A high-ranking federal official in late February warned that the United States needed to plan for not having enough personal protective equipment for medical workers as they began to battle the novel coronavirus, according to internal emails obtained by Kaiser Health News.
The messages provide a sharp contrast to President Donald Trump’s statements at the time that the threat the coronavirus posed to the American public remained “very low.” In fact, concerns were already mounting, the emails show, that medical workers and first responders would not have enough masks, gloves, face shields and other supplies, known as PPE, to protect themselves against infection when treating COVID-19 patients.
The emails, part of a lengthy chain titled “Red Dawn Breaking Bad,” includes senior officials across the Department of Veterans Affairs, the State Department, the Department of Homeland Security and the Department of Health and Human Services, as well as outside academics and some state health officials. KHN obtained the correspondence through a public records request in King County, Washington, where officials struggled as the virus set upon a nursing home in the Seattle area, eventually killing 37 people. It was the scene of the first major outbreak in the nation.
“We should plan assuming we won’t have enough PPE — so need to change the battlefield and how we envision or even define the front lines,” Dr. Carter Mecher, a physician and senior medical adviser at the Department of Veterans Affairs, wrote on Feb. 25. It would be weeks before front-line health workers would take to social media with the hashtag #GetMePPE and before health systems would appeal to the public to donate protective gear.
In the email, Mecher said confirmed-positive patients should be categorized under two groups with different care models for each: those with mild symptoms should be encouraged to stay home under self-isolation, while more serious patients should go to hospital emergency rooms.
“The demand is rising and there is no guarantee that we can continue with the supply since the supply-chain has been disrupted,” Eva Lee, director of the Center for Operations Research in Medicine and HealthCare at Georgia Tech and a former health scientist at the Atlanta VA Medical Center, wrote that same day citing shortages of personal protective equipment and medical supplies. “I do not know if we have enough resources to protect all frontline providers.”
Reached on Saturday, Lee said she isn’t sure who saw the message trail but “what I want is that we take action because at the end of the day we need to save patients and health care workers.”
Mecher, also reached Saturday, said the emails were an “an informal group of us who have known each other for years exchanging information.” He said concerns aired at the time on medical protective gear were top of mind for most people in health care. More than 35 people were on the email chain, many of them high-ranking government officials.
The same day Mecher and others raised the concern in the messages, Trump made remarks to a business roundtable group in New Delhi, India.
“We think we’re in very good shape in the United States,” he said, noting that the U.S. closed the borders to some areas. “Let’s just say we’re fortunate so far. And we think it’s going to remain that way.”
The White House declined to comment. In a statement, VA press secretary Christina Mandreucci said, “All VA facilities are equipped with essential items and supplies to handle additional coronavirus cases, and the department is continually monitoring the status of those items to ensure a robust supply chain.”
Doctors and other front-line medical workers in the weeks since have escalated concerns about shortages of medical gear, voicing alarm about the need to protect themselves, their families and patients against COVID-19, which as of Saturday evening had sickened more than 121,000 in the United States and killed at least 2,000.
As Mecher and others sent emails about growing PPE concerns, HHS Secretary Alex Azar testified to lawmakers that the U.S. had 30 million N95 respirator masks stockpiled but needed 300 million to combat the outbreak. Some senior U.S. government officials were also warning the public to not buy masks for themselves to conserve the supply for health care providers.
U.S. Surgeon General Jerome Adams tweeted on Feb. 29: “Seriously people – STOP BUYING MASKS! They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!”
Still, on Feb. 27, the FDA in a statement said that officials were not aware of widespread shortages of equipment.
“We are aware of reports from CDC and other U.S. partners of increased ordering of a range of human medical products through distributors as some healthcare facilities in the U.S. are preparing for potential needs if the outbreak becomes severe,” the agency said.
Simultaneously, Trump downplayed the risk of the novel coronavirus to the American public even though the Centers for Disease Control and Prevention was warning it was only a matter of time before it would spread across the country. On Feb. 29, the CDC also updated its strategies for health workers to optimize supplies of N95 masks.
An HHS spokesperson said Saturday the department has been in “an all-out effort to mobilize America’s capacity” for personal protective equipment and other supplies, including allowing the use of industrial N95 respirators in health care settings and awarding contracts to several private manufacturers to buy roughly 600 million masks over the next 18 months.
“Health care supply chains are private-sector-driven,” the spokesperson said. “The federal role is to support that work, coordinate information across the industry and with state or local agencies if needed during emergencies, and drive manufacturing demand as best we can.”
The emails from King County officials and others in Washington state also show growing concern about the exposure of health care workers to the virus, as well as a view into local officials’ attempts to get help from the CDC.
In one instance, local medical leaders were alarmed that paramedics and other emergency personnel were possibly exposed after encountering confirmed-positive patients at the Life Care Center of Kirkland, the Seattle-area nursing home where roughly three dozen people have died because of the virus.
“We are having a very serious challenge related to hospital exposures and impact on the health care system,” Dr. Jeff Duchin, the public health officer for Seattle and King County, wrote in a different email to CDC officials March 1. Duchin pleaded for a field team to test exposed health care workers and additional support.
Duchin’s email came hours after a physician at UW Medicine wrote about being “very concerned” about exposed workers at multiple hospitals and their attempts to isolate infected workers.
“I suspect that we will not be able to follow current CDC [recommendations] for exposed HCWs [health care workers] either,” wrote Dr. John Lynch, medical director of employee health for Harborview Medical Center and associate professor of Medicine and Allergy and Infectious Diseases at the University of Washington. “As you migh [sic] imagine, I am very concerned about the hospitals at this point.”
Those concerns have been underscored with an unusual weekend statement from Dr. Patrice Harris, president of the American Medical Association, which represents doctors, calling on Saturday for more coordination of needed medical supplies.
“At this critical moment, a unified effort is urgently needed to identify gaps in the supply of and lack of access to PPE necessary to fight COVID-19,” the statement says. “Physicians stand ready to provide urgent medical care on the front lines in a pandemic crisis. But their need for protective gear is equally urgent and necessary.”
Image via Shutterstock
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After Declaring Churches ‘Essential’ and Ordering States to Let Them Reopen Trump Spends Sunday at His Golf Club
Despite having no constitutional authority to do so President Donald Trump on Friday ordered the nation’s governors to allow churches and all houses of worship to reopen “right away.” He threatened to “override” any governor who did not. To support his actions he declared churches “essential.”
On Sunday President Trump headed to the Trump National Golf Club in Sterling, Virginia, according to press pool reports.
About 100,000 people in America have died from the coronavirus.
Sunday’s golf outing follows Trump spending several hours on the links on Saturday, the first time he’s golfed in 76 days.
Scenes from the president’s return to golf for the first time in 76 days. Coverage using long lens with the president and security aware of the camera. Watch here. pic.twitter.com/KjeRbkyyDu
— Kelly O’Donnell (@KellyO) May 23, 2020
Several protesters on Sunday stood outside the entrance to Trump’s club resort.
“I care do you, 100,000 dead,” one protestor’s sign read.
GOP Sees President’s ‘Re-Election Less Certain’ Now That Voters Have Seen the Real Trump: Report
According to a report from the Washington Post, Donald Trump, who had hoped to run a campaign on a strong economy before his botching of the coronavirus pandemic led to almost 40 million job losses, is now looking at running a campaign similar to 2016 that was described as “disruptive.”
The Post notes, “Trump’s moves in recent days make clear that the president has decided to revive the disruptive themes of his 2016 bid, aimed at branding his opponent as a corrupt member of the Washington establishment and himself as an insurgent problem-solver. It’s a message that often has seemed incongruent with the present reality as Trump leads the federal government’s response to the worst crisis in a generation,” however, “Trump’s reluctance to recalibrate his political tactics even as the country faces twin health and economic crises could be the gamble that determines his fate in an election less than six months away, according to campaign officials, strategists and pollsters on both sides of the aisle. The approach also stands as a test of whether running again as a disrupter can work in a time of already profound disruption.”
The problem for Trump this go-around is that the public has watched his performance over the past three and a half years, and what was sold in 2016, may not work this time.
“[Joe Biden pollster John] Anzalone pointed to public polling indicating that Trump’s handling of the coronavirus has cost him significantly with voters, who give the president low marks for his stewardship. Biden has gained ground with suburban voters, independent voters and senior citizens, groups that had previously leaned toward Trump but have drifted away during his presidency, Anzalone said,” the Post reports.
The report notes that the pollster explained that, “… some voters who cast their ballot for a ‘hypothetical Trump’ in 2016 have been disappointed with the real version and will be prime targets for Biden in the coming months. He pointed to senior voters, who have had some of the most dramatic swings away from Trump toward Biden in recent polls.”
“It’s different than voting on the hypothetical Trump — someone who’s going disrupt things and be a change agent,” he elaborated. “That hasn’t gone very well for him, and it is perceived by voters that it hasn’t gone very well for him.”
Republican insiders agree, saying Trump faces an uphill battle as the November election nears.
“Some Republicans acknowledge that the political landscape has changed since 2016, making Trump’s pathway to reelection less certain,” the Post notes. “Mark Jefferson, executive director of the Wisconsin Republican Party, said Trump’s support is stronger with rural voters than it was in 2016, but ‘we’ve still got work to do in suburban parts of the state.’”
Also hindering the President’s 2020 re-election bid is his inability to hold his widely-covered MAGA rallies.
“The campaign has not had discussions with the state party about having rallies in Wisconsin, Jefferson said, a sign that such events might be a ways off. He said the prospect of not having rallies would be ‘disappointing’ but pointed to the effort by Trump’s team to mount a virtual campaign,” the Post reports. “Some Trump advisers have begun to prepare for the prospect that rallies may not be able to return until just weeks before the election. That level of uncertainty has permeated some of the comments of allies who still favor Trump to win but now acknowledge the unprecedented challenge he faces in vying for a second term at a time of public disruption and hardship.”
You can read more here.
Trump’s Override Threat Immediately Gets Shrugged Off by Rhode Island’s Governor: No ‘Executive Fiat’
During a press conference this Friday, Rhode Island governor Gina Raimondo was asked about recent comments from President Trump where he announced the CDC declared houses of worship essential and ordered governors to open them, threatening to “override” them if they don’t.
“It’s been a while since I’ve been in law school but I don’t know of any executive fiat that he would have to overrule a particular governor, so I’ll have to look into that,” Raimondo said.
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