Ok, fire them all when you donāt have enough health care workers. That makes a lot of sense. I think every healthcare worker should speak up.
I also think all the admin should be helping in ER & ICU with the same amount of PPE as their staff.
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This just happened to me:
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Oh gods.
āSailors do not need to dieā: Captain of aircraft carrier hit by coronavirus outbreak begs Navy for more help
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Did you ever feel the left hand did not know what the right hand was doing??
See how Pence is now stopping shipments of healthcare supplies to USAID rcountries - like Thailand. Oops thatās something our American Hospitals need.
Last week, a Trump administration official working to secure much-needed protective gear for doctors and nurses in the United States had a startling encounter with counterparts in Thailand.
The official asked the Thais for helpāonly to be informed by the puzzled voices on the other side of the line that a U.S. shipment of the same supplies, the second of two so far, was already on its way to Bangkok.
Trump aides were alarmed when they learned of the exchange, and immediately put the shipment on hold while they ordered a review of U.S. aid procedures. Crossed wires would only confuse our allies, they worried, or worseāoffend them. And Americans confronting a surging death toll and shortages of medical equipment back home would likely be outraged.
Vice President Mike Pence soon realized another step was needed: After a phone call asking a foreign leaderās help with key supplies, he ordered his staff to make sure the review process wasnāt holding up coronavirus-related aid to countries that were assisting the United States.
The incidents have spurred the Pence-led coronavirus task force to scrutinize all of USAIDās deliveries to countries requesting personal protective equipment (PPE) needed to fight the outbreak, according to people directly involved in the discussions, causing tensions between aid officials and task-force members.
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After sending broken and insufficient supplies to blue states, Trump sent Republican Governor of Florida Ron DeSantis TWICE what he asked for.
Texas āmom and popā business flooded with orders for helmet ventilators amid coronavirus crisis
Sea-Long Medical Systems has drawn huge interest from hospitals and foreign countries seeking alternatives in treating COVID-19 patients amid a ventilator shortage.
In the midst of the coronavirus pandemic itās tempting to draw comparisons to the most severe pandemic in recent history - the 1918 flu. But as much as we can learn from the comparison, itās important to also understand just how much these two pandemics differ. This week, what we can learn from what happened then and, just as importantly, where the comparison should end.
HHS holding up delivery of 2,000 U.S. ventilators, Pentagon says
I disagree with this author about whether Fox should be sued; the First Amendment does not protect you if your words cause active, knowing harm, such as shouting āfireā in a crowded theater, and their actions on screen and behind the scenes were at complete odds. They knew they were spreading disinformation.
Social distancing canāt last forever. Hereās what should come next.
Scientists say a moonshot effort is needed to end social distancing and this pandemic. Will leaders listen?
Why Germanyās Coronavirus Death Rate Is Far Lower Than In Other Countries
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Really worth watching. Clever humor reaches people.
Mayor Lori Lightfoot launches humorous āstay home, save livesā anti-coronavirus public service announcements
Loeffler reports more stock sales amid insider trading allegations
How 3-D Printers Are Helping to Fight the Coronavirus
Partisanship is the strongest predictor of coronavirus response
Among Americans, partisanship has been a stronger predictor than age, gender, geography, even personal experience, a new study shows.
Trump rejects Obamacare special enrollment period amid pandemic
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More on Trumpās blatant favoring of red states over blue states in this crisis:
Governors plead for medical equipment from federal stockpile plagued by shortages and confusion
As states across the country have pleaded for critical medical equipment from a key national stockpile, Florida has promptly received 100 percent of its first two requests ā with President Trump and Republican Gov. Ron DeSantis both touting their close relationship.
States including Oklahoma and Kentucky have received more of some equipment than they requested, while others such as Illinois, Massachusetts and Maine have secured only a fraction of their requests.
Itās a disparity that has caused frustration and confusion in governorsā offices across the country, with some officials wondering whether politics is playing a role in the response.
Governors are making increasingly frantic requests to the Federal Emergency Management Agency for materials. State and congressional leaders are flooding FEMA with letters and calls seeking clarity about how it is allocating suddenly in-demand resources such as masks, ventilators and medical gowns.
āFrustration level is high,ā Wisconsin Gov. Tony Evers (D) said of the struggle to find ventilators for patients infected by the novel coronavirus. āWeāre hoping weāll be able to get them. The federal government needs to help us with that. Thereās no question.ā
Governors and state officials have become increasingly frustrated by what they describe as a byzantine and unsteady process for distributing medical supplies from the Strategic National Stockpile. As they try to combat a worsening pandemic, several have complained about chaos and disarray within the system and a lack of guidance about how they can secure lifesaving supplies, according to interviews and documents from officials in more than a dozen states.
Evers told FEMA on Friday that Wisconsin still needs 190,000 nonsurgical masks, adding that he thought some of the supplies were stuck in a bureaucratic queue. Oklahoma received 120,000 face shields despite requesting only 16,000, according to the stateās health department. North Carolina, by contrast, requested 500,000 medical coveralls and received 306, state records show.
Thereās no direct evidence that Republican states are receiving more favorable treatment overall, and some GOP-led states such as Georgia have had trouble filling their requests. But Trump has contributed to the sense that politics could be a factor by publicly attacking Democratic governors who criticize his handling of the public health crisis.
Trump said last week that he is inclined not to speak with anyone who is insufficiently appreciative of his administrationās efforts. He has touted his personal relationships with several governors while also declaring that the federal government wonāt be āa shipping clerkā for local officials who seek help in obtaining masks, ventilators and other critical supplies. States should buy the materials themselves, he said.
āAll I want them to do ā very simple ā I want them to be appreciative,ā Trump told reporters Friday. āI donāt want them to say things that arenāt true. I want them to be appreciative. Weāve done a great job. And Iām not talking about me. Iām talking about Mike Pence, the task force; Iām talking about FEMA, the Army Corps of Engineers.ā
Aides to governors in some states say they are wary of angering the president or making comments even slightly critical of his administration, fearful that he will lash out at them as they seek help.
But the chaotic system has made it difficult for some governors to bite their tongues.
New York Gov. Andrew M. Cuomo (D) had harsh words for the process Tuesday, comparing a lack of federal coordination toābeing on eBay with 50 other states, bidding on a ventilator.ā
New York has the nationās worst outbreak, and Cuomo has said he needs 30,000 ventilators. In addition to providing only 4,400 from the stockpile, FEMA has been outbidding states on the private market, Cuomo said.
āWhat sense does this make?ā he told reporters. āThe federal government, FEMA, should have been the purchasing agent. Buy everything, and then allocate it by need to the states.ā
Still, some Democrats have given the Trump administration plaudits for being accessible and for responding to their requests. Even after verbally attacking Democrats such as Michigan Gov. Gretchen Whitmer and Washington Gov. Jay Inslee, Trump has approved federal support for their states.
A senior Democratic gubernatorial aide involved in the response effort said White House and FEMA officials usually return calls promptly and they always agree to consider requests.
This aide said officials in his state havenāt been threatened directly if they donāt praise Trump. And the president has generally been receptive to requests on the phone, he said.
āBut we watch the news, we see what he says about people who criticize him,ā said the aide, who, like some others, spoke on the condition of anonymity to discuss internal deliberations.
Trump touted his relationship with some Democratic governors during an interview with Fox News on Monday, saying it reflected his strong federal response.
āI get along with many of them because Iām doing a good job,ā he said. āThey wouldnāt be getting along with me if I wasnāt producing.ā
But privately, state and congressional officials have expressed alarm about a system beset by shortages, inefficiencies and disorder.
Some boxes of equipment have arrived in states unexpectedly. One shipment to Minnesota arrived in the middle of the night, when the stateās warehouse to receive it was closed, said Deborah Radi, the stateās manager of public health emergency preparedness. Officials in North Carolina said they were scheduled to receive a shipment on Tuesday but did not know what it would contain.
Things have gone more smoothly in Florida, where Trumpās call for states to get their own equipment does not appear to have hurt DeSantisās ability to access the federal stockpile.
Three days after requesting 430,000 surgical masks, 180,000 N95 respirators and other equipment on March 11, Florida received all of the items. The state received an additional shipment less than two weeks later. As of late last week, it was awaiting a third shipment.
Asked Sunday about Floridaās success with the stockpile, Trump hailed the state for being āvery aggressive in trying to get things.ā
Officials in Florida have pointed to the close relationship between DeSantis and Trump as a helpful tool in shaping federal policy. The two speak almost daily. Trump has formed an especially close relationship with DeSantis, a former congressman whose pugilistic defenses of the president helped him secure a race-changing endorsement in his 2018 bid for governor. Trump will probably need the 29 electoral votes of his adopted homestead to win reelection.
During a phone call on Saturday, DeSantis complained about people with the coronavirus traveling from New York to Florida. Minutes later, Trump publicly said he was considering a quarantine for New York, New Jersey and Connecticut. He ultimately decided against it.
One White House official said Trump is attuned to the electoral importance of Florida in November, giving added weight to the arguments DeSantis has made to the administration that his stateās economy should reopen as soon as possible.
āThe president knows Florida is so important for his reelection, so when DeSantis says that, it means a lot,ā said the official, who spoke on the condition of anonymity to be frank. āHe pays close attention to what Florida wants.ā
DeSantisās office did not respond to requests for comment.
A FEMA spokeswoman, Lizzie Litzow, said requests by states are evaluated by federal task forces at the White House and FEMA. Officials weigh whether the needs are best met by the national stockpile or whether materials procured from the private sector can fill the gap, she said.
An administration official with knowledge of the rationing process said political affiliation is not a consideration in processing requests, though Trump has occasionally made promises over the phone that FEMA has had to accommodate. Aides now brief him in advance of calls about each stateās needs, the official said.
Statesā allocations are made based in part on their population, how many people they have in the hospital, existing state resources, the hospital utilization rate and overall risk levels, according to two administration officials, who spoke on the condition of anonymity to discuss the internal process. Modeling curves showing how much the virus might spread in a given state are also taken into account.
FEMA also looks at what is left in the stockpile and makes decisions based on how much remains ā given the request.
āWe try to pressure-test what they need because some of these governors are asking for a lot more than they really need,ā the official said.
New Jersey Gov. Phil Murphy (D) said his request for about 2,300 ventilators was not āoverasking.ā The state has received 300.
āThey have a limited supply of stuff, and our asks are significant,ā he said in an interview. āOur asks are significant, and we are persistent.ā
Murphy said that he had spoken to Trump several times, including on Friday and Saturday, and that the administration had āwar-gamedā how they were handling ventilators in a āfrank, fact-based conversation.ā
He said the federal government had been responsive in building emergency medical centers and setting up drive-through testing sites in New Jersey.
As states have been encouraged to pursue supplies on the open market, some have expressed concerns that they are being preempted because of federal competition.
āOur experience has been that other contracts weāve entered into have been delayed or have been diverted to the federal government, as has been the case in Massachusetts and Illinois and Kentucky,ā Whitmer said Monday.
She said she was talking to āeverybody,ā including the FEMA administrator and officials with the U.S. Army Corps of Engineers, as well as with Vice President Pence āa couple of times in the last few days.ā
While Michigan has received only a fraction of what it has requested from the stockpile, Whitmer offered praise for the federal government ā a different tack than the sharp criticism that led Trump to attack her publicly last week.
āWeāre grateful for the work that theyāre doing,ā she said.
Candice Broce, a spokeswoman for Georgia Gov. Brian Kemp Ā®, said, āThe Trump administration has been an invaluable partner in Georgiaās fight to mitigate the effects of covid-19.ā
But figures from the stateās health department reveal a shortfall in equipment supplied by the federal government. As of Tuesday, the state had received one-quarter of the requested N95 masks and just over a third of requested ventilators.
Oklahoma had received nearly 84,000 N95 mask as of Sunday, more than twice its original request, according to the Oklahoma State Department of Health.
In Kentucky, state officials had received more than they had asked for of certain materials after a second request for masks and gloves, according to materials provided as part of an open-records request. The state is still awaiting test kits, however.
Meanwhile, other states were short on critical resources, owing in part to spoiled materials.
A U.S. Conference of Mayors report released on Friday reported that 28 cases of masks shipped to Montgomery, Ala., had dry rot. The governorās office in California said it received 170 broken ventilators from the national stockpile. A sustainable-energy company fixed the devices.
There was also confusion about the scope of certain shipments and where in the federal system they were coming from. Pennsylvania received some shipments without packing lists, leaving officials there unsure about what they had been given, said Nate Wardle, a spokesman for the stateās health department.
A spokesman for Louisiana Gov. John Bel Edwards (D) said Sunday that the state has requested 5,100 ventilators from the federal government and received none. On Monday, Edwards said Trump in a conference call promised him ventilators soon. Edwards said that his state still needed protective gear but that the situation had improved.
Ohio applied for aid early, and the federal government obliged its request with shipments of personal protective equipment. Even with the aid, fewer than 30 percent of Ohio hospitals have an adequate supply of masks and shields, according to the stateās department of health.
āItās important to note the supplies we received do not match the items nor the amount we requested,ā agency spokeswoman Melanie Amato said.
Taxpayers Paid Millions to Design a Low-Cost Ventilator for a Pandemic. Instead, the Company Is Selling Versions of It Overseas.
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Research: Droplets travel up to 27 feet
Jordan Culver
USA TODAY
The novel coronavirus has prompted social distancing measures around the world. One researcher believes itās not enough.
Lydia Bourouiba, an associate professor at MIT, has researched the dynamics of exhalations (coughs and sneezes) at The Fluid Dynamics of Disease Transmission Laboratory and found exhalations cause gaseous clouds that can travel up to 27 feet.
Her research could have implications for the global COVID-19 pandemic, though measures called for by the Centers for Disease Control and Prevention and the World Health Organization call for six and three feet of space, respectively.
āThereās an urgency in revising the guidelines currently being given by the WHO and the CDC on the needs for protective equipment, particularly for the frontline health care workers,ā Bourouiba told USA TODAY.
Bourouibaās research calls for better measures to protect health care workers and, potentially, more distance from infected people.
In a Journal of the American Medical Association article published last week, Bourouiba said peak exhalation speeds can reach 33 to 100 feet per second and ācurrently used surgical and N95 masks are not tested for these potential characteristics of respiratory emissions.ā
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And Brazil has some terrible numbers with Coronavirus and they have weather now in the 80ās. So hot weather does not prevent the spread or kill out the virus.
Numbers - Cases New Cases Deaths
Brazil 6,836 +1,119 240
From Worldometers.
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Does this now mean that T needs to be nice to her, in Michigan?
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Iām inclined to believe this [that droplets can actually travel up to 27ā]ā¦it really explains how so many members that participated in a choir practice then became sick (& a few died); when you sing, your mouth is open & youāre projecting your voice as well as āmistingā everyone inadvertentlyā¦you just mostly cannot see it. What a sad way to prove the science though.
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Because Pandemic expert Tony Fauci would override what T says and give us the facts - that is what upsets far-right groups and reason to threaten Fauci.
Two feeds of newsā¦two sets of beliefsā¦and just an unreal state of affairs in a world and country being consumed by a pandemic.
Fauci, 79, is the most outspoken member of the administration in favor of sweeping public health guidelines and is among the few officials willing to correct President Trumpās misstatements. Along with Deborah Birx, the coordinator for the White Houseās task force, Fauci has encouraged the president to extend the timeline for social-distancing guidelines, presenting him with grim models about the possible toll of the pandemic.
āNow is the time, whenever youāre having an effect, not to take your foot off the accelerator and on the brake, but to just press it down on the accelerator,ā he said Tuesday as the White Houseās task force made some of those models public, warning of 100,000 to 240,000 deaths in the United States.
The exact nature of the threats against him was not clear. Greater exposure has led to more praise for the doctor but also more criticism.
Fauci has become a public target for some right-wing commentators and bloggers, who exercise influence over parts of the presidentās base. As they press for the president to ease restrictions to reinvigorate economic activity, some of these figures have assailed Fauci and questioned his expertise.
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The situation in China is a sad one. The Chinese government most definitely hid the extent of the epidemic early on, and continues to do so.
Florida governor issues stay-at-home order after weeks of resistance
And THIS is why we tell Trump not to call it the āChinese Virusā.
Doctor kicked out of Ind. gas station for being Asian in coronavirus-related discrimination
I made a little something for Donnie:
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It turns out that the reason so many ventilators in the national stockpile are broken is once again due to Trump regime incompetence. This doesnāt explain why all the broken ones are getting shipped to blue states, though.
But what federal officials have neglected to mention is that an additional 2,109 lifesaving devices are unavailable after the contract to maintain the governmentās stockpile lapsed late last summer, and a contracting dispute meant that a new firm did not begin its work until late January. By then, the coronavirus crisis was already underway.
Apparently severe shivering, or ārigorsā, is emerging as a symptom to watch for:
A White House report blows up Trumpās latest coronavirus defense
President Trump has adopted a new line of spin to explain away his catastrophic handling of the worst U.S. public health emergency in modern times: If we had listened to those misguided people who wanted to treat the new coronavirus as the seasonal flu, weād be in much worse shape right now.
Thank goodness for Trump, who is sagely telling us the coronavirus is not like the flu at all.
Of course, one of the people who wanted us to treat the coronavirus as the flu early on was Donald Trump. He repeatedly compared it to the flu as a way of downplaying it.
That Trump would try this new spin is absurd enough on its own. But a newly surfaced report from inside Trumpās own White House makes this line even more preposterous and untenable.
The report was produced in 2019 by the White House Council of Economic Advisers. It was first reported by the New York Times, which noted that the report warned a pandemic could devastate the U.S. economy, but that this warning went āunheeded.ā
But for our purposes here, what matters is that the report also explicitly warned against treating a pandemic as a seasonal flu ā and demonstrated how such a mind-set could hamper our appreciation of the damage pandemics can do.
Thatās very inconvenient for Trump, given his latest spin. At his press briefing on Tuesday, Trump claimed that āmanyā people argued early on that the correct response to coronavirus was to āride it out and think of it as the flu.ā
āThink what would have happened,ā Trump said, adding: āItās not the flu. Itās vicious.ā
But as CNN documents, Trump did this himself ā repeatedly. In late February, Trump claimed the coronavirus is āa little like the regular flu,ā and that āweāll essentially have a flu shot for this in a fairly quick manner.ā
And in early March, Trump said thousands die annually from the flu, but that ānothing is shut down, life & the economy go on,ā while claiming coronavirus has proven far less fatal ā in effect telling us to ride it out.
This is where the newly discovered report from White House economists comes in.
The White House report
The reportās focus is on influenza pandemics. These can wreak enormous economic damage, the report argues, so the federal government should work with the private sector to develop vaccine responses to them. Thatās because ordinary market incentives donāt encourage such innovation, as such vaccines only sell in times of pandemic risk.
Crucially, the report also explains at length the differences between such pandemics and the seasonal flu ā and indeed, it stresses that these differences are a key reason we need do more to prepare for them.
It is precisely because pandemics are far more rare than a seasonal flu that āthe population largely lacks residual immunityā to them, the report says. It adds that the state of virus-producing infrastructure is behind the curve, in the sense that it cannot ramp up quickly enough in such rare situations.
This means āthe infection will spread rapidly during the early weeks of a pandemic, when there is a large pool of unexposed people,ā which makes it āimperative to find ways to mitigate the impact.ā It recommends federal efforts to speed up vaccine-production technologies for exactly this reason.
Now, in one sense, it would be unfair to hold Trump responsible for failing to heed this report. As James Joyner points out, the report doesnāt say: A pandemic is coming! A pandemic is coming! Its focus is on the damage pandemics do, and on the need to improve readiness for them.
But in a different and important sense, the report does underscore the folly of early comparisons between coronavirus and seasonal flu. Itās the differences between pandemics and the seasonal flu that render the former such a threat. To conflate them is to actively downgrade that threat.
Indeed, this is exactly why public health experts forcefully challenged Trumpās early comparisons of the two. As Charles Ornstein reported back in mid-March, experts were warning that the comparisons were themselves dangerous, because they risked creating the impression that our health system was more prepared for the new coronavirus than it actually was.
As we now are learning, our health system is not remotely prepared for it. And Trumpās regular downplaying of the threat over weeks and weeks is a key culprit. It helped fuel a massive failure to ramp up testing, allowing the coronavirus to rampage, and a failure to deploy federal power to secure needed lifesaving equipment in time for cases to swamp hospitals.
Internal worries about the threat
Thereās one other angle here worth pursuing. As the Times notes, this report was done at the request of the National Security Council.
Joshua Geltzer, a senior NSC official from 2015 to 2017, said this suggests NSC officials might have thought pandemic preparedness was a serious matter that needed more focus from the administration.
āIf Iām at the NSC, and Iām worried that national security arguments on this issue arenāt getting the leadershipās attention, I might request this study in hopes that economic arguments get more traction,ā Geltzer told me. āThis shows that at least some NSC officials really worried about the threat.ā
Trumpās conflation of the coronavirus with the seasonal flu is only one failing among many, to be sure. But itās indicative of the broader mind-set that has plagued us all along. This report from the White House itself illustrates this clearly. For Trump to now claim others fell prey to this failing is doubly ridiculous.
Behind the scenes, Kushner takes charge of coronavirus response
Trumpās son-in-law sets up shop at FEMA as his portfolio balloons to include manufacturing, supplies and long-term planning.
Trump resists pressure to declare nationwide stay-at-home order
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COVID-19 Tracking Resources
Some of these have been posted earlier in this thread, but here they are in one place for convenience. Additions appreciated!
BTW, Iāll be taking extended time off for personal reasons ā no worries, all is well. Even when Iām not posting, WTFJHT is my daily lifeline!
Onward to November! Iāll be working hard to help Mike Levin (CA-49) keep the House seat he flipped to Blue in 2018 ā and working even harder to flip the Senate and, most of all, the White House. Cheers!
Vote Blue Through and Through! 
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The scramble for the rapid coronavirus tests everybody wants
As hot spots clamor for Abbott Laboratoriesā quick tests, Trump officials debate where to send them
And now weāre at this:
Not sure what to make of this, but I note that Massachusetts, a fairly blue state with a Republican governor, is having the same issues many blue states are having with getting anything out of Trump.
Bob Kraft sends Patriots plane to China to get equipment for Mass.
Army Warned in Early February That Coronavirus Could Kill 150,000 Americans
While the president was still downplaying the COVID-19 epidemic, an Army briefing shared with The Daily Beast shows the service warning of the scale of death Trump now concedes.
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More on political attitudes and behavior wrt covid-19. From one of the study authors. New: rural non-Democrats are ignoring directives.
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Funny you mention that, I literally just saw this:
Fact check: Trump again misleads on ventilator shortages and coronavirus timeline at off-topic briefing
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This could be a game changer. Getting a single test to check for antibodies which would help us understand the numbers who have been infected and potentially immune from getting Covid-19.
We have been waiting for an across-the-board testing phase, not the highly selective ways they are testing for the virus. That antibody test can help determine how many people actually had Covid-19 and can clear up any false-negatives appearing in actual testing.
Researchers at Mayo Clinic expect to release a test that would tell whether a person has had and recovered from COVID-19 on Monday. The Star Tribune reports the University of Minnesota is also narrowing in on an antibody test.
The tests would help public health officials understand the scope of the outbreak and identify people who could safely be in public to help with relief efforts. They would also help in an effort to treat critical COVID-19 patients with plasma from individuals who have recovered.
As to the testing for Covid-19
The chief medical officer at the practice where the tests were ordered is betting that the positive result is the right one.
āA false negative is problematic because it tells the patient they donāt have the virus,ā said the doctor, Craig Deligdish, an oncologist at Omni Healthcare, a Melbourne, Fla., medical group. Meanwhile, that patient can unwittingly spread it, he said.
Health experts say they now believe nearly one in three patients who are infected are nevertheless getting a negative test result. They caution that only limited data is available, and their estimates are based on their own experience in the absence of hard science.
That picture is troubling, many doctors say, as it casts doubt on the reliability of a wave of new tests developed by manufacturers, lab companies and the U.S. Centers for Disease Control and Prevention. Most of these are operating with minimal regulatory oversight and little time to do robust studies amid a desperate call for wider testing.
āThe whole testing field is in flux,ā said Bill Miller, a physician and epidemiologist at the Ohio State University. āThe thing that is different this time is most of these tests are going through a really rapid validation process. As a result we canāt be completely confident in how they will perform.ā
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The Coronavirusās Unique Threat to the South
More young people in the South seem to be dying from COVID-19. Why?
Editorās Note: The Atlantic is making vital coverage of the coronavirus available to all readers. Find the collection here.
In a matter of weeks, the coronavirus has gone from a novel, distant threat to an enemy besieging cities and towns across the world. The burden of COVID-19 and the economic upheaval wrought by the measures to contain it feel epochal. Humanity now has a common foe, and we will grow increasingly familiar with its face.
Yet plenty of this virusās aspects remain unknown. The developing wisdomāearned the hard way in Wuhan, Washington, and Italyāhas been that older people and sicker people are substantially more likely to suffer severe illness or die from COVID-19 than their younger, healthier counterparts. Older people are much more likely than young people to have lung disease, kidney disease, hypertension, or heart disease, and those conditions are more likely to transform a coronavirus infection into something nastier. But what happens when these assumptions donāt hold up, and the young people battling the pandemic share the same risks?
The world is about to find out. So far, about one in 10 deaths in the United States from COVID-19 has occurred in the four-state arc of Louisiana, Mississippi, Alabama, and Georgia, according to data assembled by the COVID Tracking Project, a volunteer collaboration incubated at The Atlantic . New Orleans is on pace to become the next global epicenter of the pandemic. The virus has a foothold in southwestern Georgia, and threatens to overwhelm hospitals in the Atlanta metropolitan area. The coronavirus is advancing quickly across the American South. And in the American South, significant numbers of younger people are battling health conditions that make coronavirus outbreaks more perilous.
The numbers emerging seem to indicate that more young people in the South are dying from COVID-19. Although the majority of coronavirus-related deaths in Louisiana are still among victims over 70 years old, 43 percent of all reported deaths have been people under 70. In Georgia, people under 70 make up 49 percent of reported deaths. By comparison, people under 70 account for only 20 percent of deaths in Colorado. āUnder 70ā is a broad category, not really useful for understanding whatās going on. But digging deeper reveals more concerning numbers. In Louisiana, people from the ages of 40 to 59 account for 22 percent of all deaths. The same age range in Georgia accounts for 17 percent of all deaths. By comparison, the same age group accounts for only about 10 percent of all deaths in Colorado, and 6 percent of all deaths in Washington State. These statistics suggest that middle-aged and working-age adults in the two southern states are at much greater risk than their counterparts elsewhere; for some reason, they are more likely to die from COVID-19.
All data in this stage of the pandemic are provisional and incomplete, and all conclusions are subject to change. But a review of the international evidence shows that, as far as we know, the outbreaks currently expanding in the American South are uniqueāand mainly because of how many people in their working prime are dying. Spainās official accounting of the pandemic last week showed that deaths among people under 70 years old make up only about 12 percent of total deaths in the country. Case-fatality rates around the world are notoriously tricky because they are based in part on the extent of testing, but a recent study of the outbreak in Wuhan, China, found a case-fatality rate of 0.5 percent among adults from the ages of 30 to 59. The current estimate of fatality rates in the same age range in Louisiana is about four times that.
A recent analysis from the Kaiser Family Foundation might shed some light on whatās going on here. The paper, drawing on the CDC guidelines, identifies people who may be at risk of serious complications from COVID-19. Kaiserās at-risk group includes all people over 60 years old and all adults younger than 60 who also have heart disease, cancer, lung disease, or diabetes. In each state, older people are the majority of the people considered to be at risk of complications. But the Deep South and mid-South form a solid bloc of states where younger adults are much more at risk. In Arkansas, Alabama, Kentucky, Tennessee, Louisiana, and Mississippi, relatively young people make up over a quarter of the vulnerable population. Compare that with the coronavirusās beachhead in Washington State, where younger adults make up only about 19 percent of the risk group.
Tricia Neuman, a senior vice president at the Kaiser Family Foundation, says this analysis points to the underlying issues that might complicate or worsen the pandemic in the South. āDue to high rates of conditions like lung disease and heart disease and obesity, the people living in these states are at risk if they get the virus,ā Neuman told me. These arenāt āpeople who are sick, but these are people who have underlying comorbidities that put them at higher risk of serious illness if they get infected.ā
The KFF analysis doesnāt include potential complications from hypertensionāwhich is also suspected to be driving coronavirus-linked hospitalizationsābut the data are predictable on that front. If you define Oklahoma as part of the South, southern states fill out the entirety of the top ten states in percentage of population diagnosed with hypertension by a doctor. Southerners are more likely to suffer from chronic diseases than other Americansāeven as Americans are more likely to suffer from chronic disease than citizens of other countries with comparable wealth. According to Neuman, these estimates donāt include people with cancer or who are immunocompromised ā groups that are also at high risk for serious illness from COVID-19. And cancer mortality rates are highest in southern states.
These differences are not innate to southerners; they are the result of policy. Health disparities tend to track both race and poverty, and the states in the old domain of Jim Crow have pursued policies that ensure those disparities endure. The South is the poorest region in the country. The poor, black, Latino, or rural residents who make up large shares of southern populations tend to lack access to high-quality doctors and care. According to the State Health Access Data Assistance Center, Mississippi, North Carolina, Texas, Florida, Georgia, and Louisiana all spend less than $25 per person on public health a year, compared to $84 per person in New York. Nine of the 14 states that have refused to expand Medicaid to poor residents under the Affordable Care Act are in the South. And many of those states are led by Republican leaders who have imitated President Donald Trumpās dallying and flip-flopping, and now find themselves flat-footed.
The slow response from those governors will be even more ruinous in a region with so many challenges. Chronic disease and the apparent increased risk for younger people from COVID-19 are only part of the story in the South. Other factors could complicate its pandemic response. Advocates have drawn attention to the extreme vulnerability of people in prison to the coronavirusāand the South incarcerates a larger proportion of its population than anywhere else in the United States. A federal prison in Louisiana has already seen a spike in COVID-19 cases this week. Also, a global fear in this pandemic is that it will sicken health professionals and doctors, and leave them unable to contend with waves of hospitalizations. Southern states have some of the lowest ratios of active physicians to patients in the country.
In all, the South seems likely to be a new kind of battleground, one in which distancing and isolation are going to be especially important in stopping the virus. Centuries of policy gave the pandemic a head startāand younger targetsāin the South. Now there are mere days to change course.
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