State Department Kinda Making Up Coronavirus Policy As It Goes Along. That Cool?

The Washington Post published a disturbing-maybe story yesterday detailing internal White House deliberations Sunday, when the US was about to fly more than 300 Americans from that quarantined cruise ship in Japan back to the USA. The Americans who wanted to return home had already been taken off the Diamond Princess, which had been sitting at anchor in Yokohama Harbor since February 3 while the Covid-19 coronavirus spread among the passengers on board. But while the 328 Americans, all wearing surgical masks and gloves, waited on buses at Haneda Airport in Tokyo for their flight home, officials from the State Department and the Centers for Disease Control were wrangling over a new problem: 14 of the Americans had tested positive for the virus, although the State Department had promised that nobody who was infected would be allowed on the two 747s — their interiors stripped of everything but seats — chartered to repatriate the Americans.

As the Post reports, it seems nobody had planned for that possibility.

A decision had to be made. Let them all fly? Or leave them behind in Japanese hospitals? [...]

The State Department and a top Trump administration health official wanted to forge ahead. The infected passengers had no symptoms and could be segregated on the plane in a plastic-lined enclosure. But officials at the Centers for Disease Control and Prevention disagreed, contending they could still spread the virus. The CDC believed the 14 should not be flown back with uninfected passengers.

"It was like the worst nightmare," said a senior U.S. official involved in the decision, speaking on the condition of anonymity to describe private conversations. "Quite frankly, the alternative could have been pulling grandma out in the pouring rain, and that would have been bad, too."

Ultimately, it may not make a huge difference — or at least we don't know yet. All the Americans who were brought back remain in quarantine at military bases in California and Texas, where they're no doubt being prevented from seeing the massive numbers of Russian and Chinese tanks left over from Barack Obama's Jade Helm 15 conspiracy. But even if none of those who tested positive for the virus actually spread it on the planes, it's not exactly reassuring to know that the people in charge were pretty much improvising their response — which is, after all, the default mode in Donald Trump's White House.

The Post's account of the government's handling of the Diamond Princess passengers includes some other troubling details. For one, the CDC didn't get in touch with the Americans aboard the ship until five days after it docked and the Japanese government said no one would be allowed to disembark. And the decision to get the Americans off the ship, where more than 600 of the 3,700 passengers and crew are now infected, was at least partly prompted because one of the passengers happened to know a member of Congress:

On Feb. 12, U.S. officials briefed members of Congress in a closed-door hearing.

Rep. Phil Roe (R-Tenn.), a doctor, had also heard from a friend and fellow doctor, Arnold Hopland, of Elizabethton, Tenn., who was on the ship with his wife, Jeanie. Hopland told Roe about the deteriorating conditions.

"That tipped the balance," said the senior administration official.

The story doesn't detail exactly when the evacuated Americans were tested, but it looks like the positive test results only became known after they'd been taken off the ship and put on buses. One US official told the Post, "Nobody anticipated getting these results." You might think they would have anticipated that?

Anne Schuchat, CDC's principal deputy director, didn't want the infected people to go on the plane; she pointed out the government had told passengers anyone who tested positive would be treated at Japanese hospitals, not flown back.

But Robert Kadlec, assistant secretary for preparedness and response for the Department of Health and Human Services and a member of the coronavirus task force, pushed back: Officials had already prepared the plane to handle passengers who might develop symptoms on the long flight, he argued. The two Boeing 747s had 18 seats cordoned off with 10-foot-high plastic on all four sides. Infectious disease doctors would also be onboard.

"We felt like we had very experienced hands in evaluating and caring for these patients," Kadlec said at a news briefing Monday.

Ultimately, the State Department, citing "protocol" for evacuation, decided to fly the infected passengers back even though that would more than double the number of known cases in the US. And the CDC said it didn't want to be mentioned in the press release State was preparing, so it wouldn't have to say it had opposed the decision.

Again, nobody knows whether anyone was infected on the flight despite the containment measures. So far, it doesn't look like it; no additional passengers have been infected. And while the virus is still being studied, the isolation of the passengers may have been sufficient, given what's known about how it spreads:

Some of its features, such as how long it can live on surfaces, are unknown. But experts say it is mainly spread by respiratory droplets produced by coughs and sneezes from an infected person. That person must be in close contact, usually defined as six feet.

"We still don't have a good understanding of the risk posed by people who are infected but without symptoms," said Jeffrey Duchin, an infectious disease specialist at the University of Washington.

So maybe this particular case of Team Trump making its policies up on the fly (or at least on the tarmac) will turn out just fine. It's a bit of a contrast to Trump's absolute certainty, as an infectious disease specialist, that Barack Obama was trying to kill us all with Ebola in 2014. Back then, Trump offered the sort of clear vision available to someone with no actual responsibility for policy, tweeting about one (1) American:

Could be that coronavirus, since it comes from a place where people buy Jared Kushner's Visa Condos, is just a lot less scary than Ebola, which only infects Africans and "left-wing" nurses who touch Africans. As far as we know, while Covid-19 has certainly excited plenty of online and real-life racists, we still haven't reached the point where wingnut thought leaders are suggesting that all infected patients be "put down" and their "villages" cleansed with napalm.

[WaPo / CNN / Wonkette Photoshoop based on images by the National Institute of Allergy and Infectious Diseases (NIAID) and Gage Skidmore, Creative Commons license 2.0]

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Doktor Zoom

Doktor Zoom's real name is Marty Kelley, and he lives in the wilds of Boise, Idaho. He is not a medical doctor, but does have a real PhD in Rhetoric. You should definitely donate some money to this little mommyblog where he has finally found acceptance and cat pictures. He is on maternity leave until 2033. Here is his Twitter, also. His quest to avoid prolixity is not going so great.


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