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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

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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.”

Sunday, March 29, 2020

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Inside the White House during '15 Days to Slow the Spread' Staffers described a time of reassessment as the West Wing reoriented itself entirely around a singular mission. They witnessed historic moments. They wondered what it would all mean.

Inside the White House during '15 Days to Slow the Spread'

Staffers described a time of reassessment as the West Wing reoriented itself entirely around a singular mission. They witnessed historic moments. They wondered what it would all mean.

“Staffers described a time of reassessment as the West Wing reoriented itself entirely around a singular mission. They witnessed historic moments. They wondered what it would all mean.

This account of the last two weeks inside the White House is based on over half a dozen interviews during that period with staffers and outside advisers, as well as prior POLITICO reporting. Collectively, staffers described a time of uncertainty and reassessment as the West Wing reoriented itself entirely around a singular mission. They witnessed historic moments from the center of power — the biggest one-day plunge ever in for the Dow Jones Industrial Average; followed by its biggest one-day gain since 1933. They wondered what it would all mean for the election — would there even be in-person voting in eight months? Is campaigning as we know it over?

Meanwhile, Americans everywhere grappled with their changing realities: Will the way we celebrate, congregate and pray change forever? Will we become a more isolated society, connected by video conferences rather than in-person gatherings?

“Should I even be here?” a White House official said squeamishly after multiple high-level staffers were exposed to the virus and forced to stay home.

On Tuesday, the White House’s “15 Days to Slow the Spread” initiative will come to an end. The country will look to Trump to tell people how much longer daily life will be paralyzed, how much longer they’ll be out of a job. 

What he will say, though, is still unknown.


U.S. cases: 0

U.S. deaths: 0

Stock Market: 28,868.80

As with many Americans, the magnitude of the situation didn’t initially set in at the White House.

As early as Jan. 2, the Robert Redfield, head of the Centers for Disease Control and Prevention, contacted the National Security Council to discuss a developing situation in China regarding a respiratory illness they had yet to confirm as a novel coronavirus, according to a White House timeline reviewed by POLITICO. Ten days later, China reported its first death from the virus. 

Then, like a dry brush fire, it spread.

The first coronavirus case in the U.S. was confirmed on Jan. 21. Days later, the president developed a task force to address the potential spread. But publicly, the president and his advisers maintained that the situation was under control, as the president cut off most travel from China at the start of February.

Internally, some White House officials monitoring the situation abroad felt frustrated the virus was being shrugged off by senior officials, including the president. Reducing travel from China was not enough, they argued. They pressed for Trump to take more aggressive action, citing forecasts that indicated the United States could face a trajectory of cases mirroring places like Italy, which saw a sudden spike in mid-February.

Trump came around in late February during an 18-hour trip back from India, where he had spent two days amid cheering throngs, miles away from coronavirus concerns. On the flight, he saw the round-the-clock media coverage of the disease. According to his acting chief of staff Mick Mulvaney, Trump didn’t sleep on the entire ride back. 

Minutes after landing on the morning of Feb. 26 in Washington, D.C., Trump tweetedthat he would be holding a briefing to address the situation. He hastily tapped Vice President Mike Pence to oversee the coronavirus task force and predicted that the number of coronavirus cases in the U.S. would soon be “close to zero.”

The opposite happened. 

In early March, the president and his team recognized the writing on the wall, besieged by concerns from allies across the country. There were now over 1,000 cases in the U.S. The World Health Organization declared a pandemic. The stock market plummeted, even halting trading for 15 minutes on March 9 to avoid a market-crashing slide.

Trump and his team scrambled to address the nation’s concerns in an Oval Office address — only the second one Trump had ever made.

“If tonight isn’t Trump saying, ‘This is bad and could get very worse, you need to take every precaution necessary,’ then he can kiss a second term goodbye,” an administration official said at the time. 

He didn’t say that. Instead, the president, in hastily arranged remarks, said he was barring all travel from Europe and promised that health insurers had agreed to cover all coronavirus treatments. Investors panicked — would necessary cargo still be allowed to come into the U.S.? Insurers were taken aback — they had only agreed to cover coronavirus tests, not all treatment.

The White House rushed to clarify. Stocks tumbled further. 

Morale bottomed out in the White House. 

One White House official said that was the week it all changed. In addition to the president’s prime-time remarks and the stock market pauses, the virus unexpectedly overturned America’s collective culture. In a span of several minutes that Wednesday night, Hollywood star Tom Hanks announced he had tested positive for the virus, the NCAA’s March Madness tournament was cancelled, the NBA suspended its season. 

“That week made the Democrats' b.s. impeachment seem trivial,” another White House official quipped.

Daily life was not going to be the same.

Within a week, most of the U.S. would be shut down. 

A week later, Congress would pass the largest economic recovery bill ever assembled. 

Here’s what those two weeks felt like inside the White House.


U.S. cases: 6,400

U.S. deaths: 83

Stock market: 20,188.52

The president and his team decided dramatic action was needed to blunt the spread of the virus. 

They had seen horrifying new projections from the Imperial College in London that showed millions dying if more extreme measures were not taken. Chastened by the new data, the president’s demeanor changed. 

On March 16, a Monday, the president announced new recommendations that Americans should not gather in groups larger than 10 — five times more extreme than guidelines introduced by the CDC just the day before. 

It was the start of the White House’s “15 Days to Slow the Spread.”

“With several weeks of focused action, we can turn the corner and turn it quickly,” Trump said. “Our government is prepared to do whatever it takes.” 

Dr. Deborah Birx, a global health specialist tasked with leading the coronavirus task force’s efforts, made a direct plea to the American people to heed the guidelines. 

“We really want people to be separated at this time, to be able to address this virus comprehensively that we cannot see, for which we don’t have a vaccine or a therapeutic,” she warned. 

The president dispatched Treasury Secretary Steven Mnuchin to hammer out a stimulus bill with Congress to give a boost to the economy. Mnuchin gave a dire, but prescient, warning to Senate Republicans during a lunch on Capitol Hill: act now or the U.S. could see double-digit unemployment numbers.


U.S. cases: 13,700

U.S. deaths: 150

Stock market: 19,898.92

On Wednesday, the streets in major cities like San Francisco and New York began to empty. 

At the White House, the president cast had a new message: The country is at war.

“To this day, nobody has seen anything like what they were able to do during World War II,” Trump said at the press podium. “And now it’s our time. We must sacrifice together because we are all in this together and we’ll come through together.”

He invoked a wartime law — the Defense Production Act — granting him broad authority to direct manufacturers to make the equipment needed in a crisis. But he said it would only use the law in a “worst case scenario.” 

America was facing an encroaching, lethal, “invisible enemy,” Trump said. 

At the White House, the enemy was already within.

Members of the president’s inner circle kept getting exposed to people with coronavirus. Several top staffers, including Ivanka Trump and acting chief of staff Mick Mulvaney, had to isolate themselves. 

Members of Congress closest to the president — including his incoming chief of staff Mark Meadows — were forced to self-quarantine. And even as the president began to use the press briefing room day after day, his own press secretary Stephanie Grisham, was conspicuously missing. She, like others in the White House who were exposed, were following the very same advice being dished out at the podium: stay home.“

Who Should Be Saved First? Experts Offer Ethical Guidance - The New York Times

This is one of the issues that scares me most about this pandemic given how America has always discriminated against people of color. Can America change in a crisis? I seriously doubt it. Please prove me wrong.

"How do doctors and hospitals decide who gets potentially lifesaving treatment and who doesn’t?

A lot of thought has been given to just such a predicament, well before critical shortages from the coronavirus pandemic.

“It would be irresponsible at this point not to get ready to make tragic decisions about who lives and who dies,” said Dr. Matthew Wynia, director of the Center for Bioethics and Humanities at the University of Colorado.

Facing this dilemma recently — who gets a ventilator or a hospital bed — Italian doctors sought ethical counsel and were told to consider an approach that draws on utilitarian principles.

In layman’s terms, a utilitarian approach would maximize overall health by directing care toward those most likely to benefit the most from it. If you had only one ventilator, it would go to someone more likely to survive instead of someone deemed unlikely to do so. It would not go to whichever patient was first admitted, and it would not be assigned via a lottery system. (If there are ties within classes of people, then a lottery — choosing at random — is what ethicists recommend.)

In a paper in The New England Journal of Medicine published Monday, Dr. Ezekiel Emanuel, vice provost for global initiatives and chairman of the Department of Medical Ethics and Health Policy at the University of Pennsylvania, and colleagues offer ways to apply ethical principles to rationing in the coronavirus pandemic. These too are utilitarian, favoring those with the best prospects for the longest remaining life.

In addition, they say prioritizing the health of front-line health care workers is necessary to maximize the number of lives saved. We may face a shortage of such workers, and some have already fallen ill.

In a recent article in The New York Times, a British researcher said, “There are arguments about valuing the young over the old that I am personally very uncomfortable with,” adding, “Is a 20-year-old really more valuable than a 50-year-old, or are 50-year-olds actually more useful for your economy, because they have experience and skills that 20-year-olds don’t have?”

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Dr. Emanuel disagreed with that interpretation: “The 20-year-old has lived fewer years of life; they have been deprived of a full life. If they have roughly comparable prognoses, then the fact that the 20-year-old has not had a full life counts in their favor for getting scarce resources.”

Some organizations, states and federal agencies have anticipated challenges like these and developed resources and guides for hospitals and health systems.

The Hastings Center has curated a list of resources that health care institutions can use to prepare for responding to the coronavirus, including for shortages. In 2015, the New York Department of Health released a report on the logistical, ethical and legal issues of allocating ventilators during a pandemic-created shortage. This and many other states’ plans are modeled on guidance from the Ontario Ministry of Health on critical care during a pandemic.

Federal health agencies, including the Department of Veterans Affairs and the Department of Health and Human Services, have also published guidance that includes approaches for allocation of scarce resources during a pandemic.

A study in Chest in April 2019 imagined a 1918 flulike pandemic in which there weren’t enough I.C.U. beds and ventilators to meet demand. The authors engaged focus groups in Maryland about views on how to ration care. The preference of the focus groups? Direct resources to those with the greatest chance of survival and the longest remaining life spans — in other words, also the pragmatic utilitarian approach. This study stemmed from work for a Maryland report on allocating scarce medical resources during a public health emergency.

“Key is to be transparent about the principles, save as many lives as possible, and ensure that there are no considerations such as money, race, ethnicity or political pull that go into allocation of lifesaving resources such as ventilators,” said Dr. Tom Frieden, president and C.E.O. of Resolve to Save Lives and former director of the Centers for Disease Control and Prevention.

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Another principle recommended by medical ethicists is to take tough choices out of the hands of front-line clinicians. Instead, have dedicated triage officers decide. Also, decisions should be free of financial considerations or the social status of patients, something that seems to have been violated in the provision of scarce coronavirus tests to N.B.A. players, for example.

“Ethically speaking, rationing by ability to pay is the worst way to allocate scarce medical resources in an emergency,” said Dr. Jerry La Forgia, chief technical officer of Aceso Global and former lead health specialist for the World Bank.

Nevertheless, precisely this kind of rationing is commonplace in the U.S. health system during more normal times.

The Hardest Questions Doctors May Face: Who Will Be Saved? Who Won’t?March 21, 2020

Health economists have also thought deeply about how to allocate finite health care resources, in government budgets for instance. Often there are winners and losers in these calculations — some treatments covered and some not — but they’re not always individually identifiable.

During a pandemic, the winners and losers are both clearly identifiable. They’re right in front of the doctor at the same time. “This shifts the ethical and emotional burden from society or government to the clinician,” said Christopher McCabe, a health economist and executive director and C.E.O. of the Institute of Health Economics in Alberta, Canada. “There’s no perfect way to choose who gets lifesaving treatment. At times like these, society may be more forgiving of utilitarian decision making.”

History offers examples of competing values. During World War II, soldiers received penicillin before civilians. In Seattle in the 1960s, social worth was among the criteria used to ration dialysis machines.

In 2005, Hurricane Katrina caused acute shortages under emergency conditions in Louisiana health centers. “Health care workers were forced to make things up as they went along, amounting to life and death decisions,” Dr. Wynia said. “This was widely viewed as unfortunate for patients, doctors, and not what we want as a society.”

Today, there is greater demand for some organs for transplants than supply can accommodate. The United Network for Organ Sharing is a system for prioritizing patients for transplants. It combines medical condition, waiting time and prognosis into a scoring system that varies by type of organ.

“It has elements of utilitarianism,” said David Vanness, Professor of Health Policy and Administration at Penn State. “But it’s not designed for the urgency of a pandemic.”

In particular, society has had time to consider how to cover the care for patients needing transplants. The vast majority of end-stage kidney disease patients are eligible for Medicare at any age, for example.

When antivirals or vaccines become available, those too will initially be in short supply, and undoubtedly discussion will arise on who should get them first.

Dr. Emanuel predicts we will soon see in the U.S. the kind of rationing happening in Italy, where there are too few ventilators and I.C.U. beds for all the patients who need them. Estimates by researchers at Harvard show that without drastic expansion of supply, many areas of the U.S. will have inadequate numbers of hospital beds.

“When you consider the shortage of coronavirus tests, we’re already seeing rationing,” he said.

Austin Frakt is director of the Partnered Evidence-Based Policy Resource Center at the V.A. Boston Healthcare System; associate professor with Boston University’s School of Public Health; and a senior research scientist with the Harvard T.H. Chan School of Public Health. He blogs at The Incidental Economist, and you can follow him on Twitter at @afrakt

Who Should Be Saved First? Experts Offer Ethical Guidance - The New York Times

C.D.C. Issues Travel Advisory; U.S. Deaths Reach 2,000

Saturday, March 28, 2020

Cuomo says possible NY quarantine 'would be chaos and mayhem'

Coronavirus numbers are going to skyrocket doctors say

Coronavirus numbers are going to skyrocket doctors say

E.P.A., Citing Coronavirus, Drastically Relaxes Rules for Polluters - The New York Times

One former senior E.P.A. official called the move “a nationwide waiver of environmental rules.”

"WASHINGTON — The Environmental Protection Agency on Thursday announced a sweeping relaxation of environmental rules in response to the coronavirus pandemic, allowing power plants, factories and other facilities to determine for themselves if they are able to meet legal requirements on reporting air and water pollution.

The move comes amid an influx of requests from businesses for a relaxation of regulations as they face layoffs, personnel restrictions and other problems related to the coronavirus outbreak.
Issued by the E.P.A.’s top compliance official, Susan P. Bodine, the policy sets new guidelines for companies to monitor themselves for an undetermined period of time during the outbreak and says that the agency will not issue fines for violations of certain air, water and hazardous-waste-reporting requirements.

Companies are normally required to report when their factories discharge certain levels of pollution into the air or water.
“In general, the E.P.A. does not expect to seek penalties for violations of routine compliance monitoring, integrity testing, sampling, laboratory analysis, training, and reporting or certification obligations in situations where the E.P.A. agrees that Covid-19 was the cause of the noncompliance and the entity provides supporting documentation to the E.P.A. upon request,” the order states.
It said the agency’s focus during the outbreak would be “on situations that may create an acute risk or imminent threat to public health or the environment” and said it would exercise “discretion” in enforcing other environmental rules.

The order asks companies to “act responsibly” if they cannot currently comply with rules that require them to monitor or report the release of hazardous air pollution. Businesses, it said, should “minimize the effects and duration of any noncompliance” and keep records to report to the agency how Covid-19 restrictions prevented them from meeting pollution rules.

“E.P.A. is committed to protecting human health and the environment, but recognizes challenges resulting from efforts to protect workers and the public from Covid-19 may directly impact the ability of regulated facilities to meet all federal regulatory requirements,” Andrew R. Wheeler, the E.P.A. administrator, said in a statement.

Environmental groups and former Obama administration officials described the policy as an unprecedented relaxation of rules for petrochemical plants and other major polluters.
Gina McCarthy, who led the E.P.A. under the Obama administration and now serves as president of the Natural Resources Defense Council, called it “an open license to pollute.” She said that while individual companies might need flexibility, “this brazen directive is nothing short of an abject abdication of the E.P.A. mission to protect our well being.’’

Cynthia Giles, who headed the E.P.A. enforcement division during the Obama administration, said: “This is essentially a nationwide waiver of environmental rules. It is so far beyond any reasonable response I am just stunned.”

Other observers defended the move. Granta Nakayama, a partner at the law firm King & Spalding who served in the E.P.A.’s office of compliance under President George W. Bush, said the memo did not give companies a free pass to pollute, but rather provided guidance in a challenging situation where many industries are facing unique circumstances.

“It’s a very straightforward and sensible, in my view, guidance,” he said.
Agency officials said the new policy relaxes compliance for monitoring and reporting only so that facilities can concentrate on ensuring that their pollution-control equipment remains safe and operational.
“It is not a nationwide waiver of environmental rules,” said Andrea Woods, an E.P.A. spokeswoman. “For situations outside of routine monitoring and reporting, the agency has reserved its authorities and will take the pandemic into account on a case-by-case basis.”

The memo said the compliance changes were retroactive to March 13."

E.P.A., Citing Coronavirus, Drastically Relaxes Rules for Polluters - The New York Times

Trump touted an anti-malarial drug as a cure for Covid-19. Don't believe the hype | World news | The Guardian

A hydroxychloroquine sulfate medication pill: Trump’s touting of the drug as a coronavirus cure has led to shortages for people who need it to treat conditions such as lupus.

"Faced with a global coronavirus pandemic that is increasingly centered upon the US, Donald Trump has touted several drugs that he claims can help tackle the outbreak.

The US president last week used a press conference to promote the use of hydroxychloroquine, a common anti-malaria drug, to treat Covid-19, saying: “I sure as hell think we ought to give it a try.”
He followed this with a tweet that claimed the use of the drug in combination with azithromycin, an antibiotic, could be “one of the biggest game changers in the history of medicine”.
Trump was immediately contradicted by public health experts including his own top infectious diseases adviser, Dr Anthony Fauci, who warned that there was only “anecdotal evidence” that the drugs could be helpful.

Confronted with this disparity Trump, who has repeatedly made false and misleading assertions throughout the coronavirus crisis and indeed his entire presidency, responded by telling reporters that “I’m a smart guy” and “I’ve been right a lot.” The Fox News hosts Laura Ingraham and Sean Hannity seem to be satisfied by this assurance and have been promoting hydroxychloroquine on their shows.
But with some Americans turning to unconventional, and potentially deadly, treatments for coronavirus, medical experts have called for considered, accurate information to avoid exacerbating the pandemic.
Last week, an Arizona man died and his wife was left in critical condition after the couple took chloroquine phosphate, an additive used to clean fish tanks that is also found in the anti-malaria treatment promoted by Trump.

“Trump kept saying it was basically pretty much a cure,” the woman told NBC, before advising: “Don’t take anything. Don’t believe anything. Don’t believe anything that the president says and his people … call your doctor.”
Here are the key things to know:

What is hydroxychloroquine?

Hydroxychloroquine, also known by its brand name Plaquenil, is a drug used to treat malaria. It is a less toxic version of chloroquine, another malaria drug, which itself is related to quinine, an ingredient in tonic water.
It is also readily available to Americans – already approved as a malaria and anti-inflammation treatment by the Food and Drug Administration – where it is an off-the-shelf drug with various low-cost generic versions.

Why is Trump touting it?

Trump was influenced by a widely publicized study in France where 40 coronavirus patients were given hydroxychloroquine, with more than half experiencing the clearing of their airways within three to six days. This apparent improvement is important as it would curtail the timeframe in which infected people could spread Covid-19 to others.
However, experts have warned that the study is small and lacks sufficient rigor to be classed as evidence of a potential treatment. The French health ministry has warned against the use of hydroxychloroquine for Covid-19, with Olivier VĂ©ran, France’s health minister, saying that it shouldn’t be used by anyone with the exception of “serious forms of hospitalization and on the collegial decision of doctors and under strict medical supervision”.

What does the evidence show?

The French study followed work by Chinese researchers which suggested that hydroxychloroquine can slow infections from Sars-CoV-2, the virus behind Covid-19, by blocking it from entering cells in the body. But more recent, albeit small-scale, research from China has shown that patients who were treated with the drugs fought off coronavirus no more quickly than those who didn’t get it. Indeed, one patient given hydroxychloroquine severely worsened in condition while four patients on the medicine developed signs of liver damage and experienced diarrhea.
Regardless of these findings, any drug being used for a certain purpose before full clinical trials are completed is, by definition, untested and unproven. It’s too early to say if hydroxychloroquine can have a major benefit or not.

Are there any downsides to this drug being in demand?

Like many drugs, hydroxychloroquine comes with a number of potential side-effects. These include headaches, dizziness, stomach pain, weight loss and mood changes.
Worse, a sudden surge in demand for hydroxychloroquine risks shortages of the drug for those who need it most. Hydroxychloroquine is able to keep lupus, a chronic autoimmune disease, in check but some people with the condition have complained they are now unable to find Plaquenil. Trump’s pushing of the treatment has caused many Americans, whether they need it or not, to stock up on the drug.

What should people do instead?

The latest Chinese research suggests that using hydroxychloroquine is no better than more conventional coronavirus treatments, such as bed rest, anti-viral drugs and oxygen inhalation. There are about 40 different research efforts around the world to find a vaccine, which may take a year or more, while scientists rummaging around in the existing medical cabinet have identified some other drugs that may be repurposed to tackle Covid-19. But this work, too, will take time.


There is no magic cure for this pandemic, no matter what Trump says."

Trump touted an anti-malarial drug as a cure for Covid-19. Don't believe the hype | World news | The Guardian

‘This all comes down to ventilators:’ Gov. Cuomo on the fight against coronavirus

‘This all comes down to ventilators:’ Gov. Cuomo on the fight against coronavirus

Stacey Abrams on how coronavirus stimulus package shortchanges election funding

Stacey Abrams on how coronavirus stimulus package shortchanges election funding

Opinion | Trump Chooses Disaster as His Re-Election Strategy - The New York Times

It’s a massive bet that political polarization is a more powerful force than the virus’s body count.
Tom Brenner/Getty Images
Donald Trump’s re-election strategy had two potential paths this week. The first path would save millions of jobs, turn Trump into a populist hero for many and perhaps prevent another depression. The second path would court chaos, playing up the partisan divide, deflecting all blame for the coronavirus pandemic onto the media, China and the Obama White House, and praying that it ends up being enough to obscure his administration’s disastrous lack of preparation.

It’s a testament to Mr. Trump’s callousness that at this decisive moment, he chose the second path.
Already we see the carnage. Last week, more than three million Americans filed for unemployment benefits, in part because of a sclerotic government response to the virus shutdown.

It didn’t have to be this way. Mr. Trump could have pressured Congress to join European leaders — including the Tory-led British government — and proposed to “freeze” the American economy in place. Denmark, the Netherlands and the United Kingdom have all committed to paying at least part of workers’ salaries if their companies don’t lay them off.

The American bailout bill does far less for workers or the small businesses that employ them, while larger corporations reap expansive benefits.

And President Trump appears poised to urge workers in some areas back into the pandemic, possibly as soon as mid-April, to restart the economy — a maneuver health experts agree would cause cases to skyrocket, effectively losing the short-term fight against the virus.
Knowingly putting workers into harm’s way to move the market is both unthinkably cruel and wildly misguided, even from an economic perspective.

With this shortsighted call, Mr. Trump is essentially making a massive bet that political polarization is a more powerful force than the virus’s body count. By picking the usual fights with the press, the president is hoping to change the narrative around the virus.

Take the president’s continued efforts to brand the pandemic as a Chinese virus. For Mr. Trump, such language operates as a grotesque division tactic. It creates an enemy for his base at the expense of inflaming racial resentment toward Asians everywhere. The controversy also creates a diversion. News cycles about the administration’s trollish language compete for airtime with reporting around the administration’s slow and costly response to the coronavirus — one that’s left millions of citizens and health care workers vulnerable. In pro-Trump circles, the conversation focuses on a deranged media that’s more obsessed with political correctness than a pandemic.

Mr. Trump’s desire to end social distancing follows a similar pattern. The president’s short attention span, thin skin and obsession with the Dow Jones industrial average all lead him to push for a reopened economy. Only the president doesn’t have that power — states do. And most states are likely to continue urging their residents to stay home. So he’ll blame the media and Democratic governors for the economic fallout. Here’s where the faulty American bailout helps the president in the most sinister way: Workers left without adequate protections could suffer more under a mass quarantine and might be more likely to resent medical experts and a mass media urging for social distancing. Mr. Trump can rail against the states’ decision to extend the quarantine and pretend, insincerely, to side with workers over the elites. After all, many of them can comfortably work from home and keep their jobs, he might argue.

For the president, it might feel like a win-win. If states ignore Mr. Trump’s advice and beat back the virus successfully before Election Day, he can claim victory. In the very unlikely event the virus doesn’t cause destruction in other parts of the country similar to what it is causing in Seattle, New York City and New Orleans, he can claim fear-mongering on behalf of Democrats and the media.

Meanwhile, the conversation around the virus shifts away from those needlessly suffering and the Trump administration’s woeful preparedness. The pandemic moves from Mr. Trump’s nightmare — a complex medical and logistical crisis requiring empathy and leadership — to Mr. Trump’s wheelhouse — an overly simplified, cynical political battle fought with cruelty and finger-pointing. Just as his coronavirus news conferences have become stand-ins for his rallies, the president’s politicization of the virus allows him to operate in a modified campaign mode. Without an official Democratic challenger to call out and a traditional election news cycle to cover the horse race, Mr. Trump is choosing to use the pandemic as a tool for his usual base-rallying division.

Under normal circumstances, this tactic seems to work for the president. But these are not normal times. Though public opinion around the virus is still starkly divided by party, there’s evidence to suggest that gap is narrowing and could shrink substantially as the spread of infection peaks across the country. Faced with an exponentially multiplying threat, the president has chosen to flirt with disaster rather than avoid it. It’s a strategy with a high risk of collateral damage — namely, us.

Opinion | Trump Chooses Disaster as His Re-Election Strategy - The New York Times