POST 42. CORONAVIRUS. August 11, 2020. . “I think that if future historians look back on this period, what they will see is a tragedy of denial….

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I think that if future historians look back on this period, what they will see is a tragedy of denial. Everything we needed to do to have lowered the infection rate on coronavirus … we had this technology. There’s nothing fancy about face masks, right? And even ventilators — OK, they’re expensive — but … that technology existed. But we didn’t use it, or we didn’t use it as effectively as we could have because we weren’t willing to be honest about what we were facing…”

“There’s no business case for stockpiling a billion face masks. But there is a scientific and public health case. We didn’t listen to that scientific and public health case because we were so enthralled in this notion that the market would solve all our problems. And I think that’s the big thing that historians will look back on and see as this sort of colossal error that ended up being very, very costly.” (A)

“Dr. Deborah L. Birx, the Trump administration’s coronavirus coordinator, said on Sunday that the nation was in a “new phase” of the coronavirus epidemic that was much more sprawling across the country than last spring’s outbreaks in major cities like New York and Seattle.

She recommended that people living in communities where cases are surging should consider wearing a mask at home, if they live with someone who is especially vulnerable because of age or underlying medical conditions.

“What we are seeing today is different from March and April — it is extraordinarily widespread,” she said on CNN’s “State of the Union” news program. “It’s into the rural as equal urban areas. So everybody who lives in a rural area, you are not immune.”

Dr. Birx emphasized the significance of asymptomatic transmission, and said that the White House coronavirus task force was working to make sure Americans in affected communities understood this risk. “If you have an outbreak in your rural area or in your city, you need to really consider wearing a mask at home, assuming that you’re positive if you have individuals in your home with comorbidities,” like respiratory problems or diabetes…

In some communities seeing recent outbreaks, household transmission has been a huge factor, public health experts say…

Admiral Giroir defended the nation’s testing program, noting it has exponentially been increased in recent months although there are still delays in getting results. He said that both testing and contact tracing efforts were crucial responses, but not particularly helpful in large, communitywide outbreaks.

“When you have a widespread, multifocal outbreak where many people are asymptomatic, testing and tracing are of limited utility versus public health policy measures like mask-wearing, like closing indoor crowded spaces,” Admiral Giroir said. “So, yes, contact tracing is important, but it’s much less important right now than the public policy mitigation measures.”” (C)

“Speaker Nancy Pelosi (D-Calif.) on Monday doubled down on questioning the credibility of Deborah Birx, the physician coordinating the White House’s coronavirus task force, arguing that she has been “enabling” President Trump to spread disinformation about the coronavirus.

“I don’t have confidence in anyone who stands there while the president says, swallow Lysol, it’s going to cure your virus. It’ll kill you and you won’t have the virus anymore,” Pelosi said during an interview with CNN’s Jim Sciutto.

“There has to be some responsibility. So if the president is saying these things, who’s advising him that this is OK and enabling that to happen while millions of people have died?” Pelosi said.

Pelosi’s comments come as Birx also faced criticism earlier Monday from Trump, who attacked her for acknowledging that the coronavirus pandemic is “extraordinarily widespread” across the U.S.

Trump suggested that Birx was trying to “counter” Pelosi’s previous criticism…

Pelosi reiterated during an appearance on ABC’s “This Week” on Sunday that she lacked confidence in Birx, saying “I think the president is spreading — spreading disinformation about the virus and she is his — she is his appointee.”

Pelosi said Monday that Birx came up during the meeting with Mnuchin and Meadows during a discussion about contact tracing.

“What happened is that we had a conversation about how we stop the virus. And when we did, they were making contentions about how tracing isn’t a valuable thing, we shouldn’t do it. I said, well that’s not what most scientists say. And they said, well we’ll bring a scientist to say that. I said, sure, [if] it’s not Dr. Birx,” Pelosi said in the CNN interview.”  (D)

Dr. Deborah Birx on Sunday strongly defended her record amid criticism from House Speaker Nancy Pelosi that she doesn’t have confidence in the White House coronavirus task force coordinator’s handling of the pandemic.

On “State of the Union,” Birx told CNN’s Dana Bash that she has “tremendous respect” for Pelosi, but criticized a New York Times article last month that reported she had painted an optimistic view of the pandemic to the White House during a critical period in getting control of the virus.

“I have tremendous respect for the speaker, and I have tremendous respect for her long dedication to the American people,” Birx said, adding, though, that she could have “brought forth the data” to back up her analysis had the Times spoken with her.

“I have never been called pollyannish, or nonscientific, or non-data driven,” Birx said. “And I will stake my 40-year career on those fundamental principles of utilizing data to really implement better programs to save more lives.”…

Asked by Bash if it was time to reset the federal government response to the pandemic, Birx said, “I think the federal government reset about five to six weeks ago when we saw this starting to happen across the South.” Roughly six weeks ago, however, Vice President Mike Pence, who heads the coronavirus task force, declared in a Wall Street Journal op-ed that the US is “winning the fight” and there “isn’t a ‘second wave.'””  (E)

President Trump on Monday publicly criticized Deborah Birx, the doctor who is coordinating the White House’s coronavirus response, suggesting she was hurting him after she bluntly acknowledged that the pandemic is widespread across the United States.

Trump targeted Birx over a weekend response to criticism from Speaker Nancy Pelosi (D-Calif.), who questioned Birx’s credibility in responding to the pandemic. He appeared to call Birx’s response to Pelosi’s criticism “pathetic.”

“So Crazy Nancy Pelosi said horrible things about Dr. Deborah Birx, going after her because she was too positive on the very good job we are doing on combatting the China Virus, including Vaccines & Therapeutics,” Trump tweeted. “In order to counter Nancy, Deborah took the bait & hit us. Pathetic!”

The tweet marks the latest instance of Trump undercutting one of his administration’s top health officials in the middle of a pandemic, but it is the first time he has publicly criticized Birx.” (F)

Dr. Anthony S. Fauci, the nation’s top infectious disease specialist, agreed on Monday with his colleague Dr. Deborah Birx that the United States has entered a “new phase” of the coronavirus pandemic, in which the virus is now spreading uncontrolled in some states by asymptomatic people — comments that drew fire from President Trump.

Dr. Fauci said Dr. Birx had been referring to the “inherent community spread” that is occurring in some states, adding: “When you have community spread, it’s much more difficult to get your arms around that and contain it.”

Speaking during a news conference with Gov. Ned Lamont of Connecticut, Dr. Fauci called the community spread “insidious” and noted that it was happening outside of confined spaces like nursing homes and prisons.

In backing up Dr. Birx, the Trump administration’s coronavirus response coordinator, Dr. Fauci indirectly put himself at odds with the president. Earlier on Monday, Mr. Trump had called Dr. Birx “pathetic” on Twitter and suggested that her comments about a “new phase” were an effort to curry favor with Speaker Nancy Pelosi.

At an evening news conference, Mr. Trump appeared to temper his comments about Dr. Birx. “She’s a person I have a lot of respect for,” he said, while defending his administration’s response to the virus…

But other Republicans piled on. “Dr. Birx, like Dr. Fauci, has been wrong much more than she has been right on COVID-19, & their destructive prescriptions have led to the devastation of countless American lives,” Representative Andy Biggs, Republican of Arizona, wrote on Twitter…

On Monday morning, shortly after Mr. Trump tweeted about her, Dr. Birx told governors on a weekly briefing call that a lack of masks at large gatherings in homes was “a critical issue,” pointing to spikes in many Southern states.

Mr. Trump has also criticized Dr. Fauci, despite his claims that the two have a “very good relationship.” In a tweet on Saturday responding to news reports that Dr. Fauci had linked the recent surge in cases to inadequate lockdowns, Mr. Trump tweeted: “Wrong!””  (G)

“I’ve gone to your rallies. I’ve talked to your people. They love you. They listen to you. They listen to every word you say. They hang on your every word,” Swan said. “And so when they hear you say, ‘everything’s under control. Don’t worry about wearing masks,’ I mean, these are people — many of them are older people.”

“Well, what’s your definition of control?” Trump replied, adding: “I think it’s under control.”

“How? A thousand Americans are dying a day,” Swan said.

“They are dying. That’s true. And you — it is what it is,” Trump said emphatically. “But that doesn’t mean we aren’t doing everything we can. It’s under control as much as you can control it.”” (H)

Dr. Anthony Fauci and Dr. Deborah Birx, two key members of the White House coronavirus task force, have warned nine major cities across the country over their high COVID-19 testing positivity rates.

Birx, coordinator of the White House task force, first raised concerns about the high positivity rates in Atlanta; Baltimore; Boston; Chicago; Detroit; Kansas City, Missouri; Portland, Oregon; Omaha, Nebraska; and Washington, D.C.; in a Wednesday call with state and local officials. Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), was asked about the remarks in an interview with CNN on Thursday morning, and he explained that the test positivity rate is “a pretty good predictor” or “indicator” that surges in new infections are coming.

“So what Dr. Birx is saying is now is the time to accelerate the fundamental preventive measures that we all talk about,” Fauci explained. “Masks, social distancing, avoiding crowds, outdoors greater than indoors, washing hands, etc. Those kind of simple things can actually prevent that uptick from becoming a surge.” Fauci emphasized that the heightened positivity rate “is a predictor of trouble ahead.”

In her Wednesday remarks to local officials, Birx raised particular concerns about the situations in Atlanta and Baltimore. “We are concerned that both Baltimore and Atlanta remain at a very high level,” she said.

“This outbreak is different from the March, April outbreak in that it’s in both rural and urban areas,” she cautioned…

Increasing rates of positive COVID-19 tests within a specific area generally correlate with an increase in community spread. If community spread rises unchecked, the novel coronavirus outbreak can quickly spiral out of control leading to overwhelmed hospitals and making it difficult to curb the spread of the pandemic.”  (I)

“Within public health circles, debate is raging over how much blame Dr. Birx bears for the virus’s spread. Some say Mr. Trump is responsible, but, they add, the dangerous misinformation he has spread has often gone uncorrected by Dr. Birx.

“Trump is like the reverse Midas,” said Gregg Gonsalves, a longtime AIDS activist and assistant professor of epidemiology at the Yale School of Public Health. “Everybody who is in his orbit, if they’ve had any integrity, it gets leeched away from them like some parasite.”

But some say Dr. Birx is at least partly responsible for mismanaging the government’s response. A report issued by the State Department’s inspector general in February relayed criticism of her AIDS program leadership team, which was called “dictatorial” and “autocratic.” She has been critical of the Centers for Disease Control and Prevention, and some public health experts view her as partly responsible for sidelining the agency.

Some also fault her for offering unduly rosy assessments of the pandemic — both in public and in private. In April, she told officials in the White House Situation Room that the United States was in good shape…

In interviews with AIDS activists and public health experts, Dr. Birx drew unfavorable comparisons with the outspoken Dr. Fauci, in whose lab she trained. Mr. Gonsalves, who has long known both of them, said he wrote in March to Drs. Birx, Fauci and Redfield, as well as Adm. Brett P. Giroir, who oversees coronavirus testing, complaining that they were “parroting the president.” Only Dr. Fauci replied.

“Debbie is now in the position where she’s saying to the emperor that those new clothes look fantastic,” Mr. Gonsalves said…

Dr. Birx has drawn criticism for what she has said — and what she has not said. She remained virtually silent while Mr. Trump suggested from the White House lectern that exposure to ultraviolet light or household disinfectants might cure Covid-19. Her lavish praise for the president on the Christian Broadcasting Network in March still rankles.

“He’s been so attentive to the scientific literature and the details and the data,” she said then.

Dr. Ashish Jha, the director of the Harvard Global Health Institute, who has known Dr. Birx for at least a decade and regards her as “a genuinely smart and caring person,” initially gave her the benefit of the doubt on that interview.

“A bunch of people in the public health world just lost their minds on that one, but I said, ‘Look, if she has to praise the president to get him to do the right thing, I can live with that,’” Dr. Jha said. But now, he said, “she has to ask herself whether she’s being effective in protecting the American people, and I would argue at this point that it is not clear that she is.””  (J)

White House coronavirus task force coordinator Deborah Birx is warning of an uptick in coronavirus cases in nine U.S. cities.

“Many of the Sun Belt states have made substantial progress with their mitigation efforts,” Birx told state and local officials on Wednesday, according to a copy of the call obtained the Center for Public Integrity, referring to a slew of Southern states that experienced surges earlier this summer.

But Birx said that the percentage of coronavirus tests coming back positive is increasing in nine U.S. cities as well as California’s Central Valley.

“We are concerned that both Baltimore and Atlanta remain at a very high level. Kansas City, Portland, Omaha, of course what we talked about in the Central Valley,” Birx said. “We are seeing a slow uptick in test positivity in cases in places like Chicago, Boston and Detroit and D.C.”

Birx also said that Nebraska and California have moved into the red category, with more than 10 percent of tests coming back positive. And she noted that while Los Angeles saw improvements, there was significant movement of the virus up California’s Central Valley.

Birx noted that the virus has entered a new phase, “in that it’s in both rural and urban areas.”

In another call obtained by the Center for Public Integrity last month, Birx warned of an uptick in 12 other U.S. cities, including Miami, New Orleans, Las Vegas, San Jose, St. Louis, Indianapolis, Minneapolis, Cleveland, Nashville, Pittsburgh, Columbus and Baltimore.

Thursday morning, Anthony Fauci, the nation’s leading infectious disease expert and member of the White House coronavirus task force, said that the infection rate is a “pretty good predictor” for potential surges.

“We’ve seen that in the Southern states as predictors,” Fauci said on CNN.  “This is a predictor of trouble ahead.”

“You’ve got to get that base line down,” he added. “Everybody on the team of American citizens need to pull together. Because we’re all in this together.”” (K)

“But on a personal level, the attack also represented a surprisingly direct assault on one of the most recognizable scientific faces on the team of officials Trump regularly puts before the cameras to describe the White House coronavirus strategy.

She has a very difficult job right now, because she’s dealing with someone who is not evidence-based

Birx, a scientist whose signature scarves are the subject of a dedicated Instagram account, was always known to be stepping on to a political tightrope by taking her current White House role. But now former allies and critics of Birx suggest that the renowned global Aids researcher, health official, medical doctor and army colonel has sacrificed her public mission for a more personal one – staying on Trump’s good side.

Birx’s defenders forcefully rebut that contention, saying her public guidance throughout the coronavirus pandemic has been reliable. They theorize, based on their personal experiences of working with her, that her private guidance of the president and his team has steered the administration in a useful direction, even if that is not always publicly evident.

“She has a very difficult job right now, because she’s dealing with someone who is not evidence-based, and is not understanding what needs to be done to address this pandemic,” said Kenneth Mayer, a professor of medicine and global health at Harvard who worked closely with Birx for years as a member of the scientific advisory committee of the President’s Emergency Plan for Aids Relief (Pepfar). “It’s hard.”” (L)

‘To this point, Dr. Anthony Fauci during a recent Q&A session at the Brown University School of Public Health articulated that the first coronavirus vaccine might only be 60% effective, if not lower. Not one to mince words, Fauci said that the probability of a coronavirus vaccine being 98% effective is “not great.”

“You’ve got to think of the vaccine as a tool to be able to get the pandemic to no longer be a pandemic,” Fauci explained, “but to be something that’s well controlled.”

That said, Fauci said a coronavirus vaccine that is only 50% effective would still be acceptable and liable to be given the green light by the FDA…

There’s also a chance the first coronavirus vaccine may not even be able to prevent someone from being infected in the first place. Rather, it may only prevent an individual from experiencing some of the coronavirus’ more severe symptoms.

Efficacy aside, Fauci earlier this week said that the United States — in a best-case scenario — would have tens of millions of COVID-19 vaccine doses ready to go by early 2021. If that actually pans out, Fauci anticipates that life in the United States will return to normal by the middle of next year at the soonest.” (M)

(Dr. Stephen Hahn, the Commissioner of the Food and Drug Administration)

“Many medical experts — including members of his own staff — worry about whether Dr. Hahn, despite his good intentions, has the fortitude and political savvy to protect the scientific integrity of the F.D.A. from the president. Critics point to a series of worrisome responses to the coronavirus epidemic under Dr. Hahn’s leadership, most notably the emergency authorization the agency gave to the president’s favorite drug, hydroxychloroquine, a decision it reversed three months later because the treatment did not work and harmed some people.” (N)

“President Donald Trump on Wednesday maintained that the coronavirus is “going away” and continued to push for schools to reopen since the virus “doesn’t have much of an impact” on children.

Trump applauded the country’s coronavirus vaccine and therapeutic development, saying it has had “tremendous success” and is “ready to deliver them literally as soon” as they’re approved.

When it comes to the coronavirus, he said children are able to “throw it off very easily.”

“It’s going away. It’ll go away. Things go away. No question in my mind that it will go away,” Trump said during a White House press briefing…

“We think we’re going to have the vaccines before the end of the year, maybe long before the end of the year,” Trump said. “ (O)

“And on Wednesday, Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases and the most senior public health official on the taskforce, said: “I don’t think we’re going to eradicate this from the planet … because it’s such a highly transmissible virus that that seems unlikely.”

And despite Trump claiming in an interview with Axios released on Monday that coronavirus is under control in the US, Fauci on Wednesday spoke of a much longer timescale to achieve that.

“I hope and feel it’s possible that by the time we get through 2021 and go around for another cycle, that we’ll have this under control … Do I think we’re going to have a much, much better control one full year from this winter? I think so,” Fauci said in an interview with Reuters.

Fauci said he was cautiously optimistic about US progress toward developing a successful and safe vaccine and achieving mass distribution next year.

“Historically, if you get a vaccine that has a moderate to high degree of efficacy, and you combine with that prudent public health measures, we can put this behind us,” he said.

He added: “We may need to go through a season of it, and then by the next season if we have a vaccine it won’t be a pandemic, it won’t be immobilizing the world, it won’t be destroying the economy.”” (P)

“After months of butting heads with his medical experts, including the government’s top infectious disease official, Dr. Anthony Fauci, President Trump introduced a new adviser to the administration during his coronavirus briefing on Monday, Dr. Scott Atlas, whose views on Covid-19 and school reopenings more closely match the president’s.

A senior fellow at Stanford University’s Hoover Institution, a conservative think tank, Atlas is not an infectious disease expert — he’s board-certified in diagnostic radiology, which means he specializes in reading and interpreting imaging like X-rays, CT scans and MRIs, and he served as a professor and chief of neuroradiology at Stanford University Medical Center from 1998 to 2012…

Atlas has recently appeared as a guest on Trump’s preferred news channel, Fox, calling on school districts and colleges to open their doors for in-person instruction and railing against the “frenzy” around mass testing…

“Scott is a very famous man who’s also very highly respected,” Trump said on Monday. “He’s working with us and will be working with us on the coronavirus. And he has many great ideas.”” (Q)

“Nearly three dozen current and former members of a federal health advisory committee, including nine appointed or reappointed by the health secretary, Alex M. Azar II, are warning that the Trump administration’s new coronavirus database is placing an undue burden on hospitals and will have “serious consequences on data integrity.”

The advisers, all current or former members of the Healthcare Infection Control Practices Advisory Committee, issued their warning in a previously unpublished letter shared with The New York Times.

The letter was made public as both hospital officials and independent data experts around the country were reporting kinks in the new system, which critics say is undermining the government’s ability to understand the course of the pandemic. The Covid Tracking Project, a respected and widely used resource, identified “major problems” with the new Department of Health and Human Services system in late July, and reported this week that “the federal data continue to be unreliable.”

The concern grows out of an order, issued last month by Mr. Azar, for hospitals to send daily reports about virus cases to a private vendor that transmits them to a central database in Washington instead of the Centers for Disease Control and Prevention, which had previously housed the data.

The information, including patient and hospital bed counts, helps guide the government’s response to the pandemic, informing critical health care decisions like how to allocate scarce supplies, including ventilators or the drug Remdesivir, approved as a treatment for Covid-19 patients…

“The U.S. cannot lose their decades of expertise in interpreting and analyzing crucial data,” the authors wrote, adding that the C.D.C.’s experts, from its Division of Healthcare Quality Promotion, must “be allowed to continue their important and trusted work.”” (R)

“I’m pretty much fighting two wars: A war against COVID and a war against stupidity,” Dr. Varon, MD, CMO and chief of critical care at United Memorial Medical Center in Houston, told NBC News. “And the problem is the first one, I have some hope about winning. But the second one is becoming more and more difficult.”  (B)


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