H5N1

US: Health officials worry nation’s not ready for COVID-19 vaccine

Thanks to Lauren Weber for sending the link to this report in Kaiser Health News: Health Officials Worry Nation’s Not Ready for COVID-19 Vaccine. Excerpt:

Millions of Americans are counting on a COVID-19 vaccine to curb the global pandemic and return life to normal. 

While one or more options could be available toward the end of this year or early next, the path to delivering vaccines to 330 million people remains unclear for the local health officials expected to carry out the work. 

“We haven’t gotten a lot of information about how this is going to roll out,” said Dr. Umair Shah, executive director of Texas’ Harris County Public Health department, which includes Houston.

In a four-page memo this summer, the federal Centers for Disease Control and Prevention told health departments across the country to draft vaccination plans by Oct. 1 “to coincide with the earliest possible release of COVID-19 vaccine.” 

But health departments that have been underfunded for decades say they currently lack the staff, money and tools to educate people about vaccines and then to distribute, administer and track hundreds of millions of doses. Nor do they know when, or if, they’ll get federal aid to do that. 

Dozens of doctors, nurses and health officials interviewed by KHN and The Associated Press expressed concern about the country’s readiness to conduct mass vaccinations, as well as frustration with months of inconsistent information from the federal government. 

The gaps include figuring out how officials will keep track of who has gotten which doses and how they’ll keep the workers who give the shots safe, with enough protective gear and syringes to do their jobs. 

With only about half of Americans saying they would get vaccinated, according to a poll from AP-NORC Center for Public Affairs Research, it also will be crucial to educate people about the benefits of vaccination, said Molly Howell, who manages the North Dakota Department of Health’s immunization program. 

The unprecedented pace of vaccine development has left many Americans skeptical about the safety of COVID-19 immunizations; others simply don’t trust the federal government.  

“We’re in a very deep-red state,” said Ann Lewis, CEO of CareSouth Carolina, a group of community health centers that serve mostly low-income people in five rural counties in South Carolina. “The message that is coming out is not a message of trust and confidence in medical or scientific evidence.” 

Paying for the Rollout   

The U.S. has committed more than $10 billion to develop new coronavirus vaccines but hasn’t allocated money specifically for distributing and administering vaccines.  

And while states, territories and 154 large cities and counties received billions in congressional emergency funding, that money can be used for a variety of purposes, including testing and overtime pay. 

An ongoing investigation by KHN and the AP has detailed how state and local public health departments across the U.S. have been starved for decades, leaving them underfunded and without adequate resources to confront the coronavirus pandemic. The investigation further found that federal coronavirus funds have been slow to reach public health departments, forcing some communities to cancel non-coronavirus vaccine clinics and other essential services.  

States are allowed to use some of the federal money they’ve already received to prepare for immunizations. But KHN and the AP found that many health departments are so overwhelmed with the current costs of the pandemic — such as testing and contact tracing — that they can’t reserve money for the vaccine work to come. Health departments will need to hire people to administer the vaccines and systems to track them, and pay for supplies such as protective medical masks, gowns and gloves, as well as warehouses and refrigerator space. 

CareSouth Carolina is collaborating with the state health department on testing and the pandemic response. They used federal funding to purchase $140,000 retrofitted vans for mobile testing that they plan to continue to use to keep vaccines cold and deliver them to residents when the time comes, said Lewis. 

But most vaccine costs will be new.

WHO: Pulse survey on continuity of essential health services during the COVID-19 pandemic

A news release from WHO about its Pulse survey on continuity of essential health services during the COVID-19 pandemic: interim report, 27 August 2020. 

The World Health Organization (WHO) today published a first indicative survey on the impact of COVID-19 on health systems based on 105 countries’ reports. Data collected from five regions over the period from March to June 2020 illustrate that almost every country (90%) experienced disruption to its health services, with low- and middle-income countries reporting the greatest difficulties. Most countries reported that many routine and elective services have been suspended, while critical care - such as cancer screening and treatment and HIV therapy – has seen high-risk interruptions in low-income countries.

"The survey shines a light on the cracks in our health systems, but it also serves to inform new strategies to improve healthcare provision during the pandemic and beyond,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. "COVID-19 should be a lesson to all countries that health is not an ‘either-or’ equation. We must better prepare for emergencies but also keep investing in health systems that fully respond to people’s needs throughout the life course."

Services hit across the board: Based on reports from key informants, countries on average experienced disruptions in 50% of a set of 25 tracer services. The most frequently disrupted areas reported included routine immunization – outreach services (70%) and facility-based services (61%), non-communicable diseases diagnosis and treatment (69%), family planning and contraception (68%), treatment for mental health disorders (61%), cancer diagnosis and treatment (55%).

Countries also reported disruptions in malaria diagnosis and treatment (46%), tuberculosis case detection and treatment (42%) and antiretroviral treatment (32%). While some areas of health care, such as dental care and rehabilitation, may have been deliberately suspended in line with government protocols, the disruption of many of the other services is expected to have harmful effects on population health in the short- medium- and long-term.

Potentially life-saving emergency services were disrupted in almost a quarter of responding countries. Disruptions to 24-hour emergency room services for example were affected in 22% of countries, urgent blood transfusions were disrupted in 23% of countries, emergency surgery was affected in 19% of the countries.

Disruption due to a mix of supply and demand side factors. 76% of countries reported reductions in outpatient care attendance due to lower demand and other factors such as lockdowns and financial difficulties. The most commonly reported factor on the supply side was cancellation of elective services (66%). Other factors reported by countries included staff redeployment to provide COVID-19 relief, unavailability of services due to closings, and interruptions in the supply of medical equipment and health products.

Adapting service delivery strategies. Many countries have started to implement some of the WHO recommended strategies to mitigate service disruptions, such as triaging to identify priorities, shifting to on-line patient consultations, changes to prescribing practices and supply chain and public health information strategies. However, only 14% of countries reported removal of user fees, which WHO recommends to offset potential financial difficulties for patients.

The pulse survey also provides an indication of countries’ experiences in adapting strategies to mitigate the impact on service provision. Despite the limitations of such a survey, it highlights the need to improve real-time monitoring of changes in service delivery and utilization as the outbreak is likely to wax and wane over the next months, and to adapt solutions accordingly.

To that end, WHO will continue to work with countries and to provide supportive tools to address the fallout from COVID-19. Given countries’ urgent demand for assistance during the pandemic response, WHO is developing the COVID19: Health Services Learning Hub, a web-based platform that will allow sharing of experiences and learning from innovative country practices that can inform the collective global response. WHO is also devising additional surveys at the sub-national level and in health facilities to gauge the longer-term impact of disruptions and help countries weigh the benefits and risks of pursuing different mitigation strategies.

Canada: Why are Indigenous communities seeing so few cases of COVID-19?

Via CMAJ: Why are Indigenous communities seeing so few cases of COVID-19? Excerpt and then a comment:

As of Aug. 6, the percentage of people living on First Nations reserves who have tested positive for COVID-19 was one-quarter that of the general Canadian population. Of a total 422 cases of COVID-19 on reserves, more than 80% have recovered. Six people have died — a fatality rate one-fifth that of the general population. According to Indigenous Services Canada, “First Nations communities are flattening the curve.” 

British Columbia is a case in point — the province reported just 90 cases of COVID-19 among First Nations people in the first six months of 2020. Health officials attributed these low numbers to the “extraordinary” public health measures taken by Indigenous communities. 

According to Dr. Nel Weiman, acting deputy chief medical officer for the First Nations Health Authority, the memory of past epidemics in which entire villages were nearly wiped out made people especially cautious about COVID-19. “Communities recognized the need to really take this seriously and install their own versions of public health measures,” says Weiman. 

Indigenous people got creative to stay connected virtually, set up trailers for self-isolation, and made roadblocks to control access to their communities. Now, as the rest of the province has reopened, many of these communities are fighting to remain closed. “Some people find it controversial, but I don’t think people can argue that by limiting access … the communities have been able to keep themselves safe to a certain extent,” says Weiman. 

The First Nations Health Authority also put out special public health messages specifically recognizing Indigenous strengths and the sacrifices made by communities during the lockdown. Many have put on hold or modified ceremonies, funerals, and rites of passage. 

Robert Bonspiel, director of First Nations Paramedics, the only Indigenous private ambulance service in Quebec, attributes low infection rates among Indigenous people to communities taking a proactive approach to the pandemic.  

As codirector of the emergency response unit for the Mohawk community of Kanehsatà:ke, Quebec, “we asked people to go back to their roots, to go back to the way it was years ago, to be caring about their neighbours like their family,” he says.  

In addition to setting up roadblocks like in BC, the community encouraged people to stay at home by delivering food hampers, prescriptions, and meals for Elders. Keeping Elders at home may have been protective, given the high number of deaths in long-term care, Bonspiel adds. “If you look at the general Quebec population, their Elders are placed [in nursing homes.] In the Mohawk community, and First Nations communities, we don’t do that.”  

For Inuit in Canada, fighting tuberculosis (TB) has prepared communities for COVID-19. “Inuit communities, unfortunately, have become adept at contact tracing and isolation for TB,” so pandemic measures were “not a new phenomenon,” says Deborah Van Dyk, senior policy director with Inuit Tapiriit Kanatami, the nonprofit representing over 60 000 Inuit in Canada.  

“Strengths-based” strategies to mobilize communities, reduce poverty and implement Inuit-specific solutions to eliminate TB may also support the response to COVID-19, Van Dyk says. Inuit communities have also been working on building up their public health staff, “so it was a lot easier for that kind of staff to redeploy.” 

Van Dyk says shutting down travel quickly may have helped to prevent the spread of COVID-19 among Inuit people, but it’s still too early to say without any evaluations of the public health response. Meanwhile, “there is still a lot of work to be done in terms of impact … around mental health, around businesses, education and that kind of thing,” she says.  

Courtney Skye, a research fellow at the Yellowhead Institute, a First Nations–led think tank, cautions that COVID-19 data are not being collected in a granular way that would show which Indigenous communities are affected at what rates. Without those data, “we lose the ability to hold decision-makers responsible for the actions that they’re taking on behalf of the community.”

Our neighbours the Tsleil-Waututh have a major road running right their reserve. Nonetheless, they seem to have avoided COVID-19 by closing the rest of the reserve off to everyone else and informing their own people. "No Visitors" signs are prominently displayed all along the road, and they keep their community updated with reliable information.

Bolivians driven from pillar to post as Covid-19 overwhelms hospitals

Via The Guardian: Bolivians driven from pillar to post as Covid-19 overwhelms hospitals. Excerpt:

In the two weeks before he died from suspected Covid-19, Grover Ponce was shuttled between six hospitals, as his wife Paola Medina battled the labyrinthine bureaucracy of Bolivia’s health system.  

Just days after he was finally admitted to the Santiago Segundo hospital in the city of El Alto, he had to be rushed to intensive care. But by then it was too late. He suffered two cardiorespiratory arrests and died on Sunday.  

“I could say a million things, but nothing will bring back my husband,” said Medina, 41, her voice breaking as she spoke by phone from the crowded main cemetery in downtown La Paz. 

“Obviously, I feel very, very angry with the health system,” Medina said. “They have made it so hard – and there are many people like me who didn’t know where to turn.” 

Ponce’s death, and his wife’s desperate efforts to save his life, have resonated with Bolivians as their country’s health service buckles under a surging coronavirus caseload. 

The daily number of new cases peaked on Thursday as the country of 11.5 million people reported 75,234 cases and 2,894 deaths – although experts suspect the true figure is much higher. 

A special police unit has collected more than 3,300 bodies from their homes or left lying in the street, about 80% of whom are suspected to have been infected with Covid-19. 

“Sometimes the patients are already dead when they arrive,” said Norma, an emergency nurse in one of La Paz’s main public hospitals who didn’t want to give her second name. “We feel powerless – we can’t give them oxygen because there are so many who need it. To see them die like that is just awful.” 

Norma, a mother of three, said she was obliged to continue working even though she had tested positive for Covid-19. “Eighty per cent of us must be infected by now and the worst is that we are going home and infecting our families,” she said.  

In desperation, many Bolivians have turned to homemade quack cures such as consuming chlorine dioxide, a toxic disinfectant, to treat the virus. The country’s health ministry warned against it, but last month Bolivia’s opposition-controlled congress promoted the chemical and the senate approved a bill for its supply and manufacture. 

Presidential elections, first slated for May, have been postponed for a second time, which will leave Bolivia’s interim president, Jeanine Áñez, in power until the end of the year. 

Áñez, who this week announced she had recovered from coronavirus, has been in office since late last year when Evo Morales was forced to step down amid electoral fraud allegations and fled the country.  

“The transitional government has been landed with a really poor health system, without economic resources, without equipment, without hospitals and without human resources,” said Dr Luís Larrea, president of La Paz’s chapter of the Bolivian Medical Association. 

The region of La Paz had just 74 intensive care doctors for more than 2 million people, he said.  

“They’ve made museums, they’ve made grand buildings for leaders but they didn’t think about health,” he said.

Global report: Philippines 'losing battle' as WHO records biggest jump in Covid-19 cases

Via The Guardian: Global report: Philippines 'losing battle' as WHO records biggest jump in Covid-19 cases. Excerpt:

Senior doctors in the Philippines have pleaded with the government to impose a strict lockdown in the capital Manila or risk losing the battle to contain the spread of coronavirus. 

As the World Health Organization recorded the highest daily number of new cases so far during the pandemic, the medics said the Philippines’ fragile health system needed a “time out” to avert collapse.  

Two of Manila City’s largest government hospitals temporarily closed this week as infections have hit healthcare workers. Many hospitals in the capital also reported full capacity of their Covid-19 beds and have closed their doors to new patients.

“Our health workers are suffering burnout with seemingly endless number of patients trooping to our hospitals for emergency care and admission,” said Jose Santiago, president of the leading doctors’ group Philippine Medical Association.  

“We are waging a losing battle against Covid-19 and we need to draw up a consolidated and definitive plan of action.”  

The doctors’ groups issued the joint statement as the country posted a record of about 4,000 cases each day in the past two days, putting its total to 93,354 infections as of 31 July. It has the second highest number of cases in south-east Asia although the recent numbers have prompted fears it could soon overtake Indonesia, which has more than 108,000 total cases. 

They asked the president, Rodrigo Duterte, to reimpose strict lockdown in the country capital and nearby provinces from 1 to 15 August to give health workers a “time out”. They said the government should also use the time to “recalibrate strategies against Covid-19”. 

Aileen Espina of the Philippine Society of Public Health Physicians said: “We have been in this fight since March. We feel we are nearing the end of our line. We are appealing for everyone’s help.” 

The Philippines imposed one of the longest and strictest lockdowns in the region not seen in other countries, but the doctors said poor detection, isolation, and contact tracing have failed to contain the disease. Since lockdowns were eased, outbreaks in construction sites and industrial plants have been reported.

COVID-19: A viral epidemic splintering into deadly pieces

Via The New York Times: A Viral Epidemic Splintering Into Deadly Pieces. Excerpt:

Once again, the coronavirus is ascendant. As infections mount across the country, it is dawning on Americans that the epidemic is now unstoppable, and that no corner of the nation will be left untouched.  

As of Tuesday, the pathogen had infected at least 4.3 million Americans, killing almost 150,000. Many experts fear the virus could kill 200,000 or even 300,000 by year’s end. Even President Trump has donned a mask, after resisting for months, and has canceled the Republican National Convention celebrations in Florida.  

Each state, each city has its own crisis driven by its own risk factors: vacation crowds in one, bars reopened too soon in another, a revolt against masks in a third.  

“We are in a worse place than we were in March,” when the virus coursed through New York, said Dr. Leana S. Wen, a former Baltimore health commissioner. “Back then we had one epicenter. Now we have lots.”

To assess where the country is heading now, The New York Times interviewed 20 public health experts — not just clinicians and epidemiologists, but also historians and sociologists, because the spread of the virus is now influenced as much by human behavior as it is by the pathogen itself.  

Not only are American cities in the South and West facing deadly outbreaks like those that struck Northeastern cities in the spring, but rural areas are being hurt, too. In every region, people of color will continue to suffer disproportionately, experts said. 

While there may be no appetite for a national lockdown, local restrictions must be tightened when required, the researchers said, and governors and mayors must have identical goals. Testing must become more targeted. 

In most states, contact tracing is now moot — there are simply too many cases to track. And while progress has been made on vaccines, none is expected to arrive this winter in time to stave off what many fear will be a new wave of deaths. 

Overall, the scientists conveyed a pervasive sense of sadness and exhaustion. Where once there was defiance, and then a growing sense of dread, now there seems to be sorrow and frustration, a feeling that so many funerals never had to happen and that nothing is going well. The United States is a wounded giant, while much of Europe, which was hit first, is recovering and reopening — although not to us.

“We’re all incredibly depressed and in shock at how out of control the virus is in the U.S.,” said Dr. Michele Barry, the director of the Center for Innovation in Global Health at Stanford University.

With so much wealth and medical talent, they asked, how could we have done so poorly? How did we fare not just worse than autocratic China and isolated New Zealand, but also worse than tiny, much poorer nations like Vietnam and Rwanda?

“National hubris and belief in American exceptionalism have served us badly,” said Martha L. Lincoln, a medical anthropologist and historian at San Francisco State University. “We were not prepared to see the risk of failure.”

COVID-19 and China: Lessons and the way forward

An editorial in The Lancet: COVID-19 and China: lessons and the way forward.

China has largely controlled COVID-19. A country of 1·4 billion people and a size similar to Europe or the USA now reports only clusters of cases rather than widespread community transmission. China has been widely criticised for its role and responsibilities during the pandemic because of censorship, transparency, and human rights concerns. But the rest of the world can still learn from China's successes in bringing its outbreak under control. 

China's response shows the importance of domestic research and public health capacity. Huge investments have left China much better prepared for COVID-19 than for severe acute respiratory syndrome (SARS). When SARS broke out in 2002, China was unprepared initially, especially as the pathogen was unknown. When COVID-19 emerged in December, 2019, Chinese scientists were quickly able to identify the virus and shared genomic sequencing data internationally on Jan 11, 2020. By the end of January, doctors from mainland China and Hong Kong had characterised the clinical features of patients with COVID-19, person-to-person transmission, genomic characteristics, and epidemiology, warning the world about the threat of COVID-19 with research papers published in The Lancet. China has also been at the forefront of vaccine research, with promising results of early trials of a recombinant adenovirus type-5-vectored COVID-19 vaccine developed in China published in The Lancet in May and July. 

Such research was done incredibly fast and rigorously through close cooperation within China at a time of national emergency. For other countries, particularly low-income and middle-income countries, China's experience shows the importance of investing in national health and research systems to enhance laboratory capacity as well as workforce. They are fundamental to a quick and effective national response to health emergencies and to global health security.

A second lesson is that a robust foundation of research cannot guarantee effective control without strong top-level political commitment to use science to tackle the outbreak decisively. Governments and their leaders must respect science, understand its value, and act on it in a way that is best for society. China's National Health Commission sent three groups of national infectious disease experts to Wuhan at the beginning of the outbreak to investigate the risks and transmission of COVID-19, and their recommendations informed the decision to lockdown Wuhan on Jan 23. When Chen Wang, president of the Chinese Academy of Medical Sciences, and colleagues saw the need for Fangcang shelter hospitals, the government was quick to respond. 

Third, achieving rapid and effective implementation of control measures for COVID-19 requires broad community engagement. Community solidarity has been unprecedented during the COVID-19 outbreak in China. Control measures that could sacrifice individual freedom, like mandatory mask-wearing in public areas, were accepted readily by the public. Millions of China's community workers have “built the first line of defense against COVID-19”, according to Xinhua News Agency, in their work to provide essential health checks and support for people with fever, severe diseases, pregnant women, and those quarantined at home. 

There are tensions between freedom and security that each country has to reckon with, and some of China's approaches to surveillance, for example, would not be acceptable elsewhere. But China's experiences show the importance of community solidarity and what it can achieve. 

So, there are lessons for health to learn from China. But how will Chinese and global health communities work together in the future? China's Foreign Minister Wang Yi has said that globalisation needs to be more inclusive and beneficial to all, that multilateralism must be safeguarded and promoted even more firmly, and that global governance needs to be reformed and improved where it is most lacking. The health community is waiting to see if China will become a multilateral leader in global health, what role it wants in international global health security, and whether it will aspire to fill the vacuum in global health left by the USA. 

China is facing legitimate questions in many areas of its domestic and foreign policy, but when it comes to COVID-19, scapegoating China for the pandemic is not a constructive response. “Now is the time for global leaders to decide: will we succumb to chaos, division and inequality? Or will we right the wrongs of the past and move forward together, for the good of all?”, as UN Secretary-General António Guterres asked in his 2020 Nelson Mandela Annual Lecture. 

Tackling a global health emergency like a pandemic requires open collaboration. The lack of global solidarity to address COVID-19 amid geopolitical instability is a threat to us all.

Maxmen: Ebola prepared these countries for COVID-19 — but now even they are floundering

Via Nature.com, Amy Maxmen writes: Ebola prepared these countries for coronavirus — but now even they are floundering. Excerpt:

Health officials who fought Ebola during the world’s deadliest outbreak of the disease in Liberia, Sierra Leone and Guinea have resurrected the tools they used during that crisis to stave off the coronavirus. Initially this led to a swift and coordinated response, and these nations have kept the number of infections low compared to many other countries around the world. But coronavirus is presenting additional challenges, and cases are on the rise.  

When COVID-19 first appeared in the region in mid to late March, health officials employed the strategies honed during the 2014–2016 Ebola outbreak, including isolating people who test positive for the virus and quarantining those who may have been in contact with it. 

These actions probably slowed the spread of the virus. The incidence of COVID-19 reported in the three West African countries — between 2 and 5 cases per 10,000 people — is at least 12 times less than in South Africa, and 22 times lower than the rate in the United States. “We had the experience of Ebola, so the political will was there from the start,” explains Mosoka Fallah, the director of the National Public Health Institute of Liberia. 

But infection rates are rising and for complex reasons. Researchers in these West African nations say that infections are hard to spot owing to asymptomatic cases among the overwhelmingly young population. Another challenge is that the three countries are among the world’s poorest, and their health systems lack resources to protect staff and care for people with the disease. 

Fallah says that slowing the transmission of the virus has become especially hard as it reaches impoverished communities without running water and electricity. There, people share latrines and wells, and go to markets regularly to purchase food that cannot be stored at home. He says, “my fear is that the coronavirus is beginning to spread from the affluent to the poor, where social distancing is almost impossible.”  

Following China’s lead 

As the coronavirus spread in January, Fallah met with the Liberian president George Weah to form a coronavirus task force that included many of the same doctors and public health experts that led the Ebola response. The group resurrected the main pillars of outbreak response. This included acquiring coronavirus tests from the World Health Organization (WHO), coordinating teams of people to trace contacts and communicating health messages to the public. In operation centres in the capitals of the three countries, each COVID-19 task force began to meet regularly to adapt responses to the latest situations. Just as they had done during the Ebola outbreak.  

Tolbert Nyenswah, the former director of Liberia’s public health institute, says the US Centers for Disease Control and Prevention (CDC) had helped to teach health officials these methods during the Ebola outbreak. Now based in Baltimore, Maryland, as a researcher at Johns Hopkins University, Nyenswah says he was stunned that the CDC downplayed these essential procedures in its own country. 

“I was shocked to see the US struggling to understand what contact tracing is, to organize a response, to put in place risk communication,” he says. 

The coronavirus task forces in Liberia, Sierra Leone and Guinea decided to follow China’s lead; they isolate everyone who tests positive — regardless of symptoms. People who are very sick go hospitals, while those with no symptoms or mild illness are sent to special facilities until they test negative. Baimba Idriss, a physician at 34 Military Hospital in Freetown, Sierra Leone, explains that isolating at home is impractical in the country. 

“A young person might be healthy, but they live with their grandmother, their aunts, their neighbours, and we need to break that chain of transmission — and also monitor people so that if they have breathing difficulties we can treat them early,” he says.

COVID-19: Europe said it was pandemic-ready. Pride was its downfall

A long, appalling report in The New York Times: Europe Said It Was Pandemic-Ready. Pride Was Its Downfall. You'd better read the whole article; it explains a great deal. And it is not kind to the "muddlers" at Imperial College London. Excerpt:

LONDON — Prof. Chris Whitty, Britain’s chief medical adviser, stood before an auditorium in a London museum two years ago cataloging deadly epidemics.  

From the Black Death of the 14th century to cholera in war-torn Yemen, it was a baleful history. But Professor Whitty, who had spent most of his career fighting infectious diseases in Africa, was reassuring. Britain, he said, had a special protection.  

“Being rich,” he explained.  

Wealth “massively hardens a society against epidemics,” he argued, and quality of life — food, housing, water and health care — was more effective than any medicine at stopping the diseases that ravaged the developing world.  

Professor Whitty’s confidence was hardly unique. As recently as February, when European health ministers met in Brussels to discuss the novel coronavirus emerging in China, they commended their own health systems and promised to send aid to poor and developing countries.  

“Responsibility is incumbent on us, not only for Italy and Europe, but also for the African continent,” said Roberto Speranza, Italy’s health minister. 

“The European Union should be ready for support,” agreed Maggie De Block, Belgium’s then health minister.  

Barely a month later, the continent was overwhelmed. Instead of serving primarily as a donor, providing aid to former colonies, Western Europe became an epicenter of the pandemic. Officials once boastful about their preparedness were frantically trying to secure protective gear and materials for tests, as death rates soared in Britain, France, Spain, Italy and Belgium. 

This was not supposed to happen. The expertise and resources of Western Europe were expected to provide the antidote to viral outbreaks flowing out of poorer regions. Many European leaders felt so secure after the last pandemic — the 2009 swine flu — that they scaled back stockpiles of equipment and faulted medical experts for overreacting.

But that confidence would prove their undoing. Their pandemic plans were built on a litany of miscalculations and false assumptions. European leaders boasted of the superiority of their world-class health systems but had weakened them with a decade of cutbacks. When Covid-19 arrived, those systems were unable to test widely enough to see the peak coming — or to guarantee the safety of health care workers after it hit.

The Trump administration’s terrible record on COVID-19 data

Via the Columbia Journalism Review: The Trump administration’s terrible record on coronavirus data. Excerpt:

Recently, the Trump administration told hospitals to stop sharing data on COVID-19, the disease caused by the coronavirus, with the Centers for Disease Control and Prevention. Instead, hospitals were to share information with a private company contracted by the Department of Human and Health Services. 

The company, TeleTracking Technologies, won its HHS contract in a noncompetitive process in April; around the same time, the department also contracted Palantir, the data-mining company founded by Peter Thiel, an early ally of Trump, to take on other data-collection functions from the CDC. 

The administration’s order, which took effect on Wednesday, seems a blow to transparency: the CDC published the patient data it collected from hospitals, but the TeleTracking database is private. Researchers and reporters who use the data are worried that vital information is being withheld for the sake of politics.  

Administration officials insist that bypassing the CDC is an efficiency measure, and that adequate data will remain available to the public. In an interview with Greta Van Susteren, of Gray TV, on Wednesday, Vice President Mike Pence said that “the American people can anticipate full transparency.” 

The same day, however, journalists noticed that the CDC’s website had taken down data on hospital capacity that it had previously shared. Online, experts reacted with dismay. 

“I had hoped it was a glitch, but no,” Charles Ornstein, a healthcare reporter and editor at ProPublica, tweeted. Dr. Eric Feigl-Ding, of Harvard, added, “epidemiologists are pulling our hair out!” 

HHS blamed the CDC for unilaterally removing the data; Michael Caputo, a former Trump campaign aide who is now an HHS spokesperson, accused the CDC of “a fit of pique,” and said that department officials had since ordered that the data be restored. Yesterday, the CDC restored existing hospitalization data and added Tuesday’s figures; it also appended a note saying that the data will never again be updated.  

The way the CDC collects and shares data is inefficient, to be sure, and not always reliable. As Ornstein reported in April, the CDC was initially slow to share hospitalization data at all. In May, the agency said that it had been combining data on tests for active COVID infections and data on tests for antibodies into a single figure—which bolstered a misleading impression that Trump was on top of testing. As I wrote last week, the New York Times went to court to force the CDC to release data on the racial disparities in COVID transmission; even then, the information provided was substantially incomplete. 

Trump officials have insisted—albeit without wishing to be named, for the most part—that taking hospitalization data away from the CDC is not censorship, but rather a good-faith effort at streamlining. 

“They’re suffering because of their lack of credibility,” an unnamed Republican told Politico, of the administration. “The problem is they had a chance to tell this story—which is not necessarily a bad story—but they didn’t do it.” 

Perhaps unwittingly, the unnamed Republican hit the key point—hospitalization data may be made public someday, and the new system for collecting it from hospitals may work better than the CDC’s, but for now, the press has no reason to believe either of those things. When it comes to pledges of transparency, the Trump administration has proved time and again that it doesn’t deserve the benefit of the doubt—on the coronavirus or anything else. 

In the past few weeks, Trump has said repeatedly that testing is bad because it shows positive cases; unnamed White House officials have dumped opposition research on Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases; and Republicans have insisted that the devastating spread of the virus is mere media scaremongering.