Donald Trump and his administration have known how chronically unprepared the United States was to deal with the coronavirus crisis for months, and they refused to act.
Here’s a rundown of what they knew and the consequences of their inaction:
New Evidence Shows The Trump Administration Knew Medical Shortages Were Coming…
February 5, 2020: Health And Human Services Secretary Alex Azar Asked OMB For $2 Billion To Buy Respirator Masks And Other Medical Supplies — The White House Cut The Request by 75%.
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“On Feb. 5 …Azar had asked OMB that morning for $2 billion to buy respirator masks and other supplies for a depleted federal stockpile of emergency medical equipment, according to individuals familiar with the request, who spoke on the condition of anonymity about internal discussions.” [Washington Post, 3/28/20]
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“The $2 billion request from HHS was cut to $500 million when the White House eventually sent Congress a supplemental budget request weeks later. White House budget officials now say the relief package enacted Friday secured $16 billion for the Strategic National Stockpile, more money than HHS had asked for.” [Washington Post, 3/28/20]
Kaiser Health News: ‘Red Dawn Breaking Bad’: Officials Warned About Safety Gear Shortfall Early On, Emails Show
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“The emails, part of a lengthy chain titled ‘Red Dawn Breaking Bad,’ includes senior officials across the Department of Veterans Affairs, the State Department, the Department of Homeland Security and the Department of Health and Human Services, as well as outside academics and some state health officials. KHN obtained the correspondence through a public records request in King County, Washington, where officials struggled as the virus set upon a nursing home in the Seattle area, eventually killing 37 people. It was the scene of the first major outbreak in the nation.” [Kaiser Health News, 3/28/20]
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“‘We should plan assuming we won’t have enough PPE — so need to change the battlefield and how we envision or even define the front lines,’ Dr. Carter Mecher, a physician and senior medical adviser at the Department of Veterans Affairs, wrote on Feb. 25. It would be weeks before front-line health workers would take to social media with the hashtag #GetMePPE and before health systems would appeal to the public to donate protective gear.” [Kaiser Health News, 3/28/20]
…But Trump Continued To Deny The Extensively Documented Shortages…
Huffington Post: Trump Official Says There’s No Shortage Of Ventilators. Reports Say Otherwise
Talking Points Memo: Trump Claims NY Doesn’t Need 30K Ventilators Despite Doctors Saying So
New York Times: After Considering $1 Billion Price Tag For Ventilators, White House Has Second Thoughts
Politico: Trump Downplays Need For Ventilators As New York Begs To Differ
As a Result, Doctors And State Officials Are Ringing The Alarm While Hospitals Start Developing Plans To Ration Ventilators…
New York Times: ‘The Other Option Is Death’: New York Starts Sharing of Ventilators
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“‘Nobody believes this is the best way to ventilate somebody — this is for the doomsday scenario when we run out of ventilators,’ Dr. Paladino said. ‘It’s suboptimal, but the other option is death.’” [New York Times, 3/26/20]
Michigan Advance: Henry Ford Hospital Letter Leaks On Who Gets Treatment If There’s A Ventilator Shortage
Baltimore Sun: Who Gets Lifesaving Care — And Who Doesn’t — When There’s A Crush Of Coronavirus Patients? Maryland Is Coming Up With A Plan
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“Simplistically, this would mean a young, otherwise healthy person receives a ventilator instead of an older person suffering from other health problems. But choices are rarely so simple.” [Baltimore Sun, 3/27/20]
NJ Advance Media: N.J. To Create Bioethics Team To Help Make ‘Difficult’ Choice Of Which Coronavirus Patients Get A Ventilator In Case Of Shortage
Politico: New Jersey Officials Planning For Possibility Of Rationing Ventilators
Times-Picayune | New Orleans Advocate: Coronavirus Spread In Louisiana Could Mean Critical Shortage Of Ventilators
York Daily Record: Pa. Coronavirus Hospitalizations Spike Sharply Up To 170; At Least 32 Needed Ventilator
Bloomberg: NYC Mayor Says Trump Needs to Face Reality On Ventilator Crisis
The Hill: Severe Ventilator Shortage Sparks Desperate Scramble
Bloomberg: Ventilators Top Fear With N.Y. Deaths at 385, N.J. Cases Up 56%
Brooklyn Hospital Center Director Of Critical Care Services Dr. James Gasperino Warned That Patients Who Develop Coronavirus Can Often Require Two To Three Weeks On A Ventilator Because “The Intensity Level Is Higher.”
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“‘Patients with the coronavirus who develop pneumonia can often require two to three weeks on a ventilator. ‘The intensity level is higher,’ said Dr. Gasperino, who is also chair of medicine. ‘It’s harder to oxygenate than your typical flu patient who’s sick.’ He added, ‘The staff is anxious.’ So far none of the coronavirus patients requiring ventilators have recovered enough not to need one, although several younger patients were rapidly improving, he said.” [New York Times, 3/26/20]
CNBC: What The Ventilator Shortage Means For America’s Fight Against The Coronavirus
Zuckerberg San Francisco General Hospital And Trauma Center Chief Of Emergency Medicine: “You Have An 80-year-old And A 20-year-old And Both Need A Vent And You Only Have One. What Do You Do?”
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“‘You have an 80-year-old and a 20-year-old and both need a vent and you only have one. What do you do?’ said Dr. Christopher Colwell, the chief of emergency medicine at Zuckerberg San Francisco General Hospital and Trauma Center.” [Los Angeles Times, 3/26/20]
California Has About 9,500 Ventilators Statewide — It May Need As Many As 20,000 At Once As The Outbreak Grows
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“Statewide, there are about 9,500 ventilators, a total that includes recent additions made by state leaders and others in anticipation of increased numbers of COVID-19 patients. The federal government’s national stockpile, which states can tap when their local supplies run low, has an additional 16,000. Gov. Gavin Newsom has not said how many ventilators he thinks California will ultimately require, but studies in China found that between 2% and 6% of people with COVID-19 needed to be on ventilators. If half of Californians fall sick with COVID-19 and 2% need ventilators, the state would need 390,000 over the course of the outbreak. Even if those cases were spread out over the next year, the state could still require 20,000 ventilators at once.” [Los Angeles Times, 3/26/20]
Infectious Disease Doctor Dr. Robert Winters Said Of California’s Ventilator Shortages: “It Could Be Catastrophic.”
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“‘It could be catastrophic,’ said Dr. Robert Winters, an infectious disease doctor in Los Angeles. Doctors will have to resort to a wartime-like triage to determine whom to put on the ventilators and whom to turn away. In Italy, hospitals have been forced to deny potentially live-saving treatment to older, frailer people due to a shortage of machines.” [Los Angeles Times, 3/26/20]
New York City Doctor: “We Don’t Have The Machines, We Don’t Have The Beds… It’s Like A Third-World Country Type Of Scenario. It’s Mind-Blowing.”
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“The doctor, who spoke to CNN on condition of anonymity out of concern for his job, described a hospital that was woefully unprepared for an influx of Covid-19 patients that started roughly two weeks ago — which has already stretched the hospital’s resources thin and led to severely ill patients outnumbering ventilators. ‘We don’t have the machines, we don’t have the beds,’ the doctor said. ‘To think that we’re in New York City and this is happening,’ he added. ‘It’s like a third-world country type of scenario. It’s mind-blowing.’” [CNN, 3/25/20]
Montefoire Medical Center ER Nurse Judy Sheridan-Gonzalez Said “Everybody Is Terrified” About Becoming Infected Because Of The Lack Of Proper Protective Gear.
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“Judy Sheridan-Gonzalez, an ER nurse at Montefiore Medical Center and president of the New York State Nurses Association, said that ‘everybody is terrified’ about becoming infected because many lack the proper protective gear, and many are being told to reuse the same mask between multiple patients. Sheridan-Gonzalez said she fears not having enough ventilators or staff to take care of everyone, but it hasn’t ‘hit that level yet’ at her hospital.” [CNN, 3/25/20]
Louisiana Governor John Bel Edwards Said Ventilator Shortages Were “Probably The Most Significant Near-Term Issue Related To Our Ability To Treat COVID-19 Patients.”
“A shortage of hospital ventilators is the biggest immediate challenge in Louisiana’s fight against COVID-19, Gov. John Bel Edwards said at a Wednesday afternoon press conference. The conference came after the Office of Public Health website reported an increase of more than 400 positive tests for the virus, including three in St. Mary, in a single day. ‘One of the consequences of this is ventilator capacity,’ Edwards told reporters Wednesday. ‘In talking to the Department of Health and the Office of Public Health, this is probably the most significant near-term issue related to our ability to treat COVID-19 patients.’” [Morgan City Daily Review, 3/25/20]
Dwindling Stores Of Protective Equipment Have Driven Hospitals To Consider Universal Do-Not-Resuscitate Orders For Coronavirus Patients
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“Hospitals on the front lines of the pandemic are engaged in a heated private debate over a calculation few have encountered in their lifetimes — how to weigh the ‘save at all costs’ approach to resuscitating a dying patient against the real danger of exposing doctors and nurses to the contagion of coronavirus. The conversations are driven by the realization that the risk to staff amid dwindling stores of protective equipment — such as masks, gowns and gloves — may be too great to justify the conventional response when a patient ‘codes,’ and their heart or breathing stops.” [Washington Post, 3/25/20]
Northwestern Memorial Hospital In Chicago, Atrium Health in the Carolinas, Geisinger In Pennsylvania And Regional Kaiser Permanente Networks Considering DNR Policy Due To Lack of Protective Gear
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“Northwestern Memorial Hospital in Chicago has been discussing a do-not-resuscitate policy for infected patients, regardless of the wishes of the patient or their family members — a wrenching decision to prioritize the lives of the many over the one.” [Washington Post, 3/25/20]
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“Several large hospital systems — Atrium Health in the Carolinas, Geisinger in Pennsylvania and regional Kaiser Permanente networks — are looking at guidelines that would allow doctors to override the wishes of the coronavirus patient or family members on a case-by-case basis due to the risk to doctors and nurses, or a shortage of protective equipment, say ethicists and doctors involved in those conversations. But they would stop short of imposing a do-not-resuscitate order on every coronavirus patient. The companies declined to comment.” [Washington Post, 3/25/20]
Los Angeles Times: Who Lives And Who Dies? With Ventilators Limited Amid Coronavirus, Doctor Might Face Hard Choices
ProPublica: Desperate Hospitals May Put Two Patients on One Ventilator. That’s Risky.
Morgan City Daily-Review (Louisiana): Governor: Ventilator Shortage Is Biggest Short-Term Problem
Nola.com (Louisiana): Even With Coronavirus Disaster Declaration, Louisiana’s Ventilator Capacity Is ‘Far From OK’
ABC News: As Coronavirus Pandemic Surges, Hospitals Prepare For Grim Possibility Of ‘Ventilator Triage’
WTAE (Pittsburgh): Medical Staff At Excela Say They Struggled To Get Masks Until Nurse Diagnosed With Coronavirus
SF Chronicle: ‘Worst Is Yet To Come:’ SFMay Need Additional 1,500 Ventilators, 5,000 Beds To Confront Coronavirus
NBC News: ‘Our Worst-Case Scenario’: Top Hospital Forced To Raid Its Emergency Stockpile Ahead Of Coronavirus Peak
Kaiser Health News: Hospital Suppliers Take To The Skies To Combat Dire Shortages Of COVID-19 Gear
New York Times: Amid Desperate Need for Ventilators, Calls Grow for Federal Intervention
…And Frontline Medical Professionals Pay For The Shortage Of Personal Protective Equipment With Their Lives.
NBC Boston: Over 100 Employees at Boston-Area Hospitals Test Positive For Coronavirus
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“Without adequate masks, gloves, gowns and more, doctors and nurses are more likely to contract the virus themselves. Many local emergency room physicians have been forced to use the supplies sparingly. ‘Practicing medicine in this country, you don’t think of needing to ration supplies,’ said Dr. Joshua Lerner, with Wachusett Emergency Physicians at Leominster Hospital.” [NBC Boston, 3/26/20]
New York Times: A N.Y. Nurse Dies. Angry Co-Workers Blame A Lack Of Protective Gear
The Hill: Photo Shows Ny Hospital Staff Using Trash Bags As Protective Gear
KGO (San Francisco): Coronavirus impact: Medical Supply Shortage Takes Toll On Bay Area Nurses, Doctors
Nebraska Educational Telecommunications: Faced With Mask Shortages, Nebraskans Are Getting Their Sewing Machines Out