The Costs of Letting Trump Believe His Authoritarian Buddies Instead of His Intelligence Community

WaPo has a story confirming something that has long been implicit (based on Trump’s treatment, for a period, of COVID-19 briefings as classified). The intelligence community was tracking and briefing on the COVID-19 outbreak long before it rose to public attention.

U.S. intelligence agencies were issuing ominous, classified warnings in January and February about the global danger posed by the coronavirus while President Trump and lawmakers played down the threat and failed to take action that might have slowed the spread of the pathogen, according to U.S. officials familiar with spy agency reporting.

[snip]

Intelligence agencies “have been warning on this since January,” said a U.S. official who had access to intelligence reporting that was disseminated to members of Congress and their staffs as well as to officials in the Trump administration, and who, along with others, spoke on the condition of anonymity to describe sensitive information.

[snip]

The warnings from U.S. intelligence agencies increased in volume toward the end of January and into early February, said officials familiar with the reports. By then, a majority of the intelligence reporting included in daily briefing papers and digests from the Office of the Director of National Intelligence and the CIA was about covid-19, said officials who have read the reports.

The money line repeats one the CIA used to describe how George Bush ignored warnings about 9/11: the system was blinking red.

“Donald Trump may not have been expecting this, but a lot of other people in the government were — they just couldn’t get him to do anything about it,” this official said. “The system was blinking red.”

What’s key though (and, because of editing decisions, doesn’t get a lot of focus in the story) is one reason why Trump didn’t heed the warnings of his briefers: because he believed Xi Jingpeng more than he believed the US intelligence community.

The intelligence reports didn’t predict when the virus might land on U.S. shores or recommend particular steps that public health officials should take, issues outside the purview of the intelligence agencies. But they did track the spread of the virus in China, and later in other countries, and warned that Chinese officials appeared to be minimizing the severity of the outbreak.

[snip]

Robert Kadlec, the assistant secretary for preparedness and response — who was joined by intelligence officials, including from the CIA — told committee members that the virus posed a “serious” threat, one of those officials said.

Kadlec didn’t provide specific recommendations, but he said that to get ahead of the virus and blunt its effects, Americans would need to take actions that could disrupt their daily lives, the official said. “It was very alarming.”

Trump’s insistence on the contrary seemed to rest in his relationship with China’s President Xi Jingping, whom Trump believed was providing him with reliable information about how the virus was spreading in China, despite reports from intelligence agencies that Chinese officials were not being candid about the true scale of the crisis.

We all pay for Robert Kadlec to make sure policymakers get warnings about such things. And yet, Trump refused to believe those warnings because someone he trusted more — Xi — told him differently.

Trump has been permitted to believe his authoritarian buddies over the intelligence community on all manner of things. It derives from two things: first, his own innate fondness for authoritarians. But also, his need to believe Vladimir Putin’s assurances that Russia didn’t help him get elected.

The enabling of Trump’s fondness for dictators will end up being very costly for the United States.

Three Things: Racist Redirects as GOP Clings to Its Brand

[Check the byline, thanks!/~Rayne]

No news on the family front with regard to COVID-19 — at least with my family. No news is good news here.

I feel so very sorry for the New Jersey family which lost three of its family members * to COVID-19 this week. It was a blessing to the matriarch she didn’t know she lost her two oldest children; the heartbreak on top of the virus would have been torture beyond human ken.

None of this had to happen, either. Not a lick of it.

And it’s really only just beginning.

~ 3 ~

Let’s get this out of the way: Donald Trump is a racist jerk. He can’t read anything but inch-high print prepared for his ease; he had to go out of his way to make absolutely certain that he referred to COVID-19 as “Chinese.”

This is wholly intentional, deliberate as hell.

The fact COVID-19 emerged from China to become pandemic was sheer dumb luck. Spare us the racist bullshit talking down about eating unfamiliar animals and wet markets.

For Christ’s sake people here in the U.S. eat road kill and celebrate those animals with a festival.

They eat organ meats, blood sausages from across their many ethnic heritages, and they do odd-looking things with products made of proteins extracted from cartilage.

Americans and all the cultures from which they emerged have their own relationships with animals which have spawned biological crises over millennia. Just read Jared Diamond’s Guns, Germs and Steel.

It was simply a crap shoot this pandemic originated in China and not from a hantavirus in the American Southwest, or a flavivirus from South America or Africa. Chances are good we may yet see another emergent threat like a virulent Zika as the climate continues to warm.

Americans don’t have room to criticize. Their president being a racist moron to China about a crappy draw of luck is just plain stupid.

So is his and his party’s escalation of tension with the other largest economy in the world which both owns a lot of our debt. It’s incredibly shortsighted to bash the country which has been incredibly generous with research data based on their harrowing national experience with COVID-19.

I can’t begin to imagine how bad off the U.S. and other countries fighting COVID-19 would be if China hadn’t shared genomic and epidemiological data with the world.

We would not only be as far behind as we are because this administration felt winning re-election was more important than doing its job. We would have had to do much of the genomic and epidemiological research ourselves, on the fly, while our country’s health was in meltdown.

One need only look at how little research material has been published by other countries during this epidemic for comparison. They, too, have relied on China’s research.

Or look at how we continue to rely on China to do human testing – likely cutting corners on human experimentation ethics – just so Americans can obtain the benefit of a successful drug therapy while an American company reaps benefits.

No one of Asian ethnicity and heritage should have to put up with the hate unleashed by that slack-assed racist in the White House and the team of inept and bigoted enablers who are propping him up.

We may have legitimate concerns with China about supply chain integrity and intellectual property theft, but it’s on the U.S. that this is an issue to begin with. Outsourcing so much of what should be critical infrastructure is our own fault.

And failing to act in a responsible timely manner to a pandemic threat is solely that of the racist scumbag at the podium.

~ 2 ~

Speaking of failing to respond to pandemic threat…

If Senator Richard Burr knew by February 13 — when he sold $1.6 million worth of stock — that COVID-19 posed a potential national emergency, who else did and did nothing?

By “did nothing” I mean the way Burr lied to our faces and said, “the United States today is better prepared than ever before to face emerging public health threats, like the coronavirus,” a day before he voted to acquit Trump and six days before he sold his stock.

Think back to the earliest time you heard about the viral illness in China. Do remember when you first heard or read about it?

I do. I had just read about two high-profile deaths from pneumonia in middle and late December. A Chinese actress died, noted in Chinese media. She wasn’t known well to the U.S. so no mention here had been made. Only days later, right around Christmas, a young ESPN anchor also died of an odd pneumonia. This time there was news in the U.S. about his passing.

A week later on New Year’s Eve there was a report in English-language Chinese media about an odd cluster of pneumonia-like illness in Wuhan, China. My awareness of pneumonia had been heightened by the two high-profile deaths so close together.

If I could see a cluster of pneumonia in China by New Year’s Day, you know somebody within the U.S. intelligence community saw it even earlier.

We know now that the Senate Intelligence Committee chair had been briefed, based on a recording made of a meeting Burr had with large-ticket donors. Who else holding elected or appointed office were also briefed by intelligence and then refused to do the right thing to protect the American public?

Now you know why there’s been a full court press from the White House through the GOP congressional caucus to the right-wing media and punditry pushing racist invective against China about the pandemic.

It’s to distract and redirect the public’s attention away from the GOP’s wholesale betrayal of the American public and its allies while COVID-19 ramped up into a pandemic.

By the middle of summer thousands, perhaps tens of thousands of American lives will be lost because Richard Burr and others as yet unnamed helped Donald Trump fuck us over for their own venal aims.

Trump and the GOP had absolutely no intention of doing anything about COVID-19, which explains why Trump has only mentioned but still not used the Defense Production Act to ensure health care workers have adequate personal protection equipment. Crafters across the country are sewing homemade masks of irregular specifications right now to make up the shortfall while health care workers scavenge hardware supplies for mashed-up PPE.

Can’t help wonder how much PPE that $1.6 million would buy.

Or how much the profits from Sen. Kelly Loeffler’s stock sale would buy, or Sen. James Inhofe’s or Sen. Ron Johnson’s stock sale profits. (Sen. Dianne Feinstein’s household also recently liquidated stock but her press secretary said it was in a blind trust with the rest of her assets.)

Loeffler’s financial moves are egregious not only because of profit taking on inside information not shared with the public and then lying directly to the public on camera about the country’s condition. She then acquired stock in a business specializing in remote work, and her spouse is the chairman and CEO of the New York Stock Exchange. There’s absolutely NO excuse for not having her assets in a blind trust to avoid the appearance of a conflict of interest, particularly because of her spouse’s role. But I guess when you’re worth half a billion dollars you just don’t give a shit about annoying little details like ethics.

~ 1 ~

In previous posts I’ve discussed the different drugs being studied as potential therapies for COVID-19. This is an extremely important point which must be emphasized: all drugs, whether antivirals or monoclonal antibodies or anti-inflammatory meds are subjects of study. Some are being used off-label as last ditch efforts.

By off-label I mean they are NOT approved by the Food and Drug Administration as safe and effective for treatment of COVID-19 infections.

We are relying on off-label medications applied by doctors in desperate conditions in China and Italy on patients who are in dire shape to tell us about their effectiveness. We are literally relying on human experimentation without a consistent ethical framework

Yesterday’s presser with Trump was a disaster not only because of his racist bullshit aimed at China, but because he fucked up and discussed off-label drug therapies. He should have left that all together to the Center for Disease Control and the Food and Drug Administration.

His half-assed, poorly-framed remarks about an anti-malarial drug set off a run on black market chloroquine in Nigeria. The drug had been removed from the Nigerian market more than a decade ago because of the risks it poses to patients. It’s quite likely people will die because of misplaced trust in Trump’s words about this drug.

Two antivirals, lopinavir and ritonavir, used as a cocktail in a study in China failed to perform as needed against COVID-19. A study announcing these unfortunate results was published just Wednesday in  the New England Journal of Medicine. (Yet another example of Chinese researchers providing a benefit to the U.S. and the world, I’ll point out. Can only wonder what happened to the subjects of the test.)

And another antiviral discussed here before, remdesivir, is still under study, and still poses an unexamined conflict of interest for at least one person in the Trump administration.

The media did not catch how bad Trump’s remarks on drugs were — that hack Chris Cillizza offers an example, failing to mention the gross and dangerous errors about these medications in his list of fail.

Trump’s words and deeds, likely the output of his inept team including his son-in-law Jared Kushner and his pet Nazi Stephen Miller, are going to kill more people here and abroad on top of COVID-19. Given Miller’s history with this administration, this may be the desired result.

~ 0 ~

* I started writing this post Thursday mid-day. Before I finished it a fourth family member died.

Meanwhile, in neighboring New York, Gov. Cuomo doesn’t want a “shelter in place” order because it sounds too much like nuclear war and might scare people.

New York City is a COVID-19 hot spot rapidly become an American Wuhan cell. More people are likely to die there of COVID-19 than died during 9/11, and we changed our society dramatically out of fear of another such event. New Yorkers and the rest of the U.S. whose banking is centered in NYC need more than Cuomo’s personal concerns about a turn of phrase.

But as I said earlier, none of this had to happen, either. Not a lick of it. It makes the ongoing daily failures even more ridiculous because most are unforced errors. Much of the daily fail could be so easily stopped if Trump just shut up and left handling COVID-19 to ethical professionals.

This is an open thread.

Shelter in Place

In the final hours before the six-county Shelter in Place order came into effect in Northern California, signs went up, people gathered for last drinks, and the homeless tried to find warm places to sleep. Here are some scenes from San Francisco’s Mission District and the Castro, just before the order came into force.

Cliff's Hardware

Cliff’s Variety is a hardware and home goods store which has a cornerstone of the Castro area of San Francisco, even since before it was know as a haven to the gay community. Hardware stores will remain open, but many are limiting their hours and the number of people who can be in the store at any one time.

A San Francisco city worker disinfects a public bathroom late at night in the Castro area. Homelessness is prevalent in the area, and many homeless people rely on these public bathrooms for health and safety.

 

Orphan Andy’s, a diner in the Castro, shuts its doors following the Shelter in Place order.

The Purple Star cannabis dispensary serving customers lining up out the door as people prepare to hunker down in San Francisco’s Mission District.

A Mission District PrEP clinic is closed by the Covid-19 Shelter in Place order, putting people in the community more at risk for HIV transmission. PrEP stands for Pre-Exposure Prophylaxis, and is often given to people at high risk of exposure to HIV, like injection drug users, mixed status couples, and sex workers. PrEP therapies are highly effective at stopping the transmission of the virus, but only if taken daily.

 

 

 

 

Birite, a small high end grocery store near Mission-Delores. Late at night employees are chatting in the closed store, in advance of the Shelter in Place order. Stores have been jammed with people for the past week in San Francisco.

Markets are changing their hours and controlling access, trying to clean and stock shops while keeping their employees and customers safe.

The 24 hour Safeway announces new hours to give employees a chance to clean and stock the story.

 

 

 

 

 


A homeless man in a wheelchair makes his way along a dead-end street next to the 16th and Mission BART station in San Francisco. Having nowhere to go, the homeless are exempt from the Shelter in Place order. Governor Newsom of California has begun securing hotel rooms to bring the homeless inside, but it’s  a fraction of what’s needed to help with the enormous homeless population of the Bay Area.

Two bins in front of a salon in the Castro area of San Francisco protect a homeless sleeper. Salons won’t be among the essential services that can remain open under the Shelter in Place order, and their workers rarely have any form of paid time off.

Harvey’s restaurant and bar, name for Castro human rights legend Harvey Milk, serves a few last patrons before closing for all but delivery service.

Bars in the Mission District that were still open as the Shelter in Place order was about to take effect were often filled, with possibly unwise patrons trying to get in last drinks.

Schools in San Francisco, like Mission High School are closed until April, though it seems possible they won’t reopen for this school year as the pandemic progresses.

Take care of each other.

 

 

 

Three Things: Even More Family Fun with COVID-19

[Check the byline, thanks!/~Rayne]

I figured it would be the oldsters in the family who would be my first worry. The grandparents still go to church, play bridge and golf, volunteer; they’re living typical retirees’ lives. They haven’t stopped mingling socially until this week.

But no. Last week I had to worry about my younger kid at college first. Fortunately they only had strep.

Last night the older adult child called, complaining of a migraine, dry cough, wheezing, and a tight chest. They’d already called the doctor about their symptoms; the doctor wouldn’t order a test because older adult child didn’t have a temperature.

All the other symptoms of COVID-19 except for a temperature. With so few tests available in Michigan, unless my kid checked ALL the boxes, there’s no way they’d be tested.

We’re pretty sure it’s not flu because the symptoms were slow onset rather than fast and adult child had a flu shot this year.

The kicker is that someone at work tested positive for COVID-19. It just hadn’t been announced across the business, likely because the business still needed to finish its plan for handling this situation.

Because my adult child couldn’t get a test, their spouse can’t say they’ve been exposed to COVID-19 and is likely now at work, probably spreading this around if indeed my adult child has COVID-19.

I won’t see my older kid or their spouse for a least a month now since we don’t yet know for certain if they have COVID-19 let alone how long exposed persons may be contagious. I dare not take the chance to see them because of my autoimmune disorder — not just because I might come down with COVID-19, but because hospitals may not be able to offer me an adequate level of care if there are no hospital beds or ventilators if one was needed.

When I saw this bullshit tweet this morning I almost levitated.

All the stress of our not knowing individual infection status and potentially exposing even more Michiganders is due to Trump, who instead directs his animosity toward an effective governor who isn’t getting the support she needs from the federal government.

My family and many others in Michigan and across the country are going through this Kafkaesque circus of uncertainty because the grossly-incompetent-when-not-corrupt Trump administration chose not to do the right thing and roll out testing back in January-February so that community acquired infections could be pinpointed earlier.

The one piece missing in this equation: why is it some people can get tested and others can’t? What arbitrary ju-ju allows Oklahoma to offer up a sizable percentage of its available tests for the Utah Jazz basketball players? Why are some political figures able to summon a test when others can’t?

Is this an additional layer of fuckery, not only the limitations on the number of tests available but an invisible prioritization of who can be tested? Does one’s political party affiliation make a difference, or the color of their state when it comes to getting a test for COVID-19 on a timely basis?

~ 3 ~

The UK did an about-face in its approach toward COVID-19. Boris Johnson backed off the idiocy of allowing the virus to simply run amok through the population to kill its most vulnerable citizens as well as those with the misfortune of being severly to critically ill while UK hospitals are overwhelmed by COVID-19 case load.

However, in spite of the noise made over the Imperial College’s latest assessment of COVID-19’s impact on the UK, nothing is being done. Leadership may have made some noises of surprise over the published mortality numbers but there have been no orders to lock down the country the way France has this past week, or Italy before that.

Instead, Johnson urged Britons to avoid pubs, restaurants and theaters.

He asked that the public only use the NHS “where we really need to.”

Britons were asked to avoid non-essential travel.

In short, a guidance was issued which appears wholly optional. It has no teeth.

Most importantly, Johnson did not order the country’s schools shut down, though young people are believed to be vectors for the virus. Murdoch’s tabloid-y outlet The Sun reports Johnson “hints” at shutting down schools in a few days, though a petition gathered more than 650,000 signatures asking for Johnson to do so immediately.

These numbers were pointedly ignored, though there was moaning at the number of deaths projected by Imperial College’s report — an estimated 250,000 souls. Johnson’s actions to date do little to mitigate let alone suppress COVID-19’S contagion, choices Imperial College explained as approaches to minimizing deaths.

The number of deaths even if Johnson implemented a more aggressive suppression regime in Great Britain* is staggering…

(*Great Britain versus United Kingdom may explain why the numbers shown are lower than a thumbnail analysis based on 67M UK residents x 40% infection rate x 2% case fatality rate.)

\Johnson’s action to date fails to respond adequately to the swamping of UK’s health care system, particularly its intensive care systems.

This past weekend the country continued to go to pubs and concerts, looking much like the revelers partying at the Masque while the Red Death roamed outside the walls of the palace.

Being on an island will not protect them, nor will having expressed a desire to leave the EU.

We won’t be able to help them, either; Trump has done little more than Johnson has for the U.S., relying instead on the states to do the heavy lifting of saving American lives.

If we survive this next year, those of us who are most at risk will owe our lives to the efforts of governors like Gretchen Whitmer, who must not only make the impossible happen with limited resources, but with an ignorant, mean asshat president whining about them at the same time.

~ 2 ~

One of our community members Surfer2099 has been digging away at pharma company Gilead Sciences; the company makes an antiviral drug, remdesivir, which has been used off-label to treat COVID-19 patients. As noted before in previous posts, the medication was shipped to China for tests without normal approval of the FDA.

Bloomberg reported yesterday that China wants to patent remdesivir (link to story at Reddit). It looks like China wants the patent in exchange for having allowed Gilead to test its drug on COVID-19 patients, bypassing the FDA’s test protocols in the U.S.

Surfer2099 noted that Gilead coincidentally launched a merger and acquisition the first week of March. How does such a move fit into the negotiations with China?

Don’t look away from this as remdesivir appears to have widening support in the treatment of COVID-19. If it’s the only drug approved by drug agencies including the FDA, there’s considerable money to be made with tens of millions of COVID-19 patients anticipated over the next 1-2 years.

~ 1 ~

Fortunately there was a little good news yesterday. A COVID-19 vaccine was injected into the first human volunteer in a Phase 1 trial. If successful, the vaccine will not be available for the public for at least a year and likely longer.

NIH Clinical Trial of Investigational Vaccine for COVID-19 Begins

The realistic time frame from this first injection to a public vaccine is at least 12 to 20 months under the best conditions, i.e., no reactions, no other hiccups like supply problems, no interference from outside entities like the Trump administration.

That’s how long we need to practice social distancing — at least 12 to 20 months. Settle in and develop a routine for the long haul.

~ 0 ~

This is an open thread. How are your friends and family doing with the changes we’ve had to make to our lifestyles?

On Ronna McDaniel’s (Still Undisclosed) Test Results

Update, 3/18: The Detroit Free Press just reported that McDaniel’s test (finally) came back negative. That’s both a relief — given who she interacted with before being tested — and a real testament to how long it still takes for (even powerful) people ot to get a test result.

On Friday night, RNC Chair Ronna [Romney] McDaniel got a test for COVID-19, the first high profile Republican tested based on the inadequate testing guidelines rolled out by the CDC rather than concerns arising just from exposure. That is, she had exposure and flu-like symptoms and tested negative for alternative explanations before she took the test.

I can find no follow-up report on the status of her test — though both Saturday and Sunday’s Michigan test reports included the description of a positive test for someone who could be her.

Oakland County, adult female with history of contact with someone with a confirmed case.

[snip]

Oakland County, adult female with contact with a person with COVID-19.

Meanwhile, on Saturday NYT updated a story — first published Friday afternoon — on how Kimberly Guilfoyle’s birthday party a week ago exposed a number of high profile people to the illness. The update quoted aides bitching that McDaniel revealed that she had “publicly acknowledged her illness.”

The president has sought for weeks to play down the severity of the outbreak and been especially sensitive about giving the impression that he himself was at risk. Indeed, several advisers to Mr. Trump on Saturday privately expressed irritation at Ms. McDaniel for publicly acknowledging her illness.

This is not confirmation McDaniel tested positive. Rather, it’s silence and expressed “irritation” about McDaniel’s honesty where other prominent Republicans like Matt Gaetz and Mark Meadows — to say nothing of the President himself — have disclosed both taking the test and their negative results without similar irritation.

As such, it’s an indication that the White House no longer wants to talk about the multiple exposures people within the White House and top ranks of the government or the Republican Party have had, and probably would not tell us if someone who had been exposed tested positive.

Negative or positive, McDaniel is entitled to her privacy, and I wish her the best with whatever was causing her symptoms. But President Trump has a duty to convey the seriousness of this disease and explain how easily one can come in contact with a person who, at the time, appears healthy, but who nevertheless might be contagious.

He hasn’t done that. As of yesterday’s press conference, however, he exhibited a new sobriety about this disease.

In the days ahead, the number of positive cases in a number of states are going to spike, in part reflecting second generation infections, in part because for the first time testing is becoming more widely available. For its part, Michigan announced a new case reporting, covering what will sure to cover those spiking numbers today, that eliminates the kind of individualized information that would allow someone to track a known potential case.

Which suggests that at the moment where we’ll finally begin to track asymptomatic transmission, the public will have less information with which to do so.

That probably explains why governments across the country just got more serious about stopping transmission without such critical data.

Trump Is Providing Free Advertising for a Bunch of Companies that Don’t Offer Paid Sick Leave

Because President Trump’s response to the Covid-19 outbreak largely consists of having press conferences designed to goose the stock market where he calls out a series of big corporations, I will start tracking the paid leave policies of those companies getting all this free advertising. This is particularly important to track given that the House excluded employers with over 500 employees from the paid sick leave benefit in their bailout bill. As you’ll see, a few of these employers rolled out some version of two weeks of sick leave in response to the crisis — but some appear to be written to require a diagnosis of the virus before granting the leave, which is too late to prevent further infections. Others appear to have no sick leave available to the workers providing our food during the crisis.

Until someone with more resources replicates this effort, I will update it as Trump provides more free advertising during the crisis.

Albertsons (President and CEO Vivek Sankaran mentioned on March 15). No leave benefits listed on website. Left message.

Amazon (mentioned on March 15). Emergency policy matches Whole Foods. Diagnosed or quarantined workers can get two weeks paid leave, and employees can have unlimited time off without pay. Delivery workers will have to apply for grants to obtain paid time off.

Campbell Soup Company (CEO Mark Clouse mentioned on March 15). Paid sick leave not differentiated in public benefits package.

Cargill (Chairman and CEO David MacLennan mentioned on March 15). Standard policy provides two weeks of short term disability at 100% of pay, and 6 weeks at 60% of pay. No paid sick leave mentioned.

Costco (CEO Craig Jelinek mentioned on March 15). Paid sick leave is a standard benefit, though on an accrual basis.

Dollar General Corporation (CEO Todd Vasos mentioned on March 15). Barebones benefits publicly listed.

General Mills (CEO Jeff Harmening mentioned on March 15). Expanded paid leave benefits for salaried and non-union production workers, including up to eight weeks of short term disability, in 2019.

Google (mentioned on March 13 and 15). Set up a fund to provide paid sick leave to contractors and temporary employees otherwise not eligible. Also provides pay for hours that furloughed employees would have worked.

Hy-Vee (Chairman, CEO, and President Randy Edeker mentioned on March 15). Website lists paid vacation and personal time, but not sick leave; does claim family medical leave.

Kroger (CEO and Chairman Rodney McMullan mentioned on March 15). Most employees do not get sick leave.

Publix Super Markets (CEO Todd Jones mentioned on March 15). Full time employees accrue paid sick leave, but not part time employees.

Sysco (President and CEO Kevin Hourican mentioned on March 15). Ties pay during leave to paid time off (that is, treats pay as an accrued benefit, not as paid sick leave).

Target (CEO Brian Cornell mentioned on March 15). Enacted an emergency policy offering 14 weeks of paid leave for employees who have tested positive for the virus or who are under mandatory quarantine. It is waiving its absence policy for employees who are not diagnosed but feel too sick to come in or are taking care of children.

Tyson Foods (Donnie King, who is neither CEO nor President, was mentioned on March 15). Hourly workers do not get paid sick days.

Walmart (CEO Doug McMillon mentioned on March 15). Enacted emergency policy offering sick leave to all hourly workers, without the normal 1-year eligibility requirement. If employees choose to stay home it comes out of their regular paid time off. In case of a quarantine, employees will get two weeks of paid leave, which will not count against their existing benefits. If an employee is diagnosed with coronavirus, that person will get two weeks of leave, with up to 26 weeks of “pay replacement” if the employee is unable to return to work.

Whole Foods (Dave Clark mentioned on March 15; John Mackey is the CEO). In response to coronavirus crisis, offered unlimited unpaid time for during March, and two weeks of paid time off if someone is diagnosed with Covid-19. Suggested workers should share their paid time off.

Meanwhile, Over at Foggy Bottom

“No, you don’t need to be tested. Never mind all those coughing people sitting across the table from you at lunch. I’m sure it’s nothing.”

It’s rough being a career member of the US State Department workforce in the Donald Trump era. In general, much of the work of these people is not particularly affected by the changes in presidential administrations. Passports get issued to US citizens who wish to travel abroad, and visas get processed for those who wish to visit here. Those posted at embassies abroad listen to what is happening around them and report the most interesting stuff back to Foggy Bottom in DC, and they take what they’re told by Foggy Bottom and share it with the country in which they are posted. Big things change, like treaty negotiation postures and diplomatic postures on big picture issues, but the nitty gritty stuff is pretty ordinary and non-controversial.

But now, there’s a new wrinkle: whatever you do, don’t do or say anything that will make the guy who sits in the room with no corners look bad. He does not react well. And that wrinkle makes even the ordinary nitty gritty stuff difficult.

“Domani Spero,” the pseudonym of the author of DiploPundit, means “See you tomorrow, I hope,” which seems a fitting moniker for someone who watches the ins and outs of the State Department. Says he, “DiploPundit wades into leadership and management issues, realities of Foreign Service life, ambassadors and nominations, embassy report cards, current events in countries and regions which may or may not include prominent U.S. interests, and other developments in the international affairs community.” His writing assume that his readers are familiar with State Dept jargon and acronyms, which can put some readers off. On the other hand, for those in and around the US diplomatic community, DiploPundit is a definite place to check in for details that might not make it into general media reporting. Along the way, he occasionally posts items that come from his “burn bag” (State Dept lingo for the receptacle for classified trash that must be burned, rather than taken to the curb), which is his place for receiving anonymous tips. These often come from current State Dept employees, raising issues that they do not feel comfortable in bringing to the attention of their superiors via in-house channels.

Four days ago, DiploPundit noted that the US Embassy in Kingston, Jamaica put out a classic non-denial non-response to a story in the local media. While he didn’t link to the story, he seems to be referring to the Jamaica Observer, which wrote this last Wednesday:

A second case of COVID-19 has been confirmed in Jamaica.

Health Minister Dr Christopher Tufton confirmed the second imported case via Twitter this evening.

Dr Tufton said the second case is a US Embassy employee who returned from the UK.

As you might guess, the US Embassy in Kingston started getting calls about this, their response boils down to “we’re aware of the report and will not confirm or deny it, but we’re working with Jamaican authorities and doing a really deep cleaning of all embassy facilities.”

Three days ago, DiploPundit wrote up a Burn Bag post, sent to him by “sickdips”:

“Members of the Embassy community at one post have fallen seriously ill with COVID-19 symptoms, but the State Department will not test them for COVID-19 or *MEDEVAC them. There is already limited medical capacity at many posts, which will be completely overwhelmed as the pandemic spreads. What is MED waiting for? Protecting our people should be our NUMBER ONE PRIORITY.”

MEDEVAC is exactly what it sounds like – medically evacuate – and MED is the acronym for the State Dept’s Bureau of Medical Services. When I went to MEDs page at State.gov, it had nothing but standard “here’s what we do” language and no news items related to COVID-19 among US embassy staffers.

This led me back to that non-denial non-response. In the middle, there’s one sentence that jumped out at me: “The U.S. Department of State has no greater responsibility than the safety and security of U.S. citizens overseas and locally-employed staff.” Remember what I said at the top? Don’t say or do anything to make the guy who sits in the room with no corners look bad. That’s what’s going on in this statement. “Make sure you tell everyone that we take care of US citizens!”

If sickdips saw this (whether Jamaica is the post about which sickdips was writing or not), it’s probably what prompted sickdips to drop a note to the Burn Bag. Fancy words about protecting the safety of embassy staffers are nice, but actions on the ground like refusing to test after exposure to a known carrier of COVID-19 suggest otherwise.

That was three days ago. The following day, DiploPundit posted a roundup of items about COVID-19 at various embassies, which laid out nine different countries (including Jamaica and Italy) where ordinary services are restricted or the embassies and consulates are completely closed for all but the most extreme emergencies. The list included this observation at the top: “As of this writing, we have not seen any public announcement or guidance from the State Department on COVID-19 for employees or family members. Let us know if we missed any statement from Pompeo or [Undersecretary of State for Management Brian] Bulatao.”

That last sentence was DP poking Pompeo and his chief aide for running the State Department with a very sharp stick, and doing it in a place where everyone in the diplomatic community could and would see it.

That was two days ago. Today, the State Department put out an updated health warning for US citizens thinking about traveling abroad. The short version is this: don’t. The longer version is this:

Global Level 3 Health Advisory – Reconsider Travel

March 15, 2020

The Department of State advises U.S. citizens to reconsider travel abroad due to the global impact of COVID-19. Many areas throughout the world are now experiencing COVID-19 outbreaks and taking action that may limit traveler mobility, including quarantines and border restrictions. Even countries, jurisdictions, or areas where cases have not been reported may restrict travel without notice.

On March 14, the Department of State authorized the departure from any diplomatic or consular post in the world of US personnel and family members who have been medically determined to be at higher risk of a poor outcome if exposed to COVID-19.

The first part of that is the language you’d find in a standard State Department warning, albeit these kinds of warning are usually aimed at specific countries or regions, not the whole world. But the second part of that — the part that begins “On March 14 . . . ” — is not standard. Not at all. It sounds to me as if someone at Foggy Bottom who read DiploPundit’s poke tried to address the concern, but “put it out with the trash” late on Saturday, hoping it wouldn’t get too much attention from the general media, and thus incur the wrath of that guy in the room with no corners.

This is a deeply serious development. This kind of “we’ll pull anybody out of anywhere” statement is damn near unheard of, and the only reason I say “damn near” is to give myself wiggle room should someone with greater historical knowledge step up. I can’t think of anything close, ever.

But even so, as broad and sweeping and unheard-of as this is, I don’t think on it’s face it is enough. As DiploPundit notes, “So the ‘authorized departure’ or voluntary evacuation depends on the determination of the local MED unit or based of current medical clearance?” You remember MED – the same folks that wouldn’t authorize testing personnel who had been in contact with an infected person?

Poke, poke, poke.

UPDATE from DiploPundit:

The cable released by State/M Brian Bulatao says: “Effective March 14, 2020, I hereby approve authorized departure (AD) from any diplomatic or consular post of U.S. direct hire employees or eligible family members (EFMs) as listed on employee orders and defined in 14 FAM 511.3 who, after confidential consultation with MED, have determined they are at higher risk of a poor outcome if exposed to COVID-19, or who have requested departure based on a commensurate justification in foreign areas.”

Our source, not from Public Affairs, interpret this to mean that MED approval is not specifically required but you need to refer to MED when you go tell your boss you want out.

The  last time we had a global authorized/ordered departure order was probably during Y2K, was it? (The State Department at that time also issued an edict stating that all embassies must be prepared to be self-sufficient for 30 days by January 1, 2000).

When Trump gave his speech last week about the “foreign virus” and the need to blockade the EU but not the UK, it was clear that Trump was acting out of his usual playbook: xenophobia, build bigger walls, get revenge on your foes and carve out loopholes for your friends. Since then, clearer heads have pushed Trump to include the UK in his travel blockade, as viruses do not care about the color of your passport. I suspect those clearer heads are folks like Anthony Fauci on the medical side and whoever at State authorized the evacuation of any diplomatic staff from any post over medical concerns.

God bless them both, because it clearly takes the concerted effort of a group of people who are willing to make the guy in the room with no corners look bad if he’s doing stuff that will kill innocent people. And make no mistake: he *is* doing stuff that will kill innocent people. (See Jim’s post on the Customs mess at airports last night.)

Domani spero, everybody. See you tomorrow, I hope.

Trump’s Customs And Border Protection Just Created Hundreds Of New COVID-19 Superspreaders

Earlier this week, Donald Trump announced Vladimir Putin’s dream of travel restrictions in response to the the COVID-19 pandemic, “banning” travel from Europe, but excepting the UK, where there are many more cases than in a number of European countries. Trump eventually was forced to add the UK to the ban. As the new policy began to roll out yesterday in the major international US airports, there was nothing less than a clusterfuck of epic proportions. The feature image for this post comes from a Brooke McDonald tweet showing a huge crowd trying to clear customs at O’Hare. Here is a tweet from a Fox station in Texas showing the crowd trying to clear customs at DFW:

What could possibly go wrong? With large crowds of people coming back from infection hot zones, milling about for what was reported to be up to seven stress-filled hours, it’s hard to imagine a scenario more conducive to efficient spread of the virus.

Here is the New York Times on what unfolded:

Under the new screening rules, when travelers arrive at 13 designated airports they are to be interviewed by a Customs officer, who will also review the person’s travel history using a Homeland Security database. The officer will ask them about their current medical condition. If they don’t show symptoms, they will be asked to quarantine in their homes for 14 days. Depending on their symptoms and previous medical history, travelers could be subject to an additional screening by a medical professional at the airport. They could also be subject to a federal quarantine.

Seems simple enough. But in Trump’s era of never having enough of the right employees in the right place, this simple screening resulted in the massive delays. Here is the Acting Head of Customs and Border Protection on the situation last night:

Yeah, right. Nothing is more important that the health of our citizens, so you trap thousands of people into tight spaces that are virtually guaranteed to have symptom-free people shedding large amounts of virus.

Here’s how that happens.

First, we know that virus can be spread by folks not showing symptoms. From CNN:

New studies in several countries and a large coronavirus outbreak in Massachusetts bring into question reassuring assertions by US officials about the way the novel virus spreads.

These officials have emphasized that the virus is spread mainly by people who are already showing symptoms, such as fever, cough or difficulty breathing. If that’s true, it’s good news, since people who are obviously ill can be identified and isolated, making it easier to control an outbreak.

But it appears that a Massachusetts coronavirus cluster with at least 82 cases was started by people who were not yet showing symptoms, and more than half a dozen studies have shown that people without symptoms are causing substantial amounts of infection.

Next, as the CNN article notes, the Boston cluster of cases arising from the Biogen conference resulted in many people being infected from a small number who were infected but asymptomatic at the time. From WBUR:

Among the coronavirus numbers that Massachusetts officials have shared recently, one is particularly striking: Of the state’s 95 cases detected as of late Wednesday, they say 77 stemmed from a meeting that the Cambridge biotech company Biogen held in late February.

In public health parlance, the Biogen meeting is looking like a “superspreading event.”

The article continues:

Yale professor Nicholas Christakis, a physician and sociologist who studies networks, says the current outbreak in Italy also stemmed from a “superspreader.”

“We know from genetic analyses in Italy that the epidemic there was started, we think, by two people, one of whom gave it to 43 other people,” he says.

But here’s the kicker:

Christakis from Yale says other factors could cause people to become superspreaders — like even a propensity to cough.

“Maybe they have a lung disease, for example,” he says. “And so they’re doing more coughing anyway. And so compared to a person who doesn’t cough, they transmit it more.”

The environment can contribute to spreading, too, he says — poor ventilation, overcrowding.

Yep. There we have it. Overcrowding can create superspreaders. And Customs and Border Protection just overcrowded thousands of people for long periods last night. In thirteen different airports.

I keep re-reading the description of the “screening” and don’t see how the outcome of screening would be any different if people cleared Customs in a normal way but were given a set of printed instructions informing them that if they were returning from Europe they should self-quarantine for at least 14 days and that if they have or develop any symptoms they should notify their health provider and/or county health department. At that point it would seem safer to have them call a call center where they can share their travel history with someone coordinating the DHS database. Making people mill around for so long really appears to have accomplished nothing other than spreading the virus.

Update

I started writing this post before finishing my coffee this morning, and so I missed this great article in the Washington Post:

Airports around the country were thrown into chaos Saturday night as workers scrambled to roll out the Trump administration’s hastily arranged health screenings for travelers returning from Europe.

Scores of anxious passengers said they encountered jam-packed terminals, long lines and hours of delays as they waited to be questioned by health authorities at some of the busiest travel hubs in the United States.

The administration announced the “enhanced entry screenings” Friday as part of a suite of travel restrictions and other strategies aimed at slowing the spread of the coronavirus. Passengers on flights from more than two dozen countries in Europe are being routed through 13 U.S. airports, where workers check their medical histories, examine them for symptoms and instruct them to self-quarantine.

And WaPo even went there:

But shortly after taking effect, the measures designed to prevent new infections in the United States created the exact conditions that facilitate the spread of the highly contagious virus, with throngs of people standing shoulder-to-shoulder in bottlenecks that lasted late into the night.

Three Things: Good (Family) News, Bad (COVID-19) News

[NB: Check the byline, thanks! / ~Rayne]

It’s absurd that I’m happy my college student child tested positive for strep throat. Whew, what a freaking relief that they only had a bacterial infection which has killed humans throughout history! Thanks to science we have effective antibiotics to treat this kind of infection, one of which is already working away and making said student feel better. …

Literally just heard from my student that Michigan State University now has one confirmed case associated with its campus. I can’t find a published report yet, more details later; so much for the brief respite provided by streptococcus.

Brace yourself for the bad news which so far is the nature of COVID-19.

~ 3 ~

Drugs. Let’s get into them.

Beleaguered Italy is using the rheumatoid arthritis medication tocilizumab off-label to treat patients in ICU. It may become their protocol for treatment of patients who develop acute respiratory distress syndrome (ARDS).

COVID-19 apparently spawns a “cytokine storm” the same way the 1918 Spanish flu virus did. Health care professionals say COVID-19 kills via fulminating viral cardiomyopathy, (inflamed heart tissue), not hypoxia (suffocation due to lung failure).

The onset of inflammation can be sudden with the cytokine action but at a later stage in the infection, which is different from the 1918 bug. The Spanish flu affected mostly younger people whose immune systems over-responded to the virus, where COVID-19 affects older people whose bodies may already have inflammatory responses at work because of cardio vascular disease or diabetes.

(We don’t know yet why some young people without preexisting conditions have become very ill and in some cases have died. Some may be related to smoking, others could be related to an undiagnosed condition. More study will be necessary; in the mean time, young people should protect both themselves and the older and sicker people who could catch COVID-19 from them.)

China tried tocilizumab on roughly 20 patients and found this monoclonal antibody halted the storm, acting on interleukin 6. There’s a preprint unreviewed study online but I can’t open it now or would include it. An immunologist in Italy came to similar conclusion about the use of this med and consulted with Chinese docs. See this story in an Italian news outlet (open in Chrome and translate).

There are other meds being tested in China — antivirals remdesivir (mentioned in a previous post), favipiravir, lopinavir/ritonavir, umifenovir — but there I haven’t seen any information about their application treating COVID-19 cases as detailed as there is for tocilizumab.

Pharma manufacturer Roche has agreed to provide to Italy the tocilizumab which should not only help reduce burden on hospitals’ intensive care units but build a body of data about the drug’s success in short order. China has also approved the drug’s use on certain COVID-19 patients.

I want to emphasize here this is NOT a cure for COVID-19. It’s a treatment for patients whose heart and lungs are in distress, requiring intensive care and a ventilator. What this drug may do for many of these patients is prevent them from needing ICU and ventilation, while their bodies continue to fight off the virus.

~ 2 ~

And more drugs — this time, antivirals.

A number of existing drugs have been revisited for repurposing against COVID-19 instead of their original intended purpose. Antiviral remdesivir and antimalarial chloroquine are among them.

Chinese researchers posted a paper about in vitro results, not peer reviewed (at least I didn’t see that it was).

There’s a paper about chloroquine alone; in vitro studies suggest it may work against COVID-19. Chinese researchers have a number of in vivo studies in progress, but no data has been released.

Chloroquine by itself as an effective therapy would be a miracle in that it’s an old drug now off patent and available as a generic, super cheap to produce. Can’t imagine Big Pharma would like this. But we won’t even face this conflict if we don’t get data from in vivo studies.

What I haven’t seen yet is adequate research related to the ACE2 receptor to which the COVID-19 binds itself to attack the body. There’s a study under way about a decoy protein drug called APN01, but I haven’t seen any details yet. A discussion about the ACE2 receptor can be found at this link.

I’d like to see more work done in related to ACE2 receptor mechanism. I’m worried we’ll end up too focused on antiviral remdesivir because there may be some political hijinks behind this drug.

Gilead Sciences, the drug’s manufacturer, shipped a bunch of this drug to China without federal approval, for tests which I assume mean human experimentation on actual COVID-19 patients.

About the same time this happened two weeks ago Gilead launched a merger/acquisition of Forty-Seven Inc, a clinical-stage immuno-oncology firm. It looks fishy yet likely to go unexamined because of the mounting desperation to have a drug therapy in hand before the anticipated explosion of cases arrives at hospital doors. In short, it’d be too easy to extort the U.S. into using this drug.

What really takes the cake is that a former Gilead lobbyist, Joe Grogan, is now the director of White House Domestic Policy Council. Grogan has already undermined Trump’s drug pricing initiative to the benefit of pharmaceutical companies. How do we know Grogan isn’t still representing Gilead’s interests, perhaps encouraging the government to turn a blind eye to corner-cutting on remdesivir?

~ 1 ~

Now it’s time for some more blunt talk with the family members.

I have a health care power of attorney or a health care directive prepared, signed, witnessed, copies distributed with one copy in my fire safe. If the worst should happen and the doctors need direction if I become incapacitated, my patient advocate is authorized to order what I want done. I have more than one advocate in a chain in case the primary advocate can’t act on my behalf.

I also have a will prepared, signed, witnessed, etc. If I’m picked off this month my kids will be disappointed that I haven’t yet finished Swedish Death Cleaning in the basement, but such is life and death. (Sorry, kids. You’re stuck dealing with all of the grandmas’ china sets and fragile antique lamps. Heh.)

I put the question to you now: are you ready? Have you done the legal legwork to help your loved ones whether family and/or friends if you’re incapacitated or *knock-on-wood* die?

Get it done if you haven’t. Stop putting it off because there’s no more time for lollygagging. We’d all like to deny we could get very sick, lose control of our lives, even die, but nature has a way of having the very last word if you don’t provide one.

Need a resource for that health care directive? See the folks at AARP — they have links to free resources for each state.

Just as important is establishing a plan for what friends/family should do if they can’t reach you. Trusted friends/family members should have current phone numbers, addresses, alternate key locations, emergency contacts, so on. They should also know who the patient advocates are and how to obtain access to the relevant documents if advocates don’t already have them.

This doesn’t have to be heavy; some of this effort we should have been doing all along as part of your disaster preparedness planning. Think about the families and friends affected by hurricanes Katrina and Maria, and imagine COVID-19 as a kind of hurricane which won’t flood your house but could certainly upend your life. You’d be prepared for a hurricane. Be ready for this one.

~ 0 ~

Treat this as an open thread. Tell us what’s in your basement or closets you need to unload because no one in your family wants it.

We Are In A Liminal Space In The COVID-19 Outbreak

Jim here.

This will be a short post, mostly to give us a new conversation thread.

But there are a few things that show us that reality is setting in in our society, if not necessarily in the White House. Virtually all professional and college sports are now shut down. Most universities are online only now. Many public schools have closed. More and more businesses are allowing employees to work from home.

We are now in a liminal space. Our church introduced me to that term while we are searching to replace a minister who recently retired. A liminal space is that time between what was and what will be. Thanks to COVID-19, normal is what was. It is gone and will be gone for quite some time.

Sadly, the beneficial effects of the social distancing that is finally coming into being will be delayed. Before we get to the benefits, we will experience the whirlwind that has been unleashed by months of denying the virus. This is just my estimate, but from all the published comparisons between the US outbreak and Italy’s, we are just a few days, probably less than a week, away from hospitals in the hot zones being over capacity and having to resort to excruciating levels of triage, literally choosing who lives and who dies.

Also, Republicans are being dragged kicking and screaming into the realization that our healthcare system and our gig economy mean that huge swathes of our population, without government intervention, face bankruptcy and death with no chance of treatment.

Each of us will have to choose how we live in this liminal space. For those who are able to go along with social distancing, we will need to learn to eat all our meals at home. We will need to find ways to occupy our time if we aren’t working and the usual sports entertainment is unavailable. But it is vital that we realize that despite being physically separated, we must embrace our shared humanity and the shared experience of facing the unknown together.

Maybe there’s someone who lives close to you who is even higher risk than you are. Perhaps you can give them a call and ask if they’d like you to leave a meal at their door. Maybe you have acquaintances whose employment has disappeared today. Maybe you can slip them a few bucks if you can afford it. Maybe they’d also like a meal at their door.

Even more frightening, is the “what will be” for folks who must continue working. Somehow, grocery stores will have to stay open. Police and fire services have to continue, along with EMS, of course. Healthcare workers are soon to be completely overwhelmed and most likely sequestered for the duration of the outbreak in areas where hospitals near capacity. If you know families of those workers, maybe they could use a hand with errands or meals. They will be terrified about their loved ones staying healthy while on the front lines of this battle. Support those families any way you can.

In the meantime, many thanks to all in this wonderful emptywheel community who have been chiming in with timely updates and analysis. Please keep it coming. So many people are getting so much help from you. But also, let’s have some fun too, to ease the tension. Share a joke. Share ideas for entertainment streaming for those sequestered. Above all, know that we are all in this together and our best bet for getting through it is to work together (just don’t cough on me or touch me).

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