Contact Me By Email

Contact Me By Email

Wednesday, April 01, 2020

Pelosi said Trump is responsible for American deaths. Watch Biden's answer

How South Korea Solved Its Face Mask Shortage

How South Korea Solved Its Face Mask Shortage

Neighborhood pharmacists and government intervention were the secret weapons.

Ed Jones/Agence France-Presse — Getty Images

The coronavirus erupted in South Korea in late January, six months into Yoo Yoon-sook’s new job. She had just moved from Seoul, where she spent three decades working in the same pharmacy, to open the Hankyeol (“Steadfast”) Pharmacy in the city of Incheon, near the international airport. Ms. Yoo hadn’t really gotten a sense of the neighborhood around her new pharmacy “before this all happened,” she told me. It became all coronavirus, all the time.

Incheon’s 1,100 pharmacies, including Ms. Yoo’s, began to sell out of KF-94 face masks, the equivalent of the American N95. So did corner stores and large retail chains like E-Mart. As Koreans learned of the scale and aggressiveness of Covid-19, first from Chinese reports, then from a surge of cases at home, the mask with the weave and construction that proved most effective against the virus could not be found, except at exorbitant prices online. Customers grew angry waiting outside stores. One Incheon pharmacy posted a sign saying, “Regarding masks: Threats, physical violence and insults against employees are punishable under criminal law.”

Such was the extent of the “mask crisis” when the central government decided to intervene in production and distribution. At the end of February, it announced that it would purchase 50 percent of KF-94 masks from the nation’s 130 or so manufacturers. The government began to ship these masks, at a discounted price of 1,500 won each (about $1.23), to some 23,000 pharmacies, in cooperation with the Korean Pharmaceutical Association.

Pharmacies would earn no more than a few dozen cents on each sale — a few even reported losing money because of credit-card fees — but they embraced their role in the epidemic response. Licensed pharmacists were ideally placed to answer questions about Covid-19, give instructions on social distancing and proper use of masks, and refer sick people to field testing stations and hospitals. (In rural areas of South Korea, where there are fewer pharmacies, agricultural cooperative offices and post offices sell the face masks.)

At Hankyeol Pharmacy, Ms. Yoo posted a sign on the door, telling customers that the sale of KF-94s would begin at 9 a.m. every morning. It was impossible to fill prescriptions or sell anything else during the mask rush. “All of us local pharmacists posted the various times of sale on our door and a map of all the nearby locations,” she told me. Popular mapping apps from Kakao and Naver also showed information on pharmacies and real-time numbers of available masks.

Ms. Yoo was initially allotted 50 masks per day, six days a week, but this wasn’t nearly enough. As South Korea’s infection and fatality numbers grew, people felt desperate for protection. Across the country, pharmacists continued to face long lines and insults when masks sold out.

On March 5, the government increased its share of mask purchases to 80 percent of national production. The following day, Ms. Yoo received a text message from President Moon Jae-in, addressed to “the pharmacists of Korea.” In addition to expanding mask manufacturing, the government was about to start a new rationing system.

“Starting today, 70 percent of all masks acquired through the public distribution system will be sold at pharmacies,” Mr. Moon wrote. “Pharmacies are the primary on-the-ground node in our public health system.” All citizens and registered noncitizens could buy two masks per week on an assigned weekday, depending on their year of birth — a system similar to one used in Taiwan since early February.

The Incheon Pharmaceutical Association encouraged its members to stay open on Sundays, to receive as many daily shipments as possible, so Ms. Yoo began working seven days a week. Her daily shipment went from 50 to 400 masks, with more on the weekends.

This week, the Centers for Disease Control and Prevention is weighing whether to recommend that everyone — not just health care workers and people infected with the coronavirus — wear masks. If this advice is issued, Americans may finally embrace wearing face masks, something that has long been common in East Asia, not only during disease outbreaks, but also during cold season and whenever air pollution levels rise.

Such guidance could also worsen the already dire shortage of N95 face masks and other personal protective equipment. 3M has promised to make more than a billion N95 masks by the end of the year. But without a vast expansion of complementary manufacturing or imports, supplies will be inadequate.

South Korea and Taiwan responded to their mask crises with significant market interventions. America needs to do the same. The U.S. government, and state and municipal bodies, should immediately enter into large-scale contracts to produce masks that can be sold at an affordable, standard price.

These masks (and other personal protective equipment) should go first to health providers and hospitals, then to essential workers in sanitation, warehouses, transportation, food service, child-care centers, and people in prisons and detention facilities. A distribution plan along the lines of those in East Asia could then get masks to the public, perhaps through pharmacies, corner stores and post offices. Some of those masks should also be allocated, free of charge, to people who are homeless or living below the federal poverty level.

For most of us, an N95 mask is not strictly necessary. Last weekend, I used a free online pattern to sew masks for myself and family members, using old handkerchiefs, shirts and elastic hair ties. I wore my homemade mask, reinforced with a large gauze bandage, to the grocery store and bodega, while trying to stay six feet away from fellow shoppers.

To survive this pandemic, we Americans must stop viewing masks as a sign of disease, and see them instead as a social kindness, a courtesy as common as “please” and “thank you.” As Choi Gwi-ok, a pharmacist in northern Seoul, told me, “Koreans wear masks to protect themselves from infections, but, even more important, to show consideration for others in public.”

Kuk Seung-gon, the president of the pharmacists’ association in Gimcheon, near South Korea’s Covid-19 hot spot, told me: “It’s been terrible to see what’s been happening in Europe and America. I really hope that, in the West, people develop a culture of mask wearing. A mask is not just for sick patients.”

By the end of March, the lines for masks outside South Korea’s pharmacies had become manageable. “Now that people are able to buy two masks per week, they feel reassured,” Ms. Yoo told me. “We pharmacists do, too.”

“After three weeks of constant work, the fatigue has built up. I’m very tired,” she said. But she feels a duty to the public, and plans to keep the pharmacy open seven days a week until the crisis is over.“

Tuesday, March 31, 2020

Opinion | The Wall That Didn’t Stop the Coronavirus - The New York Times

"Hostility toward immigrants is hurting the fight against the pandemic.

The editorial board is a group of opinion journalists whose views are informed by expertise, research, debate and certain longstanding values. It is separate from the newsroom.

Three weeks ago, with much of the United States already gearing up to limit the spread of the coronavirus, the Trump administration’s chief immigration judge sent out a stern order to immigration courts nationwide to take down all public health posters, printed in English and Spanish, on how to deal with the pandemic. “Per our leadership,” the order said, immigration judges did not have the authority to post fliers. “If you see one (attached), please remove it.”

Soon after the order was revealed by The Miami Herald, the Department of Justice, which oversees the immigration courts, reversed course and told the paper that “the signs shouldn’t have been removed.”

A bureaucratic blunder? More like a case in point of how the administration’s obsession with immigrants, undocumented, legal or aspiring, has infected its efforts to control the spread of a pandemic, exacerbating the crisis.

Tough times call for tough measures, to be sure, and the administration’s anticipated order to turn back all asylum seekers and other foreigners trying to cross the southwestern border illegally makes sense in the context of measures already taken to severely restrict movement across other American borders, land and sea.

The immigration system along the southern border is overtaxed, and detention centers across the United States are already bursting with nearly 40,000 people, at enormous risk of contagion. The coronavirus doesn’t discriminate between carriers who are held behind bars and those whose job it is to guard them. The Immigration and Customs Enforcement agency has continued to make arrests and has shown no intention of releasing nonviolent detainees, though judges in some states have ordered some released out of health concerns.

Rounding up undocumented immigrants and shutting down the border is something President Trump has yearned to do since long before the coronavirus began its fateful spread. And his animosity toward undocumented immigrants is affecting the efforts to contain the coronavirus far beyond the border.

As Miriam Jordan of The Times reported, the virus has spread more fear among immigrants, legal and undocumented — the fear that seeking medical or financial help will put them in the cross-hairs of the administration’s repressive immigration policies.

At the beginning of March, more than 700 public health and legal experts addressed a petition to Vice President Mike Pence and other federal, state and local leaders asking, among other things, that medical facilities be declared enforcement-free zones (ICE currently classifies them as “sensitive locations,” where enforcement is avoided but not precluded). The Citizenship and Immigration Service subsequently appeared to signal that it was suspending enforcement of a new “public charge” rule, which makes it harder for immigrants to obtain the green card of a permanent resident if they tap federal benefits, but the suspension has not been publicized.

Those who are not documented are afraid that going to a public health facility will expose them to ICE agents. Immigrants in the country legally and hoping to obtain a green card fear that seeking help will ruin their chances under the public charge rule, which went into effect in February after injunctions blocking it were lifted by the Supreme Court.

These immigrants are particularly at the mercy of the pandemic. They often live in crowded conditions, have little money and no paid sick leave, and so lack the ability to self-quarantine. And according to the Kaiser Family Foundation, 23 percent of noncitizens lawfully in the country and 45 percent of those who are undocumented lack health insurance.

Most immigration courts, meanwhile, were still working at full steam long after state and federal courts across the country sharply scaled back their activities. On Monday, several groups representing lawyers who work with immigrant clients sued the administration to stop in-person immigration hearings during the pandemic. It was only last week that the Executive Office for Immigration Review, the Justice Department agency that oversees immigration courts, closed down some courts and suspended hearings for immigrants not in custody.

The coronavirus does not care which passport its human hosts may carry or tongue they speak. Nor does it serve global public health for only American citizens to wash their hands and practice social distancing. Those are best practices that should transcend borders and walls and help us acknowledge our common plight, and humanity."

Opinion | The Wall That Didn’t Stop the Coronavirus - The New York Times

Why Trump's Approval Rating Has Increased l FiveThirtyEight Politics Pod...

Coronavirus Live Updates: Grim Models Project High U.S. Toll in Months-Long Crisis

Models predicting expected spread of the virus in the U.S. paint a grim picture.

The coronavirus studies that appear to have convinced President Trump to prolong disruptive social distancing in the United States paint a grim picture of a pandemic that is likely to ravage the country over the next several months, killing close to 100,000 Americans and infecting millions more.

White House officials have not specifically said which of several epidemiological models by researchers around the world they used to persuade Mr. Trump to extend federal guidelines that call for people to remain in their homes, limit travel, work from home and refrain from gathering in groups of 10 or more. But the administration’s leading scientists — including Dr. Anthony S. Fauci and Dr. Deborah Birx, who is coordinating the coronavirus response — have said that several of the publicly available studies generally match their own conclusions about the deadly impact of the virus. 

“We’ve reviewed 12 different models. And then we went back to the drawing board over the last week or two, and worked from the ground up, utilizing actual reporting of cases,” Dr. Birx told reporters during a briefing in the White House Rose Garden on Sunday. She said the evidence collected by the government experts “ended up at the same numbers.”

Dr. Birx and Dr. Fauci are expected to provide a detailed presentation about their conclusions during a briefing from the White House Tuesday evening. A senior administration official declined to reveal any information about those studies in advance. But the publicly available research suggests that even with the isolation efforts already underway to limit the spread of the virus,  infections are almost certain to soar, straining the ability of hospitals to care for infected patients and leading to a growing number of deaths.

One of those models, created by scientists at the University of Washington’s Institute for Health Metrics and Evaluation, predicts that deaths from the virus in the United States will rise rapidly during the month of April, from about 4,000 to almost 60,000, even with the many restrictions on movement now in place. The study suggests that the pace of deaths will eventually slow down, reaching a total of about 84,000 by the beginning of August. 

The model assumes that social distancing measures will be broadly effective across the country and uses the severe lockdown in Wuhan, China, to calibrate how the outbreak might play out in the United States. That approach has some critics because control measures imposed in the United States have generally been less stringent than those in Wuhan. While officials have told more than 250 million people to stay at home, some parts of the country, especially in the South, have resisted or delayed similar measures for fear of the economic consequences.

A second study, released on March 17 by the epidemic modeling group at Imperial College London and authored by 30 scientists on its coronavirus response team, predicted that if the United States had done nothing to prevent the spread of the virus, 2.2 million people could have died. If, however, the government tried to isolate people suspected of having the virus and people they were in contact with, the number of deaths could be cut in half, the researchers said. 

They concluded that only a suppression effort across the entire country — an expanded version of efforts now underway across wide swaths of the country — might significantly further reduce the death toll. But they warned that such efforts might have to be maintained for long periods of time in order to ensure that the threat is over. 

“The major challenge of suppression,” the British scientists concluded, is the length of time that intensive interventions would be needed, given that “we predict that transmission will quickly rebound if interventions are relaxed.” 

Mr. Trump appears to have been affected by the grim statistics. During his appearance in the Rose Garden on Sunday, the president repeatedly mentioned the worst-case scenario from the Imperial College study, saying that hundreds of thousands of lives would be saved by making the decision to continue social distancing.

“Think of the number: 2.2 — potentially 2.2 million people if we did nothing. If we didn’t do the distancing, if we didn’t do all of the things that we’re doing,” Mr. Trump told reporters. He acknowledged that even 100,000 would be a “horrible number,” but that bringing the deaths down from possible millions would show “we all, together, have done a very good job.”