This pandemic is no hoax! Excess deaths data "Never seen anything like it"

U.S. ‘excess deaths’ during pandemic surpassed 1 million, with COVID killing most but other diseases adding to the toll, CDC says.  
Excellent information. Echo report published in The Washington Post written by Joel Achenbach.

The United States has recorded more than 1 million “excess deaths” since the start of the pandemic, government mortality statistics show, a toll that exceeds the officially documented lethality of the coronavirus and captures the broad consequences of the health crisis that has entered its third year.

The excess-deaths figure surpassed the milestone last week, reaching 1,023,916, according to Robert Anderson, chief of the mortality statistics branch of the Centers for Disease Control and Prevention’s National Center for Health Statistics. The center updates its estimate weekly.

Although the vast majority of the excess deaths are due to the virus, the CDC mortality records also expose swollen numbers of deaths from heart disease, hypertension, dementia and other ailments across two years of pandemic misery.

“We’ve never seen anything like it,” Anderson said.

In 2019, before the pandemic, the CDC recorded 2.8 million deaths. But in 2020, and 2021, as the virus spread through the population, the country recorded roughly a half-million deaths each year in excess of the norm.

The virus emerged in China in late 2019, and began killing people there in January 2020. It did not spread significantly in the United States until that February, and it wasn’t until the final week of March 2020, that it began to send the excess-deaths metric soaring.

The CDC’s excess deaths tracker shows in detail the speed and intensity of that initial wave: Deaths soared more than 40 percent above normal in the United States in the second week of April 2020.

The lethality in early April was concentrated in a few hot spots; for example, deaths in New York City were seven times the norm, but some regions had minimal change in mortality for many months.

The CDC mortality branch’s official count of deaths from covid-19 stood at 911,145 as of Tuesday. (The mortality researchers rely on death certificates, and that tally can be slightly lower than other CDC or academic trackers that rely on data from other sources.)

Anderson said 91 percent of the deaths from covid-19 tracked by his unit were attributed directly to the disease. In the other 9 percent of deaths, covid-19 was listed as a contributing factor but not the primary cause.

Red Cross nurse

The CDC documented 13 other types of non-COVID causes of death that were inflated during the pandemic compared with historical trends starting in 2013. For example, since the start of the pandemic, the category of ischemic heart disease has recorded an additional 30,000 deaths beyond what would be expected. Deaths from hypertensive disease were nearly 62,000 higher than expected.

Anderson said the numbers carry a degree of ambiguity: Some heart attacks and hypertensive disease could have been associated with undiagnosed cases of coronavirus infections.

The CDC’s analysis estimates 208,431 excess deaths from all the non-COVID causes since the start of the pandemic. At first glance, that number plus the 911,000 covid-19 deaths would suggest the excess deaths were greater than 1.1 million. But, Anderson notes that many of the people who died of COVID-19 were elderly, sick or very frail, and, even without a pandemic, some might not have survived across the two-year span of the pandemic. “Some of those COVID deaths are not, strictly speaking, excess deaths,” he said.

The million-deaths figure highlights the broad reach of the pandemic beyond the direct lethality of the virus itself.

“The bulk of the excess deaths were a direct result of COVID-19 infections, but pandemics have major cascading impacts on all aspects of society,” said Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security.

He cited many health impacts beyond the coronavirus, including a sharp rise in drug overdoses as people with opioid use disorder struggled to get treatment or used drugs in isolation, and a drop in cancer screenings, such as mammograms and colonoscopies. The CDC previously reported that more than 93,000 people died of drug overdoses in 2020, a record number that far surpassed deaths from homicide and traffic accidents combined.

The CDC has found that 74 percent of COVID-19 deaths occurred among people age 65 and older. Anderson noted that many elderly and frail people found themselves isolated because of precautions against viral spread. During the initial wave of infections, when the country largely shut down, the quality of care for the most vulnerable populations probably suffered, Anderson said. Deaths from Alzheimer’s disease exceeded the expected total by 66,000 during the course of two years, he said.

“People with dementia, in isolation, they sometimes lose the will to live,” Anderson said.

Some critics of shutdowns have argued they caused more harm than good. That has been a contentious issue since the first weeks of the outbreak in the United States, when infections were doubling every few days and hospitals in hot spots like New York City were in danger of being overwhelmed.

The country largely shut down for 45 days, with schools transitioning to remote learning, restaurants closing or going strictly to takeout, and airports turning desolate. Many people essentially sheltered in place. That set up a secondary health crisis, as people canceled cancer screenings, ignored warning signs of heart problems or possible strokes, and failed to receive the kind of medical care and support they needed.

Adalja said the excess deaths associated with the pandemic but not directly caused by the virus suggest that in a crisis such as this, the country should favor targeted rather than broad public health interventions.

The roller-coaster trend line of excess deaths as tracked by the CDC captures the multiple waves of infection that struck the United States since early 2020. There have been five waves total. At one point last March and April, the mortality numbers came very close to returning to normal.

The CDC records show a small, but distinct spike in deaths in late 2017, and early 2018, driven by an unusually severe flu season. But that was a tiny bump compared with what the CDC has seen since the beginnings of the coronavirus.

Anderson said the CDC had to adjust its algorithm for estimating excess deaths last fall as the pandemic continued. Although the mortality branch has given a precise number for excess deaths, the data from the past couple of months is incomplete, he said. For January, for example, the CDC estimates that only about 85 percent of the death certificates have reached the agency, he said.

Steven H. Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University, said Tuesday that his published studies on excess deaths during the pandemic have consistently shown that 80 to 85 percent were caused by the virus directly. The remainder can largely be attributed to disruptions caused by the pandemic, he said.

“The economic and psychological stresses of the pandemic take their toll,” Woolf said.

Moreover, the pandemic exacerbated existing health disparities and led to much higher mortality among Black and Hispanic people, particularly early in the crisis, research has shown. A Washington Post analysis last year found that at the time, in the 40-to-64 age bracket, 1 in 480 Black people, 1 in 390 Hispanic people and 1 in 240 Native Americans had died during the pandemic, compared with 1 in 1,300 White people and Asian people.

The United States on the whole has an unusually high rate of chronic health conditions, such as obesity, diabetes and heart disease, and has a long-recognized “health disadvantage” compared with other wealthy nations.

That disadvantage was exacerbated by a weak and scattershot response to the pandemic, Woolf said. Other countries that reacted more quickly or took more aggressive postures to control viral spread early on were able to limit their death toll as well as long-term economic impacts, he said.

“We did not handle it well. That’s glaringly obvious,” he said. “The other countries got hit by the same virus, but no country has experienced the number of deaths we have, and even if you adjust for population, we are among the highest in the world.”

Dan Keating contributed to this report.

Opinion echo: COVID-19 and emergency medical services - EMT risks

 A Physician’s Vaccine Perspective

Get vaccinated!  Vaccines save lives!

• Everyone 5 years of age and older is now eligible to get a COVID-19 vaccination.
• Everyone ages 18 and older should get a booster shot

____________________________________________

To the editor of the The Lincoln County News, in Waldoboro, Maine by Dr. James Li:

I wanted you to hear my take on the COVID-19 vaccine from both a physician and an emergency medical services perspective.

Because of the important role emergency medical services providers have in patient care, they are at much higher risk of contracting and dying from COVID-19. 

Hospital staff with patient contact has a three times greater risk of dying from COVID-19 than the normal population. However, EMTs have an even higher risk — 5 times more than physicians. This makes Emergency Medical Services (EMS) providers the highest risk occupation for dying from the disease.

Thus, the most compelling reason for getting the vaccine is so you personally won’t die from COVID-19.

The science is very good on this point. In the Phase 3 trials, the Moderna vaccine eliminated critical cases of COVID-19 in the 15,000 patients getting the vaccine. As the National Institutes of Health noted, “there were 11 cases of severe COVID-19 out of the 95 total, all of which occurred in the placebo group.”

From a public health perspective, the vaccine is also a vital step in stopping the spread of COVID-19 through the “herd immunity” concept. This simply means that if enough people in the overall population become immune to COVID-19, the coronavirus has nowhere to go since it only survives and replicates itself in non-immune people.

Because this coronavirus is so contagious, the proportion of people that need to be immune for herd immunity to happen is very high. Current estimates put this proportion around 90% of the general population. These preceded the arrival of the COVID-19 mutations in Europe and Africa that make it even more contagious, further cementing the high proportions of immunity needed to stop the pandemic.

Therefore, until we reach widespread immunity in our population, we expect repeated surges and resurges in cases forever. The possibility that we never will achieve sufficient population immunity is so great that many public health and hospital models include plans for a permanent COVID-19 pandemic.

For these personal and public health reasons, I’m getting this vaccine with the rest of the EMS staff. Like many, I’m generally very conservative on adopting new therapies due to safety reasons. However, I’m pleased with how this vaccine was developed, tested, and approved. The mRNA technology has been previously vetted in cancer immunotherapy and worked well. 

Also, the immunity provided through this new type of vaccine development is more than double that afforded by older vaccine technologies like that used to make influenza vaccine. That’s because the mRNA vaccines better mimic the way viruses invade our tissues in order to trigger more than one pathway of immune response.

Over the next one to three months, news about the population-based vaccine rollout will accelerate, particularly as it becomes clear that the coronavirus will continue to disrupt our lives and our economy. We have a unique opportunity to get a well-vetted, high-tech treatment that offers incredible protection from a disease that has caused national and global distress. 

Getting vaccinated early is a good thing for us personally, professionally, and for the greater good of the public that we serve.

James Li, M.D., Medical director
Waldoboro Emergency Medical Services, Maine

COVID- Macabre mathematics: Continuous flow of patients as numbers of mortalities grow

Worldwide spread of the Coronavirus is macabre mathematics.

PARIS (Associated Press) — During their daily morning round of the intensive care unit, hospital staffers and medical students pause outside room No. 10, abruptly emptied of the patient who lost his nearly month-long battle against COVID-19 the previous evening.

The man died at 6:12 p.m., the medic leading the briefing tells the group. There is a short hush. And then they walk on.

Even for ICU workers for whom death is a constant — and never more so than this year — witnessing the loss of a fellow human being to the virus can be a churn of emotions.

COVID infections spread and continue - Bitter experience helps French ICUs crest latest virus wave. Report echo by John Leicester published in the Associated Press.

ROUEN, France (AP) — Slowly suffocating in a French intensive care ward, Patrick Aricique feared he would die from his diseased lungs that felt “completely burned from the inside, burned like the cathedral in Paris,” as tired doctors and nurses labored day and night to keep gravely ill COVID-19 patients like him alive.

A married couple in the same ICU died within hours of each other as Aricique, feeling as fragile as “a soap bubble ready to pop,” also wrestled the coronavirus. The 67-year-old retired building contractor credits a divine hand for his survival. “I saw archangels, I saw little cherubs,” he said. “It was like communicating with the afterlife".

On his side were French medical professionals who, forged on the bitter experiences of previous infection waves, now fight relentlessly to keep patients awake and off mechanical ventilators, if at all possible. They treated Aricique with nasal tubes and a mask that bathed his heaving lungs in a constant flow of oxygen. That spared him the discomfort of a thick ventilation tube deep down his throat and heavy sedation from which patients often fear — sometimes, rightly so — that they will never awake.

While mechanical ventilation is unavoidable for some patients, it’s a step taken less systematically now than at the start of the pandemic. Dr. Philippe Gouin, who heads the ICU ward where Aricique underwent treatment for severe COVID-19, said, “We know that every tube we insert is going to bring its share of complications, extensions in stay, and sometimes morbidity.”

About 15% to 20% of his intubated patients don’t survive, he said.

“It’s a milestone that weighs on survival,” Gouin said. ”We know that we will lose a certain number of patients who we won’t be able to help negotiate this corner.”

Third wave of coronavirus, a variant of the infectious COVID19 virus, is infecting France.

The shift to less-invasive breathing treatments also is helping French ICUs stave off collapse under a renewed crush of coronavirus cases. Super-charged by a more contagious virus variant that first ravaged neighboring Britain, the third infection wave in France has pushed the country’s COVID-19-related death toll past 100,000 people. Hospitals across the country are grappling again with the macabre mathematics of making space for thousands of critically sick patients.

“We have a continuous flow of cases,” said Dr. Philippe Montravers, an ICU chief at Bichat Hospital in Paris, which is again shoe-horning patients into makeshift critical care units. “Each of these cases are absolutely terrible stories — for the families, for the patients themselves, of course, for the physicians in charge, for the nurses.”

Sedated patients kept alive with mechanical ventilation often occupy their ICU beds for several weeks, even months, and the physical and mental trauma of their ordeals can take months more to heal. But 13 days after he was admitted for ICU care in the Normandy cathedral city of Rouen, Aricique was sufficiently recovered for another critically ill patient to take his place.

A non-invasive nasal ventilation system dispensing thousands of liters (hundreds of gallons) of life-sustaining oxygen every hour got him through the worst of his infection, until he was well enough for the flow to be reduced to a trickle and to sit upright, his New Testament bible at his side. Tucking into a small lunch of omelette and red cabbage to start rebuilding his strength, Aricique said he felt resurrected. A nurse freed him from drips that had been plugged into arms, binning the tubes like entrails.

Making rounds with junior doctors and nurses in tow, Dr. Dorothee Carpentier allowed herself a mini-celebration as she swept past Aricique’s room, having declared him fit for discharge. The patient in the adjacent room also could leave, she decided. She described the imminent departures as “little victories” for the full 20-bed ward, a temporary set-up in what was previously a surgical unit and is now entirely converted for C0VID-19 care.

“I imagine they’ll be filled again by the morning,” Carpentier said of the two vacated beds. “The tough thing about this third wave is that there is no stop button. We don’t know when it will start to slow.”

Further down the corridor, a 69-year-old woman placed face-down on her stomach was struggling with the effort of breathing with an oxygenation mask and getting dangerously close to the point where doctors would decide to anesthetize and intubate her. Nurse Gregory Bombard recruited the woman’s visiting daughter-in-law in an effort to stave off that next step, impressing on her the importance of sticking with the mask.

“Morale is so important, and she has to turn this corner,” Bombard said. “We do what we can. They have to make the effort to win, too, otherwise they will lose.”

“Do what you can,” the nurse told the daughter-in-law..

The relative later emerged from the patient’s room misty-eyed and shaken.

“It’s really tough to see her like this,” she said. “She is letting herself go.”

In another room, Gouin gently pleaded with a 55-year-old market stall operator who complained that his oxygenation mask made him feel claustrophobic.

“You have to play the game,” the doctor insisted. “My goal is that we don’t get to the point where we have to put you to sleep.”

The patient concurred. “I don’t want to be intubated, be in a coma, not knowing when you are going to wake up,” he said.

Intubations can be traumatic for everyone involved. A patient who sobbed when he was put to sleep remained sedated in the ICU nearly two weeks later.

“You could see he was terrified,” Bombard recalled. “It was awful.”
___
Follow AP’s pandemic coverage at https://apnews.com/hub/coronavirus-pandemic, https://apnews.com/hub/coronavirus-vaccine and https://apnews.com/UnderstandingtheOutbreak

Pandemic- A serious social perspective

A Facebook blog written by:

Dora Anne Mills, MD, MPH in "Not-So-Brief"  COVID-19 Update. Sunday November 15, 2020.   DATELINE- Maine

Tale of Two Worlds 

Sometimes, I feel like I’m living in two worlds, tugging each other in opposite directions, as we careen down a hill. 

Dissonant coronavirus pandemic split screen

Maybe others feel the same way? Just take a look at what’s been in the newspapers the last week. On one hand, I read some are disturbed about the indoor pandemic prevention gathering limit being reduced in Maine from 100 to 50. 

On the other hand, many are tiptoeing around and being careful to get groceries and other staples delivered or from curbside pickup so they can avoid stepping into indoor public places. Many are attending religious services online to assure a safer way to worship. I read that people are upset about youth hockey and similar sports being cancelled, impacting their children’s emotional as well as physical health. Yet, I also read that others are upset about outbreaks caused by sports and some school closures because of student athletes who test positive. (One positive tested athlete, if exposing a team, means that students from different grades and cohorts have been exposed, thus sometimes resulting in a school closure). I read about protests against masking. Some seem to feel their rights are violated. Others say masks make them feel uncomfortable. 

Yet others don’t believe they work. Sometimes, I’m reminded of my parents, who in the 1970s disliked the emerging seatbelt recommendations and laws. Having taken driver’s ed, I had seen films about the need for seatbelts and pestered them about it. My mother said seatbelts always felt too tight and constraining. They questioned if they were effective, given the circulating misinformation about internal injuries from seatbelts. However, it didn’t take many months for their minds to change. Perhaps it was the pestering from their teenage daughter. Maybe it was them realizing how many people they actually knew who had died because they didn’t weren’t wearing a seatbelt. Or maybe it was the irritating high-pitched dinging noise their new car made, reminding my parents to buckle up. They didn’t think twice about wearing seatbelts after making it a habit. I’m sure if they were alive today, my parents would not relish wearing a mask. After all, none of us do. But I believe they would agree mask requirements do not take away their freedoms any more than seatbelts do, and that any discomfort and inconvenience are worth the costs. 

And one major difference - masks are not permanently needed. Hopefully in a few months there won't be a need for us to wear them. The challenge of course, is that unlike the transition to seatbelts, we don’t have months for people to adjust to masking. Especially now that winter is bearing down on us, so is the pandemic. I am reminded daily of our heroic nurses and other health professionals who are wearing tight-fitting N-95 masks with face shields or hoods, gloves, and full protective outfits for 12+ hours per day. They tell me they often find it easier to and choose to work an entire shift without a meal break because of the time and effort it takes to don and doff this protective equipment. I know some of them are anxious, because they see a steady increase of very sick patients showing up on hospital doorsteps, desperate for help. I read that people feel the pandemic cannot be too bad, since they don’t even know of anyone with the disease, or if they do, the person recovered. And if it were so common, then why don’t they know of anyone who has died from it? As grim as the data are, it’s often hard for us to realize how severe this pandemic is until it hits us close to home. However, it may be helpful to look at the other leading causes of death - cancer, heart disease, or unintentional injuries (car crashes, drug overdoses). 

Most of us probably know too many people who have tragically died of each of these. 

Nevertheless, in any given eight-month period, it’s not uncommon that we don’t personally know someone well who has passed from each of these. For instance, I know plenty of people who have tragically died in car crashes or of cancer over the years, but (thankfully) no one I know very well has died from either of these the last eight months. The same may be true with COVID. We may or may not know someone well who has passed from it this last eight months. But that doesn’t make it uncommon. I read that people feel the pandemic is not too bad, since mainly old people are dying from it. It may help for us to be reminded that this is true of most of the leading causes of death. Older people are much more likely to die from these diseases than younger people are. This is true of cancer, heart disease, stroke, Alzheimer’s, and diabetes. Yet I believe all of us think these diseases deserve our collective attention - including how to prevent and treat them - even if they strike older people more than those who are younger. 

On November 11, we honored those serving our country by observing Veterans Day. The origin of this day was at 11 am on November 11, 1918 when the armistice between the Allies and Germany went into effect to end World War I. President Wilson remarked how a diverse coalition had come together and were victorious, and how the armistice “foretells the enduring conquests which can be made in peace when nations act justly and in furtherance of common interests.” (Remarks on 11/11/19) However, as is somewhat the case now as well as with the original Armistice Day, there were two wars. The world had not only been at war against each other, but also against the 1918 pandemic with influenza. In fact, 85% of the 53,000 American military personnel who died in World War I died of the pandemic. As is the case today, there were also efforts to de-emphasize the pandemic and to keep life as normal as possible. But the data from those times are clear. Several studies show those communities that recognized the science and pulled together to help each other, recovered sooner and better than those that did not. When we’re in the same pew, the same team, and the same side working for the common good, we can, as the hymn says, rise together on eagle’s wings and shine like the sun. We need to keep faith - in science, in our common humanity, and in the universal Golden Rule of treating others as you would want to be treated. But it’s not enough to keep the faith, we also need to spread it by working together. 

Indeed, working together, we are stronger.

#ThankYouDora

America is not great again: "You can see a lot by just watching"

Among the baseball legend Yogi Berra's memorable quotes, “You can observe a lot by just watching”, describes what is happening in America today.  

Certainly, we can see that America is not great again.

Echo opinion from Nogales International- Arizona and Mexico describes the hypocrisy about what 'Make America Great Again' has really meant. This essay was published in Nogales International by Manfred Cripe.

Most Americans remember the political slogan “Make America Great Again,” as the battle cry spewed by Donald Trump and the Republican Party in 2016.

In retrospect, let us examine their beliefs on making America great again. Let us begin with the economy, and what the actual effects have been.

• First of all by Jan. 20, 2017, Republicans inherited a very good economy from the previous President Barack Obama. Even as late as mid February 2020, Trump’s people were crowing on Fox Radio about how great their #fake economy was, and wrongly mocking Obama for putting in place programs that eventually led us out of the Great Recession.

As a result of failed economic policies and no plan to respond to the coronavirus pandemic, the stock market crashed and unemployment has soared to heights not seen since the 1930s. 

So, how did the Republican president and Republican Senate make America great again? They forgot that no condition is permanent, except death and taxes.

Of course you cannot blame the president for the virus, but he and his fellow #failed Republicans can be blamed for not having a plan and supplies to deal with this silent killer. At the outset, Trump said it would be over quickly, but after four months, more than 100,000 people have died in the United States and the death toll is still rising. Hey folks! That is nearly twice the number of U.S. servicemen killed in the Vietnam War over a 10-year period, and the protests over the deaths from the virus are silent. Instead, all the president and his men are concerned with is his and their re-election. 

Consequently it has nothing to do with making America great again, but making him great.

• Another way that the president seems to think he is making America great again is the way he has been removing the United States from international agreements negotiated by former presidents. Instead he is making agreements with bullies, murderers and dictators. In the minds of many he has made the United States not a democracy to be admired, but a bully who is mocked, pitied and laughed at.

If all this greatness is too much for you, on Memorial Day 2020, an incident occurred that has led to protest, violence and looting in cities all over our nation. Of course, you MAGA delusionals say that Trump cannot be blamed for this. But, think for a moment: shortly after Trump became president, a black professional football player took a knee during the National Anthem to protest violence against black men. This man was ridiculed by Trump, sworn at, tweeted against continuously and ostracized from playing professional football. 

Just like Trump downplayed the virus, Trump refused to listen to one serious black football player on one knee.

If you agree that trying to restore a failed economy before resolving the public health of the nation will not make America great again; that science should prevail over presidential decrees, anecdotes and wishful thinking; that international treaties are a positive thing; and that putting a knee on a black man’s neck by a white police officer, or any police officer, for eight minutes is not the way to deal with our racial issues; then do something about it. Vote on, or by mail, Nov. 3, 2020 to make this beautiful, wonderful, best-ever stable genius a one-term president, and make America great again!

(Cripe is a resident of Nogales.)

Making America "great again" is clearly not happening and all you have to do is watch #NoJusticeNoPeace to see the reality.

Donald Trump is politically circling the drain

"It is sometimes said that wars make presidents great; tragedies and disasters can at the very least make their greatest moments. The enduring images of many presidencies came when the commander in chief had to rally and console the nation," David A. Graham

Donald Trump's failed leadership must be flushed out of our political system

\\\\\\\New England Journal of Medicine - On January 19, 2020, a 35-year-old man presented to an urgent care clinic in Snohomish County, Washington, with a 4-day history of cough and subjective fever. 

Atlantic Magazine article by  David A. Graham:  It’s been 111 days since the first reported case of the coronavirus in the United States. It’s been 57 days since President Trump issued social-distancing guidelines, and 12 days since they expired. 

Yet the Trump administration still has no plan for dealing with the global pandemic or its fallout. The president has cast doubt on the need for a vaccine or expanded testing. He has no evident plan for contact tracing. He has no treatment ideas beyond the drug remdesivir, since Trump’s marketing campaign for hydroxychloroquine ended in disaster. And, facing the worst economy since the Great Depression, the White House has no plan for that, either, beyond a quixotic hope that consumer demand will snap back as soon as businesses reopen.

Echoing his breezy language in the earliest days of the pandemic, Trump has in recent days returned to a blithe faith that the disease will simply disappear of its own accord, without a major government response.

Stupid Donald Trump! 

“I feel about vaccines like I feel about tests: This is going to go away without a vaccine,” Trump said Friday. “It’s going to go away, and we’re not going to see it again, hopefully, after a period of time.”

He added: “They say it’s going to go—that doesn’t mean this year—doesn’t mean it’s going to be gone, frankly, by fall or after the fall. But eventually it’s going to go away. The question is, will we need a vaccine? At some point it’s going to probably go away by itself. If we had a vaccine that would be very helpful.”

As for the cratering economy, which on Friday produced the worst jobs numbers on record, Trump shrugged. “We’re in no rush, we’re in no rush,” he said.

The president’s shiftlessness in the face of the greatest crisis of his presidency, and the greatest political threat during it, is confounding. Of course, Trump has faced mortal political threats before; less than five months ago, he became only the third president in American history to be impeached. He’s shown a remarkable ability to survive damaging situations. And his plans have often been derided by skeptics as unwise, unrealistic, or simplistic. This situation is different, though: Grappling with a multifront crisis, Trump seems to have no plan at all.

Let’s begin with efforts against the illness itself. The 45 days during which Trump recommended social distancing were meant to prevent hospitals from being swamped with patients, and give the government time to devise more effective measures. 

But when that period ended at the end of April, Trump simply let his recommendations lapse, opting not to extend them in favor of vague calls for reopening the economy.

Those six weeks didn’t actually buy the country much time, because the White House wasted them. With New York City removed from the numbers, the national curve hasn’t flattened at all. States continue to fend for themselves on tests and personal protective equipment. Trump held a White House event yesterday to tout growth in testing in the U.S., but the president’s rhetoric was misleading. The U.S. does not, as he claimed, lead the world in testing, on a per capita basis. He also continues to compare the U.S. rate favorably to South Korea’s, eliding that South Korea was able to control its outbreak sooner by testing faster, and thereby reducing its need for testing.

As my colleague Robinson Meyer has reported, based on figures in the COVID Tracking Project, which is housed at The Atlantic, the U.S. has increased testing but still needs to expand it dramatically to match expert recommendations. “To an almost astonishing degree, the U.S. has no national plan for achieving this goal,” Meyer writes. “There is no effort at the federal level that has mustered anything like the funding, coordination, or real resources that experts across the political spectrum say is needed to safely reopen the country.”

Trump’s struggles to convey any emotion but anger have been foretold in past crises. Consider the first great external disaster to strike the Trump administration, the 2017 hurricane season. Visiting Texas, the president seemed unable to relate to anything other than the massive size of Hurricane Harvey. And despite fitful attempts to telegraph that he cared, he stumbled even worse in Puerto Rico after Hurricane Maria. Trump argued that the storm was not a “real catastrophe” like Hurricane Katrina and callously tossed rolls of paper towels to desperate aid-seekers.

Trump’s inability to register the suffering may have played into the disastrous federal response to the storm. Eventual estimates placed the death toll from Maria at about 3,000 people, making it far more lethal than Katrina, and among the worst natural disasters in American history.

Remdesivir - an opening to a proven treatment but not a magic bullet

Echo report published in the journal Nature by Heidi Ledford:

Also reported in USAToday:

https://www.usatoday.com/story/news/health/2020/04/30/remdesivir-what-we-know-potential-coronavirus-treatment/3054644001/

Dr. Fauci said a U.S. federal trial use of remdesivir with patiets who are ill with coronavirus showed 'proof of concept'.

As of now, remdesivir is given in combination with other prescribed pharmaceutical agents and is administered intravenously to very ill patients who are diagnosed with coronavirus infection.

An experimental drug — and one of the world’s best hopes against COVID-19 — could shorten the time to recovery from coronavirus infection, according to the largest and most rigorous clinical trial of the compound.

The experimental drug, called remdesivir, interferes with replication of some viruses, including the SARS-CoV-2 virus responsible for the current pandemic. 

On 29 April, Anthony Fauci, director of the US National Institute of Allergy and Infectious Disease (NIAID), announced that a clinical trial of more than a thousand people showed that people taking remdesivir recovered in 11 days on average, compared to 15 days for those on a placebo.

“Although a 31% improvement doesn’t seem like a knockout 100%, it is a very important proof of concept,” Fauci said. “What it has proven is that a drug can block this virus.”

Deaths were also lower in trial participants who received the drug, he said, but that trend was not statistically significant. The shortened recovery time, however, was significant, and was enough of a benefit that investigators decided to stop the trial early for ethical reasons, he said, to ensure that those participants who were receiving placebo could now access the drug. Fauci added that remdesivir would become a standard treatment for COVID-19.

The news comes after weeks of data leaks and on a day of mixed results from clinical trials of the drug. In a trial run by the drug’s maker, Gilead Sciences of Foster City, California, more than half of 400 participants with severe COVID-19 recovered from their illness within two weeks of receiving treatment. But the study lacked a placebo controlled arm, making the results difficult to interpret. Another smaller trial run in China found no benefits from remdesivir when compared with a placebo. But the trial was stopped early due to the difficulty in enroling participants as the outbreak subsided in China. Nevertheless, onlookers are hopeful that the large NIAID trial provides the first glimmer of hope in a race to find a drug that works against the coronavirus, which has infected more than 3 million people worldwide.

“There is a lot of focus on remdesivir because it’s potentially the best shot we have,” says virologist Stephen Griffin at the University of Leeds in the UK.
Small trials

The fast-flowing, conflicting information on remdesivir has left people reeling over the past weeks. 

In the rush to find therapies to combat COVID-19, small, clinical trials without control groups have been common. “I’m just very annoyed by all of these non-controlled studies,” says Geoffrey Porges, an analyst for the investment bank SVB Leerink in New York City. “It’s reassuring that 50–60% of patients are discharged from the hospital, but this is a disease that mostly gets better anyway.”

With so much uncertainty, the remdesivir-watchers were waiting anxiously for final results from the NIAID trial, which were not expected until the end of May. In lieu of a vaccine, which could still be more than a year away, effective therapies are critical to reducing deaths and limiting economic damage from the pandemic. Yet, despite the flood of small clinical trials, no therapy has been convincingly shown to boost survival in people with COVID-19.

The NIAID results put a new sheen on remdesivir. “It may not be the wonder drug that everyone’s looking for, but if you can stop some patients from becoming critically ill, that’s good enough,” says Griffin.

Fauci said the finding reminded him of the discovery in the 1980s that the drug AZT helped to combat HIV infection. The first randomized, controlled clinical only showed a modest improvement, he said, but researchers continued to build on that success, eventually developing highly effective therapies. For now, he said, remdesivir would become a standard treatment for COVID-19.

Remdesivir works by gumming up an enzyme that some viruses, including SARS-CoV-2, use to replicate. In February, researchers showed that the drug reduces viral infection in human cells grown in a laboratory.

Gilead began to ramp up production of remdesivir well before the NIAID results. By the end of March, the company had produced enough to treat 30,000 patients. By streamlining its manufacturing process and finding new sources of raw materials, Gilead announced that it hoped to produce enough remdesivir to treat more than a million people by the end of the year.

That calculation was based on the assumption that people would take the drug for 10 days, but the results announced from Gilead’s trial today suggest that a 5-day course of treatment could work just as well. If so, that would effectively double the number of people who could be treated, says Porges.
Many drugs needed

In the long term, clinicians will likely want a bevy (a large group) of anti-viral drugs — with different ways of disabling the virus — in their arsenal, says Timothy Sheahan, a virologist at the University of North Carolina in Chapel Hill, who has teamed up with Gilead researchers to study remdesivir. “There is always the potential for antiviral resistance,” he says. “And to hedge against that potential, it’s good to have not only a first-line, but also a second-, third-, fourth-, fifth-line antiviral.”

Researchers are furiously testing a wide range of therapies, but early results, while not yet definitive, have not been encouraging. The malaria drugs chloroquine and hydroxychloroquine, both of which also have anti-inflammatory effects, drew so much attention from physicians and the public that some countries have depleted their supplies of the drugs. Yet studies in humans have failed to show a consistent benefit, and some have highlighted the risks posed by side effects of the drugs on the heart.

Early interest in a mix of two HIV drugs called lopinavir and ritonavir flagged when a clinical trial in nearly 200 people did not find any benefit of the mix for those with severe COVID-19. Another promising therapeutic hypothesis — that inhibiting the action of an immune system regulator called IL-6 could reduce the severe inflammation seen in some people with severe COVID-19 — has met with mixed results thus far.

Still, a host of other therapies are being tested in people, and many researchers are hunting for new drugs at the bench. Sheahan and his colleagues have found a compound that is active against SARS-CoV-2 and other coronaviruses, including a remdesivir-resistant variant of a coronavirus, when tested in laboratory-grown human cells.

But much more testing would need to be done before the compound could be tried in people. “What we’re doing now will hopefully have an impact on the current pandemic,” he says. “But maybe more importantly, it could position us to better respond more quickly in the future.”

Failed Donald Trump: Any rational leader would use every ounce of presidential influence to urge national unity

Editorial: Liberation, defiance and revolution! 

Echo opinion published in the St. Louis Post-Dispatch 
What kind of president talks like this?

No American president since the Civil War, if even then, has ever encouraged mass insurrection and called upon citizens to “liberate” their states from elected governors. President Donald Trump has spent recent days doing exactly that, along with promoting a book whose title screams “Revolution,” while a prominent ally is urging conservative students toward rebellion.

The message here seems to stray about as far away as a president can get from unity in a time of crisis. Rather, Trump seems intent on stirring things up and fomenting instability, with particular emphasis on Democrat-held swing states like Minnesota, Michigan and Virginia.

Rarely does Trump indicate that he actually thinks through the consequences of his tweets and extemporaneous comments. 

But people are acting on his words, and therein lies the danger. Considering that Monday was the 25th anniversary of Timothy McVeigh’s anti-government terrorist attack on an Oklahoma City federal building, and that a radical segment of Trump’s base today consists of “militia” gun fanatics who practice weekend war maneuvers, the implications are too serious for Trump to continue playing rhetorical games on social media.

Even governors from Trump’s Republican Party, such as Maryland Gov. Larry Hogan and Ohio’s Mike DeWine, are publicly criticizing his language.

DeWine said Sunday on “Meet the Press” that, yes, the goal should be “to open this economy. But do it very, very carefully, so we don’t get a lot of people killed.”

Videos of crowds at various state capitols belied Trump’s assertions that protesters, including some in Jefferson City Tuesday, were observing social-distancing precautions. It appeared in several cases as if people couldn’t care less. Trump defended them, even though his own top health advisers — Drs. Anthony Fauci and Deborah Birx — have counseled the nation not to ease stay-at-home restrictions.

Any rational leader in Trump’s place, faced with a crisis of this magnitude, would recognize that science and common sense must prevail over politics. Any rational leader would use every ounce of presidential influence to urge national unity and compliance with the White House’s own guidelines. 

But Trump, as his tweets suggest, is no rational leader.

His desperate antics coincide with steeply slumping economic indicators and diminishing public support. Trump seems to reason that an uncoordinated flood of protesters onto the streets might somehow make things better, despite all of the medical evidence — including more than 800,000 coronavirus infections and 43,000 deaths — suggesting his approach is an invitation to disaster.
An NBC News/Wall Street Journal poll found that only 3% of voters believe the country is ready to reopen. 

More than two-thirds of respondents in a Pew Research Center poll said Trump was too slow to respond to the outbreak, and an even higher percentage believes the worst is yet to come. 

Morover, if Trump continues ignoring his advisers and encouraging defiance, that latter finding could well turn out to be a self-fulfilling prophecy.

We cannot rush to create a new normal - learn from pandemic history!

Our best public health strategy to prevent community spread of the coronavirus is to be diligent about social distancing, practice relentless hand washing and to continue to shelter in place, for as long as it takes to see the pandemic begin to subside.

An echo opinion published in Minneapolis, Minnesota newspaper the Star Tribune, by Scott Gillespie, the editorial editor and vice president:

Members of the Red Cross were on duty to receive people affected by the flu in St. Louis in October 1918.

Commentary writer Christopher O. Moore, a retired teacher from Belle Plaine, Minn., provides a history lesson this morning.

Moore's grandfather died at age 31 during the 1918 influenza pandemic. He points out that Donald Trump, who often expresses his dismay that people die from the flu, also lost a grandfather during the 1918 pandemic.

Moore has some questions for the president. "Has Trump ever considered remembering the past and learning lessons from 1918 and the pandemic one science journalist called “the biggest disaster of the twentieth century”?

"Does he know that at first some public officials dismissed the 'Spanish' flu as seasonal, one that typically dies out in warm weather, nothing to be taken seriously? Or that it spread widely in the summer heat, then intensified in autumn, ultimately striking in three different waves?"

Moore's commentary is especially timely given that states such as Georgia are loosening restrictions on business activity in ways that conflict with guidelines the Trump administration has announced — and in ways that conflict with the lessons learned from 1918.

Let us learn from those who died in 1918, wrote Moore:
Donald Trump's grandfather, like mine, died in the flu pandemic of 1918. He was only 31 years old. He was one of millions who perished during the global flu pandemic of 1918.

Their memories can lead us in today's crisis.

Donald Trump wondered last month, “Does anybody die from the flu? I didn’t know people died from the flu.”

But his own grandfather did, like mine — in 1918.

Whether the president never knew or just forgot is unclear; unfortunately he seems to not know a lot. For example, that the 1918 flu infected perhaps 500 million people, one third of the world’s population at the time, and that somewhere between 50 million and 100 million died worldwide, more than in the two world wars combined.

Has Trump ever considered remembering the past and learning lessons from 1918 and the pandemic one science journalist called “the biggest disaster of the twentieth century”?

Does he know that at first some public officials dismissed the “Spanish” flu as seasonal, one that typically dies out in warm weather, nothing to be taken seriously? Or that it spread widely in the summer heat, then intensified in autumn, ultimately striking in three different waves?

He might be surprised to learn that some local governments downplayed the public risk. Philadelphia held a parade celebrating Liberty Bonds even as 600-plus soldiers and sailors stationed nearby lay seriously ill. Philadelphia’s public health director assured citizens that it was just the normal flu and would be contained before infecting the civilian population.

So on Sept. 28, thousands of soldiers, Boy Scouts, marching bands and local dignitaries paraded through downtown Philadelphia, as 200,000 spectators lined the streets. Days later, hospitals in the area filled with patients suffering and dying. Soon as many as 500 corpses awaited burial, some for more than a week. Cold-storage plants became temporary morgues.

Does the Donald Trump care to remember that?

He might find it worthwhile to learn that St. Louis suffered flu-related deaths less than half the per capita rate of Philadelphia. How so? They banned large gatherings, staggered work shifts, limited streetcar ridership and encouraged wearing masks. Then, when some of the public pushed back against this “decision that infringes on people’s rights,” the mayor and city health officials held their ground.

Remember: Half the rate of death of Philadelphia.

Remembering the past might inform the president that history often repeats itself — or at least rhymes, as they say. In 1918, health care workers became endangered eyewitnesses to the contagion as one after another of their patients passed, unable to breathe, delirious, turning blue, suffocating to death.

One doctor described “bodies stacked like cords of wood in the hospitals.”

Another witness: “The memory of this sight will haunt for life the minds of those who saw it.”

Today our minds are haunted by fears of shortages, diminished incomes, even lost jobs. Serious concerns, no denying. But watching from the wrong side of a window as a family member slowly suffocates?

An estimated 195,000 Americans died of influenza during one month, October 1918. Two who passed away days apart were Frederick Trump and Charles O. Moore — the president’s grandfather and mine. Like many others who have lost loved ones to influenza, we are touched by their deaths even today.

One of them left his son a real estate business and fortune that found its way to the presidency. The other left his wife with three young children who soon found their way to a home for orphans. The president boasts of his wealth; my father claimed he was proud to be a “home kid.”

I wonder who is yet to prosper, or suffer, or perish, especially if we fail to acknowledge the past before the virus touches us all.

Christopher O. Moore, of Belle Plaine, Minn., is a retired teacher.
That’s another matter. Lost profits and limited liberty? Or unlimited suffering and lost lives?

We’re faced with lots of tough choices. We’re told information from coronavirus testing and tracing is crucial, so making the right choice may be all in the timing. But as we rush to liberate ourselves from temporary isolation, let’s not forget: It’s a choice that will alter lives forever.

Dangerous ignorance spells danger- Donald Trump's pandemic failures

The coronavirus crisis: How Trump is failing successfully
The US president is mishandling the COVID-19 pandemic and (Maine writer....with evil intent).... getting away with it.

"mixed messages, mumbled utterances, falsehoods, and overall poor performance"

An echo opinion published in Al Jazeera United States 

A lot of clever people have been predicting that the coronavirus pandemic will be a turning point for anything from globalisation, statehood, liberalism, economic and social systems to the environment, economic and cultural habits and even music.

But, Donald Trump is failing to turn. In fact, he refuses to turn.

Instead, he insists on sticking to the same trajectory that helped him win the last elections, disregarding what damage it may inflict on America and Americans amid the coronavirus outbreak.

In the deepening health and socioeconomic crisis, he sees an opportunity to project himself as the indispensable leader of a vulnerable nation.

To quote a line from Aaron Sorkin's film classic, The American President: "People want leadership, and in the absence of genuine leadership, they'll listen to anyone who steps up to the microphone. They want leadership […] They're so thirsty for it they'll crawl through the desert toward a mirage, and when they discover there's no water, they'll drink the sand."

And sand is basically all it has been ever since Trump embarked on using the coronavirus crisis to dominate the national debate, rise in the polls, and make his way towards a second term.
The vibe and the virus

From the outset, Trump misled the nation about the imminent danger of a coronavirus outbreak. In February, a month into the epidemic, he was reassuring the public that there was nothing to worry about, that all was under control.

And although he now denies it, Trump is on the record repeatedly underestimating the virus's contagion, deadliness and disruption.

The question is, why? Why did he insist that the pandemic was under "tremendous control" and that the number of those infected would be brought down to zero?

Judging by his usual erratic behaviour, it is more likely he was driven by sheer ignorance and arrogance than by wise statesmanship - by his eagerness to save the stock market rather than his concern with saving lives.

Needless to say, arrogance breeds ignorance, just as ignorance breeds arrogance, and both spell danger.

As the infections grew in number, Trump decided to personally dominate the evening news with his regular prime-time press conferences, and succeeded in dictating the news agenda despite his mixed messages, mumbled utterances, falsehoods, and overall poor performance.

With an eager, anxious nation, seeking guidance and comfort from its leader, he quickly gained the upper hand, racking up high TV ratings and even claimed (falsely) that he was "number one" on Facebook.

And to the astonishment of his detractors, his own ratings also went up five points in the polls by the end of March.

In other words, Trump was being rewarded for his failure to fully understand the implications of the coronavirus outbreak and prepare the country early on to reduce the damage.

While this bump in the polls was still lower than the double-digit bumps gained by other Western leaders, which is expected in a time of crisis, it was more than sufficient to overshadow the Democrats' presumptive presidential nominee, Joe Biden, who by mid-March had gone into a self-imposed quarantine.

Trump did not stem the spread of the virus as hundreds of thousands became infected, but he was able to shape the news vibe.

When asked on March 16 to rate his performance on the job, Trump did not hesitate. It was a 10, he insisted. That is - 10 out of 10.

But if he was so brilliant and successful, who was then to blame for the unfolding epidemic, the ill-preparedness, the mounting fatalities, the rising unemployment and the looming economic recession?

The blamer-in-chief

As the crisis deepened, America's commander-in-chief morphed into the blamer-in-chief, projecting his failures on anyone but himself or his administration, as any self-respecting populist leader would.

The first to be blamed were those journalists sitting in front of him and the "fake news" outlets they represent. The national press conferences that were meant to inform and clarify have turned into theatres of the absurd, as a conceited president faced off with constipated journalists. Trump humiliated senior White House correspondents, criticised their questions, and questioned their motives.

He also blamed his predecessor, President Barack Obama and the "do-nothing Democrats" for the lack of protective medical gear and equipment and many governors who complained about the administration's incompetence.

Trump also went on a global blaming campaign, accusing Beijing of being responsible for the pandemic, his European allies of failing to stop the outbreak early, and more recently, the World Health Organization (WHO), of acting late and spreading wrong information.

Any suggestions that he may have gravely erred, especially by closing the White House pandemic office set up by his predecessor in 2016, were immediately deflected and disparaged.
The 'war president'

While dodging blame for the looming public health disaster in the US, Trump also sought to rally the nation behind his presidency by declaring himself a "war president".

The media had been quick to draw parallels between the pandemic and the Pearl Harbor attack in 1941 or the 9/11 attacks in 2001, so the incumbent jumped at the opportunity, hoping to replicate the success of his predecessors, Franklyn D Roosevelt and George W Bush, who won, respectively, a fourth and a second term by mobilising the nation under a war flag.

If Trump is to secure re-election, however, he will need to stay on the offensive into the summer and beyond in order to maintain the momentum. So, even if the curve of coronavirus infections flattens in the next few months, the US president will likely double down on his inflammatory language, incitement and his America First doctrine as the only way forward for the country.

He will continue to ride the nationalistic wave, by advocating for closed borders and travel bans, reminding everyone it was he, against the advice of most, who shut down travel from China before the coronavirus outbreak became a pandemic, and only he could be trusted with containing China's economic and military power.

Will his strategy work, or will Americans insist on assigning responsibility for their misfortunes?

Easy come, easy go?

Since President Harry Truman popularised the phrase, "the buck stops here", meaning, it is the president who is responsible for his decisions, Americans have not taken kindly to leaders who have tried to "pass the buck".

When the nation emerges from the tragedy of the pandemic amid distressing human loss and an economy in ruins, it will seek to blame someone for the devastation. The performance of the Trump administration will be the first to be dissected.

The mainstream liberal media will readily investigate, scrutinise and ultimately provide enough dirt on the president for some of it to actually stick before the November elections.

Already last week, a New York Times investigation revealed that 430,000 travelled into the US from China including from Wuhan, after Beijing made the coronavirus outbreak public, including 40,000 who arrived in the country after the ban was enforced.

If this trend continues, the much-feted spike in the president's approval ratings could easily transform into a downward jolt.

But since Trump has successfully discredited and demonised the mainstream media, especially among his supporters, calling it "the enemy of the people", it is not clear whether Americans will blame the president for the ill-preparedness, incoherence and mismanagement of the crisis, or accept his justifications and his buck-passing to China, Obama, WHO or whoever else he blames for their misery.

The word "historic" has been overused in analyses of almost every US election in the past two decades, but the vote scheduled for November 3 is indeed slated to go down as a momentous event in US history.

How Americans vote on that day will not only determine the future of their democracy, but it will also indicate if indeed the coronavirus pandemic will prove to be that turning point that many predict it to be … for America and for the world.

About the author:  Marwan Bishara is the senior political analyst at Al Jazeera.

Donald Trump wasting time spreading "wishfulness": End supidity! Impeach him again!

"dearth of testing, dire shortages of critical medical supplies at hospitals and the absence of a coherent national strategy mean" 

https://www.ellsworthamerican.com/opinions/columnists-opinions/marvin-ott/lethal-incompetence/

“I didn’t know people died from the flu," said Donald Trump.Lethal incompetence - echo opinion published in the Maine newspaper The Ellsworth American by Marvin Ott.

Donald Trump is the bumbling example of the saying "stupid is as stupid does".

Every schoolchild in America knew that the flu killed people. But Donald Trump did not know — even though his own grandfather died of the virus. But never mind. The president is a “genius” — “a very stable genius.” He has reminded us of this several times.

The current pandemic is as predictable as it is frightening. Disease is the eternal scourge of humankind — a constant reminder that life is vulnerable and contingent. We live in an era of globalization with ever closer contact at ever higher speeds between nations and continents. In another time a disease outbreak might have remained confined to a particular region or population thanks to their relative isolation. No more. Huge concentrations of people in megacities (like Wuhan) can turn a fire into a conflagration. Countless viruses lie hidden and dormant in natural environments such as permafrost and tropical jungles. As humans and climate change disrupt those redoubts hitherto unknown contagions are set loose. We have had ample recent experience with epidemics featuring new pathogens including HIV/AIDS, SARS, MERS, Ebola — to name a few. Lest we forget, only a century ago a global flu pandemic killed an estimated 50 million people worldwide, including 675,000 in the United States.

"the White House pandemic office was effectively disbanded" 

Today we are far better equipped to cope with such a global pandemic. In 1918, medical professionals did not know that viruses existed. Today we can take pictures of a new virus with electron microscopes, identify its key characteristics and sequence its genome all in a matter of days. We have extraordinary research facilities designed to create new vaccines and antiviral drugs. The federal government is home to agencies like the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) charged with research and development of therapies and their application. Responding to its experience with the Ebola epidemic, the Obama administration created a White House office of global pandemic preparedness.

The Trump administration has shown a singular disregard for all of this. Administration budget requests have called for deep cuts in funding for the CDC. Meanwhile, the White House pandemic office was effectively disbanded — while scientists and medical experts at all levels of the federal government were dismissed. Just for good measure the administration also moved to decrease nursing home oversight and infection control regulations. These actions tracked closely with the President’s response to reports of a new, dangerous viral outbreak in China. While U.S. intelligence agencies were providing analysis that identified the new virus as a potential global pandemic that could engulf the United States, Trump announced that the virus carried a “very, very low risk” for Americans. A day after the first U.S. case of the virus surfaced, Trump was asked if he was worried. His response: “No, not at all … we have it totally under control.” At a campaign rally on Feb. 10, he dismissed any concerns: “By April— when it gets a little warmer, it miraculously goes away.” [The pandemic had already spread to tropical climates like Singapore].

As the expert medical community expressed growing alarm in late February and early March, Trump dismissed it all as “another hoax” — a view loudly echoed by Sean Hannity and Fox News. In a Feb. 26 news conference, Trump declared the virus was “like regular flu that we have flu shots for. And we will have a flu shot for this in a fairly quick manner.” Dr. Tony Fauci, head of infectious diseases at NIH, estimated a vaccine was 12 to 18 months away and that the coronavirus was 10 times more lethal than the normal flu. Meanwhile, last week with the disease rapidly spreading in the United States, the White House budget director testified before Congress in support of funding cuts for the CDC. [And in case you missed it, two Republican senators with access to government data reportedly dumped their stock holdings in the travel and hospitality industries just before the markets tanked.]

This history of missed opportunities and self-delusion has consequences. The dearth of testing, dire shortages of critical medical supplies at hospitals and the absence of a coherent national strategy mean that a great many of us will get infected and many of us will die. That is not speculation; that is fact.

The past cannot be rewritten. The focus now has to be on the near future. Important and positive things have happened over the last week or two. The White House has declared a national emergency and states and localities have implemented far-reaching — even draconian — measures to slow “community spread.” People across the country have taken “social distancing” to heart. The broad citizen response has been remarkable and heartening. Even Fox News has discovered the virus. Tony Fauci has emerged as a trusted voice — a national treasure along with infectious disease experts and epidemiologists. Research centers are working flat out to develop entirely new therapies. This will have huge consequences beyond the current pandemic – we will be much better prepared for the next one.

America got through the Great Depression, World War II and the Soviet threat to Europe with steady, even inspired, presidential leadership from FDR to Truman to Eisenhower. We have no such luxury now. Bereft of his political rallies, Trump has discovered the White House news conference as a (horrible) substitute. We are now being treated to a kind of daily reality TV show — with some actual news and a large admixture of bombast, half-truths, exaggerations and insults.

We will have to look to the rest of America — to each other — to pull through this time.