POST 43. August 22, 2020. CORONAVIRUS.” “We’ve achieved something great as a nation. We’ve created an unyielding market for FAUCI BOBBLEHEADS”!! (W)

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I used to teach a case study course on COMPLEX PROBLEMS: situations where the decision-maker must integrate or reconcile at least two competing priorities that may not be linear or complementary; having to reach agreement on goals while simultaneously evaluating options; where goals are clear but political support is not; where the definition of the problem keeps changing and consensus has to constantly be reestablished; where there are so many variables it is difficult to determine the actual possible outcomes; and, various combinations/ permutations of the above.

So here is a late-summer discombobulated collage of the COMPLEX PROBLEM OF CORONAVIRUS: successes; failures; conundrums; oxymorons; contradictions; unknown unknowns; and kerfuffles.

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“Looking back to the early days of the coronavirus pandemic, the White House coronavirus task force coordinator said Monday she wished the United States had gone into a stricter lockdown.

“I wish that when we went into lockdown (in March), we looked like Italy,” Dr. Deborah Birx said Monday. “When Italy locked down, I mean, people weren’t allowed out of their houses (without a pass). Americans don’t react well to that kind of prohibition.”…

Gov. Asa Hutchinson, Birx said she has learned what Americans are willing to do to combat the virus, and that officials must meet people where they are.

Birx cited the strategy Arizona has used to reduce the rising number of cases. People were still able to go to malls and restaurants at reduced capacity, but gyms and bars were closed, mask mandates were implemented, and gatherings of more than 10 people were prohibited…

“Tens of thousands of lives can be saved if we wear masks, and we don’t have parties in our backyards … taking those masks off,” Birx said.

Jared Kushner, a White House senior adviser, disagreed, saying President Donald Trump was “very forward-leaning” when he and the task force issued 15-day guidelines in mid-March.

“This was done at the time to make sure that we had enough hospital capacity and supplies, so that we didn’t end up like Italy, where there were people dying on gurneys in waiting rooms,” Kushner told CNN’s Wolf Blitzer.

He complimented the President on the administration’s response to a ventilator shortage, repeating the White House line that no American who needed a ventilator didn’t get one.

“So, I think we have done much better than Italy with regards to how we handled this initially,” he said.” (A)

“White House coronavirus advisor Dr. Anthony Fauci said the U.S. is currently “in the middle of a very serious historic pandemic,” adding that he has concerns about some regions seeing upticks of coronavirus….

Fauci said he is “not pleased with how things are going.” “We certainly are not where I hope we would be, we are in the middle of very serious historic pandemic,” he added. “When you look at other parts of the country – this is the thing that’s disturbing to me – is that we’re starting to see the inkling of the upticks in the percent of the tests that are positive. We know now, from sad past experience, that that’s a predictor that you’re going to have more surges.” (B)

“Even as reality continues to intrude, President Trump has either largely dismissed or ignored his science and medical advisers. And the result is that the economy, the one thing he seems to care most about, and which he hoped would escort him to a second term, has been devastated.

As both history and data from today demonstrate, health and the economy are not antagonistic; they are dance partners, with public health taking the lead. The safer people feel, the more they will engage in economic activity…

Indeed, a Morgan Stanley model predicts that under current policies the U.S. is currently on track to have 150,000 new cases a day later this year. And that number is not even a worst case. If we do suffer case counts anything like those, dramatic growth in the economy simply won’t happen.

Bad as the virus has been this summer, it actually spreads better in low temperatures, and when temperatures fall, more people will be inside in poorly ventilated areas where transmission is also more likely. If the U.S. goes into the fall with new daily cases in the tens of thousands, as they are now, then the numbers could explode and the Morgan Stanley prediction could come true. Considering our containment efforts to date, there is little reason for optimism.

If that occurs, the economy will not come back. Jerome Powell, the chairman of the Federal Reserve, said as much recently. “The path forward for the economy is extraordinarily uncertain and will depend in large part on our success in keeping the virus in check,” he said at a July 29 news conference. He added: “A full recovery is unlikely until people are confident that it is safe to re-engage in a broad range of activities.”..

Bringing the economy back requires precisely the same three measures that controlling the virus does: First, better compliance with social distancing, wearing masks, personal hygiene and avoiding crowds; second, finally — finally — getting the supply chain and personnel infrastructure in place to support the necessary testing and contact tracing; and, third, the bitter medicine of regional shutdowns…

Without active, aggressive White House leadership we cannot achieve that and — reality again — there isn’t the slightest hint that will happen. But in 1918 leadership came from cities and states. If governors and mayors act aggressively, especially if they act jointly, we can still make significant progress.” (C)

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“If you’re heading to a gym lately, you might be asked to wash your hands, have an infrared gun pointed at your head and wait for an army of workers to sanitize every surface before you touch a machine — all in the name of safety.

But how much of a difference do these kinds of measures make when it comes to coronavirus transmission?

The evidence is mixed, some experts say. And measures might not always be there for the reasons you think.

Take temperature checks, which are currently being performed at several Canadian airports. Some businesses, like the Apple Store, have also been checking customers before they enter.

“We know that this is not effective,” said Colin Furness, an infectious disease epidemiologist with the University of Toronto.

“I mean, really, just as a screening tool it’s not effective at all.”

Given that people can spread the virus before ever showing symptoms, he said, checking someone’s temperature is definitely not a guarantee that they’re healthy. Illnesses other than COVID-19 can raise a person’s temperature, too.

“And if you really want to get on that plane, you take a Tylenol and you’ll glide right past that temperature check,” Furness said.

Even the U.S. Food and Drug Administration notes that non-contact thermometers aren’t a very good screening tool.

“Even when the devices are used properly, temperature assessment may have limited impact on reducing the spread of COVID-19 infections,” the agency wrote on their website.

“Some studies suggest that temperature measurements alone may miss more than half of infected people.”…(D)

“Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Thursday that temperature checks are unreliable for detecting coronavirus symptoms in people entering businesses and other establishments as infrared thermometers have been embraced as part of safety protocol for reopenings.

Fauci made the comments during a Facebook Live broadcast with Walter Reed Medical Center, and was referencing the popular infrared thermometers that take a person’s body temperature by aiming the device at their forehead.

“We have found at the [National Institutes of Health] that it is much, much better to just question people when they come in and save the time, because the temperatures are notoriously inaccurate many times,” Fauci said.

Hot summer weather also causes inaccurate readings, Fauci said, adding that his own readings have gone as high as 103 before entering a building’s air-conditioning.

Prior to Fauci’s comments, measures like temperature screenings—along with spraying disinfectant in public transportation, or walking through hand sanitizer showers—had been criticized as “safety theater,” meaning they are not proven to stem the spread of the virus…

“All in all, temperature screening may catch some cases of the Covid-19 coronavirus. But it could miss many others,” wrote public health expert Bruce Y. Lee for Forbes in July. “Thus, be skeptical whenever anyone tries to assure you that things are safe just because they are doing temperature and symptom screening.”” (L)

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“Health experts in New York City thought that coronavirus cases would be rising again by now. Their models predicted it. They were wrong.

New York State has managed not only to control its outbreak since the devastation of the early spring, but also to contain it for far longer than even top officials expected.

Now, as other places struggle to beat back a resurgence and cases climb in former success-story states like California and Rhode Island, New York’s leaders are consumed by the likelihood that, any day now, their numbers will begin rising.

The current levels of infection are so remarkable that they have surprised state and city officials: Around 1 percent of the roughly 30,000 tests each day in the city are positive for the virus. In Los Angeles, it’s 7 percent, while it’s 13 percent in Miami-Dade County and around 15 percent in Houston.

The virus is simply no longer as present in New York as it once was, epidemiologists and public health officials said.

“New York is like our South Korea now,” said Dr. Thomas Tsai of the Harvard Global Health Institute.

But nothing is static about the viral outbreak, experts cautioned. The question now is whether the state, where 32,000 people have died of the virus, can keep from being overwhelmed by another wave, as threats loom from arriving travelers, struggles with contact tracing and rising cases just over the Hudson River in New Jersey…

In more than a dozen interviews, epidemiologists, public health officials and infectious disease specialists said New York owed its current success in large part to how New Yorkers reacted to the viciousness with which the virus attacked the state in April.

State officials shut down schools and businesses, sacrificing jobs and weakening the economy to save lives. Adherence to mask wearing has been strong. Many vulnerable New Yorkers are still sheltering in their apartments. Others decamped to second homes.

And, critically, Gov. Andrew M. Cuomo and Mayor Bill de Blasio reopened cautiously, deciding in late June against allowing indoor dining and bars after seeing those activities connected to outbreaks in other states.

“People in New York have taken matters much more seriously than in other places,” said Dr. Howard Markel, a historian of epidemics at the University of Michigan. “And all they’re doing is reducing the risk. They’re not extinguishing the virus.”

Still a resurgence is all but inevitable, public health experts said…

And even at the currently low levels, the number of new virus cases in New York City — 386 reported positive on Tuesday out of 46,185 tested, according to state data — is still too great for its contact tracers to effectively determine where people are becoming infected, said Dr. Barbot. The new norms of behavior have to continue for the foreseeable future, she said.” (E)

“We’ve known from the beginning how the end will arrive. Eventually, the coronavirus will be unable to find enough susceptible hosts to survive, fading out wherever it briefly emerges.

To achieve so-called herd immunity — the point at which the virus can no longer spread widely because there are not enough vulnerable humans — scientists have suggested that perhaps 70 percent of a given population must be immune, through vaccination or because they survived the infection.

Now some researchers are wrestling with a hopeful possibility. In interviews with The New York Times, more than a dozen scientists said that the threshold is likely to be much lower: just 50 percent, perhaps even less. If that’s true, then it may be possible to turn back the coronavirus more quickly than once thought.

The new estimates result from complicated statistical modeling of the pandemic, and the models have all taken divergent approaches, yielding inconsistent estimates. It is not certain that any community in the world has enough residents now immune to the virus to resist a second wave.

But in parts of New York, London and Mumbai, for example, it is not inconceivable that there is already substantial immunity to the coronavirus, scientists said.

“I’m quite prepared to believe that there are pockets in New York City and London which have substantial immunity,” said Bill Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health. “What happens this winter will reflect that.”

“The question of what it means for the population as a whole, however, is much more fraught,” he added.

Herd immunity is calculated from the epidemic’s so-called reproductive number, R0, an indicator of how many people each infected person spreads the virus to.

The initial calculations for the herd immunity threshold assumed that each community member had the same susceptibility to the virus and mixed randomly with everyone else in the community.

“That doesn’t happen in real life,” said Dr. Saad Omer, director of the Yale Institute for Global Health. “Herd immunity could vary from group to group, and subpopulation to subpopulation,” and even by postal codes, he said.

For example, a neighborhood of older people may have little contact with others but succumb to the virus quickly when they encounter it, whereas teenagers may bequeath the virus to dozens of contacts and yet stay healthy themselves. The virus moves slowly in suburban and rural areas, where people live far apart, but zips through cities and households thick with people.

Once such real-world variations in density and demographics are accounted for, the estimates for herd immunity fall. Some researchers even suggested the figure may be in the range of 10 to 20 percent, but they were in the minority…

“We are still nowhere near back to normal in our daily behavior,” said Virginia Pitzer, a mathematical epidemiologist at the Yale School of Public Health. “To think that we can just stop doing all that and go back to normal and not see a rise in cases I think is wrong, is incorrect.” “ (F)

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“Of all the ways to describe the fraught decision to reopen schools during a pandemic, Gov. Ron DeSantis of Florida, a former Navy prosecutor, chose an especially dramatic example when he compared the commitment of teachers and administrators to the resolve of Navy SEALs given the mission to go after Osama bin Laden.

“Just as the SEALs surmounted obstacles to bring Osama bin Laden to justice, so, too, would the Martin County school system find a way to provide parents with a meaningful choice of in-person instruction or continued distance learning — all in, all the time,” he said, citing the leader of a local school district.

He meant for the line to be inspirational. But perhaps unintentionally, Mr. DeSantis also highlighted an undeniable truth in Florida since students began returning to classrooms last week: There will be virus casualties.

In one of the states hardest hit by the coronavirus pandemic, 13 counties reopened their schools last week in accordance with a statewide order for all schools to offer in-person instruction by the end of the month. At least three districts soon reported positive coronavirus tests among students or teachers, and with the state expected to hit the 10,000-death mark this week, there is a move among some local school officials to try to delay reopenings — a pushback that has been met with threats of a loss in state funding and a reminder that the road back will not be an easy one.

“If you have a Covid case or you have symptoms, don’t panic,” the state education commissioner, Richard Corcoran, told Florida school superintendents last week. “We are going to have cases, and that’s OK.”..

Mr. DeSantis has spent weeks promoting school openings, holding events with administrators, teachers and parents who say they are eager to go back to the classroom. The benefits of opening outweigh the health risks in most of the state, Mr. DeSantis says, and it is up to each district to decide how its reopening will work in practice…

Gov. Ron DeSantis of Florida has likened reopening schools to a military operation, highlighting an undeniable truth: There will be virus casualties.” (G)

“The Los Angeles Unified School District on Sunday unveiled a plan to provide regular COVID-19 testing and contact tracing to school staff, students and their families.

The plan will begin Monday in a measured fashion, with the first test provided to staff already working at schools and their children. The program will then be expanded to provide testing to all staff and students over time, with a goal in the early phase to establish a baseline, the district said in a release.

The goal is to implement the program to help get students back into school for in-person instruction as the district is set to begin the school year with virtual learning.

“Extraordinary circumstances call for extraordinary actions, and while this testing and contact tracing effort is unprecedented, it is necessary and appropriate,” Superintendent Austin Beutner said in a statement. “This will provide a public health benefit to the school community, as well as the greater Los Angeles area.”

“This program will also provide significant education benefits for students by getting them back to school sooner and safer and keeping them there. We hope this effort also will provide learnings which can benefit other school systems and communities across the nation as we all combat this pandemic,” Beutner added.

The program is in collaboration with scientists from the University of California Los Angeles (UCLA), Stanford University, Johns Hopkins University, Microsoft and healthcare companies Anthem Blue Cross and Health Net.

Stanford, UCLA and Johns Hopkins will provide a strategic interpretation of the evidence on testing and epidemiological modeling services pro bono. Microsoft will provide an app that will allow school administrators and health officials to track insights into trends and potential risks to help manage COVID-19 exposures and cases.

Beutner did not identify the source of funding for the program. The plan to test all students and staff will cost roughly $300 per student over a year, close to $150 million, according to the Los Angeles Times. The district has received hundreds of millions of state and federal dollars for its coronavirus response efforts, the newspaper noted.

Last month the Los Angeles school district, along with San Diego, said they will start instruction in August virtually amid an outbreak of the virus across California.” (H)

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“HENDERSONVILLE, N.C. — The coronavirus entered Cherry Springs Village quietly, then struck with force. Nearly every staff member and resident of the long-term care facility would become infected.

They needed help — fast — and the county responded: It sent in a “strike team” of medical workers, emergency responders, clergy and others, in what is becoming a new model for combating Covid-19 in residential care centers.

Nurses and doctors from hours away came to aid sick residents and replace staff who had contracted the virus. They set up oxygen and IV drips, to avoid sending residents with milder illness to overburdened hospitals.

Members of the county’s emergency management department conducted rapid testing of all staff and residents. The Henderson County Rescue Squad, a volunteer paramedic group, erected decontamination tents outside for staff to safely remove protective gowns, masks and other equipment after shifts, and educated them on proper use and removal of the garments.

Chaplains and therapists came from a nearby hospice to provide emotional support to families and staff, who sometimes witnessed several residents die in one day. A public relations employee was dispatched to communicate with family members about ill loved ones and the situation inside.

Covid strike teams apply an emergency response model traditionally used in natural disasters like hurricanes and wildfires to combating outbreaks in long-term care facilities. Composed of about eight to 10 members from local emergency management departments, health departments, nonprofit organizations, private businesses — and at times, the National Guard — the teams are designed to bring more resources and personnel to a disaster scene.”  (I)

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“Without a vaccine or a highly successful treatment, widespread testing is seen as a cornerstone for fighting a pandemic in which as many as 40 percent of infected people do not show symptoms and may unknowingly spread the virus. Testing a lot of people is crucial to seeing where the virus is going and identifying hot spots before they get out of hand. Experts see extensive testing as a key part of safely reopening schools, businesses and sports.

The nation’s testing capacity has expanded from where it was only a few months ago, but public health experts believe it must grow far more to bring the virus under control.

The Harvard Global Health Institute has suggested the country needs at least 1 million tests per day to slow the spread of the virus, and as many as 4 million per day to get ahead of the virus and stop new cases. Some experts view that goal as too ambitious, and others say the benchmark should focus not on a particular number of tests but on the percent of people testing positive.

Yet there is broad consensus that the current level of testing is inadequate and that any decrease in testing is a worrisome move in the wrong direction.

“There is a reasonable disagreement about what that number ought to be, but all of them are way ahead of where we are right now,” said Dr. Ashish Jha, director of the Harvard Global Health Institute. “There is no expert that I know of that thinks that our testing infrastructure right now meets the needs of the American people.”

Adm. Brett P. Giroir, the assistant secretary for health and the Trump administration’s virus testing czar, said that conducting millions of tests per day was not realistic. The administration has asked states to test at least 2 percent of their populations each month, or the equivalent of about 220,000 people per day nationally, which Admiral Giroir said would be enough to identify rising hot spots.

“We are doing the appropriate amount of testing now to reduce the spread, flatten the curve, save lives,” he told reporters on Thursday.

He said the government was already testing large numbers of asymptomatic people, and he described an effort to strategically deploy tests, including to those who are hospitalized and in nursing homes. “You do not beat the virus by shotgun testing everyone all the time,” Admiral Giroir said, adding: “Don’t get hung up on a number.”

Admiral Giroir also cited a decline in known cases in states like Florida as an indication that testing is sufficient. But experts say the rate of people testing positive in places like Florida remains high, suggesting too little testing.” (J)

“Earlier this summer, Trump administration officials hailed a new strategy for catching coronavirus infections: pooled testing.

The decades-old approach combines samples from multiple people to save time and precious testing supplies. Federal health officials like Dr. Anthony S. Fauci and Adm. Brett Giroir said pooling would allow for constant surveillance of large sectors of the community, and said they hoped it would be up and running nationwide by the time students returned to school.

But now, when the nation desperately needs more tests to get a handle on the virus’s spread, this efficient approach has become worthless in many places, in part because there are simply too many cases to catch.

Pooled testing only works when the vast majority of batches test negative, among other drawbacks with the procedure. If the proportion of positives is too high, more pools come up positive — requiring each individual sample to then be retested, wasting precious chemicals.

Nebraska’s state public health laboratory, for example, was a pooling trailblazer when it began combining five samples a test in mid-March, cutting the number of necessary tests by about half.

But the lab was forced to halt its streak on April 27, when local positivity rates — the proportion of tests that turn up positive — surged past 10 percent. With that many positives, there was little benefit in pooling.

“It’s definitely frustrating,” said Dr. Baha Abdalhamid, the assistant director of the laboratory. In combination with physical distancing and mask wearing, pooling could have helped keep the virus in check, he added. But the pooling window, for now, has slammed shut.

Still, the strategy has made significant headway in some parts of the country. In New York, where test positivity rates have held at or below 1 percent since June, universities, hospitals, private companies and public health labs are using the technique in a variety of settings, often to catch people who aren’t feeling sick, said Gareth Rhodes, an aide to the governor and a member of his virus response team. Last week, the State University of New York was cleared to start combining up to 25 samples at once.” (K)

“Gov. Phil Murphy has vetoed a coronavirus bill that would have expanded testing in New Jersey, while also signing five into law. One new law gives student-athletes more leeway with physical testing amid the crisis.

Murphy vetoed a bill that would have allowed licensed pharmacists to order and administer COVID-19 tests authorized and approved by the federal Food and Drug Administration.

Under the bill (S2436), in order to administer the test, the pharmacy must ensure that personal protection equipment is distributed to all pharmacy staff and that proper social distancing protocols are observed…

Murphy also wants to make sure that administering a test includes “collecting or overseeing the collection of a specimen and causing the specimen to be sent to a laboratory with the capacity to perform the test.”  (M)

“Today, the U.S. Food and Drug Administration posted a new template for commercial developers to help them develop and submit emergency use authorization (EUA) requests for COVID-19 diagnostic tests that can be performed entirely at home or in other settings besides a lab, such as offices or schools, and that could be available without a prescription.

“The FDA continues to help facilitate innovation in test development, thereby enhancing Americans’ access to COVID-19 tests,” said FDA Commissioner Stephen M. Hahn, M.D. “The recommendations provided today are intended to help get tests to market that are simple enough to use at home, similar to a pregnancy test. We hope that with the innovation we’ve seen in test development, we could see tests that you could buy at a drug store, swab your nose or collect saliva, run the test, and receive results within minutes at home, once these tests become available. These types of tests will be a game changer in our fight against COVID-19 and will be crucial as the nation looks toward reopening.”” (N)

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Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and expert on infectious diseases for four decades, delivered some blunt messages to the American public during an online video interview with actor Matthew McConaughey. In an election year, the doctor asked the American people NOT to politicize the coroanvirus pandemic.

In response to a question about the politicization of the virus, he compared the pandemic to other challenging times in U.S. history. “Our country has been through very, very difficult situations. We’ve been through a Depression, we’ve been through a World War. We pulled together through 9/11.” But, he added, if you are not taking precautions, “You are part of the problem rather than the solution.”…

In the absence of a vaccine, Fauci told McConaughey that social distancing, regular hand washing and face masks are the only alternatives as “herd immunity” — where those who are immune protect the most vulnerable in the population — is not feasible for coronavirus. That requires a very high level of population immunity for COVID-19, and for the virus to not mutate.

Island nations and Asian countries, such as New Zealand, Singapore and South Korea, managed to control coronavirus. These countries shut down decisively, avoiding the worst of the pandemic, and carried out more effective contact tracing to prevent community spread. Warmer island nations, he said, may have better weathered COVID-19 as people spend more time outside.

Fauci also said that aiming for 100% herd immunity, which Sweden attempted before reversing their policy, instead of maintaining safety procedures and waiting for a vaccine in early 2021, would have dire consequences. “If everyone contracted it, a lot of people are going to die,” he said. “You’re talking about a substantial portion of the population.”” (O)

“The director of the Centers for Disease Control and Prevention (CDC) is “hopeful” that the COVID-19 pandemic will be over by spring next year, as reports emerged that a top Food and Drug Administration (FDA) official threatened to resign if approval for a coronavirus vaccine was rushed…

“I’m hopeful that the steps we take to prevent COVID are going to prevent flu and other respiratory viruses, Redfield said. “People are going to realize this is the year to get flu vaccine and we’ll begin to see our nation get through this pandemic.”

“As we then—and I do anticipate it will happen—begin to deploy an efficacious and safe COVID vaccine, then hopefully when you and I talk next spring we’ll have this pandemic behind us.”

Redfield’s comments came as Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, told Reuters he would resign if the Trump administration pressured the agency to approve a COVID vaccine before it has been proven to be safe and effective.” “(Y)

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“Joe Biden, the presumptive Democratic nominee for president, called for a nationwide mask mandate on Thursday, drawing a sharp contrast with President Donald Trump, who rarely wears a mask himself and opposes such mandates.

“Every single American should be wearing a mask when they’re outside for the next three months at a minimum,” Biden said at a press appearance in Wilmington, Delaware. “Every governor should mandate mandatory mask wearing. The estimates by the experts are that it will save over 40,000 lives in the next three months. Forty thousand lives, if people act responsibly.”

“It’s not about your rights. It’s about your responsibilities as an American,” said Biden, flipping the script on Republicans who argue that mandates infringe on an individual’s right not to wear one.” (R)

“President Donald Trump on Thursday rejected former Vice President Joe Biden’s call for a national mask mandate to combat the coronavirus, accusing the Democratic candidate for president of politicizing the outbreak and of shunning science in combating the pandemic.

“It’s a shameful situation for anybody to try and score political points while we’re working to save lives and defeat the pandemic,” Trump said during a White House press briefing…

However, Trump claimed that Biden “wants to shut down our economy and close our schools and grind society to a halt.” Trump, who has repeatedly said lockdowns intended to prevent the further spread of the virus would inflict more harm than good, told reporters that Biden is “in favor of locking all Americans in their basements for months on end.”  (S)

“President Donald Trump has found a new doctor for his coronavirus task force — and this time there’s no daylight between them.

Trump last week announced that Dr. Scott Atlas, a frequent guest on Fox News Channel, has joined the White House as a pandemic adviser. Atlas, the former chief of neuroradiology at Stanford University Medical Center and a fellow at Stanford’s conservative Hoover Institution, has no expertise in public health or infectious diseases.

But he has long been a critic of coronavirus lockdowns and has campaigned for kids to return to the classroom and for the return of college sports, just like Trump.

“Scott is a very famous man who’s also very highly respected,” Trump told reporters as he introduced the addition. “He has many great ideas and he thinks what we’ve done is really good.”

Atlas’ hiring comes amid ongoing tensions between the president and Drs. Anthony Fauci, the nation’s top infectious diseases expert, and Deborah Birx, the task force’s coordinator. While Birx remains closely involved in the administration’s pandemic response, both she and Fauci have publicly contradicted the rosy picture the president has painted of a virus that has now killed more than 167,000 people in the United States and infected millions nationwide.

Atlas, the sole doctor to share the stage at Trump’s pandemic briefings this past week, has long questioned polices that have been embraced by public health experts both in the U.S. and abroad. He has called it a “good thing” for younger, healthy people to be exposed to the virus, while falsely claiming children are at near “zero risk.”

In an April op-ed in The Hill newspaper, Atlas bemoaned that lockdowns may have prevented the development of “natural herd immunity.”

“In the absence of immunization, society needs circulation of the virus, assuming high-risk people can be isolated,” he wrote.

In television appearances, Atlas has called on the nation to “get a grip” and argued that “there’s nothing wrong” with having low-risk people get infected, as long as the vulnerable are protected.

“It doesn’t matter if younger, healthier people get infected. I don’t know how often that has to be said. They have nearly zero risk of a problem from this,” he said in one appearance. “When younger, healthier people get infected, that’s a good thing,” he went on to say, “because that’s exactly the way that population immunity develops.”

While younger people are certainly at far lower risk of developing serious complications from the virus, they can still spread it to others who may be more vulnerable, even when they have no symptoms. And while their chances of dying are slim, some do face severe complications, with one study finding that 35% of young adults had not returned to normal health two weeks to three weeks after testing positive.

But Atlas’ thinking closely aligns with Trump’s perspective on the virus, which he has played down since its earliest days. While Trump eventually supported the lockdowns that once helped slow the disease’s spread, he has since pressured states to reopen schools and businesses as he tries to revive a battered economy before the November election.” (T)

“Last week, just as the Food and Drug Administration was preparing to issue an emergency authorization for blood plasma as a Covid-19 treatment, a group of top federal health officials including Dr. Francis S. Collins and Dr. Anthony S. Fauci intervened, arguing that emerging data on the treatment was too weak, according to two senior administration officials.

The authorization is on hold for now as more data is reviewed, according to H. Clifford Lane, the clinical director at the National Institute of Allergy and Infectious Diseases. An emergency approval could still be issued in the near future, he said.

Donated by people who have survived the disease, antibody-rich plasma is considered safe. President Trump has hailed it as a “beautiful ingredient” in the veins of people who have survived Covid-19.

But clinical trials have not proved whether plasma can help people fighting the coronavirus.

Several top health officials — led by Dr. Collins, the director of the National Institutes of Health; Dr. Fauci, the government’s top infectious disease expert; and Dr. Lane — urged their colleagues last week to hold off, citing recent data from the country’s largest plasma study, run by the Mayo Clinic. They thought the study’s data to date was not strong enough to warrant an emergency approval.

“The three of us are pretty aligned on the importance of robust data through randomized control trials, and that a pandemic does not change that,” Dr. Lane said in an interview on Tuesday.

The drafted emergency authorization leaned on the history of plasma’s use in other disease outbreaks and on animal research and a spate of plasma studies, including the Mayo Clinic’s program, which has given infusions to more than 66,000 Covid-19 patients thanks to financing from the federal government…”  (U)

“Anthony Fauci, the top U.S. infectious disease specialist, said he’s preparing for extended talks with Scott Atlas, President Donald Trump’s newest pandemic adviser who’s been pushing for schools to reopen…

Fauci, a public health expert who has led the U.S. National Institute of Allergy and Infectious Diseases since 1984, said he’s already had brief discussions with Atlas. He hopes to “get a feel of where we are with regard to these issues, and do we differ and if so, how much,” he said Tuesday in a Twitter interview with Bloomberg QuickTake.

Meeting with Atlas will provide an opportunity for the two to exchange views directly, said Fauci, who said he would keep an open mind on the issues.

“I’ve always been of the bent to go right to the source and have an open, honest conversation,” he said. “Hopefully we can come to some sort of agreement, if you want to call it that.”” (V)

“Dr. Scott Atlas, President Trump’s newest coronavirus adviser, is pressing the case for ensuring that schools are open.

“There’s nothing more important than educating our children. In fact, we are the only nation of the Western European and our peer nations … that are somehow sacrificing our children out of our own fear,” Atlas told the Washington Examiner.” (Z)

“Michael Caputo, HHS assistant secretary, told Texas-based News West 9 that the hospital COVID-19 data reporting system will not be transitioning back to the CDC, despite statements made by White House coronavirus official Deborah Birx, MD, earlier this week….

However, Mr. Caputo refuted the change and said the data collection process will stay with HHS after all. An HHS spokesperson clarified that the “interim system” Dr. Birx referred to in her statement was the manual data collection process and that the CDC is working on an automated process that will send the data to the HHS data platform, HHS Protect.” (X)

______________________________________________________________________________

“We asked six experts — including scholars from Vanderbilt, Harvard, and Johns Hopkins University — to set an agenda for Biden and Harris’ first day in office, should they win. Here’s what they came up with.

1. Give the CDC its authority back

Almost every expert mentioned the same priority: restoring the authority of the Centers for Disease Control and Prevention, which is headquartered in Atlanta.

2. Institute daily press briefings

If elected, Biden has said, he intends to place one of his first calls to Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases. Multiple experts said a Biden-Harris administration should put Fauci in front of the public on day one.

3. Mandate universal mask-wearing

During their first public address under a Biden-Harris administration, Fauci and his fellow experts should issue a universal mask mandate, Schaffner said. Research clearly shows that face masks can prevent coronavirus transmission and save lives.

4. Ramp up testing

The US is already testing more people per capita than almost any other nation: around 204 daily tests for every 100,000 people. But it also represents a quarter of the world’s coronavirus cases — meaning its testing capacity is still relatively limited. The weekly average of daily tests is now 13% lower than it was at the end of July, according to data from The COVID Tracking Project.

5. Use the Defense Production Act

Experts also hope Biden will more fully utilize the Defense Production Act, which allows the president to require businesses to prioritize the federal government’s supply-chain needs. The law also restricts companies from hoarding or price gouging critical supplies.

6. Appoint Ron Klain as testing czar

One of Biden’s first priorities should be to appoint strong leaders, Gates said.

“There are lots of people who are involved in the global response to Ebola and smallpox and polio, who would love to help out the US bring this thing to a close,” he said.

7. Develop a federal dashboard with live data

In January, researchers at Johns Hopkins University developed a live dashboard to track coronavirus cases. For a while, the tool was one of the sole resources for measuring the scope of the US outbreak. It’s still one of the most prominent and widely used.

8. Convene scientific experts to come up with a new response plan

Finally, experts called for a new national strategy led by a panel of scientific experts.

“The key will be to rely on scientific understanding, not wishful thinking,” Dr. Joshua Sharfstein, a vice dean at the Johns Hopkins Bloomberg School of Public Health, said…

“Our big challenge has been that we’ve pitted the economy against health,” Levine added. “That administration, if it were to be elected, needs to bring those two together.” (Q)

________________

“As some parts of America gingerly begin to open up after months of near total lockdown, people have questions. Will it be safe to take a train? A plane? Visit the hair salon? An indoor restaurant?

There are many knowable parameters in the equation: your health; the prevalence of cases where you live; the safety precautions being taken any place you want to visit. But the final answer may depend on your individual risk tolerance for exposure to infectious disease.

Most Americans alive today have never before had to make that self-assessment.

In the past, deadly outbreaks of plague, flu and polio were regular occurrences. Up until the mid to late 20th century there were mumps, measles and chickenpox to contend with.

In a world of effective antibiotics and antivirals and other treatments, deaths or even serious illnesses from infectious disease seem nearly incomprehensible. So our fear is enormous, and our risk tolerance for exposure is just about zero…

Covid-19 is a very serious disease. But it is not the Black Death, which killed up to half of Europe in the 14th century. A vaccine, when and if it arrives, will be a big help. But in the meantime, we have science. We know what causes Covid-19. We are learning more about how to detect, prevent and treat it every day.

So instead of taking your temperature and checking your pulse oximeter reading twice a day, it may be time to take stock of your risk tolerance. In those places where governments, businesses and administrators have set the stage properly, we can — with sensible precautions — begin to live again.” (P)

“Critics accuse Fauci of “mistakes.” They take one Fauci statement, often out of context, and then blast him when something happens to disprove that statement. The most repeated example of this is when Fauci, and others, advised the public against wearing masks in early 2020. There was a shortage of masks at that time, and healthcare workers might not have been able to get them. Statements made early on during a crisis need to be revised as we learn more, and this pandemic is unlike anything we have seen in our lifetimes.

But critics use such statements to undermine valued experts like Fauci. This makes it impossible for us to solve problems. If we don’t listen to the people who have the most education, training and knowledge, and if we place trust in people who are ignorant and refuse to learn, we ensure that our response to the crisis will continue to fail, as it has for this country.” (AA)

____________

“Former Vice President Joe Biden said in an exclusive interview with ABC “World News Tonight” Anchor David Muir on Friday that as president, he would shut the country down to stop the spread of COVID-19 if the move was recommended to him by scientists.

“I would shut it down; I would listen to the scientists,” Biden told Muir Friday, alongside his running mate, Sen. Kamala Harris, D-Calif., during their first joint interview since officially becoming the Democratic Party’s presidential and vice presidential nominees.

Biden also criticized what he argued is the “fundamental flaw” of the Trump administration’s response to the coronavirus pandemic, that the nation cannot begin to recover economically until the virus and public health emergency is under control.

“I will be prepared to do whatever it takes to save lives because we cannot get the country moving, until we control the virus,” Biden said. “That is the fundamental flaw of this administration’s thinking to begin with. In order to keep the country running and moving and the economy growing, and people employed, you have to fix the virus, you have to deal with the virus.” (BB)

__________

“Well folks, we’ve done it. It took a lot of grit, activism, and cooperation, but we’ve achieved something great as a nation. We’ve created an unyielding market for Bobblehead Faucis.

We’re now almost half a year into the coronavirus pandemic and every other developed country in the world has been able to flatten the curve, some to the point where life looks almost like the Before Times. Idiots. The first rule of Bobblehead Fauci economics is to create an environment so politically and biologically toxic that the only solace people can find is in a $25 hunk of wobbling plastic molded after the septuagenarian tasked with leading a divided nation through a pandemic that disproportionately kills members of his own age group.

The market is so strong right now that the original Bobblehead Fauci is completely sold out, and the proceeds helped raise over $200,000 for frontline healthcare workers.”  (W)

• A.Birx says she wishes US started with lockdown like Italy, https://www.cnn.com/2020/08/17/health/us-coronavirus-monday/index.html
• B.Coronavirus update: Fauci ‘not pleased’; Chicken wings test positive for coronavirus, by Leada Gore, https://www.al.com/news/2020/08/coronavirus-update-fauci-not-pleased-chicken-wings-tests-positive-for-coronavirus.html
• C.A Warning for the United States From the Author of ‘The Great Influenza’, By John M. Barry, https://www.nytimes.com/2020/08/18/opinion/coronavirus-economy.html?referringSource=articleShare
• D.Temperature checks and ‘deep cleaning’ aren’t good at stopping coronavirus. So why do we bother?, By Leslie Young, https://globalnews.ca/news/7257464/coronavirus-prevention-ineffective/
• E.New York Has Tamed the Virus. Can It Hold Off a Second Wave?, By J. David Goodman, https://www.nytimes.com/2020/08/17/nyregion/coronavirus-second-wave-nyc.html?referringSource=articleShare
• F.What if ‘Herd Immunity’ Is Closer Than Scientists Thought?, By Apoorva Mandavilli, https://www.nytimes.com/2020/08/17/health/coronavirus-herd-immunity.html?referringSource=articleShare
• G.‘All In, All the Time’: Reopening Florida Schools Is Likened to Military Operation, By Patricia Mazzei and Manny Fernandez, https://www.nytimes.com/2020/08/19/us/coronavirus-schools-florida-local-control.html?referringSource=articleShare
• H.LA school district unveils coronavirus testing, contact tracing program for students, staff, BY REBECCA KLAR, https://thehill.com/homenews/state-watch/512296-la-school-district-unveils-coronavirus-testing-contact-tracing-program
• I.A Novel Way to Combat Covid-19 in Nursing Homes: Strike Teams, By Hannah Critchfield, https://www.nytimes.com/2020/08/18/health/Covid-nursing-homes.html?referringSource=articleShare
• J.‘We’re Clearly Not Doing Enough’: Drop in Testing Hampers Coronavirus Response, By Sarah Mervosh, Nicholas Bogel-Burroughs and Sheryl Gay Stolberg, https://www.nytimes.com/2020/08/15/us/coronavirus-testing-decrease.html?referringSource=articleShare
• K.Pooled testing has become worthless in areas of the U.S., in part because there are simply too many cases., https://www.nytimes.com/2020/08/18/world/coronavirus-covid.html?referringSource=articleShare
• L.Fauci Says Coronavirus Temperature Checks ‘Notoriously Inaccurate’, by Lisette Voytko, https://www.forbes.com/sites/lisettevoytko/2020/08/13/fauci-says-coronavirus-temperature-checks-notoriously-inaccurate/#1e8aaf1733f0
• M.Gov. Murphy Vetoes NJ Coronavirus Testing Bill, Signs 5 Into Law, By Tom Davis, https://patch.com/new-jersey/hoboken/s/h7l1t/gov-murphy-vetoes-nj-coronavirus-testing-bill-signs-5-into-law?utm_source=nearby-news&utm_medium=email&utm_campaign=alert
• N.Coronavirus (COVID-19) Update: FDA Posts New Template for At-Home and Over-the-Counter Diagnostic Tests for Use in Non-Lab Settings, Such as Homes, Offices or Schools, https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-posts-new-template-home-and-over-counter-diagnostic-tests-use-non
• O.Dr. Fauci: ‘We’ve been through a Depression, we’ve been through a World War. We pulled together through 9/11’, By Quentin Fottrell, https://www.marketwatch.com/story/dr-fauci-on-why-asian-countries-and-island-nations-are-better-controlling-covid-19-and-how-the-us-can-learn-from-them-2020-08-13
• P.You’ve Checked Your Temperature. Now, What’s Your Risk Tolerance?, By Elisabeth Rosenthal, https://www.nytimes.com/2020/08/19/opinion/coronavirus-risk-prevention.html?referringSource=articleShare
• Q.6 public-health experts offer a coronavirus agenda for Biden and Harris’ first day in office, should they win, by Aria Bendix, https://www.businessinsider.com/us-coronavirus-strategy-under-joe-biden-kamala-harris-2020-8
• R.Joe Biden calls for a nationwide mask mandate as he pushes his plan to combat coronavirus, by Christina Wilkie, https://www.cnbc.com/2020/08/13/joe-biden-calls-for-a-nationwide-mask-mandate-to-combat-coronavirus.html
• S.Trump calls Biden’s coronavirus plan unscientific, rejects call for national mask mandate, by Noah Higgins-Dunn, https://www.cnbc.com/2020/08/13/trump-calls-bidens-coronavirus-plan-unscientific-rejects-call-for-national-mask-mandate.html
• T.President Trump makes call for new White House doctor’s coronavirus advice, by Jill Colvin, https://www.clickorlando.com/news/politics/2020/08/16/trump-makes-call-for-new-white-house-doctors-virus-advice/
• U.F.D.A.’s Emergency Approval of Blood Plasma Is Now on Hold, By Noah Weiland, Sharon LaFraniere and Sheri Fink, https://www.nytimes.com/2020/08/19/us/politics/blood-plasma-covid-19.html?referringSource=articleShare
• V.Fauci Prepping to Talk Covid Strategy With Newest Trump Adviser, By John Lauerman and Madison Mills, https://www.bloomberg.com/news/articles/2020-08-18/fauci-prepping-to-talk-covid-strategy-with-newest-trump-adviser
• W.You Can Now Buy a Facepalming Dr. Fauci Bobblehead Because We’re Still F***ing It Up, BY JANE RECKER, https://www.washingtonian.com/2020/08/14/you-can-now-buy-a-facepalming-dr-fauci-bobblehead-because-were-still-fing-it-up/
• X.HHS says COVID-19 data reporting system won’t go back to CDC, Laura Dyrda, https://www.beckershospitalreview.com/data-analytics/hhs-says-covid-19-data-reporting-system-won-t-go-back-to-cdc.html
• Y.CDC Director ‘Hopeful’ Pandemic Will End by Spring, As FDA Official Says He’ll Quit if Vaccine Rushed, BY ARISTOS GEORGIOU, https://www.newsweek.com/cdc-director-hopeful-pandemic-will-end-spring-1526710
• Z.New Trump coronavirus adviser makes case for opening all schools, by Cassidy Morrison, https://www.washingtonexaminer.com/news/new-trump-coronavirus-adviser-makes-case-for-opening-all-schools
• AA.Marcia Meoli: Listen to Fauci and stop with the nonsense, By Marcia Meoli, https://www.hollandsentinel.com/opinion/20200821/marcia-meoli-listen-to-fauci-and-stop-with-nonsense
• BB.Biden to ABC’s David Muir: ‘I would shut [country] down’ to prevent spread of COVID-19 if scientists recommended, by John Verhovek, https://abcnews.go.com/Politics/biden-abcs-david-muir-shut-country-prevent-spread/story?id=72519690