'It's demoralising and makes me want to leave': How poor pay is impacting home carers in this 'lucrative' sector

Part two of Noteworthy’s investigation examines pay and conditions of these frontline workers, as well as profits made by providers.

THIS IS FROM IRELAND BUT THE PROBLEM IS GLOBAL

“MY SON IS after getting a job in Aldi for the summer and he’s getting more money per hour than me. It’s demoralising and makes me want to leave the profession.” 

Linda Byrne is a home carer who has been working on the frontline throughout the pandemic, yet, like many Noteworthy spoke to over the past few weeks, feel that carers in the community are the forgotten heroes of Covid-19.  

She is fully qualified, has five years’ experience and is paid €12 per hour – less than the recommended living wage of €12.30 though above the minimum wage of €10.10.  

“Carers say that they don’t do it for the money, which is very true, but when that’s what you’re relying on for your mortgage, bills and to look after three kids… you need more money.”  

Linda Byrne feels that carers in the community are the forgotten heroes of Covid-19Source: Linda Byrne

Over the past number of weeks, Noteworthy has taken a deep dive into the home care sector. In this, the second of our three-part investigation, we examine the pay and conditions of these vital frontline workers, as well as the profits made by providers. We reveal:

• The HSE pays around €25 per hour of care to providers for home support services but home carers and healthcare assistants (HCAs) can pocket less than half of this fee. 
• There is debate over operating costs of private home care as some experts say that ‘generous’ margins have created problems with the retention of carers.
• Funding for home care provision has shifted substantially from the HSE to private providers over the past decade, according to new research by UCD.
• The top five home care private providers received grants of €128 million between them last year.
• Of the four with accessible accounts, they were all profitable, with accumulated profits of up to €2.3 million.
• The parent companies of the top three providers receiving HSE grants are based outside of Ireland – in Switzerland, France and the United States.
• The directors of Clemac Home Care Services – the previous owners of one of these top three companies, the Irish Bluebird Care franchise – were paid over €900,000 in 2018.

In the first part of our investigation, we showed that many carers took a pay hit and felt unsupported by their companies during the pandemic. Tomorrow, we examine the impact that lack of regulation is having on home care and discover what’s in store for the future of the sector.  

A shift from public to private 

Home care in Ireland was traditionally provided by the public sector, through the HSE, as well as voluntary organisations, often run by the Catholic Church. However, this has shifted in recent years with private providers now supplying a substantial chunk of home care services.  

UCD associate professor Dr Julien Mercille, studying government spending on home care over the past decade, found that the proportion of funding being allocated to the private sector grew from insignificant levels in the mid-2000s to nearly half the public home care budget last year. The full study he conducted with student Nicholas O’Neill is set to be published in the coming months.

This trend towards the private sector is similar to other areas of Irish healthcare. When looking previously at the nursing home sector, Mercille showed that over the last 20 years it had transformed from a mostly public system into a mostly private, for-profit one. 

The reason for this outsourcing of services is not really clear due to a lack of data, Mercille explained.

You can ask: ‘Is this because the private sector is really cheaper or is it more of an ideological thing?’

Mercille also found that funding to the nonprofit sector has stagnated during the same period. From talking to providers, Mercille said this is partly explained by “regulation burden” from the tender system as private providers were better able to handle this.  

Passing profits to carers 

The home care sector “is a lucrative business but not enough of those funds are flowing to carers”, according to Michael Harty, founder of the online platform Home Care Direct, which enables people to employ carers through the site. He was also the chairperson of the representative body for private for-profit providers, Home and Community Care Ireland (HCCI), from 2012 to 2016, when he previously owned a traditional home care provider.  

Noteworthy sent a number of inquiries to private providers in the Dublin region to find out how much it would cost  per hour for home care for an older person. The quotes we got back ranged from an average of €25 on weekdays and rose up to an average of €29 at the weekend. Private clients can get up to 40% tax back on this cost. 

This is similar to what the public purse is paying providers.

In a statement to Noteworthy, the HSE said that “funding for home support services in 2020 is based on a blended rate across all provision at €25.26 per hour”. It added that this rate varies depending on tender or service arrangements. 

However, recent research showed that home carers and healthcare assistants (HCAs) pocket less than half of this fee. 

A survey carried out during the pandemic by HCA and Carers Ireland found that over half of the 450 qualified public and private carers and HCAs that responded were earning €12 or less per hour, with 12% stating they earned €10 when their hourly wage was rounded to the nearest euro. This means that if carers were on the minimum wage, they would report it as €10 for the purposes of this survey, and does not suggest that carers are being paid below minimum wage.   

The current minimum wage is €10.10 per hour and the recommended living wage is €12.30 per hour.  

Source: Noteworthy/Flourish

An interactive version of this graph can be found here.

Joint research by HCA & Carers Ireland and UCD, published in March, reported that “those employed in the private sector were, on average, paid 40% less than their fellow healthcare assistant with the same qualification and experience within the public sector”. The same study found that many would be paid more on social welfare than they would in a full week of work as a home carer. 

This was also what we found when speaking to carers over the course of this investigation. Carers working for private for-profit providers were paid between €11 and €12.30 per hour. There was little distinction between part- and fully-qualified carers, with one carer telling us her hourly rate would increase by a euro to €12 when she was fully qualified.  

‘Generous’ corporate margins  

Allison Metcalfe, founder of HCA and Carers Ireland said that there have been some wage increases in recent years but more could be done. “There needs to be a minimum basic rate of €14 per hour” as people are putting themselves through higher education and training but then often getting the “basic minimum wage”. 

In a submission to the Government last November, HCCI said “the average reported hourly rate for a HCA employed by a HCCI member is €12.14”. The submission continued: “This well exceeds the national minimum wage and is virtually at parity with the 2019 Irish living wage.” 

This is in contrast to wages in the public sector which, according to SIPTU, have risen to a maximum of about €15.50 an hour through collective agreements. Carers working in the not for profit sector are also paid more than private providers. SIPTU shop steward Ellen McNamee told us most are paid €14 upwards. 

“By the time you get to the operational cost, you are left with a margin in the private sector of five to ten percent,” according to Joseph Musgrave, chief executive of HCCI. He said that this translates to one to two euro per hour of care.

If you’re a small business owner, you can’t get by on one percent margins, because any shock puts you under.

Harty, a past chair of HCCI, had a different view. “The margins are very generous whether it’s a small or large provider.”  He said these margins have already created problems with the retention of carers. He felt that unless “margins are controlled, those problems will continue”.

With HSE budgets under pressure, he said he is sure it “wants to ensure value for money” but is not sure “large corporate margins are the best way to ensure proper use of those funds”.  

A profitable business  

Source: Noteworthy/Flourish

An interactive version of this graph can be found here.

The top five private providers – Home Instead, Bluebird Care, Comfort Keepers, Irish Homecare and Caremark Ireland – received grants of €128 million between them last year. These five received over 70% of all revenue allocated to private home care providers by the HSE in 2019. 

In 2017, this figure was €100 million so it has risen by almost €30 million in the space of two years. 

Noteworthy analysed the profits of these five providers to find out just how much profit they are making. The company accounts we could access all showed profits, with accumulated profits ranging from €273,000 in the case of Caremark Ireland to €2.3 million for Irish Homecare. 

Home Instead Senior Care was paid €140 million over the past three years by the HSE, with €55.5 million of this in 2019. This was more than any other private home care provider. 

This franchise operator is owned by a Swiss company and since 2018 has consolidated its accounts. This means that very little financial detail is provided in relation to the various individual Irish subsidiaries as their accounts were submitted in Ireland in combination with accounts for the rest of the Swiss-Irish group.

A statement from Home Instead in Ireland said that “the accounts of Home Instead Holding AG have been filed in accordance with the Companies Act 2014 and have been accepted by the registrar of companies”. It continued: “Our public tenders are subject to State tendering rules, to which we adhere.”

In 2017, the last year before the accounts were consolidated, the Irish holding company had accumulated losses of €260,000 since its incorporation in 2014. However, it had shareholders’ funds of €6.3 million at the end of 2017, suggesting it was well capitalised and in the black. 

This table can also be viewed here.

Bluebird Care’s accounts were also complicated, even more so as the company who owned the master franchise in Ireland, Clemac Home Care Services, recently sold the franchise to UK Bluebird, which is ultimately owned by a US company.  

Irish-based Clemac received over €75 million from the HSE over the past three years. From its incorporation in 2007 to the end of 2018, it had accumulated profits of €1.2 million and made a trading profit in 2018 of more than €500,000.  

The company did make a trading loss of over €550,000 in 2017 yet the two directors, Brian and Lyn MacGoey were paid over €625,000 between them that year. They were also paid over €900,000 in 2018 between “emoluments in respect of qualifying services”, pension contributions and “compensation for loss of office”.  

When asked about this, Brian MacGoey said he was “bound by the sale purchase agreement not to discuss or disclose details”. He passed our query to Bluebird Care UK who said it would be inappropriate to comment as it relates “to a separate business entity that we have no involvement in”. They subsequently suggested we revert back to MacGoey.  

The HSE paid Comfort Keepers a similar amount to Bluebird Care over the past three years, receiving €67 million in revenue. From their incorporation in 2005, the company accumulated profits of €2.6 million by the end of 2018, making them the most profitable of these companies over the course of their lifetime. Trading profits in that financial year topped €600,000. 

They are also owned by a company outside the State, being a subsidiary of a Belgian company, which is, in turn, a subsidiary of French-registered Sodexo Plc, whose worldwide revenues totalled €22 billion last year.  

Irish Homecare and Caremark Ireland received €35 million and €28 million respectively from the HSE over the past three years. Both had healthy accumulated profits over each of the company’s lifetimes.  

‘They don’t let you be heroes when it comes to your rights’ 

Carers are not receiving the benefit of home care funding, according to Emily*, a carer for a Home Instead branch in the West of Ireland. “Private home care agencies are businesses so they’re trying to make money.” She believes there is no reason for private providers and feels the HSE should employ more carers directly.  

After a number of their carers in various branches across the country contacted us, Noteworthy reached out to the headquarters of Home Instead in Ireland. We told them that those that spoke to us were not happy with their pay and conditions. We then asked a spokesperson if Home Instead felt they paid carers adequately. They answered: “Home Instead Senior Care’s pay, benefits and practices are not as you’ve presented.” 

SIPTU agreed that there should be more public provision of care. “We shouldn’t have a profit motive,” said Marie Butler, healthcare assistants’ sector organiser for SIPTU.
Brian Rusk, healthcare assistant in a private nursing home in the Midlands and founder of the Facebook group Care Assistants Ireland, explained:  

Many carers are trying to get out [of the private sector] and into a HSE post so they have a pension, sick pay, better representation with trade unions.

“People don’t think of the wages when they get into caring. It’s at the later stage when you realise ‘I have no permanent job so I can’t get a mortgage’ and the real issues start showing up”. 

Geraldine McNamara is looking for better recognition for those who look after older peopleSource: Graham Seely

Though pay and conditions may be better in the HSE, Geraldine McNamara, HSE community healthcare support assistant and SIPTU shop steward, told Noteworthy that “the people who look after older people in their own homes have always been at the bottom of the list” in Ireland.  

People seem to have an image of what we do, that isn’t the real image [and] don’t realise that you’re looking after people from the time they’re getting ill until the time they die.  

This was a common sentiment amongst all the carers and HCAs we spoke to over the course of this investigation. They felt forgotten, unappreciated, undervalued and overlooked.  

Providers say that they do support their workers. A spokesperson from Home Instead said: “As you can appreciate, the home care sector has experienced challenges over the last number of months and we have worked closely with the HSE to continue to provide care for vulnerable seniors in our community.”  

Bluebird Care said they “pay above market rates and throughout the pandemic, have invested heavily in protecting both our staff and customers and also in additional training”. Comfort Keepers said that they review “carer pay on an ongoing basis and in 2016 and 2017 invested millions of euros to ensure hourly and 30-minute rates of pay for carers were enhanced”.  

“They don’t let you be heroes when it comes to your rights,” said McNamara who outlined issues for HSE HCAs such as lack of rosters and unpaid travel time. There has been some progress within the HSE, with a new pay scale being implemented from September for those working in the community.  

Working from week to week 

“The biggest problem in the community is that we’re not guaranteed our hours,” said Ellen McNamee, home carer in the community not for profit sector and SIPTU shop steward. “None of us can be sure from month to month” the number of hours we will work, she added. 

Carers have to “keep at” companies in order to get more hours, she explained. Newer carers often contact her as it is “a worry all the time for them” and they find it hard having to constantly ask their employers for this.  

She is calling on the Government to implement guaranteed hours. McNamara is in her 50s and said that most of her colleagues are older, with some 30 years in the job. 

If they want to keep older people at home and out of hospitals, they have to make it attractive for the younger person coming up.

The recent UCD study “noted a growing trend towards older adults working in care compared with younger groups”. Of the almost 2,000 carers who participated in this research, 45% were 46 or older and over 90% were women. In comparison, the last census in 2016 found 37% of women in the overall labour force were 45 or older. 

Some of McNamee’s colleagues have left the sector to work in care homes or in hospitals “for less money” because of these issues. “They often get more holidays and have a pension whereas in the private and not for profit sector we don’t,” she added.  

Butler from SIPTU said that those depending on their hours in the private sector are very vulnerable. “It’s an issue we haven’t got to the bottom of yet.” 

The UCD study recommended:

[The] pay rate for those working in private sectors, who are usually working on ‘if and when required’ contracts should have a set hourly rate, across the board.

One of the difficulties in campaigning for better conditions in the private sector is that HCAs “would be afraid to be seen in a union” due to a fear of getting hours cut as a consequence. Butler found this is particularly true for migrant workers.  

This is also something that Noteworthy encountered when talking to carers in the private sector and is the reason why most workers that we spoke to asked to use a pseudonym, for fear of the consequences of speaking out.  

Travelling out of pocket 

In addition to low pay, many carers are not compensated for either travel time or mileage costs.  Using your own transport for work proposes and not being paid for this is a “clear violation of the Court of Justice of the European Union in Case 266/14 generally referred to as the ‘TYCO case’”, according to the recent UCD study.  

“Agencies don’t have to pay mileage. It costs me roughly €20 per week out of my salary to visit my clients,” according to Emily, who works with Home Instead in the West. Another carer at a different branch of the provider was paid €30 for mileage every two weeks.

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Home Instead told Noteworthy that their home carers receive mileage or travel allowance. When it was put to them that some carers we spoke to said they did not receive this, with detail of Emily’s mileage expenses, a spokesperson said: “We cannot comment on individual cases or claims such as the one to which you refer.” They added:  

A large number of Home Instead companies are independently owned and operated and as such there may be variation on terms and conditions across the offices, based on local HSE agreements and/or local circumstance.

We also asked other companies in the top five for-profit provider list whether their home carers were in receipt of mileage or travel allowance.

Bluebird Care said that they pay travel or mileage allowances “in line with sector norms” and Comfort Keepers said that it does so “where relevant”. Caremark stated that “this is determined on a case by case basis in conjunction with the HSE”.  

John Florence, chief executive of Irish Homecare, said: “The majority of our work is in highly populated areas and we have an extremely robust automated scheduling system allowing us to align our carers with clients in close proximity, therefore mileage is not an issue for us.”

He added that in areas where there may be more distance between calls, they “provide different travel allowances” which are either funded by the HSE or Irish Homecare.  

A spokesperson for the HSE told Noteworthy:

Pay, terms and conditions of employment of home support workers employed by Approved Providers including arrangements for travel and fuel allowances is a matter for those private agencies.  

In the HSE tender for the provision of home support services, it states that “providers may seek support with travel costs in recognition of rural area travel costs”. One of the tender documents details the rates and they range from €3 for a journey of 20km to €5 to a journey of up to 60km. This is significantly lower than the rates the HSE pays for its own staff which for the smallest engine size, range from over €7.50 for 20km to almost €23 for 60km.   

HCCI’s chief executive blamed the tender system for issues with travel time and mileage. It is at the financial discretion of each HSE area but some “allow you to invoice for the cost of mileage”, Musgrave said. He added that you cannot include travel time as part of your cost of care delivery.  

However, Butler of SIPTU, challenged whether this is so, as “they’re expected to tender for all of their costs”. She claims that private providers don’t do that as they want to get the tender. If they did, then “their costs would be very similar to that of the HSE or not much lower” so they leave out items such as mileage.  

Butler said that workers are out of pocket in relation to mileage in the private sector. This is one reason that they lose staff.

Sometimes you get the impression, from the private sector in particular, that they’re vocational workers and they should be happy to do this for nothing.

Ellen McNamee said there is inconsistency, even within the not for profit sector, in terms of mileage and travel allowance. Her company, which McNamee preferred us not to name, pays a set travel allowance as part of their wage but others pay a set amount of mileage or don’t pay travel costs at all.  

No emphasis on upskilling 

From our contact with carers working for for-profit providers, those that were fully qualified earned around one euro more than their part-qualified colleagues, and did not feel that they were rewarded for their level of experience.  

In order to change this, Musgrave felt that a new tender system that provides a variety of levels of care, should replace the current time-on-task model. This would give carers the “incentive to upskill” as they could move up the levels from more basic care to advanced complex clients.  

The introduction of specialities in home care has been recommended in official reports in recent years. A HSE review of HCAs in 2017 recommended:

The potential for the development of modular extensions for HCAs working in specialist areas or locations should be considered.  

In a report last year, the Joint Committee on Health on home care provision recommended that “carers be incentivised with career pathways”. This issue not only applies to the home care sector but across the variety of roles and workplaces of healthcare support assistants.  

The recent UCD study on HCAs and carers found that a third of respondents stated that their employer does not allow or support opportunities to upskill. The survey does not specify which companies provide these opportunities so it should be noted that two-thirds of those who responded did feel they had the opportunity to upskill. 

HSE community HCA and SIPTU shop steward McNamara said “even if you progress and get specialties, you still get the same wages as a person who refuses to do any courses”.  

Citing the different types of HCAs such as nursing home, community, disability, childcare and others, McNamara felt that “you should be able to branch out and specialise in certain areas”. This is needed in order for people to feel valued in their job, she added.  

Knock-on impacts

These issues with pay and conditions in the private sector have led to a high staff turnover, according to Butler from SIPTU, which can affect those receiving care. “You don’t necessarily see the same carer twice.” 

This is an issue that affected Nancy* who is in her 80s and lives on her own. After a stroke, she needed home care and received a HSE package. “It was a disaster from the start,” she explained, as living in a rural town in the West, she found it hard to find a provider who serviced her area. 

During the first year, she had a new carer almost every month, with some leaving because of travel distance. Nancy found this hard as with each new carer she had to “show them where everything is and what she needs”. 

Her private provider that is contracted by the HSE often does not provide cover if her regular carer is away.

There would be a full week where she wouldn’t show up and there wouldn’t be anybody to replace her.

This has left Nancy paying for care at these times as well as extra care she needs in the evenings which has eaten into her savings. She said that she “can’t continue to pay for it”. She asked Noteworthy to use a pseudonym as her care hours were significantly cut by the HSE recently which left her “low mentally and physically” and she was worried about a further cut.  

“We have a shortage of carers because it’s an unattractive career,” said Metcalfe from HCA and Carers Ireland. “It’s a low rate of pay, you don’t get paid for travel, you’re spending most of your time driving.” 

She added that “there is one way to ensure that carers are treated well with good terms and conditions of employment, and that’s to regulate the system”. 

 ***

Noteworthy delves further into the impact that this lack of regulation is having on the sector in part three of this investigation tomorrow. In part one, which you can read now, we revealed how home carers became the forgotten frontline workers of the pandemic.

*Names have been changed due to requested anonymity

 ***

This investigation was carried out by Maria Delaney of Noteworthy, with additional reporting by Ian Curran of TheJournal.ie. It was proposed and funded by you, our readers, as well as with support from the Noteworthy general fund. 

Due to the volume of issues raised by carers about the home care sector when they answered our call-out, we decided to expand the investigation into a three-part series. If you would like to help towards the cost of this additional work, please support the general fund here.

Noteworthy is the investigative journalism platform from TheJournal.ie. You can support our work by helping to fund one of our other investigation proposals or submitting an idea for a story. Click here to find out more >>

Bank of Ireland plans to cut 1,400 jobs from its workforce

It comes after the bank posted a pre-tax loss of €669 million in its half-year results this morning.

Image: Leah Farrell


BANK OF IRELAND plans to shed 1,400 jobs.

The announcement comes after the bank incurred a pre-tax loss of €669 million in the first six months of 2020, according to its interim results, posted this morning.

Speaking on a call with analysts this morning, BoI chief executive Francesca McDonagh unveiled plans to cut 1,400 jobs from its current workforce of 10,400.A spokesperson for the bank said, “We have launched a groupwide voluntary redundancy programme to colleagues this morning. Into the medium term, we anticipate a headcount of fewer than 9,000 within the group from our current position of under 10,400.”

The job cut announcement was made following an appearance by McDonagh on RTÉ’s Morning Ireland programme this morning.

Asked why McDonagh did not mention the planned redundancies during her interview, a BoI spokesperson told TheJournal.ie, “The voluntary redundancy programme was being announced to colleagues this morning. We made it a priority to ensure that colleagues would be briefed on this first.”
Earlier today, the bank released its half-year results, revealing a €669 million pre-tax loss after setting aside €937 million to cover various pandemic-related costs including potential bad loans.

In the report, McDonagh said, “Covid-19 has had a material impact on the Group’s financial performance and outlook.

“However, there is much uncertainty related to Covid-19, in particular the risk of a second wave and the timeline for a vaccine to become widely available.

“As a result, the longer-term impacts of Covid-19 on the economy and the Group’s financial performance remain uncertain; our medium-term targets should therefore no longer be considered current in these circumstances.”

Bank of Ireland’s largest single shareholder is the Irish government, which holds a 14% stake in the bank.

Rescuers work through the night as death toll rises following massive Beirut explosions

Lebanon’s prime minister said the blast was caused by 2,750 tonnes of ammonium nitrate.

Drone footage of the blast area in Beirut
Image: Hussein Malla/AP/PA Images

RESCUERS WORKED THROUGH the night into today after two enormous explosions ripped through Beirut’s port, killing at least 100 people and injuring thousands, as they wrecked buildings across the Lebanese capital.

The second blast sent an enormous orange fireball into the sky, immediately followed by a tornado-like shockwave that flattened the port and shattered windows across the city.

The explosions — which were heard in Nicosia, 240 kilometres away in Cyprus — were logged by seismologists, registering as the equivalent of a 3.3-magnitude earthquake.

Bloodied, dazed and wounded people stumbled among the debris, glass shards and burning buildings in central Beirut.

The wounded receive treatment in the car park of Al Roum Hospital.Source: Marwan Naamani/DPA/PA Images

Around 4,000 people were hurt by the blasts, with injuries recorded right across the city.

Lebanon is already reeling from an economic crisis that has left more than half of the population in poverty. The situation has been worsened in recent months by the coronavirus pandemic.

Prime Minister Hassan Diab said 2,750 tonnes of the agricultural fertiliser ammonium nitrate that had been stored for years in a portside warehouse had blown up, sparking “a disaster in every sense of the word”.

“What happened today will not pass without accountability,” said Diab. “Those responsible for this catastrophe will pay the price.”

General Security chief Abbas Ibrahim said the material had been confiscated years earlier and stored in the warehouse, just minutes from Beirut’s shopping and nightlife districts.

A soldier at the port, where relatives of the missing scrambled for news of their loved ones, told AFP: “It’s a catastrophe inside. There are corpses on the ground. Ambulances are still lifting the dead.”

A woman in her twenties stood screaming at security forces, asking about the fate of her brother, a port employee.

“His name is Jad, his eyes are green,” she pleaded, to no avail as officers refused her entry.

“It was like an atomic bomb,” said Makrouhie Yerganian, a retired schoolteacher in her mid-70s who has lived near the port for decades.

“I’ve experienced everything, but nothing like this before,” even during the country’s 1975-1990 civil war, she said.

“All the buildings around here have collapsed.”

AFP correspondents across the city saw shop and apartment windows blown out and streets covered with broken glass.

Photos posted online showed damage to the inside of Beirut airport’s terminal, nine kilometres from the explosion.

Hospitals already struggling with the country’s coronavirus outbreak were overwhelmed by the influx of wounded people and the country’s Red Cross called for urgent blood donations.

‘We saw the mushroom’

As the national defence council declared Beirut a disaster zone, Diab appealed to Lebanon’s allies to “stand by” the country and “help us treat these deep wounds”.

President Michel Aoun declared three days of mourning, and announced he would release 100 billion lira (€55 million) of emergency funds.

Condolences poured in from across the world with Gulf nations, the United States and even Lebanon’s arch foe Israel offering to send aid. France also promised to send assistance.

Ambulances driving by the site of the explosions.Source: Hassan Ammar/PA Images

AFP video footage showed areas of near-complete devastation, with cars flipped onto their roofs, warehouses flattened and survivors drenched from head to toe in their own blood.

“We heard an explosion, then we saw the mushroom,” said a Beirut resident who witnessed the second deafening explosion from her balcony in the city’s Mansourieh district.

“The force of the blast threw us backwards into the apartment.”

An AFP correspondent at the scene minutes after said every shop in the Hamra commercial district had been damaged, with entire storefronts destroyed and many cars wrecked.

A huge blaze sent up black smoke from the port area, as helicopters dumped water on burning buildings.

A ship moored off the port was on fire, and the blasts also damaged a vessel deployed with United Nations peacekeeping force UNIFIL and injured some of its personnel.

‘Like an earthquake’

Hundreds shared their shock and grief on social media.

“Buildings are shaking,” tweeted one resident, while another wrote: “An enormous, deafening explosion just engulfed Beirut. Heard it from miles away.”

Online footage from a Lebanese newspaper office showed blown-out windows, scattered furniture and demolished interior panelling.

The explosions hit a country already reeling from its worst economic crisis in decades.

The local currency has plunged, and businesses have shuttered en masse, as poverty and unemployment have soared at an alarming rate.

Charity Save the Children said “the incident could not have occurred at a worse time”.

Ammonium nitrate: What is the chemical that has been blamed for the Beirut blast?

Prime Minister Hassan Diab has said 2,750 tonnes of the agricultural fertiliser had blown up.

Thick smoke billows from the site where a massive explosion rocked Beirut's portSource: Marwan Naamani/dpa via PA Images

LEBANESE AUTHORITIES HAVE said ammonium nitrate was the cause of yesterday’s two major explosions that ripped through Beirut’s port, killing at least 100 people and injuring thousands.

The second blast sent an enormous orange fireball into the sky, immediately followed by a shockwave that flattened the port and shattered windows across the city.

The explosions — which were heard in Nicosia, 240 kilometres away in Cyprus — were logged by seismologists, registering as the equivalent of a 3.3-magnitude earthquake.

Prime Minister Hassan Diab has said 2,750 tonnes of the agricultural fertiliser ammonium nitrate that had been stored for years in a portside warehouse had blown up, sparking “a disaster in every sense of the word”.

“What happened today will not pass without accountability,” said Diab. “Those responsible for this catastrophe will pay the price.”

So, what exactly is ammonium nitrate?

Ammonium nitrate is an odourless crystalline substance commonly used as a fertiliser that has been the cause of numerous industrial explosions over the decades.

These include notably at a Texas fertiliser plant in 2013 that killed 15 and was ruled deliberate, and another at a chemical plant in Toulouse, France in 2001 that killed 31 people but was accidental.

When combined with fuel oils, ammonium nitrate creates a potent explosive widely used by the construction industry, but also by insurgent groups like the Taliban for improvised explosives.

It was a component in the bomb at the 1995 Oklahoma City attack.

In agriculture, ammonium nitrate fertiliser is applied in granule form and quickly dissolves under moisture, allowing nitrogen – which is key to plant growth – to be released into the soil.

Lebanese soldiers search for survivors after the massive explosion in BeirutSource: Hassan Ammar via PA Images

Lebanon’s General Security chief Abbas Ibrahim said the material at the port had been confiscated years earlier and stored in the warehouse, just minutes from Beirut’s shopping and nightlife districts.

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Under normal storage conditions and without very high heat, it is difficult to ignite ammonium nitrate, Jimmie Oxley, a chemistry professor at the University of Rhode Island in the US, said.

“If you look at the video (of the Beirut explosion), you saw the black smoke, you saw the red smoke, that was an incomplete reaction,” she said.

“I am assuming that there was a small explosion that instigated the reaction of the ammonium nitrate - whether that small explosion was an accident or something on purpose I haven’t heard yet.”

That’s because ammonium nitrate is an oxidiser – it intensifies combustion and allows other substances to ignite more readily, but is not itself very combustible.

For these reasons, there are generally very strict rules about where it can be stored: for example, it must be kept away from fuels and sources of heat.

In fact, many countries in the European Union require that calcium carbonate to be added to ammonium nitrate to create calcium ammonium nitrate, which is safer.

In the United States, regulations were tightened significantly after the Oklahoma City attack.

Under the Chemical Facility Anti-Terrorism Standards, for example, facilities that store more than 2,000 pounds (900 kilograms) of ammonium nitrate are subject to inspections.

Despite its dangers, Oxley said legitimate uses of ammonium nitrate in agriculture and construction has made it indispensable.

“We wouldn’t have this modern world without explosives, and we wouldn’t feed the population we have today without ammonium nitrate fertiliser,” she said.

“We need ammonium nitrate, we just need to pay good attention to what we’re doing with it.”

Includes reporting by © – AFP 2020

‘It was a bomb of some kind’: Trump pushes conspiracy theory about Beirut explosion

QUOTING TWITCHY AND OTHER ALT RIGHT SOURCES

THAT PROVIDED NO EVIDENCE EITHER FOR THE CLAIM

Published August 4, 2020 By Matthew Chapman

At Tuesday’s White House press briefing on coronavirus, President Donald Trump opened by discussing the fireworks factory explosion in Beirut, Lebanon, saying that it “looks like a terrible attack.”

Pressed by reporters, Trump doubled down. “I met with some of our great generals,” he said. “They seem to think it was an attack. It was a bomb of some kind.”

It is not clear yet exactly how the explosion happened, but the current prevailing theory was that it was an explosion of hazardous materials in a warehouse in the port. A fire, and a series of small detonations of fireworks, preceded the main explosion.Trump on the Beirut explosion: I met with some our great generals. "They seem to think it was an attack. It was a bomb of some kind."
— Geoff Bennett (@GeoffRBennett) August 4, 2020

He’s now winging it about the explosion, some of his “generals” said “it was a bomb of some kind."
Jesus, the PM of Lebanon has enough trouble today.
— Charles P. Pierce (@CharlesPPierce) August 4, 2020

Trump says US generals 'feel' Beirut explosion was an 'attack', despite no evidence

Lebanese officials say they have not determined the cause of the explosion. 

Image: AP/PA Images

US PRESIDENT DONALD Trump has said American military generals have told him that they “seem to feel” the massive explosion that rocked Beirut was a “terrible attack” likely caused by a bomb.

Trump was asked why he called it an attack and not an accident, especially since Lebanese officials say they have not determined the cause of the explosion.

He told reporters at the White House: “It would seem like it, based on the explosion. I met with some of our great generals and they just seem to feel that it was.

“This was not a — some kind of a manufacturing explosion type of an event … They seem to think it was an attack. It was a bomb of some kind, yes.”

Trump offered condolences to the victims and said the United States stands ready to assist Lebanon.

“It looks like a terrible attack,” he said.

A Pentagon spokesman declined to comment on the matter last night, referring questions back to the White House.

The cause of the blast was not immediately known, but initial reports suggested a fire had detonated a warehouse at the port.

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Abbas Ibrahim, chief of Lebanese general security, said it might have been caused by highly explosive material that was confiscated from a ship some time ago and stored at the port.

Lebanese Prime Minister Hassan Diab has said 2,750 tonnes of the agricultural fertiliser ammonium nitrate that had been stored for years in a portside warehouse had blown up, sparking “a disaster in every sense of the word”.

“What happened today will not pass without accountability,” said Diab. “Those responsible for this catastrophe will pay the price.” 

Witnesses reported seeing a strange, orange cloud like that which appears when toxic nitrogen dioxide gas is released after an explosion involving nitrates.

With reporting by © – AFP 2020

THE RIGHT WING DEFENSE OF TRUMP IS TRADITIONAL REPUBLICANISM

QUOTING FROM NATIONAL REVIEW COLUMNIST JOHN YOO

https://www.aei.org/op-eds/how-donald-trump-defends-presidential-power/

Trump represents something new, but not in the way his critics imagine and fear. He has not played the role of standard populists, who usually seek to remove constitutional barriers to their reform agendas. Instead, he has become, by the end of his four years, an unexpected constitutional traditionalist who has relied on theories of executive power held by his predecessors — even (gasp) Barack Obama and George W. Bush — to defend the rights of his office. He has fought off the efforts of so-described progressives, who have wanted to revolutionize our constitutional order by vesting ever more power in a permanent bureaucracy with virtually limitless authority but without democratic accountability. Whether consciously or by reacting to his own political incentives (which the Constitution itself creates), Trump has become a stouter defender of our original governing document than his critics.

Progressives have unwittingly engineered similar results across the constitutional landscape. Even though Trump lost the popular vote in the 2016 election, he legitimately won the presidency under the rules of the Electoral College, which grants each state votes based on their number of members of the House and Senate (thereby favoring smaller states and, because states award all of its electoral votes to the winner, slightly muting the popular vote). Progressives responded by seeking to abolish the Constitution’s two-centuries-old method for presidential selection. Representative Alexandria Ocasio-Cortez claimed the Electoral College is “a shadow of slavery’s power on America today that undermines our nation as a democratic republic.” In spring 2019, Democratic senators Brian Schatz, Dick Durbin, Dianne Feinstein, and Kirsten Gillibrand even introduced a constitutional amendment to abolish the Electoral College. Progressive intellectual leaders and retiring Representative John Dingell, the longest-serving member of the House, want to abolish the Senate too while they are at it. When it comes to defending our Constitution and its existing institutions, progressives eagerly cede the field to Trump.

Democrats would do even more damage to the constitutional order if they were to win this November. During the primaries, they launched proposals for a Medicare-for-All health-care system that would abolish private insurance, a Green New Deal that would escalate Washington’s control over the economy, federal wealth or sales taxes that violate the income-tax amendment, and the takeover of state and local areas of governance ranging from criminal justice to consumer contracts to property. Trump could protect the Constitution merely by winning the 2020 election (again through the Electoral College), governing with the Senate, and simply stopping progressive efforts to vest even more new powers in a permanent, unaccountable bureaucracy.

Third, Trump appointed a Supreme Court that could return the Constitution to its original understanding on questions ranging from federalism to individual liberties nominated Neil Gorsuch and Brett Kavanaugh, conservative judges with eminent qualifications, to the Supreme Court, and has filled more than a quarter of the lower courts with young, bright, conservative intellects. 

  The liberals rightly worry that these appointments augur a sea change in constitutional law that could threaten the vast administrative state, the creeping control of Washington, D.C., over everyday life, and even Roe v. Wade’s protections for abortion. Progressives responded by attacking the Supreme Court. During the Democratic presidential primaries, senators Elizabeth Warren and Kamala Harris and Mayor Pete Buttigieg, among others, called for expanding the Supreme Court from nine to 15 justices so that the next Democratic president could pack it with liberals. Democrats have attacked the personal records of judicial nominees and have even threatened to impeach Kavanaugh for sexual-harassment claims that the Senate fully aired during his confirmation. All of these attacks leave Trump in the position of defending the Supreme Court and the institution of judicial independence.

These battles over presidential power and the Constitution provide an important insight into the political and constitutional change of the Trump years. Political analysts have observed that Trump represents a realignment in American politics, with Republicans coming to represent a populist nationalism suspicious of globalization, foreign entanglements, and immigration, while Democrats evolve away from their (WHITE)working-class constituents to represent the cosmopolitan, educated elites in coastal cities and suburbs.

THESE SO CALLED ELITES ARE NOT THE RULING CLASS OR EVEN THE 1% THEY ARE THE BROAD PROLETARIAT, BLUE, WHITE AND PINK COLLARS, BLACK, LATINO, AND WOMEN WORKING CLASS CONSTITUENTS. IT IS ALSO AN ATTACK ON LGBTQ COMMUNITY AS COSMOPOLOTIN COASTAL ELITES

 But the deeper change that Trump’s election may have triggered is a revolution in the nature of government. At certain periods in our history, government can become ossified and overgrown with rules and bureaucracy that have separated from the wishes of the people. Jefferson, Jackson, Lincoln, FDR,*** and Reagan led popular movements that swept away old political orders and replaced them with new, spartan forms of government more responsive to the political times.

FDR IS HATED BY REPUBLICANS AS A STATIST AND THEY BEGAN THEIR WAR ON AMERICAN PROGRESS WAY BACK THEN AND IT HAS NEVER STOPPED. IT WAS INCLUDED AS A BACK HANDED COMPLEMENT.

Trump’s presidency may signal a similar seismic shift in government, one that extends far beyond his own personal political interests or his low polling. Today’s federal government can trace its lineage directly to the New Deal. Large, expert federal bureaucracies exercising broad powers delegated by Congress continue to govern an economy and society that have evolved far from the world of the 1930s–1960s. Even as America races into a post-industrial society, where information has become the foundation of the most valuable goods and services, it continues to govern itself with forms suited for continent-spanning GMs and IBMs and their matching labor unions.  A more spartan government, controlled by a Constitution of limited powers, may well prove more nimble and effective in the new 21st-century world than the government of the New Deal. Even while he recalls America to the society of the past, Trump may have shaken up the political system enough to allow it to adapt to the new economy of social media, networks, and AI. Presidential power provides the critical leverage to spark such significant government change, and it may be Trump’s most unlikely legacy to have preserved the constitutional authorities of his office that make such reform possible.

How Jared Kushner’s Secret Testing Plan “Went Poof Into Thin Air”

This spring, a team working under the president's son-in-law produced a plan for an aggressive, coordinated national COVID-19 response that could have brought the pandemic under control. So why did the White House spike it in favor of a shambolic 50-state response?

BY KATHERINE EBAN JULY 30, 2020 VANITY FAIR

BY TOM BRENNER/REUTERS (KUSHNER);

 EVERYTHING ELSE FROM GETTY IMAGES

On March 31, three weeks after the World Health Organization designated the coronavirus outbreak a global pandemic, a DHL truck rattled up to the gray stone embassy of the United Arab Emirates in Washington, D.C., delivering precious cargo: 1 million Chinese-made diagnostic tests for COVID-19, ordered at the behest of the Trump administration.

Normally, federal government purchases come with detailed contracts, replete with acronyms and identifying codes. They require sign-off from an authorized contract officer and are typically made public in a U.S. government procurement database, under a system intended as a hedge against waste, fraud, and abuse.

This purchase did not appear in any government database. Nor was there any contract officer involved. Instead, it was documented in an invoice obtained by Vanity Fair, from a company, Cogna Technology Solutions (its own name misspelled as “Tecnology” on the bill), which noted a total order of 3.5 million tests for an amount owed of $52 million. The “client name” simply noted “WH.”

Over the next three months, the tests’ mysterious provenance would spark confusion and finger-pointing. An Abu Dhabi–based artificial intelligence company, Group 42, with close ties to the UAE’s ruling family, identified itself as the seller of 3.5 million tests and demanded payment. Its requests were routed through various divisions within Health and Human Services, whose lawyers sought in vain for a bona fide contracting officer.



During that period, more than 2.4 million Americans contracted COVID-19 and 123,331 of them died of the illness. First in New York, and then in states around the country, governors, public health experts, and frightened citizens sounded the alarm that a critical shortage of tests, and the ballooning time to get results, were crippling the U.S. pandemic response.


But the million tests, some of which were distributed by the Federal Emergency Management Agency to several states, were of no help. According to documents obtained by Vanity Fair, they were examined in two separate government laboratories and found to be “contaminated and unusable.”

Group 42 representatives did not respond to repeated requests for comment.

The invoice for 3.5 million COVID-19 tests listed the client name as "WH."
Click to Enlarge

TEAM JARED

The secret, and legally dubious, acquisition of those test kits was the work of a task force at the White House, where Jared Kushner, President Donald Trump’s son-in-law and special adviser, has assumed a sprawling role in the pandemic response. That explains the “WH” on the invoice. While it’s unclear whether Kushner himself played a role in the acquisition, improper procurement of supplies “is a serious deal,” said a former White House staffer. “That is appropriations 101. That would be not good.”

Though Kushner’s outsized role has been widely reported, the procurement of Chinese-made test kits is being disclosed here for the first time. So is an even more extraordinary effort that Kushner oversaw: a secret project to devise a comprehensive plan that would have massively ramped up and coordinated testing for COVID-19 at the federal level.

Six months into the pandemic, the United States continues to suffer the worst outbreak of COVID-19 in the developed world. Considerable blame belongs to a federal response that offloaded responsibility for the crucial task of testing to the states. The irony is that, after assembling the team that came up with an aggressive and ambitious national testing plan, Kushner then appears to have decided, for reasons that remain murky, to scrap its proposal. Today, as governors and mayors scramble to stamp out epidemics plaguing their populations, philanthropists at the Rockefeller Foundation are working to fill the void and organize enough testing to bring the nationwide epidemic under control.

Inside the White House, over much of March and early April, Kushner’s handpicked group of young business associates, which included a former college roommate, teamed up with several top experts from the diagnostic-testing industry. Together, they hammered out the outline of a national testing strategy. The group—working night and day, using the encrypted platform WhatsApp—emerged with a detailed plan obtained by Vanity Fair.

Rather than have states fight each other for scarce diagnostic tests and limited lab capacity, the plan would have set up a system of national oversight and coordination to surge supplies, allocate test kits, lift regulatory and contractual roadblocks, and establish a widespread virus surveillance system by the fall, to help pinpoint subsequent outbreaks.

The solutions it proposed weren’t rocket science—or even comparable to the dauntingly complex undertaking of developing a new vaccine. Any national plan to address testing deficits would likely be more on the level of “replicating UPS for an industry,” said Dr. Mike Pellini, the managing partner of Section 32, a technology and health care venture capital fund. “Imagine if UPS or FedEx didn’t have infrastructure to connect all the dots. It would be complete chaos.”

The plan crafted at the White House, then, set out to connect the dots. Some of those who worked on the plan were told that it would be presented to President Trump and likely announced in the Rose Garden in early April. “I was beyond optimistic,” said one participant. “My understanding was that the final document would make its way to the president over that weekend” and would result in a “significant announcement.”

But no nationally coordinated testing strategy was ever announced. The plan, according to the participant, “just went poof into thin air.”

In a statement, White House press secretary Kayleigh McEnany said, “The premise of this article is completely false.”

This summer has illustrated in devastating detail the human and economic cost of not launching a system of national testing, which most every other industrialized nation has done. South Korea serves as the gold standard, with innovative “phone booth” and drive-through testing sites, results that get returned within 24 hours, and supportive isolation for those who test positive, including food drop-offs.

In the U.S., by contrast, cable news and front pages have been dominated by images of miles-long lines of cars in scorching Arizona and Texas heat, their drivers waiting hours for scarce diagnostic tests, and desperate Sunbelt mayors pleading in vain for federal help to expand testing capacity. In short, a “freaking debacle,” as one top public health expert put it.

We are just weeks away from dangerous and controversial school reopenings and the looming fall flu season, which the aborted plan had accounted for as a critical deadline for establishing a national system for quickly identifying new outbreaks and hot spots.
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Without systematic testing, “We might as well put duct tape over our eyes, cotton in our ears, and hide under the bed,” said Dr. Margaret Bourdeaux, research director for the Harvard Medical School Program in Global Public Policy.

Though President Trump likes to trumpet America’s sheer number of tests, that metric does not account for the speed of results or the response to them, said Dr. June-Ho Kim, a public health researcher at Ariadne Labs, a collaboration between Harvard’s T.H. Chan School of Public Health and Brigham and Women’s Hospital, who leads a team studying outlier countries with successful COVID-19 responses. “If you’re pedaling really hard and not going anywhere, it’s all for naught.”

With no bankable national plan, the effort to create one has fallen to a network of high-level civilians and nongovernmental organizations. The most visible effort is led by the Rockefeller Foundation and its soft-spoken president, Dr. Rajiv Shah. Focused and determinedly apolitical, Shah, 47, is now steering a widening and bipartisan coalition that includes three former FDA commissioners, a Nobel Prize–winning economist, a movie star, and 27 American cities, states, and tribal nations, all toward the far-reaching goal of getting to 30 million COVID-19 tests a week by autumn, up from the current rate of roughly 5.5 million a week.

“We know what has to be done: broad and ubiquitous testing tied to broad and effective contact tracing,” until a vaccine can be widely administered, Shah told Vanity Fair. “It takes about five minutes for anyone to understand that is the only path forward to reopening and recovering.” Without that, he said, “Our country is going to be stuck facing a series of rebound epidemics that are highly consequential in a really deleterious way.”

AN ABORTED PLAN

Countries that have successfully contained their outbreaks have empowered scientists to lead the response. But when Jared Kushner set out in March to solve the diagnostic-testing crisis, his efforts began not with public health experts but with bankers and billionaires. They saw themselves as the “A-team of people who get shit done,” as one participant proclaimed in a March Politico article.

Kushner’s brain trust included Adam Boehler, his summer college roommate who now serves as chief executive officer of the newly created U.S. International Development Finance Corporation, a government development bank that makes loans overseas. Other group members included Nat Turner, the cofounder and CEO of Flatiron Health, which works to improve cancer treatment and research.

A Morgan Stanley banker with no notable health care experience, Jason Yeung took a leave of absence to join the task force. Along the way, the group reached out for advice to billionaires, such as Silicon Valley investor Marc Andreessen.

The group’s collective lack of relevant experience was far from the only challenge it faced. The obstacles arrayed against any effective national testing effort included: limited laboratory capacity, supply shortages, huge discrepancies in employers’ abilities to cover testing costs for their employees, an enormous number of uninsured Americans, and a fragmented diagnostic-testing marketplace.

According to one participant, the group did not coordinate its work with a diagnostic-testing team at Health and Human Services, working under Admiral Brett Giroir, who was appointed as the nation’s “testing czar” on March 12. Kushner’s group was “in their own bubble,” said the participant. “Other agencies were in their own bubbles. The circles never overlapped.”

In the White House statement, McEnany responded, “Jared and his team worked hand-in-hand with Admiral Giroir. The public-private teams were embedded with Giroir and represented a single and united administration effort that succeeded in rapidly expanding our robust testing regime and making America number one in testing.”

As it evolved, Kushner’s group called on the help of several top diagnostic-testing experts. Together, they worked around the clock, and through a forest of WhatsApp messages. The effort of the White House team was “apolitical,” said the participant, and undertaken “with the nation’s best interests in mind.”


Kushner’s team hammered out a detailed plan, which Vanity Fair obtained. It stated, “Current challenges that need to be resolved include uneven testing capacity and supplies throughout the US, both between and within regions, significant delays in reporting results (4-11 days), and national supply chain constraints, such as PPE, swabs, and certain testing reagents.”

The plan called for the federal government to coordinate distribution of test kits, so they could be surged to heavily affected areas, and oversee a national contact-tracing infrastructure. It also proposed lifting contract restrictions on where doctors and hospitals send tests, allowing any laboratory with capacity to test any sample. It proposed a massive scale-up of antibody testing to facilitate a return to work. It called for mandating that all COVID-19 test results from any kind of testing, taken anywhere, be reported to a national repository as well as to state and local health departments.

And it proposed establishing “a national Sentinel Surveillance System” with “real-time intelligence capabilities to understand leading indicators where hot spots are arising and where the risks are high vs. where people can get back to work.”

By early April, some who worked on the plan were given the strong impression that it would soon be shared with President Trump and announced by the White House. The plan, though imperfect, was a starting point. Simply working together as a nation on it “would have put us in a fundamentally different place,” said the participant.

But the effort ran headlong into shifting sentiment at the White House. Trusting his vaunted political instincts, President Trump had been downplaying concerns about the virus and spreading misinformation about it—efforts that were soon amplified by Republican elected officials and right-wing media figures. Worried about the stock market and his reelection prospects, Trump also feared that more testing would only lead to higher case counts and more bad publicity. Meanwhile, Dr. Deborah Birx, the White House’s coronavirus response coordinator, was reportedly sharing models with senior staff that optimistically—and erroneously, it would turn out—predicted the virus would soon fade away.

Against that background, the prospect of launching a large-scale national plan was losing favor, said one public health expert in frequent contact with the White House’s official coronavirus task force.

Most troubling of all, perhaps, was a sentiment the expert said a member of Kushner’s team expressed: that because the virus had hit blue states hardest, a national plan was unnecessary and would not make sense politically. “The political folks believed that because it was going to be relegated to Democratic states, that they could blame those governors, and that would be an effective political strategy,” said the expert.

That logic may have swayed Kushner. “It was very clear that Jared was ultimately the decision maker as to what [plan] was going to come out,” the expert said.


In her statement, McEnany said, “The article is completely incorrect in its assertion that any plan was stopped for political or other reasons. Our testing strategy has one goal in mind—delivering for the American people—and is being executed and modified daily to incorporate new facts on the ground.”

On April 27, Trump stepped to a podium in the Rose Garden, flanked by members of his coronavirus task force and leaders of America’s big commercial testing laboratories, Quest Diagnostics and LabCorp, and finally announced a testing plan: It bore almost no resemblance to the one that had been forged in late March, and shifted the problem of diagnostic testing almost entirely to individual states.

Under the plan released that day, the federal government would act as a facilitator to help increase needed supplies and rapidly approve new versions of diagnostic-testing kits. But the bulk of the effort to operate testing sites and find available labs fell to the states.

“I had this naive optimism: This is too important to be caught in a partisan filter of how we view truth and the world,” said Rick Klausner, a Rockefeller Foundation adviser and former director of the National Cancer Institute. “But the federal government has decided to abrogate responsibility, and basically throw 50 states onto their own.”

THE SUMMER OF DISASTER

It soon became clear that ceding testing responsibility to the states was a recipe for disaster, not just in Democratic-governed areas but across the country.

In April, Phoenix, Arizona, was struggling just to provide tests to its health care workers and patients with severe symptoms of COVID-19. When Mayor Kate Gallego reached out to the federal government for help, she got an unmistakable message back: America’s fifth-largest city was on its own. “We didn’t have a sufficient number of cases to warrant” the help, Gallego told Vanity Fair.

Phoenix found itself in a catch-22, which the city’s government relations manager explained to lawyers in an April 21 email obtained by Vanity Fair through a public records request: “On a call with the county last week the Mayor was told that the region has [not] received FEMA funds related to testing because we don’t have bad numbers. The problem with that logic is that the Mayor believes we don’t have bad numbers because [of] a lack of testing.”

In June, Phoenix’s case counts began to rise dramatically. At a drive-through testing site near her house, Gallego saw miles-long lines of cars waiting in temperatures above 100 degrees. “We had people waiting 13 hours to get a test,” said Gallego. “These are people who are struggling to breathe, whose bodies ache, who have to sit in a car for hours. One man, his car had run out of gas and he had to refill while struggling to breathe.”

Gallego’s own staff members were waiting two weeks to get back test results, a period in which they could have been unwittingly transmitting the virus. “The turnaround times are way beyond what’s clinically relevant,” said Dr. James Lawler, executive director of international programs and innovation at the Global Center for Health Security at the University of Nebraska Medical Center.

By July 5, Gallego was out of patience. She went on ABC News, wearing a neon-pink blouse, and politely blasted the federal response: “We’ve asked FEMA if they could come and do community-based testing here. We were told they’re moving away from that, which feels like they’re declaring victory while we’re still in crisis mode.”

Three days later, at a press conference, the White House’s testing czar, Admiral Giroir, blasted her back by name. Claiming that the federal government was already operating or contributing support for 41 Phoenix testing sites, he said: “Now, two days ago, I heard that Mayor Gallego was unhappy because there was no federal support…. It was clear to me that Phoenix was not in tune with all the things that the state were doing.”

Gallego recounted how her mother “just happened to catch this on CNN. She sent me a text message saying, ‘I don’t think they like you at the White House.’”

Despite Giroir’s defensiveness, however, Gallego ultimately prevailed in her public demand for help: Health and Human Services agreed to set up a surge testing site in Phoenix. “The effect was, we had to be in a massive crisis before they would help,” said Gallego.

And that is where the U.S. finds itself today—in a massive testing crisis. States have been forced to go their own way, amid rising case counts, skyrocketing demand for tests, and dwindling laboratory capacity. By mid-July, Quest Diagnostics announced that the average time to turn around test results was seven days.

It is obvious to experts that 50 individual states cannot effectively deploy testing resources amid vast regulatory, financial, and supply-chain obstacles. The diagnostic-testing industry is a “loosely constructed web,” said Dr. Pellini of Section 32, “and COVID-19 is a stage five hurricane.”

Dr. Lawler likened the nation’s balkanized testing infrastructure to the “early 20th century, when each city had its own electrical grid and they weren’t connected.” If one area lost power, “you couldn’t support it by diverting power from another grid.”


Experts are now warning that the U.S. testing system is on the brink of collapse. “We are at a very bad moment here,” said Margaret Bourdeaux. “We are about to lose visibility on this monster and it’s going to rampage through our whole country. This is a massive emergency.”

THE PLOT TO SAVE AMERICA

In late January, Rajiv Shah, president of the Rockefeller Foundation, went to Davos, Switzerland, and served on a panel at the World Economic Forum with climate activist Greta Thunberg. There, he had coffee with WHO Director-General Dr. Tedros Adhanom Ghebreyesus, whom he’d known from his years working in global public health, first at the Gates Foundation and then as director of USAID, an international development agency within the U.S. government.

Shah returned to New York, and to the Rockefeller Foundation headquarters, with a clear understanding: SARS-CoV-2 was going to be the big one.

The Rockefeller Foundation, which aims to address global inequality with a $4.4 billion endowment, helped create America’s modern public health system through the early work of the Rockefeller Sanitary Commission to eradicate hookworm disease. Shah immediately began to refocus the foundation on the coming pandemic, and hired a worldwide expert, Dr. Jonathan Quick, to guide its response.

Meanwhile, he kept watching and waiting for what he assumed would be a massive federal mobilization. “The normal [strong] federal emergency response, protocols, guidance, materials, organization, and leadership were not immediately taking form,” he said. “It was pretty obvious the right things weren’t happening.”

As director of USAID from 2009 to 2015, Shah led the U.S. response to both the Haiti earthquake and the West African Ebola outbreak, and knew that the “relentless” collection of real-time metrics in a disaster was essential.

During the Ebola outbreak, which he managed from West Africa, he brought in a world-famous European epidemiologist, Hans Rosling, and President Barack Obama’s chief information officer to develop a detailed set of metrics, update them continuously in a spreadsheet, and send them daily to 25 top U.S. government officials. When it comes to outbreaks, said Shah, “If you don’t get this thing early, you’re chasing an exponentially steep curve.”

On April 21, the Rockefeller Foundation released a detailed plan for what it described as the “largest public health testing program in American history,” a massive scale-up from roughly 1 million tests a week at the time to 3 million a week by June and 30 million by the fall.

Estimating the cost at $100 billion, it proposed an all-hands-on-deck approach that would unite federal, state, and local governments; academic institutions; and the private and nonprofit sectors. Together, they would rapidly optimize laboratory capacity, create an emergency supply chain, build a 300,000-strong contact-tracing health corps, and create a real-time public data platform to guide the response and prevent reemergence.

The Rockefeller plan sought to do exactly what the federal government had chosen not to: create a national infrastructure in a record-short period of time. “Raj doesn’t do non-huge things,” said Andrew Sweet, the Rockefeller Foundation’s managing director for COVID-19 response and recovery. In a discussion with coalition members, Dr. Anthony Fauci called the Rockefeller plan “music to my ears.”

Reaching out to state and local governments, the foundation and its advisers soon became flooded with calls for help from school districts, hospital systems, and workplaces, all desperate for guidance. In regular video calls, a core advisory team that includes Shah, former FDA commissioner Mark McClellan, former National Cancer Institute director Rick Klausner, and Section 32’s Mike Pellini worked through how best to support members of its growing coalition.

Schools “keep hitting refresh on the CDC website and nothing’s changed in the last two months,” Shah told his colleagues in a video meeting in June. In the absence of trustworthy federal guidance, the Rockefeller team hashed out an array of issues: How should schools handle symptomatic and asymptomatic students? What about legal liability? What about public schools that were too poor to even afford a nurse?

(Last week, the CDC issued new guidelines that enthusiastically endorsed reopening schools and downplayed the risks, after coming under heavy pressure from President Trump to revise guidelines that he said were “very tough and expensive.”)

Through a testing-solutions group, the foundation is collaborating with city, state, and other testing programs, including those on Native American reservations, and helping to bolster them.

“They came on board and turbocharged us,” said Ann Lee, CEO of the humanitarian organization CORE (Community Organized Relief Effort), cofounded by Lee and the actor Sean Penn. CORE now operates 44 testing sites throughout the U.S., including Dodger Stadium in Los Angeles and mobile units within the Navajo Nation, which also offer food and essential supplies.

It may seem impossible for anyone but the federal government to scale up diagnostic testing one hundred-fold through a painstaking and piecemeal approach. But in private conversations, dispirited members of the White House task force urged members of the Rockefeller coalition to persist in their efforts. “Despite what we might be hearing, there is nothing being done in the administration on testing,” one of them was told on a phone call.


“It was a scary and telling moment,” the participant recounted.

A BAD GAMBLE

Despite the Rockefeller Foundation’s round-the-clock work to guide the U.S. to a nationwide testing system essential to reopening, the foundation has not yet been able to bend the most important curve of all: the Trump administration’s determined disinterest in big federal action.

On July 15, in a video call with journalists, Dr. Shah looked visibly frustrated. The next day, the Rockefeller Foundation would be releasing a follow-up report: It called on the federal government to commit $75 billion more to testing and contact tracing, work to break through the testing bottlenecks that had led to days-long delays in the delivery of test results, and vastly increase more rapid point-of-care tests.

Though speaking in a typically mild-mannered tone, Shah delivered a stark warning: “We fear the fall will be worse than the spring.” He added, putting it bluntly: “America is not near the top of countries who have handled COVID-19 effectively.”

Just three days later, news reports revealed that the Trump administration was trying to block any new funding for testing and contact tracing in the new coronavirus relief package being hammered out in Congress. As one member of the Rockefeller coalition said of the administration’s response, “We’re dealing with a schizophrenic organization. Who the hell knows what’s going on? It’s just insanity.”

On Friday, July 31, the U.S. House Select Subcommittee on the Coronavirus, which is investigating the federal response, will hold a hearing to examine the “urgent need” for a comprehensive national plan, at which Dr. Fauci, CDC director Robert Redfield, and Admiral Brett Giroir will testify. Among other things, the subcommittee is probing whether the Trump administration sought to suppress testing, in part due to Trump’s claim at his Tulsa, Oklahoma, rally in June that he ordered staff to “slow the testing down.”

The gamble that son-in-law real estate developers, or Morgan Stanley bankers liaising with billionaires, could effectively stand in for a well-coordinated federal response has proven to be dead wrong. Even the smallest of Jared Kushner’s solutions to the pandemic have entangled government agencies in confusion and raised concerns about illegality.

In the three months after the mysterious test kits arrived at the UAE embassy, diplomats there had been prodding the U.S. government to make good on the $52 million shipment. Finally, on June 26, lawyers for the Department of Health and Human Services sent a cable to the embassy, directed to the company which had misspelled its own name on the original invoice: Cogna Technology Solutions LLC.

The cable stated, “HHS is unable to remit payment for the test kits in question, as the Department has not identified any warranted United States contracting officer” or any contract documents involved in the procurement. The cable cited relevant federal contract laws that would make it “unlawful for the Government to pay for the test kits in question.”

But perhaps most relevant for Americans counting on the federal government to mount an effective response to the pandemic and safeguard their health, the test kits didn’t work. As the Health and Human Services cable to the UAE embassy noted: “When the kits were delivered they were tested in accordance with standard procedures and were found to be contaminated and unusable.”

An FDA spokesperson told Vanity Fair the tests may have been rendered ineffective because of how they were stored when they were shipped from the Middle East. “The reagents should be kept cold,” the spokesperson said.

Although officials with FEMA and Health and Human Services would not acknowledge that the tests even exist, stating only that there was no official government contract for them, the UAE’s records are clear enough. As a spokesperson for the UAE embassy confirmed, “the US Government made an urgent request for additional COVID-19 test kits from the UAE government. One million test kits were delivered to the US government by April 1. An additional 2.5 million test kits were delivered to the US government by April 20.”

The tests may not have worked, in other words, but Donald Trump would have been pleased at the sheer number of them.

This article has been updated to include a statement from the White House.