Grading Trump's Pandemic Leadership

woohorn · March 28, 2020

Well, if Trump, or whomever, had avoided his two colossal fuckups to date, testing and PPE/Ventilators, let's examine what might have happened.

I figure one of the biggest fuckups was comments minimising significance instead of telling US travelers to come home, cancel SB/Mardi Gras.

tantric superman · March 28, 2020

Trump is going to come out of this absolutely fine, because that is the way power in large organizations work. He can fuck up to the nth degree and various actions by governors and mayors and private parties and individual actors will help avoid a complete catastrophe.

In large companies, the CEO can be a complete moron, but layers of institutional knowledge below him will keep the ship afloat.

This is only different in that his baked-in supporters are more insane than the most Dilbert-ish company boot lickers.

He's going to sell his obstreperousness and foolishness as business acumen. And the pinheads are going to be able to justify it.

Example: He's done nothing to help coordinate extra ventilators, forcing individual governors (Cuomo) to scramble to get them. Now of course, Trumpkins are accusing Cuomo of hoarding ventilators. Of course he has to fucking hoard them. There is no leadership providing guidance on production and distribution and timing. So the governor's are likely doing this on their own. They will make it work, and Trump will take the credit for not panicking, because he knew that the private sector and our heroic AmericaFirst citizens would get it done, because they wanted to get back to work in our beautiful economy.

I realize you guys all know that, but grading the President is about as satisfying as filing out a Survey Monkey after you've taken the company Ethics Training. Fuckall that accomplishes.

bolverk · March 28, 2020

23 minutes ago, Anastasis said:

Well since you asked, you are the one who jumped in to white knight even a glancing suggestion that the political system failed us in 2016, demanding a condemnation of all sides. Which was readily given of course.

I didn't make this a both sides argument. I laughed at another posters notion that he didn't think that much less of the country when it elected Donald Trump, and suggested maybe there were leading indicators.

Ha. The thread topic was to grade Trump's response. At some point during the evening, you became perturbed by the piling on (in spite of your own vote) that you decided it was necessary to compare his fecklessness to others and imply that no other candidate would've performed better.

Are you truly willing to go on record to state that every major/minor party 2016 candidate (including Willie) would have poured gasoline on this fire of a crisis to make it worse? Is it impossible for you to admit that Clinton (since you brought it up to change the topic) would've listened to her advisors instead of firing them?

It's easy to say: Trump, among all viable options, appears to have been the worst choice. Is it possible for you to even state that?

(Btw, show me where I had a "conniption" when I was only posting between episodes of the "Tiger King"?)

Edited March 28, 2020 by bolverk

triplehorn · March 28, 2020

42 minutes ago, TwiceHorn said:

Well, if Trump, or whomever, had avoided his two colossal fuckups to date, testing and PPE/Ventilators, let's examine what might have happened.

For testing, I suppose we would have found community spread earlier and could have more swiftly moved to "shelter in place" in specific areas. Probably other benefits from the "demographic" data, some tangible, some less so

That, in turn, may have permitted more strategic allocation of existing PPE/ventilators while production ramped up, and postponed the urgent need for such apparatus in the future

On the first one, the "blanket" SIP and social distancing polices, made without benefit of testing data, may have had the same effect, or lack thereof. I fear we don't know how the PPE/ventilators is going to shake out, yet. Also, it's kind of appearing that the CDC and federal authorities may not have been ready to make good use of testing data (some of which is Trump's fault, some of which isn't), but state authorities and academics seem more than ready to fill that breach.

I think any other leader, with a shred of empathy, would have willingly risked overreaction and all that entails (economic slowdown, infringement of liberty, spending of vast governmental sums) rather than leave the nation hanging and exposed to this threat.

Trump's No. 1 fuck up, and it isn't even close, is actively denying the seriousness of the emerging pandemic. Extreme social distancing is the only way to minimize and contain the exponential spread. And when dealing with exponential curves, every single day delayed in taking action has proportionally massive worse effects visible just 20 days later. PPE/ventilators and testing are important, but actual understanding and acknowledgement of the threat are primary. If you're relying on testing in your own backyard (yields snapshot of appx numbers 9 days prior with 3 days doubling time) to make important decisions, it's too late. This is not new. And it is not a case of "no one could have foreseen."

horn4life · March 28, 2020

I voted fucking failure. But my bro in law thinks he is doing a great job, Who coulda known, closed the borders, Obama...

RomaVicta · March 28, 2020

Has Trump used the federal government to take substantive action? Certainly not for the weeks he denied the problem. Weeks.

The Army Corps of Engineers has been put into action to create more hospital beds and the two hospital ships are activated as well. That's something, I suppose. But late.

Otherwise, Trump is obstructing supply flow, delaying supply creation, and lying to the the public about what is going on. Medical personnel are getting sick and some are dying while we look at twitter pictures of NYC front line medical professionals wearing garbage bags for protection. Trump is making decisions on supply based on his own personal hunches in defiance of the advice of experts. He randomly chose Easter as a "beautiful" time to get people back to work nationwide.

All this, and Trumpists are going to show me an inapt graph to negate the above? Defend a single thing I've pointed out. This isn't math; it's plain eyesight. Open your goddamn eyes.

Anastasis · March 28, 2020

1 hour ago, TwiceHorn said:

Well, if Trump, or whomever, had avoided his two colossal fuckups to date, testing and PPE/Ventilators, let's examine what might have happened.

For testing, I suppose we would have found community spread earlier and could have more swiftly moved to "shelter in place" in specific areas. Probably other benefits from the "demographic" data, some tangible, some less so

That, in turn, may have permitted more strategic allocation of existing PPE/ventilators while production ramped up, and postponed the urgent need for such apparatus in the future

On the first one, the "blanket" SIP and social distancing polices, made without benefit of testing data, may have had the same effect, or lack thereof. I fear we don't know how the PPE/ventilators is going to shake out, yet. Also, it's kind of appearing that the CDC and federal authorities may not have been ready to make good use of testing data (some of which is Trump's fault, some of which isn't), but state authorities and academics seem more than ready to fill that breach.

I think any other leader, with a shred of empathy, would have willingly risked overreaction and all that entails (economic slowdown, infringement of liberty, spending of vast governmental sums) rather than leave the nation hanging and exposed to this threat.

I agree 100% that the testing strategy was and still is fucked. The CDC fucked up the tests. The FDA was not agile enough to manage the situation. Trump as the executive is absolutely accountable for those failings.

Would the hypothetical alternative be able to overcome the situation and the institutionalized dysfunction of the bureaucracy in rolling out an aggressive testing strategy? Maybe. Maybe not. Put Biden in the same situation and I have zero doubt that we will see an empathetic presence in the press briefing. Would he have made the specific decisions necessary to put us in a substantively different place today wrt case and death rates? I honestly don't think so. There is no magical wand that turns us into Japan.

Edited March 28, 2020 by Anastasis

TwiceHorn · March 28, 2020

11 minutes ago, triplehorn said:

Trump's No. 1 fuck up, and it isn't even close, is actively denying the seriousness of the emerging pandemic. Extreme social distancing is the only way to minimize and contain the exponential spread. And when dealing with exponential curves, every single day delayed in taking action has proportionally massive worse effects visible just 20 days later. PPE/ventilators and testing are important, but actual understanding and acknowledgement of the threat are primary. If you're relying on testing in your own backyard (yields snapshot of appx numbers 9 days prior with 3 days doubling time) to make important decisions, it's too late. This is not new. And it is not a case of "no one could have foreseen."

I don't disagree. But I was more focused on the actions that would have been taken in the absence of denial. To some extent, his denial slowed local officials from the blanket SIP orders (I use the shelter-in-place SIP rubric to denote all of the related measures). The two most tangible things that are opposite to denial is enabling/encouraging the development of tests and upping production on apparatus and fortifying health care facilities.

TwiceHorn · March 28, 2020

4 minutes ago, Anastasis said:

I agree 100% that the testing strategy was and still is fucked. The CDC fucked up the tests. The FDA was not agile enough to manage the situation. Trump as the executive is absolutely accountable for those failings.

Would the hypothetical alternative be able to overcome the situation and the institutionalized dysfunction of the bureaucracy in rolling out an aggressive testing strategy? Maybe. Maybe not. Put Biden in the same situation and I have zero doubt that we will see an empathetic presence in the press briefing. Would he have made the specific decisions necessary to put us in a substantively different place today wrt case and death rates? I honestly don't think so. There is no magical wand that turns us into Japan.

I knew this was what you were driving at. It is somewhat amazing to me that CDC and FDA needed prodding to get going on the testing.

triplehorn · March 28, 2020

5 minutes ago, RomaVicta said:

He randomly chose Easter as a "beautiful" time to get people back to work nationwide.

Trump was spouting his embellished Easter imagery day before yesterday as the US rocketed through 100k cases and a death rate doubling every 3 days.

Millions heed his selfish call. Calling it mass criminal negligence doesn’t seem too harsh.

workswithseed · March 28, 2020

4 minutes ago, TwiceHorn said:

I knew this was what you were driving at. It is somewhat amazing to me that CDC and FDA needed prodding to get going on the testing.

FDA just had lots of bureaucracy that was getting in the way wasn't it?

Anastasis · March 28, 2020

19 minutes ago, bolverk said:

Ha. The thread topic was to grade Trump's response. At some point during the evening, you became perturbed by the piling on (in spite of your own vote) that you decided it was necessary to compare his fecklessness to others and imply that no other candidate would've performed better.

And I graded it. And I also did a Michael Scott "What?" when another poster said he didn’t think THAT much less of this country when Trump was elected. That response is quoted up page if you need a refresher. You are the one who, in response, demanded a condemnation of all candidates. Which was given. You are also the poster who started asking for comparisons to other candidates. If you need a refresher, here is the post where you decided that you felt it necessary to weigh actions against other candidates.

FondrenRoad · March 28, 2020

1 minute ago, triplehorn said:

Trump was spouting his embellished Easter imagery day before yesterday as the US rocketed through 100k cases and a death rate doubling every 3 days.

Millions heed his selfish call. Calling it mass criminal negligence doesn’t seem too harsh.

Is it only negligent? Mofo has malice aforethought, IMO.

Anastasis · March 28, 2020

3 minutes ago, triplehorn said:

Trump was spouting his embellished Easter imagery day before yesterday as the US rocketed through 100k cases and a death rate doubling every 3 days.

Millions heed his selfish call. Calling it mass criminal negligence doesn’t seem too harsh.

Deadlines based on embellished Easter imagery, huh triple?

triplehorn · March 28, 2020

Easter strikes again. Cuts both ways.

workswithseed · March 28, 2020

I also thought that's what he hoped and actually and listened to Dr. Fauci.

triplehorn · March 28, 2020

Just now, workswithseed said:

I also thought that's what he hoped and actually and listened to Dr. Fauci.

Trump didn’t say “Easter” once in the presser yesterday after going off on Easter sugar plum tales Thursday. It was a day over day radical departure, but he’s still not communicating to millions who still lack awareness what is essential for national health and security. We’ll be at over 1000 Americans dying every day by the middle of next week, and likely double that daily by next weekend.

bolverk · March 28, 2020

1 hour ago, TwiceHorn said:

I knew this was what you were driving at. It is somewhat amazing to me that CDC and FDA needed prodding to get going on the testing.

Considering the fuck-ups at the leadership level that was pointed out by @Bama Chick in a separate post indicating there have been multiple "acting" commissioners, it shouldn't be a surprise that both agencies have been rudderless the last few year.

bolverk · March 28, 2020

1 hour ago, workswithseed said:

FDA just had lots of bureaucracy that was getting in the way wasn't it?

Look, man, I actually like you as a poster but this shit you just posted is something based on pure ignorance or out of pure trolling (which I honestly believe you don't indulge in). Regardless, this was NOT a bureaucratic fuck-up. Everything lies at the feet of the leadership level.

bolverk · March 28, 2020

1 hour ago, Anastasis said:

And I graded it. And I also did a Michael Scott "What?" when another poster said he didn’t think THAT much less of this country when Trump was elected. That response is quoted up page if you need a refresher. You are the one who, in response, demanded a condemnation of all candidates. Which was given. You are also the poster who started asking for comparisons to other candidates. If you need a refresher, here is the post where you decided that you felt it necessary to weigh actions against other candidates.

Before that post, you decided to "both sides" the ledger knowing full well that you'd get a reaction. Congratulations,I fell for it.

No evidence given, no data, no nothing. You stated: "You should have recognized the dire nature of the situation when we were forced to pick between two totally shit options."

And my question was a rational one: Among the option given, who would've responded best in your estimation? Trump? Clinton? Johnson? Stein? Willie? Which one?

After multiple posts, you have refused to answer that simple question.

Anastasis · March 28, 2020

15 minutes ago, bolverk said:

Before that post, you decided to "both sides" the ledger knowing full well that you'd get a reaction. Congratulations,I fell for it.

No evidence given, no data, no nothing. You stated: "You should have recognized the dire nature of the situation when we were forced to pick between two totally shit options."

This is you just manufacturing a reason to lower your seizure threshold because you cannot bear somebody expressing the opinion that our two party political system failed us in 2016. The post was a flippant response with a WHAT? to another poster saying that he didn’t think THAT much less of this country when Trump was elected. And the suggestion that, in terms of an assessment in the political context, maybe he should have been arrived at that position much earlier. Somehow that triggers your reflexive need to white knight HRC.

Anastasis · March 28, 2020

41 minutes ago, bolverk said:

Regardless, this was NOT a bureaucratic fuck-up. Everything lies at the feet of the leadership level.

whynotboth.gif.

From the Atlantic

Here are the four main reasons the testing issues have been so bad:

RED TAPE

The Food and Drug Administration has a protocol called emergency use authorization, or EUA, through which it clears tests from labs around the country for use in an outbreak. Getting more of these tests up and running would greatly increase the capacity of doctors and public-health officials to screen patients for the coronavirus.

Former FDA officials I spoke with said that during past outbreaks, EUAs could be granted in just a couple of days. But this time, the requirements for getting an EUA were so complicated that it would have taken weeks to receive one, says Alex Greninger, the assistant director of the virology division at the University of Washington Medical Center, which is located right near the heart of the American outbreak. Greninger told me clinical labs were not allowed to begin testing at all before they had received the EUA, even if they had already internally made sure their tests worked. Though these regulations are in place to ensure that faulty lab tests don’t get used on patients, several microbiologists told me they felt the precautions were excessive for a fast-moving outbreak of this scale. “The speed of this virus versus the speed of the FDA and the EUA process is mismatched,” he said.

Read: What will you do if you start coughing?

On February 28, Greninger and dozens of other clinical microbiologists wrote a letter to Congress complaining that the EUA process was slowing down the ability of their labs to deploy coronavirus tests. “Many of our clinical laboratories have already validated [tests] that we could begin testing with tomorrow, but cannot due [to] the FDA EUA process,” they wrote. The following day, the FDA changed the EUA process so that labs like Greninger’s could begin testing—they would just have to submit data for the FDA’s authorization two weeks later. But weeks had already passed during which many labs and hospitals were unable to use their tests.

“The EUA pathway … has served for Ebola and Zika, etc.,” says Mark Miller, the chief medical officer at bioMérieux, an infectious-disease diagnostic company based in France. “And then you have a situation like now with coronavirus, which I don't think any of us have ever lived through.”

Margaret Hamburg, who served as the FDA commissioner from 2009 to 2015, told me that while she doesn’t have knowledge of what went on inside the FDA over the past few months, the agency could have proactively reached out to different national and international labs to see whether their tests could be approved for use in the U.S. For example, the FDA might ask a lab, “Would you be interested to try to redirect what you were doing for a MERS diagnostic to a novel-coronavirus diagnostic?” she says. Instead, as The New York Times reported, federal officials told one Seattle infectious-disease expert, Helen Chu, to stop testing for the coronavirus entirely. (In an email, an FDA spokesperson denied that the agency acted slowly. Ensuring the validity of tests is important, she noted, to prevent false results.)

It looks like Chu was not alone. Dozens of labs in the U.S. were eager to make tests and willing to test patients, but they were hamstrung by regulations for most of February, even as the virus crept silently across the nation.

HARD-TO-GET VIRUS SAMPLES

Labs and companies need samples of the virus itself in order to make their tests, but delays in getting access to samples further slowed down the test-development process. The coronavirus originated in China, and as several microbiologists told me, the Chinese government does not allow specimens to be shipped outside its borders.

Many researchers have had difficulty getting their hands on samples even as the virus has spread. “I was working the phones to try to get access to the virus,” Greninger said.

BioMérieux just released three versions of its coronavirus test this week, after beginning work on it on January 23. Miller says that with every viral outbreak, the company’s biggest problem by far is getting access to virus and patient specimens so that it can validate its tests. Even when working with nonauthoritarian countries, a combination of government processes, researcher reticence, complex shipping regulations, and patient-privacy concerns makes getting samples difficult for diagnostic companies like his.

Read: How to understand your state’s coronavirus numbers

Miller said it would help if researchers, governments, and companies firmed up pathogen-sharing contracts in advance of an outbreak, but so far that hasn’t happened. “The problem is that in the past, industry has been viewed as this dirty participant in all of this, and we can't be trusted, and why would I have contracts with you?” Miller says. “But that’s ignoring the plain fact that we’re the ones that create the product in the end.”

LACKING EQUIPMENT

The type of test Greninger is making is called a lab-developed test. To be used in other labs, his test requires special instruments that extract and then amplify the RNA that makes up the virus. However, labs across the country—like those at many county hospitals—don’t have the tools to do this. They can only run a simple type of test called a sample-to-answer test. As late as this week, several lab directors told me that no sample-to-answer versions of the coronavirus test had been approved in the U.S. “That means that the vast majority of clinical labs in this country will not be able to do in-house testing at this time,” says Susan Butler Wu, an associate professor of clinical pathology at the University of Southern California.

The U.S. health-care system is broken up into state and county public-health laboratories, which have different equipment than academic research institutions, which have different equipment than hospitals that diagnose patients. So the same test won’t necessarily work in different places. “We don’t have a nationalized health-care system where you put the same equipment in all the hospitals,” Wu says. “We have all these independent hospital systems with their own equipment in their own labs.”

Even though some hospitals actually have the new, functional CDC tests, the extraction machines and reagents that are used to perform them are in short supply. “We’ve been pleading to the research laboratories to please, if they have RNA-extraction machines, to give them to the hospital,” says Michael Mina, an associate medical director in the department of pathology at Brigham and Women’s Hospital in Boston.

LEADERSHIP AND COORDINATION PROBLEMS

For months, President Trump has made light of the coronavirus, telling attendees at a Black History Month reception, for instance, that perhaps the virus could miraculously disappear. He claimed on Twitter that the U.S. has done a “great job” handling the outbreak. Such a cavalier attitude seems unlikely to have motivated health officials to take things seriously. It also contradicted advice from most public-health experts. Even Scott Gottlieb, who recently resigned as Trump’s FDA commissioner, wrote in The Wall Street Journal on February 4 that “it’s time to start testing more people.”

Containing a new infectious disease requires a lot of close collaboration between the president, the CDC, the FDA, and other parts of the Department of Health and Human Services, several Obama-era health officials told me. “One reason we were able to move quickly [during the Ebola outbreak] was that there was a great deal of coordination and issue spotting and troubleshooting that went on,” Hamburg, the former FDA commissioner, told me.

Read: You’re likely to get the coronavirus

The different arms of the sprawling health department have to feel like they’re all pulling toward the same goal. “I think you have fabulous people at CDC and FDA all doing the best they can, but we always found it was incredibly important to have all the agencies together in the same room,” says Jesse Goodman, a former FDA chief scientist who helped manage the country’s response to the 2009 H1N1 outbreak. When issues came up that merited the attention of the White House, he says, they got it.

Though Trump has proposed a payroll-tax break, as my colleague Peter Nicholas has pointed out, “Much of what he’s said publicly about the virus has been wrong, a consequence of downplaying any troubles on his watch.”

On top of that, there’s reportedly been tension and infighting between the president and his HHS secretary, Alex Azar, as well as between the FDA and the CDC. Politico reported that Vice President Mike Pence, who has no background in public health, repeatedly sidelined Azar from the coronavirus-response task force, and the White House appears to be blaming Azar for any failures in its coronavirus response. Politico also reported that an FDA scientist was “initially rebuffed”—made to wait overnight—when he attempted to visit the CDC in order to help coordinate testing. (In an email, a CDC spokesperson said this was “in full compliance with standard security processes required for all individuals whether they are federal employees or other visitors.”)

“I gather that there was a huge amount of infighting about who could or who should lead this, and there was a sense that a lot of people [inside HHS] weren’t considering it a major threat,” said a former Obama-administration official who has been in contact with current staffers and who related these private discussions under the condition of anonymity. “And why that was, I don’t know.”

It’s possible that all of these other hurdles could have been cleared if officials at the highest levels of government had been working together smoothly. Instead, we’ve seen confusion, doubt, and even more delays.

bolverk · March 28, 2020

1 minute ago, Anastasis said:

This is you just manufacturing a reason to lower your seizure threshold because you cannot bear somebody expressing the opinion that our two party political system failed us in 2016. The post was a flippant response with a WHAT? to another poster saying that he didn’t think THAT much less of this country when Trump was elected. And the suggestion that, in terms of an assessment in the political context, maybe he should have been arrived at that position much earlier. Somehow that triggers your reflexive need to white knight HRC.

You still refuse to answer the question: Of the the four major/minor party candidates, which one would've responded in the best (least harmful) way?

Your choices are: Trump, Clinton, Johnson, and Stein.

Bateshorn · March 28, 2020

2 hours ago, tantric superman said:

Trump is going to come out of this absolutely fine, because that is the way power in large organizations work. He can fuck up to the nth degree and various actions by governors and mayors and private parties and individual actors will help avoid a complete catastrophe.

In large companies, the CEO can be a complete moron, but layers of institutional knowledge below him will keep the ship afloat.

This is only different in that his baked-in supporters are more insane than the most Dilbert-ish company boot lickers.

He's going to sell his obstreperousness and foolishness as business acumen. And the pinheads are going to be able to justify it.

Example: He's done nothing to help coordinate extra ventilators, forcing individual governors (Cuomo) to scramble to get them. Now of course, Trumpkins are accusing Cuomo of hoarding ventilators. Of course he has to fucking hoard them. There is no leadership providing guidance on production and distribution and timing. So the governor's are likely doing this on their own. They will make it work, and Trump will take the credit for not panicking, because he knew that the private sector and our heroic AmericaFirst citizens would get it done, because they wanted to get back to work in our beautiful economy.

I realize you guys all know that, but grading the President is about as satisfying as filing out a Survey Monkey after you've taken the company Ethics Training. Fuckall that accomplishes.

TL;DR: There is no peak Trump.

Anastasis · March 28, 2020

30 minutes ago, bolverk said:

And my question was a rational one: Among the option given, who would've responded best in your estimation? Trump? Clinton? Johnson? Stein? Willie? Which one?

After multiple posts, you have refused to answer that simple question.

Oh, and sorry I missed this. As I have previously stated, I don't think that we would be looking at substantively different case or death rates under any. I think that we would be in same doubling range as the rest of the western world. I guarantee that the pressers would be lit under Willie though.

Anastasis · March 28, 2020

7 minutes ago, bolverk said:

You still refuse to answer the question: Of the the four major/minor party candidates, which one would've responded in the best (least harmful) way?

Your choices are: Trump, Clinton, Johnson, and Stein.

LOL. Chill turbo, give me a sec to respond. For somebody very tweaked that I supposedly decided it was necessary to compare the fecklessness of 2016 presidential candidates, you see really fixated on the necessity of comparing the fecklessness of 2016 presidential candidates.

Edited March 28, 2020 by Anastasis

bolverk · March 28, 2020

2 minutes ago, Anastasis said:

Oh, and sorry I missed this. As I have previously stated, I don't think that we would be looking at substantively different case or death rates under any. I think that we would be in same doubling range as the rest of the western world. I guarantee that the pressers would be lit under Willie though.

THANK YOU! for your answer.

That underlying question, at least on my end, is the sole point of this entire back and forth. Now, I'll go back to reading the article you posted.

jimmyjazz · March 28, 2020

Why was Trump's FDA so incapable of getting EUAs out in short order, as the article indicates used to be the case? Did something change under Trump, or was this inertia part of his complaint about what he inherited from Obama?

Never mind the fact that we're 3 years into his administration and it's fault for not fixing whatever needed fixing . . .

yoladu · March 28, 2020

21 hours ago, ndawg said:

I mean, it's not even a comparison, because Charlie Strong rose through the coaching ranks and built a resume strong enough for consideration.

The closest analogy would be if an actor who played a high school coach in a bad TV show suddenly became the head coach for the Green Bay Packers.

It would go as well as if Jerry Jones had hired Craig T Nelson to be head coach of the Dallas Cowboys with half the fans cheering along exclaiming he was awesome on “Coach”.

Anastasis · March 28, 2020

16 minutes ago, bolverk said:

THANK YOU! for your answer.

That underlying question, at least on my end, is the sole point of this entire back and forth. Now, I'll go back to reading the article you posted.

I made basically the same statement a few pages back. Thank you for finally reading it.

Prepuce of Doom · March 28, 2020

TwiceHorn · March 28, 2020

2 hours ago, bolverk said:

Considering the fuck-ups at the leadership level that was pointed out by @Bama Chick in a separate post indicating there have been multiple "acting" commissioners, it shouldn't be a surprise that both agencies have been rudderless the last few year.

While I don't doubt that instability at the top had some influence, one might think that there's a civil servant or two who might have said, "hey, we probably need to fast track coronavirus testing approvals, and same for vaccines."

TwiceHorn · March 28, 2020

19 minutes ago, TwiceHorn said:

While I don't doubt that instability at the top had some influence, one might think that there's a civil servant or two who might have said, "hey, we probably need to fast track coronavirus testing approvals, and same for vaccines."

This article

Seems to lay the blame pretty heavily on the administration and the appointed heads of the FDA and CDC, both of whom had zero governmental or regulatory experience.

Bama Chick · March 28, 2020

While I don't doubt that instability at the top had some influence, one might think that there's a civil servant or two who might have said, "hey, we probably need to fast track coronavirus testing approvals, and same for vaccines."

But part of the leadership failure is a lot of those long time civil servants have been fired or quit in frustration. And their positions have either gone unfilled or replaced with wholly unqualified Trump cult hacks.

One of the most damaging long term effects of this administration will be the decimation of the rank and file civil service pool and the erasure of the institutional memory of our governmental agencies.

The front line folks can’t sound an alarm when the front line doesn’t exist.

Anastasis · March 28, 2020

10 minutes ago, TwiceHorn said:

This article

Seems to lay the blame pretty heavily on the administration and the appointed heads of the FDA and CDC, both of whom had zero governmental or regulatory experience.

its worth the read so I will add it in tags here directly.

By Michael D. Shear, Abby Goodnough, Sheila Kaplan, Sheri Fink, Katie Thomas and Noah Weiland

March 28, 2020, 1:29 p.m. ET

WASHINGTON — Early on, the dozen federal officials charged with defending America against the coronavirus gathered day after day in the White House Situation Room, consumed by crises. They grappled with how to evacuate the United States consulate in Wuhan, China, ban Chinese travelers and extract Americans from the Diamond Princess and other cruise ships.

The members of the coronavirus task force typically devoted only five or 10 minutes, often at the end of contentious meetings, to talk about testing, several participants recalled. The Centers for Disease Control and Prevention, its leaders assured the others, had developed a diagnostic model that would be rolled out quickly as a first step.

But as the deadly virus from China spread with ferocity across the United States between late January and early March, large-scale testing of people who might have been infected did not happen — because of technical flaws, regulatory hurdles, business-as-usual bureaucracies and lack of leadership at multiple levels, according to interviews with more than 50 current and former public health officials, administration officials, senior scientists and company executives.

The result was a lost month, when the world’s richest country — armed with some of the most highly trained scientists and infectious disease specialists — squandered its best chance of containing the virus’s spread. Instead, Americans were left largely blind to the scale of a looming public health catastrophe.

The absence of robust screening until it was “far too late” revealed failures across the government, said Dr. Thomas Frieden, the former C.D.C. director. Jennifer Nuzzo, an epidemiologist at Johns Hopkins, said the Trump administration had “incredibly limited” views of the pathogen’s potential impact. Dr. Margaret Hamburg, the former commissioner of the Food and Drug Administration, said the lapse enabled “exponential growth of cases.”

And Dr. Anthony S. Fauci, a top government scientist involved in the fight against the virus, told members of Congress that the early inability to test was “a failing” of the administration’s response to a deadly, global pandemic. “Why,” he asked later in a magazine interview, “were we not able to mobilize on a broader scale?”

Across the government, they said, three agencies responsible for detecting and combating threats like the coronavirus failed to prepare quickly enough. Even as scientists looked at China and sounded alarms, none of the agencies’ directors conveyed the urgency required to spur a no-holds-barred defense.

Dr. Robert R. Redfield, 68, a former military doctor and prominent AIDS researcher who directs the C.D.C., trusted his veteran scientists to create the world’s most precise test for the coronavirus and share it with state laboratories. When flaws in the test became apparent in February, he promised a quick fix, though it took weeks to settle on a solution.

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Dr. Robert R. Redfield is the head of the C.D.C.. The test his agency developed failed in February.Credit...Anna Moneymaker/The New York Times

The C.D.C. also tightly restricted who could get tested and was slow to conduct “community-based surveillance,” a standard screening practice to detect the virus’s reach. Had the United States been able to track its earliest movements and identify hidden hot spots, local quarantines might have confined the disease.

Dr. Stephen Hahn, 60, the commissioner of the Food and Drug Administration, enforced regulations that paradoxically made it tougher for hospitals, private clinics and companies to deploy diagnostic tests in an emergency. Other countries that had mobilized businesses were testing tens of thousands daily, compared with fewer than 100 on average in the United States, frustrating local health officials, lawmakers and desperate Americans.

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Regulations at the F.D.A., led by Dr. Stephen Hahn, made it difficult for hospitals to test patients at the same rate as in other countries.Credit...Anna Moneymaker/The New York Times

Alex M. Azar II, who led the Department of Health and Human Services, oversaw the two other agencies and coordinated the government’s public health response to the pandemic. While he grew frustrated as public criticism over the testing issues intensified, he was unable to push either agency to speed up or change course.

Mr. Azar, 52, who chaired the coronavirus task force until late February, when Vice President Mike Pence took charge, had been at odds for months with the White House over other issues. The task force’s chief liaison to the president was Mick Mulvaney, the acting White House chief of staff, who was being forced out by Mr. Trump. Without high-level interest — or demands for action — the testing issue festered.

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Under Alex M. Azar II, the health secretary, the C.D.C. and F.D.A. failed to break out of their business-as-usual habits.Credit...Anna Moneymaker/The New York Times

At the start of that crucial lost month, when his government could have rallied, the president was distracted by impeachment and dismissive of the threat to the public’s health or the nation’s economy. By the end of the month, Mr. Trump claimed the virus was about to dissipate in the United States, saying: “It’s going to disappear. One day — it’s like a miracle — it will disappear.”

By early March, after federal officials finally announced changes to allow more expansive testing, it was too late to escape serious harm.

Now, the United States has more than 100,000 coronavirus cases, the most of any country in the world. Yet even with deaths on the rise, cities shuttered, the economy sputtering and everyday life upended, many Americans who come down with symptoms of Covid-19 still cannot get tested.

In a statement, Judd Deere, a White House spokesman, said that “any suggestion that President Trump did not take the threat of Covid-19 seriously or that the United States was not prepared is false.” He added that at Mr. Trump’s direction, the administration had “expanded testing capacities.”

Dr. Bruce Aylward, a senior adviser at the World Health Organization, led an expert team to China last month to research the mysterious new virus. Testing, he said, was “absolutely vital” for understanding how to defeat a disease — what distinguishes it from others, the spectrum of illness and, most important, its path through populations.

“You want to know whether or not you have it,” Dr. Aylward said. “You want to know whether the people around you have it. Because you know what? Then you could stop it.”

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“You can’t stop it,” he warned, “if you can’t see it.”

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Medical workers with a patient in Wuhan, China, in January. The U.S. health secretary would declare a public health emergency at the end of the month.Credit...EPA, via Shutterstock

A Startling Setback

The first time Dr. Robert Redfield heard about the severity of the virus from his Chinese counterparts was around New Year’s Day, when he was on vacation with his family. He spent so much time on the phone that they barely saw him. And what he heard rattled him; in one grim conversation about the virus days later, George F. Gao, the director of the Chinese Center for Disease Control and Prevention, burst into tears.

Dr. Redfield, a longtime AIDS researcher, had never run a government agency before his appointment to lead the C.D.C. in 2018. Until then, his biggest priorities had been fighting the opioid epidemic and the spread of H.I.V. Suddenly, a man who preferred treating patients in Haiti or Africa to being in the public glare was facing a new pandemic threat.

At first, Dr. Redfield’s agency moved quickly.

On Jan. 7, the C.D.C. created an “incident management system” for the coronavirus and advised travelers to Wuhan to take precautions. By Jan. 20, just two weeks after Chinese scientists shared the genetic sequence of the virus, the C.D.C. had developed its own test, as usual, and deployed it to detect the country’s first coronavirus case.

“That’s our prime mission,” Dr. Redfield said later in an interview, “to get eyes on this thing.”

Assessing the virus would prove challenging. It was so new that scientists had little information to work with. China provided limited data, and rebuffed an early attempt by Mr. Azar and Dr. Redfield to send C.D.C. experts there to learn more. That the virus could cause no symptoms and still spread — something not initially known — made it all the more difficult to understand.

To identify the virus, the C.D.C. test used three small genetic sequences to match up with portions of a virus’s genome extracted from a swab. A German-developed test that the W.H.O. was distributing to other countries used just two, potentially making it less precise.

But soon after the F.D.A. cleared the C.D.C. to share its test kits with state health department labs, some discovered a problem. The third sequence, or “probe,” gave inconclusive results. While the C.D.C. explored the cause — contamination or a design issue — it told those state labs to stop testing.

The startling setback stalled the C.D.C.’s efforts to track the virus when it mattered most. By mid-February, the nation was testing only about 100 people per day, according to the C.D.C.’s website.

Dr. Redfield played down the problem in task force meetings and conversations with Mr. Azar, assuring him it would be fixed quickly, several administration officials said.

With capacity so limited, the C.D.C.’s criteria for who was tested remained extremely narrow for weeks to come: only people who had recently traveled to China or had been in contact with someone who had the virus.

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The lack of tests in the states also meant local public health officials could not use another essential epidemiological tool: surveillance testing. To see where the virus might be hiding, nasal swab samples from people screened for the common flu would also be checked for the coronavirus.

The C.D.C. announced a plan on Feb. 14 to perform the screening in five high-risk cities: New York, Chicago, Los Angeles, San Francisco and Seattle. An agency official said it could provide “an early warning signal to trigger a change in our response strategy.” But most of the cities could not carry it out.

“Had we had done more testing from the very beginning and caught cases earlier,” said Dr. Nuzzo, of Johns Hopkins, “we would be in a far different place.”

The consequences became clear by the end of February. For the first time, someone with no known exposure to the virus or history of travel tested positive, in the Seattle area, where the U.S.’s first case had been detected more than a month earlier. The virus had probably been spreading there and elsewhere for weeks, researchers later concluded. Without a more complete picture of who had been infected, public health workers could not do “contact tracing” — finding all those with whom any contagious people had interacted and then quarantining them to stop further transmission.

The C.D.C. gave little thought to adopting the test being used by the W.H.O. The C.D.C.’s test was working in its own lab — still processing samples from states — which gave agency officials confidence. Dr. Anne Schuchat, the agency’s principal deputy director, would later say that the C.D.C. did not think “we needed somebody else’s test.”

And the German-designed W.H.O. test had not been through the American regulatory approval process, which would take time.

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Throughout February, Dr. Redfield shuttled between Atlanta, where the C.D.C. is based, and Washington, holding multiple calls every day with Mr. Azar and participating in the coronavirus task force.

Mr. Azar’s take-charge style contrasted with the more deliberative manner of Dr. Redfield, who lacked the kind of commanding television presence that impressed Mr. Trump. He was “a consensus person,” as one colleague described him, who sought to avoid conflict. He relied heavily on some of the C.D.C.’s career scientists, like Dr. Schuchat and Dr. Nancy Messonnier, the director of the agency’s National Center for Immunization and Respiratory Diseases.

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Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, has taken a public role in the crisis.Credit...Amanda Voisard/Reuters

Under scrutiny from Congress, Dr. Redfield offered reassurances. Responding on Feb. 24 to a letter from 49 members of Congress about the need for testing in the states, he wrote, “CDC’s aggressive response enables us to identify potential cases early and make sure that they are properly handled.”

Days later, his agency provided a workaround, telling state and local health department labs that they could finally begin testing. Rather than awaiting replacements, they should use their C.D.C. test kits and leave out the problematic third probe.

Meanwhile, the agency’s epidemiologists were growing more concerned as the virus spread in South Korea and Italy. On Feb. 25, Dr. Messonnier gave a briefing with a much blunter warning than usual. “Disruption to everyday life might be severe,” she said.

Mr. Trump, returning from a trip to India, was furious, according to senior administration officials. Later that day, Mr. Azar seemed to be tamping down the level of concern. All Dr. Messonnier had meant, he said at a news conference, was that people should “start thinking about, in their own lives, what that might involve.”

“Might,” Mr. Azar repeated emphatically. “Might involve.”

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The C.D.C.’s flawed testing kit for the new coronavirus.Credit...Centers for Disease Control and Prevention

Barriers to Testing

Dr. Stephen Hahn’s first day as F.D.A. commissioner came just six weeks before Mr. Azar declared a public health emergency on Jan. 31. A radiation oncologist and researcher who helped turn around MD Anderson in Houston, one of the nation’s leading cancer centers, Dr. Hahn had come to Washington to oversee a sprawling federal agency that regulates everything from lifesaving therapies to dog food.

But overnight, his mission — to manage 15,000 employees in a culture defined by precision and caution — was upended. A pathogen that Mr. Trump would later call the “invisible enemy” was hurtling toward the United States. It would fall to the newly arrived Dr. Hahn to help build a huge national capacity for testing by academic and private labs.

Instead, under his leadership, the F.D.A. became a significant roadblock, according to current and former officials as well as researchers and doctors at laboratories around the country.

Private-sector tests were supposed to be the next tier after the C.D.C. fulfilled its obligation to jump-start screening at public labs. In other countries hit hard by the coronavirus, governments acted quickly to speed tests to their populations. In South Korea, for example, regulators in early February summoned executives from 20 medical manufacturers, easing rules as they demanded tests.

But Dr. Hahn took a cautious approach. He was not proactive in reaching out to manufacturers, and instead deferred to his scientists, following the F.D.A.’s often cumbersome methods for approving medical screening.

Even the nation’s public health labs were looking for the F.D.A.’s help. “We are now many weeks into the response with still no diagnostic or surveillance test available outside of C.D.C. for the vast majority of our member laboratories,” Scott Becker, chief executive of the Association of Public Health Laboratories, wrote to Mr. Hahn in late February. “We believe a more expeditious route is needed at this time.”

Ironically, it was Mr. Azar’s emergency declaration that established the rules Dr. Hahn insisted on following. Designed to make it easier for drugmakers to pursue vaccines and other therapies during a crisis, such a declaration lets the F.D.A. speed approvals that could otherwise take a year or more.

But the emergency announcement created a new barrier for hospitals and laboratories that wanted to create their own tests to diagnose the coronavirus. Usually, they faced minimal federal regulation. But once Mr. Azar took action, they were subject to an F.D.A. process called an “emergency use authorization.”

Even though researchers around the country quickly began creating tests that could diagnose Covid-19, many said they were hindered by the F.D.A.’s approval process. The new tests sat unused at labs around the country.

Stanford was one of them. Researchers at the world-renowned university had a working test by February, based on protocols published by the W.H.O. The organization had already delivered more than 250,000 of the German-designed tests to 70 laboratories around the world, and doctors at the Stanford lab wanted to be prepared for a pandemic.

“Even if it didn’t come, it would be better to be ready than not to be ready,” said Dr. Benjamin Pinsky, the lab’s medical director.

But in the face of what he called “relatively tight” rules at the F.D.A., Dr. Pinsky and his colleagues decided against even trying to win permission. The Stanford clinical lab would not begin testing coronavirus samples until early March, when Dr. Hahn finally relaxed the rules.

Executives at bioMérieux, a French diagnostics company, had a similar experience. The company makes a countertop testing system, BioFire, that is routinely used to check for the flu and other respiratory illnesses in 1,700 hospitals around the country. It can provide results in about 45 minutes.

“A lot of us said, you know, your typical E.U.A. is just much too demanding,” said Dr. Mark Miller, the company’s chief medical officer, referring to the emergency approval. “It’s going to take much too much time. And can’t you do something to shorten that?”

Officials at the F.D.A. tried to be responsive, Dr. Miller said. But rather than throw out the rules, the agency only modified the regulatory requirements, still requiring weeks of discussions and negotiations.

After conversations with the F.D.A. in mid-February, the company received emergency approval for its BioFire test on March 24. (The company also began talking to the F.D.A. in January about another type of test, but decided not to pursue it in the United States for now.) Dr. Miller said that while he was ultimately satisfied with the F.D.A.’s actions, the overall response by the government was too slow, especially when it came to logistical questions like getting enough testing supplies to those who needed them.

“You’ve got other countries — and I’m sorry, unfortunately, the U.S. is one of those — where they’ve been slow, disorganized,” he said. “There are still not enough tests available there to test everybody who needs it.”

In an emailed statement, Dr. Hahn maintained that his agency had moved as quickly as it safely could to ensure that tests would be accurate. “Since the early days of this pandemic,” he said, “the F.D.A.’s doors have always been and still remain open to test developers.”

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Mr. Azar speaking about the public health response in January after five cases were confirmed in the United States.Credit...Samuel Corum/Getty Images

A Lack of Trust

Alex Azar had sounded confident at the end of January. At a news conference in the hulking H.H.S. headquarters in Washington, he said he had the government’s response to the new coronavirus under control, pointing out high-ranking jobs he had held in the department during the 2003 SARS outbreak and other infectious threats.

“I know this playbook well,” he told reporters.

A Yale-trained lawyer who once served as the top attorney at the health department, Mr. Azar had spent a decade as a top executive at Eli Lilly, one of the world’s largest drug companies. But he caught Mr. Trump’s attention in part because of other credentials: After law school, Mr. Azar was a clerk for some of the nation’s most conservative judges, including Justice Antonin Scalia of the Supreme Court. And for two years, he worked as Ken Starr’s deputy on the Clinton Whitewater investigation.

As Mr. Trump’s second health secretary, confirmed at the beginning of 2018, Mr. Azar has been quick to compliment the president and focus on the issues he cares about: lowering drug prices and fighting opioid addiction. On Feb. 6 — even as the W.H.O. announced that there were more than 28,000 coronavirus cases around the globe — Mr. Azar was in the second row in the White House’s East Room, demonstrating his loyalty to the president as Mr. Trump claimed vindication from his impeachment acquittal the day before and lashed out at “evil” lawmakers and the F.B.I.’s “top scum.”

As public attention on the virus threat intensified in January and February, Mr. Azar grew increasingly frustrated about the harsh spotlight on his department and the leaders of agencies who reported to him, according to people familiar with the response to the virus inside the agencies.

Described as a prickly boss by some administration officials, Mr. Azar has had a longstanding feud with Seema Verma, the Medicare and Medicaid chief, who recently became a regular presence at Mr. Trump’s televised briefings on the pandemic. Mr. Azar did not include Dr. Hahn on the virus task force he led, though some of the F.D.A. commissioner’s aides participated in H.H.S. meetings on the subject.

And tensions grew between the secretary and Dr. Redfield as the testing issue persisted. Mr. Azar and Dr. Redfield have been on the phone as often as a half-dozen times a day. But throughout February, as the C.D.C. test faltered, Mr. Azar became convinced that Dr. Redfield’s agency was providing him with inaccurate information about testing that the secretary repeated publicly, according to several administration officials.

In one instance, Mr. Azar appeared on Sunday morning news programs and said that more than 3,600 people had been tested for the virus. In fact, the real number was much smaller because many patients were tested multiple times, an error the C.D.C. had to correct in congressional testimony that week. One health department official said Mr. Azar was repeatedly assured that the C.D.C.’s test would be widely available within a week or 10 days, only to be given the same promise a week later.

Asked about criticism of his agency’s response to the pandemic, Dr. Redfield said: “I’m personally not focused on whether they’re pointing fingers here or there. We’re focused on doing all we can to get through this outbreak as quickly as possible and keep America safe.”

For all Mr. Azar’s complaints, however, he continued to defer to the scientists at the two agencies, according to several administration officials. Mr. Azar’s allies said he was told by Dr. Redfield and Dr. Fauci that the C.D.C. had the resources it needed, that there was no reason to believe the virus was spreading through the country from person to person and that it was important to test only people who met certain criteria.

But even in the face of a crescendo of complaints from doctors and health care researchers around the country, Mr. Azar failed to push those under him to do the one thing that could have helped: broader testing.

In a statement, Caitlin Oakley, Mr. Azar’s spokeswoman, said that the secretary had “empowered and followed the guidance of world-renowned U.S. scientists” on the testing issue. “Any insinuation that Secretary Azar did not respond with needed urgency to the response or testing efforts,” she said, “are just plain wrong and disproven by the facts.”

By Feb. 26, Dr. Fauci was concerned that the stalled testing had become an urgent issue that needed to be addressed. He called Brian Harrison, Mr. Azar’s chief of staff, and asked him to gather the group of officials overseeing screening efforts.

Around noon on Feb. 27, Dr. Hahn, Dr. Redfield and top aides from the F.D.A. and H.H.S. dialed in to a conference call. Mr. Harrison began with an ultimatum: No one leaves until we resolve the lag in testing. We don’t have answers and we need them, one senior administration official recalled him saying. Get it done.

By the end of the day, the group agreed that the F.D.A. should loosen regulations so that hospitals and independent labs could move forward quickly with their own tests.

But the evening before, Mr. Azar had been effectively removed as the leader of the task force when Mr. Trump abruptly put Mr. Pence in charge, a decision so last-minute that even the top health officials in the White House learned of it while watching the announcement.

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President Trump announcing the rollout of additional tests at the C.D.C. in early March.Credit...T.J. Kirkpatrick for The New York Times

A Tacit Acknowledgment

Previous presidents have moved quickly to confront disease threats from inside the White House by installing a “czar” to manage the effort.

During an outbreak of the Ebola virus in 2014, President Barack Obama tapped Ron Klain, his vice president’s former chief of staff, to direct the response from the West Wing. Mr. Obama later created an office of global health security inside the National Security Council to coordinate future crises.

“If you look historically in the United States when it is challenged with something like this — whether it’s H.I.V. crises, whether it’s pandemic, whether it’s whatever — man, they pull out all the stops across the system and they make it work,” said Dr. Aylward, the W.H.O. epidemiologist.

But faced with the coronavirus, Mr. Trump chose not to have the White House lead the planning until nearly two months after it began. Mr. Obama’s global health office had been disbanded a year earlier. And until Mr. Pence took charge, the task force lacked a single White House official with the power to compel action.

Since then, testing has ramped up quickly, with nearly 100 labs at hospitals and elsewhere performing it. On Friday, the health care giant Abbott said it had received emergency approval for a portable test that could detect the virus in five minutes.

The president boasted on Tuesday that the United States had “created a new system that now we are doing unbelievably big numbers” of tests for the virus. The U.S., he said, had done more testing for the coronavirus in the last eight days than South Korea had done in eight weeks.

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Vice President Mike Pence discussing 15-day federal guidelines this month to “slow the spread” of the pandemic.Credit...Doug Mills/The New York Times

Yet hospitals and clinics across the country still must deny tests to those with milder symptoms, trying to save them for the most serious cases, and they often wait a week for results. In tacit acknowledgment of the shortage, Mr. Trump asked South Korea’s president on Monday to send as many test kits as possible from the 100,000 produced there daily, more than the country needs.

Public health experts reacted positively to the increased capacity. But having the ability to diagnose the disease three months after it was first disclosed by China does little to address why the United States was unable to do so sooner, when it might have helped reduce the toll of the pandemic.

“Testing is the crack that split apart the rest of the response, when it should have tied everything together,” said Dr. Nahid Bhadelia, the medical director of the Special Pathogens Unit at Boston University School of Medicine.

“It seeps into every other aspect of our response, touches all of us,” she said. “The delay of the testing has impacted the response across the board.”

Hookah Horns · March 28, 2020

15 hours ago, ndawg said:

This is where you're showing your ass.

JimmyJames engaged in conjecture in the context of grading Trump's leadership. I believe Nick Saban would have won more games in the last five years than Strong / Herman. That's also conjecture. Also fair, if I'm grading our hoad coaches.

You're stuck inside your framing of the discussion that demands an epistemological standard that is utterly irrational given the context. As if there could be no basis for his conjecture except empirical data gathered from an alternate universe where Trump lost in 2016.

The basis for JJ's very valid conjecture is that he hasn't been in a fucking coma for the last three and a half years. I'm beginning to wonder about you.

*choad

TwiceHorn · March 28, 2020

16 minutes ago, Bama Chick said:

But part of the leadership failure is a lot of those long time civil servants have been fired or quit in frustration. And their positions have either gone unfilled or replaced with wholly unqualified Trump cult hacks.

One of the most damaging long term effects of this administration will be the decimation of the rank and file civil service pool and the erasure of the institutional memory of our governmental agencies.

The front line folks can’t sound an alarm when the front line doesn’t exist.

I understand that to be the case with the State Department. Haven't seen anything to so indicate with respect to CDC or FDA.

The article quoted seems to indicate that Messonier was muzzled and Schuchat screwed the pooch, both high level and long term CDC deputies. The FDA director, Hahn, seems to have done most of the pooch-screwing at that agency.

Edited March 28, 2020 by TwiceHorn

Anastasis · March 28, 2020

15 minutes ago, TwiceHorn said:

I understand that to be the case with the State Department. Haven't seen anything to so indicate with respect to CDC or FDA.

The article quoted seems to indicate that Messonier was muzzled and Schuchat screwed the pooch, both high level and long term CDC deputies. The FDA director, Hahn, seems to have done most of the pooch-screwing at that agency.

That article is mind blowing. I'll have to reread it cause there is a lot there and I skimmed, but Azar comes off as totally shitting the bed. I am shocked not one bit that the FDA would put in place counterproductive regulatory hurdles based on SOPs. I am surprised that the CDC botched the test formulation.

Bama Chick · March 28, 2020

Seems relevant to this discussion.

DanTheHorn · March 28, 2020

Quote

Satisfactory - Doing the best he can with limited resources.

I did not expect votes for this one. I expected all Trumpkins to go with excellent so I have to assume these are reasonable people. So the key must be Best He Can or these folks expected less from Hillary. I believe Hillary would have been just as big of a fuck up. She reminds me of the election character hiding her test so no one can cheat. She would have been sharing little useful info instead of stupid info.

Edited March 28, 2020 by DanTheHorn

triplehorn · March 28, 2020

3 minutes ago, Bama Chick said:

Seems relevant to this discussion.

WASHINGTON — Sen. Chris Murphy, a Connecticut Democrat, says that Trump administration officials declined an offer of early congressional funding assistance that he and other senators made on Feb. 5 during a meeting to discuss the coronavirus.

The officials, including Health and Human Services Secretary Alex Azar, said they “didn’t need emergency funding, that they would be able to handle it within existing appropriations,” Murphy recalled in an interview with Yahoo News’ “Skullduggery” podcast.

“What an awful, horrible catastrophic mistake that was,” Murphy said.

On Feb. 5, Murphy tweeted: “Just left the Administration briefing on Coronavirus. Bottom line: they aren't taking this seriously enough. Notably, no request for ANY emergency funding, which is a big mistake. Local health systems need supplies, training, screening staff etc. And they need it now.”

triplehorn · March 28, 2020

Looming accelerant to an already spiraling disaster.

jimmyjazz · March 28, 2020

Up is down, black is white. Welcome to Amerika.

JimmyJames · March 28, 2020

2 hours ago, triplehorn said:

Looming accelerant to an already spiraling disaster.

Well that seems like bad news.

Hate to say it but I was probably right.

Trump’s greatest concern at this moment, is not that the Coronavirus is decimating certain cities, not that it is inevitably spreading throughout the entire country, not that Americans are dying and will die, and not that our health care systems are about to be overwhelmed.

No, his greatest concern is that Dr. Fauci is in his mind upstaging him, making him look bad, and therefore needs to be either removed or at a minimum neutralized.

This is the mind of a severe pathological narcissist. The worst I’ve ever seen. He will destroy this country before he thinks it might destroy him. I say again, he must be removed as the president immediately. I will gladly take Mother Pence in charge over him. At least he’s not a severe case of narcissistic personality disorder hell bent on destroying the country.

triplehorn · March 29, 2020

Trump can only create a show to manipulate and distort, and he knows Fauci's character representing the plain truth to the people doesn't fit his script. Only in this case, his denial of reality to preserve his damaged ego has already directly contributed to the unnecessary and preventable loss of untold thousands of lives. Lives already consigned to premature death from infectious viral pneumonia.

Edited March 29, 2020 by triplehorn

achooloco · March 29, 2020

4 hours ago, Bama Chick said:

Seems relevant to this discussion.

5 hours ago, Anastasis said:

its worth the read so I will add it in tags here directly.

Hide contents

By Michael D. Shear, Abby Goodnough, Sheila Kaplan, Sheri Fink, Katie Thomas and Noah Weiland

March 28, 2020, 1:29 p.m. ET

WASHINGTON — Early on, the dozen federal officials charged with defending America against the coronavirus gathered day after day in the White House Situation Room, consumed by crises. They grappled with how to evacuate the United States consulate in Wuhan, China, ban Chinese travelers and extract Americans from the Diamond Princess and other cruise ships.

The members of the coronavirus task force typically devoted only five or 10 minutes, often at the end of contentious meetings, to talk about testing, several participants recalled. The Centers for Disease Control and Prevention, its leaders assured the others, had developed a diagnostic model that would be rolled out quickly as a first step.

But as the deadly virus from China spread with ferocity across the United States between late January and early March, large-scale testing of people who might have been infected did not happen — because of technical flaws, regulatory hurdles, business-as-usual bureaucracies and lack of leadership at multiple levels, according to interviews with more than 50 current and former public health officials, administration officials, senior scientists and company executives.

The result was a lost month, when the world’s richest country — armed with some of the most highly trained scientists and infectious disease specialists — squandered its best chance of containing the virus’s spread. Instead, Americans were left largely blind to the scale of a looming public health catastrophe.

The absence of robust screening until it was “far too late” revealed failures across the government, said Dr. Thomas Frieden, the former C.D.C. director. Jennifer Nuzzo, an epidemiologist at Johns Hopkins, said the Trump administration had “incredibly limited” views of the pathogen’s potential impact. Dr. Margaret Hamburg, the former commissioner of the Food and Drug Administration, said the lapse enabled “exponential growth of cases.”

And Dr. Anthony S. Fauci, a top government scientist involved in the fight against the virus, told members of Congress that the early inability to test was “a failing” of the administration’s response to a deadly, global pandemic. “Why,” he asked later in a magazine interview, “were we not able to mobilize on a broader scale?”

Across the government, they said, three agencies responsible for detecting and combating threats like the coronavirus failed to prepare quickly enough. Even as scientists looked at China and sounded alarms, none of the agencies’ directors conveyed the urgency required to spur a no-holds-barred defense.

Dr. Robert R. Redfield, 68, a former military doctor and prominent AIDS researcher who directs the C.D.C., trusted his veteran scientists to create the world’s most precise test for the coronavirus and share it with state laboratories. When flaws in the test became apparent in February, he promised a quick fix, though it took weeks to settle on a solution.

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In Praise of a Normal, Boring Country

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Dr. Robert R. Redfield is the head of the C.D.C.. The test his agency developed failed in February.Credit...Anna Moneymaker/The New York Times

The C.D.C. also tightly restricted who could get tested and was slow to conduct “community-based surveillance,” a standard screening practice to detect the virus’s reach. Had the United States been able to track its earliest movements and identify hidden hot spots, local quarantines might have confined the disease.

Dr. Stephen Hahn, 60, the commissioner of the Food and Drug Administration, enforced regulations that paradoxically made it tougher for hospitals, private clinics and companies to deploy diagnostic tests in an emergency. Other countries that had mobilized businesses were testing tens of thousands daily, compared with fewer than 100 on average in the United States, frustrating local health officials, lawmakers and desperate Americans.

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Regulations at the F.D.A., led by Dr. Stephen Hahn, made it difficult for hospitals to test patients at the same rate as in other countries.Credit...Anna Moneymaker/The New York Times

Alex M. Azar II, who led the Department of Health and Human Services, oversaw the two other agencies and coordinated the government’s public health response to the pandemic. While he grew frustrated as public criticism over the testing issues intensified, he was unable to push either agency to speed up or change course.

Mr. Azar, 52, who chaired the coronavirus task force until late February, when Vice President Mike Pence took charge, had been at odds for months with the White House over other issues. The task force’s chief liaison to the president was Mick Mulvaney, the acting White House chief of staff, who was being forced out by Mr. Trump. Without high-level interest — or demands for action — the testing issue festered.

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Under Alex M. Azar II, the health secretary, the C.D.C. and F.D.A. failed to break out of their business-as-usual habits.Credit...Anna Moneymaker/The New York Times

At the start of that crucial lost month, when his government could have rallied, the president was distracted by impeachment and dismissive of the threat to the public’s health or the nation’s economy. By the end of the month, Mr. Trump claimed the virus was about to dissipate in the United States, saying: “It’s going to disappear. One day — it’s like a miracle — it will disappear.”

By early March, after federal officials finally announced changes to allow more expansive testing, it was too late to escape serious harm.

Now, the United States has more than 100,000 coronavirus cases, the most of any country in the world. Yet even with deaths on the rise, cities shuttered, the economy sputtering and everyday life upended, many Americans who come down with symptoms of Covid-19 still cannot get tested.

In a statement, Judd Deere, a White House spokesman, said that “any suggestion that President Trump did not take the threat of Covid-19 seriously or that the United States was not prepared is false.” He added that at Mr. Trump’s direction, the administration had “expanded testing capacities.”

Dr. Bruce Aylward, a senior adviser at the World Health Organization, led an expert team to China last month to research the mysterious new virus. Testing, he said, was “absolutely vital” for understanding how to defeat a disease — what distinguishes it from others, the spectrum of illness and, most important, its path through populations.

“You want to know whether or not you have it,” Dr. Aylward said. “You want to know whether the people around you have it. Because you know what? Then you could stop it.”

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“You can’t stop it,” he warned, “if you can’t see it.”

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Medical workers with a patient in Wuhan, China, in January. The U.S. health secretary would declare a public health emergency at the end of the month.Credit...EPA, via Shutterstock

A Startling Setback

The first time Dr. Robert Redfield heard about the severity of the virus from his Chinese counterparts was around New Year’s Day, when he was on vacation with his family. He spent so much time on the phone that they barely saw him. And what he heard rattled him; in one grim conversation about the virus days later, George F. Gao, the director of the Chinese Center for Disease Control and Prevention, burst into tears.

Dr. Redfield, a longtime AIDS researcher, had never run a government agency before his appointment to lead the C.D.C. in 2018. Until then, his biggest priorities had been fighting the opioid epidemic and the spread of H.I.V. Suddenly, a man who preferred treating patients in Haiti or Africa to being in the public glare was facing a new pandemic threat.

At first, Dr. Redfield’s agency moved quickly.

On Jan. 7, the C.D.C. created an “incident management system” for the coronavirus and advised travelers to Wuhan to take precautions. By Jan. 20, just two weeks after Chinese scientists shared the genetic sequence of the virus, the C.D.C. had developed its own test, as usual, and deployed it to detect the country’s first coronavirus case.

“That’s our prime mission,” Dr. Redfield said later in an interview, “to get eyes on this thing.”

Assessing the virus would prove challenging. It was so new that scientists had little information to work with. China provided limited data, and rebuffed an early attempt by Mr. Azar and Dr. Redfield to send C.D.C. experts there to learn more. That the virus could cause no symptoms and still spread — something not initially known — made it all the more difficult to understand.

To identify the virus, the C.D.C. test used three small genetic sequences to match up with portions of a virus’s genome extracted from a swab. A German-developed test that the W.H.O. was distributing to other countries used just two, potentially making it less precise.

But soon after the F.D.A. cleared the C.D.C. to share its test kits with state health department labs, some discovered a problem. The third sequence, or “probe,” gave inconclusive results. While the C.D.C. explored the cause — contamination or a design issue — it told those state labs to stop testing.

The startling setback stalled the C.D.C.’s efforts to track the virus when it mattered most. By mid-February, the nation was testing only about 100 people per day, according to the C.D.C.’s website.

Dr. Redfield played down the problem in task force meetings and conversations with Mr. Azar, assuring him it would be fixed quickly, several administration officials said.

With capacity so limited, the C.D.C.’s criteria for who was tested remained extremely narrow for weeks to come: only people who had recently traveled to China or had been in contact with someone who had the virus.

A string of critical errors.

The U.S.’s Slow Start to Coronavirus Testing: A Timeline

March 28, 2020

The lack of tests in the states also meant local public health officials could not use another essential epidemiological tool: surveillance testing. To see where the virus might be hiding, nasal swab samples from people screened for the common flu would also be checked for the coronavirus.

The C.D.C. announced a plan on Feb. 14 to perform the screening in five high-risk cities: New York, Chicago, Los Angeles, San Francisco and Seattle. An agency official said it could provide “an early warning signal to trigger a change in our response strategy.” But most of the cities could not carry it out.

“Had we had done more testing from the very beginning and caught cases earlier,” said Dr. Nuzzo, of Johns Hopkins, “we would be in a far different place.”

The consequences became clear by the end of February. For the first time, someone with no known exposure to the virus or history of travel tested positive, in the Seattle area, where the U.S.’s first case had been detected more than a month earlier. The virus had probably been spreading there and elsewhere for weeks, researchers later concluded. Without a more complete picture of who had been infected, public health workers could not do “contact tracing” — finding all those with whom any contagious people had interacted and then quarantining them to stop further transmission.

The C.D.C. gave little thought to adopting the test being used by the W.H.O. The C.D.C.’s test was working in its own lab — still processing samples from states — which gave agency officials confidence. Dr. Anne Schuchat, the agency’s principal deputy director, would later say that the C.D.C. did not think “we needed somebody else’s test.”

And the German-designed W.H.O. test had not been through the American regulatory approval process, which would take time.

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Throughout February, Dr. Redfield shuttled between Atlanta, where the C.D.C. is based, and Washington, holding multiple calls every day with Mr. Azar and participating in the coronavirus task force.

Mr. Azar’s take-charge style contrasted with the more deliberative manner of Dr. Redfield, who lacked the kind of commanding television presence that impressed Mr. Trump. He was “a consensus person,” as one colleague described him, who sought to avoid conflict. He relied heavily on some of the C.D.C.’s career scientists, like Dr. Schuchat and Dr. Nancy Messonnier, the director of the agency’s National Center for Immunization and Respiratory Diseases.

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Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, has taken a public role in the crisis.Credit...Amanda Voisard/Reuters

Under scrutiny from Congress, Dr. Redfield offered reassurances. Responding on Feb. 24 to a letter from 49 members of Congress about the need for testing in the states, he wrote, “CDC’s aggressive response enables us to identify potential cases early and make sure that they are properly handled.”

Days later, his agency provided a workaround, telling state and local health department labs that they could finally begin testing. Rather than awaiting replacements, they should use their C.D.C. test kits and leave out the problematic third probe.

Meanwhile, the agency’s epidemiologists were growing more concerned as the virus spread in South Korea and Italy. On Feb. 25, Dr. Messonnier gave a briefing with a much blunter warning than usual. “Disruption to everyday life might be severe,” she said.

Mr. Trump, returning from a trip to India, was furious, according to senior administration officials. Later that day, Mr. Azar seemed to be tamping down the level of concern. All Dr. Messonnier had meant, he said at a news conference, was that people should “start thinking about, in their own lives, what that might involve.”

“Might,” Mr. Azar repeated emphatically. “Might involve.”

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The C.D.C.’s flawed testing kit for the new coronavirus.Credit...Centers for Disease Control and Prevention

Barriers to Testing

Dr. Stephen Hahn’s first day as F.D.A. commissioner came just six weeks before Mr. Azar declared a public health emergency on Jan. 31. A radiation oncologist and researcher who helped turn around MD Anderson in Houston, one of the nation’s leading cancer centers, Dr. Hahn had come to Washington to oversee a sprawling federal agency that regulates everything from lifesaving therapies to dog food.

But overnight, his mission — to manage 15,000 employees in a culture defined by precision and caution — was upended. A pathogen that Mr. Trump would later call the “invisible enemy” was hurtling toward the United States. It would fall to the newly arrived Dr. Hahn to help build a huge national capacity for testing by academic and private labs.

Instead, under his leadership, the F.D.A. became a significant roadblock, according to current and former officials as well as researchers and doctors at laboratories around the country.

Private-sector tests were supposed to be the next tier after the C.D.C. fulfilled its obligation to jump-start screening at public labs. In other countries hit hard by the coronavirus, governments acted quickly to speed tests to their populations. In South Korea, for example, regulators in early February summoned executives from 20 medical manufacturers, easing rules as they demanded tests.

But Dr. Hahn took a cautious approach. He was not proactive in reaching out to manufacturers, and instead deferred to his scientists, following the F.D.A.’s often cumbersome methods for approving medical screening.

Even the nation’s public health labs were looking for the F.D.A.’s help. “We are now many weeks into the response with still no diagnostic or surveillance test available outside of C.D.C. for the vast majority of our member laboratories,” Scott Becker, chief executive of the Association of Public Health Laboratories, wrote to Mr. Hahn in late February. “We believe a more expeditious route is needed at this time.”

Ironically, it was Mr. Azar’s emergency declaration that established the rules Dr. Hahn insisted on following. Designed to make it easier for drugmakers to pursue vaccines and other therapies during a crisis, such a declaration lets the F.D.A. speed approvals that could otherwise take a year or more.

But the emergency announcement created a new barrier for hospitals and laboratories that wanted to create their own tests to diagnose the coronavirus. Usually, they faced minimal federal regulation. But once Mr. Azar took action, they were subject to an F.D.A. process called an “emergency use authorization.”

Even though researchers around the country quickly began creating tests that could diagnose Covid-19, many said they were hindered by the F.D.A.’s approval process. The new tests sat unused at labs around the country.

Stanford was one of them. Researchers at the world-renowned university had a working test by February, based on protocols published by the W.H.O. The organization had already delivered more than 250,000 of the German-designed tests to 70 laboratories around the world, and doctors at the Stanford lab wanted to be prepared for a pandemic.

“Even if it didn’t come, it would be better to be ready than not to be ready,” said Dr. Benjamin Pinsky, the lab’s medical director.

But in the face of what he called “relatively tight” rules at the F.D.A., Dr. Pinsky and his colleagues decided against even trying to win permission. The Stanford clinical lab would not begin testing coronavirus samples until early March, when Dr. Hahn finally relaxed the rules.

Executives at bioMérieux, a French diagnostics company, had a similar experience. The company makes a countertop testing system, BioFire, that is routinely used to check for the flu and other respiratory illnesses in 1,700 hospitals around the country. It can provide results in about 45 minutes.

“A lot of us said, you know, your typical E.U.A. is just much too demanding,” said Dr. Mark Miller, the company’s chief medical officer, referring to the emergency approval. “It’s going to take much too much time. And can’t you do something to shorten that?”

Officials at the F.D.A. tried to be responsive, Dr. Miller said. But rather than throw out the rules, the agency only modified the regulatory requirements, still requiring weeks of discussions and negotiations.

After conversations with the F.D.A. in mid-February, the company received emergency approval for its BioFire test on March 24. (The company also began talking to the F.D.A. in January about another type of test, but decided not to pursue it in the United States for now.) Dr. Miller said that while he was ultimately satisfied with the F.D.A.’s actions, the overall response by the government was too slow, especially when it came to logistical questions like getting enough testing supplies to those who needed them.

“You’ve got other countries — and I’m sorry, unfortunately, the U.S. is one of those — where they’ve been slow, disorganized,” he said. “There are still not enough tests available there to test everybody who needs it.”

In an emailed statement, Dr. Hahn maintained that his agency had moved as quickly as it safely could to ensure that tests would be accurate. “Since the early days of this pandemic,” he said, “the F.D.A.’s doors have always been and still remain open to test developers.”

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Mr. Azar speaking about the public health response in January after five cases were confirmed in the United States.Credit...Samuel Corum/Getty Images

A Lack of Trust

Alex Azar had sounded confident at the end of January. At a news conference in the hulking H.H.S. headquarters in Washington, he said he had the government’s response to the new coronavirus under control, pointing out high-ranking jobs he had held in the department during the 2003 SARS outbreak and other infectious threats.

“I know this playbook well,” he told reporters.

A Yale-trained lawyer who once served as the top attorney at the health department, Mr. Azar had spent a decade as a top executive at Eli Lilly, one of the world’s largest drug companies. But he caught Mr. Trump’s attention in part because of other credentials: After law school, Mr. Azar was a clerk for some of the nation’s most conservative judges, including Justice Antonin Scalia of the Supreme Court. And for two years, he worked as Ken Starr’s deputy on the Clinton Whitewater investigation.

As Mr. Trump’s second health secretary, confirmed at the beginning of 2018, Mr. Azar has been quick to compliment the president and focus on the issues he cares about: lowering drug prices and fighting opioid addiction. On Feb. 6 — even as the W.H.O. announced that there were more than 28,000 coronavirus cases around the globe — Mr. Azar was in the second row in the White House’s East Room, demonstrating his loyalty to the president as Mr. Trump claimed vindication from his impeachment acquittal the day before and lashed out at “evil” lawmakers and the F.B.I.’s “top scum.”

As public attention on the virus threat intensified in January and February, Mr. Azar grew increasingly frustrated about the harsh spotlight on his department and the leaders of agencies who reported to him, according to people familiar with the response to the virus inside the agencies.

Described as a prickly boss by some administration officials, Mr. Azar has had a longstanding feud with Seema Verma, the Medicare and Medicaid chief, who recently became a regular presence at Mr. Trump’s televised briefings on the pandemic. Mr. Azar did not include Dr. Hahn on the virus task force he led, though some of the F.D.A. commissioner’s aides participated in H.H.S. meetings on the subject.

And tensions grew between the secretary and Dr. Redfield as the testing issue persisted. Mr. Azar and Dr. Redfield have been on the phone as often as a half-dozen times a day. But throughout February, as the C.D.C. test faltered, Mr. Azar became convinced that Dr. Redfield’s agency was providing him with inaccurate information about testing that the secretary repeated publicly, according to several administration officials.

In one instance, Mr. Azar appeared on Sunday morning news programs and said that more than 3,600 people had been tested for the virus. In fact, the real number was much smaller because many patients were tested multiple times, an error the C.D.C. had to correct in congressional testimony that week. One health department official said Mr. Azar was repeatedly assured that the C.D.C.’s test would be widely available within a week or 10 days, only to be given the same promise a week later.

Asked about criticism of his agency’s response to the pandemic, Dr. Redfield said: “I’m personally not focused on whether they’re pointing fingers here or there. We’re focused on doing all we can to get through this outbreak as quickly as possible and keep America safe.”

For all Mr. Azar’s complaints, however, he continued to defer to the scientists at the two agencies, according to several administration officials. Mr. Azar’s allies said he was told by Dr. Redfield and Dr. Fauci that the C.D.C. had the resources it needed, that there was no reason to believe the virus was spreading through the country from person to person and that it was important to test only people who met certain criteria.

But even in the face of a crescendo of complaints from doctors and health care researchers around the country, Mr. Azar failed to push those under him to do the one thing that could have helped: broader testing.

In a statement, Caitlin Oakley, Mr. Azar’s spokeswoman, said that the secretary had “empowered and followed the guidance of world-renowned U.S. scientists” on the testing issue. “Any insinuation that Secretary Azar did not respond with needed urgency to the response or testing efforts,” she said, “are just plain wrong and disproven by the facts.”

By Feb. 26, Dr. Fauci was concerned that the stalled testing had become an urgent issue that needed to be addressed. He called Brian Harrison, Mr. Azar’s chief of staff, and asked him to gather the group of officials overseeing screening efforts.

Around noon on Feb. 27, Dr. Hahn, Dr. Redfield and top aides from the F.D.A. and H.H.S. dialed in to a conference call. Mr. Harrison began with an ultimatum: No one leaves until we resolve the lag in testing. We don’t have answers and we need them, one senior administration official recalled him saying. Get it done.

By the end of the day, the group agreed that the F.D.A. should loosen regulations so that hospitals and independent labs could move forward quickly with their own tests.

But the evening before, Mr. Azar had been effectively removed as the leader of the task force when Mr. Trump abruptly put Mr. Pence in charge, a decision so last-minute that even the top health officials in the White House learned of it while watching the announcement.

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President Trump announcing the rollout of additional tests at the C.D.C. in early March.Credit...T.J. Kirkpatrick for The New York Times

A Tacit Acknowledgment

Previous presidents have moved quickly to confront disease threats from inside the White House by installing a “czar” to manage the effort.

During an outbreak of the Ebola virus in 2014, President Barack Obama tapped Ron Klain, his vice president’s former chief of staff, to direct the response from the West Wing. Mr. Obama later created an office of global health security inside the National Security Council to coordinate future crises.

“If you look historically in the United States when it is challenged with something like this — whether it’s H.I.V. crises, whether it’s pandemic, whether it’s whatever — man, they pull out all the stops across the system and they make it work,” said Dr. Aylward, the W.H.O. epidemiologist.

But faced with the coronavirus, Mr. Trump chose not to have the White House lead the planning until nearly two months after it began. Mr. Obama’s global health office had been disbanded a year earlier. And until Mr. Pence took charge, the task force lacked a single White House official with the power to compel action.

Since then, testing has ramped up quickly, with nearly 100 labs at hospitals and elsewhere performing it. On Friday, the health care giant Abbott said it had received emergency approval for a portable test that could detect the virus in five minutes.

The president boasted on Tuesday that the United States had “created a new system that now we are doing unbelievably big numbers” of tests for the virus. The U.S., he said, had done more testing for the coronavirus in the last eight days than South Korea had done in eight weeks.

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Vice President Mike Pence discussing 15-day federal guidelines this month to “slow the spread” of the pandemic.Credit...Doug Mills/The New York Times

Yet hospitals and clinics across the country still must deny tests to those with milder symptoms, trying to save them for the most serious cases, and they often wait a week for results. In tacit acknowledgment of the shortage, Mr. Trump asked South Korea’s president on Monday to send as many test kits as possible from the 100,000 produced there daily, more than the country needs.

Public health experts reacted positively to the increased capacity. But having the ability to diagnose the disease three months after it was first disclosed by China does little to address why the United States was unable to do so sooner, when it might have helped reduce the toll of the pandemic.

“Testing is the crack that split apart the rest of the response, when it should have tied everything together,” said Dr. Nahid Bhadelia, the medical director of the Special Pathogens Unit at Boston University School of Medicine.

“It seeps into every other aspect of our response, touches all of us,” she said. “The delay of the testing has impacted the response across the board.”

@leaf @Xcalibur @zork @Hpara759

Helobious · March 29, 2020

I really, really thought he was going to go fully into the “it’s no threat, life will go on as normal” direction he stated when this first broke out. I thought we were headed for unmitigated disaster. Now we’re just headed for slightly mitigated disaster. I do applaud him for his change of tone, however brief it may last. Seriously.

henrygandorf · March 29, 2020

1 hour ago, JimmyJames said:

This is the mind of a severe pathological narcissist. The worst I’ve ever seen. He will destroy this country before he thinks it might destroy him. I say again, he must be removed as the president immediately. I will gladly take Mother Pence in charge over him. At least he’s not a severe case of narcissistic personality disorder hell bent on destroying the country.

i can't remember the exact timeline, i mean shit, it's been nearly a month. but at the beginning, weren't the first couple of pressers mostly just pence + medical experts? it wasn't right at the beginning where trump was front and center (maybe i'm remembering it wrong).

there was a tweet or something joking about this, that said, "trump made pence the coronavirus czar...until he realized that meant he would be on tv more than him, so then he changed his mind."

i go back and forth on whether cnn, et al should even be airing these. i don't like the open mic/rally versions. but then again, i feel like if people get to watch him, they'll get a daily reminder what a clueless buffoon he is. the press needs to push him, agitate, irritate, for the good of the country.

Horn Dogg · March 29, 2020

F fucking minus!!!!!!

TwiceHorn · March 29, 2020

8 hours ago, jimmyjazz said:

Why was Trump's FDA so incapable of getting EUAs out in short order, as the article indicates used to be the case? Did something change under Trump, or was this inertia part of his complaint about what he inherited from Obama?

Never mind the fact that we're 3 years into his administration and it's fault for not fixing whatever needed fixing . . .

I don't really understand it, but apparently the EUA process initially delayed things. It appears that the EUA process had to be modified to actually speed things up.

In February 2020, FDA issued an Immediately in Effect Guidance on policy for diagnostics testing in laboratories certified to perform high complexity testing under CLIA prior to Emergency Use Authorization for Coronavirus Disease-2019 during the public health emergency. For more information, please see the March 6, 2020, Federal Register notice.

Edited March 29, 2020 by TwiceHorn

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