“If you believed the Republican National Convention, you’d think President Donald Trump has taken unprecedented action to defeat the Covid-19 pandemic. He bragged about the US doing more testing than any other country, the approval of new treatments, support for Americans hit hard by the economic downturn, and his work to expedite a vaccine.
“To save as many lives as possible, we are focusing on the science, the facts, and the data,” Trump said. “We are aggressively sheltering those at highest risk — especially the elderly — while allowing lower-risk Americans to safely return to work and school.”
Experts, and the data, tell a very different story — one in which Trump has let Covid-19 win.”
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“A pandemic was always likely to be a challenge for the US, given the country’s large size, fragmented federalist system, and libertarian streak. The public health system was already underfunded and underprepared for a major disease outbreak before Trump.
Yet many other developed countries dealt with these kinds of problems too. Public health systems are notoriously underfunded worldwide. Australia, Canada, and Germany, among others, also have federalist systems of government, individualistic societies, or both.
Instead, experts said, it’s Trump’s leadership, or lack thereof, that really sets the US apart. Before Covid-19, Trump and his administration undermined preparedness — eliminating a White House office set up by the previous administration to combat pandemics, making cuts across other key parts of the federal government, and proposing further cuts.
Once the coronavirus arrived, Trump downplayed the threat, suggesting it would soon disappear “like a miracle.” The Centers for Disease Control and Prevention (CDC) took weeks to fix botched tests, and the administration actively abdicated control of issues to local, state, and private actors.”
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“A few other developed countries — including Belgium, France, and Italy — were caught off-guard by the Covid-19 pandemic and were hit hard early, suffering massive early outbreaks with enormous death tolls. But after those outbreaks, these countries and those around them generally took Covid-19 seriously: implementing lengthy and strict lockdowns, widespread testing and contact tracing, masking mandates, and consistent public messaging about the virus.
The US did not, even after an outbreak spiraled out of control in New York. It was this failure to act even after a major epidemic, and a continued failure to implement stronger measures as other large outbreaks occurred, that makes the US unique.”
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“During the 2014 Ebola outbreak, President Barack Obama’s administration realized that the US wasn’t prepared for a pandemic. Jeremy Konyndyk, who served in the Obama administration’s Ebola response, said he “came away from that experience just completely horrified at how unready we would be for something more dangerous than Ebola,” which has a high fatality rate but did not spread easily in the US and other developed nations.
The Obama administration responded by setting up the White House National Security Council’s Directorate for Global Health Security and Biodefense, which was meant to coordinate the many agencies, from the CDC to the Department of Health and Human Services to the Pentagon, involved in contagion response.
But when John Bolton became Trump’s national security adviser in 2018, he moved to disband the office. In April 2018, Bolton fired Tom Bossert, then the homeland security adviser, who, the Washington Post reported, “had called for a comprehensive biodefense strategy against pandemics and biological attacks.” Then in May, Bolton let go the head of pandemic response, Rear Adm. Timothy Ziemer, and dismantled his global health security team. Bolton claimed that the cuts were needed to streamline the National Security Council, and the team was never replaced.
In the months before the coronavirus arrived, the Trump administration also cut a public health position meant to detect outbreaks in China and another program, called Predict, that tracked emerging pathogens around the globe, including coronaviruses. And Trump has repeatedly called for further cuts to the CDC and National Institutes of Health, both on the front lines of the federal response to disease outbreaks; the administration stood by the proposed cuts after the pandemic began, though Congress has largely rejected the proposals.
The Trump administration pushed for the cuts despite multiple, clear warnings that the US was not prepared for a pandemic. A 2019 ranking of countries’ disaster preparedness from the Johns Hopkins Center for Health Security and Nuclear Threat Initiative had the US at the top of the list, but still warned that “no country is fully prepared for epidemics or pandemics.”
A federal simulation prior to the Covid-19 pandemic also predicted problems the US eventually faced, from a collapse in coordination and communication to shortages in personal protective equipment for health care workers.”
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“South Korea, which has been widely praised for its response to coronavirus, tested more than 66,000 people within a week of the first community transmission within its borders. By comparison, the US took roughly three weeks to complete that many tests — in a country with more than six times the population.
Asked about testing problems in March, Trump responded, “I don’t take responsibility at all.” In June, Trump claimed that “testing is a double-edged sword,” adding that “when you do testing to that extent, you’re going to find more people — you’re going to find more cases. So I said to my people, ‘Slow the testing down, please.’”
The testing shortfall was a problem few thought possible in the wealthiest, most powerful nation on earth. “We all kind of knew if a biological event hit during this administration, it wasn’t going to be good,” Saskia Popescu, an infectious disease epidemiologist, told me. “But I don’t think anyone ever anticipated it could be this bad.””
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“The most aggressive steps Trump took to halt the virus — travel restrictions on China and Europe imposed in February and March, respectively — were likely too limited and too late. And to the extent these measures bought time, it wasn’t properly used.
The federal government is the only entity that can solve many of the problems the country is facing. If testing supply shortfalls in Maine are slowing down testing in Arizona or Florida, the federal government has the resources and the legal jurisdiction to quickly act. Local or state offices looking for advice on how to react to a national crisis will typically turn to the federal government for guidance.
But the inaction, contradictions, and counterproductive messaging created a vacuum in federal leadership.”
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“After the initial wave of coronavirus cases began to subside in April, the White House stopped its daily press briefings on the topic. By June, Trump’s tweets and public appearances focused on Black Lives Matter protests and the 2020 election — part of what Politico reporter Dan Diamond described, based on discussions with administration officials, as an “apparent eagerness to change the subject.”
Then another wave of coronavirus infections hit beginning in June, peaking with more than 70,000 daily new cases, a new high, and more than 1,000 daily deaths.
America’s response to the initial rise of infections was slow and inadequate. But other developed countries also struggled with the sudden arrival of a disease brand new to humans. The second surge, experts said, was when the scope of Trump’s failure became more apparent.
By pushing states to open prematurely, failing to set up national infrastructure for testing and tracing, and downplaying masks, Trump put many states under enormous pressure to reopen before the virus was under control nationwide. Many quickly did — and over time suffered the consequences.”
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“One explanation for the shortfalls in the US response is Trump’s obsession with getting America, particularly the economy, back to normal in the short term, seemingly before Election Day this November. It’s why he’s called on governors to “LIBERATE” states. It’s why he’s repeatedly said that “the Cure can’t be worse than the problem itself.” It’s one reason, perhaps, he resisted embracing even very minor lifestyle changes such as wearing a mask.
The reality is that life will only get closer to normal once the virus is suppressed. That’s what’s working for other countries that are more earnestly reopening, from Taiwan to Germany. It’s what a preliminary study on the 1918 flu found, as US cities that emerged economically stronger back then took more aggressive action that hindered economies in the short term but better kept infections and deaths down overall.
“Dead people don’t shop,” Jade Pagkas-Bather, an infectious diseases expert and doctor at the University of Chicago, told me. “They can’t stimulate economies.””
“On June 20, Trump tried to rejuvenate his flagging reelection campaign with a rally in Tulsa, Oklahoma, that was meant to symbolize how life in America was returning to normal. But it turned out to be a disaster.
After weeks of massive Trump campaign hype, only about 6,200 people showed up to the BOK Center, which holds about 19,000. Even worse, the Trump campaign’s decision to ignore warnings from public health experts likely fueled a spike in coronavirus cases in the area
“In the past few days, we’ve seen almost 500 new cases, and we had several large events just over two weeks ago, so I guess we just connect the dots,” Tulsa City/County Health Department Director Dr. Bruce Dart said days after the rally, according to the Associated Press.
Herman Cain, a prominent Trump supporter who was photographed at the rally without a mask, contracted Covid-19 after the rally and died. And instead of doing everything possible to keep people safe, Trump campaign workers were filmed removing thousands of “Do Not Sit Here, Please!” stickers meant to encourage rally-goers to social distance.”
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“if Trump wanted to have an in-person convention this month, he needed to do the work back in February, March, and April. Instead, he spent that time insisting the virus would go away on its own and passing the buck to governors who lack the resources and jurisdictional authority to handle a pandemic that has shuttered economies and spread like wildfire across state boundaries.
So now, instead of serving as a symbol of Trump’s successes, the RNC will serve as a symbol of everything he’s done wrong. While other countries reopen schools and even sporting events with fans, the US continues to report 40,000 or more new coronavirus cases a day.
Trump has no plan to get the virus under control. On the contrary, he continues to insist the virus will go away on its own — the same talking point he used more than 170,000 deaths ago during the early days of the pandemic.”
“This fall and winter, health experts expect two types of deadly viruses to be circulating widely in the US. But they don’t yet know what the extent of the damage will be when the two collide.
In the absence of a coherent federal response, the novel coronavirus continues to spread across the country, with several states still battling active outbreaks. Experts estimate it could continue to hospitalize thousands and kill hundreds of people a day into September — likely with more spikes in the coming months.
We’re also now staring down the annual flu season, which typically starts in October and burdens the health care system even in normal years. The 2018–2019 flu season in the US, for example, resulted in about half a million hospitalizations and more than 34,000 deaths. The previous season, deaths were double that. And communities of color, which have already been disproportionately impacted by Covid-19, historically have also been more likely to have chronic health conditions that put them at higher risk of influenza-related complications.”
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“One problem is that because influenza and Covid-19 are both respiratory viruses, severe cases will be treated on much of the same limited medical equipment, like ventilators. And because they can have overlapping symptoms, figuring out whether someone has the flu or Covid-19 — or neither — will be tricky but also important.
Fortunately, we already have a safe vaccine for the flu, and nearly 200 million doses are slated to be available in the coming months.”
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“The Centers for Disease Control and Prevention (CDC) says that everyone 6 months and older (with very rare exceptions, like a life-threatening egg allergy) should get a flu shot. And this year, it is more crucial than ever to get one, experts say, to reduce the spread of the virus and keep the health care system from being overtaxed with continued surges of Covid-19.”
“Even before the pandemic, there were signs that the drug overdose crisis was worsening. Preliminary data from the Centers for Disease Control and Prevention (CDC) found drug overdose deaths hit 72,000 in 2019, up almost 5 percent from nearly 69,000 in 2018. A preliminary study from researchers at Stanford, UCLA, and the Los Angeles LGBT Center found that fentanyl, a synthetic opioid more potent and dangerous than heroin, has started to spread to illegal drug markets in the West — a trend that will likely cause more overdoses.”
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“The demands of social distancing have worsened social isolation, possibly leading more people to use drugs to cope. Social services and addiction treatment programs — many of which already lacked funding and rigor — have fallen to the side as the economic collapse has crushed public and private revenues, and social distancing has forced some places to close.
Meanwhile, the actions that different levels of government have taken to shore up the gaps caused by the pandemic simply haven’t been enough. As experts told me, telemedicine — while certainly helpful for many and better than nothing — simply can’t make up for being able to pick up new syringes or naloxone, the opioid overdose antidote, at the local needle exchange program.
The result: As America sees more than 166,000 Covid-19 deaths (and rising), it’s also suffering tens of thousands of drug overdose deaths due to a decades-old crisis now likely worsened by the coronavirus pandemic.”
“In Georgia’s Cherokee County School District, for example, there have been at least 80 positive cases since August 3, and more than 1,100 students, teachers, and staff have had to quarantine. At the high school in Paulding County School District, which came to national attention after photos of halls crowded with mostly maskless students went viral, several students and staff have tested positive, forcing the school to adopt a hybrid model of in-person and virtual learning. In Atlanta, one second-grader tested positive the day after classes started; the same week, a seven-year-old with no underlying conditions died from the virus.
Scientists have found clear evidence that children, especially those over 12, can and do transmit the virus, though the disease is generally more mild than in adults. This means school outbreaks can be a risk for students, teachers, and the wider community.”
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“it’s not just kids, teachers, and parents who are then at risk — school outbreaks can fan wider outbreaks in communities. A recent superspreading event in Ohio, for example, found that children between ages 6 and 16 were part of the chain of transmission, passing the virus on to other children and adults.”
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“The World Health Organization recommends that schools open only if fewer than five percent of those tested for the virus over a two-week period are positive. In the US, the cut-off for what is considered “safe” for reopening schools currently varies by state, but they all tend to look at similar factors”
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“In Georgia, many schools also reopened despite high positivity rates — the percentage of people being tested for Covid-19 who have a positive result. Georgia’s number of positive tests per 100,000 people were also well above the general threshold that public health experts recommend for in-person activities.”
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“Since testing overall is still inadequate to control the virus in the US, the CDC says the true incidence of Covid-19 in children is still unknown. But as Tom Frieden, former director of the CDC recently tweeted, kids between 5 and 17 now have the highest positivity rate of all age groups. “Age groups aren’t an island,” he wrote. “Spread in any group is a risk to all.””
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“Denmark reopened elementary schools with extensive safety measures in place, like staggered entry time. Students were placed in small groups to reduce interaction, and hotels and libraries were utilized as additional class space. Even still, the rate of infection increased after Danish schools reopened, although not enough to keep total cases from declining.”
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“there’s a definite trend: Countries like Vietnam and New Zealand, which have generally done a good job controlling spread, have successfully reopened schools. Others, with higher community transmission, like Chile, have struggled.”
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“Overall, the sum of evidence — including independent studies from the US, Iceland, and Germany — finds older children may be as likely to spread the virus as adults when infected. A recent literature review found that “opening secondary/high schools is likely to contribute to the spread of SARS-CoV-2.” (The same review found that children under age 10 may be less susceptible to infection.)
Another review published in The Lancet highlights that adequate testing and contact tracing are essential to reopening schools. That’s not possible currently in many US states, which are still seeing positivity rates as high as 23 percent, along with extreme delays in test results.”
“The Trump administration is holding unaccompanied migrant children in hotels before rapidly expelling them from the US under a new policy that allows officials to turn away anyone who poses a risk of spreading coronavirus — even if they show no symptoms and are seeking asylum.”
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“It’s just the latest in a long line of Trump administration policies designed to gut the asylum system on the southern border. Before the pandemic, officials were turning away tens of thousands of migrants at the southern border through the “Remain in Mexico” program, under which asylum seekers were forced to wait in Mexico, often for months at a time, for their immigration court hearings in the US. The new expulsion policy has largely replaced that program as a mechanism for keeping migrants out.
According to court documents, the administration had expelled about 2,000 unaccompanied children under the policy as of June. Though the government has not released more recent data on unaccompanied children specifically, CBP reported expelling more than 105,000 migrants total under the policy by the end of July.
“They’re coming here because they have legitimate claims for humanitarian protection,” Steven Kang, an attorney for the ACLU, said Friday. “For this country turn them right around is not only wrong — it’s not what Congress wanted. This whole shadow deportation scheme bypasses and ignores all the important rights that Congress gave them.””
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“Though overcrowding of such facilities was a concern at the outset of the pandemic, HHS shelters are now operating at 5-to-10-percent capacity — well below normal, Kang said. That suggests that there is plenty of room to safely enforce social distancing and quarantine anyone who tests positive for Covid-19 or develops symptoms.
The lawsuit also argues that children have the right to an attorney and a full immigration court hearing to determine whether they are entitled to protections that would allow them to stay in the US, which is required by the Trafficking Victims Protection Act (TVPRA).
The government has argued that it has the authority to reject any migrant who poses a risk of spreading communicable disease under Title 42, a federal public health provision. Mark Morgan, the acting CBP commissioner, said earlier this month that the policy helps mitigate the risk of spreading the virus to anyone the migrants might come into contact with while being processed and in HHS shelters.”
“Doctors, nurses and caregivers at smaller and poorer hospitals and medical facilities across the country are still struggling to obtain the protective gear, personnel and resources they need to fight the coronavirus despite President Donald Trump’s repeated assertions that the problems are solved.
Health care workers at all types of facilities scrambled for scarce masks, gloves and other life-protecting gear at the beginning of the pandemic. The White House was letting states wage bidding wars against one another, rather than establish a central national manufacturing, supply and distribution chain.
But now, health care workers say a clear disparity has emerged and persisted. Larger and richer hospitals and practices outbid their smaller peers, sometimes for protective gear, sometimes to fill in staffing gaps. And some of those having the hardest time are precisely where the virus is spreading.”
“For the second time this summer, voters in a solidly Republican state have decided now is the moment to expand Medicaid coverage through the Affordable Care Act.
Missouri voters passed a ballot initiative to expand Medicaid during Tuesday’s primary elections; 53 percent of voters supported the measure and 47 percent opposed it. That vote comes about a month after Oklahoma voters also decided to expand Medicaid via ballot referendum by less than 1 percentage point.
Once the expansion takes effect in those two states next year, an estimated 340,000 people who currently have no affordable health insurance option will become eligible for Medicaid. That still leaves nearly 2 million people in 12 states nationwide who are stuck in the Medicaid expansion gap — ineligible for coverage because their state refuses to expand the program but with an income too low to qualify for tax credits to buy private insurance — but it is yet another step toward the universal Medicaid expansion Obamacare authors envisioned. In the last few years, voters in Idaho, Maine, Nebraska, and Utah have also approved Medicaid expansion via ballot initiative.”
“Poll after poll, most recently a Gallup poll from July 13, has found American men are more likely to not wear masks compared to women. Specifically, the survey found that 34 percent of men compared to 54 percent of women responded they “always” wore a mask when outside their home and that 20 percent of men said they “never” wore a mask outside their home (compared to just 8 percent of women).”
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“Glick and Reny echoed a sentiment that health experts I spoke to in July said: To get people to change behavior, masks have to become a socially accepted norm. Once people start accepting masks as normal behavior, like they do wearing seat belts and not smoking indoors, the number of people going against the norm decreases.
Getting to that tipping point is a lot easier said than done.”
“More than one-in-five Texans who are tested for coronavirus are positive, the worst statewide rate in the country. But the number of people getting tests has plummeted in the last two weeks, which could understate how widespread the virus really is as schools reopen and hospitalizations and deaths remain near record highs.”
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“Public health experts say a number of factors may have depressed demand for tests, including long wait times and changing rules for who is eligible and the effects of Tropical Storm Hanna, which battered the southern part of the state late last month and disrupted services near the border with Mexico.
But the biggest reason may be an apparent false sense of security. The drop off in testing coincides with a decline in infections after Abbott ordered people to wear masks, reimposed seating limits in restaurants and closed down bars again. That worries disease trackers who suspect any positive news will breed complacency and make people willing to ignore the possibility they could be infected without showing symptoms. Without widespread testing, new Covid spikes could pop up and go unnoticed.”
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“Texas’s drop in testing is part of a larger nationwide trend that’s seen the average number of coronavirus tests fall from more than 800,000 a day in late July to roughly 700,000 over the last week.”
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“But the testing problems aren’t all linked to Texans’ behavior. There also are questions about flaws in the state’s data collection that may have distorted who was sick and where. Texas at the end of July had 1 million completed tests whose results had not been assigned to a particular county. Officials are now sorting through the backlog, which could have had the effect of making the tested population appear smaller than it really was.”
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“Abbot said testing numbers should rebound in the coming days. There will be a surge in Houston, the governor said, where he aims to test an additional 50,000 people over a 10-day stretch.”