“”From the first months of the COVID-19 pandemic, scientists baffled by the disease’s ferocity have wondered whether the body’s vanguard virus fighter, a molecular messenger called type I interferon, is missing in action in some severe cases. Two papers published online in Science this week confirm that suspicion. They reveal that in a significant minority of patients with serious COVID-19, the interferon response has been crippled by genetic flaws or by rogue antibodies that attack interferon itself,””
“In America, our ideological conflicts are often understood as the tension between individual freedoms and collective actions. The failure of our pandemic response policy exposes the falseness of that frame. In the absence of effective state action, we, as individuals, find ourselves in prisons of risk, our every movement stalked by disease. We are anything but free; our only liberty is to choose among a menu of awful options. And faced with terrible choices, we are turning on each other, polarizing against one another. YouTube conspiracies and social media shaming are becoming our salves, the way we wrest a modicum of individual control over a crisis that has overwhelmed us as a collective.
“The burden of decision-making and risk in this pandemic has been fully transitioned from the top down to the individual,” says Dr. Julia Marcus, a Harvard epidemiologist. “It started with [responsibility] being transitioned to the states, which then transitioned it to the local school districts — If we’re talking about schools for the moment — and then down to the individual. You can see it in the way that people talk about personal responsibility, and the way that we see so much shaming about individual-level behavior.” (You can hear my whole conversation with Marcus on this podcast.)
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“But in shifting so much responsibility to individuals, our government has revealed the limits of individualism.”
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“Think of coronavirus risk like an equation. Here’s a rough version of it: The danger of an act = (the transmission risk of the activity) x (the local prevalence of Covid-19) / (by your area’s ability to control a new outbreak).
Individuals can control only a small portion of that equation. People can choose safer activities over riskier ones — though the language of choice too often obscures the reality that many have no economic choice save to work jobs that put them, and their families, in danger. But the local prevalence of Covid-19 and the capacity of authorities to track and squelch outbreaks are collective functions. They rely on competent testing infrastructures, fast contact tracing, universal health insurance, thoughtful reopening policies, strong public health communication, reliable economic support for the displaced, and social trust. Managed well, they lower the background risk, making more activities safe enough to consider, making the decisions individuals face easier. But in America, that public infrastructure has failed most people, in most places. The result is a maddening world of risk that individuals have been left to navigate virtually alone.”
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“There are dozens of ways the government could make it easier for individuals to make safe choices, ranging from effective policies to control the spread of the virus to a renewed economic support package that would allow people to protect their health without sacrificing their livelihoods. This is how other countries are responding to the crisis, and it is working. But Trump has refused to put forward — much less follow — a plan to suppress the virus, and congressional Republicans have insisted on withdrawing support from the labor market, in a bid to force workers to return to jobs. In that way, the impossible choices being forced on Americans are a policy decision being made by their elected leaders.”
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“Governmental failure has paved the way for social fracture. If the US government had succeeded as Canada or Germany’s governments succeeded, it would be easier to trust each other because we would pose less danger to each other. If we could depend more on the state, we could make more reasonable requests of ourselves. In the wreckage of state failure, though, it is nearly impossible for us to thrive.”
“A vocal Trump ally and spokesperson for the US Department of Health and Human Services, Michael Caputo, and a scientific adviser he hired, Paul Alexander, are pushing the CDC to alter or halt reports that are unflattering to the president and his administration’s response to Covid-19.”
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“The CDC’s response to the pandemic hasn’t been faultless. Under Redfield, the agency took weeks to fix botched Covid-19 tests it sent out to labs across the country. The slowdown in testing, also caused by the Food and Drug Administration’s initial resistance to approving more testing from private and other independent labs, led to what’s now considered a “lost month” in February as the US should have ramped up its testing capacity to prepare for the coronavirus.
But the Trump administration’s concerns about the agency don’t seem to be so much about its efficacy but that the facts on Covid-19 — including those the CDC reports on — make the president look bad.”
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“Trump even admitted to this in an interview with journalist Bob Woodward: “I wanted to always play [the coronavirus] down,” Trump said on March 19. “I still like playing it down, because I don’t want to create a panic.””
“The economy is certainly improving: The August report shows that the labor force participation rate increased a bit and millions more furloughed workers returned to their jobs.
But there are a bunch of clues in this month’s report that the growth we’re seeing now isn’t as robust as it looks, and that it probably isn’t sustainable without a dramatic change in public health conditions:
A significant chunk of the jobs gained in August were added thanks to a once-in-a-decade phenomenon that has nothing to do with the current recession — a slew of temporary hiring for the U.S. Census.
Private-sector job growth is slowing overall, and the industries that were hit hardest by the pandemic — like leisure and hospitality — appear to be stalling out well below their pre-pandemic peak.
Getting people back to work will likely be harder and harder in the coming months, because a growing share of unemployed people have lost their jobs permanently.
The recovery is arriving faster for some groups than others — which means that workers of color, in particular, are still suffering much higher levels of unemployment than white workers.”
“the US accounts for about 4 percent of the world’s population but 22 percent of its confirmed Covid-19 deaths. So how many lives would be saved if those numbers were even? Leonhardt calculated: “about 145,000.”
Columnist Ross Douthat took issue with that approach. Arguing that “the patterns for Covid-19 fatalities often look more region-specific than country-specific,” he compared the US to a slew of countries in the Western Hemisphere, particularly in Latin America and parts of Europe. By that toll, the US doesn’t seem to do so badly, with a death rate close to that of Brazil, France, Mexico, and the United Kingdom.
But Douthat’s list, despite calling for a regional comparison, doesn’t include Canada, arguably the country most similar to the US in the Western Hemisphere and one that’s done a much better job fighting the coronavirus than the US.
So that got me wondering: What would a more comprehensive comparison look like? What would the US death toll be like if the country had the same rate of Covid-19 deaths as some other wealthy nations, accounting for population differences?”
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“peer-country death tolls really don’t look like ours. The US is doing about seven times worse than the median developed country, ranking in the bottom 20 percent for Covid-19 deaths among wealthy nations. Tens of thousands of lives have been lost as a result.”
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“a lot of this is on Trump. As cases climbed in the US, the president abdicated problems with testing to local, state, and private actors; pushed states to reopen way too early to supposedly “LIBERATE” their economies; spoke negatively about masks while refusing to wear one himself; and backed unproven and even dangerous approaches to treating Covid-19, including injecting bleach. Each of these failures compounded and led to the current US death toll — and local and state governments, as hard as some tried, simply don’t have the resources to fight a pandemic on their own.
Compare that to Australian Prime Minister Scott Morrison, German Chancellor Angela Merkel, or Canadian Prime Minister Justin Trudeau. These are leaders all over the political spectrum, but they took the pandemic seriously — building up testing, advocating for mask-wearing, encouraging social distancing, or all of the above. And their countries are much better off.
There’s still time for things to go a different way. Maybe the US will somehow get its act together, avoiding another wave of infections and deaths. Maybe other developed countries will see massive second waves similar to America’s. (Spain and France, after relaxing social distancing and going easy on masking, already are.)
But for now, the US has suffered a much worse Covid-19 outbreak and death toll than all but a handful of its developed peers. It’s a predictable, preventable catastrophe.”
“Within days of the coronavirus pandemic taking hold, the Trump administration had to confront a reality it had long tried to ignore: The nation’s 2.5 million farmworkers, about half of whom the government estimates are undocumented, are absolutely critical to keeping the food system working. It was a major shift for a president who continues to reduce any debate about immigration to stoking fears about border defense and crime. But the Trump administration and Congress have done little to help keep farmworkers safe on the job.
Six months into the pandemic, according to a POLITICO analysis, these workers appear to be victims of the worst of the Covid-19 crisis. For several weeks, many of the places that grow the nation’s fruits and vegetables have seen disproportionately high rates of coronavirus cases — a national trend that, as harvest season advances in many states, threatens already vulnerable farmworkers, their communities and the places they work.”
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“The pandemic’s impact on farmworkers underscores how a worst-case scenario can develop when an essential but extremely vulnerable workforce is ignored. The Trump administration has repeatedly declined to impose mandatory safety requirements for agricultural workplaces. No federal assistance has been designated to help farmers obtain personal protective gear for their laborers, like it has for other essential workers like nurses and police officers.
The Trump administration has largely left state and local governments to fend for themselves in addressing coronavirus. Yet critics say that state officials have also failed to adequately confront the virus.”
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“As farmworkers unwittingly infect each other, their families and their broader communities with coronavirus, the situation exposes the extent to which rural areas are ill-equipped to deal with a public health crisis. A lack of access to testing and protective gear, an aging and consolidated health care system and rampant fear of the Trump administration’s strict immigration policies has created ideal conditions for the virus to spread across farmworker camps and small towns, according to interviews with more than two dozen people familiar with the situation across the country.
After months of requests from advocates, the CDC in June issued safety recommendations specific to farmworkers. The CDC guidance detailed how employers should protect their workers by taking steps such as taking temperatures, allowing for six-foot distancing on the job where possible and grouping healthy workers into cohorts to minimize spread.
But the Labor Department, which has the power to make such standards mandatory, declined to do so. The Occupational Safety and Health Administration, an arm of the Labor Department, argues that the government already has requirements in place that broadly ensure workplaces are safe.”
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“Just eight states, including Washington, California and New Mexico, have some form of mandated protections for farmworkers including access to testing, hand-washing stations, social distancing and education. Major agricultural states including Idaho, South Carolina, Texas and Arizona have either no regulations or only some recommendations, but no mandates.
Washington Gov. Jay Inslee recently visited Okanogan County in central Washington, which has become a Covid-19 hot spot, and acknowledged that agricultural workplaces continue to be a serious public health problem.
Inslee suggested that several coronavirus outbreaks in the state have followed harvest periods.
“The labor intensive agriculture presents environments that are just ripe for high transmission rates,” he said, noting that the state has seen more transmission of the coronavirus where crops require the most labor.
A few days later, Inslee announced that farms will now be required to test their employees if there’s an outbreak at their operation above a certain threshold. One large orchard at the center of a major Covid-19 outbreak, in which three workers have died, has been ordered to test all of its employees, state officials announced.
The state recently set aside $43 million in federal aid money to help undocumented residents who do not qualify for unemployment or stimulus checks. The tranche of funds includes $3 million earmarked for helping agricultural workers in the state who lack legal status.
Having money to directly aid workers could help individuals properly isolate if they test positive. As it stands now, many low-income laborers are resistant to taking tests because if they are positive, they may lack the resources or living space to self-quarantine for two weeks, according to advocates. They may also fear losing their job or being stigmatized in the workplace, especially if they are the sole breadwinner for their extended family.
But unlike Washington, most states do not have funds targeted at their farmworker populations, nor do they have comprehensive plans about how to stop the spread of the coronavirus in communities that are already suffering from health issues at disproportionately high rates.”
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“State and local health departments often lack even basic knowledge about their farmworker populations, including where they are migrating from or where they are headed next as the harvest seasons change — a blind spot that has only made controlling the spread of coronavirus more difficult, Ramírez said.
“This shouldn’t be a state to state issue,” she said, noting that the fact that workers move constantly means their problems can’t be solved by any state alone.”
“Cuomo and other New York leaders were initially slow to react to the coronavirus, letting the pathogen spread rapidly through the population before the state closed down. Some of that was due to a lack of understanding of the disease early on, but there were also steps Cuomo and others, experts argued, should have known to take even back then.
But once New York’s leaders and the public acted, they did a lot of things right, from social distancing to testing to masking.”
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“nursing homes. A New York State Department of Health advisory memo was widely interpreted by the facilities as forcing them to take Covid-19 patients from hospitals, potentially worsening the spread of the disease.
Cuomo’s office has rebuked the criticisms, arguing that it acted on the best evidence and expert advice it had at the time. To the extent the state was slow to recognize the threat of Covid-19, officials claim it was due to federal missteps and inaction that hindered testing early on in the crisis, leaving the state, one adviser said, “flying blind” and unable to detect its full epidemic before it was too late.”
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“The state’s late success as much of the country continues to struggle with a second coronavirus wave offers a lesson to the rest of the US and world: Covid-19 is not something that can simply be vanquished in a matter of weeks or months. It requires continued and sustained vigilance.
Unfortunately, it’s a lesson that only came about after Cuomo and state leaders oversaw and learned from the worst Covid-19 outbreak in the country and one of the worst in the world.”
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“On March 1, New York state reported its first Covid-19 case. On March 2, Cuomo acknowledged that community transmission within the state “is inevitable.” By March 3, the state confirmed the first case of community transmission. At that point, the state’s first big outbreak took off in New Rochelle. On March 5, New York City Mayor Bill de Blasio said that “you have to assume [the virus] could be anywhere in the city.” Each of these events could have served as early red flags for aggressive action.
It became increasingly clear, too, that the coronavirus was spreading not just in far-flung places like China and Iran, but in the West too. Italy was struck hard first by March, leading to haunting stories of overflowing hospital wards, patients turned away, and a growing death toll. Spain, Belgium, and France soon followed with big outbreaks and climbing death tolls.
Cuomo and other New York leaders started to mobilize. They began holding regular news conferences, warning of the virus and threats. They started to close down parts of the state, including in-person teaching at schools and large gatherings, while recommending people work from home if possible.
Even then, the messaging was muddled. Cuomo on March 2 told reporters, “We have been ahead of this from Day 1.” De Blasio on the same day tweeted that he was “encouraging New Yorkers to go on with your lives” and “get out on the town despite Coronavirus” — offering a movie recommendation for The Traitor.”
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“Cuomo was vocally skeptical of a stay-at-home order. Asked about de Blasio’s comments advocating for a “shelter-in-place” order, Cuomo on March 19 suggested such a move was unnecessary, arguing, “I’m as afraid of the fear and the panic as I am of the virus, and I think that the fear is more contagious than the virus right now.” Behind the scenes, the mayor and governor reportedly bickered about the order, with Cuomo remaining resistant.
Meanwhile, the San Francisco Bay Area issued the country’s first regional stay-at-home order on March 16, which went into effect the next day, and California issued an order on March 19 that went into effect the same day.
On March 20, Cuomo acquiesced — issuing a stay-at-home order for the whole state that would take effect two days later.
A few days of delayed action may not seem like a long time. But exponential growth means cases of Covid-19 can double in a couple of days, quickly spiraling out of control — making early action key to nipping the problem in the bud before it explodes out of control. Tom Frieden, who served as the director of the Centers for Disease Control and Prevention under President Barack Obama, told the New York Times that the state could have reduced its death toll by 50 to 80 percent if it locked down a week or two earlier.”
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“Cuomo’s office questioned whether the state could have acted quicker. A week before Cuomo issued a stay-at-home order, the state had reported around 50 Covid-19 cases a day and zero deaths. By the time of the order, there were nearly 1,000 cases and 10 deaths a day. Without that level of spread, the public may have been skeptical of drastic measures.”
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“New York may have gotten unlucky, too. Its position as a major international hub, its density, and its widespread dependence on public transportation made it uniquely vulnerable to Covid-19. These factors — considered upsides to New York in most other situations — were out of Cuomo’s control.
The virus also initially spread when we simply knew less about it. We didn’t know what parts of lockdowns would be effective, or that outdoor spaces, for example, were comparatively safer. We had much less research on the benefits of masks. And it was still unclear how this virus would affect the US in particular.”
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“Cuomo’s second big mistake came after the state started treating Covid-19 as a serious threat. On March 25, his administration issued an advisory that effectively forced nursing homes to take in Covid-19 patients from hospitals after they supposedly recovered. The rules barred nursing homes from demanding a coronavirus test prior to the transfer. In general, nursing homes interpreted the rules to force them to take in Covid-19 patients.
The idea was to limit hospital occupancy — a huge point of concern, as the coronavirus strained hospitals worldwide, including in New York. But critics say the advisory pushed Covid-19 into some of the most vulnerable places in the state.”
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“Cuomo and the New York State Health Department have pushed back against the claims. Cuomo has described the criticisms as “political.” The New York State Health Department released a report suggesting Covid-19 was spreading in nursing homes prior to the advisory and largely due to infections among staff, not formerly hospitalized patients.
But experts have been highly critical of the state’s report, arguing its shoddy methodology wouldn’t make it into a reputable scientific journal.
Experts told me that, overall, New York’s nursing homes were likely to suffer Covid-19 deaths once there was a big outbreak in the state, even if Cuomo’s administration hadn’t issued the advisory — a reflection of longstanding problems with infection control in these facilities.
Still, they argued that the advisory likely made things worse. Even the state’s report admits that some patients who were transferred back to nursing homes were infectious, although it’s not clear how many and which led to more infections.”
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“While New York did some things very wrong, it was also true that Trump and the federal government often didn’t help — and, with their own failures and inaction, actually made it much harder for New York and other state and local governments to respond to the coronavirus pandemic.”
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“The situation has improved dramatically in New York since the spring. Today, the state is in the bottom three for daily new cases, with a rate of 3 per 100,000 people. Its test positive rate is the third lowest in the country at less than 1 percent — an indication of a controlled outbreak.
Experts say Cuomo and other leaders in the state deserve a lot of credit for such outcomes. New York dramatically scaled up testing — with the third-highest testing rate, when controlling for population, among all states. It built up a contact tracing system. It imposed a masking mandate. It has, in general, adhered closely to expert advice and empirical data as it’s evolved and shifted.
Perhaps most importantly, Cuomo resisted what many other states did not: reopening too quickly. The state imposed strict regional metrics that localities have to meet to reopen, and it’s stuck with them. New York City still hasn’t allowed indoor dining or bars, both of which present a huge risk for Covid-19 transmission.
It’s a sharp contrast to California Gov. Gavin Newsom (D). He was the first in the country to close down his state but, under pressure from local and private actors, allowed counties to reopen more quickly, getting waivers that effectively allowed them to ignore the standards the state previously set. That allowed indoor dining, bars, and other risky indoor spaces to reopen — until cases exploded in California, forcing Newsom to eventually reel back.”
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“There are factors beyond policy that have helped New York. Because the state suffered a massive outbreak in the spring, there’s likely some element of population immunity making it more difficult for cases to spread too widely as long as people follow some precautions. The public has helped, too, remaining cautious even as the state has reopened; a New York Times analysis, for example, found New York had some of the highest rates of mask-wearing in public of any state.
“Once we did [act], it’s truly an incredible testament to New Yorkers that we have been able to do what was needed to get where we are today,” Nash, of the City University of New York, said.
New York’s success in the aftermath of a deadly outbreak shows the need for continued and sustained vigilance. It’s not enough to merely push down cases and test positive rates — as many states did early in the summer — people also need to stay cautious and keep the spread of the virus from getting out of control again. Resisting temptation, such as with reopening risky indoor spaces like bars, is crucial.
The unfortunate reality is Covid-19 won’t go away until a vaccine or similar treatment is widely available.”
“The 52-47 vote, which was intended to demonstrate Republican unity and support for the stimulus while putting pressure on Democrats, was only mildly successful in that aim, with 52 Republicans supporting the bill and Sen. Rand Paul voting against it. No Democratic senators, who’ve long pushed for a more expansive stimulus package, voted in favor of it. As a result, the bill was unable to meet the 60-vote threshold it needed to advance.
Republicans’ legislation contained roughly $650 billion in aid, according to the Wall Street Journal, including funding for school reopenings, the US Postal Service, and a weekly $300 supplement to unemployment insurance. Democrats’ more expansive HEROES Act, meanwhile, contained $3 trillion in aid including money for a $600 weekly unemployment supplement, another round of $1,200 stimulus payments, and support for state and local governments, in addition to funding for schools and USPS.
Since Thursday’s vote was a strategic maneuver aimed more at sending a message than producing actual policy, it wasn’t expected to pass to begin with. Instead, it was intended to give vulnerable Republican senators something to point toward as evidence they’ve backed more aid going into the election this fall.
The vote was also a way to get Democrats “on the record” opposing stimulus, according to Senate Majority Leader Mitch McConnell — a framing that could be used to cast blame in the coming months, though it ignores the fact that the Democrat-led House passed its own stimulus package months ago.”