As the coronavirus outbreak in the USA continues to grow, it's also becoming clearer and clearer that the Trump administration's response to the public health crisis has been a huge clusterfuck. For starters, Trump's 2018 decision to fire the chain of command for pandemic preparedness sure didn't help! And now that we have an epidemic on our hands (which we should wash vigorously for 20 seconds), the government has suffered operational fuckups like the Centers for Disease Control's rollout of a coronavirus test kit that didn't work, a screwup made worse by internal power struggles in the healthcare bureaucracy. And it's all made worse by everyone's fear of angering the toddler-in-chief, who doesn't like bad news.

Good lord, it's all enough to make us want to lie down in a dark room with a nice cool washcloth on our forehead. Hey, does bourbon kill the coronavirus? Not if taken internally? Damn.


First up, that failed coronavirus test kit from the CDC. The New York Times has an excellent examination of some of the things we know so far about what went wrong, although the story notes that CDC officials "have never provided a full account of the obstacles the agency faced in producing a diagnostic test," and points out that Monday, the CDC

appeared to have removed figures on the agency website counting how many Americans had been tested, and [officials] abruptly canceled a news conference just as it was to begin.

That's not good. And yes, mistakes happen, but in this case, it's not just that the test kits were no good, it's that there doesn't appear to have been any fallback strategy. It took until late last week for the government to offer an alternative to waiting for the CDC to release a replacement. The Food and Drug Administration finally

[authorized] state and local laboratories to do initial testing on their own. If labs had developed and validated a test, they could use it for diagnosis instead of relying on the C.D.C.'s version or waiting for a replacement.

In its initial response to the virus, the government appears to have "managed" the lack of widely available test kits by restricting testing to only people who had returned from China or had contact with someone who had already been diagnosed with COVID-19. Last week, those criteria were expanded somewhat, to include "travelers returning from places like South Korea and Italy, and hospitalized patients who were very ill and whose symptoms could not be otherwise explained."

But as a Twitter thread that went viral yesterday (wash your Twitter vigorously for at least 20 seconds) points out, that still leaves out a lot of people who have good reason to seek testing:



The Times also points out that shortly after the first CDC-developed test failed, the agency insisted on developing its own test, even though German researchers had developed a test that was adopted by the UN's World Health Organization. The FDA could have approved the WHO test for use in America, but nah — "America First," in this case, isn't just a Trump slogan. It's how our public health infrastructure has always preferred to work. Wouldn't want to use no European tests, heck no.

The FDA's action to now allow wider use of non-CDC tests is likely to result in more testing becoming more available, soon-ish, but it's still taking time to ramp up, and as the Times points out, there'll always be the question of whether the "failure to provide adequate testing [gave] the coronavirus time to gain a toehold in the United States?"

Then there's all the infighting and turf wars, which Politico discusses at great length in a report published yesterday. Prepare to feel ill. Much of the article focuses on Alex Azar, the former pharma executive who's Trump's Health and Human Services secretary, and who just might be getting a close-up view of the underside of a bus soon. One unnamed "administration official" said the delays in rebounding from the CDC's test kit fuckup constitute a "management failure" on Azar's behalf, adding that "CDC and FDA should have been working hand in hand to get Plan B, Plan C and Plan D ready to go." Seems there's no shortage of blame to go around; Politico talked to a bunch of Azar critics and defenders, and notes that insiders at HHS (who declined to be identified because "fear of retaliation") said

Azar's failure to reach out to a wider circle of advisers is typical of his management style, which has grown increasingly distrustful of his own aides.

We won't go into all the ins and outs of the palace intrigue, but how's this for unsettling? It's difficult to read that Politico piece without coming away with the impression that Mike Fucking Pence may do a marginally more competent job of managing the coronavirus response than Azar. Yes, even with the strict information control Pence is imposing. It's all a matter of degree, because this administration sucks, but at least Pence appears to have brought in some people Azar had sidelined (Azar's defenders insist he hadn't done anything of the sort, mind you).

Among those who had been fairly quiet about coronavirus until last week is Surgeon General Jerome Adams, who was appointed by Pence to the coronavirus task force and immediately got busy yelling at people on social media to make smart preparations instead of being idiots:

Adams, it seems, had been kept on a short leash by Azar, because the surgeon general was too close to Centers for Medicare & Medicaid Administrator Seema Verma. As we've noted previously, Politico has reported that Azar and Verma have been fighting to win Donald Trump's affections, like the cast of "The Jersey Shore" in a production of King Lear. So that's helpful in a public health crisis. Verma is now on the task force, too, and Azar was sent out to twist in the wind during a decidedly unfriendly interview with Fox Business's Lou Dobbs last night.

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Dobbs yelled at Azar for not calling the outbreak a "pandemic," and when he tried to point out — accurately, really — that such a designation normally comes from the World Health Organization, Dobbs blasted him with a good dose of nationalism (which despite being very heated, is not as effective at disinfecting as vigorous hand-washing with soap and hot water for 20 seconds):

I'm not interested in their thinking, to be candid with you. You're responsible for your department. The NIH and the CDC are responsible for the public's health. I'm delighted to speak to you, sir, and delighted to have the opportunity, but I could care less what the World Health Organization has to say to what is happening to Americans and how this government is being led.

Dobbs went on to yell at Azar about the test kit delays and whether Americans are safe; at one point, when Azar mentioned an existing 2017 "pandemic action plan," Dobbs got very excited that maybe he'd GOTCHA'd Azar: "Wait a minute, did you say pandemic?!" It was pretty fucking stupid, and shame on Fox Business for making us feel a little sorry for Alex Azar, who really came off looking like a dead bureaucrat walking.

And then there's the strange semi-silencing of Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, who's been the nation's top voice on infectious disease since 1984, when he was talking about AIDS and Ronald Reagan wasn't. Fauci told Politico in a recent interview that he's definitely not being muzzled, but that he wants to make sure he's very clear, while being very careful:

You should never destroy your own credibility. And you don't want to go to war with a president [...] But you got to walk the fine balance of making sure you continue to tell the truth.

As far as how ready America is for the public health challenges posed by coronavirus, Fauci said,

I don't think that we are going to get out of this completely unscathed [...] I think that this is going to be one of those things we look back on and say boy, that was bad. [...]

It could be really, really bad. I don't think it's gonna be, because I think we'd be able to do the kind of mitigation. It could be mild. I don't think it's going to be that mild either. It's really going to depend on how we mobilize.

He emphasized the need to strike the right balance between caution ("you have to be honest with the American public and you don't want to scare the hell out of them") and reassurance ("in attempts to calm people down, [leaders] have had people be complacent about it") in communicating about the disease.

And lordy, we hope Pence is listening to Fauci.

[NYT / Politico / Mediaite / Politico]

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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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