#BLOOD ON THEIR HANDS!

Although I am actually not on Twitter, this should be the new trending hashtag all across the country!  We have been waiting to see how Trump would handle a real national crisis, and although few if any expected it to be a pandemic, we are now getting to find out. Despite the unfortunate reality that government at every level is inherently inefficient, incompetent and corrupt, especially in dealing with crises of all types (witness hurricane Katrina), the critical importance and impact of leadership at the top cannot be denied. There would undoubtedly be missteps, possibly major ones, with any administration’s efforts to deal with the greatest national health crisis in over a century, but those of Trump and his administration are glaring, appalling and ultimately deadly. 

Although the middle of a pandemic is not the best time for both sides to use valuable resources to battle this out, Trump et al need to be exposed and strongly called out for their previous and ongoing failings. It’s great that the idiot-in-chief has finally realized that regardless of the economy, it could make him look pretty bad to have at least tens and possibly hundreds of thousands of Americans dying from a pandemic on his watch, so he has finally recently come around to accept the necessity of shutting everything down for a prolonged period to try to minimize the viral spread. This is probably thanks to strong lobbying and good psychology on the part of Anthony Fauci, Deborah Birx et al and disease models projecting huge death tolls. Deprived of his ability to hold his mass rallies, Trump has hijacked the daily televised late afternoon virus task force briefings, originally dominated by Pence, and which conveniently compete with network local and national news, for his own free political exposure and propaganda. I have to admit that I find myself frequently talking back to Trump on the TV screen, usually alternating between “what a fucking moron” and “what a fucking asshole”. So now Trump takes almost every opportunity during these drawn out affairs to brag about what a great job he and his whole crew are doing (Hot campaign idea: a Trump doll with a battery operated self back-patter!), and to try to rewrite history, claiming how his unprecedented halt on travel from China and subsequently from parts of Europe (he just says Europe) saved countless lives. Well, those were certainly good moves, but it is undeniable (unless you are Trump, Pence or any of his cronies) that Trump consistently denied, downplayed and even ridiculed as a Democratic and media hoax the epidemic in the US for well over a month, as memorialized on many video clips. Some of these clips are already being used in early Democratic campaign ads, and this will doubtless continue throughout the campaign. As a result of Trump’s reckless gamble that this virus would just miraculously fade away, doubtless despite briefings from medical experts to the contrary, priceless time was lost while the virus silently took hold in communities across the country, leading to exponentially greater unimpeded and undetected spread.

Partly related to this neglect and compounded by CDC incompetence and poor judgment, the capacity for testing has been a catastrophic disaster from the beginning. As a result, doctors and public health officials were essentially operating in the dark for well over a month. Testing capacity has still not nearly caught up to the demand, including routine wait times for results of a week or more from commercial labs! Although finally developed and approved, rapid tests, which are essential for effective patient management, have not even started to become available to any useful extent. All this has resulted in the missed and delayed diagnosis of countless cases, and with it the missed opportunity for early contact tracing and isolation, not to mention missing cases in both symptomatic and asymptomatic health care and nursing home workers, which has needlessly put many patients and other health workers at risk. These testing shortages and delays continue in most places, where testing is still largely limited to symptomatic people with risk factors, with no end in sight despite almost daily promises by task force officials for the past month of millions of tests becoming available “very soon”! There have only been about 1.1 million tests done so far, and about half of the data from those has not even reached the task force for analysis! The bottom line is that this epic testing failure has resulted in who knows how many needless infections and deaths, as well as totally inadequate knowledge of the prevalence of the disease to allow the public health experts and government leaders to make optimally informed decisions regarding the best policies to enact. In short, Delay = Death!! 

The same applies to the delayed and haphazard development and institution of social distancing and stay at home orders and advisories from the CDC as well as from local, state and federal governments, including the virus task force and Trump himself. Many Republican governors as well as regular Trump supporters have clearly taken their cues from the imbecile-in-chief and ignored (and some still ignore) all the critical public health advisories. Although some states (all with Republican governors) have still refused to institute statewide stay at home orders, most local and state governments have fortunately taken the initiative to institute various lockdowns, though some much earlier and stricter than others, despite Trump’s early lack of leadership and conflicting and inadequate CDC and other federal guidelines. Trump himself was shaking hands long after that was universally discouraged, and still does not practice proper social distancing on the speaker’s platform of his daily briefings. This confused and mixed messaging and the delay and non-uniformity of the social distancing and stay at home policies resulting from the lack of strong presidential and federal leadership is another major example of Delay = Death.

The other major disaster is the current and looming nationwide shortage of personal protective equipment and ventilators for hospitals and healthcare workers, as well as ICU and other bed capacity and staff shortages, particlularly in current hot spots. This exposes the huge inherent limitations of the existing healthcare system to deal with pandemics or other major disasters, and the reality that the state and/or federal government must step in to fill that void. Unfortunately we are now witnessing how ill-prepared our government is to do that, which should come as no surprise to anyone. National stockpiles of equipment of all kinds are too small and also apparently poorly maintained and outdated, with recent shipments of masks to some states found to be 10 years past their expiration date and/or moldy, and entire shipments of ventilators all non-functional! Trump had to be dragged kicking and screaming into invoking and finally using (but still only to a limited extent) the defense production act, but it looks like that will be too little too late for the current surge of cases, and FEMA is still reportedly not adequately overseeing the entire supply chain, leading to mass chaos and forcing states to bid against each other and against the feds for scarce equipment on the commercial market, with FEMA sometimes commandeering equipment already ordered by the states! Fortunately many governors and state and local governments have taken extraordinary measures to deal with the crisis, including creating makeshift hospitals, some in conjunction with the Army Corps of Engineers, but it is clear that they cannot and should not be expected to handle this alone. Outrageously but not surprisingly, Trump has as much as said that he expects the governors to show personal appreciation to him if they want him to help them!!   

Many hospitals in the hardest hit cities have already been drastically rationing and reusing PPE in anticipation of imminent shortages, which may well be resulting in unnecessary infection of doctors and nurses as well as patients. Although it remains to be seen whether this happens, several cities are expecting to run out of available ventilators within a week despite their governors constantly begging the feds for more. Trump has publicly cast doubt on NY Governor Cuomo‘s estimate for the needed number of ventilators for the peak of infection, and has even made the vague accusation, of course without any evidence, that some of what he thinks are overly numerous extra masks that hospitals claim they need are somehow mysteriously disappearing, i.e. being stolen. Although I realize this probably won’t happen, in my opinion if patients end up dying in the hardest hit cities as a result of lack of available ventilators when those are still sitting in federal stockpiles, then assuming Trump loses in November, the affected states’ attorneys general should consider charging Trump, Pence and the head of FEMA with negligent homicide! 

And what about the political implications of all of this, including the unfolding economic disaster, the severity and duration of which remain to be determined? It is incredible that so far Trump‘s approval rating has actually been inching upward during this disaster, although that does tend to happen for any leader in a crisis. Like anything else in politics, most people are probably not even paying close attention to everything that is going on that doesn’t personally affect them, even in a pandemic. So, many people tuning into Trump’s daily propaganda sessions may fall for his lies, con-boasts of doing a fantastic job and claims that the economy will bounce back stronger than ever in no time without hearing all the evidence to the contrary. My guess is that depending on how things go, Trump will probably try to portray himself as the savior of the country through this crisis in the fall campaign, including on how he lowered the death rate from the estimate of 1.6-2.2 million if no action were taken to whatever it ends up being. And who to blame? Although there is plenty of legitimate blame to go around, the victim-in-chief is already variously blaming China, Obama and all other previous administrations, the governors and the media for the inadequate preparation and response, and will probably figure out some way to blame the Democrats in general. He also keeps repeating the lie that nobody could ever have predicted any of this. And the Democratic primary process has essentially ground to a halt, with the convention now postponed until August. It remains to be seen whether the expected widespread anger and discontent over the economic disaster resulting from the shutdown, on top of whatever the Democrats can successfully hammer home about the colossal bungling of the Trump administration’s response to the virus, contributes to anti-incumbent voting in November. It’s still way too early to accurately predict anything, being still in the relatively early stages of the greatest public health crisis and possibly also the greatest economic crisis of our lifetime. 

I hope everyone tries to stay safe and healthy! Good luck to all! And THANK YOU to all the health care workers and first responders!!!!