Trump, American exceptionalism and the virus
Americans normally hear from President Donald Trump when he is opining on Twitter, riffing from a rally stage or otherwise improvising. This past week was different as he sat in the Oval Office with a script laid out for him to read on a matter grave enough for a primetime address to the nation.
He addressed the coronavirus crisis that is spreading germs and fear. But his words were as factually fraught as many of his tweets.
Most broadly, Trump hailed American exceptionalism in health care and science — “The virus will not have a chance against us” — even as the public health system failed in making diagnostic testing accessible to all who need it.
It’s been more than a week now since Trump assured the country: “Anybody, right now, and yesterday, anybody that needs a test, gets a test. They’re there. They have the test. And the test is beautiful.”
He persisted with that thought as recently as Thursday, a day after his Oval Office address, when he asserted “the testing has been going very smooth.” This, as the government’s top infection expert, Dr. Anthony Fauci, was telling lawmakers: “It is a failing, let’s admit it.”
A review of Trump’s recent rhetoric:
Exceptionalism?
TRUMP: “No nation is more prepared or more resilient than the United States.” — Oval Office address Wednesday.
THE FACTS: American resilience will be measured over time. But the U.S. is not more prepared than all other countries. Seven weeks since the first U.S. case of coronavirus was announced, the government cannot account for what could be thousands of additional infections because of continuing stumbles on testing.
Nearly a month after U.S. health officials promised to tap into a national network of labs that monitor for flu, that system is only just getting started. Large-scale testing is a critical part of tracking the spread of infectious diseases and allocating resources for treatment. The lack of comprehensive figures means U.S. health providers could quickly be overwhelmed by undetected cases.
Fauci told a congressional hearing that other countries grappling with the virus have been making it easy for people to get tested, but in the U.S., “the system is not really geared to what we need right now.”
For most people, COVID-19 causes only mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with health problems, it can cause more severe illness, including pneumonia. The vast majority of people recover from it.
TRUMP: “If an American is coming back or anybody is coming back, we’re testing. We have a tremendous testing setup where people coming in have to be tested . ... We’re not putting them on planes if it shows positive, but if they do come here, we’re quarantining. There’s going to be a pretty strong enforcement of quarantine.” — remarks Thursday.
THE FACTS: That’s not true. All people coming to the U.S. are not subject to mandatory, universal testing, nor are they being forced to quarantine.
As well, his proclamation detailing the broad travel restrictions that took effect midnight Friday night on visitors from most of Europe does not specify that everyone allowed in will have to be tested. Trump was probably referring to plans that are expected to be put in place soon to channel those arriving from many European countries to certain U.S. airports, where they will receive screening and be subjected to quarantine instructions, just like visitors from China.
TRUMP: “Taking early intense action, we have seen dramatically fewer cases of the virus in the United States than are now present in Europe. “— Oval Office address.
THE FACTS: “Seen” so far may be true. But that does not mean Europe is being hit harder by infections than the United States. Because of test shortages in the U.S., many Americans with COVID-19 aren’t being diagnosed and counted.
TRUMP: “The European Union failed to take the same precautions and restrict travel from China and other hot spots. As a result, a large number of new clusters in the United States were seeded by travelers from Europe.” — Oval Office address.
THE FACTS: That’s a distorted account of travel restrictions in Europe.
By the time U.S. travel restrictions were announced on Jan. 31, many major European airlines had already cut service to China. While restrictions in some European countries were not as widespread, others were much broader.
The Czech Republic had stopped issuing visas to Chinese citizens. Germany issued a travel advisory urging citizens to postpone nonessential travel to China. Italy had declared a state of emergency for six months. Russia had shut down its land border with China, as well as almost all train traffic and most flights there.
Trump on Jan. 31 signed an order that would temporarily bar entry to the U.S. of foreign nationals, other than immediate family of U.S. citizens and permanent residents, who have traveled in China within the last 14 days. The ban took effect Feb. 2.
A recent study from the journal Science found China’s internal crackdown modestly delayed the spread of the virus but it cast doubt that travel restrictions elsewhere will do much compared with other preventive measures.
Despite Trump’s boast of “early intense action,” his former homeland security adviser, Tom Bossert, said restrictions on entry into the U.S. from Europe came too late. “We have nearly as much disease here in the US as the countries in Europe,” he tweeted.
What’s covered
TRUMP: “Earlier this week, I met with the leaders of (the) health insurance industry, who have agreed to waive all copayments for coronavirus treatments, extend insurance coverage to these treatments, and to prevent surprise medical billing.” — Oval Office address.
THE FACTS: No, they did not say they will cover copays for treatment.
As Vice President Mike Pence stated more accurately, the insurers agreed to cover coronavirus testing with no cost sharing — so no copays or deductibles. That assurance applies to tests that can confirm or rule out the virus, and doesn’t extend to treatment or to other tests that the patient’s doctor may order. Consumers should check with their insurance company because policies may vary on this. They should not count on the president’s word.
What’s more, in the process of diagnosing COVID-19, other tests may be ordered. Insurers have not pledged to waive costsharing for those. Copays and deductibles may apply for imaging tests such as X-rays or CT scans of the chest, for example, and hospital stays are also subject to cost-sharing.
Federal programs including Medicare, Medicaid, children’s health insurance and “Obamacare” all cover the coronavirus tests. Of particular importance, clinical diagnostic tests are covered under Medicare with no cost-sharing, a longstanding policy. But cost-sharing may apply for other tests, such as imaging.
When people get sick from the coronavirus, there currently is no antiviral treatment that can cure the disease. Instead, the current treatment is geared to relieving patients’ symptoms and helping them to recover. For those who are very sick, that can involve using machinery to help them breathe. Insurers cover such treatment based on the terms of the individual’s health plan, including any applicable deductibles and copays.
Tests & treatment
TRUMP: “We are cutting massive amounts of red tape to make antiviral therapies available in record time. These treatments will significantly reduce the impact and reach of the virus.” — Oval Office address.
THE FACTS: People with COVID-19 or those who get it in the outbreak should not expect those therapies to be available to them. Dr. Anthony Fauci of the National Institutes of Health told a congressional committee Wednesday that while antivirals are being tested, “we don’t know if it works. I don’t want to promise anything.”
An antiviral is a medicine that specifically attacks a virus to hasten recovery. An experimental drug named remdesivir, which was being developed to fight Ebola, is being tested in COVID-19 patients in the U.S. and abroad. There also are studies underway using combinations of some HIVattacking drugs.