Dr. Fauci says the coronavirus is 'shining a bright light' on 'unacceptable' health disparities for African Americans

BUSINESS INSIDER APRIL 8, 2020

Director of the National Institute of Allergy and Infectious Diseases at the

 National Institutes of Health Anthony Fauci walks on the North Lawn 

outside the West Wing at the White House, after TV interviews Thursday,

 March 12, 2020, in Washington.

 (AP Photo/Manuel Balce Ceneta) Associated Press

Dr. Anthony Fauci struck an emotional tone when discussing the disproportionate death toll facing African Americans from COVID-19 during Tuesday's White House Coronavirus Task Force press briefing.

"And the reason I want to bring it up, because I couldn't help sitting there reflecting on how sometimes when you're in the middle of a crisis, like we are now with the coronavirus, it really does have, ultimately, shine a very bright light on some of the real weaknesses and foibles in our society," Fauci said.

Fauci said mortality rates and ICU intubations are higher among African Americans because of a greater prevalence of "underlying medical conditions — the diabetes, the hypertension, the obesity, the asthma."

Serving as director of the National Institute of Allergy and Infectious Diseases (NIAID) since 1984, Fauci recalled the bulk of his career's work, which has focused on HIV/AIDS.

" ... [I]f you go back then during that period of time when there was extraordinary stigma — particularly against the gay community — and it was only when the world realized how the gay community responded to this outbreak with incredible courage and dignity and strength and activism, that I think that really changed some of the stigma against the gay community, very much so."

Dr. Anthony Fauci took time to look at the big picture of broader societal problems during Tuesday's White House Coronavirus Task Force press briefing, delving into how African Americans have been harder hit by the coronavirus in terms of ICU intubations and a mounting death toll compared to the rest of the population.

In Chicago, more than half of all COVID-19 positive test results and 72% of virus-related deaths have been among African Americans, who make up just 32% of the city's population and 15% for the entire state of Illinois.

In Wisconsin, the numbers have been even more disproportionate. Seventy-three percent of all COVID deaths in Milwaukee County have been among black people, who otherwise make up under half of all positive test results and just 28% of the county's total population.

Fauci raised the subject after President Donald Trump left the briefing halfway through on Tuesday evening.

"And the reason I want to bring it up, because I couldn't help sitting there reflecting on how sometimes when you're in the middle of a crisis, like we are now with the coronavirus, it really does have, ultimately, shine a very bright light on some of the real weaknesses and foibles in our society," Fauci said.

"As some of you may know, the greater proportion of my professional career has been defined by HIV/AIDS, and if you go back then during that period of time when there was extraordinary stigma — particularly against the gay community — and it was only when the world realized how the gay community responded to this outbreak with incredible courage and dignity and strength and activism, that I think that really changed some of the stigma against the gay community, very much so," Fauci added.

"I see a similarity here because health disparities have always existed for the African American community," he said. "But here again, with the crisis, how it's shining a bright light on how unacceptable that is."

Fauci, along with Dr. Deborah Birx, noted that there are no biological reasons why African Americans are dying at higher rates from COVID-19.

Fauci said that it's not the case that African Americans are getting infected more often, but said that prevalence of "underlying medical conditions — the diabetes, the hypertension, the obesity, the asthma" lead to higher ICU and death rates.

Trump also briefly addressed the topic, saying the virus' impact has been "disproportional," but that more research needs to be done to determine why.


Not all states count a patient's race upon hospitalization or death.

At New York Gov. Andrew Cuomo's press briefing on Tuesday, his top adviser Melissa DeRosa said state officials have been contacting local coroners to determine demographic information about those dying from COVID-19.

Fauci later told a reporter that the trend is not limited to particular cities or states.

"The underlying reason why that is happening does not change from state to state," Fauci said.

The disproportionate impact should be a call for broader action once the dust settles, he noted earlier.

"So when all this is over — and as we said, it will end, we will get over coronavirus — but there will still be health disparities, which we really do need to address in the African American community."

Why African Americans are dying at higher rates from COVID-19

AFP / JEFF KOWALSKYThere is no nationwide data available on COVID-19 cases by race, but a pattern of over-representation by black Americans has emerged in states or jurisdictions that are sharing the numbers

The new coronavirus isn't biased about who it infects -- so why does data emerging from some states suggest that African Americans are bearing the brunt of the pandemic in the US?

Experts say blacks are disproportionately impacted by underlying health conditions linked to poverty, face discrimination in medical care, and are more likely to work jobs that require them to leave their home.

"We know that blacks are more likely to have diabetes, heart disease, lung disease," the nation's top doctor, Surgeon General Jerome Adams told CBS News on Tuesday.

These chronic illnesses, which are in turn linked to poverty and structural racism, can lead to more serious forms of the COVID-19 disease.

Adams, who is himself black and has high blood pressure and asthma, added: "I represent that legacy of growing up poor and black in America.

"And I, and many black Americans, are at higher risk for COVID."

- Emerging trend -

AFP / SAUL LOEBPeople wearing masks to try and prevent the spread of COVID-19 leave a supermarket in Washington, DC, April 7, 2020

There is no nationwide data available on COVID-19 cases by race, but a pattern of over-representation by black Americans has emerged in states or jurisdictions that are sharing the numbers.

Sixty-eight percent of coronavirus deaths in Chicago have been among African Americans, who make up just 30 percent of the city's population.

"Those numbers take your breath away," the city's mayor Lori Lightfoot said Monday at a coronavirus briefing. "This is a call to action for all of us."

The trend is repeated in North Carolina, Louisiana, Michigan, Wisconsin and the capital Washington.

Doctor Georges Benjamin, executive director of the American Public Health Association, told AFP the issue was also linked to social class, with black people more likely to work jobs deemed essential that expose them to potential infection.

"That population is more public facing," he said. "More bus drivers, more people taking public transportation to work, more people providing services in nursing homes, more folks working in grocery stores."

- Structural bias -

AFP / KAMIL KRZACZYNSKIA man waits in long line to vote in a presidential primary election outside the Riverside High School in Milwaukee, Wisconsin, on April 7, 2020

The problem is compounded by implicit and explicit bias that African Americans face in the medical system.

Doctor James Hildreth, president of the historically black Meharry Medical College in Nashville, Tennessee told AFP that in his city, most of the initial testing took place at Vanderbilt University Medical Center.

Most of the patients who go to hospital systems like these have insurance, and it was only recently that three assessment centers run by the city of Nashville were built for the underprivileged and minority communities -- one of them located at Meharry's campus and run by its staff.

"My point is, depending on which community you live in, and whether or not you have insurance... the chances for getting assessed are much less," he said.

What's more, it's well documented that when black people seek care, they are less likely to have their symptoms believed or get adequately treated, Doctor Ebony Hilton, an anesthesiologist at the University of Virginia Medical Center told AFP.

For example, black women are less likely to have their breast cancer mammograms seen by a specialist as opposed to a general radiologist, according to a 2012 study from the University of Illinois at Chicago.

Black heart patients who present with elevated levels of a group of proteins indicating cardiac injury are also less likely to be seen by specialists, per a 2018 study.

A civil rights group wrote this week to the US health secretary, Alex Azar, calling on him to "release daily racial and ethnic demographic data related to COVID-19 testing, disease burden and patient outcomes."

This, said the Lawyers' Committee for Civil Rights Under Law, was necessary to ensure a robust public health response, and to make certain care and testing aren't being administered in a discriminatory manner.

The group said the Centers for Disease Control and Prevention (CDC) was already collecting the information but deliberately withholding it.

Hilton stressed that it was in the interests of Americans as a whole to address the problem, because -- unlike high rates of heart disease or cancer -- a wave of coronavirus spreading through the black and Hispanic population will ultimately impact everyone else.

"When you have a system that's not treating these people of lower social economic status and these minority groups, they are then not being tested, they're sent back home to infect their community," she said.

"Those workers who are now infected are going to the grocery store, and when the upper echelon of America are going to get their food, they will get infected too."

PANDEMIC PROFITEERING

'Hellbent on making money off of dying Americans': Inside the black market where multimillion dollar orders for masks lead to empty warehouses

Tom LoBianco and Darren Samuelsohn Apr 4, 2020 BUSINESS INSIDER PRIME

Hospital clinicians get into their protective equipment before testing 

patients for the coronavirus, Covid-19 at Newton-Wellesley Hospital 

in Newton, Massachusetts on March 18, 2020, as the hospital has 

set up three tents in the parking garage where patients who have 

been pre-screened can show up for testing.

 JOSEPH PREZIOSO / Contributor/Getty Images

As mask manufacturers direct sales of vital supplies to healthcare workers, scammers are luring states into fake deals in order to obtain legitimate purchase orders so they can buy masks for the black market, sources tell Business Insider.

Florida's top emergency management official railed against a "Ponzi scheme" full of empty warehouses and "phantom planes." 

The Sunshine State was ready to pay $13 million to Mexican businessmen for two million masks that may have never existed.

Well-connected political operatives are using their relationships to make money on medical supplies for coronavirus response. 

Florida's top emergency management official Jared Moskowitz raised eyebrows earlier this week at a press conference when, with Gov. Ron DeSantis at his side, he vented his frustrations at the Wild West facing states trying to procure desperately needed medical supplies.

In blistering terms, Moskowitz described state governments chasing after ghost caches of protective masks and other critical medical equipment dangled by under-the-radar political operatives and mysterious middlemen who seem to be taking advantage of the biggest global health crisis in a century.

"The N95 private market right now is like a Ponzi scheme," Moskowitz told reporters on Monday, using the technical term for respirator masks that filter 95 percent of airborne particles. "All day long we try to find these masks. We're talking to brokers. We're talking to distributors. We're talking to medical salespeople. We're chasing down warehouses only to get there to find out that they're empty."

"We're being told these supplies are on planes only to see that they're phantom planes, chasing ghosts when they don't appear on FlightAware," the former Democratic state legislator continued. "We're constantly engaging in bidding wars, being asked to wire money to accounts that were set up that very same day with email addresses that were created only a couple of days ago."

Moskowitz didn't offer more specifics. But Business Insider has uncovered details of a scheme that he may have been referring to: Just a few days before the press conference, Moskowitz's office had become ensnared in what insiders say was an attempt by a mysterious broker to trick Florida into agreeing to buy two million of the highly-prized masks for the exorbitant price of $13 million.

Various N95 respiration masks at a laboratory of 3M, that has been 

contracted by the U.S. government to produce extra marks in response

 to the country's novel coronavirus outbreak, in Maplewood, Minnesota, 

U.S. March 4, 2020. Reuters/Nicholas Pfosi

"It's just madness"There were no masks — a broker representing the state at one point rushed to the alleged seller's headquarters only to find an empty and abandoned warehouse — and Florida never ended up paying any money. But the state did sign a $13 million purchase agreement.

In the wild, highly speculative pop-up market for masks, sources involved in procurement efforts tell Business Insider, such agreements have become a currency in their own right. Because 3M, the largest maker of N95 masks, is prioritizing mask orders bound for hospitals or states, these sources say, official state purchase orders have become golden tickets, granting whomever obtains one access to the lucrative 3M supply chain.

As a result, the sources say, some scammers have been luring states into fake deals just to secure purchase agreements, which they can either sell upstream to medical equipment distributors or use to buy masks for the black market.

The states don't lose any money on these phantom deals, but they end up left in a lurch, wasting the valuable time and attention of emergency response officials.

"It's just madness," Moskowitz said on Wednesday during an appearance on a talk radio show hosted by Jay Sekulow, the Trump personal lawyer who served as key defense counsel for the president during his Senate impeachment trial earlier this year.
Another challenge for states

Florida isn't alone. Governors across the country have been sounding the alarm about the slapdash wheeling and dealing which has left them competing with each other and countless international players in a bid to find masks and other equipment to help care for their sick and protect healthcare workers and other vulnerable populations.

New York Gov. Andrew Cuomo has repeatedly bemoaned price-gouging, noting that medical supplies which would typically cost 58 cents a piece now run up to $7.50 each.

Trump's government is also taking steps to address the situation. Attorney General William Barr last month created task forces that are investigating medical supply hoarders, price gougers, and anyone else looking to use the coronavirus pandemic to make a fast buck.

On Thursday, DOJ and the Department of Health and Human Services announced the confiscation of more than a half million medical supplies from price gougers, including nearly 200,000 masks that are being distributed to the front lines of the coronavirus response.

DONALD TRUMPS NEW HOME STATE; FLORIDA

MIAMI GARDENS, FLORIDA - MARCH 22: Jared Moskowitz, 

Director of Florida's Division of Emergency Management speaks at

 the opening of a drive-thru coronavirus testing facility at Hard Rock 

Stadium in Miami Gardens, Florida. MPI10 / MediaPunch /IPXA 

$13 million deal that never happened

The demand for masks in Florida is real — and urgent. COVID-19 cases have begun doubling every three days in most parts of the state, matching spikes in areas like the Northeast and New Orleans, according to The New York Times' case-tracker.

After weeks of criticism for keeping the state's beaches open through Spring Break, and in the face of clear evidence that Florida will be among the hardest hit states, DeSantis on Wednesday issued a mandatory stay-at-home order, following the lead of almost 40 other governors, according to a New York Times analysis.

Behind the scenes, the Republican governor's officials were already racing to find medical supplies.

A week ago, former D.C. Beltway Republican operative John Plishka and Dallas-based investor Jacob Watters teamed up with a prominent GOP lobbyist in Florida in an effort to secure two million masks for the Sunshine State. The trio made contact with people in Mexico claiming to be representatives for 3M.

It sounded like a networking home run: Plishka's team knew an operative in Texas, who knew an operative in Mexico City, who said he knew the 3M reps for Latin America.

For Plishka and Watters, creators of a new company, Critical Supply, the stars were starting to align. The two men had been working for nearly a year connecting with medical equipment manufacturers in China, as part of a major e-commerce effort to build a direct supply line to hospitals. By the time coronavirus hit at the start of 2020, Plishka's team had plenty of experience in navigating the markets for masks and other medical supplies.

Last Thursday, Plishka's Florida-based partners met with a state-approved pre-purchase inspector to pick up the masks from the people who said they were connected to 3M. The state had $13 million ready for the deal, which works out to an exorbitant unit price of $6.50 per mask, an 800 percent markup.

But as soon as Plishka and his team sent the alleged 3M representatives a copy of the purchase order, along with a letter of intent signed by Moskowitz on Florida Division of Emergency Management letterhead, the sellers went silent. Plishka's team recalled the business address and name of the company that the alleged reps had used and darted to its South Florida warehouse, hoping to find the two million masks.

But the warehouse was abandoned and empty.

A worker wearing personal protective equipment builds a splash guard during a mass manufacturing operation to supply New York City government with protection to distribute against COVID-19 transmission, Friday, March 27, 2020, at the Brooklyn Navy Yard in New York. The new coronavirus causes mild or moderate symptoms for most people, but for some, especially older adults and people with existing health problems, it can cause more severe illness or death AP Photo/John Minchillo

The new coronavirus commodity: Purchase orders

A few hours later, the supposed 3M representatives resurfaced. They apologized for disappearing and explained that the masks had already been sold to another buyer. But they had a path to get another line of masks if Plishka's team could provide another purchase order from the state.

Plishka and Watters told Business Insider that they came to believe the people his team was talking to didn't want money. They were after the purchase orders.

In an effort to stem the tide of fraud and profiteering, on March 20, 3M announced that it would work with "governments, medical officials, customers and distributors around the world to help get supplies where they are needed most." It later clarified that it was directing more than 90 percent of its respirator production to healthcare and public health. The new guidelines, Plishka and Watters told Business Insider, had the unintended consequence of creating a black market for purchase orders — just the piece of paper — from states or other authorized buyers.

Now, anyone who wants to get into the lucrative 3M supply chain needs to have such a purchase order to demonstrate that the ultimate recipient of the masks is a priority. Potential scammers, Watters and Plishka told Business Insider, can "flip" the orders by selling them to other middlemen, who use them to buy masks from 3M that they can sell on the black market.

The paper-flipping scheme, they said, is wasting crucial time and keeping masks from getting to hospitals. "What they are doing is using people like us, who have the relationships," Watters said. "They then fraudulently issue that letter to their 3M distributor to get on the supply line."

Ordinarily, a source familiar with the process says, brokers send such letters of intent through intermediaries to 3M, which then sends an engagement letter and certificates authorizing the purchase directly to the entity that issued the letter — in this case, the state of Florida. The process is designed to keep scammers out of the supply chain. But the chaos of the current market appears to have short-circuited those safeguards in some cases.

Enter Mark Cuban

As word got out that Plishka was trying to buy masks for Florida, other alleged suppliers approached his team. Each claimed to have photos of stockpiles of N95 masks ready for immediate delivery. Different alleged suppliers sent him copies of an identical grainy video of cardboard boxes stamped with "3M" on wooden pallets. One supplier said the video was from a warehouse in London; a different person sent the same video but claimed it came from a warehouse in Miami. Both alleged suppliers said all they needed was a purchase order from a state or hospital.

In one call, someone purporting to have 10 million masks in Texas quickly hung up the phone after Watters said he could be at the warehouse to check the inventory in 20 minutes.

The state of Florida didn't lose any money in the scam that Moskowitz was caught up in, and it's unclear if there's an obvious victim, as in traditional fraud cases. But Plishka and Watters said the damage is nonetheless still life-threatening.

Florida isn't alone in facing phantom mask sellers. This week, according to the Los Angeles Times, a federal task force in charge of clamping down on COVID-19 medical supply fraud launched an investigation into a strikingly similar case in California, in which a seller claiming to have 39 million masks disappeared before money changed hands.

Moskowitz's office declined an interview request and did not respond to detailed questions from Business Insider about his efforts to secure masks. But the once-obscure Florida official hasn't held back on social media and interviews with conservative media outlets since making his initial remarks on Monday.

On Twitter, Moskowitz appeared to trash one of the deals that fell through by blaming 3M for the foul-up. "Hi @3M. I'm your new Troll," he wrote. "How many brokers and distributors do we have to negotiate with only to find empty warehouses?"

That blast went viral, and caught the attention of Dallas Mavericks owner Mark Cuban, who replied on Twitter, "Great question, Jared. Have you been able to get in contact with anyone @3M or their distributors?"

Moskowitz's media blitz continued Wednesday on Sekulow's radio program, which is carried by about 1,000 mostly conservative stations around the country. Asked by the Trump lawyer if he'd flagged the shady market dealings to the federal government, Moskowitz replied that he'd been in touch with the Federal Emergency Management Agency and praised the creation of several Trump administration initiatives to address the medical product supply chain.

Feds are aware of the issue, 3M CEO says

On Thursday, Moskowitz told Fox News' Tucker Carlson that for the last several weeks his staff had been working from a "boiler room" to identify any way to get masks and supplies to the state. "What's even more troubling is what we expected, is that the system is completely broken," Moskowitz complained. "And that the authorized distributors who right now can't tell me a timeline when I'm going to receive my masks orders that I put in a month ago. And, by the way, the terms and conditions are I gotta pay for my masks and can't cancel my order."

Moskowitz also complained that 3M-authorized distributors were engaged in "criminal" activity by prioritizing foreign buyers. "They're specifically saying, 'Listen, we are sorry that your order got pushed down, but there are folks showing up to the factories, there are folks showing up to us, calling us, paying cash.'" he recalled. "And when I said, 'What do you mean there are folks?' They said, 'Well, listen there are foreign countries that do business differently and they're showing up with cash."

Plishka said 3M's dominance in the respirator mask market is part of the problem. "The end result is an increasing black market of immoral traders of 3M products — hellbent on making money off of dying Americans," Plishka told Business Insider. "All while healthcare providers, first responders, and the vulnerable are lacking the proper protection they need."

For its part, 3M has been scrambling to address the issue. CEO Mike Roman on March 24 in a letter to Barr and key state leaders referenced the "many reports of fraudulent activity and price-gouging involving medical devices" and described outreach with logistics providers and large e-marketplace operators "on a coordinated strategy and action plan to ensure products rapidly get to where they are needed most.

A week later, Roman said 3M was pledging to "take decisive action against those seeking to take illegal and unethical advantage of the COVID-19 outbreak."

"We are working with law enforcement authorities around the world on this matter, including federal, state, and local authorities in the US," he added.

On Thursday, Trump's administration invoked the Korean War-era Defense Production Act with an order to 3M to put U.S. orders first ahead of foreign demand. The company responded by noting the "significant humanitarian implications" for Canada and Latin American markets and raised the prospect of international retaliation from other countries.

Representatives for 3M did not respond to multiple requests for comment from Business Insider.

A DeSantis spokesman deferred questions to Moskowitz's office.

Political operatives seize opportunity in medical supplies

In any normal medical transaction, hospitals would purchase goods like N95 masks through group purchasing organizations, which are bulk wholesalers who buy from manufacturers and sell to hospitals in large quantities. But that supply chain fell apart early in the coronavirus pandemic, leaving doctors and nurses pleading on social media for equipment as they treat nonstop waves of sick people in hot zones from coast to coast.

That's where the likes of Plishka and Watters have stepped in.

Amid the dire demand and the broken supply lines, political operatives who would otherwise be working to elect federal, state, and local candidates in the 2020 election have rushed into the void — with mixed results.

Longtime Republican fundraiser Mike Gula announced in late March that he'd abruptly shut down his practice to enter the medical supply business, POLITICO reported. And a Republican candidate for Congress mired in the Trump impeachment probe frantically tweeted earlier this week that he was looking for buyers for 10 million masks. On Monday, Trump even welcomed Mike Lindell to the lectern at the Rose Garden, where "the My Pillow Guy" promised he could manufacture 50,000 masks a day to the federal government. (Lindell later attacked those mocking him on Twitter, telling Yahoo News they were angry at him for referencing God.)

A longtime lobbyist for Indiana's hospitals told Business Insider he's been bombarded with calls from political operatives claiming to have access to masks. Some of the offers appear to be more serious than others.

"I don't believe there's any gold at the end of the rainbow, but I do believe they think it's legitimate," the lobbyist said, adding that he has been able to ignore the overtures for now because Indiana is suffering less than others and can rely on the limited federal supply.

Congressional candidate Robert Hyde of Simsbury, Conn., 

displays campaign phone-grips under the Genius of Connecticut 

statue in the Connecticut State Capitol in Hartford, Conn., 

on Friday, Jan. 17, 2020. Mark Mirko/Hartford Courant/TNS

An impeachment player makes a cameo

Another entry into the market is Rob Hyde, a long-shot GOP candidate for Congress from Connecticut who said he started getting unsolicited offers of millions of masks while calling around Tuesday for donations for local hospitals.

Hyde, who gained fame last year after texts emerged between him and Rudolph Giuliani associate Lev Parnas indicating that he had been spying on U.S. Ambassador to the Ukraine Marie Yovanovitch, said he is working with suppliers in Florida, Pennsylvania, and Israel. In an interview with Business Insider, he explained that he can get masks to hospitals within four days in some cases or a week if they want them shipped from the Middle East.

The masks housed in Florida, Hyde said, were from a supplier who had stockpiled them after Hurricane Maria hit Puerto Rico in September 2017. He declined to say who his suppliers were, if he had actually seen the masks in person, or whether he even had proof of their existence. He also said he had access to the Arizona governor's office and other officials ready to buy from him.

"Literally, in 24 hours my life has gone from donations for local hospitals, to I'm selling to the biggest hospitals in New York," Hyde said Thursday. "I've got like three solid contacts, they're all solid — in Florida, Pennsylvania, and out of Israel, and I've got huge purchasing power."

But Hyde struggled to explain how he got into the supply chain, and how he could prove he had access to the hard-to-find masks. When asked about the apparent rise of a speculative market that's causing consternation among state and federal officials, Hyde briefly paused and went silent. He said he wasn't aware of the controversy but added that it sounded scandalous.

Hyde appeared to mistake an Business Insider reporter for a buyer. After figuring out the journalist was not interested in buying masks from him, Hyde asked if he could call him back.

That call never came.

How America's decimated pandemic response capabilities led to one of the worst coronavirus outbreaks in the world

Sonam Sheth INSIDER Apr 4, 2020

The US is the global epicenter of the novel coronavirus pandemic.

The story of how the country got here was set in motion years ago, when the Trump administration began weakening the very agencies responsible for handling such an outbreak.

The result was a beleaguered public health system scrambling to come to grips with a looming crisis, and a disastrous failure to conduct early, rigorous testing.

The US response was further hobbled by a lack of interagency communication and ineffective leadership from top brass.

Meanwhile, the president spent the critical early weeks of the crisis downplaying its severity and claiming it was a "hoax" to hurt his reelection chances, even as his own intelligence officials briefed him daily about an impending pandemic.

On January 20, a 35-year-old man in Washington state who had recently traveled to Wuhan, China, became the first case of the novel coronavirus in the US.

"We have it totally under control," President Donald Trump said in an interview with CNBC two days later. "It's one person coming in from China. We have it under control. It's going to be just fine."

By February 10, the US had recorded 12 confirmed cases, but Trump assured the public that the country was "in great shape" and that the virus would "go away" by April. On February 29, the US announced its first death tied to COVID-19; on March 11, the same day the World Health Organization declared a pandemic, there were 1,000 US cases and 28 deaths.

It's now April, and the US leads the rest of the world in confirmed cases. "China warned Italy," Fred Milgrim, an emergency room physician in Queens, wrote in The Atlantic last week. "Italy warned us. We didn't listen."

The Trump Administration helped hamstring the country's public health agencies

The story of how the US — the world's richest country and home to some of its most brilliant scientific minds — became the global epicenter of the crisis was set in motion years ago.

In 2018, the newly minted Trump administration was intent on distinguishing itself from its predecessor by trimming bureaucracy and what Trump characterized as "waste, fraud, and abuse" across the government. But some of the agencies that took the biggest hit were those tasked with responding to public health crises.

In May of that year, the National Security Council's pandemic response team was disbanded amid a reorganization of the NSC under then-national security adviser John Bolton. One month earlier, Bolton forced out Tom Bossert, the White House homeland security adviser who had called for a robust strategy against pandemics and bioweapons attacks.

Rear Adm. Timothy Ziemer, who would have overseen the US's response to the coronavirus pandemic in his previous role as head of the pandemic response team, also abruptly left the Trump administration after the unit was disbanded. The group, called the Global Health Security and Biodefense unit, was created under the Obama administration in 2015 following the Ebola outbreak.

The Trump administration also eliminated the US government's $30 million Complex Crises Fund, which consisted of emergency response money that the secretary of state could use to deploy disease experts and others in a crisis.

More recently, it ended a pandemic research program aimed at training scientists in China and other countries to detect and prepare for a threat like the coronavirus, the Los Angeles Times reported. The US Agency for International Development (USAID) launched the initiative, called PREDICT, in 2009; it worked with 60 different foreign laboratories, including the lab in Wuhan that identified the coronavirus that causes COVID-19.

The program shut down in September when it ran out of funding — about two months before the novel coronavirus began surging through China.

The administration has continued targeting the nation's health and science agencies for budget reductions, even in the face of a rapidly escalating pandemic. According to the 2021 fiscal year budget proposal the White House sent to Congress in February, the administration has requested an almost 10% cut to the Department of Health and Human Services (HHS) and a 16% cut to the Centers for Disease Control and Prevention (CDC).

A man is wheeled into an ambulance during the outbreak

 of coronavirus disease (COVID-19), in the Manhattan

 borough of New York City, New York, U.S., March 27, 2020. 

REUTERS/Carlo Allegri

Once the virus gained a stronger foothold in the US, the administration was still slow to act. In early February, HHS Secretary Alex Azar asked the White House to allocate $2 billion to replenish the national emergency stockpile of medical equipment, The Washington Post reported. The White House agreed to just a quarter of that.

Meanwhile, The New York Times reported on Wednesday that the Trump administration allowed a contract with a company maintaining the government's stockpile of emergency, life-saving medical devices to expire last summer. A contract dispute meant a new firm didn't begin its work until late January, when the US coronavirus outbreak was well underway.
The US outbreak was exacerbated after the country botched its early response

The New York Times reported recently that in the nascent days of the outbreak, leaders on the federal coronavirus task force assured their peers that the CDC had developed a diagnostic testing model that would be quickly rolled out as a first step to contain the virus.

But that large-scale testing didn't happen as planned, The Times reported, because of a series of bureaucratic and regulatory flaws at the US agencies responsible for handling the crisis. For one, top officials seemingly failed to grasp the seriousness of scientists' warnings about the virus's spread in China.

Some of the tests the CDC distributed to state labs also turned out to be flawed, and more than half of the labs received inconclusive results. A problem with one ingredient in the test kits resulted in further distribution delays.

And when it surfaced that there were significant problems with the CDC's initial screening test, director Robert R. Redfield promised a speedy solution but failed to deliver on it for weeks. In February, only three out of 100 public-health labs were equipped to test for the virus, according to Politico.

Doctors test hospital staff for coronavirus at St. Barnabas 

hospital in the Bronx on March 24, 2020. Misha Friedman/Getty Images

The CDC also imposed strict guidelines on who could get tested for the virus, The Times reported, and dragged its feet on doing "community-based surveillance," making it impossible for federal and local officials to track the early spread of the disease. Meanwhile, the Food and Drug Administration's regulations hamstrung medical centers and private companies from developing and implementing their own diagnostic tests in emergency situations.

As a result, the US was initially performing fewer than 100 tests per day on average; other countries like South Korea were conducting tens of thousands of tests daily.

A host of emails detailed in a recent ProPublica investigation showed that the CDC also lagged behind on updating its testing guidelines, training states on how to use a new digital platform to track and monitor coronavirus cases, and developing a screening process for travelers arriving at US airports.

Taken together, the Times and ProPublica reports paint a damning picture of a beleaguered public health system scrambling to come to grips with the severity of a looming crisis.

"We're behind the curve, possibly well behind the curve" when it comes to being prepared, Jeremy Konyndyk, who served as the director of office of foreign disaster assistance at USAID during the Obama administration, told Insider.

Trump and Health and Human Services Secretary Alex Azar. Reuters

"A bad flu season is typically enough to strain US healthcare services to their limit," said Konyndyk, who led the US response to the Ebola outbreak in West Africa and is now a senior policy fellow at the Center for Global Development. "This is a disease that has the potential to be much worse than that."

Intelligence officials warned Trump about an impending pandemic but 'couldn't get him to do anything about it'

As the extent of the virus's spread in China became clearer toward the end of 2019 and at the beginning of this year, US intelligence officials began warning Trump about a pandemic, the Washington Post reported. The president was receiving briefings on the situation as early as January.

By the end of January and beginning of February, a majority of the intelligence contained in Trump's daily briefings was about the coronavirus, the report said. At the same time that he was getting those briefings, the president was publicly downplaying the risk of the virus.


"The system was blinking red," one US official with access to the intelligence told The Post. "Donald Trump may not have been expecting this, but a lot of other people in the government were — they just couldn't get him to do anything about it."

Some of the warnings came even earlier. Days before Trump's inauguration, Obama administration officials briefed Trump officials on how to respond to a pandemic, Politico reported. The hypothetical scenario Obama officials presented to the incoming administration bore many similarities to the coronavirus outbreak.

When asked whether any information from the session made its way to the president-elect, a former senior Trump administration official wasn't sure but said hypotheticals like that were not "the kind of thing that really interested the president very much."

Director of the Centers for Disease Control and Prevention

 (CDC) Dr. Robert Redfield. REUTERS/Joshua Roberts

Politico also reported that the Trump administration declined to use a nearly 70-page pandemic playbook that the NSC's health unit put together under the Obama administration. The document instructed federal officials on how to prepare for many of the same obstacles the Trump administration is now facing, including medical equipment shortages and a lack of coordination.

Then, from January to August 2019, the HHS conducted a training simulation about a hypothetical pandemic, caused by a disease that bore striking parallels to the novel coronavirus.


In the simulation, federal agencies fought over who was in charge, state officials and hospitals couldn't figure out what and how much medical equipment was available, and there was no centralized coordination on state lockdowns and school closings.

The team conducting the simulation put together a draft report laying out the roadblocks they discovered in the exercises, but their warnings went unheeded, according to The New York Times.
Trump consistently downplayed the outbreak and attempted to control messaging, further obscuring the depth of the crisis

The president spent the early weeks of the outbreak insisting there was nothing to worry about, and that warnings about a potential pandemic were a "hoax" meant to hurt his re-election bid and tank the stock market.

He appointed loyalists to head up the White House coronavirus task force and instructed some public health officials not to discuss any more matters related to the virus with the public without prior clearance. The president also has a powerful ally in the right-wing media, which has largely echoed his messaging from the start.

As the number of coronavirus cases in the US began ticking up and the death count increased, Trump acknowledged the problem but assured the public it would go away soon, and the pro-Trump media followed suit.

"There's this effort here to craft the truth about the disease for political purposes, and certainly partisan media is operating in a similar way to how state media functions in places like China," Stephen Hess, a professor of political science at Transylvania University who is an expert in authoritarianism, told Insider.

Trump's attempt to control messaging about the virus mirrors that of Chinese President Xi Jinping when the coronavirus hit China, Hess added.

The consequences have been devastating

The US is on track to have the worst coronavirus outbreak in the world. Entire cities and states have been placed on lockdown as the economy grinds to a halt. Schools and restaurants have been shuttered, and unemployment claims have shot up to unprecedented levels.

Hospitals are overflowing as healthcare workers race against the clock to save their patients, even as they place themselves at risk because of a dangerous shortage in personal protective equipment (PPE) like masks, gloves, and gowns.

"If this isn't a public health crisis, I don't know what is," a nurse in Detroit told The Daily Beast.

A paramedic described the situation in New York, which is the epicenter of the US outbreak, as a "war zone." An emergency worker in Queens, New York told The New York Times her hospital was using refrigerated trucks to store the bodies of deceased patients because there was no more space in the morgue.

Patrick Marmo, a funeral director in New York, told Insider's Dave Mosher the pandemic is straining his work to a breaking point as well.

"I don't know how many more bodies I can take," Marmo said. "No one in the New York City area possibly has enough equipment to care for human remains of this magnitude."

John Haltiwanger and Ashley Collman contributed reporting.

The Four Rules of Pandemic Economics
A playbook that should govern America’s short-term reaction to the health crisis.
APRIL 2, 2020


Derek Thompson
Staff writer at The Atlantic

SIMOUL ALVA

WE CANNOT LET THE CURE BE WORSE THAN THE PROBLEM ITSELF.”

With this tweet, President Donald Trump summarized a disturbingly common reaction to social-distancing measures. Texas Lieutenant Governor Dan Patrick expressed the same sentiment when he told Americans to “get back to work,” even if doing so means more death. Fox News commentators, likewise, have argued that Americans should break free of the shackles of quarantine to reboot the economy.
Call it the gospel of growth: the notion that Americans cannot afford to save tens of thousands, even hundreds of thousands, of lives, if it means sacrificing a quarter or two of gross domestic product.

While this might sound like an economic argument, it enjoys little support among economists. In a recent University of Chicago survey of dozens of prominent economists, almost all of them agreed with the idea that the economy would suffer if the U.S. abandoned “severe lockdowns” while the infection risk remained high.
Still, the growth evangelists are right about one thing. Severe lockdowns produce a parallel human misery—with millions of unemployed Americans, thousands of looming bankruptcies, and extreme financial anguish.

What are the economic rules of this upside-down world, where opening the economy too soon produces mass death, but shutting it down for too long produces mass suffering?
Over the past few weeks, I’ve asked a version of this question to a dozen economists. What follows is an attempt to distill their thoughts into four rules that should govern our short-term reaction to the health crisis. It is not just a rebuke to the gospel of growth. It is a new playbook for pandemic economics.

Rule 1: “Save the economy or save lives” is a false choice.

Last week, a group of economists from the Federal Reserve and MIT published a paper on the 20th century’s most murderous flu, the 1918 outbreak. Because the federal government in 1918 offered little if any economic assistance to suffering Americans, the local response from city leaders varied widely. Some places, such as New York and St. Louis, quickly ordered social distancing and other interventions, while others, such as New Haven and Buffalo, allowed public gatherings even weeks after the flu reached crisis levels. This variance gave researchers the ability to see which cities recovered the fastest after the outbreak.

“We were expecting that the areas with more [social distancing] would have a worse economy but less mortality,” said Emil Verner, a co-author of the paper and a finance professor at MIT. But early and aggressive interventions both saved lives and triggered a faster rebound in several measures, such as job growth and banking assets.

The infamous trade-off between people and GDP? It doesn’t exist—or, at least, it didn’t in 1918. The reason, Verner told me, is that pandemics are “so, so disruptive that anything that you can do to mitigate that destructive impact of the pandemic itself is going to be useful.” Without a healthy population, there can be no healthy economy.

This simple idea has some weird implications. “In a normal recession, you want to boost demand,” said the Northwestern economist Martin Eichenbaum. “But we don’t really want to boost demand in the very short run at all, right now. We don’t want United to be flying full planes. We don’t want restaurants serving food to dine-in customers. We want everybody to stay in and hold on.”

It follows that we should—as incomprehensible as this may sound—hope for a deep, short recession, caused by a cliff dive in many forms of economic activity. That would be a clear signal that people have gone home and that the face-to-face economy has been shut down to limit the spread of disease.

“The question I would ask of our leaders is: What will you regret?” Eichenbaum said. “Will the government regret that it didn’t save money in early 2020? Or will it regret that we let a viral infection kill millions of people, which also, by the way, led to the death of a lot of great companies? It’s pretty obvious what the worst-case scenario is. You want to err on the side of saving lives.”

Rule 2: Pay people a living wage to stop working.

In a pandemic, public gatherings are a kind of social pollution, and asymptomatic individuals who violate social-distancing rules are like factories that spew invisible carbon. “We can’t ask people to internalize health risks on an individual basis any more than we can expect polluting factories to self-regulate,” Eichenbaum said. “So governments have to freeze the economy and order people to stay home.”

But asking millions of able-bodied workers to stop working creates a crisis of unemployment for which the word unprecedented does no justice. On Thursday, the government announced that 3.28 million people had applied for jobless benefits in the previous week. That’s not just the highest weekly figure in recorded history; it’s roughly five times larger than the highest-ever figure in recorded history. In seven days, unemployment benefits rose by as much as they did during the first six months of job losses in the Great Recession.
Once the government has put the economy into an artificial coma, it must keep the patient alive. The U.S. economic-relief package does so in a few ways. Washington will send to most households one-time payments of $1,200 per adult—plus $500 per child—and expand unemployment benefits, bumping up weekly payments for eligible workers, including independent contractors and the self-employed, by $600 for the next few months. The new law also delays tax filing, suspends wage garnishing among those who have defaulted on their student loans, and establishes a four-month eviction moratorium among landlords with mortgages from federal entities, such as Fannie Mae and Freddie Mac. This is a huge and kaleidoscopic response. But it still might not be enough.

Denmark and other northern-European countries are taking a different approach. Their governments are directly paying businesses to maintain their payrolls to avoid the sort of mass layoffs and furloughs that are already happening across the United States. The chief benefit of this approach is that restaurants, factories, and so on don’t have to go through the bureaucratic rigmarole of firing thousands of workers and then rehiring them all when the economy bounces back (and those workers don’t have to waste time applying for jobs, either). They’re putting their entire economy in the freezer for three months.

Rule 3: Build companies a time machine.

The U.S. has about 6 million companies, according to the census, and 99.7 percent of them employ fewer than 500 people. Many of these small- and medium-size companies face extinction during the pandemic shutdown. While their income has evaporated, they still owe wages to workers and rent to landlords. This is a recipe for cascading bankruptcies.

If America’s small businesses begin to fail en masse, the damage will spread quickly throughout the economy. Just imagine the closed wine bars in Manhattan. Without money from thirsty New Yorkers, they can’t afford to buy more bottles from family wineries. Without commercial buyers, those wineries can’t buy new fruit from local grape growers, who can’t pay tractor manufacturers for new equipment. One sector’s problem quickly becomes every sector’s problem.

Financial markets may experience a parallel domino effect. If thousands of restaurants suddenly can’t make rent, their property owners might default on mortgage payments. When their banks suffer catastrophic losses, the financial system will seize up because nobody wants to lend anybody money. This is how a pandemic recession could become the Great Depression of the 21st century.

How do we begin to solve this impossible problem? The Federal Reserve has said it will pull all available levers to keep the financial system alive, by buying up government debt, corporate debt, and a variety of asset-backed securities. But something more will be needed to save America’s businesses.

We have to build companies a time machine,” Justin Wolfers, an economist at the University of Michigan, told me. He isn’t talking about the H. G. Wells contraption. He’s referring to anything—including grants, cheap loans, and debt relief—that would allow companies to shift their expenses to the future.

“My local burrito shop, which used to be a thriving business, could go belly-up any day now,” Wolfers said. “But in the post-coronavirus world, it should be a thriving business again. What that burrito business needs is what every business needs right now—a time machine to go from the present pandemic to the future.”

In the U.S. economic-rescue package, that time machine looks like $370 billion in low-interest loans backed by the government. Many businesses won’t have to pay back a cent if they use the cash to make basic expenses, like payroll or rent, and don’t lay off workers. As Slate’s Jordan Weissmann explains, private banks will make the loans to local companies with whom they already have a relationship, and the Small Business Administration will guarantee those loans—at least, until they run out of the roughly $370 billion.

Most economists I spoke with had the same reaction to the economic-rescue plan: Nice idea, too late, and too small. “This should have been passed three weeks ago, and it should have been much larger,” said John Lettieri, CEO of the Economic Innovation Group, a think tank and an advocacy group. Steven Hamilton, an economist at George Washington University, wrote that if the bill is intended to cover 11 weeks of payroll for all companies with fewer than 500 employees, the right figure should be closer to $600 billion. When the U.S. Senate returns to draft follow-up legislation, small-business relief will have to be at the top of the list.

Rule 4: The business of America is now science.

The new rules of pandemic economics are meant to guide U.S. policy during a period of weeks or months—not quarters or years. A three- or four-month freeze is one thing, but a full year of isolation and economic inactivity is untenable.

That brings us to the $100 trillion question: How do we get out of this? A lot more science.
Our lack of knowledge about the virus is our greatest weakness in combatting it. Not knowing who has the virus, or who is most susceptible, contributes to higher infection rates. Not knowing who has recovered from, and built immunity to, the virus delays our ability to treat individuals, or release select individuals from isolation. The possibility that the virus is anywhere means that we have to shut down economic activity everywhere. The road back to normalcy is through more clear and public information.

First, we need more tests, which can tell us where the virus already is. As The Atlantic’s Ed Yong explains, that means we need more masks, more nasopharyngeal swabs for collecting samples, more extraction kits to retrieve the virus’s genetic material, and more trained people to administer the tests.

Second, we need sophisticated tracing technology to tell us where the virus is spreading. “Contact tracing” means reaching out immediately to people who came into contact with an infected person, testing them, and recommending isolation if they test positive. While some countries’ tracing methods draw on mobile data in a way that might make Americans uncomfortable, Germany is looking to deploy a national app that has (for now) won approval from its health minister and data-protection commissioner.

In addition to coordinating a test-and-trace strategy, Washington should train its prodigious energies toward defeating the disease as fast as possible, by establishing billion-dollar prizes for vaccine and antiviral breakthroughs and by relaxing regulations to accelerate the approval of new treatments. After weeks of delay, the administration is finally using the wartime Defense Production Act to force manufacturers to produce ventilators and surgical masks.

We need to get people money, or they will die. We need to get companies cash, or they will die. But if we don’t clear the way for health-care workers to treat the sick, or for scientists to treat the disease, people and companies are going to die, anyway. There is no such thing as a normal economy until we contain the virus. But if we can’t contain the virus quickly, we might not have anything normal to return to.

DEREK THOMPSON is a staff writer at The Atlantic, where he writes about economics, technology, and the media. He is the author of Hit Makers and the host of the podcast Crazy/Genius.

Internationalizing the Crisis
Apr 6, 2020 JOSEPH E. STIGLITZ

The public-health effects and economic impact of the COVID-19 pandemic in developing and emerging economies are only just becoming apparent, but it is already clear that the toll will be devastating. If the international community wants to avoid a wave of defaults, it must start developing a rescue plan immediately.

NEW YORK – As it spread from one country to another, the novel coronavirus paid no attention to national frontiers or “big, beautiful” border walls. Nor were the ensuing economic effects contained. As has been obvious since the outset, the COVID-19 pandemic is a global problem that demands a global solution.

In the world’s advanced economies, compassion should be sufficient motivation to support a multilateral response. But global action is also a matter of self-interest. As long as the pandemic is still raging anywhere, it will pose a threat – both epidemiological and economic – everywhere.

The impact of COVID-19 on developing and emerging economies has only begun to reveal itself. There are good reasons to believe that these countries will ravaged far more by the pandemic than the advanced economies have been. After all, people in lower-income countries tend to live in closer proximity to one another. A higher share of the population suffers from pre-existing health problems that render them more vulnerable to the disease. And these countries’ health systems are even less prepared to manage an epidemic than those of the advanced economies (which have hardly functioned smoothly).1

A March 30 report from the United Nations Conference on Trade and Development offers an early glimpse of what lies in store for emerging and developing economies. The most successful of them rely on export-led growth, which will now collapse as the global economy contracts. Not surprisingly, global investment flows are also plummeting, as are commodity prices, indicating a tough road ahead for natural-resource exporters.

These developments are already being reflected in the yield spreads on developing countries’ sovereign debt. Many governments will find it exceedingly difficult to roll over the debts coming due this year on reasonable terms, if at all.

Moreover, developing countries have fewer and harder choices about how to confront the pandemic. When people are living hand to mouth in the absence of adequate social protections, a loss of income could mean starvation. Yet these countries cannot replicate the US response, which features (so far) a $2 trillion economic package that will blow up the fiscal deficit by some 10% of GDP (on top of a pre-pandemic deficit of 5%).


Following a virtual emergency summit on March 26, G20 leaders issued a communiqué committing “to do whatever it takes and to use all available policy tools to minimize the economic and social damage from the pandemic, restore global growth, maintain market stability, and strengthen resilience.” To that end, at least two things can be done about the dire state of affairs in emerging and developing economies.

First, full use must be made of the International Monetary Fund’s Special Drawing Rights, a form of “global money” that the institution was authorized to create at its founding. The SDR is an essential ingredient in the international monetary order that John Maynard Keynes advocated during the Bretton Woods Conference of 1944. The idea is that, because all countries will obviously want to protect their own citizens and economies during crises, the international community should have a tool for assisting the neediest countries without requiring national budgets to take a hit.

A standard SDR issuance – with some 40% of the SDRs going to developing and emerging economies – would make an enormous difference. But it would be even better if advanced economies like the United States donated or lent (on concessionary terms) their SDRs to a trust fund dedicated to helping poorer countries. One might expect that the countries providing this assistance will attach conditions, in particular, that the money not go to bailing out creditors.

It’s also crucial that creditor countries help by announcing a stay on developing and emerging economies’ debt service. To understand why this is so important, consider the US economy. Last month, the US Department of Housing and Urban Development announced that there would be no foreclosures on federally insured mortgages for 60 days. In essence, this policy is part of a broader “stay” on the entire US economy as a response to the COVID-19 crisis. Workers are staying home, restaurants are staying closed, and airlines are all but shut down. Why should creditors be allowed to continue racking up returns, especially when the interest rates they charge should have already created a sufficient risk cushion? Unless creditors grant such a stay, many debtors will emerge from the crisis owing more than they can possibly repay.

Such stays are just as important internationally as they are domestically. Under current conditions, many countries simply cannot service their debts, which, in the absence of a global stay on repayment, could lead to massive, rolling defaults. In many developing and emerging economies, the government’s only choice is either to funnel more income to foreign creditors or allow more of its citizens to die. Obviously, the latter will be unacceptable to most countries, so the real choice for the international community, then, is between an orderly or a disorderly stay, with the latter scenario inevitably resulting in severe turbulence and far-reaching costs to the global economy.

Of course, it would be even better if we had an institutionalized mechanism for restructuring sovereign debt. The international community tried to achieve that in 2015, when the United Nations General Assembly adopted a set of shared principles with overwhelming support. Unfortunately, that framework lacked the necessary buy-in from key creditor countries. It is probably too late to establish such a system now for use in the current crisis. But there will inevitably be more crises down the line, which means that sovereign-debt restructuring should be high on the agenda for the post-pandemic reckoning.

In John Donne’s immortal words, “No man is an island …” Nor is any country – as the COVID-19 crisis has made abundantly clear. If only the international community would get its head out of the sand


JOSEPH E. STIGLITZ
Joseph E. Stiglitz, a Nobel laureate in economics, is University Professor at Columbia University and Chief Economist at the Roosevelt Institute. His most recent book is People, Power, and Profits: Progressive Capitalism for an Age of Discontent.

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Will COVID-19 Make Modern Monetary Theory Mainstream?

https://soundcloud.com/projectsyndicate/will-covid-19-make-modern-monetary-theory-mainstream-pavlina-r-tcherneva

PODCASTS Apr 7, 2020 PAVLINA R. TCHERNEVA , ELMIRA BAYRASLI
From the ashes of the Great Depression, US President Franklin D. Roosevelt pushed through a raft of labor and social reforms that remade the American state and economy. We need FDR’s brand of “bold experimentation” to recover from the coronavirus pandemic.

PAVLINA R. TCHERNEVA
Pavlina R. Tcherneva, Associate Professor of Economics at Bard College, is a research scholar at the Levy Economics Institute and author of the forthcoming book, The Case for a Job Guarantee.

ELMIRA BAYRASLI
Elmira Bayrasli is the director of the Bard Globalization and International Affairs program and the co-founder and CEO of Foreign Policy Interrupted. She is the author of From The Other Side of The World: Extraordinary Entrepreneurs, Unlikely Places.