The fact that Birx, who's somewhat an apologist and often spins for this admin is calling for his ousting is telling.
Trumpy ain't gonna like this... Scott Atlas Took Trump’s Place at Resolute Desk in President’s Absence in Task Force Meeting, Report Says https://www.thedailybeast.com/scott...nts-absence-in-task-force-meeting-report-says Scott Atlas, the neuroradiologist whose Fox News spots led President Trump to bestow on him a senior White House pandemic-response role, allegedly shot down attempts to expand U.S. testing, openly feuded with and sidelined top experts on the coronavirus task force, advanced fringe theories (such as that social distancing and mask-wearing were pointless), and advocated allowing infections to spread naturally among most of the American population to attain herd immunity. A report in The Washington Post says that Atlas’ ascendancy was made visually apparent after Trump left a recent Oval Office meeting and Atlas “startled other aides by walking behind the Resolute Desk and occupying the president’s personal space to keep the meeting going.” Atlas has denied all the claims leveled against him, dismissing the Post’s story as politically motivated. Meanwhile, a separate jaw-dropping claim in the Post report alleges that on a call in August with Francis Collins, director of the National Institutes of Health and leader of the Human Genome Project, Trump berated the agency for moving too slowly to approve a vaccine or other treatments; in fact, the NIH is a biomedical research agency and has no role in approving treatments or vaccines.
Trump’s den of dissent: Inside the White House task force as coronavirus surges https://www.washingtonpost.com/poli...f8ee6a-0a6e-11eb-859b-f9c27abe638d_story.html As summer faded into autumn and the novel coronavirus continued to ravage the nation unabated, Scott Atlas, a neuroradiologist whose commentary on Fox News led President Trump to recruit him to the White House, consolidated his power over the government’s pandemic response. Atlas shot down attempts to expand testing. He openly feuded with other doctors on the coronavirus task force and succeeded in largely sidelining them. He advanced fringe theories, such as that social distancing and mask-wearing were meaningless and would not have changed the course of the virus in several hard-hit areas. And he advocated allowing infections to spread naturally among most of the population while protecting the most vulnerable and those in nursing homes until the United States reaches herd immunity, which experts say would cause excess deaths, according to three current and former senior administration officials. Atlas also cultivated Trump’s affection with his public assertions that the pandemic is nearly over, despite death and infection counts showing otherwise, and his willingness to tell the public that a vaccine could be developed before the Nov. 3 election, despite clear indications of a slower timetable. Atlas’s ascendancy was apparent during a recent Oval Office meeting. After Trump left the room, Atlas startled other aides by walking behind the Resolute Desk and occupying the president’s personal space to keep the meeting going, according to one senior administration official. Atlas called this account “false and laughable.” Discord on the coronavirus task force has worsened since the arrival in late summer of Atlas, whom colleagues said they regard as ill-informed, manipulative and at times dishonest. As the White House coronavirus response coordinator, Deborah Birx is tasked with collecting and analyzing infection data and compiling charts detailing upticks and other trends. But Atlas routinely has challenged Birx’s analysis and those of other doctors, including Anthony S. Fauci, Centers for Disease Control and Prevention Director Robert Redfield, and Food and Drug Administration Commissioner Stephen Hahn, with what the other doctors considered junk science, according to three senior administration officials. The lost days of summer: How Trump fell short in containing the virus Birx recently confronted the office of Vice President Pence, who chairs the task force, about the acrimony, according to two people familiar with the meeting. Birx, whose profile and influence have eroded considerably since Atlas’s arrival, told Pence’s office that she does not trust Atlas, does not believe he is giving Trump sound advice and wants him removed from the task force, the two people said. In one recent encounter, Pence did not take sides between Atlas and Birx, but rather told them to bring data bolstering their perspectives to the task force and to work out their disagreements themselves, according to two senior administration officials. The result has been a U.S. response increasingly plagued by distrust, infighting and lethargy, just as experts predict coronavirus cases could surge this winter and deaths could reach 400,000 by year’s end. This assessment is based on interviews with 41 administration officials, advisers to the president, public health leaders and other people with knowledge of internal government deliberations, some of whom spoke on the condition of anonymity to provide candid assessments or confidential information. Atlas defended his views and conduct in a series of statements sent through a spokesperson and condemned The Washington Post’s reporting as “another story filled with overt lies and distortions to undermine the President and the expert advice he is being given.” Atlas said he has always stressed “all appropriate mitigation measures to save lives,” and he responded to accounts of dissent on the task force by saying, “Any policy discussion where data isn’t being challenged isn’t a policy discussion.” On the issue of herd immunity, Atlas said, “We emphatically deny that the White House, the President, the Administration, or anyone advising the President has pursued or advocated for a wide-open strategy of achieving herd immunity by letting the infection proceed through the community.” The doctor’s denial conflicts with his previous public and private statements, including his recent endorsement of the “Great Barrington Declaration,” which effectively promotes a herd immunity strategy. On Saturday, Atlas wrote on Twitter that masks do not work, prompting the social media site to remove the tweet for violating its safety rules for spreading misinformation. Several medical and public health experts flagged the tweet as dangerous misinformation coming from a primary adviser to the president. “Masks work? NO,” Atlas wrote in the tweet, followed by other misrepresentations about the science behind masks. He linked to an article from the American Institute for Economic Research — a libertarian think tank behind the Barrington effort — that argued against masks and dismissed the threat of the virus as overblown. Trump and many of his advisers have come to believe that the key to a revived economy and a return to normalcy is a vaccine. “They’ve given up on everything else,” said a senior administration official involved in the pandemic response. “It’s too hard of a slog.” Infectious-disease and other public health experts said the friction inside the White House has impaired the government’s response. “It seems to me this is policy-based evidence-making rather than evidence-based policymaking,” said Marc Lipsitch, director of the Center for Communicable Disease Dynamics at the Harvard T.H. Chan School of Public Health. “In other words, if your goal is to do nothing, then you create a situation in which it looks okay to do nothing [and] you find some experts to make it complicated.” These days, the task force is dormant relative to its robust activity earlier in the pandemic. Fauci, Birx, Surgeon General Jerome Adams and other members have confided in others that they are dispirited. Birx and Fauci have advocated dramatically increasing the nation’s testing capacity, especially as experts anticipate a devastating increase in cases this winter. They have urged the government to use unspent money Congress allocated for testing — which amounts to $9 billion, according to a Democratic Senate Appropriations Committee aide — so that anyone who needs to can get a test with results returned quickly. But Atlas, who is opposed to surveillance testing, has repeatedly quashed these proposals. He has argued that young and healthy people do not need to get tested and that testing resources should be allocated to nursing homes and other vulnerable places, such as prisons and meatpacking plants. White House spokeswoman Sarah Matthews defended Trump and the administration’s management of the crisis. “President Trump has always listened to the advice of his top public health experts, who have diverse areas of expertise,” Matthews said in a statement. “The President always puts the well-being of the American people first as evidenced by the many bold, data-driven decisions he has made to save millions of lives. Because of his strong leadership, our country can safely reopen with adequate PPE, treatments, and vaccines developed in record time.” Yet amid a public health crisis that has claimed the lives of more than 219,000 people in the United States — a far higher death toll than any other nation has reported — a consensus has formed within the administration that some measures to mitigate the spread of the virus may not be worth the trouble. The president gave voice to this mind-set during an NBC News town hall Thursday night, when he declined to answer whether he supported herd immunity. “The cure cannot be worse than the problem itself,” Trump told host Savannah Guthrie. But medical experts disagreed, saying it is dangerous for government leaders to advocate herd immunity or oppose interventions. “We’d be foolish to reenter a situation where we know what to do and we’re not doing it,” said Rochelle Walensky, chief of the division of infectious diseases at Massachusetts General Hospital and a professor of medicine at Harvard Medical School. “This thing can take off. All you need to do is look at what’s happened at 1600 Pennsylvania Avenue over the last two weeks to see that this thing is way faster than we’re giving it credit for.” 'The cure' After Trump came home from the hospital this month, he all but promised Americans that they could soon be cured from the coronavirus just as he claimed to have been. In a video taped at the White House on Oct. 5, he vowed, “The vaccines are coming momentarily.” Then, at a rally last Tuesday night in Johnstown, Pa., Trump told supporters, “The vaccines are coming soon, the therapeutics and, frankly, the cure. All I know is I took something, whatever the hell it was. I felt good very quickly . . . I felt like Superman.” Trump’s miraculous timeline has run headlong into reality, however. On the same day that he declared “the cure” was near, Johnson & Johnson became the second pharmaceutical giant, after AstraZeneca, to halt its vaccine trial. A third trial, a government-run test of a monoclonal antibody manufactured by Eli Lilly & Co., was also paused. Each move was prompted by safety concerns. And on Friday, Pfizer said it will not be able to seek an emergency use authorization from the FDA until the third week of November, at the earliest, seemingly making a vaccine before Election Day all but impossible. Trump’s notion of a vaccine as a cure-all for the pandemic is similarly miraculous, according to medical experts. “The vaccines, although they’re wonderful, are not going to make the virus magically disappear,” said Tom Frieden, a former CDC director who is president of Resolve to Save Lives. “There’s no fairy-tale ending to this pandemic. We’re going to be dealing with it at least through 2021, and it’s likely to have implications for how we do everything from work to school, even with vaccines.” Frieden added: “Remember, we have vaccines against the flu, and we still have flu.” Still, Trump has ratcheted up his push for vaccines over the past several months, intensifying the pressure on government scientists, federal regulators and pharmaceutical executives. He has had one end date in mind: Nov. 3, which is Election Day. Trump has envisioned a greenlit vaccine as the kind of breakthrough that could persuade voters to see his management of the pandemic as successful and thus upend a race in which virtually all public polls show him trailing Democratic nominee Joe Biden. Earlier this fall, Trump called Albert Bourla, the chief executive of Pfizer, and asked whether a vaccine could be ready for distribution by late October, before the election. Pfizer spokeswoman Sharon Castillo said executives have regular communications with administration officials on a wide range of health policy issues but that she could not comment on private conversations. On a call in August with Francis Collins, director of the National Institutes of Health, Trump accused the agency of moving too slowly to approve a vaccine or other treatments, including convalescent plasma, according to two officials familiar with the conversation. The NIH, which declined to comment, is a biomedical research agency and does not approve treatments or vaccines. Matthews denied that Trump sees the vaccine timetable through the prism of the campaign calendar. “This is not about politics; it’s about saving lives,” she said. She added, “any vaccine approval will maintain the FDA’s gold standard for safety and efficacy and be proven to save lives.” The relationships between FDA officials and White House staffers have grown more acrimonious since September, when details of stricter FDA vaccine guidance were reported by The Post. Trump and White House Chief of Staff Mark Meadows — who has involved himself in the work of health agencies to a degree other officials consider inappropriate — have repeatedly challenged Hahn over his agency’s proposals and rules, much to the FDA commissioner’s frustration. Trump is asserting control over the messaging campaign around a vaccine. His politically minded aides in the White House have taken over the government’s communications effort, as opposed to health or scientific communicators at the relevant agencies. For example, White House aides have sought to persuade Moncef Slaoui, head of “Operation Warp Speed,” the government’s initiative to mass-distribute an eventual vaccine, to speak more positively about the vaccine, and sometimes he has pushed back on their talking points, two officials said. Trump fixates on the promise of a vaccine — real or not — as key to reelection bid Trump routinely has told his political advisers that a vaccine would be ready by the time he stands for reelection. And he has plotted with his team on a pre-election promotional campaign to try to convince voters a vaccine is safe, approved and ready for mass distribution — even if none of that is true yet. These are some of the ingredients of a public health disaster, experts say. “The one thing you can’t do — and it’s what everybody fears, it’s what the pharmaceutical companies fear, it’s what everybody on the inside fears — is that the government would, because of political purposes or because other countries put a vaccine out before us, truncate the normal process you’d accept for a safe and effective vaccine,” said Paul A. Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, a professor of vaccinology at the University of Pennsylvania and a member of the FDA’s vaccine advisory council. Trump’s view of the FDA has darkened considerably in recent weeks. The president now believes — despite the absence of any such evidence — that officials there are working against him to slow-walk vaccine approval as “some sort of ‘deep state’ push to keep him from winning reelection,” according to an administration official. Trump has said as much himself. “New FDA Rules make it more difficult for them to speed up vaccines for approval before Election Day. Just another political hit job! @SteveFDA,” the president wrote in an Oct. 6 tweet, tagging Hahn’s Twitter handle. Trump’s conspiratorial view of the FDA is shaped in part by White House trade adviser Peter Navarro and others in the president’s orbit, both inside and outside the government. Saad B. Omer, director of the Yale Institute for Global Health, said the atmosphere of pressure and recrimination, nurtured by the president, is “very concerning.” “These are people who have dedicated their lives to working in public health and medicine and research,” he said. “To think that in the biggest public health event of their lives they would sleep an extra hour or slow-walk this for any reason is absurd.” He added, “It’s like how an ambulance drives faster than a regular car because it’s an emergency, but even an ambulance driver is not foolhardy. They don’t want to drive over the bridge.” 'A lot of political pressure' The distrust in Washington has trickled down to the states, where friction has increased between several governors and the administration over the vaccine process. Some governors and officials close to them privately have expressed alarm about Trump and his aides laying the groundwork for a rushed vaccine announcement. The president has delegated much of the state outreach to Pence, who in regular calls with governors has come across as a smooth salesman for Trump’s speedy approach. The vice president has encouraged governors to help build confidence for eventual vaccines among their constituents. Illinois Gov. J.B. Pritzker (D), whose state is the site for vaccine trials, said in an interview, “I certainly fear there is a lot of political pressure being applied.” He said his state is preparing for a vaccine rollout, but would carefully evaluate the integrity of any announcement emanating from the White House. “Nobody has told me that it’ll be ready by November 2nd or anytime before the election,” Pritzker said. “But [Trump] will no doubt claim such a thing because of the cocktail of drugs that he seems to be on now. He’s liable to say anything that isn’t true.” The concerns are not limited to Democrats. One Republican state official who works with the Trump administration and spoke on the condition of anonymity to preserve that relationship, said, “It’s what I would call soft power. Pence comes on these calls and sounds normal and upbeat, and basically says, ‘Stand with us.’ ” The official added, “We all want a vaccine, right? We obviously want it. We’ll take it. But we don’t really know if they’ll do this right.” The politicization of the process has damaged public credibility in an eventual vaccine. A Gallup poll released this month found that 50 percent of Americans said they would be willing to take a coronavirus vaccine approved by the FDA “right now at no cost.” That is a sharp decline from 61 percent in August and 66 percent in July. During a virtual task force meeting led by Pence on Sept. 21, Washington Gov. Jay Inslee (D) said, “There is a substantial concern,” according to an audio recording of the meeting. “A significant part of that problem is the president’s continued anti-science statements that are contradictory to his medical advisers in so many different ways.” Inslee asked Pence directly, “Have you discussed with the president how he’s been eroding public confidence in our efforts, including the vaccine approval? Have you discussed that with him? Have you urged him to stop this behavior?” Pence did not directly answer the question. Rather, he replied, “We think you and all the governors on this call have a great responsibility to make sure the public knows while we’re moving rapidly and while there may be differences in opinion about various events, we just don’t want any undermining of confidence in the vaccine.” The vice president added, “I can assure you the president will continue to speak clearly about that process.” Inslee later said in an interview that Pence was anything but assuring. “There is a pressure campaign,” Inslee said. “We need to follow science and not this distortion campaign . . . The people are on to [Trump]. They know he is trying to turn this into an electoral issue.” 'A magic dust' As the election nears, one of Trump’s biggest vulnerabilities with voters is his handling of the pandemic — which he increasingly has sought to blame on others. For instance, the president has complained bitterly about Hahn and Redfield, pointing to congressional testimony and other public comments they have made as undermining his chances for reelection, according to multiple administration officials. Trump also has vented about the slow pace of vaccine trials and has fumed privately about the pharmaceutical industry, even though he speaks highly of some industry executives. Lately, he has expressed particular concern that the absence of a vaccine announcement has been hurting him with early voting, according to an administration official. Health and Human Services Secretary Alex Azar, a former Eli Lilly president who has close ties to the pharmaceutical industry, has sought to cool Trump’s temper and assure him that the process is sound. Also whispering optimism in the tempestuous president’s ear has been Atlas, who is said to be operating with the full confidence of Jared Kushner, Trump’s son-in-law and senior adviser overseeing key aspects of the pandemic response, and Hope Hicks, the president’s counselor and confidante. This is in part because Atlas has sought to spin the public with what others deride as “happy talk” that the outbreak is close to over. “Everybody looks for what Atlas is giving them,” one official involved in the response said. Offit said, “This administration, like it does with everything, is overselling vaccines. They make it sound like a magic dust they’ll distribute over the country and the disease will go away . . . What could happen is people think, great, I just got my vaccine, I can throw away my mask, I can engage in high-risk activity, and then we’d actually take a step back.” Most controversially, Atlas has pushed a baseless theory inside the task force that the U.S. population is close to herd immunity — the point at which enough people become immune to a disease either by becoming infected or getting vaccinated that its spread slows — despite a scientific consensus that the United States is nowhere close. Given the transmissibility of the coronavirus, experts estimate about 60 to 70 percent of the population would need to become infected to reach herd immunity, a course that they warn would probably result in hundreds of thousands of excess deaths. A recent CDC study, about which Redfield testified to the Senate, showed about 9 percent of people in the United States had antibodies against the virus. But Atlas publicly contradicted Redfield last month, telling reporters that more of the population was protected against the virus because of so-called T-cell immunity, in which people with exposure to previous coronaviruses — such as the common cold— have T cells that also protect them against covid-19, the disease caused by the novel coronavirus. No credible scientific study has proved this theory, and Atlas’s advocacy of it dismayed other task force officials. At a task force meeting late last month, Atlas stated that there was herd immunity in much of the country because of a combination of high infection rates in cities such as New York and Miami and T-cell immunity, according to two senior administration officials. He said that only 40 to 50 percent of people need to be infected to reach the threshold. And he argued that because of this immunity, all restrictions should be lifted, schools should be opened and only the most vulnerable populations, such as nursing home residents, should be sheltered. This resulted in a fierce debate with Birx and Fauci, who demanded Atlas show them the data that backed up his assertions, one of the officials said. “It is not the case there’s extra immunity around in T cells,” Lipsitch said. “The vast, vast majority of infectious-disease epidemiologists in this country don’t believe several of the key points these people are arguing for and don’t believe it because the evidence isn’t there and points in the other direction.” Regardless, Trump has used Atlas to back up his own rejection of medical expertise. At Thursday’s NBC News town hall, a Florida voter asked the president whether after contracting covid-19 he now believed in the importance of mask-wearing. Trump equivocated. “I’ve heard many different stories on masks,” he said. When Guthrie challenged him by noting that all of his health officials were united in advocating masks, Trump countered by invoking Atlas. “Scott Adkins,” Trump said, mispronouncing the doctor’s name. “If you look at Scott, Dr. Scott, he’s from — great guy — from Stanford, he will tell you.” “He’s not an infectious-disease expert,” Guthrie said. “Oh, I don’t know,” Trump replied. “Look, he’s an expert. He’s one of the experts of the world.”
Dr. Birx Reportedly Refusing to Participate in White House Meetings With Dr. Atlas Because He Is Spreading Covid Misinformation https://www.mediaite.com/tv/dr-birx...because-he-is-spreading-covid-misinformation/ Dr. Deborah Birx, a physician and member of the White House coronavirus task force, is reportedly refusing to participate in any meetings with Dr. Scott Atlas — citing his spread of Covid-19 misinformation. CNN’s Kate Bennett, Elizabeth Cohen, and Jake Tapper reported on the news Thursday, adding that Birx left a meeting at the White House this summer vowing to never sit in another meeting with Atlas again. “I hate to use the term doctor shopping, but it almost feels like if this is what President Trump did until he found someone in the medical field that agrees with him,” Bennett told Tapper before citing some of Atlas’ controversial coronavirus opinions. Atlas has often been criticized for his controversial proposed pandemic strategies, his claims that masks do not work, and his support for herd immunity. “Her personality is to pick up and go where the fight is,” a colleague of Birx’s reportedly told CNN. “She always told us — keep your bags packed. She’d say if you’re assigned to another country, don’t sit in the embassy — go to the distant villages. You need to go where the action is, see what they are doing.” Birx has reportedly not been at a coronavirus briefing since the summer, when Atlas, a radiologist lacking expertise in epidemiology, was starting to become the president’s top influencer regarding the pandemic. Birx even reportedly confronted Vice President Mike Pence, demanding his kick Atlas off the task force. “I’ve known Debbie a long time,” said Dr. Jerome Kim, the director general of the International Vaccine Institute, and a former colleague at the Walter Reed Army Institute of Research told CNN. “She really is completely driven by getting things done and being effective, and I think she’s frustrated.” “If she can’t get it done in the White House, the way to do it is go into the field and use personal diplomacy to convince politicians there is a right way to do this and a right way to approach things, and the consequences of failure are significant,” Kim added. “Without an authority coordinating things centrally, the only thing you can do is make people aware of the facts and the truth, and my guess is this is her solution.”
Birx cedes White House turf to Atlas while hitting the road to spread her public health gospel https://www.cnn.com/2020/10/29/politics/deborah-birx-task-force-scott-atlas/index.html Dr. Deborah Birx emerged from a meeting at the White House one day in late summer with a new resolution: Never again would she sit in a meeting with Dr. Scott Atlas and listen to him pontificate on the pandemic. That's when she went all-in on a plan to essentially abandon the White House and avoid the growing influence of Atlas, a radiologist with no expertise in epidemiology who was nevertheless rising in influence with President Donald Trump. Birx, a physician with decades of experience in global health, told a friend that she would take her message directly to the people and simply sidestep the kind of misleading messages she'd just heard from Atlas in that meeting. The friend requested anonymity to discuss the exchange with CNN. Now Atlas is Trump's single go-to adviser on the coronavirus. And Birx, one of the most prominent figures of the early pandemic, is in North Dakota. She has now been to 40 states and logged more than 20,000 miles, many of them since that fateful August meeting. She tours the country by commercial air, advising small groups of state and local officials on combating transmission. She pulls a small suitcase packed with essentials and an array of the signature scarves she wears each day. Her friends call it her "self-exile." "Her personality is to pick up and go where the fight is," said a colleague of hers for many years. "She always told us -- keep your bags packed. She'd say if you're assigned to another country, don't sit in the embassy -- go to the distant villages. You need to go where the action is, see what they are doing." It's a handy personal credo given that Trump hasn't consulted in person with Birx in months. She still belongs to the White House coronavirus task force, but it rarely meets these days and its reports aren't widely disseminated. The President isn't deploying her to anything, so she's deploying herself. "I've known Debbie a long time," said Dr. Jerome Kim, the director general of the International Vaccine Institute, and a former colleague at the Walter Reed Army Institute of Research. "She really is completely driven by getting things done and being effective, and I think she's frustrated." "If she can't get it done in the White House, the way to do it is go into the field and use personal diplomacy to convince politicians there is a right way to do this and a right way to approach things, and the consequences of failure are significant," Kim said. "Without an authority coordinating things centrally, the only thing you can do is make people aware of the facts and the truth, and my guess is this is her solution," said Kim. Finding her lane For months, Birx put up with Trump's rhetoric about the pandemic. She told friends she could live with it, though, as long as she could occasionally get a chance to weigh in with the President. But soon after Atlas was formally named to the task force on August 10, Birx told friends, it became clear that she wasn't going to get much time with Trump -- if any at all. After that August meeting, she came out of the room and told a friend Atlaswas "not going to tell me what to do," the friend said, recounting the conversation. She felt even further vindicated recently when Atlas tweeted about the folly of requiring mask-wearing and Twitter removed the tweet. She said to a friend that she wished the administration would take the same editorial approach to his statements. Birx's own future is uncertain, like so many in the federal health bureaucracy. She's on the outs with the current administration and, if former Vice President Joe Biden is elected, it's not clear if she would be invited to stay on. Though it's a move she has successfully navigated before, working first for President George W. Bush, then President Barack Obama and now Trump. Some prominent health officials may have harmed their credibility with Biden by working to remain relevant in the Trump orbit all these months. But even if Birx no longer has Trump's ear, she still has a public persona. And plenty of officials around the country -- struggling to deal with the pandemic in the absence of a coordinated national strategy -- are more than happy to have her help. (More at above url)
"New Covid cases yesterday hit an all-time high of more than 90,000 cases with 1,000+ deaths. So what is our VP the point man for our pandemic response doing about it? Not much. He hasn't even hopped on a task force conference call in over a month." Pence absent from Covid-19 planning calls for more than a month As coronavirus cases spike upwards, the vice president’s task force is less active than before https://www.politico.com/news/2020/10/29/pence-absent-coronavirus-calls-433637 When Vice President Mike Pence first took charge of the White House’s coronavirus task force, among his earliest moves was establishing a standing call with all 50 governors aimed at closely coordinating the nation’s pandemic fight. Yet as the U.S. confronts its biggest Covid-19 surge to date, Pence hasn’t attended one of those meetings in over a month. Pence – who has been touting the Trump administration’s response effort on the campaign trail for weeks – is not expected to be on the line again Friday, when the group holds its first governors call since Oct. 13, said a person with knowledge of the plan. It’s a prolonged absence that represents just the latest sign of the task force’s diminished role in the face of the worsening public health crisis it was originally created to combat. Once a driving force behind the White House’s coronavirus messaging, the group hasn’t held a collective press briefing in months. Inside the West Wing, task force members’ growing alarm over the virus’ resurgence has gone largely ignored. And among health officials on the front lines, there is mounting consensus that the federal government has little new aid to offer – leaving states to face the pandemic’s third and potentially worst wave increasingly on their own. “There’s not any acknowledgment or appreciation of the severity of the surge,” said an official in one governor's office long frustrated with the federal response. “The stark reality that we’re facing is the White House – from top to bottom – has stopped governing and is only campaigning.” The task force’s shrinking stature comes amid warnings that the nation is headed toward its darkest days since the beginning of the pandemic, as cases hit record highs and hospitals across several states struggle to deal with a fresh crush of Covid-19 patients. The U.S. on Thursday recorded a record 88,452 cases, bringing its average over the past week to around 76,000 — the highest point so far this year. Hospitalizations are on the rise too, reaching numbers not seen since mid-August. It’s a more expansive outbreak than during previous waves, when the coronavirus swamped the Northeast in April and tore through the South and West in July. On Thursday, cases were increasing across three dozen states. Hospitals in states like Idaho, Utah, Texas and Wisconsin, which had been left relatively untouched by the pandemic in its early days, are now at risk of being overrun – with governors preparing to have the National Guard repurpose convention centers as field hospitals. In Montana, the nearly 300-bed Kalispell Regional Medical Center found itself so short-staffed earlier this month that it stopped quarantining employees exposed to Covid-19. Indiana, meanwhile, has nearly 1,700 people in its hospitals and 470 patients in the ICU, the latter figure up 70 percent in the five weeks since Republican Gov. Eric Holcomb removed most coronavirus-related restrictions. “This is the most worrisome of the three surges so far,” said Bruce Siegel, the CEO of America’s Essential Hospitals, which represents safety net providers. “This is the first time we’ve had such widespread outbreaks across America.” A White House spokesperson defended the administration's pandemic response, adding that Pence regularly chairs task force meetings and updates Trump frequently on coronavirus-related issues. "The task force proactively reaches out to, meets with, and has calls with jurisdictions across America to ensure they are receiving data, supplies, medication, and personnel," the spokesperson said. The administration has also continued shipping supplemental testing supplies to states monthly, and authorized the National Guard's continued deployment to aid relief efforts -- albeit at a higher cost to some states than earlier this year. But as the crisis mushrooms, state and local health officials say there’s no indication that the Trump administration’s response is growing with it. In media appearances and meetings, task force coordinator Deborah Birx and other officials have mostly offered the same advice – emphasizing the need for personal responsibility, mask wearing and continued avoidance of large gatherings. Though the administration in September celebrated shipping millions of rapid tests around the country to slow the virus' transmission, cases have continued to spread uncontrolled. Roughly a dozen states have seen their positive test rates soar well above the 10 percent benchmark the task force initially targeted. Perhaps most distressingly for cash-strapped states headed into their eighth month of the pandemic response, there is little promise of new funding to alleviate the cutbacks and furloughs that have hit health departments across the country. Congress has deadlocked for months over how much aid to send states – with the Trump administration balking at Democrats' push for hundreds of billions of dollars in funding. In the meantime, health officials say, they've seen no new efforts to find existing federal funds that could go toward reinforcing the state and local response. “We still are having huge issues with money getting down to the local health departments, and that has continued to be the theme since the first Covid supplemental dollars were released,” Lori Tremmel Freeman, who heads the National Association of County and City Health Officials, said, adding that there is little federal communication about what dollars are still available and how to access them. For many state leaders, the White House’s relative detachment from the crisis on the ground is unsurprising. Trump made clear early on that despite creating the task force, his administration would not coordinate a national response. Most states have long since set up their own supply lines and procedures instead. In recent months, the White House has only pivoted further away from leading a comprehensive effort – embracing a narrower approach that prioritizes protecting the elderly and vulnerable populations while otherwise pushing for the country’s broader reopening and pouring efforts into developing a vaccine. Still, health officials say the contrast between the White House’s view and the pandemic reality is increasingly jarring – especially as task force members themselves voice dire worries about the surge. In stops in Wyoming, Montana and North Dakota this past week, Birx has implored people to wear masks – scolding those in North Dakota this week for their “deeply unfortunate” lack of adherence to masking recommendations in a state where the governor has refused to mandate them. She’s traveled to dozens of universities to promote social distancing and urged more frequent testing to control on-campus outbreaks. And over the last month, Birx began holding private calls with the heads of a handful of organizations representing state and territorial health officials to discuss their needs and offer guidance – meetings that one participantsaid reflect the depth of the current crisis, but also represent the kind of basic outreach that should have taken place in the pandemic’s first months. Asked whether those meetings brought the promise of new resources or support, the participant was blunt: “No.” Other task force members like HHS testing czar Brett Giroir and infectious disease expert Anthony Fauci have issued similarly grim outlooks of late, with Giroir saying Wednesday the U.S. has reached a “critical point.” A status update on the pandemic sent nightly by Trump’s health department to state and local health officials, meanwhile, raised eyebrows after its reliably upbeat tone turned dour earlier this month. “Mask skeptics remain, but the data is strong: wearing a mask decreases your exposure to the virus,” said its Oct. 13 email, which was later obtained by POLITICO, adding that the department was seeing a “very concerning” uptick in cases. The next week, health officials characterized the nation as at a “very sobering” stage, stressing in an Oct. 19 emailthe need for Americans to “double down” on mitigation measures. Yet for governors and public health officials on the front lines, those warnings have more often been frustrating than helpful – a reminder that the pandemic’s bleak outlook appears to be hitting home everywhere except at the top levels of the White House. As Trump stumps through the final days of his re-election campaign, his consistent dismissals of the virus as a nuisance that will soon go away are drowning out any competing message that Birx and the rest of the task force try to send during small group meetings and local radio hits. And as for Pence, just his presence on the campaign trail alone has dismayed public health officials, coming soon after five members of his inner circle contracted Covid-19. “The communications coming out of the federal government continue to be confusing and, in some cases, a detriment to what locals are saying,” said Chrissie Juliano, executive director of the Big Cities Health Coalition, which represents metropolitan health departments. “It’s problematic when you see the vice president on the campaign trail. … Do as I say, not as I do: that’s a really complicated message.” It’s a conflict not lost on members of the task force who have grown exasperated with the White House’s dismissive attitude of the virus down the campaign’s home stretch – and their own increasing irrelevance amid a pandemic surge. “There is no task force. It’s not serving any role at all,” one Republican close to the task force said. “You’ve got a bunch of very thoughtful, intelligent people who want to contribute twiddling their thumbs.”
If so, then it is high time we either figure out how to make masks effective or come up with a strategy to mitigate the spread of dangerous pathogens. As bad as Covid apparently is, it is all but guarenteed we have another Spanish Flu or Ebola like virus that goes pandemic on us. Whether is a mutation of a known virus, a new emerging virus, or another accident of several that we see per year out of the 1000 or so medical laboratories around the world, we will be likely tested again. Further, do I really need to point out our vulnerability to terrorists again? Most measures suggest Covid is a serious enough disease to take seriously while also helping us to prepare ourselves for future outbreaks of similar or more dangerous viruses. We are better off taking a problem solving approach rather than a partisan, “Bury our head in the sand” approach to a virus taken seriously by most countries, even to the point of putting their economies under additional economic stress through proposed and partial shutdowns. Let’s figure out a way to reliably minimize transmission of Covid such that the R0 is less than 1 and while keep businesses open. Any ideas towards that objective?
Masks stop high viral loads... The 'dose' of coronavirus a person gets may determine how sick they get; masks could help https://www.cnn.com/2020/11/01/health/viral-dose-coronavirus-severity/index.html "The dose makes the poison" is an adage credited to Paracelsus, a Swiss physician-philosopher from the early Renaissance. Basically, it means that any substance can become toxic if given at a high enough concentration. Even too much water can throw off your electrolytes and be potentially fatal. Viewing the coronavirus through that lens -- that the "dose" of the virus you receive might make the difference between being asymptomatic, getting mildly sick or becoming critically ill -- may be helpful when thinking about protection against Covid-19 as the colder temperatures arrive and cases spike. SARS-CoV-2 likely behaves like other viruses The concept of needing a certain dose of a pathogen -- a disease-causing organism -- to trigger an infection has been shown to be the case for many viruses, such as the influenza virus, poxviruses and others, explained Erin Bromage, an associate professor of biology at the University of Massachusetts, Dartmouth. "If you hit an animal with a low enough dose, they'll be able to fend that off without developing any disease at all. If you get a magic number of an infectious dose, an infection will establish and that animal will then succumb to the disease from that particular pathogen. But if you hit them with more than the infectious dose, in most situations a high dose of pathogens -- like a high dose of a virus, for example -- leads to more severe outcomes. So, dose becomes really important," he said, calling the relationship "dose-dependent." It's not because you need a certain number of particles of virus to infect a cell -- it just increases the odds that one of those viral particles will make it into the cell and infect it, setting off the chain reaction. Another way to think of it is like conception: You don't need millions of sperm to fertilize an egg -- you only need one -- but men make millions of sperm to improve the chances that one will reach the egg, overcome its defenses and fertilize it. Getting a viral dose all at once or spread out over time There's another dimension to viral dose and it has to do with time. It's not the dose of the virus you get simply at one point in time that matters; it may also be the sum of viral doses you get over a certain period of time. "Some people are speculating about it: Is this why, for example, bus drivers or people working in emergency rooms are more likely to have more adverse outcomes? Because they're exposed to higher doses, or because they're in an environment where they get exposed to it over an extended period and get a larger swath of it into them?" asked Bromage. In mid-October, of the US Centers for Disease Control and Prevention changed its definition of "close contact" to include multiple, brief exposures that add up to 15 minutes or more with an infected person. Previously, the CDC defined a close contact as 15 minutes of continuous exposure to an infected individual. It's not only about the virus, it's also about the host The virus itself isn't the only organism that plays a role -- it also has to do with the individual. "Each person has a different amount of virus that they need," said Bromage. "Somebody that is immunosuppressed, or somebody that is stressed, for example, may need less of a [virus] challenge in order to get the same outcomes as somebody that is in a healthy condition." Put it all together, and the chance of infection depends on the physiology of the potential host, as well as their personal behaviors and health habits such as smoking status, diet, physical activity and sleep. An elderly or unhealthy host in the face of large, recurrent exposures is clearly the worst case scenario. But a medically fragile person could be sickened by even a low dose of virus; conversely, a healthy person can be overwhelmed with a high enough dose. One tragic example is the death of the young and seemingly healthy doctor Li Wenliang in Wuhan, China. On December 30, 2019, he privately raised the alarm after seeing seven cases of a SARS-like illness among patients at his hospital; four days later he was accused by the police of "severely disrupting social order," and "spreading rumors online." Shortly after spending time caring for those critically ill patients, Li developed symptoms of Covid-19; he died less than a month later. He was only 34. Still, we are just talking about odds and likelihoods. Pinning down the exact scenario that leads to infection is much harder to do. "We simply can't study the exact viral dose that would make someone sick because it's completely unethical," said Dr. Monica Gandhi, an infectious disease doctor and professor of medicine at the University of California, San Francisco. That's because it would mean knowingly exposing people to progressively higher doses of the virus to determine when an infection occurs. "I don't think we're going to actually get to that value. We can in animals -- there's been a ferret model and there's been a hamster model -- now two animal models where the more you give them the more sick those animals get and that is helpful, and it may give us a sense. But we won't know with humans, unfortunately, how much it takes," she said. Viral dose and viral load "There is an interesting two-sides-of-the-coin dance coming out between viral [dose] -- what goes in -- and viral load -- what comes out," said Gandhi. Viral load is the amount of virus an infected person has in their body; some, but not all, studies have shown that the sicker a patient is with Covid-19, the higher the viral load. "If you get less of a viral dose in, then you can calmly take care of it and wall it off. You have this asymptomatic infection and maybe you are less likely to produce a high viral load; you produce a lower viral load, and thus it's related to less severe disease," she said. She noted that in places and situations that had adopted universal masking -- such as on an Argentine cruise ship and at several US food-processing plants -- the asymptomatic infection rate, at above 80%, was more than double the CDC's estimated asymptomatic infection rate of approximately 40%. The mask appears to lower the dose by filtering out some of the viral particles. The connection between masks and vaccines There is, however, another fascinating and important way to think about virus dosing. If the dose is small enough, it may not cause illness but could still generate an immune response, similar to a vaccine. This is a remarkable and critically important concept. In fact, Gandhi and her coauthor, Dr. George Rutherford from the department of epidemiology and biostatistics at UCSF, wrote a perspective piece in the New England Journal of Medicine in September putting forth the argument that by wearing a mask, a person, if exposed, would get a smaller dose of the virus than they otherwise might -- preventing illness but still triggering the body's immune system. In her article, she and Rutherford drew the comparison with "variolation," which is what a similar process was called when people were deliberately exposed to a bit of smallpox matter from a sick person in order to create immunity. This was before the introduction of the smallpox vaccine. "We're going to give them a teeny bit of virus and they're going to get just a teeny bit sick and then they'd develop an immune response -- and it totally worked," she said. It could also help explain why some people never develop symptoms of Covid-19, but still have antibodies to the virus. But more research will need to be done to confirm that. Because people can't control if, let alone how much, of a viral dose they get, Gandhi reiterated what most all public health experts have been saying we should do to stay as safe as possible: maintain physical distance from those not in our household, choose outdoor spaces over indoors, practice good hand hygiene and -- please -- mask up!