PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments…

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Staff from the Department of Health and Human Services (HHS) told the House Oversight and Reform Committee that the Trump administration has made its final shipments of personal protective equipment to states from the Strategic National Stockpile.

According to the staff, 90 percent of the stockpile’s inventory of N95 respirators, surgical and face masks, face shields, gowns and gloves have already been distributed to every state.

The remaining 10 percent is reserved for federal workers and will not be distributed to states.  

Governors have said that a shortage of medical supplies has led to states navigating the private marketplace in an escalating bidding war against each other and the federal government. The depletion of the federal stockpile means those practices will continue.

“Now that the national stockpile has been depleted of critical equipment, it appears that the administration is leaving states to fend for themselves, to scour the open market for these scarce supplies, and to compete with each other and federal agencies in a chaotic, free-for-all bidding war,” committee Chairwoman Carolyn Maloney (D-N.Y.) said in a statement.

States that have turned to the federal government’s stockpile for emergency equipment have not received all they need.

An internal administration document released by the committee on Wednesday showed that only 11.7 million N95 respirator masks have been distributed nationwide, which is less than 1 percent of the 3.5 billion masks that the administration estimated would be necessary in the event of a severe pandemic.

The committee also found that only 7,920 ventilators have been distributed from the stockpile.” (A)

For weeks, the Trump administration pushed states to procure their own ventilators and protective gear, like masks, gloves and face shields. But a new effort by the administration to create a hybrid system of distribution — divided between the federal government, local officials and private health care companies — has led to new confusion, bordering on disarray, and charges of confiscation.

“Either be in or out, folks,” Governor Polis said on CNN. “Either you’re buying them and you’re providing them to the states and you’re letting us know what we’re going to get and when we’re going to get them, or stay out and let us buy them.”..

Federal officials say they are trying to expedite the shipment to the United States of large quantities of medical supplies procured by private health care providers such as McKesson Corporation, Cardinal Health, Owens & Minor, Medline and Henry Schein. FEMA allows those distributors to sell about half of the equipment to companies and counties that had previously placed orders. The other half of the shipments must be sold to counties that the federal government prioritizes by the severity of the outbreak, based on data compiled by the Centers for Disease Control and Prevention.

The federal government will also soon save 10 percent of the supplies on each flight for the national stockpile, according to officials. A Korean War-era production act also allows the federal government to force companies to prioritize its order over another client’s, whether it be a private hospital or another nation.

In the past week, 14 flights carrying more than 83 million gloves, four million masks, one million gowns and 300,000 respirators have landed in New York, Chicago, Miami, Los Angeles, Columbus, Ohio, and Louisville, Ky. Mr. Pence said more than 50 flights had been scheduled.

The administration pivoted to the system of distribution after President Trump tapped FEMA to replace the Department of Health and Human Services as the agency leading the response to the coronavirus pandemic. States had previously submitted formal requests to the government to obtain materials from the stockpile.

Because the federal government determines which states are in greater need, governors and hospitals executives preparing in advance for the worst have complained that FEMA was effectively commandeering their personal protective equipment, or P.P.E…

The intervention has confused some local officials and company executives who have watched as the administration has repeatedly called on states to find medical supples on their own without relying on the federal government. But hundreds of hospitals continue to struggle with widespread shortages of test kits, protective gear for staff members and ventilators, according to a new report by the inspector general for the Department of Health and Human Services….

Adding to the disarray is the White House’s ad hoc system of disaster response in which the right call to Mr. Trump can result in one county getting priority over another. Advisers to Jared Kushner, the president’s son-in-law, have surprised FEMA officials in recent weeks to deploy supplies to communities after the area’s representatives got through to Mr. Trump, even if the state had not yet gone through the formal process to secure supplies.” (V)

“Top White House trade adviser Peter Navarro warned in stark terms about how deadly and economically devastating the coronavirus outbreak could be, weeks before it became a full-blown pandemic.

Navarro delivered the warnings to others at the White House in internal memos in January and February, saying that the United States could see up to 2 million deaths and trillions of dollars in economic damage.

The first Navarro memo was dated Jan. 29 and was addressed to the White House National Security Council, according to The New York Times, which first reported on the document. In it, Navarro made his case for an “immediate travel ban on China.”

In that memo, Navarro also reportedly warned that “the lack of immune protection or an existing cure or vaccine would leave Americans defenseless in the case of a full-blown coronavirus outbreak on U.S. soil.”

“This lack of protection elevates the risk of the coronavirus evolving into a full-blown pandemic, imperiling the lives of millions of Americans,” Navarro wrote in the memo, according to the Times.

Navarro’s first memo came as the president was downplaying the prospect of the virus coming to the U.S., while, at the same time, just days later on Jan. 31 restricting travel from China, after it was reported that COVID-19 was first discovered in China in December 2019 in Wuhan, Hubei province.

The memo reportedly warned of up to $5.7 trillion in economic costs and up to a half-million American deaths in a worst-case scenario.

In late February Navarro penned another memo, this time addressed to the president himself and escalating the warnings.

The Feb. 23 memo, first reported by Axios and confirmed by Fox News, warned that “there is an increasing probability of a full-blown COVID-19 pandemic that could infect as many as 100 million Americans, with a loss of life as many as 1-2 million souls.”…

The inspector general for the Department of Health and Human Services released a report on Monday, which revealed severe shortages of testing supplies and extended waits for results at hospitals across the nation; widespread shortages of PPE which put staff and patients at risk; difficulty maintaining adequate staffing; and shortages of critical supplies, like hand sanitizer, facemasks, toilet paper, linen, disinfectant cleaning supplies and more, as well as materials and logistics support.” (B)

“Jared Kushner, President Trump’s son-in-law and senior adviser, criticized governors Thursday, saying they don’t have a handle on their own supplies of masks and ventilators needed to combat the coronavirus outbreak.

In a rare appearance in the White House briefing room, Kushner urged governors and some senators to be more resourceful in their own states instead of looking first to the federal government for help.

“What a lot of the voters are seeing now is that when you elect somebody to be a mayor or governor or president, you’re trying to think about who will be a competent manager during the time of crisis,” he said. “This is a time of crisis, and you’re seeing certain people are better managers than others.”..

On Thursday, he explained that Trump and Vice President Pence came to him looking for new ideas and “outside of the box” thinking.

But his lack of experience has drawn scrutiny, especially when he referred to the national stockpile of medical supplies as “our stockpile.”

“The notion of the federal stockpile was it’s supposed to be our stockpile,” he said. “It’s not supposed to be states’ stockpiles that they then use.”..

A day after Kushner made his remarks, language on a government website about the national stockpile was changed to more closely reflect his description. But a spokesperson for the Department of Health and Human Services said the department had been using the new language for weeks. The assistant secretary for preparedness and response “first began working to update the website text a week ago to more clearly explain to state and local agencies and members of the public the role of the” Strategic National Stockpile, the spokesperson said.” (C)

“President Donald Trump has upended the panel of federal watchdogs overseeing implementation of the $2 trillion coronavirus law, tapping a replacement for the Pentagon official who was supposed to lead the effort.

A panel of inspectors general had named Glenn Fine — the acting Pentagon watchdog — to lead the group charged with monitoring the coronavirus relief effort. But Trump on Monday removed Fine from his post, instead naming the EPA inspector general to serve as the temporary Pentagon watchdog in addition to his other responsibilities.

That decision, which began circulating on Capitol Hill Tuesday morning, effectively removed Fine from his role overseeing the coronavirus relief effort, since the new law permits only current inspectors general to fill the position…

Trump has also begun sharply attacking Health and Human Services Inspector General Christi Grimm, following a report from her office that described widespread testing delays and supply issues at the nation’s hospitals.” (D)

“Over the weekend, First Lady Melania Trump urged Americans to continue to follow the recommendations of the Centers for Disease Control and Prevention in order to slow the spread of the novel coronavirus.

 “As the weekend approaches I ask that everyone take social distancing & wearing a mask/face covering seriously,” the First Lady wrote in a tweet. “#COVID19 is a virus that can spread to anyone — we can stop this together.”…

 “I don’t think I’m going to be doing it,” the president said during a Friday press conference. “Wearing a face mask as I greet presidents, prime ministers, dictators, kings, queens — I just don’t see it.” Trump touted that he was glad his wife was taking action in the wake of the pandemic, but he himself would not be following those same guidelines.” (E)

“President Donald Trump and his administration are promoting an anti-malaria drug not officially approved for fighting the new coronavirus, even though scientists say more testing is needed before it’s proven safe and effective against COVID-19.

Trump trade adviser Peter Navarro championed hydroxychloroquine in television interviews Monday, a day after the president publicly put his faith in the medication to lessen the toll of the coronavirus pandemic.

“What do I know, I’m not a doctor,” Trump said Sunday. “But I have common sense.” In promoting the drug’s possibilities, the president has often stated, ”What have you got to lose?”

Trump held out promise for the drug as he grasps for ways to sound hopeful in the face of a mounting death toll and with the worst weeks yet to come for the U.S. The virus has killed more than 10,000 in the U.S., and measures meant to contain its spread have taken a painful economic toll and all but frozen life in large swaths of the country.

But medical officials warn that it’s dangerous to be hawking unproven remedies, and even Trump’s own experts have cautioned against it.

The American Medical Association’s president, Dr. Patrice Harris, said she personally would not prescribe the drug for a coronavirus patient, saying the risks of severe side effects were “great and too significant to downplay” without large studies showing the drug is safe and effective for such use.

Harris pointed to the drug’s high risk of causing heart rhythm problems.

“People have their health to lose,” she said. “Your heart could stop.”..

Doctors are already prescribing the malaria drug to patients with COVID-19, a practice known as off-label prescribing. Research studies are now beginning to test if the drugs truly help COVID-19 patients, and the Food and Drug Administration has allowed the medication into the national stockpile as an option for doctors to consider for patients who cannot get into one of the studies.” (F)

“After receding from the limelight once the Russia investigation and impeachment wrapped up, former New York City Mayor Rudy Giuliani is making headlines again, lobbying President Donald Trump on untested coronavirus treatments, according to a new report from The Washington Post.

Giuliani, 75, has served as Trump’s personal attorney on a pro bono basis throughout the first term thus far, most often dispatched to defend the president on television amid the Russia and Ukraine scandals.

Now, Giuliani is pushing for the malaria drug hydroxychloroquine and what he describes as removing “placenta killer cells” in a stem cell treatment for COVID-19. As the Post put it, the former mayor is attempting to position himself as “personal science adviser” to the president.

Both hydroxychloroquine and the stem cell treatment are unproven and have yet to receive FDA approval to treat the coronavirus.

Last week, Giuliani had a tweet removed for violating Twitter’s misinformation policy when he promoted the anti-malaria drug…

Trump said he would take hydroxychloroquine to keep himself immune from COVID-19 during a White House press briefing last week.

Giuliani is joining a growing number of Trump confidants backing the drug, which The Post reports is “worrying health experts who fear such comments undermine efforts to slow the virus’s spread and downplay the risks of the unproven treatments.”

The former mayor told The Post he has spoken to Trump about the potential treatment “three or four times,” and has sought medical advice from a controversial Long Island doctor with a conservative following and a pharmacist who previously pleaded guilty for conspiring to extort Steven Seagal.” (G)

“A nationwide shortage of two drugs touted as possible treatments for the coronavirus is being driven in part by doctors inappropriately prescribing the medicines for family, friends and themselves, according to pharmacists and state regulators.

“It’s disgraceful, is what it is,” said Garth Reynolds, executive director of the Illinois Pharmacists Association, which started getting calls and emails Saturday from members saying they were receiving questionable prescriptions. “And completely selfish.”..

A pharmacist in Houston, who asked to remain anonymous for fear of retaliation and violating patient privacy, said he was recently asked by a surgeon for an unusually large quantity with unlimited refills. “He said it was because his wife had lupus,” the pharmacist said, “but when I asked him for her name and diagnosis, he told me just to put it in his.”

Lupus patients are reporting difficulty in refilling their prescriptions for the drug. On Monday, the Lupus Foundation of America issued a joint statement asking the White House Coronavirus Task Force to “take action to ensure current supplies are allocated for patients taking them for indicated uses.” Several states in the past few days have already moved to limit prescriptions of the drugs, neither of which is approved to treat the coronavirus. Trump, in press conferences and tweets over the past week, has promoted the use of the drugs as potentially blunting the impact of the COVID-19 outbreak.

“It’s unfortunate that a news conference, I think prematurely, made it sound like this was the answer, and that’s led to this panic,” Michelle Petri, director of Johns Hopkins University School of Medicine’s Lupus Center, said Friday. “I have spent the last two days trying to help lupus patients who actually need their refills.” She said some patients have refills on back order while others are being provided smaller amounts than usual.

The West Virginia Board of Pharmacy, in an alert Saturday, ordered pharmacists to limit new prescriptions to no more than 30 tablets and only to cases where the drugs were being used for approved indications…

On Twitter, pharmacy workers traded stories about dentists and opthamologists requesting hydroxychloroquine under dubious pretenses. “A dentist just tried to call in scripts for hydroxychloroquine + azithromycin for himself, his wife, & another couple (friends),” tweeted a pharmacist in Eugene, Oregon. “I have patients with lupus that have been on HCQ [Hydroxychloroquine] for YEARS and now can’t get it because it’s on backorder.”

Steve Moore, president of the Pharmacists Society of the State of New York, said medical providers hoarding the drugs is occuring in the state, which has the highest number of coronavirus cases in the country.

“That’s a double whammy,” he said. “We’re potentially taking that medication away from patients with autoimmune conditions and patients with the actual virus that may need treatment.”” (H)

“In audio of the call published by CBS News, Montana Gov. Steve Bullock (D) details two problems with testing. First, that his state doesn’t have enough tests, saying “we’re one day away if we don’t get test kits from the CDC that we wouldn’t be able to do testing.” And second, that the federal government has depleted the tests available on the private market…

Trump’s response to questions of testing typically mirrors the answer he gave Bullock — that the US is doing more testing than anyone else. And this, to a point, appears to be true. As of Saturday, Adm. Brett Giroir, coronavirus task force member and assistant secretary for health at the Department of Health and Human Services, said the US had done 894,000 tests.

But while that is a large number, the number of tests done per capita is much smaller: According to the Washington Post, the US had conducted 2,250 tests per million people by March 28, a figure roughly two-thirds of the per capita testing rate South Korea achieved three weeks earlier.

The reason this distinction is important is that if we are to end social distancing in the next few months, rather than ending it only when a vaccine becomes available, it is imperative enough tests exist to test on a massive scale, as Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, has explained” (I)

“Dr. Deborah Birx said that the White House coronavirus task force is missing 50% of the data for coronavirus tests that have been conducted.

Birx, one of the top officials on the White House’s coronavirus task force, said Thursday that part of the $2 trillion economic stimulus measure that was signed into law by President Donald Trump requires that all tests conducted get reported to the Centers for Disease Control and Prevention. But Birx says she has not received that data yet.

“Well, I’m telling you, I’m still missing 50% of the data from reporting,” she said. “I have 660 (thousand) tests reported in. We’ve done 1.3 million. … So, we do need to see — the bill said you need to report. We are still not receiving 100% of the tests.”” (J)

“President Donald Trump had a hard time deciding Tuesday whether impeachment distracted him from fighting the coronavirus – but he eventually claimed it “probably” did.

“Well, I don’t like to think I did,” Trump said at a news conference with the White House coronavirus task force. “I think I handled it very well, but I guess it probably did. I mean, I got impeached.”

He added that, “I certainly devoted a little time to thinking about it.”

The president later expanded on his answer.  

“But certainly I guess I thought of it. And I think I probably acted – I don’t think I would have done better had I not been impeached, OK? And I think that’s a great tribute to something. Maybe it’s a tribute to me. But I don’t think I would’ve acted any differently or I don’t think I would’ve acted any faster.””(K)

“New White House press secretary Kayleigh McEnany repeatedly downplayed the threat of the coronavirus in comments made in February and March, a CNN KFile review has found.

In radio and television appearances, McEnany, in her role as spokeswoman for President Donald Trump’s 2020 campaign, said the administration had the rapidly spreading coronavirus “under control” and said that because of travel restrictions enacted by the President, “we will not see diseases like the coronavirus come here.”

She also said Democrats were “actively rooting against what’s in the best interest of America,” including rooting for coronavirus to take hold. She said coronavirus, like the Russia and Ukraine scandals, was being used to take down Trump…

“We will not see diseases like the coronavirus come here”

Speaking on Fox Business on February 25, McEnany said because of travel policies enacted by the President, coronavirus would not continue to come to the United States…

In March, McEnany continued to defend the president as the outbreak spread. On local Michigan radio on March 10, she said it was incumbent on the public to take adequate political health measures but the situation was under control.

“This is something that is under control,” she said on the Frank Beckmann Show. “We have a President who has taken unprecedented action and mandatory quarantines and travel restrictions, and he’s taken every measure that he possibly could to protect the American people. I’m confident we have a great leader at the top, but it’s incumbent upon all of us just to take those precautions.”

“This President’s taken unprecedented action to protect this country from the coronavirus,” she continued. “He stopped it from being so much worse than it could have been, but leave it to the media and the left to score those cheap political points.”” (L)

“Since Chinese officials disclosed the outbreak of a mysterious pneumonialike illness to international health officials on New Year’s Eve, at least 430,000 people have arrived in the United States on direct flights from China, including nearly 40,000 in the two months after President Trump imposed restrictions on such travel, according to an analysis of data collected in both countries.

The bulk of the passengers, who were of multiple nationalities, arrived in January, at airports in Los Angeles, San Francisco, New York, Chicago, Seattle, Newark and Detroit. Thousands of them flew directly from Wuhan, the center of the coronavirus outbreak, as American public health officials were only beginning to assess the risks to the United States…

Mr. Trump has repeatedly suggested that his travel measures impeded the virus’s spread in the United States. “I do think we were very early, but I also think that we were very smart, because we stopped China,” he said at a briefing on Tuesday, adding, “That was probably the biggest decision we made so far.” Last month, he said, “We’re the ones that kept China out of here.”” (M)

“A US Navy hospital ship currently docked in New York City harbor is treating only 22 patients as of Friday afternoon, despite having a 1,000 bed capacity to treat non-coronavirus patients, according to a US Navy official.

Navy officials told CNN that they expect the number of patients being treated to increase significantly in the coming days as the process of referring patients to the ship is refined.

The USNS Comfort was deployed to New York City, the epicenter of the virus outbreak in the United States, to free up capacity in the city’s civilian hospitals so that they can focus on treating coronavirus patients.

New York City’s hospitals have been overwhelmed with coronavirus cases and are struggling to respond to patients constantly streaming in. A shortage of personal protective equipment has also placed medical workers at risk of contracting the virus. On Thursday, New York Gov. Andrew Cuomo announced that the temporary hospital facility at the Javits Convention Center, which holds 2,500 beds, will now treat Covid-19 patients….

Ambulances are not taking people directly to the ship, which docked in New York City on Monday. Patients are referred to the ship by shore-based hospitals and must be screened and tested for the virus before being admitted on board.

The Department of Defense said Friday that it would begin streamlining the process to admit patients onto the ship.

“Screening for care on the USNS Comfort will be modified and will now occur pier-side in an effort to reduce the backlog at some of the nearby New York hospitals,” the Pentagon said in a statement. “The screening effort for the USNS Comfort will no longer require a negative test (for coronavirus), but each patient will still be screened by temperature and a short questionnaire.”

There are some patients that the Comfort can’t bring on board, mainly those who are immunosuppressed due to the fact the ship is open bay and does not have the ability to isolate patients, according to a Navy official familiar with operations on the ship.

“We are conducting data analysis to see how we need to change our configuration — bottom line we’ve been here 48 hours, and this is a scenario no one has ever seen before,” the official told CNN. “No one wants to get this wrong. We hear the feedback from medical professionals, and are fine tuning,” but the Comfort will still only treat non-coronavirus patients.” (N)

“AS MUCH OF the New York City’s media focused on the brewing coronavirus disaster in the city’s jails on Rikers Island, a parallel crisis is looming at the federal jails located in the city: the Metropolitan Correctional Center in Lower Manhattan and the Metropolitan Detention Center in Brooklyn.

Nationwide, according to Bureau of Prison statistics, the number of positive cases of coronavirus in federal jails and prisons exploded by 8,600 percent in the two weeks since March 20 — an increase that’s especially concerning given the vulnerability of the people locked in conditions they can’t control. By Bureau of Prison estimates, roughly a third of the people incarcerated in MDC and MCC are at elevated risk of severe illness by the Centers for Disease Control and Prevention’s standards.

Jail officials are not holding off on testing for want of incarcerated people showing alarming symptoms: Clients have told lawyers that their housing units are full of coughing people.

It is hardly reassuring that, so far, few incarcerated people at either facility have tested positive. Jail officials admitted last week — only because of a judge’s order — that they’re doing almost no testing. As of Friday, only seven people out of a population of roughly 1,700 had been tested at MDC, of whom two tested positive. Of the roughly 760 people held at MCC, only five had been tested, of whom four tested positive.” (O)

“The Covid-19 pandemic is stretching our public health system to its limits and challenging our ability to meet the urgent and critical medical needs of the country as never before. As executives responsible for the legal affairs of major hospitals and lawyers working in Covid-19 hot spots, we know how crucial it is to have every available front-line medical worker fighting this pandemic.

But 29,000 of those workers are being threatened with deportation by the Trump administration. They have been protected by the Deferred Action for Childhood Arrivals program, under which undocumented immigrants who came to the United States as children can obtain protection against deportation and authorization to work in the United States. The Trump administration terminated that program, the Supreme Court is currently considering the lawfulness of that determination, and the court’s decision could come at any time.

New data from the Center for American Progress reveals that the DACA-recipient health care work force includes more than 6,000 diagnosing and treating practitioners, including respiratory therapists, physicians assistants and nurses; some 8,000 health aides, including nursing assistants and orderlies; more than 7,000 other health care support workers; and some 5,500 health technologists and technicians.

The Association of American Medical Colleges told the Supreme Court that nearly 200 physicians, medical students and residents depend on DACA for their ability to practice medicine and serve their communities. Those 200 trainees and physicians alone would care for hundreds of thousands of patients per year in normal times — the association estimates as many as 4,600 patients per year, per person. Under the demands of the Covid-19 pandemic, those numbers will be much higher.

The Center for Migration Studies found that 43,500 DACA recipients work in the health care and social-assistance industries, including more than 10,000 in hospitals…

If the Supreme Court allows the termination of DACA during this pandemic, the work of our hospitals will suffer a critical blow at exactly the moment when we can least afford it. At a time when the importance — and scarcity — of our medical resources has never been clearer, neither our institutions nor the nation can afford a disruption to the health care work force. We desperately need all hands on deck for this fight.” (P)

“Why is Germany’s death rate so low?..A Robust Public Health Care System

Before the coronavirus pandemic swept across Germany, University Hospital in Giessen had 173 intensive care beds equipped with ventilators. In recent weeks, the hospital scrambled to create an additional 40 beds and increased the staff that was on standby to work in intensive care by as much as 50 percent.

“We have so much capacity now we are accepting patients from Italy, Spain and France,” said Susanne Herold, a specialist in lung infections at the hospital who has overseen the restructuring. “We are very strong in the intensive care area.”

All across Germany, hospitals have expanded their intensive care capacities. And they started from a high level. In January, Germany had some 28,000 intensive care beds equipped with ventilators, or 34 per 100,000 people. By comparison, that rate is 12 in Italy and 7 in the Netherlands.

By now, there are 40,000 intensive care beds available in Germany.

Some experts are cautiously optimistic that social distancing measures might be flattening the curve enough for Germany’s health care system to weather the pandemic without producing a scarcity of lifesaving equipment like ventilators.

“It is important that we have guidelines for doctors on how to practice triage between patients if they have to,” Professor Streeck said. “But I hope we will never need to use them.”

The time it takes for the number of infections to double has slowed to about nine days. If it slows a little more, to between 12 and 14 days, Professor Herold said, the models suggest that triage could be avoided.

“The curve is beginning to flatten,” she said.

Beyond mass testing and the preparedness of the health care system, many also see Chancellor Angela Merkel’s leadership as one reason the fatality rate has been kept low.

Ms. Merkel, a trained scientist, has communicated clearly, calmly and regularly throughout the crisis, as she imposed ever-stricter social distancing measures on the country. The restrictions, which have been crucial to slowing the spread of the pandemic, met with little political opposition and are broadly followed.

The chancellor’s approval ratings have soared.

“Maybe our biggest strength in Germany,” said Professor Kräusslich, “is the rational decision-making at the highest level of government combined with the trust the government enjoys in the population.”” (Q)

Georgia Gov. Brian Kemp signed an executive order on Thursday that requires residents of the state to shelter in place.

But the order overrides all local efforts to combat the coronavirus, including beach closures.

As of Friday night, Georgia state beaches are open once again, though visitors are required to follow social-distancing guidelines.

The governor of Georgia has imposed a state-wide order to shelter in place, as of Friday night — and, at the same time, reopened the state’s beaches.

In an executive order signed on Thursday, Gov. Brian Kemp, a Republican, issued an executive order April 2 that requires Georgians to remain in their homes for the next 10 days, with exceptions for vital businesses and necessary travel. But it also suspends “any local ordinance or order” aimed at “combating the spread of coronavirus or COVID-19.”

As a result, popular tourist spots like Tybee Island, which receives hundreds of thousands of visitors every year, are now back in business, even as the rest of the state shuts down.” (R)

“President Donald Trump’s top health advisers are developing medical criteria for safely reopening the U.S. economy in coming weeks should trends showing a crest in the coronavirus outbreak hold steady.

Deborah Birx, the immunologist who coordinates the White House virus task force, met into the night Tuesday with health experts, including Anthony Fauci, the nation’s top infectious disease expert, Centers for Disease Control and Prevention Director Robert Redfield and Food and Drug Administration Commissioner Stephen Hahn.

Notably absent from the late-night discussion were economic and political advisers to the president, along with the leader of the coronavirus task force, Vice President Mike Pence, and his chief of staff, Marc Short.

Excluding the political and economic advisers was a deliberate signal that the White House would continue for now to prioritize health considerations over economic ones, according to three people familiar with the meeting who requested anonymity to discuss internal deliberations.” (S)

“President Trump said he’d like to open the economy with a “big bang” and suggested that may first happen in regions of the country where the coronavirus outbreak has begun to subside.

“I’d love to open with a big bang, one beautiful country, but it’s very possible,” the president said Tuesday on Sean Hannity’s Fox News show.

“So we are looking at two concepts, we are looking at the concept we open up sections and also looking at the concept where you open up everything,” the president explained. “I think New York is getting ready if not already, but getting ready to peak and once it peaks, it will start coming down and it’s going to come down fast.”

Unlike New York and New Jersey, Trump said some states haven’t had the same level of coronavirus spread.

He said parts of Michigan and Detroit have been “hit very hard” – “so there are some places hit very hard in other places that have not been hit very hard frankly by comparison, very little.”

The president has kept an eye on the economy and the stock market during the battle against the pandemic, watching the financial tailspin as lockdowns were expanded in states across the country and workers were laid off or furloughed…

 “We have to get our country open again. This wasn’t designed to have this. You crack it – you crack it in half, it’s no good. And we’ll be open again much sooner rather than later,” he told Hannity. “And we are going to be coming up with some ideas in the very near future, probably putting them out to the public, putting them out, but, you know, we’re going through April – as you know, April 30 – and we are going to make a decision from there.”” (T)

“A Sunday update of a prominent COVID-19 forecasting model suggests that fewer lives will be lost during the first wave of the coronavirus outbreak than previously thought.

The University of Washington’s Institute for Health Metrics and Evaluation (IHME) now predicts that 81,766 people will die of COVID-19 in the U.S. through early August. When the model was last updated, on April 2, it predicted 11,765 deaths more deaths, for a total of 93,531…

…The model’s latest update includes several important changes related to that planning. Many fewer hospital beds will be needed at peak than previously anticipated, according to the new projections. The April 5 update predicts the need for 140,823 total hospital beds and 29,210 ICU beds at the peak of the outbreak. Those numbers are down 121,269 and 10,517, respectively.

The model also revised downward the prediction for the number of ventilators needed at the height of the outbreak. It now predicts the need for 18,992 ventilators, down from 31,782.

One thing that didn’t change between the April 2 and April 5 models is the projected date of the outbreak’s peak. The model still predicts an April 16 apex for the daily COVID-19 death rate. Hospital use is expected to peak on April 15.” (U)

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