Kim was making an opening statement during an online roundtable with public health experts from academia, local U.S. health departments and hospital systems about tried-and-true infection containment strategies like testing, contact tracing and isolation, which have been employed effectively in other countries.
“The thing that’s been driving me crazy is that we’ve just decided that the standard health response — the only thing that’s worked in any of the countries that suppressed the virus — is something that we’re just not going to do,” said Kim, who headed the World Health Organization’s HIV response during the second George W. Bush administration and led the World Bank for parts of the Obama and Trump administrations.
Sara Cody, head of the public health department in California's Santa Clara County, known now for orchestrating one of the country’s earliest coronavirus shutdowns, was also on the call. She seemed relieved to hear him say so.
“I begin to feel like, am I the one that’s not thinking straight? It feels a little lonely,” Cody said then.
Cody is not alone among U.S. health officials, epidemiologists, virologists and other experts in feeling like she missed the memo saying the world’s richest nation really couldn’t do much to keep this virus from paralyzing it. Many local officials are still asking the same question Kim posed that day: “Why have we given up on containment?”
The pressing question is whether political officials have the will to employ reliable measures to curtail the virus.
So far, that political will has been largely lacking, from President Trump down to many state and local officials trying to limit the virus's spread without destroying the economy. The country as a whole sets a new high in cases almost every day. The virus is spreading unchecked in states as distant geographically and ideologically as California and Alabama. Arizona has diagnosed more cases per capita than any European country.
A new influential model released Tuesday from the University of Washington's Institute for Health Metrics and Evaluation predicts 208,255 American deaths by Nov. 1 if no further mitigation efforts are enforced. If mask use becomes widespread, then those projected deaths would drop to 162,807 people.
“The key is we did not have to be here right now,” Leana Wen, a Washington Post contributing columnist and former Baltimore health commissioner and head of Planned Parenthood, told CNN. Wen argued that if the United States employs effective containment measure — including social distancing and mask wearing — “that 200,000 number doesn't have to be inevitable.”
Anthony S. Fauci, director of the National Institute of Allergies and Infectious Diseases, said Monday that the country is still experiencing the beginning stages of the pandemic.
“We are still knee-deep in the first wave of this, and I would say this would not be considered a wave — this is a surge and resurgence of infections, superimposed on a baseline that never got down where we wanted to go,” Fauci said.
That only hardened the notion of inevitability — cementing the feeling that the virus would have spread no matter what.
The Trump administration isn't aggressively messaging around or clamping down on the virus, as the president has violated recommendations from his own health officials to wear a mask in public, not to attend crowded gatherings and to distance from others. Indeed, the Trump administration seems bent on getting Americans to forget about the contagion, even as cases surge in some states.
“White House officials also hope Americans will grow numb to the escalating death toll and learn to accept tens of thousands of new cases a day, according to three people familiar with the White House’s thinking, who requested anonymity to reveal internal deliberations. Americans will ‘live with the virus being a threat,’ in the words of one of those people, a senior administration official," according to my colleagues Yasmeen Abutaleb and Josh Dawsey.
But the virus didn’t have to become so widespread that officials aren't sure they will be able to offer full in-person teaching at American schools in the fall, although Trump is pressuring state and local officials to do so. Just look at other places like Taiwan, South Korea and Hong Kong that have successfully contained the virus. The United States, experts say, was not doomed to lose control.
“Other countries have taken it seriously, and we have not,” said Ashish Jha, director of the Global Health Institute at Harvard University. “Other [countries] have had a very aggressive shutdown. We have not. Other countries have taken an aggressive approach to testing and tracing and isolation. We have not. Some countries have universal masking laws, and we don’t.”
Kim led the HIV response in Haiti. He oversaw implementation of contact tracing for Ebola in Liberia and Sierra Leone. Still, he said the coronavirus pandemic in the United States is still one of the most difficult public health challenges he has ever encountered, in part because of a convoluted health insurance system and political dysfunction.
Certainly, the effort required to contain the virus in the United States sooner would have qualified as Herculean — adjusted upward for 3,000 years or so of inflation. But there were a host of missed opportunities, from not recognizing the threat early enough, to a botched testing strategy rolled out by the Centers for Disease Control and Prevention, to a patchwork of erratic orders from states and not the central government.
Containment would have required coordinated mobilization of federal and state resources to acquire or manufacture enough personal protective equipment and testing supplies to avoid shortages if at all possible. It would have required outfitting a nation of long understaffed and underfunded health departments. It would have required a cohesive public messaging campaign strong enough to unify to a divided nation behind the common cause of eradicating the virus before hundreds of thousands could die from it.
But containment was not impossible here.
After the 2014 Ebola outbreak in West Africa, experts from the nonprofit Nuclear Threat Initiative and Johns Hopkins University partnered with the Economist Intelligence Unit and philanthropic groups to develop a Global Health Security Index measuring countries’ readiness to combat dangerous outbreaks based on the answers publicly available data yielded to 140 questions across six categories. In a report published in 2019, the United States ranked as the most prepared country overall.
“One of the things they didn’t think about was political inaction and political ineptitude,” Jha said of that report, echoing other experts who say the United States has lacked the “political will” to meet the covid-19 moment.
Local officials and nationally visible epidemiologists alike say that when federal and state officials downplayed the public health threat posed by the virus, they undermined the sense of urgency necessary to mobilize a country of this size and keep it focused on the problem.
As with most public health responses, success is not usually measured in what does happen but what doesn’t. In this case, success would be measured in people not suffering and dying from a virus they needn’t have been exposed to in the first place. Beating the virus, therefore, would feel significant only in hindsight and by comparison, when what could have been is juxtaposed with what was.
Fighting a pandemic, therefore, requires commitment to consistency and delayed gratification — something public health experts like Kim and Jha say federal leadership has not modeled for the public. Each day now costs the country more than 500 lives. The country no longer has weeks to prepare testing, tracing and isolation strategies. Our nationwide public health infrastructure cannot fit into a few panicked weeks what it needed to do over months.
So far, the cost of American apathy has been 128,566 lives in the United States in four months — or a fourth of what the country lost to World War II in three and a half years.
In the meantime, local officials who haven’t given up on containment are being forced to lead the massive undertaking themselves, knowing that whatever they achieve in their own jurisdictions, they can't control what happens in the next county over. Some have been rewarded with criticism and even death threats from those who believe their efforts cratered the economy or are imposing on individual freedoms.
Health departments from Louisville to Portland, Ore., to Sauk County, Wis., are trying to hire more staff on the fly — in some cases more than doubling the size of their departments — so they will also have enough staff to trace cases, assuming they have the testing supplies to identify them in the first place.
Mayors are begging citizens to wear masks, even as their state governments won’t mandate them. A country’s worth of local officials with tired arms is holding tiny umbrellas they must patch as they go, hoping it will prevent their localities from being inundated with the virus.
So far, it isn’t really working.
“The current state is really not good,” Fauci said. “ … We went up, never came down to baseline, and now are surging back up. It’s a serious situation we have to address immediately.”
More on the coronavirus
Florida invited the nation to its reopening. Then it became the nation's new coronavirus epicenter.
“Nearly 1 out of every 100 residents is infected with the virus, hospital intensive care units are full or filling up, and big-name visitors who chose Florida for their first post-isolation events are now mired in questions and controversies about safety. Amid escalating infections, Florida, once held up by Trump as a model for how to manage the novel coronavirus, is faring poorly. Residents worry the situation will get much worse,” Cleve R. Wootson Jr., Isaac Stanley-Becker and Lori Rozsa report. “On Tuesday there were 213,794 cases of the coronavirus in Florida, according to Post data. … 52 intensive care units across more than a third of the state’s counties had reached capacity…
“Hospital leaders, lawmakers, physicians, epidemiologists, advocates and others familiar with the state’s response said a false sense of security set in when grim predictions about the virus’s spread in Florida did not come to pass in March and April. … Sports leagues that opted to restart their seasons in Florida will now play in a state that is in worse shape than when the pandemic began. … The Republican National Convention, scheduled to take place in Jacksonville next month, faces similar questions about safety … Several hundred doctors have signed a petition that says the convention needs stronger safety measures … Disney World has announced it would begin to allow visitors back into the Magic Kingdom this week. …
“There has been a rise in cases affecting older Floridians as well as those living in nursing homes and other long-term care facilities … Testing sites across the state are seeing shortages, and the wait time for results is now as long as 10 days … There were also acute shortages of the antiviral drug remdesivir in parts of the state, causing Democratic members of Florida’s congressional delegation to send a letter Tuesday to HHS Alex Azar asking him to speed the shipment of emergency supplies. … Amid the array of old and new concerns, teachers across Florida learned they would have to begin preparing their classrooms for an influx of students. … ‘I’ve spoken with a lot of my teacher friends, and a lot of them don’t want to go back,’ [first-grade teacher Cara Conlogue said]. ‘We love our students, we miss them, and we love our jobs. But we don’t feel safe.’”
As the virus spreads and hospitalizations rise, it’s America vs. the world.
“Trump pitted America against the world [by] moving to pull the United States out of the WHO while his FBI director accused China of hacking U.S. health-care companies that are researching the novel coronavirus,” Joshua Partlow reports. “‘At this very moment, China is working to compromise American health-care organizations, pharmaceutical companies and academic institutions conducting essential covid research,’ [FBI Director Christopher] Wray said in remarks at the Hudson Institute...
"His remarks came as cases and hospitalizations in the United States continued to mount … Arizona reported 117 deaths on Tuesday, a daily record for the state, as more than 3,000 people were being treated in hospitals and ICU beds neared capacity. Texas canceled its annual state fair, the longest-running fair in the country, as more than 8,000 Texans were hospitalized on Monday, a third higher than last week. Ohio Gov. Mike DeWine (R) issued an order Tuesday requiring residents to wear masks in public in seven counties, including those that are home to Cincinnati and Cleveland. … More than 890 U.S. deaths were reported Tuesday, the highest total in 12 days, amid signs the country’s death rate might be creeping up after falling for the past three months.
"Trump has repeatedly complained that not enough attention is being paid to the country’s death rate. ... Scientists say many countries have lower death rates than the United States. … Anthony S. Fauci, said that although the fatality rate of the coronavirus has dropped, Americans should not be complacent. ‘It’s a false narrative to take comfort in a lower rate of death,' Fauci [said] … The lower mortality rate is a result of two factors, he said. The country has gotten better at treating people, particularly through therapies that work in the advanced stages of the disease. And, Fauci said, the mean age of those getting infected has dropped by about 15 years.”
Trump’s new visa rules are seen as a way to pressure colleges into reopening.
“A directive by the Trump administration that would strip international college students of their U.S. visas if their coursework was entirely online prompted widespread confusion on Tuesday as students scrambled to clarify their statuses and universities reassessed their fall reopening policies amid the coronavirus pandemic,” the Times reports. “The effect may be to dramatically reduce the number of international students enrolling in the fall. Together with delays in processing visas as a result of the pandemic, immigrant advocates say the new rules, which must still be finalized this month, might discourage many overseas students from attending American universities, where they often pay full tuition. … Although higher education officials saw the move by the Trump administration as an attempt to force their hands on reopening, which Trump has pushed for, the directive also holds appeal to groups that favor reducing legal immigration to the United States.”
- Southeastern Veterans’ Center, a Pennsylvania nursing home, gave some veterans hydroxychloroquine even without testing them for the coronavirus in what nurses referred to as the “covid cocktail.” There is no way to know whether the treatment played a role in any deaths at the home, which has attributed 42 fatalities to covid-19. (Debbie Cenziper and Shawn Mulcahy)
- Arizona has the highest percentage of positive cases in the country. That signals that testing is limited and may only be reaching those who are the sickest as the virus impacts wide swaths of people. (Arizona Republic)
- Texas saw a sharp $650 million drop in tax revenue as the surge unleashed more budget uncertainty. Texas leaders attributed the decline to consumers shelling out less for cars, gasoline, alcohol and other goods, as well as precipitous drops in travel and tourism. (Tony Romm)
- Cases increased in the D.C. region one day after recording the lowest numbers in months. The DMV recorded 1,184 new cases and 48 additional fatalities, bringing the number of cases in the three jurisdictions since the start of the pandemic to 147,705, with a death toll of 5,708. The District reported 54 new cases and no additional deaths, the first day without new fatalities reported in the city since June 30. (Dana Hedgpeth)
Brazilian President Jair Bolsonaro tested positive for the virus.
“Bolsonaro, who has sought repeatedly to minimize the novel coronavirus as he urges his country back to work, said Tuesday he has tested positive for it. Bolsonaro, an outlier among world leaders in his skepticism of the virus and measures intended to curb it, was tested Monday evening after developing symptoms that included a fever,” Terrence McCoy reports. “‘There’s no problem,’ he told reporters Tuesday. ‘It’s natural. There’s no dread. It’s life.’ The result adds one more case to what has become the world’s second-worst outbreak, after that of the United States." (Antonia Farzan)
- Israel is seeing a covid-19 spike after initially crushing the outbreak. An Israeli official said government researchers have traced the bulk of new infections to a single category of activity: public gatherings, particularly weddings. (Steve Hendrix)
- Australia put Melbourne, its second-largest city, under lockdown as it battles a second wave. (Kate Shuttleworth)
- Sweden has become the world’s cautionary tale as its decision to carry on as normal as possible amid the pandemic has yielded a surge of deaths without sparing its economy from damage. (NYT)
The Trump presidency
Trump’s attacks on mail voting are turning Republicans off absentee ballots.
The dynamic is alarming “Republican strategists, who say it could undercut their own candidates, including Trump himself,” Amy Gardner and Josh Dawsey report. “In several primaries this spring, Democratic voters have embraced mail ballots in far larger numbers than Republicans during a campaign season defined by the pandemic. And when they urge their supporters to vote by mail, GOP campaigns around the country are hearing from more and more Republican voters who say they do not trust absentee ballots, according to multiple strategists. … The growing Republican antagonism toward voting by mail comes even as the Trump campaign is launching a major absentee-ballot program in every competitive state, according to multiple campaign advisers – a delicate balancing act … The president, however, has been arguing the opposite. Nearly daily in recent weeks and usually on Twitter, Trump has attacked mail balloting, leveling many unsubstantiated allegations."
In a new guidance, the CDC is recommending that voters consider alternatives to casting their ballots in person. “The guidance was issued with little fanfare on June 22 and suggested that state and local election officials take steps to minimize crowds at voting locations, including offering ‘alternative voting methods,’” Michelle Ye Hee Lee reports. “Voters who want to cast ballots in person should consider showing up at off-peak times, bringing their own black ink pens or touch-screen pens for voting machines, and washing their hands before entering and after leaving the polling location, the guidance said. Workers and voters alike, it said, should wear face coverings.”
At least five Republican lawmakers are not going to the Jacksonville convention.
“Senate Majority Leader Mitch McConnell (R-Ky.), 78, indicated Tuesday he will attend the convention, but two other top Senate Republicans, Iowa’s Charles E. Grassley, 86, and Tennessee’s Lamar Alexander, 80, are taking a pass,” Michael Scherer and Josh Dawsey report. “Maine’s Susan Collins, 67, said though a spokesman that she avoids attending the party convention in years when she is facing reelection. Alaska’s Lisa Murkowski, 63, also has no plans to attend, according to a spokesperson, nor does Utah’s Mitt Romney, 73. Collins, Murkowski and Romney have criticized Trump on occasion, making their presence potentially uncomfortable at an event that will largely be a tribute to the president. But Grassley made it clear his decision is motivated solely by fear of contracting the coronavirus. …
“Trump himself signaled Tuesday some flexibility regarding the convention. ‘When we signed a few weeks ago, it looked good. And now all of a sudden it’s spiking up a little bit and that’s going to go down,’ the president told television host Greta Van Susteren. ‘It really depends on the timing. . . . We can do a lot of things, but we’re very flexible.’… For some, going is a way to show their support for Trump. Sen. Lindsey O. Graham (R-S.C.), 64, avoided the nominating convention in 2016 as part of his public rejection of Trump’s candidacy … But the senator’s spokesman … said Graham, who is facing a contested election in a Trump-friendly state, would be there this time. Sen. Joni Ernst (R-Iowa), 50, who is also looking to win another term in November, has signaled she plans to be in Jacksonville, as has Sen. Mike Braun (R-Ind.), 66, who credits Trump with helping him win election in 2018.”
New Hampshire’s Republican governor defended Trump’s decision to hold a rally in the state, but he’s not attending. Gov. Chris Sununu assured reporters that Trump's rally in the state could be pulled off safely and without a mandatory mask order, CNN reports. Sununu said that he plans on greeting Trump at some point during his visit, but that it was unlikely that he’d attend the rally, citing health concerns.
Biden criticized Trump’s campaign for taking aim at Sen. Tammy Duckworth, one of his potential running mates.
“Speaking at a virtual fundraiser that Duckworth (D-Ill.) also attended, [Biden] said it was ‘disgusting, sickening’ of Trump’s circle to question her patriotism and that it was a ‘reflection of the depravity of what’s going on in the White House right now,’” Sean Sullivan reports. On Sunday, Duckworth was asked on CNN about activists’ demands that statues of George Washington be removed because he owned slaves. “I think we should listen to everybody. I think we should listen to the argument there,” she said. Fox News host Tucker Carlson then attacked Duckworth, calling her an “unimpressive person” and suggesting that she and other Democratic leaders “actually hate America.” Trump shared a clip from Carlson’s show.
No Americans are known to have died in the reported Russian bounty operation.
Marine Gen. Frank McKenzie, “a top U.S. military official confirmed Tuesday that U.S. intelligence assessed that Russia had offered to pay Taliban militants to kill American service members, but said there was no evidence the proposed payment scheme resulted in any U.S. troop deaths,” the WSJ reports. “According to the classified assessment, Russia’s GRU military intelligence agency paid members of Afghanistan’s Taliban movement to carry out lethal attacks on U.S. troops in that country. Russia has denied the existence of the arrangement.”
McKenzie said he’s confident that Iraqis will ask American troops to remain. "I believe the government of Iraq recognizes the true value that the coalition brings to the fight against Daesh (another name for ISIS) in Iraq, and I believe that going forward, they're going to want us to be with them," McKenzie said. The U.S. still has more than 5,200 American troops in Iraq. (ABC News)
Trump’s worldview was forged by neglect and trauma at home, according to his niece’s new book.
“Trump’s view of the world was shaped by his desire during childhood to avoid his father’s disapproval, according to the niece, Mary L. Trump, whose book is by turns a family history and a psychological analysis of her uncle,” Shane Harris and Michael Kranish report. “But she writes that as Donald matured, his father came to envy his son’s ‘confidence and brazenness,’ as well as his seemingly insatiable desire to flout rules and conventions, traits that brought them closer together as Donald became the right-hand man in the family real estate business.”
A book by NBC’s Jacob Soboroff quotes top Pence aide Katie Miller questioning immigrant-heavy neighborhoods. Miller, a Florida native, singled out Miami’s Little Havana. “I believe that if you come to America, you should assimilate,” Miller said, per Soboroff. “Why do we need to have Little Havana?” The comments drew ire from Republicans, since older Cuban American voters in Miami are a key part of Trump’s strategy to win Florida in 2020. (Miami Herald)
Park Police didn’t record their radio transmissions when they swept protesters out of Lafayette Square.
“The sudden march into the group of protesters, featuring members of the Park Police, Secret Service, D.C. National Guard and Arlington County police, is now under investigation by Congress and the inspectors general of the Interior Department and Justice Department and the subject of civil lawsuits,” Tom Jackman reports. “When investigators review a police operation, they typically rely on audio and video recordings made by police to verify accounts made in statements or interviews. But the Park Police, along with nearly all federal uniformed police, have never worn body cameras. Officers and commanders said they expected that their comments and orders made during the operation would be captured electronically, to create a contemporaneous record of the event. But that didn’t happen. ‘At the conclusion of the demonstrations,’ Park Police Lt. Jonathan Hofflinger said, ‘we discovered that the radio recorder was not working and did not record any transmissions. However, written radio logs were generated as a redundant practice. This recorder issue has since been rectified.’”
As statues of the Founding Fathers fall, a debate rages over where protesters should draw the line. “In three cases, protesters targeted figures of U.S. presidents — George Washington, Thomas Jefferson and Ulysses S. Grant — prompting a Twitter storm from Trump and outrage from those who see the felling of the statues as an attack on American history. The monuments have also ignited debate among the protesters themselves over where to draw the line on historical figures that some say are too morally compromised to be venerated,” Annie Gowen reports. “The demonstrators’ views range from support for removal of all monuments to an embrace slow-paced community discussion and historical review. … For some demonstrators, it’s not the image of a particular president that is important, but how the leader is portrayed.”
Christopher Columbus symbols are falling across the country. Is Columbus, Ohio, next? “Some activists in Ohio’s capital city of Columbus are confident that they can bring down another honor to the Italian explorer, one that would be harder to remove — the city’s name,” Jasmine Hilton reports. “But efforts to change the city’s name have persisted for decades. … Franklin County Commissioner Kevin Boyce said that a name change is worthy of conversation, but he expects it would be challenging given the name has been in place for more than two centuries.”
Washington’s NFL team is conducting a name review, but Native American groups say they haven’t heard from it. “More than a dozen Native American activists signed and delivered a letter to the NFL on Monday imploring the league to force an immediate name change by the team, and nearly 450 advocates and groups later endorsed the petition,” Roman Stubbs reports. “‘Failing to include our community would be a grave injustice considering the impact the team’s name and logo, as well as a plethora of other sports names and logos, have had on our communities,’ stated the two-page letter, which ended with the recommendation that the current team name be retired with a pipe ceremony and traditional prayer by spiritual leaders in the community.”
Americans can be kicked out of a jury pool for supporting Black Lives Matter. A California appeals court is going to decide whether such a move is legal. State lawmakers are also considering legislation that would tighten rules on removing potential jurors. (Marshall Project)
Quote of the day
“Man, there’s so many more things that are going on in the world that I feel like he should be worried about,” said NASCAR driver Bubba Wallace about Trump's attacks. (The Daily Beast)
Social media speed read
The president’s Sharpie notes clearly spelled out “Bob Woodward,” famed Post reporter who’s about to publish another book on Trump:
Mexican president Andrés Manuel López Obrador will meet with Trump today. He flew commercial from Mexico City to D.C.:
The Carters celebrated their anniversary:
And a reminder that you have to wear your mask over your nose:
Videos of the day
Your local bar may be a coronavirus hotspot:
U.S. protesters are demanding police reform. Here’s what it could look like: