration say a meaningful share of the responsibility lies with HHS and Trump appointee Azar.
“You have to blame the problem on the virus, but it’s Azar’s operation,” said Lynn Goldman, the dean of the public health school at George Washington University, who has served on advisory boards of the FDA and CDC. “And the buck stops there.”
HHS declined to make Azar available for an interview. Michael Caputo, the new chief HHS spokesman, declined to answer Reuters questions about Azar’s stewardship, saying in a statement: “We are communicating to the American public during a deadly pandemic.”
DALLAS LABRADOODLES

Azar is a Republican lawyer who once clerked for the late conservative Supreme Court Justice Antonin Scalia and counts current Supreme Court Justice Brett Kavanaugh as a friend. Under George W. Bush, Azar worked for HHS as general counsel and deputy secretary. During the Obama years, he cycled through the private sector as a pharmaceutical company lobbyist and executive for Eli Lilly. After Trump’s first HHS secretary was forced out in a travel corruption scandal, Azar stepped in, in January 2018.

Two years later, at the dawn of the coronavirus crisis, Azar appointed his most trusted aide and chief of staff, Harrison, as HHS’s main coordinator for the government’s response to the virus.

Harrison, 37, was an unusual choice, with no formal education in public health, management, or medicine and with only limited experience in the fields. In 2006, he joined HHS in a one-year stint as a “Confidential Assistant” to Azar, who was then deputy secretary. He also had posts working for Vice President Dick Cheney, the Department of Defense and a Washington public relations company.

Before joining the Trump Administration in January 2018, Harrison’s official HHS biography says, he “ran a small business in Texas.” The biography does not disclose the name or nature of that business, but his personal financial disclosure forms show that from 2012 until 2018 he ran a company called Dallas Labradoodles.

The company sells Australian Labradoodles, a breed that is a cross between a Labrador Retriever and a Poodle. He sold it in April 2018, his financial disclosure form said. HHS emailed Reuters that the sales price was $225,000.

At HHS, Harrison was initially deputy chief of staff before being promoted, in the summer of 2019, to replace Azar’s first chief of staff, Peter Urbanowicz, an experienced hospital executive with decades of experience in public health.

This January, Harrison became a key manager of the HHS virus response. “Everyone had to report up through him,” said one HHS official.
One questionable decision, three sources say, came that month, after the White House announced it was convening a coronavirus task force. The HHS role was to muster resources from key public health agencies: the CDC, FDA, National Institutes of Health, Office of Global Affairs and the Assistant Secretary for Preparedness and Response.

Harrison decided, the sources say, to exclude FDA Commissioner Stephen Hahn from the task force. “He said he didn’t need to be included,” said one official with knowledge of the matter.

When task force members were announced January 29, neither Hahn nor the FDA were included. Hahn wasn’t put on the task force until Vice President Mike Pence took over in February. Two of Hahn’s high-profile counterparts were on it from the start: CDC director Robert Redfield and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

The HHS denied it was Harrison’s decision to leave out Hahn and the FDA, but declined to say who made the call. The agency lauded Harrison’s work on the task force.

In a statement, Hahn said the FDA was focused on the coronavirus epidemic, “not on when we were added to the task force,” and that the agency was not “excluded.”

Fauci, who has become a public face of the Trump Administration’s COVID-19 effort, said he wasn’t sure including the FDA was necessary at the start. Initially, the Chinese government was saying the virus spread through animals, not human to human, he said. “You would include the FDA when you want to expedite drugs or devices,” Fauci said.

Others said the lack of a strong FDA role early on had direct consequences. Two sources familiar with events say the White House wasn’t getting information from the FDA about the state of the testing effort, a crucial element of the coronavirus response.

Reached by phone, Harrison declined to answer Reuters’ questions. In a later statement, he did not address questions about the task force but said he was proud of his work history. “Americans would be well served by having more government officials who have started and worked in small family businesses and fewer trying to use that experience to attack them and distort the record,” he wrote.

In a statement to Reuters, Azar said Harrison has been an asset. “From day one, Brian has demonstrated remarkable leadership and managerial talents,” Azar wrote.

For several weeks, Trump has been promoting an anti-malaria drug called hydroxychloroquine to treat COVID-19. FOX News has enthusiastically echoed Trump’s claims, disregarding the judgment of medical doctors who warned that the drug’s effectiveness had not been proven in clinical trials.

But suddenly FOX went silent.

The Washington Post reporters Paul Farhi and Elahe Izadi explained.

At the height of Fox News’s coverage of a would-be treatment for the novel coronavirus, the network’s medical correspondent, Marc Siegel, offered a remarkable testimonial during Tucker Carlson’s show.

Siegel said his 96-year-old father, suffering from symptoms of the virus and fearing he would die, made a full recovery thanks to the drug, hydroxychloroquine, and a course of antibiotics. “He got up the next day and was fine,” Siegel told an astonished Carlson.

Siegel’s miraculous-recovery story was part of a near-campaign for hydroxychloroquine by Fox News and its sister network, Fox Business.
Echoing President Trump’s description of the drug as a “game changer,” Carlson, Laura Ingraham, Sean Hannity, Lou Dobbs and “Fox & Friends” hosts spoke of its potential benefits in dozens of segments from mid-March to mid-April.

They also criticized those in the media and the medical establishment who raised concerns, turning a debate among researchers and scientists into another front in the culture wars.

But in the past week or so, Trump has all but stopped talking about hydroxychloroquine. And so have Fox News’s hosts.

The relative silence follows disappointing, even alarming, new research about hydroxychloroquine as a treatment for covid-19, the disease caused by the virus. A study released this week on 368 male Veterans Affairs patients with the disease showed that the death rate among those given the drug, both in combination with another drug and alone, was higher than for those who were not. Researchers also said its use made no difference in the need for ventilators.

Like other fast-moving research about covid-19 treatments, the study by VA and academic researchers hasn’t undergone the typical peer-review process and isn’t the kind of formal clinical trial, like those underway elsewhere, that will offer more definitive answers. However, it was based on one of the largest collections of data about the drug’s use.

Claims about hydroxychloroquine to treat covid-19 have gained traction despite a lack of scientific evidence. How did this happen? (Elyse Samuels, Meg Kelly, Sarah Cahlan/The Washington Post)

Another study, released by French researchers last week, offered more discouraging clues. It found no statistically significant difference in the death rates among 181 covid-19 patients who had taken hydroxychloroquine within 48 hours of being admitted to a hospital and those who hadn’t. The study also highlighted dangerous side effects; eight developed arrhythmia, or abnormal heart rhythms, and had to stop taking it.

On Tuesday, an expert panel convened by the National Institute of Allergy and Infectious Diseases advised physicians against prescribing hydroxychloroquine with the antibiotic azithromycin because of the potential side effects. The panel said there wasn’t enough evidence yet to recommend for or against hydroxychloroquine as a treatment. The agency is headed by Trump’s top infectious disease adviser, Anthony S. Fauci, who has repeatedly tempered Trump’s upbeat commentary about the drug.

All of which raises a question about the Fox News hosts’ advocacy of hydroxychloroquine: Were they pushing a potentially ineffective, even dangerous, remedy in the absence of sound science and well in excess of their expertise or knowledge?

For Fox News hosts, the hydroxychloroquine controversy is fuel for the culture war

A Fox spokeswoman declined to comment directly on any prime-time commentary but mentioned recent segments that “show the network’s attention to all sides of this story from a news and opinion perspective.”

Carlson, Hannity and Ingraham didn’t mention the new research on their programs on Tuesday. The topic was replaced by rhetoric about China’s culpability for the pandemic and advocacy for reopening the country, again seemingly as part of a feedback loop with Trump’s own comments.

Ingraham, who met with Trump in early April to urge him to push the drug, hadn’t discussed hydroxychloroquine since April 15. But on Wednesday, Ingraham devoted the beginning of her show to address the study of VA patients, calling it a “shockingly irresponsible” survey and “perhaps even agenda-driven.” She also criticized the media coverage around the study.

She said the study lacked methodological rigor and that the drug works best on patients who aren’t yet severely sick, unlike in the survey.
“What’s driving this? It’s a blind obsession to disprove the effectiveness of a drug that’s being used right now tonight in medical centers across America,” Ingraham said. “Is this a mad impulse to discount any benefit from the therapy? Is it triggered by pure hatred of Trump, Fox or me? I don’t know. Is it motivated by a secret desire to keep America hopeless?”

Syndicated TV host Mehmet Oz — an enthusiastic promoter of the drug in his many guest appearances on Fox News — seemed to backpedal from his usual advocacy on Wednesday’s “Fox & Friends.”

“The fact of the matter is, we don’t know,” he told co-host Brian Kilmeade, adding, “There’s a lot of variables. Brian, I gotta say at this point there is so much data coming from so many places, we are better off waiting for the randomized trials Dr. Fauci has been asking for. Otherwise, we keep reacting back and forth to studies that show opposite results, and a lot of it might have to do with when you get the medication.”

Oz, a cardiac surgeon with limited expertise in pharmacology or virology, had previously said on Fox News that Fauci — the government’s leading infectious-disease expert — needed to “respect” the positive results of studies conducted to date, even if they were small.

Given the new data, Fox News has an obligation to give equal time to the doubts and potential dangers of hydroxychloroquine, said William Haseltine, the eminent biologist and biotech entrepreneur.

“That’s just public responsibility,” said Haseltine, who is chairman and president of Access Health International, a nonprofit organization that seeks to expand access to health care. “They have a duty to inform their [viewers] that they made a mistake. It’s not a crime to make a mistake, but they do need to correct it.”

In contrast to the network’s popular commentators, Fox’s news programs and website have been more cautious and have reported on the new research.

The network on Tuesday played clips from a White House press briefing in which Stephen Hahn, commissioner of the Food and Drug Administration, urged waiting for randomized clinical trials “to actually make a definitive decision around safety and efficacy.”
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Trump sounded a bit less enthusiastic about hydroxychloroquine during the same briefing. He said he was unaware of the VA study. He also said, “Obviously, there have been some very good reports and perhaps this one is not a good report. But we’ll be looking at it.”

Lamar Alexander and Roy Blunt are senior Republican Senators who chair important committees. In this article, they propose a “shark tank” competition for government agencies, believing that the funding and the competition will ramp up the number of tests produced. They admit that the federal government has failed to supply the numbers of reliable tests needed by the American public to feel safe and ready to resume work.

Lamar Alexander (R-Tenn.) is chairman of the Senate Health, Education, Labor and Pensions Committee. Roy Blunt (R-Mo.) is chairman of the Senate’s health appropriations subcommittee.

As I read the article, I couldn’t help but think that the premise of the article is silly. The scientists at NIH and other federal agencies need more funding but they don’t need a “shark tank” to spur them on. The scientists know the gravity of the situation. They are doing the best they can with the resources they have. If they need more resources for staff and equipment, they should get it without the phony spur of a “race.”

They should be encouraged to collaborate, not to compete. Science works best when scientists share what they know worth their peers.

Alexander and Blunt rely on the same thinking that leads to “merit pay,” which has always failed. That thinking presumes that most professionals are slackers and won’t do their best without incentives. It was wrong for teachers and it’s wrong now for scientists.

Give them the resources needed to do their job and let them do it without hokey tricks or “shark tank” competition. They want to develop better tests; they want to find a cure. They don’t need a prize to motivate them.

The stringent restrictions in place are “flattening the curve,” but the director of the Centers for Disease Control warned of the possibility of a new outbreak next winter.

Even as states move ahead with plans to reopen their economies, the director of the Centers for Disease Control and Prevention warned Tuesday that a second wave of the novel coronavirus will be far more dire because it is likely to coincide with the start of flu season.

“There’s a possibility that the assault of the virus on our nation next winter will actually be even more difficult than the one we just went through,” CDC Director Robert Redfield said in an interview with The Washington Post. “And when I’ve said this to others, they kind of put their head back, they don’t understand what I mean.”

“We’re going to have the flu epidemic and the coronavirus epidemic at the same time,” Redfield said, and having two simultaneous respiratory outbreaks would put unimaginable strain on the health-care system. The first wave of covid-19, the disease caused by the coronavirus, has already killed more than 42,000 people across the country. It has overwhelmed hospitals and revealed gaping shortages in test kits, ventilators and protective equipment for health-care workers.

In a wide-ranging interview, Redfield said federal and state officials need to use the coming months to prepare for what lies ahead. As stay-at-home orders are lifted, officials need to stress the continued importance of social distancing. Officials also need to massively scale up their ability to identify the infected through testing and find everyone they interact with through contact tracing. Doing so prevents new cases from becoming larger outbreaks.

Asked about the appropriateness of protests against stay-at-home orders and calls on states to be “liberated” from restrictions, Redfield said: “It’s not helpful.”

Steven Singer hears the growing demand to reopen schools in the midst of the pandemic, and he sees an ulterior motive.

The clamor to reopen the schools is not about education or even the lives of children, but freeing their parents to go back to work.

He writes that despite the lack of testing or vaccines, the Trump administration is eager to open up the economy, and reopening schools is central to that goal.

The rich need the poor to get back to work. And they’re willing to put our lives on the line to do it.

What’s worse, they’re willing to put our children’s lives on the line.

I don’t know about you, but I’m not willing to risk my daughter’s life so that the stock market can open back up.

As a public school teacher, I’m not willing to bet my students lives so that the airlines and cruise industry can get back in the green.

Nor am I willing to gamble with my own life even if it means the NBA, NFL and MLB can start playing games and Hollywood can start premiering first run movies again.

There’s still so much we don’t know about COVID-19.

Initial reports concluded that older people were more susceptible to it, but as infections have played out worldwide, we’ve seen that 40% of patients are between 20-50 years of age. Children seem mostly asymptomatic. However, many immunologists suspect they are acting as carriers spreading the virus to the older people with whom they come into contact.

Children have a more difficult time with the constant hand washing and separating themselves at least 6 feet apart recommended by health experts. This is one of the justifications for closing schools in the first place. If we reopen schools too quickly, it could jumpstart another wave of infections.

Trump froze funding to the World Health Organization on grounds that it had not given forewarning about the virus but had parroted the Chinese government line that it was contained. Dr. Birx dutifully parroted the Trump line.

The Washington Post disagreed in an editorial.

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 staffers are regularly detailed to work at 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.
The presence of so many U.S. officials undercuts President Trump’s charge that the WHO’s failure to communicate the extent of the threat, born of a desire to protect China, is largely responsible for the rapid spread of the virus in the United States.

The administration has also sharply criticized the Chinese government for withholding information.

But the president, who often touts a personal relationship with Chinese President Xi Jinping and is reluctant to inflict damage on a trade deal with Beijing, appears to see the WHO as a more defenseless target.

Asked early Sunday about the presence of CDC and other officials at the WHO, and whether it was “fair to blame the WHO for covering up the spread of this virus,” Deborah Birx, the State Department expert who is part of the White House pandemic team, gently shifted the onus to China, and the need to “over-communicate.”
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“It’s always the first country that get exposed to the pandemic that has a — really a higher moral obligation on communicating, on transparency, because all the other countries around the world are making decisions on that,” Birx told ABC’s This Week. “And when we get through this as a global community, we can figure out really what has to happen for first alerts and transparency and understanding very early on about … how incredibly contagious this virus is.”

One reason that the U.S. was unprepared for the pandemic is that we were shipping medical supplies to a China even though government officials had been warned that the disease was likely to reach our country.

U.S. manufacturers shipped millions of dollars of face masks and other protective medical equipment to China in January and February with encouragement from the federal government, a Washington Post review of economic data and internal government documents has found. The move underscores the Trump administration’s failure to recognize and prepare for the growing pandemic threat.


In those two months, the value of protective masks and related items exported from the United States to China grew more than 1,000 percent compared with the same time last year — from $1.4 million to about $17.6 million, according to a Post analysis of customs categories which, according to research by Public Citizen, contain key PPE. Similarly, shipments of ventilators and protective garments jumped by triple digits.
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Instead of taking steps to prepare, they ignored the advice of one expert after another,” said Rep. Lloyd Doggett (D-Tex.). “People right now, as we speak, are dying because there have been inadequate supplies of PPE.”


While the percentage increase of exports to China was steep, they represent a small fraction of the overall U.S. need. Throughout the country, the shortage has forced hospitals, nursing homes and first responders to ration masks and other protective gear as they treat infected and high-risk patients, creating a secondary health crisis among first line providers.


In the early days of the covid-19’s exponential march across the globe, when it was still mostly contained in China, there was no widespread sense of crisis in the White House. But by the end of January, briefings to White House national security staff made clear that the danger of a major pandemic was real. By then seven Americans had fallen ill, and experts said the need for an adequate supply of protective gear should have been apparent.


Nonetheless, on Jan. 30, Commerce Secretary Wilbur Ross said on Fox Business that the outbreak could “accelerate the return of jobs to North America” because companies would move factories away from impacted areas.

You can open the link and read the article. Both the Washington Post and New York Times are making articles about the coronavirus free, not behind a paywall.