Ancient DNA paints genetic portrait of Andes civilizations

UNIVERSITY OF ADELAIDE

IMAGE: IMAGE OF MACHU PICCHU FROM PIXABAY view more 

CREDIT: FROM PIXABAY

An international team of researchers including the University of Adelaide, has completed the first large-scale study of DNA belonging to ancient humans of the central Andes in South America and found early genetic differences between groups of nearby regions, and surprising genetic continuity over thousands of years.

In the study, published in the journal Cell, researchers analysed the DNA of 89 ancient humans who lived in the central Andes between 500 and 9,000 years ago, and compared it with the genetic diversity of present day occupants, to shed light on the genetic changes over time.

The ancient remains included 65 newly reported humans never before studied.

Associate Professor Bastien Llamas from the University of Adelaide's Australian Centre for Ancient DNA, who was part of the research team, says there are many unanswered questions about the population history of the central Andes and in particular the large-scale societies that lived there including Inca, Tiwanaku, Moche and Wari.

"We know from archeological research that the central Andes region is extremely rich in cultural heritage, however up until now the genomic makeup of the region before arrival of Europeans has never been studied," he said.

"While archaeological records play a role in connecting cultures, studying ancient DNA can provide a finer grain picture.

"For example, archaeological information may tell us about two or three cultures in the region, and eventually who was there first, but ancient DNA can inform about actual biological connections underlying expansion of cultural practices, languages or technologies."

In the study, researchers found that genetic differences between the people of the central Andean Highlands and Coastal regions were in place as early as 9,000 years ago; with a north-south substructure of the Highlands developing by 5,800 before present (BP). These differences are still apparent in people living in those areas today.

After 5,800 BP there was evidence of genetic mingling, indicating movement of the Highlands people between north and south, central and coastal regions. However, the migrations appear to slow down by 2,000 BP, with minimal changes to the genetic structure of the central Andean region between 2,000 and 500 BP.

"This was quite surprising given this period saw the rise and fall of many large-scale Andean cultures such as Moche, Wari and Nasca, and suggests that these empires implemented a cultural domination without moving armies," Associate Professor Llamas said.

There were two exceptions to the slowing of migration, and these were within the Tiwanaku and Inca populations, whose administrative centres were largely cosmopolitan - people of diverse ancestries living side-by-side.

"It was interesting to uncover signs of long-range mobility during the Inca period. Archaeology shows Incans occupied thousands of kilometres from Ecuador through to northern Chile - which is why when Europeans arrived they discovered a massive Inkan empire, but we found close genetic relationships between individuals at the extreme edges of the empire," Associate Professor Llamas said.

Scientists across eight countries and multiple institutions were involved in the study including Harvard University, the Max Planck Institute, and the University of California at Santa Cruz. The key members of the team were from Bolivia, Argentina, Chile and Peru where the ancient remains originated.

"Ancient DNA is fascinating because it literally connects past and present people, but it is only by engaging early on and continually with local communities and governments, and with scholars who work closely with these communities, that we can perform research that respects people's cultural heritage and provide results that are truly meaningful," said Associate Professor Llamas.

Associate Professor Llamas, who has been studying ancient DNA within South America for more than 10 years, says that the study has expanded previous research, which provided an overall picture of the whole continent and how people arrived in migration waves.

"We hope this more detailed genetic picture of populations of the central Andean Highlands will allow archeologists to ask new questions about the history of the region and will lead to further cultural learnings and strengthen collaboration with local communities," he said.

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Canadian study finds temperature, latitude not associated with COVID-19 spread

School closures, physical distancing and public health measures have effect

CANADIAN MEDICAL ASSOCIATION JOURNAL 

Temperature and latitude do not appear to be associated with the spread of coronavirus disease 2019 (COVID-19), according to a study of many countries published in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.200920, but school closures and other public health measures are having a positive effect.

"Our study provides important new evidence, using global data from the COVID-19 epidemic, that these public health interventions have reduced epidemic growth," says Dr. Peter Jüni, Institute for Health Policy, Management and Evaluation, University of Toronto, and St. Michael's Hospital, Toronto, Ontario.

The Canadian study looked at 144 geopolitical areas -- states and provinces in Australia, the United States and Canada as well as various countries around the world -- and a total of more than 375 600 confirmed COVID-19 cases. China, Italy, Iran and South Korea were excluded because the virus was either waning in the case of China or in full disease outbreak at the time of the analysis in others. To estimate epidemic growth, researchers compared the number of cases on March 27 with cases on March 20, 2020, and determined the influence of latitude, temperature, humidity, school closures, restrictions of mass gatherings and social distancing measured during the exposure period of March 7 to 13.

They found little or no association between latitude or temperature with epidemic growth of COVID-19 and a weak association between humidity and reduced transmission. The results -- that hotter weather had no effect on the pandemic's progression -- surprised the authors.

"We had conducted a preliminary study that suggested both latitude and temperature could play a role," says Dr. Jüni. "But when we repeated the study under much more rigorous conditions, we got the opposite result."

The researchers did find that public health measures, including school closures, social distancing and restrictions of large gatherings, have been effective.

"Our results are of immediate relevance as many countries, and some Canadian provinces and territories, are considering easing or removing some of these public health interventions," says Dr. Jüni.

"Summer is not going to make this go away," says Prof. Dionne Gesink, a coauthor and epidemiologist at Dalla Lana School of Public Health. "It's important people know that. On the other hand, the more public health interventions an area had in place, the bigger the impact on slowing the epidemic growth. These public health interventions are really important because they're the only thing working right now to slow the epidemic."

The authors note several study limitations, such as differences in testing practices, the inability to estimate actual rates of COVID-19 and compliance with social distancing.

When deciding how to lift restrictions, governments and public health authorities should carefully weigh the impact of these measures against potential economic and mental health harms and benefits.

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Riot police chase Hong Kong Mother's Day protesters

AFP / ISAAC LAWRENCEAn undercover Hong Kong police officer arrests a pro-democracy demonstrator during a protest calling for the city's independence from China

Riot police chased protesters through Hong Kong's shopping malls and streets on Sunday as democracy activists launched Mother's Day flash mob rallies calling for independence and for the city's unpopular leader to resign.

The semi-autonomous Chinese city was convulsed by seven straight months of often violent pro-democracy protests last year, with millions hitting the streets.

Mass arrests and the coronavirus pandemic ushered in a period of enforced calm.

But with the finance hub successfully tackling its COVID-19 outbreak, small protests have bubbled up once more in the last fortnight.

AFP / ISAAC LAWRENCESmall flash mob demonstrations broke out in at least eight malls, prompting riot police to rush in and disperse heckling crowds of activists and shoppers

Small flash mob demonstrations broke out in at least eight malls throughout Sunday afternoon, prompting riot police to rush in and disperse heckling crowds of activists and shoppers.

At least three arrests were made while groups of officers conducted multiple stop and searches.

Live broadcasts also showed police issuing $2,000 ($260) on-the-spot fines to those allegedly breaching emergency anti-virus measures banning more than eight people gathering in public.

AFP / ISAAC LAWRENCEIn the evening, clashes spilled into the streets, with police using batons and pepper spray in the busy commercial neighbourhood of Mong Kok and making more arrests

Hong Kong celebrates the American Mother's Day, and protester chat groups had pushed the occasion to focus on chief executive Carrie Lam, a Beijing loyalist appointee.

At the start of last year's protests, Lam likened herself to an exasperated mother -- and protesting Hong Kongers to demanding children -- in comments that only poured oil on the fire of public anger at the time.

Authorities banned an application for a Mother's Day march, so small groups of masked protesters instead played cat and mouse with police in different shopping centres, a tactic used frequently last year.

"This is just a warm-up, our protest movement needs to start again," a university student who gave his name as "B" told AFP.

"It's a sign that the movement is coming back to life. We all need to wake up now."

AFP / ISAAC LAWRENCEPolice detain a group of people during a pro-democracy protest calling for Hong Kong's independence from China on Mother's Day 2020

In the evening, clashes spilled onto the streets, with police using batons and pepper spray in the busy commercial neighbourhood of Mong Kok and making more arrests, including of a pro-democracy lawmaker.

Lam, who has been staunchly backed by Beijing, has record-low approval ratings.

She has resisted calls for universal suffrage or an independent inquiry into the police's handling of the protests.

In the New Year, she vowed to heal the divisions coursing through Hong Kong, but her administration has offered little in the way of reconciliation or a political solution.

AFP / ISAAC LAWRENCEHong Kong riot police hold back reporters during an operation to arrest pro-democracy demonstrators

Arrests and prosecutions have continued apace, while Beijing's offices in the city sparked a constitutional row last month by announcing a greater say in how Hong Kong is run.

Plans to pass a law banning insulting China's national anthem sparked scuffles in the city's legislature on Friday.

Top Beijing officials have suggested opposition lawmakers who blocked the bill with filibustering could be prosecuted and have also called for a new anti-sedition law to be passed.

Hong Kong began to ease major social distancing measures on Friday with bars, gyms, beauty parlours and cinemas reopening after the financial hub largely halted local transmissions of the deadly coronavirus.

Most of Hong Kong's entertainment venues were shuttered in early April when the city suffered a second wave of infections -- primarily residents returning from Europe and North America as the pandemic spread rapidly there.

But health officials made impressive headway thanks to efficient testing, tracing and treatment programmes, with just over 1,000 infections and four deaths.

10MAY2020

 

   

 

Rhino killed as poaching attempts increase amid India virus lockdown

AFP / Biju BOROHunting and habitat loss have slashed the number of one-horned rhinos to just a few thousand, almost all in the northeastern Indian state of Assam

A rare one-horned rhino has been killed as poaching attempts increase in one of India's best-known national parks during the coronavirus lockdown, officials said Sunday.

The lack of vehicles on the highway near Kaziranga National Park in Assam state -- home to the world's biggest population of one-horned rhinos -- amid the lockdown has seen animals move towards the boundaries, making them vulnerable to poachers.

"It is suspected that the rhino was killed at least two to three days ago," the park's director P. Sivakumar told AFP, adding that the rhino's horn was also missing.

Hunters can earn as much as $150,000 for one rhino horn or around $60,000 per kilo on a black market according to media reports, serving foreign demand for its use in traditional Chinese medicine.

"We have also recovered eight rounds of empty cartridge of AK 47" automatic rifle, Sivakumar said.

The rhino carcass was found near a water body inside the park, he said, adding that it was a confirmed poaching incident.

Officials said it was the first poaching case in the UNESCO-listed heritage site in a year. Previous years had seen numerous poaching incidents.

Officials said poaching attempts have increased in and around the park since the start of the nationwide lockdown in late March.

In April, more than five attempts to slaughter the rare creatures were thwarted by park rangers and a special rhino protection force set up by the state government.

The one-horned rhinos used to be widespread in the region but hunting and habitat loss has slashed their numbers to just a few thousand, almost all in the northeastern state of Assam.

Their main haven now is Kaziranga, with 2,413 of the animals living there, according to a 2018 count.

The 850-square-kilometre (330-square-mile) park, created in 1908 after the wife of the British viceroy visited and complained there were no rhinos, is also home to tigers, elephants and panthers.

With prices down and jobs leaving, US oil workers learn patience

AFP/File / Paul RatjeOil pumps in Eddy County, New Mexico, part of the Permian Basin crude oil field hit hard by the brutal drop in petroleum prices

Wait for an upturn, or pick up stakes and look for work elsewhere? That's the dilemma facing oil workers around Carlsbad in New Mexico, where a brutal drop in petroleum prices has hit the local economy hard.

Many oil workers in the arid southwestern state have already left the campgrounds where they had parked their RVs, after being drawn here by exceptionally high salaries.

In this dusty town in the Permian Basin -- site of the planet's largest oil and natural gas deposits, astride the Texas-New Mexico border -- a worker can earn $100,000 or even $150,000 a year, twice or more than the average private sector wage there.

- Salary cuts -

AFP/File / Paul RatjeClenon Weaver, 34, a welding inspector from Texas, poses with his truck and trailer on May 6, 2020 in Carlsbad, New Mexico; like many other oil-field workers, a sharp drop in prices has left his future unclear

Clenon Weaver, a 34-year-old welder sitting in the shade outside his camper, said he had told his wife back in Texas, "I'm bummed that I'm not going to work, but I'm excited to get to come home and see y'all."

Weaver, who is trying to take things in stride -- "laughing and cutting up (making jokes) makes everything easier," he said -- plans to take a few weeks to enjoy being with his wife, their daughters and new baby girl in their home near Houston, a 10-hour drive away.

After that, he plans to start looking for work again.

Thousands of people in the Carlsbad region work in the oil business -- drilling or operating wells, or building or maintaining pipelines.

Like Weaver, many of them live in "man camps" just outside the city. In a region where real estate prices have soared after a decade of booming oil prices, they pay $600 to $900 a month for a spot to park their camper and pickup truck.

Many of these oil workers -- known colloquially as "roughnecks" because of their grueling, physical outdoor work -- have lost their jobs in recent weeks.

On April 20, the price of a barrel of American crude oil fell so sharply that it even moved briefly below zero, as storage tanks filled up amid the collapse in demand occasioned by the coronavirus pandemic.

This past week, the Permian Basin had fewer than half the active oil rigs it had a year earlier.

Sitting on a folding chair outside his camper, Benjamin Loreto says he feels fortunate to still have a job, even if his hours have been scaled back.

The 48-year-old pipeline foreman said his pay has been cut by $5 an hour and his work week sliced in half, from 80 hours to 40.

"A lot of people, they don’t got a job," he said, the raucous sound of Guns N' Roses coming from a nearby speaker. "They (are) right here, but they don't work. They just hanging around, see if something comes up."

The region is not the easiest to live in, said Jace Gentry, a 21-year-old refinery worker, who looks forward to getting back to his native Louisiana after being laid off.

"I hate it out here," he said, one knee on the ground as he stroked his pet puppy. "It's sandy and dusty; can't get a breath of fresh air no matter how hard you try."

Still, he adds, "you can't beat that money," especially for someone, like him, without a college degree.

"People (would) do really anything, they'll live anywhere to get it."

Carlsbad has seen oil prices fall before. People remember how, in 2016, the price of a barrel fell below $30.

In this country of "black gold," these fluctuations are nothing new. But for younger workers experiencing it for the first time, the drop has been jolting.

- 'It's our life' -

AFP/File / Paul RatjeTwenty-year-old Amber came to the Carlsbad area from Texas with her boyfriend hoping oil-field work would mean a better life; now she's unsure what the future might hold

Twenty-year-old Amber, who declined to give her last name, left home last year. She now works in a supermarket and lives in a camper with her boyfriend, an oil-field worker.

"The situation we're in kind of gets my anxiety up," she said. Oil is "what we're depending on. It's our life, you know, so if it goes down, we're kind of left stuck."

Many oil-dependent companies here are surviving only thanks to the administration's emergency relief plan for small and medium-sized companies.

With no orders coming in from oil producers, some wells have had to close. "We didn't have anything to work on," said Michael Bassett, operations manager for an oil services company.

To keep the company's welders working in the meantime, he said, his boss had them converting surplus lengths of wire into barbecue grills.

"Until recently, this was a good town to get back on your feet," said Michael Garner, who manages a recreational-vehicle park and previously worked in construction and welding. He's lived most of his life in Carlsbad.

Of the 120 sites in his normally full campground, 30 have fallen vacant since oil prices began to drop.

AFP/File / Paul RatjeMichael Garner, who manages an RV park outside Carlsbad, New Mexico, poses with his dog, Pretty Girl, on May 8, 2020; Garner has lost about 30 tenants as the sharp drop in oil prices has led to petroleum-sector layoffs

Here in Carlsbad, where unemployment was a scant three percent just two years ago, people know that black gold can turn to lead in a moment.

Garner is philosophical about it. "Anyone that's done oilfield very long knows it's up and down; it climbs gradually and it drops like a stone; when it drops, it drops fast.

"You learn to save some money."

Schumer calls on VA to explain use of unproven drug on vets

WASHINGTON (AP) — The Senate’s top Democrat on Sunday called on the Department of Veterans Affairs to explain why it allowed the use of an unproven drug on veterans for the coronavirus, saying patients may have been put at unnecessary risk.

Sen. Charles Schumer of New York said the VA needs to provide Congress more information about a recent bulk order for $208,000 worth of hydroxychloroquine. President Donald Trump has heavily promoted the malaria drug, without evidence, as a treatment for COVID-19.

Schumer’s request comes after a whistleblower complaint filed this past week by former Health and Human Services official Rick Bright alleged that the Trump administration, eager for a quick fix to the onslaught of the coronavirus, wanted to “flood” hot spots in New York and New Jersey with the drug. Major veterans organizations have urged VA to explain under what circumstances VA doctors initiate discussion of hydroxychloroquine with veterans as a treatment option.

“There are concerns that they are using this drug when the medical evidence says it doesn’t help and could hurt,” Schumer said in an interview with The Associated Press.





He said given the fact the malaria drug, despite being untested, had been repeatedly pushed publicly by Trump, VA Secretary Robert Wilkie must address whether anyone at the department was pressured by the White House or the administration to use hydroxychloroquine for COVID-19.

Schumer said Wilkie also should answer questions about a recent analysis of VA hospital data that showed there were more deaths among patients given hydroxychloroquine versus standard care, including how much patients knew about the drug’s risks before taking it.

In a statement Sunday, VA spokeswoman Christina Noel called it “preposterous” for anyone to suggest that VA would make treatment decisions based on anything other than “the best medical interests of patients.”

“VA only permits use of the drug after ensuring veterans and caretakers are aware of potential risks associated with it, as we do with any other drug or treatment,” she said.

Wilkie in recent weeks has denied that veterans were used as test subjects for the drug and that it was instead administered at government-run VA hospitals only when medically appropriate, with mutual consent between doctor and patient.

Still, Wilkie and the department have repeatedly declined to say how widely the drug was being used for COVID-19, including how many veterans were given the drug, and whether VA doctors were given guidance by VA headquarters on specific scenarios when it should be used.

In a weekly call with veterans’ groups this past week, Wilkie continued to defend VA’s use of hydroxychloroquine. He dismissed the recent analysis of VA hospital data showing no benefits to patients, suggesting the poor outcomes were because the cases involved older, very sick veterans.

“Use of this medication for treatment of COVID-19 is considered ‘off label’ — perfectly legal and not rare,” he wrote in an April 29 letter to veterans’ groups.

The analysis of hospital data, done by independent researchers at two universities with VA approval, was not a rigorous experiment. Researchers analyzed medical records of 368 older male veterans hospitalized with confirmed coronavirus infection at VA medical centers who died or were discharged by April 11.

About 28% of veterans who were given hydroxychloroquine plus usual care died, versus 11% of those getting routine care alone.

The VA recently said most of its recent bulk order for hydroxychloroquine was being used for approved uses, such as treating lupus and rheumatoid arthritis, but it didn’t provide breakdowns.

Wilkie in recent weeks took advocacy of the drug even further than Trump by claiming without evidence that it has been effective for young and middle-aged veterans in particular. In fact, there is no published evidence showing that.

Veterans are “very concerned that we still do not have clarity on the VA’s past and present use of hydroxychloroquine in treating veterans with COVID-19,” Jeremy Butler, chief executive officer of Iraq and Afghanistan Veterans of America, told the AP.

“Now that the federal government issued an emergency use authorization for remdesivir to treat COVID-19, we need answers to these questions as well as the VA’s plans for administering, or not administering, remdesivir,” he said. That action by the Food and Drug Administration came after preliminary results from a government-sponsored study showed that remdesivir shortened the time to recovery by 31%, or about four days on average, for hospitalized COVID-19 patients.

In a tweet Sunday, former VA Secretary David Shulkin urged the department to immediately curtail use of hydroxychloroquine for COVID-19. “With studies showing no benefit, VA should restrict use exclusively to clinical trials,” he wrote. Shulkin was fired by Trump in March 2018, and Wilkie replaced him.

Schumer said his main concern is determining whether the VA had conducted any “clandestine studies to determine whether hydroxychloroquine was effective without their permission.” He said there’s also concern that the department won’t address specifically where the drug was sent.

“These are people who risked their lives for us,” Schumer said. “They should be treated only with the utmost dignity, respect and high standards of care.”

The drug has long been used to treat malaria and other ailments. A few, very small preliminary studies suggested it might help prevent the coronavirus from entering cells and possibly help patients clear the virus sooner. But the FDA last month warned doctors against prescribing the drug for COVID-19 outside hospitals because of the risks of serious side effects and death.

YA THINK
Experts worry CDC is sidelined in coronavirus response

NEW YORK (AP) — The Centers for Disease Control and Prevention has repeatedly found its suggestions for fighting the coronavirus outbreak taking a backseat to other concerns within the Trump administration. That leaves public health experts outside government fearing the agency’s decades of experience in beating back disease threats are going to waste.

“You have the greatest fighting force against infectious diseases in world history. Why would you not use them?” said Dr. Howard Markel, a public health historian at the University of Michigan.

The complaints have sounded for months. But they have become louder following repeated revelations that transmission-prevention guidance crafted by CDC scientists was never adopted by the White House.


The latest instance surfaced Thursday, when The Associated Press reported that President Donald Trump’s administration shelved a CDC document containing step-by-step advice to local authorities on how and when to reopen restaurants and other public places during the current pandemic.

The administration has disputed the notion that the CDC had been sidelined, saying the agency is integral to the administration’s plans to expand contact tracing nationwide.

But it’s clear that the CDC is playing a much quieter role than it has during previous outbreaks.

The nation’s COVID-19 response has seen a strange turn for the CDC, which opened in 1946 in Atlanta as The Communicable Disease Center to prevent the spread of malaria with a $10 million budget and a few hundred employees. Today, the agency has a core budget of more than $7 billion — a sum that has been shrinking in recent years — and employs nearly 11,000 people.

The CDC develops vaccines and diagnostic tests. Its experts advise doctors how best to treat people, and teach state, local and international officials how to fight and prevent disease. Among the CDC’s elite workforce are hundreds of the world’s foremost disease investigators — microbiologists, pathologists and other scientists dispatched to investigate new and mysterious illnesses.

In 2009, when a new type of flu virus known at the time as swine flu spread around the world, the CDC held almost daily briefings. Its experts released information on a regular basis to describe the unfolding scientific understanding of the virus, and the race for a vaccine.

The federal response to the coronavirus pandemic initially followed a similar pattern.

CDC first learned in late December of the emergence of a new disease in China, and the U.S. identified its first case in January. In those early days, the CDC held frequent calls with reporters. It also quickly developed a test it could run at its labs, and a test kit to be sent to state health department labs to detect the virus.


But February proved to be a disaster. The test kit was flawed, delaying the ability of states to do testing. A CDC-run surveillance system, meant to look for signs of the virus in people who had thought they had the flu, was slow to get off the ground. Officials at the CDC and at other federal agencies were slow to recognize infections from Europe were outpacing ones from travelers to China.

But politically speaking, one the most striking moments that month was something that the CDC — in the eyes of public health experts — got perfectly right.

In late February, Dr. Nancy Messonnier — a well-respected CDC official who was leading the agency’s coronavirus response — contradicted statements by other federal officials that the virus was contained. “It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen – and how many people in this country will have severe illness,” she said.

Stocks plunged. President Donald Trump was enraged.

The White House Coronavirus Task Force moved to center stage. Vice President Mike Pence took control of clearing CDC communications about the virus. CDC news conferences stopped completely after March 9. Messonnier exited the public stage.

CDC Director Robert Redfield continued to keep the low profile he’s had since getting the job. Two other task force members — Dr. Deborah Birx, the task force coordinator, and Dr. Anthony Fauci of the National Institutes of Health — became the task force’s chief scientific communicators.

Health experts have praised Fauci, but they say CDC’s voice is sorely missed.

“At the White House briefings, they (CDC) should be talking about antibody tests and if they work. How long do people have the virus if they’re infected? What are the data for that? The issue ought to be front and center. These are the questions CDC can answer,” said Dr. James Curran, a former CDC star scientist who is now dean of Emory University’s public health school.

The government has continued to look to CDC officials for information and guidance, but there have been repeated instances when what the agency’s experts send to Washington is rejected.

In early March, administration officials overruled CDC doctors who wanted to recommend that elderly and physically fragile Americans be advised not to fly on commercial airlines because of the new coronavirus, the AP reported.

Last month, USA Today reported that the White House task force had forced the CDC had to change orders it had posted keeping cruise ships docked until August. The post was altered to say the ships could sail again in July, the newspaper reported.

And last week, officials nixed CDC draft guidance that was researched and written to help faith leaders, business owners, educators and state and local officials as they begin to reopen.

The 17 pages of guidelines were never approved by Redfield to present to the White House task force, said an administration official who spoke on condition of anonymity to discuss internal deliberations. They were only discussed at the task force level once the drafts leaked publicly, and no decisions about them were ever made.

Still, the CDC guidelines were the subject of intense debate at the upper echelons of the White House. Some officials saw them as essential to helping businesses and other organizations safely reopen.

Others, including chief of staff Mark Meadows, did not believe it appropriate for the federal government to set guidelines for specific sectors whose circumstances could vary widely depending on the level of outbreak in their areas, according to a person familiar with the discussion. What was necessary for a coffee shop in New York and one in Oklahoma was wildly different, in their view.

They worried about potential negative economic impact from the guidelines, and some aides expressed doubts about whether the government should be prescribing practices to religious communities.

The decision not to issue detailed sector guidance is also in keeping with the White House’s strategic decision to leave the specific details of reopening to states. While Trump had at one point claimed absolute authority to detail how and when states open, he’s adopted a largely hands-off approach as more and more states begin to lift lockdowns.

Trump suggests his decision is in keeping with the principles of federalism, but White House aides acknowledge that it also lessens the political peril for the president — who has come under pressure from conservative allies, particularly in states that haven’t experienced wide outbreaks, to swiftly reopen the country.

On a conference call Thursday afternoon with the House members on the White House’s “Opening Up America” panel, lawmakers in both parties pressed the White House to release sector-specific guidance of the sort currently held up by the administration.

“There was clear bipartisan support for the need to have CDC guidance and the need to have best practices,” said Rep. Ted Deutch, D-Fla.

The CDC did not respond to a Thursday request for an interview with Redfield.

In a recent interview with the AP, the agency’s No. 2 administrator, Dr. Anne Schuchat, was asked to address reports that CDC recommendations were being ignored in Washington.

She paused, and then replied slowly.

“The CDC is providing our best evidence-based information to policy makers and providing that on a daily basis to protect the American people,” she said, without further comment.

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Dearen reported from Gainesville, Florida. Miller reported from Washington.

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This story has been corrected to reflect the proper spelling of the last name of Rep. Ted Deutch, D-Fla.

Becoming ‘King of Ventilators’ may result in unexpected glut

THE CRISIS OF CAPITALISM IS OVERPRODUCTION

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FILE - In this April 20, 2020, file photo a ventilator waits to be used for a COVID-19 patient going into cardiac arrest at St. Joseph's Hospital in Yonkers, N.Y. An analysis of federal contracting data by The Associated Press shows the Department of Health and Human Services is now on track to exceed 100,000 new ventilators by around July 13, about a week later than the 100-day deadline Trump first gave on March 27. (AP Photo/John Minchillo, File)


WASHINGTON (AP) — As requests for ventilators from the national stockpile reached a crescendo in late March, President Donald Trump made what seemed like a bold claim: His administration would have 100,000 within 100 days.

At the time, the Department of Health and Human Services had not ordered any new ventilators since the start of the COVID-19 pandemic in January. But records show that over the following three weeks, the agency scrambled to turn Trump’s pledge into a reality, spending nearly $3 billion to spur U.S. manufacturers to crank out the breathing machines at an unprecedented pace.


An analysis of federal contracting data by The Associated Press shows the agency is now on track to exceed 100,000 new ventilators by around July 13, about a week later than the 100-day deadline Trump first gave on March 27.

By the end of 2020, the administration is expected to take delivery of nearly 200,000 new ventilators, based on the AP’s review of current federal purchasing contracts. That would more than double the estimated 160,000 ventilators hospitals across the U.S. had before the pandemic.

“We became the king of ventilators, thousands and thousands of ventilators,” Trump boasted in an April 29 speech.

But over the past month, demand for ventilators has decreased even as the U.S. death toll from the novel coronavirus has surged past 80,000. After observing unusually high death rates for coronavirus victims who were put on ventilators, many doctors are using them only as a last resort.

That’s raising the unexpected prospect that the United States could soon be awash in surplus ventilators, so much so the White House is now planning to ship thousands overseas to help boost the virus response of other nations.

In a speech to Republican members of Congress on Friday, the president credited his son-in-law, White House senior adviser Jared Kushner, with heading up the effort to purchase the ventilators.

“We built, and we built, and we built,” Trump said. “Now we have nine factories that are throwing out ventilators at numbers that nobody can believe. It was really — there’s not been anything like that, since the Second World War, where we did the same thing with other types of product.”

Daniel Adelman, a professor at the University of Chicago Booth School of Business who teaches health care analytics, said the U.S. government is now buying more than twice the number of ventilators it needs, even under a worst-case scenario forecasting the spread of COVID-19.

But Adelman said mathematical models cannot predict with certainty how many ventilators will be needed if there is a resurgence of the coronavirus later in the year or if there is another pandemic in the future.

“It seems incongruent with the forecasts that you’re seeing,” Adelman said of the government purchases. “I’d probably rather they order too many rather than ordering too few.”

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In patients with severe cases of COVID-19, the virus attacks the lungs, causing fluid to collect in tiny air sacs called alveoli. That makes it difficult for the lungs to transfer oxygen from the air to the blood, which can be deadly. To treat these low oxygen levels, doctors have historically relied on ventilators.

The Strategic National Stockpile, the federal government’s emergency reserve of medical supplies, had about 16,660 ventilators ready to deploy at the start of March, with an additional 2,400 out for maintenance.

By the middle of the month, health officials and governors in states with the worst virus outbreaks began expressing concerns that the supply of breathing machines could run out, potentially leaving thousands of critically ill patients gasping for air.


Among those calling for additional ventilators was Gov. Andrew Cuomo (D-N.Y.), who predicted on March 24 that all of the ventilators in his state would be in use, and patients in need would be left without proper treatment. Cuomo said projections showed New York would need at least 30,000 additional ventilators to get through the mid-April peak of the outbreak. At that point, FEMA had sent New York 400.

Trump expressed skepticism at Cuomo’s figures even as his administration rushed to send New York 4,000 additional ventilators — about one-quarter of the nation’s entire emergency stockpile. Still, Cuomo pleaded for more.

“You pick the 26,000 people who are going to die,” Cuomo said at a news conference,

It wasn’t just New York, however. Similarly dire projections of a ventilator shortfall were also then circulating within the White House.

“The scariest day of my life was about a month ago when, after a long day of meetings, my team told me that we were going to be needing 130,000 ventilators; that we were short hundreds of thousands of ventilators,” Trump recounted in an April 14 briefing. “I had governors requesting unreasonable sums that the federal government just didn’t have.”

By late March, a bipartisan chorus of state governors and members of Congress were calling on the president to exercise his emergency authority under the Defense Production Act to force U.S. companies to produce ventilators.

Trump had resisted invoking the Korean War-era law, which grants the president sole authority to direct U.S. industrial production of critical supplies in times of national emergency, saying the private sector was stepping up production of ventilators and other medical supplies on its own.

But on March 27, Trump changed course, announcing that he would invoke the Defense Production Act to produce ventilators, which meant companies would have to give priority to federal orders over other customers.

“In the next 100 days — well, first of all, we’ve already delivered thousands of them — but within the next 100 days, we will either make or get, in some form, over 100,000 additional units,” Trump said.

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By the start of April, FEMA officials confirmed to the House Oversight and Reform Committee that demand for ventilators would soon outpace the available supply. To ration what was left, FEMA Administrator Peter Gaynor directed that the remaining ventilators in the national stockpile be designated as a “strategic national asset” — to be provided to states only on a case-by-case basis where hospitals could demonstrate an “exigent need” to sustain life within 72 hours.

Federal purchasing records show that three months into the pandemic, HHS, which includes the Strategic National Stockpile, had not yet placed any orders for new ventilators in 2020.
Full Coverage: Virus Outbreak

That changed within three days of Trump’s March 27 edict, with HSS signing a $350 million deal with Zoll Medical Corp. Records show a flurry of about a dozen big orders with other ventilator makers over the next two weeks, most of them no-bid contracts exempted from the typical federal purchasing rules due to the national emergency.

In a typical year, U.S. companies produce about 29,000 ventilators, according to data cited by the White House. Though several domestic manufacturers had already announced they were adding extra shifts and hiring additional workers to ramp up production, AP’s analysis of HHS contracts show that even with the emergency no-bid orders the traditional medical device makers would deliver about 73,990 new ventilators by July 6 — the 100-day mark since Trump’s March 27 pledge.

It was clear additional industrial capacity would be needed to get 100,000 units by the president’s deadline.

General Motors, which had shut down auto production, had already entered into a partnership on March 20 with Ventec Life Systems, a small ventilator company, to simplify an off-the-shelf design for rapid production at GM’s Kokomo, Indiana, plant.

Though GM had announced it was “working night and day” to launch production, Trump accused CEO Mary Barra via Twitter of dragging her feet, and revived his long-running feud with the company over its 2019 closure of an Ohio factory that Trump had pledged to save.

“As usual with ‘this’ General Motors, things just never seem to work out,” Trump tweeted on March 27. “General Motors MUST immediately open their stupidly abandoned Lordstown plant in Ohio, or some other plant, and START MAKING VENTILATORS, NOW!!!!!!”

GM had sold the Lordstown factory in 2019.

The president also took aim at Ford Motor Co., tweeting that the rival automaker should also “GET GOING ON VENTILATORS, FAST!!!!!!”

On April 8, HHS announced it had reached a $489.4 million deal with GM to produce 30,000 ventilators by the end of August, with the first 6,132 delivered by June 1.

The following week, HHS announced a $336 million contract with Ford and General Electric, which teamed up to make 50,000 of GE Healthcare’s ventilators by July 13.

Assuming all the companies meet their deadlines, AP’s analysis shows the national stockpile should surpass 100,000 new ventilators by mid-July.

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HHS declined to release to AP its contracts with ventilator producers without a Freedom of Information Act request, a legal process that can often take months or even years.

But AP’s analysis of the limited contract data available online and figures taken from HHS media releases shows the agency will spend more than $2.9 billion for 198,890 ventilators by the end of 2020, an average per-unit cost of $14,618.

Whether that’s a good deal for U.S. taxpayers is difficult to determine because medical device makers generally don’t publish their prices. HHS is buying at least 13 different models of ventilators from 10 different companies, all with different capabilities, features and accessories.

When AP sought details from HHS about the per-unit cost of four models from manufacturer Hamilton Medical, the agency’s press office provided figures that did not add up to the totals announced in earlier media releases. An HHS spokesperson said the previously provided figures were wrong and would be corrected on the agency’s website.

AP found several instances where the U.S. government had purchased the same models of ventilators before the pandemic. For example, contracting data does show that in December the Department of Defense bought a single, portable ventilator from Zoll Medical for $12,260.

Under its current contract with Zoll, HHS is purchasing 18,900 of the same model for slightly more than $350 million. That works out to about $18,500 each, which would be a more than 50 percent increase from what the Pentagon paid less than five months ago.

A HHS spokeswoman said Friday the government was paying about $12,100 for each ventilator, and that the additional money was for hoses, face masks and other related supplies needed to treat COVID-19 patients. The ventilators also came with a wheeled plastic case with power port, which cost an additional $722 each, according to HHS.

The Defense Department did not respond to questions Friday about whether its 2019 ventilator deliveries also included accessories.

Zoll’s top executive said his company’s pricing had remained consistent.

“Zoll is supplying the U.S. government with its requested products at our usual and customary government pricing, absorbing the additional costs associated with Zoll’s rapid increase in production capacity,” Zoll CEO Jonathan Rennert said Friday. “We are focused on fulfilling the government’s order on time and meeting this urgent public need.”

Erik Gordon, a business professor at the University of Michigan who studies the medical device industry, said ventilator companies are probably incurring increased costs as they ramp up production to meet high demand. Manufacturers haven’t had time to bulk buy additional parts and probably had to add workers to make more of the machines, he said.

U.S. ventilator makers have raised production from a rate of about 700 per week in February to about 5,000 per week by early April, according to the Advanced Medical Technology Association, an industry trade group.

“If you don’t have time to change your manufacturing processes to get those economies of scale, you get there by brute force, extra labor,” said Gordon, who teaches a course in monetizing medical device ideas. “Your costs actually go up, not down.”

With the federal government buying most of the new ventilators being made in the U.S., state governments and hospital systems urgently seeking the machines have often been forced to go through middlemen or foreign suppliers.

Cuomo has compared the free-for-all bidding to going on eBay, and said during a March 31 briefing that New York had ordered 17,000 ventilators from China for $25,000 each.

“We are paying $25,000 per ventilator, and we are broke,” Cuomo said. “The last thing I want to do is buy a single ventilator I don’t need.”

More than a month later, only 2,500 of the Chinese machines have been delivered, according to Cuomo’s office. In a separate case, New York officials are trying to recover another $69.1 million paid to a Silicon Valley electrical engineer who promised 1,450 ventilators that never materialized.

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With nearly 200,000 new ventilators set for delivery to the federal stockpile by the end of the year, Trump is declaring victory. But it is now unclear whether the stockpile of new ventilators will be needed.

In the little more than a month since Trump announced the buying spree, a series of medical studies has spurred questions about whether ventilators are effective at saving the lives of critically ill COVID-19 patients.

A study published in the New England Journal of Medicine on March 30 found that only 1 of 7 patients older than 70 who were put on a ventilator survived. For patients younger than 70, just 36% lived.

In New York City, state officials say 80% or more of coronavirus patients placed on the machines died.

The studies have caused doctors to reevaluate the use of ventilators in favor of less intensive forms of respiratory support.

Trump administration officials say the new ventilators could still prove valuable if the virus outbreak were to intensify into a second wave after the warm summer months.

“It’s very important that we have a completely refreshed and a comprehensive stockpile going into the fall,” Dr. Deborah Birx, a medical adviser on the White House Coronavirus Task Force, said at a briefing on April 21. “I think that’s why we’ve continued to bring in those shipments and work on the ventilators so that those would be available not only for the United States but certainly if other partner countries have this level of tragedy.”

Trump said he intends to ship thousands of the breathing machines overseas, where the needs are greater.

On Tuesday, Mexico said it received a shipment of ventilators from the United States. Trump said last week Russia is also set to receive U.S. ventilators, along with other countries.

“People dying because they don’t have ventilators, and they’re not equipped to do what we did,” Trump said Friday. “So we’re giving thousands and thousands of these ventilators away to many countries that have suffered greatly: Italy, France, Spain, so many countries. And Nigeria called. Tremendous problems in Nigeria. Tremendous problems all over. And so they’re very happy.”

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Krisher reported from Detroit. Associated Press writer Marina Villeneuve in Albany, New York, contributed to this report.

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Follow AP Investigative Reporter Michael Biesecker at http://twitter.com/mbieseck and Krisher at http://twitter.com/tkrisher

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Contact AP’s global investigative team at Investigative@ap.org