Public health officials and community leaders are walking a fine line between responsiveness and alarmism as they respond to the coronavirus quickly spreading across the United States.
That leaves some Americans feeling overly policed, while other say they’re not being taken seriously enough.
One example from over the weekend: About 1 a.m. on Saturday, 30 students at George Washington University got calls from the university’s health center. The students — who attended the American Israel Public Affairs Committee’s national conference the previous weekend — said they were told they needed to self-quarantine, although a university spokeswoman denied that. University officials were reacting to an announcement from AIPAC that two conference attendees had tested positive for the virus.
Some of the students — holding towels over their mouths — were escorted by a student emergency medical services supervisor to One Washington Circle Hotel, an 18-year-old freshman told me. “They told me I didn’t have a choice and I needed to leave my dorm immediately and stay at a hotel,” said one freshman, who refused to the university’s demand she leave her on-campus residence in the middle of the night. Instead, she took a train to her mom’s home in New Jersey on Saturday morning.
Less than 12 hours later, in a sudden reversal, the students who did spend the night at the hotel were released from quarantine, according to an email sent by Kathleen Fox, GWU’s assistant vice president of health and security. In the email, Fox said the university had determined “there is no identifiable risk to the community from the conference.”
“We realize this situation, especially with how quickly information develops can be scary and we did not take the decision lightly,” Fox wrote. “We received information from DC [Department of Health], GW’s public health experts, and, importantly, from members of the student community as it was developing.”
“With the information we had at the time, we took the action we believed would minimize risk to you all and to the community,” the email said. “Today we have worked with DC [Department of Health] and our healthcare community to determine that, at this time, there is no identifiable risk to the community from the conference.”
A university spokeswoman said the students were not forced or told they had to self-quarantine, and some students chose not to.
But the incident left some students feeling as though the university acted in a knee-jerk manner, even though no cases of coronavirus have been identified on campus. “I wasn’t going to leave my room to comply with something that wasn’t logical,” the freshman told me.
The coronavirus is now spreading quickly on U.S. soil, infecting more than 500 people in more than 30 states and confounding efforts by public health officials here and around the world who are trying to halt or at least slow infections.
“Governments intensified their efforts Sunday to combat the global spread of the novel coronavirus, as Saudi Arabia followed Italy in enacting new travel restrictions, Iran suspended flights to Europe, and the United States… warned citizens against cruise travel,” my colleagues Felicia Sonmez, Juliet Eilperin and Kim Bellware write.
“Uncertainty continued to permeate the response effort, however, amid muddled directives from the Trump administration and reports of some patients unable to access testing,” they write. “A virus-stricken cruise ship made its way to California to dock — only for Housing and Urban Development Secretary Ben Carson to decline to discuss the details of the federal response plan during a national television interview.”
The Washington area now has a number of confirmed coronavirus cases. The first reported patient in the district is the rector of Christ Church Georgetown. The church canceled services yesterday as its officials reported that the Rev. Timothy Cole, the church’s top-ranking clergyman, tested positive on Saturday. Meanwhile, Virginia announced its second presumptive case. The Fairfax City resident, in his or her 80s, “traveled on a similar Nile cruise” as other patients who have tested positive, The Post’s Fenit Nirappil, Rebecca Tan and Jenna Portnoy report.
There’s concern about the virus spreading at political events or large-scale gatherings, including to senior officials. Coronavirus got closer to Trump after an individual who attended the Conservative Political Action Conference less than two weeks ago tested positive. Trump, Vice President Pence and a number of other top White House officials had appeared at the four-day event in Maryland. Sen. Ted Cruz (R-Tex.) and Rep. Paul Gosar (R-Ariz.) said they had contact with the attendee, and decided to self-quarantine even though they did not show symptoms.
And Trump “was photographed shaking hands with Matt Schlapp, the chairman of the American Conservative Union, who confirmed that he had been in direct contact with the infected man” putting him “just two degrees of separation away from the virus,” Toluse Olorunnipa, Josh Dawsey and Juliet Eilperin reported.
Politico’s Heather Caygle:
The Capitol physician sent an update late last night:
“The ill individual …was able to recall specific names of people he had contact with …Members of the Congress, were identified and were contacted on evening of March 7 by Office of Attending Physician.”
— Heather Caygle (@heatherscope) March 9, 2020
Despite all this, the United States lags significantly behind other countries in even being able to determine who is infected. There were significant technical problems in getting tests out the door — partly because of dysfunction within the administration — and they’re just now being made more available.
“Production is ramping up, but tests — and the labs and equipment necessary to run them — are still very limited,” my colleagues Carolyn Y. Johnson and Laurie McGinley report.
“Even where test kits are available, many states are following strict criteria for who should be tested to avoid overwhelming their labs,” they write. “Interviews with a dozen laboratory experts and government health officials reveal a six-week series of glitches, missed opportunities and delays that contributed to the shortage.”
Larry Levitt, a senior vice president at the Kaiser Family Foundation:
As the coronavirus spreads, health coverage, access, and affordability issues are going to become more pronounced.
How do people who are uninsured or underinsured afford not only testing, but treatment too?
It will expose the inadequacies and inequalities in our health system.
— Larry Levitt (@larry_levitt) March 7, 2020
Bloomberg News opinion writer Noah Smith:
Free universal coronavirus testing should have been a no-brainer.
Making people pay for testing in the middle of a pandemic = a civilizational death wish. https://t.co/C7YyeNTnjA
— Noah Smith 🐇 (@Noahpinion) March 8, 2020
Some people have been publicly sharing their personal stories of trying — and failing — to obtain a test.
In a Facebook post with more than 5,000 shares, a woman named Maggie McDow wrote about her experience with seeking a coronavirus test at George Washington Hospital. After traveling to South Korea for work, McDow said she came down with flu-like symptoms.
But when she visited GW’s emergency department — where she had been told she could get tested — staff told her the D.C. health department wouldn’t run the test because she wasn’t in South Korea long enough to be considered high risk.
“Do I have Covid-19? Who knows,” McDow wrote. “Do we have a broken public health care system that is utterly failing during a health pandemic? Absolutely.”
Per Jenna, a top Health Department official said McDow did not qualify for a test because airport exposure, even in a country like Korea with community spread of the disease, does not warrant testing.
“We bring a different perspective to that single clinical encounter,” said Anjali Talwalkar, senior deputy director for the community health administration at the D.C. Department of Health. She made the comments Saturday evening at a news conference in the District. “An airport is not considered by CDC to be that kind of exposure.”
Carolyn and Laurie spoke with North Hills, Calif. resident Renee Schwartz, who has been trying to get a coronavirus test after developing shortness of breath and a severe cough two weeks ago.
“I feel like crap,” Schwartz told them. “I want to know, why can’t I get this test?”
While Trump has denied the testing problems — declaring on Friday that “anybody that needs a test gets a test” — his officials have been more open lately about the widespread problems. Anthony Fauci, head of the infectious diseases division at the National Institutes of Health, acknowledged there were technical problems but said 1.1 million tests were available as of Sunday and 640,000 more would be made available today.
But Fauci also denied a report by the Associated Press that the White House overruled proposed guidance the Centers for Disease Control that elderly people and those who are “physically fragile” shouldn’t fly on commercial airplanes.
“I can tell you right away no one overruled anybody,” Fauci said yesterday on “Fox News Sunday.”
“If you are an individual who has an underlying condition, right now you should start to distance yourself from the risk, crowds, getting on a plane, and above all don’t get on a cruise ship,” Fauci said. “No one has told us not to say that and I’m saying that very clearly right now on your show.”
The Post’s Juliet Eilperin:
This is the strongest statement from the federal government so far, when it comes to cruise ship travel. https://t.co/Npr2q7g0vM
— Juliet Eilperin (@eilperin) March 8, 2020
— The Post’s Ashley Parker, Yasmeen Abutaleb and Lena H. Sun detail the federal government’s many preventable missteps and blunders in its handling of the outbreak, based on interviews with 16 current and former administration officials, state health officials and outside experts.
“Public health experts and officials faced a deluge of challenges, almost from the beginning,” they write. “First there were the problems with the initial coronavirus test kits, which contained an unspecified problem with a compound that prompted inconclusive results; it took experts nearly three weeks of troubleshooting to find a workaround. Initial U.S. guidelines for testing also were overly narrow, only screening individuals who presented with respiratory symptoms and had either recently traveled to China or come in close contact with an infected person.”
— Our colleague Josh Dawsey writes about how quickly the situation escalated when, after he presented himself at MedStar Washington Hospital Center’s emergency department with flulike symptoms, medical staff suspected he might have the coronavirus.
“After I was whooshed into a private, Manhattan-studio-size room at MedStar Washington Hospital Center, nurses in heavy-duty hazmat-like suits and masks suddenly surrounded me, inserting an intravenous needle, checking my heart and pulse, examining my organs and writing measurements on charts,” Josh writes.
“New masks were changed. One doctor stood at least 10 feet away from me, his back against the wall, as he talked to me,” Josh writes. “It suddenly dawned on me, though no one had said it. They thought I had coronavirus.”
It turns out Josh actually has mononucleosis. “Mono never seemed so good,” he writes.
— Thousands of local health officials across the country have been working nonstop and scrambling to prepare for coronavirus infections, The Post’s Derek Hawkins and William Wan report.
— Sen. Bernie Sanders (I-Vt.) and former vice president Joe Biden are moving full steam ahead with campaign events, barring advice to the contrary from public health officials, The Post’s Felicia Sonmez and Juliet Eilperin report. Sanders plans to hold campaign rallies ahead of Tuesday’s primaries in six states.
“We will not endanger the health of anybody in this country. . . . We are watching this thing very, very carefully,” Sanders said on CNN. “What is most important is the health of the American people.”
“With the outbreak in the United States now affecting 30 states, some political organizations have reassessed their plans for conferences and large-scale events,” Felicia and Juliet write. “The AFL-CIO, the largest group of labor unions in the country, announced that it is canceling its presidential forum, which had been scheduled for Thursday in Orlando. Sanders and [Biden] had been planning to attend.”
AHH, OOF and OUCH
AHH: Ahead of the Affordable Care Act’s 10th anniversary, Gallup finds 52 percent of Americans approve of the health-care law.
The survey, out this morning, finds 47 percent disapprove of the ACA. The approval rate for the ACA mimics two previous Gallup surveys, both early in the Trump tenure. Since President Trump has been in office, Americans have either leaned in favor of the law or have been closely split. But between 2012 and 2016, Gallup found Americans more often opposed the law.
Approval hit a record high in 2017, when 55 percent of Americans approved of it while 41 percent disapproved.
The new survey found Democrats are more likely than ever to approve of the law — 94 percent of Democrats say they approve of it, compared to 53 percent of independents and 11 percent of Republicans who approve of it.
OOF: In comparing the coronavirus with the flu, Trump said he was “shocked” to hear the rate of people who died because of the flu.
“I never heard those numbers. I would’ve been shocked. I would’ve said, ‘Does anybody die from the flu? I didn’t know people died from the flu,’” he said in Atlanta on Friday. “And again, you had a couple of years where it was over 100,000 people died from the flu.”
As our Post colleague Gillian Brockell reports, Trump’s own grandfather died because of the flu.
“There have been several years where more than 100,000 Americans were killed by particularly nasty influenza strains,” she writes. “One of those episodes was the 1958 pandemic, which killed 116,000 in the United States. Another was 1918. That is the year Trump’s paternal grandfather died.”
Friedrich Trump was the “victim of the first wave of the Spanish flu pandemic. A second, deadlier wave hit in the fall. All told, the pandemic killed at least 50 million people worldwide and 675,000 in the United States, according to the CDC.”
OUCH: In recent speeches, Sanders has targeted Biden’s record on numerous issues, including on his vote to prohibit federal funding of abortions, our Post colleague Jose A. Del Real reports.
“For much of the campaign, Sanders has focused on economics and inequality, attacking his opponents for accepting donations from the wealthy and opposing Medicare-for-all. But in recent days, Sanders has also begun to challenge Biden’s record on LGBT rights and women’s reproductive health,” he writes. “He repeatedly knocked Biden for, until recently, supporting the Hyde amendment, which banned Medicaid funds from being used to cover abortions.”
In contrast, Sanders touted his “100 percent pro-choice voting record throughout my entire life … I believed then, and I believe now, that it is women who have a right to control their own bodies, not the government.”
His targeted criticisms come as tensions between the liberal and moderate lanes of the Democratic Party have ramped up, our colleague adds, and as Sanders seeks to gain momentum ahead of the upcoming caucuses and primary contests on Tuesday.
— The Trump administration is set to release today much-anticipated rules about the sharing of electronic health information between patients and providers, Modern Healthcare’s Matthew Weinstock reports.
“Lobbyists from multiple healthcare organizations over the weekend confirmed receiving emails inviting them to a stakeholder conference call with HHS Secretary Alex Azar, Deputy Secretary Eric Hargan, CMS Administrator Seema Verma and National Coordinator for Health Information Technology Dr. Donald Rucker,” Matthew writes. “During the call, the HHS officials will discuss ‘an important policy announcement regarding the administration’s commitment to empowering American patients.’ ”
The president was expected to release the rules at the now-cancelled Health Information and Management Systems Society’s annual conference.
In remarks at the annual Office of the National Coordinator for Health Information Technology meeting in January, Azar said: “I want to be quite clear: Patients need and deserve control over their records; interoperability is the single biggest step we can take toward that goal …Unfortunately, some are defending the balkanized, outdated status quo and fighting our proposals fiercely.”
— And here are a few more good reads:
HEALTH ON THE HILL
Neither South Dakota nor nearby Wyoming and Nebraska have legalized marijuana, and tribal leaders think pot could rake in millions of dollars. If the measure is approved, the Oglala Sioux Tribe would become the only Native American tribe to set up a cannabis market in a state where it’s otherwise illegal.
Despite the inroads women have made entering the workforce and politics, paid family and medical leave remains a heavy lift in Colorado and across much of the country. For each of the past six years, the Colorado legislature has considered bills to establish a statewide paid leave program, but none have passed.
Kaiser Health News
- The House Appropriations Subcommittee on Departments of Labor, Health and Human Services, Education, and Related Agencies holds a hearing on the Centers for Disease Control and Prevention’s budget request for fiscal year 2021 on Tuesday.
- The House Oversight and Reform Subcommittee on National Security holds a hearing on the coronavirus outbreak response on Tuesday.
- The House Homeland Security Subcommittee on Emergency Preparedness, Response, and Recovery holds a hearing on community perspectives on the coronavirus preparedness and response on Tuesday.
- The House Oversight and Reform Committee holds a hearing on coronavirus preparedness and response on Wednesday.
- The House Appropriations Subcommittee on Agriculture, Rural Development, Food and Drug Administration, and Related Agencies holds a hearing on the FDA budget request for fiscal year 2021 on Wednesday.
- The House Ways and Means Subcommittee on Worker and Family Support holds a hearing on combatting child poverty in America on Wednesday.