COVID-19: End of Week Two

Ken AshfordEbola/Zika/COVID-19 Viruses, Trump & AdministrationLeave a Comment

World as of this morning:

And in the U.S., we have more cases than any other country:

636 in North Carolina (2 deaths); 17 in Forsyth County.

Boris Johnson – England’s PM – has tested positive.

There is massive outrage as many are hearing President Donald Trump telling Fox News host Sean Hannity that New York City hospitals usually just have two ventilators while he mocked Governor Andrew Cuomo’s request – based on scientific models – for 30,000 to 40,000 of the life-saving units. That outrage is growing as more and more read The New York Times article revealing FEMA is refusing to place an order for ventilators fearing the price tag is too high.

“You know you go into major hospitals sometimes they’ll have two ventilators,” Trump continued. “And now, all of a sudden they’re saying, ‘Can we order 30,000 ventilators?’ so it’s a very bad situation, we haven’t seen anything like it, but the end result is we gotta get back to work.”

The outrage online is palpable.

But as Trump scoffs at the idea that hospitals actually need more ventilators, NewYork-Presbyterian Hospital has begun a desperate practice: sharing a ventilator between two patients. Because when Trump is providing nothing at all, half a lung is better than nothing. Maybe.

Trump’s scoffing at the idea that New York hospitals actually need thousands of additional ventilators got additional support from another member of his coronavirus task force. Incredibly, this support didn’t come from Mike Pence or Steven Mnuchin, but from actual doctor: Deborah Birx.

Speaking at the daily coronavirus-themed Trump rally on Thursday, Birx dismissed the thought that hospitals were short of either beds or ventilators, denied that a large percentage of the public would become infected, and suggested that there were “thousands” of ventilators sitting idle in New York state hospitals that could be moved to where they were needed. 

With less than 1% of the United States currently infected, Birx was particularly dismissive of the idea that there would be widespread infection. “When people start talking about 20% of a population getting infected, it’s very scary but we don’t have data that matches that based on the experience,” said Birx. Except, of course, we do. The seasonal flu regularly infects 20% or more of the population in spite of a widely available vaccine, residual immunity in a large portion of the population, and a transmission rate that is much lower than that of COVID-19. There is absolutely no evidence that the infection in the United States will not spread to much more than 20% of the population, unless it’s held in check by social distancing and a greatly expanded testing program.

As if realizing that 20% might be something of a low mark, Birx’s next statement moved the bar considerably higher: “There’s no … no reality … on the ground where we can see that 60% to 70% of Americans are going to get infected in the next eight to 12 weeks,” said the White House coronavirus response coordinator. Actually, the current doubling rate of the coronavirus in the United States is between two and three days. Unchecked, the United States could top 20% in fewer than three weeks. Eight weeks to get to 60% from there would mean that things had actually improved considerably.

But long before either of those numbers would be reached, the health care system would absolutely collapse under the weight of the epidemic. There are only enough hospital beds out there in the entire nation to accommodate less than 0.3% of the population. On any given day, more than half those beds—including the ones that need ventilators—are already occupied by people fighting ordinary, non-epidemic diseases and recovering from accidents. 

But Birx insisted that there are still somewhere between 1,000 and 2,000 ICU beds with ventilators in New York state, outside of New York City. Birx suggested that these ventilators, and presumably the beds, should be stripped and shipped to the hot spots rather than bothering the federal government with requests for more equipment. Except taking those beds away from the remainder of the state would mean that those hospitals have absolutely no capacity to deal with coronavirus cases in their area—or even a large accident or other cause that brought in patients. What Birx is suggesting is that, rather than bolster the straining system, the system be made even more fragile in the midst of a crisis. Even then, the number of devices she is talking about are unlikely to meet the number of cases that will be present in New York in the next 48 hours, much less the next weeks and months.

Again and again, Birx dismissed questions about hospitals under strain, or large numbers of patients waiting for care, or health care workers without needed equipment. “We don’t have any evidence of that right now,” said Birx. Instead, she accused news media of “spreading fear.” She also insisted on spending much of her time talking about “19 states” where the number of cases were low.

Which is exactly what you want to hear from a doctor in a crisis: “Did you know there are some people who are not sick?”

THIS graph is crazy:

UPDATES:

Trump, meanwhile is LOSING it.

This is, of course, blame-shifting. Trump could have invoked the Defense Production Act days ago, but refused to, saying that companies are stepping up. he lied.

In fact, Trump could invoke the DPA right NOW. And he’s not. He’s just complaining on Twitter.

The other development of the day is Republican Congressman Thomas Massie of Kentucky, who is insisting on a floor vote in the House to approve the financial assistance package. NOBODY is happy about this, even Trump, as it will mean a delay. It would also mean that Congressional representatives would have to get on planes, risking themselves to illness.

A few conservatives back Massie, but not many:

Other developments:

In recent days, a growing contingent of Trump supporters have pushed the narrative that health experts are part of a deep-state plot to hurt Trump’s reelection efforts by damaging the economy and keeping the United States shut down as long as possible. Trump himself pushed this idea in the early days of the outbreak, calling warnings on coronavirus a kind of “hoax” meant to undermine him.

The notion is deeply troubling, say leading health experts, because what the country does next and how many people die depend largely on what evidence U.S. leaders and the public use to inform their decisions. Epidemiologists worry their research — intended to avert massive deaths in situations exactly like this pandemic — will be dismissed by federal leaders when it is needed most.

1:40 pm:

Massie got foiled. The House just passed the bill.

Here’s the moment:

Fox Business Network’s Trish Regan is leaving the network.

In a statement provided to Mediaite Friday, the network announced, “FOX Business has parted ways with Trish Regan – we thank her for her contributions to the network over the years and wish her continued success in her future endeavors.”

Recently Regan came under scrutiny for her commentary calling the media coverage of coronavirus another “impeachment scam” trying to “destroy the president.”

A few days later the network announced her primetime show would be going on hiatus, citing demands of coronavirus coverage.