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The Surging Coronavirus Finds a Federal Leadership Vacuum

first_imgDr. Shikha Gupta, the executive director of Get Us PPE, a volunteer effort that matches available supplies to health care providers, said 70 percent of those requesting help from the organization last month reported being completely out of one type of critical gear. Masks, gloves and disinfecting wipes topped the list.“Health care workers are exhausted and frustrated, and it’s really hard to believe that on Nov. 10, it feels very much like the middle of March all over again,” she said. “We’re hitting the highest numbers of caseload that we’ve ever seen, and we’re running into the same problems that we’ve been having since Day 1.”Governors are once again competing with one another and big hospital chains for scarce gear. Nursing homes are grappling with staff shortages, which have left hospitals unable to discharge patients to their care. In Wisconsin, the situation is so severe that health officials are mulling a plan to train family members of nursing home residents to fill in at facilities that lack enough workers.- Advertisement – “We’re throwing every idea that we can conceivably think of to the state, but we really need bold action from the federal government,” said John Sauer, the president of LeadingAge Wisconsin, an association that represents nonprofit nursing homes and long-term care facilities. “We can’t muddle through this on our own.” But as the country enters what may be the most intense stage of the pandemic yet, the Trump administration remains largely disengaged. President-elect Joseph R. Biden Jr. is trying to assume a leadership mantle, with the appointment of a coronavirus advisory board and a call for all Americans to wear masks, but until his inauguration on Jan. 20, he lacks the authority to mobilize a federal response.“With 1,000 deaths per day, it’s like two jumbo jets dropping from the sky,” said Dr. Carlos del Rio, an infectious disease specialist at Emory University who is close to Dr. Deborah L. Birx, the White House coronavirus response coordinator. “If every day, two jumbo jets would drop from the sky and kill everybody, don’t you think that everybody would be in a panic? But somehow, we’re not doing that. Somehow, as a nation we’re not outraged.”“We need a Churchill,” he added. “We need somebody to step into the vacuum and lead the nation.”Instead, Mr. Trump is at war with his own health officials. He was furious after the drug maker Pfizer announced Monday that early clinical trial data suggested its coronavirus vaccine was more than 90 percent effective. In a conversation with Dr. Hahn, a senior administration official said, the president accused the company and the F.D.A. of conspiring to delay news that could have bolstered his chances of re-election.Aides said the president believed that Pfizer could have announced the success of its clinical trial before Nov. 3 but deliberately chose to hold up the news, possibly not to taint the company’s vaccine as a last-minute effort to save Mr. Trump’s re-election bid. White House aides were particularly incensed that Mr. Biden publicly said his public health advisers knew of Pfizer’s results on Sunday, before aides said the news had reached the White House.Beyond Mr. Trump’s Twitter feed, the federal bully pulpit — an essential component of an effective infectious disease response — has largely gone silent. Dr. Anthony S. Fauci, the government’s top infectious disease expert, said in an interview on Tuesday that the vaccine would be “a game changer” over time. The pandemic caught the nation flat-footed in March, but epidemiologists have been warning for months of a fall and winter wave as people are driven indoors, schools resume in-person classes and Americans grow tired of months of precautions. Yet shortages of personal protective equipment are back, especially among rural hospitals, nursing homes and private medical practices that lack access to the supply networks that serve larger hospital chains.- Advertisement – He questioned Dr. Hahn’s timeline for an emergency authorization of Pfizer’s vaccine.The president’s allies suspected that Pfizer could have obtained results from its trial earlier, but chose not to. Pfizer had in fact initially planned to request seeing the results from an independent safety monitoring board once 32 of its clinical trial participants who had received either the vaccine or a placebo had come down with Covid-19. That would have been the company’s first barometer of its effectiveness.But weeks ago, Pfizer officials said, F.D.A. regulators had advised that they would be unlikely to issue an emergency use authorization for Pfizer’s vaccine based on just 32 cases in a trial with nearly 44,000 people.Pfizer decided to wait for more cases. By last weekend, 94 subjects had tested positive for Covid-19, a sample seemingly more than sufficient to satisfy the F.D.A. The company said an early analysis showed the vaccine was more than 90 percent effective.Pfizer has said it expects to apply for emergency use authorization by late November, and experts expect the F.D.A. to decide as early as mid-December. But Pfizer has said it has manufactured only a few million doses, and experts are hoping the government can step in to help speed up manufacturing. A second vaccine maker, Moderna, could soon seek F.D.A.’s review of its clinical trial results. The United States is on somewhat better footing now than in the earliest days of the pandemic. States and hospitals have their own stockpiles, and Admiral Polowczyk said the federal government had met its goal of acquiring 153,000 ventilators. Dr. del Rio said federal health officials such as the health secretary, Alex M. Azar II, or Dr. Robert R. Redfield, the director of the Centers for Disease Control and Prevention, must begin convening daily news conferences to provide public health guidance.In the absence of leadership, local officials feel as if they are struggling alone. New weekly cases among nursing home residents jumped fourfold from the end of May to late October, and deaths have more than doubled in 20 states, according to R. Tamara Konetzka and Rebecca J. Gorges, researchers at the University of Chicago who analyzed data from the C.D.C.“The depressing message is that nothing much has changed since the spring,” Professor Konetzka said.Even many large hospital chains, which say they have adequate supplies of medical gear, continue to operate in crisis mode. That often means requiring employees to repeatedly reuse respirator masks that are meant to be discarded after each use.Deborah Burger, a president of National Nurses United, the largest organization of registered nurses, said the lack of clear guidance from the C.D.C. had allowed hospitals to create their own standards for reusing disposable protective gear, which she said put hospital workers and patients at increased risk of infection.“We’re 11 months into the pandemic, and the administration is still not adequately addressing the safety of health care workers and the safety of our communities,” she said. “I’ve been a nurse for over 45 years, and I have never seen anything like this. It’s like we’re in ‘The Twilight Zone.’”The White House has fixated on Operation Warp Speed, the administration’s crash vaccine and therapy development program, while its coronavirus task force has whittled down to rote weekly gatherings in the Situation Room. But far from celebrating the Pfizer news on Monday, the administration initiated a round of recriminations. But a vaccine is not an immediate panacea, and until doses become widely available — likely in mid-2021 — the nation is in a “difficult situation,” he said, that calls for Americans to wear masks and social distance, and to avoid crowded settings, particularly indoors.“My message to the American public is: Hang on, help is coming, a vaccine is on its way, we need to all pull together,” Dr. Fauci said.Washington’s leadership void is raising anxiety in the states.“We’re facing a dire situation as we head into the fall and winter,” said Casey Katims, the federal liaison for Gov. Jay Inslee of Washington State.In Ohio, Gov. Mike DeWine, a Republican, canceled his customary Tuesday afternoon virus news conference and instead planned to deliver a statewide address early Wednesday evening as local officials reported a daily caseload of more than 6,500 — nearly 1,000 more than the record set on Saturday.In North Dakota, Gov. Doug Burgum said this week that the state’s hospitals were full and that even health workers who test positive for the virus but do not display symptoms would be allowed to work in wards dedicated to coronavirus patients.center_img WASHINGTON — When senior Food and Drug Administration officials held their morning call on Tuesday, they received a sobering warning from the agency’s chief, Dr. Stephen M. Hahn, who had just gotten off the phone with the White House: Block out “all the craziness” afoot and stay focused on fighting the pandemic, he said.There is plenty of craziness. President Trump is pushing to overturn the results of the election and his only public statements about the coronavirus in the last few days were to make clear his pique that good news about a vaccine had not come until after Election Day — even as the average number of new daily infections topped 116,000, average daily deaths neared 1,000, and Covid-19 hospitalizations hit a record high of 61,964 on Tuesday.- Advertisement – In a Twitter message on Monday, Mr. Trump said that Pfizer deliberately postponed announcing its good news, and that the F.D.A. had supported that delay.In a meeting of the coronavirus task force on Monday afternoon, Mr. Azar confronted Dr. Hahn about the Pfizer announcement and said the F.D.A.’s coordination with Pfizer and its exhaustive vaccine guidelines had delayed the news of the breakthrough, according to senior administration officials who witnessed the exchange. On Monday, the F.D.A. granted emergency authorization to Eli Lilly for an antibody treatment similar to a therapy given to Mr. Trump shortly after he contracted the coronavirus. The company has a limited number of doses and the treatment is only authorized for newly infected patients who have not been hospitalized.Some in the agency took Dr. Hahn’s Tuesday warning to his senior staff members about “craziness” afoot as a sign that the president might fire him. Others said the commissioner was merely acknowledging the obvious: The postelection period will be rocky.Sheryl Gay Stolberg, Sharon LaFraniere and Noah Weiland reported from Washington, and Andrew Jacobs from New York. Reporting was contributed by Maggie Haberman and Jo Becker from New York, Katie Thomas from Chicago, and Sheila Kaplan from San Francisco. “Leadership does matter,” said Dr. Howard Markel, a professor of the history of medicine at the University of Michigan who helped shape federal social distancing policy during the George W. Bush administration. “What your leaders do, like flaunting the mask or having parties without masks, almost encourages people to do the same.” Vice President Mike Pence canceled a vacation at the last minute this week as the virus numbers grew worse, but the White House coronavirus task force that he leads has been all but publicly silent. Mark Meadows, the White House chief of staff who is infected with the virus, declared last month, “We are not going to control the pandemic,” and said the focus should instead be on the longer-term goals of developing vaccines and treatments.Meantime, the Strategic National Stockpile, the nation’s emergency reserve, has only 115 million N95 masks, far short of the 300 million the administration had hoped to amass by winter, Rear Adm. John Polowczyk, who retired on Monday as the national supply chain commander, said in a recent interview, though he added that the government is continuing to expand its supplies of protective gear. – Advertisement –last_img read more

Mascot change a symbol of new brand

first_imgUSC doesn’t throw out some cartoon, costumed mascot on the football field like many other colleges. Instead, Tommy Trojan rides his noble steed Traveler around the field to pump up the crowd. And the pair often succeeds in rousing the Coliseum after each USC touchdown.The basketball team, however, appears to be going in a different direction — and not just because there’s no room for Traveler to gallop around the Galen Center.On Wednesday, USC unveiled the new Tommy Trojan and Traveler, a more kid-friendly version of the mascot with full-on cartoon costumes. The new mascots will be cheering from the Galen Center every home game for both the men’s and women’s basketball team.The mascot change in itself is not a major development in USC athletics, but sparks a greater discussion that the basketball team has clearly answered and the football team will be asked at the end of this current season: What’s next?USC men’s basketball comes into its season opener today at Utah State with a drastically different-looking program from last season. The biggest change of course is new head coach Andy Enfield, the high-flying bundle of energy taken from Florida Gulf Coast to lead this year’s team.Enfield led Florida Gulf Coast University to the Sweet Sixteen of last year’s NCAA Division I National Championship tournament. Florida Gulf Coast had easily the maddest run of March Madness — well, save for maybe Kevin Ware’s right fibula. The Eagles came into the tournament as a No. 15 seed and shocked the No. 2-seeded Georgetown Hoyas, then upset the 7-seeded San Diego State Aztecs before ultimately falling to          No. 3-seeded Florida.The Eagles used a fast-paced style, pushing transition whenever possible and avoiding set 5-on-5 half-court possessions, and had arguably the best dunkers in the tournament.USC basketball, on the other hand, spent all of March Madness on the couch. For the second year in a row, the men’s team didn’t qualify for the 68-team tournament. The team finished 14-18 overall with a slightly more respectable 9-9 finish in Pac-12 play. Former head coach Kevin O’Neill was fired midway through the year after going 6-26 the year before with only one win and 17 losses in conference play. Former interim head coach Bob Cantu did well to prevent the season from becoming another complete failure like the year before, but the team still missed the tournament.Athletic Director Pat Haden obviously wanted to make a splash in the coaching market to see if that would turn things around in the Galen Center. So the Trojans made Enfield a contract offer he could not refuse — no surprise that USC has a little more financial support behind its storied athletic program than Florida Gulf Coast — and fans have been anxiously waiting to see the new look of the team ever since.Enfield isn’t the only change to this year’s basketball team. Since Enfield was announced as the new head coach, several noteworthy players have transferred to USC, including former Maryland point guard Pe’Shon Howard, former UNLV shooting guard Katin Reinhardt and former Charlotte forward Darion Clark. Though the new players might not be enough for USC to legitimately compete for the Pac-12 title just yet, the surge of player interest since the new hire shows how much a coach can influence the recruiting process.The question Enfield will have to answer is if an exciting new recruiting pitch is enough to change the program’s dynamics. Will March Madness become a rite of passage for USC basketball players every year like it is for schools such as Duke, UNC, Louisville or even UCLA? Is transitioning to a fun style of play all that it will take to build some tradition around USC basketball?It’s the same question USC football will have to address at the end of the season. Unlike Enfield’s squad, the Trojans who compete in the Coliseum already have a lot of tradition to build on. But recent struggles beg the question of whether or not a team needs something more in today’s game.Should USC bring in a football coach that can run a spread offense? Is the traditional pro-style offense that won USC two Heismans and two national titles (insert NCAA sanction joke here) from 2004 to 2005 too old-school? Can USC rely on its tradition, or does it need to change the face of the football program with a new coach, new offense and even a new costumed mascot?The pro-style offense is the same style that legendary head coach John McKay relied on to mold USC into a national power long before Pete Carroll came and built upon the tradition. But today, so many teams are replacing traditional offenses with no-huddle, hurry-up, pass-heavy, dual-threat quarterback offenses because the system is both much more fun to watch and much more fun to play, regardless of any real strategic benefit that such a system could bring.Interim head football coach Ed Orgeron has shown on the football field that the right coach can certainly make a huge difference just by bringing a bunch of new energy, even if most of the style of play stays the same. Maybe the basketball team didn’t need to totally change the team’s style of play, and just needed to bring in more enthusiasm at the head coaching position.USC has some time before it has to answer all of the football team’s big questions. For now, Trojan fans can finally start enjoying one of the greatest times in all of USC sports, when the tail end of football season overlaps with the beginning of basketball season and fans have twice as many games to watch.And since the basketball team tips off tonight at Utah State, the Trojan faithful won’t have to wait long to see if a new coach — or mascot — on the court is all the program needs to kick-start a streak of success to rival that of their counterparts on the football field. “Holthouse Party” runs every other Friday. To comment on this story, email Luke at cardinalsandgold@gmail.com or visit dailytrojan.com.last_img read more

Ghana faces toughest test so far against Morocco

first_imgGhana coach Maxwell Konadu has warned his Black Satellites team that this Sunday’s clash against Morocco will be the toughest test so far.The men’s U-20 team host their North African opponents in the first leg of the final-round qualifier for the 2013 African Youth Championship at the Tamale Stadium.Konadu, who hopes his side can push for a good first leg win to improve their chances of reaching next year’s finals has cautioned his team against looking beyond Sunday’s match.“This will be our toughest task so far,” Konadu said ahead of the game.“We need to be relaxed but be filled with the determination needed to win such a game. We must get a good home result.”The Ghana coach fully expects his side to claim a win in Tamale and continue their great work towards qualifying as the aggregate winner over both legs will qualify for next year’s Championship in Algeria. “I’m confident we’ll keep up the good work on Sunday. We have to impose ourselves on the game against Morocco, create chances and not be in a rush but finish off well,” he explained.Seven teams will make it from the qualifiers and join hosts, Algeria, in the finals next year.last_img read more