US in disarray on Covid plans
Donald Trump is at war with his own health officials
WWith 1000 deaths per day, it’s like two jumbo jets dropping from the sky.
Dr Carlos del Rio, Emory University
hen senior US Food and Drug Administration officials held their morning call one day this week, they received a sobering warning from the agency’s chief, Dr Stephen Hahn, who had just got off the phone with the White House: Block out “all the craziness” and stay focused on fighting the pandemic.
There are plenty of distractions. President Donald Trump is pushing to overturn the results of the election, and his only public statements about the coronavirus in the past few days were to make clear his pique that good news about a vaccine had not come until after Election Day — even as the average number of new daily infections topped 123,000, average daily deaths passed the 1000 mark and Covid-19 hospitalisations hit a record high of 61,964.
“With 1000 deaths per day, it’s like two jumbo jets dropping from the sky,” said Dr Carlos del Rio, an infectious disease specialist at Emory University.
Vice-President Mike Pence cancelled a vacation at the last minute as the virus numbers grew worse, but the White House coronavirus taskforce that he leads has been all but publicly silent. Mark Meadows, the White House chief of staff who is infected with the virus, declared last month, “We are not going to control the pandemic,” and said the focus should instead be on the longer-term goals of developing vaccines and treatments.
Since then, White House political director Brian Jack has become the latest administration official to test positive for the virus.
The pandemic caught the nation flat-footed in March, but epidemiologists have been warning for months of an autumn and winter wave as people are driven indoors, schools resume in-person classes and Americans grow tired of months of precautions. Yet shortages of personal protective equipment are back, especially among rural hospitals, nursing homes and private medical practices that lack access to the supply networks that serve larger hospital chains.
The Strategic National Stockpile, the nation’s emergency reserve, has only 115 million N95 masks, far short of the 300 million the administration had hoped to amass by winter, Rear Admiral John Polowczyk, who retired on Tuesday as the national supply chain commander, said in a recent interview.
Dr Shikha Gupta, executive director of Get Us PPE, a volunteer effort that matches available supplies to healthcare providers, said 70 per cent of those requesting help from the organisation last month reported being completely out of one type of critical gear, especially masks, gloves and disinfecting wipes.
“Healthcare workers are exhausted and frustrated, and it’s really hard to believe that [in November] it feels very much like the middle of March all over again,” she said.
Governors are once again competing with one another and big hospital chains for scarce gear. Nursing homes are grappling with staff shortages, which have left hospitals unable to discharge patients to their care. In Wisconsin, the situation is so severe that health officials are mulling a plan to train family members of nursing home residents to fill in at facilities that lack enough workers.
“We’re throwing every idea that we can conceivably think of to the state, but we really need bold action from the federal government,” said John Sauer, president of LeadingAge Wisconsin, an association that represents non-profit nursing homes and long-term care facilities.
The United States is on somewhat better footing now than in the earliest days of the pandemic. States and hospitals have their own stockpiles, and Polowczyk said the Federal Government had met its goal of acquiring 153,000 ventilators.
But as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains disengaged. President-elect Joe Biden is trying to assume a leadership mantle with the appointment of a coronavirus advisory board and a call for all Americans to wear masks, but until his inauguration on January 20, he lacks the authority to mobilise a federal response.
A White House spokesman, Brian Morgenstern, said Trump and his administration “remain focused on saving lives”, citing their efforts to produce a vaccine and therapeutics. He added that the taskforce “is in constant contact with state and local officials” to provide help when needed.
But Trump is at war with his own health officials. He was furious after Pfizer, the drugmaker, announced on Tuesday that early clinical trial data suggested its coronavirus vaccine
was more than 90 per cent effective. In a conversation with Hahn, a senior administration official said, Trump accused the company and the FDA of conspiring to delay news that could have bolstered his chances of re-election.
Beyond Trump’s Twitter feed, the federal bully pulpit — an essential component of an infectious disease response — has largely gone silent.
Dr Anthony Fauci, the government’s top infectious disease expert, warned in an interview on Wednesday that a vaccine is not an immediate panacea, and until doses become widely available — likely in mid-2021 — Americans must wear masks and social distance, and to avoid crowded settings, particularly indoors.
Local officials say they are struggling alone. New weekly cases among nursing home residents jumped four-fold from the end of May to late October, and deaths have more than doubled in 20 states, according to R Tamara Konetzka and Rebecca Gorges, researchers at the University of Chicago who analysed data from the CDC.
“The depressing message is that nothing much has changed since the spring,” Konetzka said.
Even many large hospital chains, which say they have adequate supplies of medical gear, continue to operate in crisis mode. That often means requiring employees to repeatedly reuse respirator masks that are meant to be discarded after each use.
Deborah Burger, a president of National Nurses United, the largest organisation of registered nurses, said the lack of clear guidance from the CDC had allowed hospitals to create their own standards for reusing disposable protective gear, which she said put hospital workers and patients at increased risk of infection.
“We’re 11 months into the pandemic, and the administration is still not adequately addressing the safety of healthcare workers and the safety of our communities,” she said.