“So why was I once again sanguine about Florida? Because despite the surge in positive cases, the number of deaths remained extremely low, and I believed that deaths were the most concrete way to measure the pandemic’s toll. It’s not that hospitalization data isn’t important, but it’s hard to come by and often unreliable. Some people have reported long-lasting and debilitating symptoms, but we don’t know yet whether they are common or rare. All through June, the average number of daily Covid-19 deaths in Florida remained below 40. I thought then — and I think now — that that was remarkable.
In retrospect, it’s clear that DeSantis — as well as governors in Texas, Arizona, California and a lot of other states — reopened too early because they too were swayed by their low death rates and were eager to get their economies back on track. They didn’t anticipate how opening bars, in particular, would spread the virus. They weren’t willing to get tough on people who refused to wear masks. Perhaps most important, they didn’t pay enough attention to the reproduction rate — that is, the estimate of the number of people each Covid-positive person would infect. (In Florida, according to one model, it is 1.42)”
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“When you look at the states that are facing surges right now — Florida, Texas, Arizona, Mississippi, Nevada, and others(3)— they follow the same pattern. They saw very little of the virus when the Northeast was getting crushed. They let their guard down — even bragged about their success. Then, when it turned out that virus had simply taken its sweet time making its way south and west, it took them too long to awaken to the threat.
Although the positive case numbers are terrible across the board, the death rates are still low. Texas has 347,000 cases but only 4,100 deaths. Mississippi has 45,000 cases and 1,400 deaths. Arizona has 149,000 cases, and less than 3,000 deaths. Florida’s 380,000 positive cases had yielded 5,435 deaths as of Wednesday.
Whenever I bring this up, I’m reminded that deaths are a lagging indicator. But this surge began in early June; if the virus were acting the same way it did in the Northeast, the death rate would be far higher by now. I also realize that doctors know a lot more about how to treat Covid-19. But that can’t be the whole answer either. For reasons not yet understood, the virus simply isn’t killing as many people in these states as it did in New York and New Jersey in March and April. The one thing we can say with some certainty is that it’s not the governors’ doing.”
“Covid-19 testing in the US improved dramatically over the first half of 2020, but things now appear to be breaking down once more as coronavirus cases rise and outstrip capacity — to the point that the mayor of a major American city can’t get testing quickly enough to potentially avoid spreading the virus.”
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““Basically, two things are happening,” Ashish Jha, faculty director of the Harvard Global Health Institute (HGHI), told me. “One is the outbreaks are getting much bigger, so the amount of testing we need to get our arms around the outbreak is going up. And second, what we did [before] was some tweaking on capacity issues to get ourselves up to 500,000 to 600,000 tests a day, but didn’t fundamentally address the supply chain problems.”
He added, “This was supposed to be the job of the White House. … But they just never have prioritized really building up a robust testing infrastructure for the country.””
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“The benchmark of 500,000 tests per day was particularly important, as it was the minimum experts had long called for in order to get the pandemic in the US under control.
But as the country neared that benchmark, attention to testing seemed to plummet. The Trump administration, which had already delegated testing down to lower levels of government and private actors, especially appeared to lose interest: The country’s “testing czar,” Brett Giroir, stood down and went back to his regular job at the Department of Health and Human Services. Trump falsely claimed in May that “America leads the world in testing”; at his Tulsa rally in June, he said he told his people to “slow the testing down” because the rising case count made him look bad. (He later asserted that his statement at the rally was not a joke, despite White House officials insisting it was.)
As all this happened, many of the underlying problems with testing capacity remained.
For one, there’s still a lot of variation between states. While most states, as of July 8, had 150 new tests per 100,000 people per day — the equivalent to 500,000 daily tests nationwide — 18 states still didn’t.”
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“Earlier on, the hurdles with testing were linked to supply chain problems: not enough swabs to collect samples, vials to store them, or reagents and kits to run the tests. Over time, those problems were fixed or worked around.
The issue, experts say, is that these kinds of problems were always bound to come back as testing demand increased. Fixing a bottleneck for kits may let the country get to 500,000 tests a day, but that bottleneck can easily come back if, for instance, the nation needs 1 million per day and there are only enough kits for 700,000.”
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“labs aren’t sure that making the massive investment for way more tests is financially sustainable, he explained, especially as Covid-19 outbreaks ebb and flow — and, as a result, occasionally deplete demand for those tests, as well as the number of people who need them.
Ideally, the federal government would be in charge of handling these problems. It’s the one entity that can go to labs across the country, see what the holdups are, then work along the global supply chain to see what can be done to address the issues. It has the funding ability to ensure labs and suppliers remain whole. And it can prioritize limited resources to specific cities, counties, or states that need them most, instead of leaving these supplies to a free-for-all.
This is, in fact, what the federal government does with other issues — such as when it ensures that a manufacturer has all the parts needed for an order of guns, tanks, or jets.”
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“The Trump administration, however, has described the federal government as a “supplier of last resort.” That’s very different from the kind of proactive approach the feds take on other issues to get ahead of supply constraints.
So the problem is left to private actors as well as local and state governments, which often face legal, financial, and practical constraints that hinder their ability to move quickly. And the problem persists, even as Covid-19 cases continue to rise.”
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“Lockdowns, however, were also supposed to buy the nation time to build up its testing system. As Natalie Dean, a biostatistics professor at the University of Florida, previously told me, “The whole point of this social distancing is to buy us time to build up capacity to do the types of public health interventions we know work. If we’re not using this time to scale up testing to the level that we need it to be … we don’t have an exit strategy. And then when we lift things, we’re no better equipped than we were before.”
It’s now clear that the US didn’t take full advantage of the time it bought with lockdowns. While testing did dramatically improve compared to the early days of the pandemic, it’s still not at a point where America can handle the higher demand brought on by another surge in coronavirus cases.
“It’s pathetic. This is not how a first-world country functions,” Jha said. “That people should not expect to access a test to an infectious disease many, many months into a pandemic — I find myself amazed that this is where we are as a country.””
“much of California let its guard down. While the state, and the Bay Area in particular, was among the first in the US to embrace a shelter-at-home order, parts of California have since relaxed or outright halted those measures, letting the coronavirus creep in bit by bit. Meanwhile, precautions against Covid-19 have been inconsistently adopted by the public and businesses — especially as some of the recommended practices, such as wearing a mask, have become politicized.
At the same time, the state has seen major outbreaks in nursing homes, in prisons, and among migrant workers — many of whom are deemed “essential” and are therefore forced to work — that have driven up coronavirus cases further, simultaneously planting seeds for broader community outbreaks.”
““Wait. I can catch Covid twice?” my 50-year-old patient asked in disbelief. It was the beginning of July, and he had just tested positive for SARS-CoV-2, the virus that causes Covid-19, for a second time — three months after a previous infection.
While there’s still much we don’t understand about immunity to this new illness, a small but growing number of cases like his suggest the answer is yes.
Covid-19 may also be much worse the second time around. During his first infection, my patient experienced a mild cough and sore throat. His second infection, in contrast, was marked by a high fever, shortness of breath, and hypoxia, resulting in multiple trips to the hospital.
Recent reports and conversations with physician colleagues suggest my patient is not alone. Two patients in New Jersey, for instance, appear to have contracted Covid-19 a second time almost two months after fully recovering from their first infection. Daniel Griffin, a physician and researcher at Columbia University in New York, recently described a case of presumed reinfection on the This Week in Virology podcast.
It is possible, but unlikely, that my patient had a single infection that lasted three months. Some Covid-19 patients (now dubbed “long haulers”) do appear to suffer persistent infections and symptoms.
My patient, however, cleared his infection — he had two negative PCR tests after his first infection — and felt healthy for nearly six weeks.”
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“repeat infections in a short period are a feature of many viruses, including other coronaviruses. So if some Covid-19 patients are getting reinfected after a second exposure, it would not be particularly unusual.”
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“Herd immunity depends on the theory that our immune systems, once exposed to a pathogen, will collectively protect us as a community from reinfection and further spread.”
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“Experts generally consider natural herd immunity a worst-case-scenario backup plan. It requires mass infection (and, in the case of Covid-19, massive loss of life because of the disease’s fatality rate) before protection takes hold.”
“The controversy surrounding the PPP, which supports businesses with 500 employees or fewer, has a lot to do with a disconnect between the program’s design and how Americans think about business. The real goal of the PPP was to keep American workers on payroll, not to simply keep small businesses going. And so the majority of the money was disbursed to businesses with more employees, rather than to tiny ones with small staffs. That’s why a program widely perceived as being meant to boost the United States’ most vulnerable small businesses ended up prioritizing businesses that aren’t actually that small.”
“In a rally in Tulsa, Oklahoma, this past weekend, President Donald Trump used the term “kung flu” to describe the coronavirus, one of several racist statements he made during a wide-ranging speech that touched on his administration’s handling of the pandemic.
“By the way, it’s a disease, without question, [that] has more names than any disease in history,” Trump said at the time. “I can name kung flu, I can name 19 different versions of names.”
Since then, Trump’s press secretary Kayleigh McEnany has gone on to defend his use of the term. And Senate Majority Leader Mitch McConnell has been noncommittal: When asked how he and his wife, Transportation Secretary Elaine Chao, felt about Trump’s remarks, McConnell declined to say whether he was comfortable with the president’s rhetoric, instead suggesting that the question should be directed to Chao, who immigrated from Taiwan to the US as a child.
McEnany’s defense of Trump is the same flimsy one he’s been using ever since he began calling the coronavirus the “Chinese virus:” She argued that such names simply associate the illness with its “place of origin,” an effort that even if conducted in good faith goes against World Health Organization guidelines that warn against promoting labels that could stigmatize an entire region.
“The president does not believe it’s offensive to note that the virus came from China,” McEnany said during a briefing on Monday.”
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“Trump’s decision to lean into racist rhetoric — including terminology his own adviser, Kellyanne Conway, has condemned in the past — comes as Asian Americans continue to report hate incidents such as verbal abuse, physical assault, and property damage during the pandemic. As the coronavirus spread around the world, tropes that treat Asians as perpetual foreigners have also resurfaced, fueling racist and hostile anti-Asian sentiment.
Stop AAPI Hate, an organization that’s been tracking self-reported hostile anti-Asian incidents since late March, says it’s received more than 2,100 reports since the project began. Such incidents have included instances of employees getting shunned in the workplace, families being spat on at fast food restaurants, and children getting beaten up by their classmates. The group says it saw a surge in reports after Trump began using rhetoric like the “Chinese virus” and noted that many “anti-China” comments were frequently associated with verbal and physical assaults.
“A White male walked by me and said, ‘you f—king Chinese spread the Coronavirus to this country, you should all leave this country!’” one incident report read.
“A woman sitting at a bus stop was screaming at myself and other Asians that she saw walking,” read another. “She said that we were ‘dirty Chinese,’ that we were trying to take over the US.”
Researchers, too, emphasize that Trump’s rhetoric has mattered in the past: An NBC News report by Kimmy Yam points to a February study, which determined that Trump’s racist comments against Latino Americans “emboldened” others who held similar views to express them.
Trump’s continued use of racist statements about the coronavirus — ultimately trying to deflect blame by pointing out it is foreign-born — comes as he struggles to deal with the fallout of his own handling of the pandemic: Most recently he came under fire for saying he intends to slow down coronavirus testing because doing so would reveal the presence of fewer cases.
“President Trump continues to utilize white supremacist and nationalist views as a means of scapegoating his failures for political gain,” said Manjusha Kulkarni, executive director of the Asian Pacific Policy and Planning Council, in a statement. “Unless we hold him accountable, the discrimination and harassment against Asian Americans will become deeply entrenched, cause unimaginable harm and suffering, and take decades to unwind.””
“The pursuit of a vaccine across federal health agencies has also forced tradeoffs. The Biomedical Advanced Research and Development Authority, for example, has halted a push for lung treatments to fight the coronavirus, potentially putting a treatment option on the back burner.
The danger of going all in on a vaccine may be that President Donald Trump is pinning hopes on a miracle shot while there’s considerable reason to believe that the outbreak could stretch on for years.
“There’s no guarantee that a vaccine is going to work,” said Luciana Borio, who served as the FDA’s acting top scientist and worked on White House pandemic preparedness efforts earlier in the Trump administration. “And even if it does, there’s no guarantee that it’ll be the right product for most people, or that people will want to take it, or that the virus won’t mutate.”
Vaccines are notoriously difficult to make; the vaccine for mumps, the fastest ever developed, took four years. Many take far longer, and more still fail in animal or human testing and never reach the market. Public health experts say the U.S. government is making a risky bet by focusing so much of its pandemic response on the hope that a shot will end the coronavirus’ devastating march.”
“An outbreak at a Pentecostal church in Oregon, where hundreds of worshipers resumed gathering over Memorial Day weekend, forced an entire county to return to phase one of its reopening after local officials traced 258 cases of Covid-19 back to the facility. In West Virginia, six health departments across the state have reported coronavirus outbreaks linked to churches. One of them, a Baptist church in Greenbrier County, had 34 congregants test positive for the virus. And in Texas, which hit an all-time high of new cases last week, health officials have received numerous reports of church-related exposures.”
“The temporary 60-day pause that President Donald Trump declared on legal immigration in mid-April after the coronavirus hit was not so temporary after all. Starting tomorrow, Trump will extend this pause until the end of 2020. But that’s not all. He is also expanding the scope of the ban to cover even more categories of immigrants.
Trump is justifying all this as an effort to save American workers from foreign competition. But if America’s past experience with restrictionist policies is any indication, the ban will backfire and end up hurting, not helping, American workers, its intended beneficiaries, while crimping America’s economic recovery.”
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“There are already significant obstacles built into labor and immigration law that make it far more time consuming and costly for businesses to hire foreign workers. So businesses already automatically prioritize American workers over foreign workers. As Sen. Lindsey Graham (R–S.C.) tweeted after Trump’s announcement: “Work visas for temporary and seasonal jobs covering industries like hospitality, forestry, and many economic sectors can only be issued AFTER American workers have had a chance to fill the position.”
The fact of the matter is that American employers only hire immigrants to fill niches at the top and the bottom end of the labor spectrum where qualified Americans aren’t available or willing to take jobs. Restrictionists like White House aide Stephen Miller, the real architect of Trump’s immigration pause, claim that starving businesses of foreign workers will force them to invest in training domestic workers and/or paying them more, resulting in more jobs and higher wages for Americans.
But this is the flawed logic of central planning. It ignores the fact that there are limits to the price increases that a market can bear. Businesses will automate functions that can’t be performed abroad and will outsource other functions to keep a lid on the costs of a key input—all of which will hurt, not help, American workers.”
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“Interestingly, Trump’s immigration ban does not extend to H-2A visas for farm workers. In fact, that’s the one category of visas that has expanded on his watch. Why? Because agriculture is the mainstay of many red state economies whose leaders have indicated that they would not take kindly to being cut off from a key source of labor. Trump has also carved a very narrow exemption for foreign workers “involved with the provision of medical care to individuals who have contracted COVID-19” and who are “currently hospitalized.”
But high-skilled foreign workers that blue states like California, Washington, and New York depend on are out of luck. What is likely to happen in these states? Will they rush to hire Americans with big bucks in hand? Not really.
For starters, there just aren’t enough high-skilled Americans sitting around to be hired. The unemployment rate last month—the peak of the pandemic—for computer jobs was 2.5 percent compared to the overall rate of 13.3 percent for all jobs, according to an analysis by the National Foundation for American Policy.
So as high-tech companies are choked off from hiring foreign workers, they’ll start outsourcing more operations abroad. This is what happened in 2004 when Congress slashed the H-1B cap from 195,000 to less than half”