OSHA SURE HAS BEEN QUIET 
Trump Administration Tells Employers Not To Worry About Recording COVID-19 Cases

GUESS THEY HAVE NOTHING TO DO

Only health care facilities and select other employers will have to figure out if infections happened at work. Safety advocates are beside themselves.

By Dave Jamieson, HuffPost US

The Trump administration announced Friday afternoon that employers outside of the health care industry generally won’t be required to record coronavirus cases among their workers, a decision that left some workplace safety advocates incredulous.

COVID-19, the disease caused by the coronavirus, is classified as a recordable illness, meaning employers would have to notify the Occupational Safety and Health Administration when an employee gets sick from an exposure at work. But the nation’s top workplace safety agency now says the majority of U.S. employers won’t have to try to determine whether employees’ infections happened in the workplace unless it’s obvious.

“OSHA is kidding, right?” tweeted David Michaels, who helmed OSHA throughout the presidency of Barack Obama.

It is not a joke. OSHA, which is part of the Labor Department, released an enforcement memo Friday spelling out the recording rules.

Employers in health care, emergency response and corrections would have to inform the agency when they become aware of a COVID-19 case that probably resulted from work. But other entities would not have to do so unless there was “objective evidence” that the transmission was work-related, or there was evidence “reasonably available to the employer” ― for example, if a whole slew of people who work right next to each other got sick.

The rationale: Those employers outside of health care “may have difficulty making determinations about whether workers who contracted COVID-19 did so due to exposures at work,” the memo stated.But if employers don’t have to try to figure out whether a transmission happened in the workplace, it could leave both them and the government in the dark about emerging hotspots in places like retail stores or meatpacking plants.

“So all you infected bus drivers, grocery store clerks, poultry processors ― you didn’t get it at work,” tweeted Jordan Barab, a former OSHA official now with the House Committee on Education and Labor.

The announcement is part of an ongoing fight between the Trump administration and occupational safety experts who say OSHA is failing to fulfill its obligations under the president. Employer record keeping has been a key issue in that spat. Early in his presidency, Donald Trump loosened the recording requirements employers must follow, a move critics said would make it easier for companies to fudge their data and hide their injuries.

So, #OSHA says the employers outside of health care no longer have to determine whether employees' COVID infections may be work-related. So all you infected bus drivers, grocery store clerks, poultry processors -- you didn't get it at work. https://t.co/3kjXjx7gaM— Jordan Barab (@jbarab) April 10, 2020

Safety advocates say recording injuries and illnesses like COVID-19 helps officials discover growing hazards and shape sound public policy to address them. The Labor Department, under Trump and Labor Secretary Eugene Scalia, has portrayed those kinds of employer obligations as burdensome red tape.

In its memo on COVID-19 recording, OSHA said that by not enforcing the requirement on most employers, the agency would “help employers focus their response efforts on implementing good hygiene practices in their workplaces, and otherwise mitigating COVID-19’s effects, rather than on making difficult [work-related] decisions in circumstances where there is community transmission.”

The Labor Department and OSHA in particular have drawn a lot of heat for their response to the coronavirus pandemic. Labor unions have been asking Scalia to issue an emergency standard for infectious disease, which would would give health care facilities clear, enforceable standards to protect their workers during the pandemic.

Scalia hasn’t done that. Instead, OSHA has created a new poster for employers with tips on preventing infections, and tweaked the rules around respirators to help employers deal with a shortage.

A Labor Department spokesperson defended the agency’s work responding to the outbreak, saying in an email to HuffPost Friday that it had taken “swift and direct action to protect America’s workers.”

SEE  
https://plawiuk.blogspot.com/search?q=OSHA

SON OF SCOTUS JUSTICE SCALAWAG
Trump’s Labor Secretary Scalia condemned for ‘despicable’ efforts to roll back unemployment benefits, paid leave in coronavirus stimulus

WHICH EXPLAINS HIS BEING AN ANTI WORKER BOTTOM FEEDER 

THE FRUIT DOES NOT FALL FAR FROM THE POISONED TREE

 April 11, 2020 By Jake Johnson, Common Dreams- Commentary

From his guidance rolling back paid leave benefits to his attempt to limit who qualifies for beefed up unemployment insurance, Labor Secretary Eugene Scalia’s implementation of the multi-trillion-dollar coronavirus stimulus package is coming under fire from Democratic lawmakers and advocacy groups who say the former corporate lawyer’s handling of the new law favors businesses over people in desperate need of assistance.

Scalia, son of the late Supreme Court justice Antonin Scalia, “has used his department’s authority over new laws enacted by Congress to limit who qualifies for joblessness assistance and to make it easier for small businesses not to pay family leave benefits,” the Washington Post reported Friday.

In a tweet late Friday, Rep. Steve Cohen (D-Tenn.) pointed to the unprecedented surge in jobless claims over the past month and ripped Scalia’s “despicable” management of the CARES Act, which temporarily expands relief for the unemployed.

“Because of COVID-19, more than 16 million Americans have submitted unemployment claims in the past three weeks, but Labor Secretary Eugene Scalia is using his authority to limit who qualifies for assistance,” Cohen wrote. “This is despicable. We are in the midst of a pandemic!”

While criticizing the stimulus package—which President Donald Trump signed into law late last month—as far too business-friendly overall, progressives have cautiously applauded the law’s across-the-board expansion of unemployment benefits by $600 for a period of four months.

But lawmakers have voiced alarm at the Labor Department’s lack of urgency in rolling out the benefits and, as the Post reported, Scalia issued guidance earlier this week that aims to “make it more difficult for gig workers such as Uber and Lyft drivers to get benefits.”

Andrew Stettner, a senior fellow at the Century Foundation, ripped the department’s guidance in a series of tweets:

The Trump-Scalia Dept of Labor released new regulatory guidance for the new pandemic #unemployment assistance (PUA) program passed by Congress in the #CARESAct, and it’s criminally narrow. https://t.co/A8FwrrX13A
— AndrewStettner (@pelhamprog) April 6, 2020

While the program will cover #gigeconomy workers, it only extends to those who are “forced to suspend operations” because of #COVID19, leaving those who could still turn their apps on—even if they can’t find work—in a grey area.
— AndrewStettner (@pelhamprog) April 6, 2020

Earlier this month, as Common Dreams reported, Sen. Patty Murray (D-Wash.) and Rep. Rosa DeLauro (D-Conn.) slammed Scalia for quietly scaling back the already inadequate paid leave provisions in the CARES Act and creating “gratuitous loopholes” for companies to deny benefits to their employees.

“The Trump administration is twisting the law to allow employers to shirk their responsibility and is significantly narrowing which workers are eligible for paid leave,” Murray said in a statement. “This simply can’t stand. This guidance needs to be rewritten so workers get the leave they are guaranteed under the law.”

The Post reported that under the Labor Department’s newly issued rules, “businesses that deny workers paid leave don’t have to send the government any paperwork justifying why. The Labor Department’s guidance asks companies to ‘retain such records for its own files,’ a contrast with the heavy documentation required from gig workers who must prove they were affected by the coronavirus outbreak to get aid.”

Scalia has not been shy in offering his opinion on the stimulus law’s expansion of benefits.

“Unemployment is not the preferred outcome when government stay-at-home orders force temporary business shutdowns,” Scalia wrote earlier this week in a Fox Business op-ed with Jovita Carranza, the head of the Small Business Administration. “We want workers to have work, not to become dependent on the unemployment system.” 

Heidi Shierholz, a labor economist with the Economic Policy Institute, called Scalia’s warning about unemployment dependency in the midst of a global pandemic “an absolute disgrace.”

This is outrageous. The Secretary of Labor suggesting that what we really need to worry about right now—when we have shut down huge portions of the economy and thrown millions out of work—is workers becoming *dependent on the unemployment system* is an absolute disgrace. pic.twitter.com/IpMdBoFX30
— Heidi Shierholz (@hshierholz) April 6, 2020

As New York magazine’s Eric Levitz put it Friday, “Trump’s Labor Department has been working diligently to ensure that no U.S. worker has it too easy in the middle of a pandemic and burgeoning economic depression.”

FIRST DAUGHTER VS FIRST SON IN LAW AND MINISTER OF EVERYTHING
Chelsea Clinton blasts Jared Kushner for taking lead role on Coronavirus Task Force as she says despite teaching courses on global health even she is not qualified to do the job

Chelsea tweeted Friday: 'I'm not qualified to lead a national #covid19 effort'

Former First Daughter spoke of her Public Health masters and how she wrote a doctoral dissertation on efforts to tackle AIDS pandemic but still wasn't up to it

Hillary and Bill Clinton's daughter added that she co-authored a book on global health governance and teaches MPH courses on health systems & global health

Jared Kushner spoke at the Coronavirus Task Force Briefing on Thursday

Chelsea didn't mention him by name in the tweets but replied to one social media user who criticized Trump's decision to give a role to his son-in-law 

Asked to imagine if Chelsea's parents did the same, she replied: 'My imagination doesn't stretch that far'

By LEAH SIMPSON FOR DAILYMAIL.COM PUBLISHED: 6 April 2020

Former First Daughter Chelsea Clinton has seemingly criticized Jared Kushner's involvement in the efforts to combat COVID-19, saying that even with her experience in public health, she wouldn't be qualified to take on a role in the Coronavirus Task Force.

Donald Trump's son-in-law addressed the country during a briefing Thursday – alongside Vice President Mike Pence, response coordinator for White House Coronavirus Task Force Deborah Birx, Rear Adm. John Polowczyk, and Director of Trade and Manufacturing Policy Peter Navarro.

But Chelsea – who lived in the White House from 1993 to 2001 – appeared to take aim at Kushner, senior advisor to the president, in a series of tweets the following day.

'(Keep thinking: I've a Masters in Public Health; wrote my doctoral dissertation on global efforts to tackle AIDS pandemic; co-authored a book on global health governance; teach MPH courses on health systems & global health & I'm not qualified to lead a national #covid19 effort.),' she tweeted.
Jared Kushner, advisor and son-in-law to US President

 Donald Trump, speaks at a coronavirus task force 

briefing at the White House, Washington, DC, on Thursday. 

Chelsea Clinton tweeted Friday: 'I'm not qualified

 to lead a national #covid19 effort'

The former First Daughter tweeted about how she received her masters in Public Health and wrote a doctoral dissertation on global efforts to tackle AIDS pandemic but wasn't up to leading the pandemic response

Kushner's prior experience is in real estate development, investment and newspaper publishing.

Since he started his term in office, Trump has been criticized for making his children, Ivanka, Eric and Donald Jr., advisers.

Chelsea was only a child when her father Bill Clinton led the country.

But after one social media user suggested Republicans would not have accepted it if First Lady Hillary won the 2016 election and did the same with Chelsea and her husband Marc Mexvinsky, she appeared to confirm she was referring to Kushner in her previous tweet.

'Imagine Hillary Clinton in the White House putting Chelsea Clinton's husband, Mark, in charge of handling the COVID-19 situation,' the Twitter user wrote. 'And when Mark briefed the country, he always praised her. 'Republicans would go insane, but not if the conflict of interest benefits them.'

Chelsea retweeted the message and commented: 'My imagination doesn't stretch that far.'

On Friday she appeared to further criticize Trump's decision making following the coronavirus outbreak when she retweeted Sen. Brian Schatz's (D-Hawaii) message that 'we are seeing preventable mass deaths in the United States'.

Hillary Clinton celebrates with her husband, former President Bill 

Clinton (rear), and their daughter Chelsea Clinton (R) at her caucus

 night rally in Des Moines, Iowa on February 1, 2016

Left, Chelsea Clinton and her husband Marc 

Mezvinsky are pictured September 26, 2019. 

Senior Advisers to the President, Ivanka Trump and

 Jared Kushner, listen as Donald Trump speaks at 

 rally in Manchester, New Hampshire on February 10

Asked to imagine if Hillary Clinton had done the same had she won the White House, she replied: 'My imagination doesn't stretch that far'




On Friday she appeared to further criticize Trump's decision making following the coronavirus outbreak when she retweeted Sen. Brian Schatz's (D-Hawaii) message that 'we are seeing preventable mass deaths in the United States'

Above shows the number of coronavirus cases and deaths in the US and how they have escalated since January

As the pandemic has claimed the lives of more than 9,500 Americans since the end of January, Chelsea has criticized Trump's handling of the crisis.

On Tuesday she retweeted a reporter who said it was 'breathtaking' how the White House's briefing room slide listed a projected 100,000 to 240,000 deaths from coronavirus as 'goals of community mitigation'.

Chelsea added that there had been 'multiple failures-to test every suspected case, to isolate confirmed cases, to contact trace, to adequately prepare & protect our health workers'.

'President @realDonaldTrump didn't cause #covid19 but people are dying because of his failure in public health, leadership & humanity,' Chelsea continued.

A week prior she blasted Trump on Twitter after he said that if states want the federal government to be a good partner to them in fighting coronavirus, 'they have to treat us well'.

'YOU ARE THE PRESIDENT OF THE UNITED STATES. Not some states,' she commented on the tweet which contained a video of Trump's utterance. 'Not just of the people who voted for you. Not just of the people who are American citizens (2020 census). THE UNITED STATES. It's never too late to start acting like it.'

Tuesday, Chelsea Clinton criticized Trump as she said there had been 'multiple failures - to test every suspected case, to isolate confirmed cases, to contact trace, to adequately prepare & protect our health workers'

Last month Chelsea Clinton blasted the president for treating some states more favorably in the fight against COVID-19

Rare look at stockpile handouts shows which states got ventilators, masks amid coronavirus

Dinah Voyles Pulver and Erin Mansfield, USA TODAY•April 10, 2020

Report shows stockpile handouts of personal protective equipment, masks amid coronavirus


More than half the nearly 8,000 ventilators the federal stockpile sent to states to fight the coronavirus pandemic went to New York, while the rest were split among 14 other states and territories, a report from the federal government shows.

The report was released Wednesday by the U.S. House Oversight Committee amid criticism from its chairwoman that states with the biggest COVID-19 problems didn’t get enough supplies.

It gives the nation its closest look yet at how the Strategic National Stockpile distributed much-needed ventilators, N95 respirators, surgical masks and other protective equipment across the country since the pandemic began.

The stockpile, which is operated within the U.S. Department of Health and Human Services, distributed the ventilators based on requests from areas with high case counts.

New York received 4,400 ventilators. The remaining 3,520 went to places like New Jersey, Washington, Michigan, Illinois and Florida.

Shipments of other personal protective equipment — like masks, gloves, face shields and gowns — were allocated on a per capita basis after hospitals reported critical shortages. States with the fewest cases of coronavirus got the biggest per capita distributions of supplies, a USA TODAY Network analysis found.

Alaska and Wyoming, for example, each received more than 70,000 of the N95 respirator masks thought to be the best protection for medical workers, the report shows. Neither state had more than 230 cases by Thursday, according to the latest figures by the U.S. Centers for Disease Control and Prevention. That’s more than 300 respirators for each COVID-19 patient.

Meanwhile, the state of New York — with upwards of 150,000 people testing positive and hospitals desperate for supplies — received just seven N95 masks per coronavirus patient.

New York had more cases than 40 other states combined, Thursday’s CDC data showed. Those states got a total of more than 7.6 million N95 masks, while New York received around 1.1 million. New York City alone had requested double that number from the stockpile.

Maria Leta, who works in kitchen services at Westchester County Medical Center in Valhalla, was among nurses and staff members who called for adequate protective equipment during a protest outside Westchester Medical Center in Valhalla April 9, 2020. 

Nurses also called for more ventilators, adequate staffing, and better ventilation and HEPA filters for all COVID-19 areas in the hospital.More

New York Gov. Andrew Cuomo has repeatedly begged the federal government for more supplies, estimating his state would need 30,000 ventilators. U.S. President Trump has questioned that number.

"We’ll need what we need," Cuomo said at a briefing last week. "I have no desire to acquire more ventilators than we need."

Although the pandemic sparked the demand for medical supplies, hospitals can use them to treat all patients, not just those infected with the coronavirus.

In total, the federal government sent the following supplies to U.S. states and territories between mid-March and early April:


11.7 million N95 masks


26.5 million surgical masks


5.3 million face shields


4.4 million surgical gowns


22.6 million gloves


7,920 ventilators

The numbers of what was actually distributed have raised fears among stakeholders that states and medical providers will continue to face shortages of critical equipment to keep patients and medical workers alive.

The distributions depleted about 90% of the stockpile’s supplies of personal protective equipment. The remaining 10% is reserved for the protection of federal workers.

“It appears that the administration is leaving states to fend for themselves, to scour the open market for these scarce supplies, and to compete with each other and federal agencies in a chaotic, free-for-all bidding war,” New York Rep. Carolyn B. Maloney, chairwoman of the Committee on Oversight and Reform, said in a statement Wednesday.

Health and Human Services and the Federal Emergency Management Agency distributed supplies in the “most equitable way possible for a nationwide response taking into account population and need for areas of high transmission,” said a department official who declined to be identified without authorization.

Efforts to procure additional supplies are underway, according to Health and Human Services, which received $16 billion in the federal coronavirus relief plan to restock critical supplies including masks, respirators and pharmaceuticals.

The department has awarded contracts to buy another 600 million N95 respirators over the next 18 months and has ordered additional ventilators and protective suits.
First-of-its-kind peek at stockpile

This is the first time such an accounting of the stockpile has been made publicly available. Even members of Congress have struggled to obtain such a list.

Connecticut Rep. Rosa DeLauro, who chairs a House appropriations committee subcommittee overseeing the stockpile’s annual budget, said she tried for weeks to get a list of supplies available from and distributed by the stockpile.

Instead she learned about the list from a USA TODAY Network reporter on Wednesday.

“It has been an unending series of stonewalling, obfuscation and essentially not a willingness to give us any report about what’s happening,” said DeLauro, a Democrat.

What’s in the stockpile and where it’s going should be “very simple questions,” DeLauro said. “I don’t want you to give me proprietary information. Tell us what you have and what you needed and where it’s going. These are very simple questions.”

In late-March, hospitals across the country were running out of the crucial respirators and other supplies they needed not only to protect staff while treating coronavirus patients, but also to protect other patients with infectious diseases, immune disorders, undergoing chemotherapy or being treated in an emergency room.

Gov. Andrew M. Cuomo shows how bag valve masks can help patients suffering from respiratory problems due to coronavirus, but they are less effective than ventilators. He spoke during a press conference in the Red Room at the State Capitol in Albany on Saturday, March 28, 2020.

Supplies had plummeted nationwide, in part because companies had shipped supplies to other countries hit first by coronavirus and in part because imports dropped as manufacturers in China were hit by the coronavirus. Meanwhile demand skyrocketed as countries across the globe scrambled to stock up.

That’s when the Association for Professionals in Infection Control and Epidemiology surveyed more than 1,100 health care facilities in all 50 states and the District of Columbia. More than 20% reported having no N95 respirators and another 28% said they were almost out. The survey also noted shortages of face shields and other masks.

Ann Marie Pettis, the association’s president elect, said the flow of supplies had “not functioned how one would expect and how it needed to function.”

“When this is over, it’s going to be a huge focus,” she said. “We really need to get to the bottom of how we could have improved that."
Funding woes

In addition to DeLauro, Oklahoma Rep. Tom Cole, a Republican, also expressed concern this week about the stockpile’s available supplies and distribution. Both serve on the subcommittee on labor, health and human services, education and related services.

“We need to have a rational way to distribute limited resources in times of crisis,” Cole said. “Americans are actually pretty good in a crisis but it would help to have more of a system in place.”

The pandemic has raised the question of what’s in the stockpile and whether it was enough, Cole said, adding that the issue “needs to get more attention at all levels.”

Consistent increases to the stockpile’s budget over the past five years have been completely bi-partisan, he said.

The stockpile’s budget reached a high of $596 million in 2010, then dropped year after year until reaching a low of $477 million in 2013. Much of the funding was restored the following year, but the budget stayed flat at about $575 million through 2018 – the same year it was transferred from the CDC to the Office of the Assistant Secretary for Preparedness and Response.

The 2020 budget appropriation was $705 million.

“There is never enough money there for everything,” said Deborah Levy, chair of epidemiology at the University of Nebraska Medical Center, who oversaw the stockpile as acting division director under the CDC in 2013-2014, in an interview with the USA TODAY Network last week.

“You need to decide what the threat is, what the cost is, what can be negotiated with companies,” Levy said at the time.

Both Cole and DeLauro said they have questions about the distributions to the states.

DeLauro said one of her constituents had called her Wednesday — one of the many expressing fear about the inadequate supply of personal protective equipment. This time it was a local fire chief asking if he could “just vent,” she said.

“He said ‘I can’t get any of this protective equipment, and my people are going in and out of facilities,’” DeLauro said. He told her he was at his “wit’s end.”

This article originally appeared on USA TODAY: Rare look at stockpile shows which states got supplies amid COVID

Instacart customers are baiting workers by enticing them with hefty tips and then removing the money once an order is complete

Bethany Biron

2 hours ago

Instacart

Instacart employees said customers have been tip baiting to entice them to make deliveries, promising large tips only to remove the funds retroactively once orders are complete.

"It's very demoralizing," Instacart employee Annaliisa Arambula told CNN Business. "When you know that it's somebody who's just doing it to game the system and to get their order when they want it, it's really frustrating."

Instacart workers had originally asked for tip protections during a strike for increased protections and hazard pay in late March.
As grocery stores and online delivery services struggle to respond to overwhelming consumer demand during the coronavirus, customers are turning to ruthless methods.

Instacart employees said customers are enticing them with hefty tips, only to retroactively remove them for the order, leading to an influx of canceled or reduced tips in recent weeks. As reported by CNN Business, an employee in Portland, Oregon said she was "flabbergasted" after the $55 she was slated to receive in tips from an order suddenly disappeared, leaving her earnings at just $8.95 from Instacart's batch payment fee.

"It's very demoralizing," Annaliisa Arambula, the Portland Instacart employee, told CNN. "I don't pretend to be a hero, like a nurse in a hospital ... but I literally am exposing myself [to coronavirus] and when I return home, exposing my own family to the possibility of transmitting this disease. When you know that it's somebody who's just doing it to game the system and to get their order when they want it, it's really frustrating."

The tip baiting comes after Instacart employees staged a strike in late March calling for adequate safety gear to prevent the spread of the coronavirus, hazard pay of an additional $5 per order, and an automatic 10% tip, among other requests.

In response, Instacart executives said they would provide precautions like hand sanitizer and claimed it would use a customers' last tip as the default on new orders — efforts Instacart workers said was not enough.

"Workers should not be risking their lives for pocket change," Instacart workers said in a statement at the time. "Setting the tip amount to whatever a customer had previously tipped is ridiculous, because most previous customers would have tipped a different (lesser) amount back when things were more normal. This will, in all likelihood, provide no meaningful benefit to Shoppers."

Instacart workers have had to contend with challenging conditions, as empty store shelves and limited availability have created difficulty in completing orders. Employees have also had to juggle high volumes of orders with mass amounts of items, as homebound Americans look to stock up on essentials.

While Instacart told users in an email to "please consider tipping above and beyond to reflect the extra effort of your shopper," the company hasn't established any efforts to prevent tip baiting. A spokesperson told CNN that tips are determined by customers, but declined to comment on canceled tips.

"We always say: No matter what, never trust a tip," an employee in Pennsylvania told CNN.

Instacart had not yet responded to a request for comment.

He Could Have Seen What Was Coming: Behind Trump’s Failure on the Virus

Eric Lipton, David E. Sanger, Maggie Haberman, Michael D. Shear, Mark Mazzetti and Julian E. Barnes
4/11/2020

WASHINGTON — “Any way you cut it, this is going to be bad,” a senior medical adviser at the Department of Veterans Affairs, Dr. Carter Mecher, wrote on the night of Jan. 28, in an email to a group of public health experts scattered around the government and universities. “The projected size of the outbreak already seems hard to believe.”

© Erin Schaff/The New York Times President Trump has repeatedly 

that no one could have seen the effects of the coronavirus coming.

A week after the first coronavirus case had been identified in the United States, and six long weeks before President Trump finally took aggressive action to confront the danger the nation was facing — a pandemic that is now forecast to take tens of thousands of American lives — Dr. Mecher was urging the upper ranks of the nation’s public health bureaucracy to wake up and prepare for the possibility of far more drastic action.

“You guys made fun of me screaming to close the schools,” he wrote to the group, which called itself “Red Dawn,” an inside joke based on the 1984 movie about a band of Americans trying to save the country after a foreign invasion. “Now I’m screaming, close the colleges and universities.”


His was hardly a lone voice. Throughout January, as Mr. Trump repeatedly played down the seriousness of the virus and focused on other issues, an array of figures inside his government — from top White House advisers to experts deep in the cabinet departments and intelligence agencies — identified the threat, sounded alarms and made clear the need for aggressive action.

The president, though, was slow to absorb the scale of the risk and to act accordingly, focusing instead on controlling the message, protecting gains in the economy and batting away warnings from senior officials.

© T.J. Kirkpatrick for The New York Times

 Dr. Robert Kadlec with the Department of Health and Human Services ran an exercise with the White House Task Force in February that helped convince some in the administration to push for taking more urgent action against the virus.

Even after Mr. Trump took his first concrete action at the end of January — limiting travel from China — public health often had to compete with economic and political considerations in internal debates, slowing the path toward belated decisions to seek more money from Congress, obtain necessary supplies, address shortfalls in testing and ultimately move to keep much of the nation at home.

Unfolding as it did in the wake of his impeachment by the House and in the midst of his Senate trial, Mr. Trump’s response was colored by his suspicion of and disdain for what he viewed as the “Deep State” — the very people in his government whose expertise and long experience might have guided him more quickly toward steps that would slow the virus, and likely save lives.

Decision-making was also complicated by a long-running dispute inside the administration over how to deal with China. The virus at first took a back seat to a desire not to upset Beijing during trade talks, but later the impulse to score points against Beijing left the world’s two leading powers further divided as they confronted one of the first truly global threats of the 21st century.

The shortcomings of Mr. Trump’s performance have played out with remarkable transparency as part of his daily effort to dominate television screens and the national conversation.

But dozens of interviews with current and former officials and a review of emails and other records revealed many previously unreported details and a fuller picture of the roots and extent of his halting response as the deadly virus spread:

■ The National Security Council office responsible for tracking pandemics received intelligence reports in early January predicting the spread of the virus to the United States, and within weeks was raising options like keeping Americans home from work and shutting down cities the size of Chicago. Mr. Trump would avoid such steps until March.

■ Despite Mr. Trump’s denial weeks later, he was told at the time about a Jan. 29 memo produced by his trade adviser, Peter Navarro, laying out in striking detail the potential risks of a coronavirus pandemic: as many as half a millions deaths and trillions of dollars in economic losses.

■ The health and human services secretary, Alex M. Azar II, directly warned Mr. Trump of the possibility of a pandemic during a call on Jan. 30, the second warning he delivered to the president about the virus in two weeks. The president, who was on Air Force One while traveling for appearances in the Midwest, responded that Mr. Azar was being alarmist.

■ Mr. Azar publicly announced in February that the government was establishing a “surveillance” system in five American cities to measure the spread of the virus and enable experts to project the next hot spots. It was delayed for weeks. The slow start of that plan, on top of the well-documented failures to develop the nation’s testing capacity, left administration officials with almost no insight into how rapidly the virus was spreading. “We were flying the plane with no instruments,” one official said.




C. Douglas Mcmillon, Mike Pence are posing for a picture: Vice President Mike Pence visiting a Walmart distribution center in Gordonsville, Va. this month. He was put in charge of the coronavirus task force after Mr. Trump clashed with Alex M. Azar II, the health and human services secretary.3 SLIDES © Anna Moneymaker/The New York Times

Vice President Mike Pence visiting a Walmart distribution center in Gordonsville, Va. this month. He was put in charge of the coronavirus task force after Mr. Trump clashed with Alex M. Azar II, the health and human services secretary.

■ By the third week in February, the administration’s top public health experts concluded they should recommend to Mr. Trump a new approach that would include warning the American people of the risks and urging steps like social distancing and staying home from work. But the White House focused instead on messaging and crucial additional weeks went by before their views were reluctantly accepted by the president — time when the virus spread largely unimpeded.

When Mr. Trump finally agreed in mid-March to recommend social distancing across the country, effectively bringing much of the economy to a halt, he seemed shellshocked and deflated to some of his closest associates. One described him as “subdued” and “baffled” by how the crisis had played out. An economy that he had wagered his re-election on was suddenly in shambles.

He only regained his swagger, the associate said, from conducting his daily White House briefings, at which he often seeks to rewrite the history of the past several months. He declared at one point that he “felt it was a pandemic long before it was called a pandemic,” and insisted at another that he had to be a “cheerleader for the country,” as if that explained why he failed to prepare the public for what was coming.

Mr. Trump’s allies and some administration officials say the criticism has been unfair. The Chinese government misled other governments, they say. And they insist that the president was either not getting proper information, or the people around him weren’t conveying the urgency of the threat. In some cases, they argue, the specific officials he was hearing from had been discredited in his eyes, but once the right information got to him through other channels, he made the right calls.

“While the media and Democrats refused to seriously acknowledge this virus in January and February, President Trump took bold action to protect Americans and unleash the full power of the federal government to curb the spread of the virus, expand testing capacities and expedite vaccine development even when we had no true idea the level of transmission or asymptomatic spread,” said Judd Deere, a White House spokesman.

There were key turning points along the way, opportunities for Mr. Trump to get ahead of the virus rather than just chase it. There were internal debates that presented him with stark choices, and moments when he could have chosen to ask deeper questions and learn more. How he handled them may shape his re-election campaign. They will certainly shape his legacy.

The Containment Illusion

By the last week of February, it was clear to the administration’s public health team that schools and businesses in hot spots would have to close. But in the turbulence of the Trump White House, it took three more weeks to persuade the president that failure to act quickly to control the spread of the virus would have dire consequences.

When Dr. Robert Kadlec, the top disaster response official at the Health and Human Services Department, convened the White House coronavirus task force on Feb. 21, his agenda was urgent. There were deep cracks in the administration’s strategy for keeping the virus out of the United States. They were going to have to lock down the country to prevent it from spreading. The question was: When?





Traders at the New York Stock Exchange on March 9, when stocks suffered their worst single-day decline in more than a decade. Two days later, Mr. Trump announced restrictions on travel from Europe 5 SLIDES © Ashley Gilbertson for The New York Times

There had already been an alarming spike in new cases around the world and the virus was spreading across the Middle East. It was becoming apparent that the administration had botched the rollout of testing to track the virus at home, and a smaller-scale surveillance program intended to piggyback on a federal flu tracking system had also been stillborn.

In Washington, the president was not worried, predicting that by April, “when it gets a little warmer, it miraculously goes away.” His White House had yet to ask Congress for additional funding to prepare for the potential cost of wide-scale infection across the country, and health care providers were growing increasingly nervous about the availability of masks, ventilators and other equipment.

What Mr. Trump decided to do next could dramatically shape the course of the pandemic — and how many people would get sick and die.

With that in mind, the task force had gathered for a tabletop exercise — a real-time version of a full-scale war gaming of a flu pandemic the administration had run the previous year. That earlier exercise, also conducted by Mr. Kadlec and called “Crimson Contagion,” predicted 110 million infections, 7.7 million hospitalizations and 586,000 deaths following a hypothetical outbreak that started in China.

Facing the likelihood of a real pandemic, the group needed to decide when to abandon “containment” — the effort to keep the virus outside the U.S. and to isolate anyone who gets infected — and embrace “mitigation” to thwart the spread of the virus inside the country until a vaccine becomes available.

Among the questions on the agenda, which was reviewed by The New York Times, was when the department’s secretary, Mr. Azar, should recommend that Mr. Trump take textbook mitigation measures “such as school dismissals and cancellations of mass gatherings,” which had been identified as the next appropriate step in a Bush-era pandemic plan.

The exercise was sobering. The group — including Dr. Anthony S. Fauci of the National Institutes of Health; Dr. Robert R. Redfield of the Centers for Disease Control and Prevention, and Mr. Azar, who at that stage was leading the White House Task Force — concluded they would soon need to move toward aggressive social distancing, even at the risk of severe disruption to the nation’s economy and the daily lives of millions of Americans.

If Dr. Kadlec had any doubts, they were erased two days later, when he stumbled upon an email from a researcher at the Georgia Institute of Technology, who was among the group of academics, government physicians and infectious diseases doctors who had spent weeks tracking the outbreak in the Red Dawn email chain.

© Kevin Frayer/Getty Images A worker at a Starbucks 

at an airport in Beijing in January checks a customer’s temperature.

A 20-year-old Chinese woman had infected five relatives with the virus even though she never displayed any symptoms herself. The implication was grave — apparently healthy people could be unknowingly spreading the virus — and supported the need to move quickly to mitigation.

“Is this true?!” Dr. Kadlec wrote back to the researcher. “If so we have a huge whole on our screening and quarantine effort,” including a typo where he meant hole. Her response was blunt: “People are carrying the virus everywhere.”

The following day, Dr. Kadlec and the others decided to present Mr. Trump with a plan titled “Four Steps to Mitigation,” telling the president that they needed to begin preparing Americans for a step rarely taken in United States history.

But over the next several days, a presidential blowup and internal turf fights would sidetrack such a move. The focus would shift to messaging and confident predictions of success rather than publicly calling for a shift to mitigation.

These final days of February, perhaps more than any other moment during his tenure in the White House, illustrated Mr. Trump’s inability or unwillingness to absorb warnings coming at him. He instead reverted to his traditional political playbook in the midst of a public health calamity, squandering vital time as the coronavirus spread silently across the country.

Dr. Kadlec’s group wanted to meet with the president right away, but Mr. Trump was on a trip to India, so they agreed to make the case to him in person as soon as he returned two days later. If they could convince him of the need to shift strategy, they could immediately begin a national education campaign aimed at preparing the public for the new reality.

A memo dated Feb. 14, prepared in coordination with the National Security Council and titled “U.S. Government Response to the 2019 Novel Coronavirus,” documented what more drastic measures would look like, including: “significantly limiting public gatherings and cancellation of almost all sporting events, performances, and public and private meetings that cannot be convened by phone. Consider school closures. Widespread ‘stay at home’ directives from public and private organizations with nearly 100% telework for some.”

The memo did not advocate an immediate national shutdown, but said the targeted use of “quarantine and isolation measures” could be used to slow the spread in places where “sustained human-to-human transmission” is evident.

Within 24 hours, before they got a chance to make their presentation to the president, the plan went awry.

Mr. Trump was walking up the steps of Air Force One to head home from India on Feb. 25 when Dr. Nancy Messonnier, the director of the National Center for Immunization and Respiratory Diseases, publicly issued the blunt warning they had all agreed was necessary.

But Dr. Messonnier had jumped the gun. They had not told the president yet, much less gotten his consent.

© Anna Moneymaker/The New York Times 

Dr. Deborah Birx eventually helped convince Mr. Trump that stricter measures needed to be taken.On the 18-hour plane ride home, Mr. Trump fumed as he watched the stock market crash after Dr. Messonnier’s comments. Furious, he called Mr. Azar when he landed at around 6 a.m. on Feb. 26, raging that Dr. Messonnier had scared people unnecessarily. Already on thin ice with the president over a variety of issues and having overseen the failure to quickly produce an effective and widely available test, Mr. Azar would soon find his authority reduced.

The meeting that evening with Mr. Trump to advocate social distancing was canceled, replaced by a news conference in which the president announced that the White House response would be put under the command of Vice President Mike Pence.

The push to convince Mr. Trump of the need for more assertive action stalled. With Mr. Pence and his staff in charge, the focus was clear: no more alarmist messages. Statements and media appearances by health officials like Dr. Fauci and Dr. Redfield would be coordinated through Mr. Pence’s office. It would be more than three weeks before Mr. Trump would announce serious social distancing efforts, a lost period during which the spread of the virus accelerated rapidly.

Over nearly three weeks from Feb. 26 to March 16, the number of confirmed coronavirus cases in the United States grew from 15 to 4,226. Since then, nearly half a million Americans have tested positive for the virus and authorities say hundreds of thousands more are likely infected.

The China Factor

The earliest warnings about coronavirus got caught in the crosscurrents of the administration’s internal disputes over China. It was the China hawks who pushed earliest for a travel ban. But their animosity toward China also undercut hopes for a more cooperative approach by the world’s two leading powers to a global crisis.

It was early January, and the call with a Hong Kong epidemiologist left Matthew Pottinger rattled.

Mr. Pottinger, the deputy national security adviser and a hawk on China, took a blunt warning away from the call with the doctor, a longtime friend: A ferocious, new outbreak that on the surface appeared similar to the SARS epidemic of 2003 had emerged in China. It had spread far more quickly than the government was admitting to, and it wouldn’t be long before it reached other parts of the world.

Mr. Pottinger had worked as a Wall Street Journal correspondent in Hong Kong during the SARS epidemic, and was still scarred by his experience documenting the death spread by that highly contagious virus.

Now, seventeen years later, his friend had a blunt message: You need to be ready. The virus, he warned, which originated in the city of Wuhan, was being transmitted by people who were showing no symptoms — an insight that American health officials had not yet accepted. Mr. Pottinger declined through a spokesman to comment.

It was one of the earliest warnings to the White House, and it echoed the intelligence reports making their way to the National Security Council. While most of the early assessments from the C.I.A. had little more information than was available publicly, some of the more specialized corners of the intelligence world were producing sophisticated and chilling warnings.

In a report to the director of national intelligence, the State Department’s epidemiologist wrote in early January that the virus was likely to spread across the globe, and warned that the coronavirus could develop into a pandemic. Working independently, a small outpost of the Defense Intelligence Agency, the National Center for Medical Intelligence, came to the same conclusion.

By mid-January there was growing evidence of the virus spreading outside China. Mr. Pottinger began convening daily meetings about the coronavirus. He alerted his boss, Robert C. O’Brien, the national security adviser.








The early alarms sounded by Mr. Pottinger and other China hawks were freighted with ideology — including a push to publicly blame China that critics in the administration say was a distraction as the coronavirus spread to Western Europe and eventually the United States.

And they ran into opposition from Mr. Trump’s economic advisers, who worried a tough approach toward China could scuttle a trade deal that was a pillar of Mr. Trump’s re-election campaign.

With his skeptical — some might even say conspiratorial — view of China’s ruling Communist Party, Mr. Pottinger initially suspected that President Xi Jinping’s government was keeping a dark secret: that the virus may have originated in one of the laboratories in Wuhan studying deadly pathogens. In his view, it might have even been a deadly accident unleashed on an unsuspecting Chinese population.

During meetings and telephone calls, Mr. Pottinger asked intelligence agencies — including officers at the C.I.A. working on Asia and on weapons of mass destruction — to search for evidence that might bolster his theory.

They didn’t have any evidence. Intelligence agencies did not detect any alarm inside the Chinese government that analysts presumed would accompany the accidental leak of a deadly virus from a government laboratory. But Mr. Pottinger continued to believe the coronavirus problem was far worse than the Chinese were acknowledging. Inside the West Wing, the director of the Domestic Policy Council, Joe Grogan, also tried to sound alarms that the threat from China was growing.

Mr. Pottinger, backed by Mr. O’Brien, became one of the driving forces of a campaign in the final weeks of January to convince Mr. Trump to impose limits on travel from China — the first substantive step taken to impede the spread of the virus and one that the president has repeatedly cited as evidence that he was on top of the problem.

In addition to the opposition from the economic team, Mr. Pottinger and his allies among the China hawks had to overcome initial skepticism from the administration’s public health experts.

Travel restrictions were usually counterproductive to managing biological outbreaks because they prevented doctors and other much-needed medical help from easily getting to the affected areas, the health officials said. And such bans often cause infected people to flee, spreading the disease further.

But on the morning of Jan. 30, Mr. Azar got a call from Dr. Fauci, Dr. Redfield and others saying they had changed their minds. The World Health Organization had declared a global public health emergency and American officials had discovered the first confirmed case of person-to-person transmission inside the United States.

The economic team, led by Treasury Secretary Steven Mnuchin, continued to argue that there were big risks in taking a provocative step toward China and moving to curb global travel. After a debate, Mr. Trump came down on the side of the hawks and the public health team. The limits on travel from China were publicly announced on Jan. 31.

Still, Mr. Trump and other senior officials were wary of further upsetting Beijing. Besides the concerns about the impact on the trade deal, they knew that an escalating confrontation was risky because the United States relies heavily on China for pharmaceuticals and the kinds of protective equipment most needed to combat the coronavirus.

But the hawks kept pushing in February to take a critical stance toward China amid the growing crisis. Mr. Pottinger and others — including aides to Secretary of State Mike Pompeo — pressed for government statements to use the term “Wuhan Virus.”

Mr. Pompeo tried to hammer the anti-China message at every turn, eventually even urging leaders of the Group of 7 industrialized countries to use “Wuhan virus” in a joint statement.

Others, including aides to Mr. Pence, resisted taking a hard public line, believing that angering Beijing might lead the Chinese government to withhold medical supplies, pharmaceuticals and any scientific research that might ultimately lead to a vaccine.

Mr. Trump took a conciliatory approach through the middle of March, praising the job Mr. Xi was doing.

That changed abruptly, when aides informed Mr. Trump that a Chinese Foreign Ministry spokesman had publicly spun a new conspiracy about the origins of Covid-19: that it was brought to China by U.S. Army personnel who visited the country last October.

Mr. Trump was furious, and he took to his favorite platform to broadcast a new message. On March 16, he wrote on Twitter that “the United States will be powerfully supporting those industries, like Airlines and others, that are particularly affected by the Chinese Virus.”

Mr. Trump’s decision to escalate the war of words undercut any remaining possibility of broad cooperation between the governments to address a global threat. It remains to be seen whether that mutual suspicion will spill over into efforts to develop treatments or vaccines, both areas where the two nations are now competing.

One immediate result was a free-for-all across the United States, with state and local governments and hospitals bidding on the open market for scarce but essential Chinese-made products. When the state of Massachusetts managed to procure 1.2 million masks, it fell to the owner of the New England Patriots, Robert K. Kraft, a Trump ally, to cut through extensive red tape on both sides of the Pacific to send his own plane to pick them up.

The Consequences of Chaos

The chaotic culture of the Trump White House contributed to the crisis. A lack of planning and a failure to execute, combined with the president’s focus on the news cycle and his preference for following his gut rather than the data cost time, and perhaps lives.

Inside the West Wing, Mr. Navarro, Mr. Trump’s trade adviser, was widely seen as quick-tempered, self-important, prone to butting in and obsessively anti-China.

So it elicited eye rolls when, after being prevented from joining the coronavirus task force, he circulated a memo on Jan. 29 urging Mr. Trump to limit travel from China, arguing that failing to confront the outbreak aggressively could be catastrophic, leading to hundreds of thousands of deaths and trillions of dollars in economic losses.

The uninvited message could not have conflicted more with the president’s approach at the time of playing down the severity of the threat. And when aides raised it with Mr. Trump, he responded that he was unhappy that Mr. Navarro had put his warning in writing.

From the time the virus was first identified as a concern, the administration’s response was plagued by the rivalries and factionalism that routinely swirl around Mr. Trump and, along with the president’s impulsiveness, undercut decision making and policy development.

Faced with the relentless march of a deadly pathogen, the disagreements and a lack of long-term planning had significant consequences. They slowed the president’s response and resulted in problems with execution and planning, including delays in seeking money from Capitol Hill and a failure to begin broad surveillance testing.

The efforts to shape Mr. Trump’s view of the virus began early in January, when his focus was elsewhere: the fallout from his decision to kill Maj. Gen. Qassim Suleimani, Iran’s security mastermind; his push for an initial trade deal with China; and his Senate impeachment trial, which was about to begin.

Even after Mr. Azar first briefed him about the potential seriousness of the virus during a phone call on Jan. 18 while the president was at his Mar-a-Lago resort in Florida, Mr. Trump projected confidence that it would be a passing problem.

“We have it totally under control,” he told an interviewer a few days later while attending the World Economic Forum in Switzerland. “It’s going to be just fine.”

Back in Washington, voices outside of the White House peppered Mr. Trump with competing assessments about what he should do and how quickly he should act.

The efforts to sort out policy behind closed doors were contentious and sometimes only loosely organized.

That was the case when the National Security Council convened a meeting on short notice on the afternoon of Jan. 27. The Situation Room was standing room only, packed with top White House advisers, low-level staffers, Mr. Trump’s social media guru, and several cabinet secretaries. There was no checklist about the preparations for a possible pandemic, which would require intensive testing, rapid acquisition of protective gear, and perhaps serious limitations on Americans’ movements.

Instead, after a 20-minute description by Mr. Azar of his department’s capabilities, the meeting was jolted when Stephen E. Biegun, the newly installed deputy secretary of state, announced plans to issue a “level four” travel warning, strongly discouraging Americans from traveling to China. The room erupted into bickering.

A few days later, on the evening of Jan. 30, Mick Mulvaney, the acting White House chief of staff at the time, and Mr. Azar called Air Force One as the president was making the final decision to go ahead with the restrictions on China travel. Mr. Azar was blunt, warning that the virus could develop into a pandemic and arguing that China should be criticized for failing to be transparent.

Mr. Trump rejected the idea of criticizing China, saying the country had enough to deal with. And if the president’s decision on the travel restrictions suggested that he fully grasped the seriousness of the situation, his response to Mr. Azar indicated otherwise.

Stop panicking, Mr. Trump told him.

That sentiment was present throughout February, as the president’s top aides reached for a consistent message but took few concrete steps to prepare for the possibility of a major public health crisis.

During a briefing on Capitol Hill on Feb. 5, senators urged administration officials to take the threat more seriously. Several asked if the administration needed additional money to help local and state health departments prepare.

Derek Kan, a senior official from the Office of Management and Budget, replied that the administration had all the money it needed, at least at that point, to stop the virus, two senators who attended the briefing said.

“Just left the Administration briefing on Coronavirus,” Senator Christopher S. Murphy, Democrat of Connecticut, wrote in a tweet shortly after. “Bottom line: they aren’t taking this seriously enough.”
The administration also struggled to carry out plans it did agree on. In mid-February, with the effort to roll out widespread testing stalled, Mr. Azar announced a plan to repurpose a flu-surveillance system in five major cities to help track the virus among the general population. The effort all but collapsed even before it got started as Mr. Azar struggled to win approval for $100 million in funding and the C.D.C. failed to make reliable tests available.

The number of infections in the United States started to surge through February and early March, but the Trump administration did not move to place large-scale orders for masks and other protective equipment, or critical hospital equipment, such as ventilators. The Pentagon sat on standby, awaiting any orders to help provide temporary hospitals or other assistance.

As February gave way to March, the president continued to be surrounded by divided factions even as it became clearer that avoiding more aggressive steps was not tenable.

Mr. Trump had agreed to give an Oval Office address on the evening of March 11 announcing restrictions on travel from Europe, where the virus was ravaging Italy. But responding to the views of his business friends and others, he continued to resist calls for social distancing, school closures and other steps that would imperil the economy.

But the virus was already multiplying across the country — and hospitals were at risk of buckling under the looming wave of severely ill people, lacking masks and other protective equipment, ventilators and sufficient intensive care beds. The question loomed over the president and his aides after weeks of stalling and inaction: What were they going to do?

The approach that Mr. Azar and others had planned to bring to him weeks earlier moved to the top of the agenda. Even then, and even by Trump White House standards, the debate over whether to shut down much of the country to slow the spread was especially fierce.

Always attuned to anything that could trigger a stock market decline or an economic slowdown that could hamper his re-election effort, Mr. Trump also reached out to prominent investors like Stephen A. Schwarzman, the chief executive of Blackstone Group, a private equity firm.

“Everybody questioned it for a while, not everybody, but a good portion questioned it,” Mr. Trump said earlier this month. “They said, let’s keep it open. Let’s ride it.”

In a tense Oval Office meeting, when Mr. Mnuchin again stressed that the economy would be ravaged, Mr. O’Brien, the national security adviser, who had been worried about the virus for weeks, sounded exasperated as he told Mr. Mnuchin that the economy would be destroyed regardless if officials did nothing.

Soon after the Oval Office address, Dr. Scott Gottlieb, the former commissioner of the Food and Drug Administration and a trusted sounding board inside the White House, visited Mr. Trump, partly at the urging of Jared Kushner, the president’s son-in-law. Dr. Gottlieb’s role was to impress upon the president how serious the crisis could become.

But in the end, aides said, it was Dr. Deborah L. Birx, the veteran AIDS researcher who had joined the task force, who helped to persuade Mr. Trump. Soft-spoken and fond of the kind of charts and graphs Mr. Trump prefers, Dr. Birx did not have the rough edges that could irritate the president. He often told people he thought she was elegant.

On Monday, March 16, Mr. Trump announced new social distancing guidelines, saying they would be in place for two weeks. The subsequent economic disruptions were so severe that the president repeatedly suggested that he wanted to lift even those temporary restrictions. He frequently asked aides why his administration was still being blamed in news coverage for the widespread failures involving testing, insisting the responsibility had shifted to the states.

During the last week in March, Kellyanne Conway, a senior White House adviser involved in task force meetings, gave voice to concerns other aides had. She warned Mr. Trump that his wished-for date of Easter to reopen the country likely couldn’t be accomplished. Among other things, she told him, he would end up being blamed by critics for every subsequent death caused by the virus.

Within days, he watched images on television of a calamitous situation at Elmhurst Hospital Center, miles from his childhood home in Queens, N.Y., where 13 people had died from the coronavirus in 24 hours.

He left the restrictions in place.

Mark Walker contributed reporting from Washington, and Mike Baker from Seattle. Kitty Bennett contributed research.

Mark Walker, Mike Baker and Kitty Bennett contributed reporting.

Trump administration shuttered pandemic monitoring program, then scrambled to extend it

By Zachary Cohen, CNN, Fri April 10, 2020

(CNN)As early indications of China's coronavirus outbreak emerged in late December, the Trump administration notified Congress it would still follow through with its plan to shutter a US Agency for International Development surveillance program tasked with detecting new, potentially dangerous infectious diseases and helping foreign labs stop emerging pandemic threats around the world.

The administration ultimately backtracked nearly three months later, granting an emergency six-month extension for the program known as PREDICT on April 1. The extension allowed the US to provide "emergency support to other countries for outbreak response including technical support for early detection" of the virus that causes the disease Covid-19, according to a notice posted by University of California-Davis, one of the project's implementing partners.

But by that time, the coronavirus outbreak had already been declared as a global pandemic by the World Health Organization and had claimed the lives of more than 4,300 people in the US.

Spillover

The administration planned to launch a successor project for PREDICT sometime in 2020 but did not appear to have an interim plan until that happened.

The PREDICT program's cancellation and the subsequent scramble to secure an emergency extension reflects the Trump administration's broader pattern of dismantling or downsizing key offices and programs focused on protecting the US from a pandemic, despite multiple warnings in recent years about the need to prepare for such an event.
It is also indicative of the Trump administration's seeming lack of urgency in the months leading up to the coronavirus outbreak in the US, even as the disease was beginning to ravage countries overseas.

The PREDICT program was launched in 2009 and is tasked with monitoring zoonotic infectious diseases -- those that normally exist in animals but can jump to humans -- in an effort to help stop pandemics before they emerge. Nearly 75% of all new, emerging or re-emerging diseases affecting humans at the beginning of the 21st Century are zoonotic, according to USAID.

While there is still some disagreement among scientists regarding the exact origins of coronavirus, researchers agree that it was the result of "zoonotic spillover," exactly the type of virus the PREDICT program was tasked with monitoring.

Sen. Angus King, an Independent from Maine, wrote to USAID in late November to express concerns over the plan to end the PREDICT surveillance program, which was written before the US had clear information related to the emerging coronavirus outbreak in China.

"The work that these projects do may help our country and our world to avoid future catastrophic epidemic and pandemic events akin to Ebola and HIV," King said in the letter.
USAID officials responded on December 31 to inform King that PREDICT would not be renewed after it expired in March 2020, despite concerns raised by the Maine Independent that canceling it before a replacement program was up and running could hinder the US ability to track possible pandemics.

"As planned, PREDICT is scheduled to end in March 2020 following the expiration of its second, five-year period of performance. While PREDICT is closing, the Bureau for Global Health at USAID is planning a successor project, which we intend to award through a competitive procurement process in 2020," wrote Richard Parker, assistant administrator for the Bureau of Legislative and Public Affairs, according to a copy of the letter obtained by CNN.

"The new program will seek to continue our investments in this critical area, by focusing on mitigating risks associated with the spillover of emerging viruses from animals, based on a more-informed understanding of what is needed at the country level to address these risks," he added.

The letter is dated on the same day that China reported its first cases of an unknown virus to the World Health Organization, marking the first public acknowledgment of the coronavirus outbreak in the Wuhan region.

'Great ironies'

In an interview on Tuesday, King called the administration's December response "one of the great ironies," given how rapidly the outbreak has spread in the months since and President Donald Trump's initial comments downplaying the situation in China earlier this year.
CNN previously reported that two top administration officials last year listed the threat of a pandemic as an issue that greatly worried them, undercutting Trump's repeated claims that the pandemic was an unforeseen problem.

Health and Human Services Secretary Alex Azar and Tim Morrison, then a special assistant to the President and senior director for weapons of mass destruction and biodefense on the National Security Council, made the comments at the BioDefense Summit in April 2019.
"Of course, the thing that people ask: 'What keeps you most up at night in the biodefense world?' Pandemic flu, of course. I think everyone in this room probably shares that concern," Azar said, before listing efforts to mitigate the impact of flu outbreaks.

Technically, PREDICT ended in September, two months prior to King's letter to USAID after its second, five-year contract expired, but was given a "no cost extension" so implementing partners could allow some core staff to finish work that was still in progress, according to Christine Kreuder Johnson of UC Davis One Health Institute.

"We just had a few things that were remaining to do both on the in country side as well as on the global side. That's what carried us through this whole year," she said, referring to the initial no-cost extension.

But the situation changed in January once the scale of the outbreak became clearer.

USAID administrator makes long-planned departure as coronavirus crisis rages

PREDICT staff were deployed to several countries almost immediately to provide technical assistance with testing and additional supplies as needed.

For months, those efforts were funded by a limited pool of funds the program had left over from the previous year, as USAID worked to secure an emergency extension, Johnson told CNN.

That extension came more than two months after the first case of coronavirus was confirmed on US soil. USAID announced on March 31 that a $2.26 million extension had been granted for the program and would take effect on April 1.

"With the $2.26 million extension, the PREDICT project will continue to provide technical expertise to support detection of SARS CoV-2 cases in Africa, Asia and the Middle East to inform the public health response. The project will also investigate the animal source or sources of SARS CoV-2 using data and samples collected over the past 10 years in Asia and Southeast Asia," the UC Davis notice posted on March 31 said.

'All hands on deck'

Still, the future of the program remains unclear once the six-month extension expires. While Johnson says PREDICT implementing partners plan to apply for the new contract award when the competition opens this spring, details about the new program remain murky. A USAID spokesperson emphasized that it will "build on the lessons learned and data gathered" during PREDICT's 10-year run.

"USAID is currently developing the STOP Spillover Project that will focus on strengthening national capacity to develop, test and implement interventions to reduce the risk of the spillover, amplification, and spread of zoonotic pathogens in animal and human populations," they told CNN.

Johnson told CNN that implementing partners are already communicating with other colleagues who work in the same field, as the current situation will require "all hands on deck," regardless of who is awarded the next contract.

But she also acknowledged that there will likely be inevitable challenges going forward.
"The kind of work that we're doing requires a lot of forward thinking on the preparedness front in between epidemics. It's always really easy after a huge epidemic to get Congress and other funding mechanisms behind public health, but what happens in terms of these emerging zoonotic diseases, which is the wildlife health sector, needs to be strengthened," she said.

CNN's Jennifer Hansler contributed reporting