Trump has 'blood on his hands' as US reflects on missteps of Covid-19 response - health expert

[beijingwalker]

Trump has 'blood on his hands' as US reflects on missteps of Covid-19 response - health expert
9:35AM • SOURCE: ASSOCIATED PRESS
A president who downplayed the coronavirus threat, scorned masks and undercut scientists at every turn. Governors who resisted or rolled back containment measures amid public backlash. State lawmakers who used federal Covid-19 aid to plug budget holes instead of beefing up testing and contact tracing.


As a powerful new wave of infections sweeps the US just ahead of Election Day, the nation's handling of the nearly eight-month-old crisis has been marked by what health experts see as grave missteps, wasted time and squandered opportunities by leaders at all levels of government.

The result: The country could be looking at a terrible winter.

"The inconsistency of the response is what's been so frustrating," said Dr Irwin Redlener of the National Center for Disaster Preparedness at Columbia University.
"If we had just been disciplined about employing all these public health methods early and aggressively, we would not be in the situation we are in now."
Though Redlener sees some of the new wave as inevitable, he estimates at least 130,000 of the nation's more than 227,000 deaths could have been avoided had the country more widely embraced masks and social distancing.

Even if a Chinese-style lockdown wasn't possible, Redlener said, a more modest approach like Canada's, with a strong central message of caution in reopening and widespread mask-wearing and distancing, would have saved lives over the state-by-state and widely partisan approach.

Now the US is seeing cases spike, especially in the Midwest and the Plains, with the country posting a record high number of new infections last week of nearly a half-million.

Dr Anthony Fauci, the nation's top infectious-disease expert, likewise pointed to states' varied responses to reopening for the rocketing case numbers.
"It was like a free-for-all," Fauci said in an online forum yesterday.

The handling of the crisis has emerged as a central issue in the race between President Donald Trump and Democrat Joe Biden.
Trump has mocked Biden's mask-wearing and repeatedly assured the country that it is "rounding the corner" on the outbreak.


Biden has hammered the president for downplaying the virus and undermining scientists.

Governors in many of the hard-hit states have been under fierce political pressure that has made it difficult to enact the kind of measures public health officials say are necessary to stop the spread of the virus and keep hospitals from being overwhelmed.

In the early days of the outbreak, governors were nearly universal in enacting aggressive restrictions to try to flatten the curve. But they quickly faced backlash from residents who were irate over the economic devastation and what they saw as an infringement on their constitutional freedoms.

At the same time, many states were snapping up millions of doses of hydroxychloroquine, the anti-malaria drug that Trump touted as a remedy but was later dropped by the Food and Drug Administration as a Covid-19 treatment.

Utah alone spent US$800,000 (NZ$1.2 million) to build up its stockpile of the drug.

States also started receiving a flood of federal dollars from the CARES Act, in part to help local governments deal with Covid-19. But many states have been criticised for spending the money on efforts completely unrelated to public health, like the US$16 million (NZ$24 million) North Dakota is doling out to support fracking at a time the state has become one of the worst hot spots for the virus.

Meanwhile, Iowa has spent millions on information technology projects in state agencies.

In Utah, state epidemiologist Angela Dunn called for restrictions to be reinstated in June to avoid overwhelming hospitals, warning: "This might be our last chance for course correction."

Republican Governor Gary Herbert did not heed the advice and refused to impose a statewide mask requirement.

Utah's hospitals are now treating more Covid-19 patients than ever before even as the state remains open for business, most high school students are attending class in person, and football and other sports have gone on.

"This response to this third wave has been very half-hearted," said Dr Andrew Pavia, chief of pediatric infectious disease at University of Utah Health in Salt Lake City.
"Everyone in health care from the ED tech to the ICU doc is just really going: 'C'mon, people, help us out here.' The frustration, the fatigue, the disappointment is really palpable."

In neighboring Idaho, Republican Governor Brad Little has also resisted a mask mandate even as hospitals are in a crisis and having to airlift patients to Seattle and other locations.


As Little added small restrictions this week such as limits on crowd sizes, his lieutenant governor and a few GOP lawmakers released a video denouncing such measures as unconstitutional.

"This pandemic has been more politicised than any pandemic I've ever experienced or worked on or studied, and that's a lot of pandemics," said Dr Howard Markel, a public health historian at the University of Michigan.

While some of the blame goes to local leaders and their supporters, Markel said a large share belongs to Trump and other administration officials who have not supported governors taking tougher steps, have undercut and insulted infectious-disease experts, and have themselves refused to wear masks.

"That sets an example, whether you recognise it or not," he said.

Redlener, too, questioned how it was that Trump "didn't understand how many people followed his advice" and said the president has "blood on his hands".
Cooler weather driving more people indoors where the virus is more easily spread are now combining with fatigue and anger over virus restrictions for a dangerous new stage.

"When you put those three together, we shouldn't be surprised what we're seeing," said Michael Osterholm, a University of Minnesota expert on infectious diseases and pandemic preparations.

Some of the same factors are playing out in Europe, which is also seeing a surge.

"We lost control of the epidemic," Dr Eric Caumes, head of infectious and tropical diseases at Paris' Pitie-Salpetriere Hospital, told broadcaster Franceinfo.


Though infections rose in France over the summer, the government didn't impose additional restrictions, encouraging people to return to work and school.
Italy, the one-time European epicenter of the pandemic, has seen days of protests over new restrictions that have forced bars and restaurants to close at 6 pm, shuttered theaters, gyms and pools, and required high school students to transition to 75 per cent distance learning.

Italy is averaging over 20,000 cases a day, and hospital Covid-19 wards are filling up.


At Rome's Gemelli hospital, few beds remain in the intensive care unit, while one of the country's leading virologists, Andrea Crisanti, has blistered the government's response to the surge.

He said he submitted a proposal August 20 calling for ramped-up testing and never got a response.

"Three months later they're passing new decrees," he wrote in an essay published by the Lettera 150 online think tank.

"They continue in the error of not asking themselves how, once the contagion levels are reduced via progressively more restrictive measures, they're going to keep them low."

In Britain, the government has tried to strike a balance between saving lives and protecting the economy - and has been widely accused of getting it wrong on both fronts.

Britain has Europe's highest coronavirus death toll, at more than 45,000, and one of its deepest economic slumps.

After locking down the country in March, Prime Minister Boris Johnson eased restrictions in June. By August, the government encouraged people back into restaurants with an "Eat Out to Help Out" discount scheme.

When a new surge came, the government clamped down again.

Trump has 'blood on his hands' as US reflects on missteps of Covid-19 response - health expert

At least 130,000 US deaths from Covid-19 could have been avoided if the country embraced masks and social distancing, one academic says.

www.tvnz.co.nz

 

[beijingwalker]

'There's no way to sugarcoat it': COVID-19 cases are surging; one American dies every 107 seconds
John Bacon
USA TODAY

Oct. 30, 2020


The U.S. set a record this week for new coronavirus cases over a seven-day period with more than 500,000 infections. An American is testing positive every 1.2 seconds.

Daily deaths are also climbing – one of us is dying every 107 seconds, according to Johns Hopkins data.

And daily hospitalizations have been rising steadily for more than a month, from 28,608 on Sept. 20 to more than 44,000 on Tuesday.

"There's no way to sugarcoat it: We are facing an urgent crisis, and there is an imminent risk to you, your family members, your friends, your neighbors and the people you care about," said Wisconsin Gov. Tony Evers, whose state is seeing one of the nation's worst outbreaks.

As winter approaches, America is facing a crucial fork in the road, said Melissa Nolan, an infectious disease expert and professor at the University of South Carolina.


"We might see a larger surge due to the pandemic fatigue Americans are experiencing," Nolan told USA TODAY. "Americans are tired of adhering to public health guidelines and getting tested."

She repeated the familiar plea of public health experts: Masks. Social distancing. Hand washing. Risk mitigation strategies until a vaccine is developed.

While the White House’s science policy office ranked “ending the Covid-19 pandemic” among President Donald Trump's top achievements, the world isn't buying in. Stock markets around the globe fell sharply Wednesday amid investor fears that global lockdowns are once again on the horizon.

"We're well behind this virus," Dr. Mike Ryan, executive director of the World Health Organization's emergencies program, said this week. "We will have to get ahead of this virus, and that may require sacrifice for many, many people in terms of their personal lives."



Some suggest a national lockdown might allow a “reset” for states more severely affected to reduce their spiraling numbers, but that is unlikely to happen given the political climate, most experts agree.

"A national mandate from the federal government for universal masking is more likely to achieve the greatest impact to reduce deaths in the next several months," said Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City.

That's not very likely either, however.

Meanwhile, states like Wisconsin suffer. State officials there are urging residents to stay home and avoid social gatherings – despite a series of legal challenges that have frustrated efforts by Evers to order restrictions.


"It's a nightmare scenario, frankly, that this could get quite a bit worse in the next several weeks or months before it gets better," said Ryan Westergaard, chief medical officer for the Wisconsin Department of Health Services.

Experts say at least one vaccine candidate could win FDA approval by year's end. But that could just be the beginning of questions related to vaccinating a nation of more than 300 million people. And a world of more than 7 billion people.


Nolan warns that until it becomes clear what type of vaccine clears FDA guidelines for mass distribution, it won't be clear what problems the nation faces in getting it to the public. For example, some vaccines require refrigeration – and, because this is how the world works in 2020, it turns out we are nearing a national shortage of clinical laboratory refrigerators.

We still don't know how well any vaccines actually will work. And even if they do work, Americans must be convinced it is safe and effective before they line up to get the shot.


Once the vaccine is available, "uptake issues" must be overcome, said Ogbonnaya Omenka, an associate professor and public health specialist at Butler University. Will the vaccine be mandatory or optional? And if mandatory, how will it be enforced "in view of the clash between individual liberty and public health?"

Also, there are questions of prioritization: figuring out who should get the vaccine first because there won't be enough to go around for some time. Young, healthy people would seem to be last in line, but what effect will that have on in-classroom learning for students?

There is also evidence that vaccine hesitancy may be higher in minority communities, the communities that have been hit the hardest by the pandemic, said Dr. Anuj Mehta, a pulmonary and critical care physician at National Jewish Health in Denver.

"Convincing people that a vaccine is a safe and effective will be a critical part of widespread dissemination," Mehta said.


"We're rounding the turn," the president said at recent campaign stop. "We're doing great. Our numbers are incredible."

Trump points to daily death totals, which, while rising, have not reached numbers seen in April, when thousands of Americans died each day. Glatter said deaths have not reached those numbers during this surge because of increased testing, more judicious use of intubation and noninvasive forms of ventilation, and use of steroids and the medication remdesivir when indicated.

'There's no way to sugarcoat it': COVID-19 cases are surging; one American dies every 107 seconds

The U.S. set a record this week for new coronavirus cases over a seven-day period with more than 500,000 infections

www.usatoday.com