Here is a fascinating new bit of information. It’s not new per se. But either I hadn’t heard about it or perhaps it’s simply been overrun in the furious last month of news. As recently as the end of February, the US Commerce Department was encouraging US companies to take advantage of newly relaxed Chinese import regulations to export masks, ventilators and other COVID-relevant medical supplies to China.
This appears potentially quite important. Since it has to do with technical clinical details and treatment protocols I’ll try to be both as precise and general as possible. Yesterday I noticed this grainy youtube video posted on March 31st by a New York City emergency and critical care physician, Cameron Kyle-Sidell. Kyle-Sidell said that he thought the treatment protocol and basic understanding of acute COVID-19-induced respiratory distress were both wrong. He said that what he is seeing in his ICU does not look like pneumonia but rather oxygen deprivation (hypoxia). Thus the treatment shouldn’t be focused on high pressure for someone whose lungs aren’t able to function but rather more effective ways of delivering additional oxygen. Critically, he argued that the high pressure ventilation might be damaging the lungs. He also said his impressions were based both on his ICU work over the previous two weeks and conversations with other clinicians around the country.
In our on-going efforts to form a clearer picture of the true scale of mortality in the COVID-19 crisis yesterday I referenced a tweet by the New York City Council’s health committee which noted a 10 fold run up in the number of deaths that are being reported in homes across New York City. Here’s a great piece of reporting from WNYC/Gothamist filling out the details of what is happening.
I want to thank you and again encourage you to keep sending in the emails. They are providing a huge assist to our understanding of the crisis and thus what we are able to report to the larger TPM community. Some is showing up in reports you’ve already seen. More we’re still in the process of reporting out. For confidential tips about information you know, for guidance based on your general knowledge of key aspects of the story (epidemiological, clinical career, transport logistics, et al.) and just for links to new press reports. These are all hugely helpful. Keep them coming. We cannot always respond but all of these emails are being looked at closely.
My routine as a kid was pretty simple. I’d wake up, grab the Cleveland Plain Dealer (or The News-Herald, published in the neighboring county) sports section, read every single story and then try as best I could to memorize every box score, statistic and name for every sport. I loved (and love) sports. I also loved the Plain Dealer, but sadly the Plain Dealer is being murdered.
We are still in a space where we’re just getting hints and clues about just how this COVID-19 Crisis response is being handled, who’s doing what and just how much private companies are involved – and if so whether they are being allowed to extract windfall profits. Here’s a snippet from yesterday’s Morning Joe where The Washington Post’s Robert Costa reported that Jared Kushner’s role in the taskforce is largely to liaise with GOP donors and the White House’s corporate allies. I think that speaks for itself.
Robert Costa on Kushner's role in White House COVID response: "Jared Kushner is there and he's really being a liaison to different donors and corporate allies of this administration, which has created confusion about the chain of command." pic.twitter.com/S8avc0UPIM
— Josh Marshall (@joshtpm) April 7, 2020
White House press secretary Stephanie Grisham is returning to the first lady’s team as chief-of-staff, leaving behind a likely calculated legacy of not once holding a press briefing.
Been a long day. So I don’t have time for a full write up. But the airlift program and the shipment seizures are finally getting some big media org attention. The Times put out this article tonight. They were able to name the entity on the West Coast which I alluded to as having a shipment seized but wasn’t at liberty to name: Kaiser Permanente hospital system. They also add more detail on the airlift. The companies can sell half on the open market, half they have to allocate according to need as ascertained by FEMA. The details on seizures raise more questions than they answer. Give it a read. More tomorrow.
Here are a couple more details on shipment seizures and inter-state bidding we’ve been discussing here in recent days. Both are interviews on this evening’s Newshour, flagged to me by TPM Reader KM.
Gov. J.B. Pritzker (D-IL) appeared to confirm one point that remained ambiguous from the press conference last week in which Rear Admiral Polowczyk explained the ‘Airbridge’ flights from China. According to Pritzker, the US military planes airlift the PPE and other medical supplies to the US and then hand them over to the major medical supply distributors the White House taskforce is working with. That part was clear from the discussion April 2nd. What Pritzker confirmed is that the states then have to bid against each other to purchase the supplies from those distributors.
There’s some very tentative information today that New York may be nearing the peak of its outbreak. I want to emphasize very tentative. If we go by the progression in the hardest hit countries in Europe, even if this is at or near the peak we are likely to see more days where numbers spike again. And I will finally say that there has been evidence of some numbers slowing over weekends. With all that, the number of fatalities in New York was lower yesterday and today than it was on Saturday when it hit 630. The number of new hospitalizations has also slowed while discharges have risen. There’s also some evidence of decline in new cases. But, as we’ve discussed, this can simply be an echo of testing constraints. We can finally note that before its revisions yesterday, the IHME COVID-19 model had predicted that New York would hit its peak on April 6th.
If this does turn out to be the plateau of the epidemic in New York I want to share some information about dates and how they compare with the remarkably consistent pattern from China and Italy.
The resistance some states have shown to implementing aggressive coronavirus responses has led public health experts to call for President Trump to issue nationwide stay-at-home guidance.
Staying mentally grounded has become increasingly difficult as COVID-19 continues to dominate the news cycle and our lives. Finding things to help distract ourselves and to get out of our heads for a little bit are a must, whether it’s a new hobby or skill, talking to family and friends, TV shows, movies or a good book. While we at TPM join much of the world in practicing social distancing, we asked our staff to share what books they’re reading while they cope with isolation.