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Monday, December 09, 2019 {{ new Date().getDay() }}


Cuomo Rebuffs Trump’s Political Baiting As ‘Anti-American’

On Monday, Donald Trump was asked by the hosts of Fox & Friends about possibly running in the presidential election against New York Gov. Andrew Cuomo, who is not a candidate.

“I wouldn’t mind running against Andrew. I’ve known Andrew for a long time. I wouldn’t mind that, but I’ll be honest, I think he’d be a better candidate than sleepy Joe,” he told the network, using his frequent epithet for former Vice President Joe Biden.

In his daily briefing on the coronavirus, Cuomo pushed back against the notion that he is focused on politics in his current efforts in governing New York.

From a March 30 press briefing:

ANDREW CUOMO: As far as the president’s comment about having a political contest with me, I am not engaging the president in politics. My only goal is to engage the president in partnership. This is no time for politics. And, you know, lead by example.

I’m not going to get into a political dispute with the president, I’m not going to rise to the bait of a political challenge. I’m not running for president, I was never running for president, I said from day one I wasn’t running for president, I’m not running for president now. I’m not playing politics. I just want partnership to deal with this.

And I said to the president quite clearly: Look, when you do good things for my state and you’re a good partner, I will be the first one to say you’re a good partner. And I have. I went to the ship Comfort today, I said, “Thank you, Mr. President.”

We opened up this Javits Center, I said thank you to the Army, they did a great job here, the Army Corps of Engineers. When you help my state, I’ll say thank you.

If I believe that New York is not being served – the federal legislation that they passed – I will say that too.

You know, sometimes it’s simple. Just tell the truth, right? And that’s where we are. Tell the truth. If you’re doing the right thing by New York, I’ll say it. If he’s doing the wrong thing by New York or the rest of the country, I’ll say it.

But I’m not going to engage in politics. Not because I’m unwilling to tangle but because I think it’s inappropriate and I think it’s counterproductive and I think it’s anti-American.

Forget the politics. Forget the politics, we have a national crisis. We are at war. There is no politics. There is no red and blue. It’s red, white, and blue. So let’s get over it and, again, lead by example.

Published with permission of The American Independent Foundation.

Internal Emails Show How CDC Chaos Slowed Coronavirus Response

Reprinted with permission from ProPublica.

On Feb. 13, the U.S. Centers for Disease Control and Prevention sent out an email with what the author described as an “URGENT” call for help.

The agency was struggling with one of its most important duties: keeping track of Americans suspected of having the novel coronavirus. It had “an ongoing issue” with organizing — and sometimes flat-out losing — forms sent by local agencies about people thought to be infected. The email listed job postings for people who could track or retrieve this paperwork.

“Help needed urgently,” the CDC wrote.

This email is among hundreds of pages of correspondence between federal and state public health officials obtained by ProPublica through a records request in Nevada.

During the period in which the correspondence was written, from January to early March, health officials were trying to stay ahead of the coronavirus outbreak underway in China. By mid-February, when the CDC job postings email went out, the virus had a toehold in the United States, where there were already 15 confirmed cases. In another two weeks, the first case of community transmission would be reported in California, followed shortly by cases in Washington.

The documents — mostly emails — provide a behind-the-scenes peek into the messy early stages of the U.S. response to the coronavirus, revealing an antiquated public health system trying to adapt on the fly. What comes through clearly is confusion, as the CDC underestimated the threat from the virus and stumbled in communicating to local public health officials what should be done.

The same week the CDC sent out the email about the job openings, the agency sent Nevada officials alerts about 80 potential coronavirus patients to monitor, documents show. Four were not Nevada residents.

A state epidemiologist, in each instance, corrected the agency, informing the CDC that the person was from New York, not Nevada. (The CDC then redirected each report to New York, the documents show.)

The confusion sometimes went both ways. On March 4, a program manager in the Nevada Health Department reached out to the CDC to ask about congressional funding for COVID-19, the disease caused by the novel coronavirus.

“There seems to be a communications blackout on this end,” the program manager wrote, wondering if funds would be distributed based on the number of cases in each state or by population.

“Unfortunately, there is no clear answer to your questions,” responded a CDC staffer, apologizing for the lack of information. “We are hearing all of the rumor mills as well.”

“Thank you,” the Nevada program manager replied. “It’s good to be confused together.”

Chaotic Coordination

For much of February, the CDC kept a tight grip on who should be tested for the coronavirus, a strategy that has been criticized by epidemiologists for limiting the ability to track the spread of the disease.

In a Feb. 19 presentation to state health officials, the CDC described the definition of a person who ought to be tested: You had to have had close contact with someone confirmed to have COVID-19, or to have traveled from China and then had respiratory symptoms and a fever at the same time.

However, the CDC’s own guidance from a month prior, distributed to the states on Jan. 17, had a footnote that said that “fever may not be present in some patients,” such as people who had taken fever-lowering medications, according to one of the documents obtained by ProPublica. That caveat was not on the slides presented to the states in mid-February.

In a statement to ProPublica, the CDC said clinicians could always use their judgment to decide who received a test. “CDC never declined a request for testing that came from a state or local health department,” the agency said.

In mid to late February, the CDC was trying to move responsibility for coronavirus testing from itself to state health departments — a critical step, since the CDC does not have the capacity to be the nation’s testing lab. Slides from the Feb. 19 presentation describe the process for transitioning from “Phase 1,” in which the CDC determined who was a potential COVID-19 patient and conducted all the testing, to “Phase 2,” in which local health departments would do that work and report data back to the CDC.

Because of delays with test kits, Phase 2 had to be “redesigned,” the presentation said, so the CDC would continue to test specimens and return results. The CDC told ProPublica that all states have now transitioned to the original Phase 2 plan, where they can run their own tests.

The CDC presentation also directed the states to use a web platform called DCIPHER, which the agency was already using for food-related outbreaks, to report potential COVID-19 patients and confirmed cases.

But it wasn’t until the week of Feb. 24 — the same week that the U.S. would discover its first case of community-acquired COVID-19 — that the CDC scheduled a training for states on how to use the platform, according to the documents.

On March 1, the CDC emailed Nevada’s Health Department, requesting that it send a list of users and email addresses to connect to the DCIPHER system, to “ensure that we can onboard your jurisdiction.”

“We sent a spread sheet a couple weeks ago which I thought covered this,” a state epidemiologist responded.

Four days later, Nevada announced its first confirmed case of the coronavirus. It’s unclear when the state managed to successfully get on the DCIPHER system. Officials from Nevada declined to comment.

“Maybe Just Kidding”

A key part of the CDC’s strategy during the early days of the outbreak was identifying infected travelers returning from China. The process for screening passengers arriving at Los Angeles International Airport did not go smoothly, the correspondence obtained by ProPublica indicates.

On Feb. 16, a CDC staff member sent a message to colleagues about a buggy electronic traveler screening questionnaire that wouldn’t save correctly, among other issues. Also, the tool’s drop down field auto-populated with “United Kingdom” instead of “United States,” forcing users to type “United States of America.”

The CDC staffer also said the agency was struggling to interview non-English speakers in a timely manner and needed additional interpreters.

“Hello Team,” another CDC staff member responded, offering a solution: “The Google translate App has a real-time voice translation option.”

The screening protocol also wasn’t always clear. On Feb. 29, a CDC officer at LAX sent an email to her colleagues, saying: “In case this comes up again, we are not screening private flights. These would be flights that land at LAX but don’t arrive into the regular terminal … mainly for rich people.”

Just over two hours later, the officer emailed again. “And, maybe just kidding,” she wrote. Information from headquarters seemed to contradict what she had said about private flights, she said.

The CDC told ProPublica that it scaled up the screening almost overnight, so it focused on vetting the largest segment possible of high-risk passengers coming from places like Wuhan, China. The agency trained staff and dealt as best it could with limited staffing and translation services, it said.

“Protecting Americans Is What We Do”

The CDC’s initial response to COVID-19, particularly its failure to initiate swift, widespread testing, has drawn intense criticism.

Nonetheless, the correspondence ProPublica obtained shows that the CDC director, Dr. Robert Redfield, exuded confidence in communications with others at the agency.

On Jan. 28, when the CDC had confirmed five cases of the coronavirus, all in travelers who arrived from outside the country, he emailed colleagues to acknowledge it posed “a very serious public health threat,” but he assured them “the virus is not spreading in the U.S. at this time.”

That actually may not have been the case. The CDC confirmed the first case of COVID-19 in Washington on Jan 20. Trevor Bedford, a computational epidemiologist at the Fred Hutchinson Cancer Research Center in Seattle, has said he believes that the virus could have begun circulating in the state immediately after the traveler arrived in mid-January, based on his analysis of genetic data from the initial Washington cases.

The CDC said in its statement that Redfield’s comments were based on the data available at the time. “At no time, did he underestimate the potential for COVID-19 becoming a global pandemic,” the agency’s statement said. “He stated consistently that more cases, including person to person spread, were likely.”

On March 3, Redfield wrote to his staff again, stressing the agency’s readiness, despite the growing evidence that it wasn’t. “We anticipated and prepared for the possible spread of COVID-19 in communities across the United States,” he said in an email.

The CDC said in its statement that Redfield was telling staffers that the agency would continue to be engaged in a sustained response to COVID-19. Redfield’s email was not characterizing the state of the outbreak, the CDC said.

By that point, it was clear that the coronavirus was gaining ground within the country, even if the inability to test for it was obscuring the true numbers. Physicians and public health experts begged for more tests while warning that thousands of cases would soon emerge.

Still, Redfield’s March 3 email struck a reassuring note.

“Confronting global outbreaks and protecting Americans is what we do,” Redfield wrote in the message. “More and more, people are turning to us for guidance, and we respond consistently with evidence-based information and professionalism.”

Trump Fails To Mobilize VA Hospital Resources For Covid-19 Emergency

Reprinted with permission from ProPublica.

The Trump administration is leaving untapped reinforcements and supplies from the U.S. Department of Veterans Affairs, even as many hospitals are struggling with a crush of coronavirus patients.

The VA serves nine million veterans through 170 hospitals and more than 1,000 clinics, but it’s also legally designated as the country’s backup health system in an emergency. As part of the National Disaster Medical System, the VA has deployed doctors and equipment to disasters and emergencies in recent instances such as Hurricane Maria and the Pulse nightclub shooting in Orlando, Florida. The VA system has 13,000 acute care beds, including 1,800 intensive care unit beds.

But for the coronavirus pandemic, VA Secretary Robert Wilkie told lawmakers this week that the agency won’t spring into action on its own. Instead of responding to pleas for help from states and cities, Wilkie said he’s waiting for direction from the Department of Health and Human Services or the Federal Emergency Management Agency.

And those calls, for the most part, haven’t come. HHS hasn’t asked the VA for significant help with the coronavirus pandemic. FEMA did not take a leading role in the government’s response until last Friday, and it has yet to involve the VA either.

“VA stands ready to support civilian health care systems in the event those systems encounter capacity issues,” press secretary Christina Mandreucci said. “At this time, VA has not received specific requests from FEMA for assistance.”

The White House referred questions to the VA. The VA referred a question about taking directions from HHS and FEMA to those agencies. HHS referred questions to FEMA, and FEMA referred questions to the VA.

The VA has fielded a handful of limited tasks. It asked 12 health technicians and nursing assistants to volunteer to help HHS and the Centers for Disease Control and Prevention with coronavirus screenings for two weeks in February. The agency sent 14 medical technicians to help HHS with screenings at an Air Force base in California where evacuees from the Diamond Princess cruise ship were being quarantined. And a spokeswoman for CalVet, the state’s veterans agency, told ProPublica that the VA emergency manager in the region has helped provide supplies such as N95 masks.

Lawmakers are frustrated to see the VA largely sitting on its hands as the crisis escalates.

“It is unconscionable that HHS has not utilized every tool it has to address the real suffering of individuals in this nation and called upon VA,” Sen. Jon Tester of Montana, the ranking Democrat on the Senate Veterans’ Affairs committee, said in a March 25 letter to HHS Secretary Alex Azar. “States, communities and patients are already suffering as a result of HHS’s inaction. Get them help now.”

According to the VA’s pandemic plan released on Friday, the agency’s role in the governmentwide response may include helping emergency responders with protective gear, screening and training; helping to staff FEMA’s operations teams; dispatching advisers to state and local public health authorities; supplying medicines and equipment; and helping with burials.

The stimulus deal that the Senate passed late Wednesday includes $27 billion for HHS to reimburse the VA for providing care to the general public. That’s on top of $20 billion to help the VA care for veterans.

Just a month ago, at a House budget hearing, Wilkie declined additional funding. “Right now I don’t see a need for us,” he said. “We are set.”

The VA held its first planning meeting on the coronavirus on Jan. 22, the day after the first case was confirmed in the U.S., according to the agency’s response to an inspector general report released Thursday. But the department did not implement measures until two days after the World Health Organization formally declared a pandemic, on March 11. The VA did not issue guidance on screening patients until March 16.

Wilkie abruptly fired his deputy last month and is under investigation by the VA’s inspector general for allegedly seeking damaging information about a congressional staffer who said she was sexually assaulted at a VA hospital. (He denies doing so.) Wilkie took time off in recent weeks and has taken a back seat at White House task force meetings. Since joining the White House’s Coronavirus Task Force on March 2, Wilkie has spoken publicly only once, on March 18. (Mandreucci said Wilkie has attended 20 task force meetings.) At that time, Wilkie said the VA was preparing to join the disaster response but had not yet engaged.

“We are the buttress force in case that FEMA or HHS calls upon us to deploy medical professionals across the country to meet crises,” Wilkie said. “We plan for that every day. We are gaming out emergency preparedness scenarios. And we stand ready, when the president needs us, to expand our mission.”

Wilkie told Politico the VA was preparing to deploy 3,000 doctors, nurses and other emergency workers but had no timeline.

The VA’s role as the country’s emergency medical backup was first established by Congress in 1982 and is known as the agency’s “Fourth Mission.” (The first three missions are sometimes identified as care, training and research, and other times as health, benefits and memorials.) This month, a description of this Fourth Mission was suddenly scrubbed from the website of the VA’s Office of Emergency Management. Mandreucci noted it appeared on a different page.

The VA’s ability to support FEMA could be limited by demands from its own patients, who are largely older and part of the demographic that’s most vulnerable to the coronavirus. As of Friday, the VA had 571 patients who tested positive and nine who have died.

The VA’s inspector general said in a report on Thursday that health center leaders reported concerns about running out of medicines and protective gear. Leaders at the VA hospitals in Durham, North Carolina, and Detroit said they needed more ventilators. The inspector general’s report said 43% of the facility leaders surveyed planned to share ICU beds or protective gear with local providers.

“That assistance is dependent upon the availability of resources and funding, and consistency with VA’s mission to provide priority services to veterans,” Wilkie said in a March 23 letter to lawmakers.

Trump Snarls When Pressed On Ventilators By ABC Correspondent

Reprinted with permission from Alternet

During the White House coronavirus briefing on Friday, President Donald Trump gave a bizarre and uninspiring response when a reporter pressed him on the supply of ventilators in the United States.

“Are you able to guarantee, to assure, these states, these hospitals, that everyone who needs a ventilator will get a ventilator?” asked ABC News’ Jonathan Karl.

“I think we’re in really good shape,” Trump replied. “This is a pandemic the likes of which nobody’s seen before. I think we’re in great shape.”

He added that the administration is “prepared to do vast numbers” of ventilators and he “hopes that’s the case.” He said “hopes” the United States will have “leftovers” that it can give to other countries in need.

But Karl pushed forward since Trump didn’t answer his question.

“Everbody who needs one will be able to get one?” Karl asked.

“Don’t be a cutie pie! OK?” Trump said in response. “‘Everyone who needs one,’” he repeated mockingly.

“It’s a fundamental question!” Karl shot back.

Trump went on to brag about his administration’s performance during the crisis, even as the outbreak has spiraled out of control. He also, as usual, tried to blame previous administrations for not being prepared enough, even though the Obama team had extensive planning and infrastructure in place to respond to pandemics which Trump tore down or ignored.