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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

H1N1 FLU BREAKING NEWS: Vaccine development, underreporting of cases, Mexico City lowers alert as Australia raises it

first_imgMay 22, 2009HHS funnels $1 billion toward vaccine for novel H1N1 fluHealth and Human Services (HHS) Secretary Kathleen Sebelius announced today that she is allocating about $1 billion in existing funds toward clinical vaccine studies this summer and for commercial-scale production of both antigen (active ingredient) and adjuvant (which boosts a person’s immune response) for a novel H1N1 influenza vaccine. “The actions we are taking today will help us be prepared if a vaccine is needed,” Sebelius said in a news release.[May 22 HHS news release]Global novel flu numbers rise slightlyGlobal novel H1N1 influenza totals pushed to 11,168 cases and 86 deaths, the World Health Organization (WHO) reported today. The Philippines reported its first case, to push the number of affected countries to 42 as the global case total grew by 134 since yesterday. The numbers include 3,892 cases with 75 deaths in Mexico, 5,764 cases and 9 deaths in the United States as of yesterday, 719 cases and 1 death in Canada, and 20 cases and 1 death in Costa Rica.[WHO update 36]US case count tops 6,500The number of confirmed and probable novel H1N1 flu cases in the United States today swelled to 6,552, up 212 cases from yesterday, the Centers for Disease Control and Prevention (CDC) reported. No new deaths were reported. Also, no new states reported cases, to hold the total of affected states at 47, plus the District of Columbia.[Current CDC numbers]Cases underreported in Britain?Some influenza experts suspect that the number of novel H1N1 influenza cases may be higher than reported in Britain, the Associated Press reported today. The country is reportedly trying to contain the virus by blanketing suspect cases and their contacts with oseltamivir, which several experts, such as Michael T. Osterholm, PhD, MPH, at the University of Minnesota, said won’t work. According to the AP, Britain and Spain are also testing only those who have a travel history or are case contacts.[May 22 AP story]Mexico City downgrades alertMexico City yesterday lowered its novel flu alert, which removed restrictions on visiting public places, the British Broadcasting Corporation (BBC) reported. The city’s mayor, Marcelo Ebrard, said resident no longer need to wear masks, and he noted that no new infections with the novel flu virus had been reported for a week in the city.[May 22 BBC article]Australia raises its pandemic alert levelAustralia’s health ministry today raised its pandemic alert to the “containment” phase, as the number of novel H1N1 influenza rose to 11 and the country detected its first instance of community transmission of the virus, Bloomberg News reported. Two schools closed for a week after student cases were confirmed, and health officials are testing 28 more suspected cases. The government also said it was considering ordering H1N1 vaccine from Australia-based CSL Ltd.[May 22 Bloomberg News story]last_img read more

UCF QB McKenzie Milton says severe knee injury could have resulted in amputation

first_img“It wasn’t excruciating pain. It was like a shock. That kind of moment feels like a dream almost,” he said.The junior quarterback had to be carted off the field and underwent surgery soon after suffering the injury. But in the end, he was lucky it didn’t turn out worse. Related News Utah coach Kyle Whittingham signs contract extension through 2023 “It was tough, but at the same time, 50 percent of people that suffer my injury — I had a knee dislocation and a popliteal artery — have to have their leg amputated.”He continued: “I’m already beating the odds by the grace of God. When you have a knee dislocation, you tear everything. It was miracle after miracle.”Milton threw for 2,663 yards with 25 touchdowns and six interceptions for the Knights last year. He also rushed for 307 yards and nine touchdowns.Now he begins his long road back to playing football as he is expected to miss the entire 2019 season. “For me right now, I’m just checking off like little accomplishments at a time,” he said. “On Friday, I’ll be able to start weight bearing on my legs. That’s a little check. When I first got hurt, I had to take blood thinners and take shots in my stomach every day. So when I had to stop doing those, that was a little check.”In two months, I’ll be able to walk in my brace, so that’s a little check. For me, I’ve always looked at small victories like those will add up inch by inch and then it’ll be something big when it comes into fruition.”Central Florida will hold a quarterback competition next season with Milton out. Darriel Mack Jr., who took over the starting job for Milton, will get a chance to be next season’s starter, along with Brandon Wimbush, who transferred from Notre Dame in the offseason. Central Florida quarterback and 2018 Heisman Trophy contender McKenzie Milton is taking recovery one day at a time.Milton suffered a severe knee injury in UCF’s win over South Florida at the end of last season and revealed how dangerous his situation was in an interview on Real Radio 104.1 (via the Orlando Sentinel) on Tuesday.last_img read more

Bill Bryce receives Micklem Award

first_img Bill Bryce, who has spent over 40 years at the highest levels of golf administration, has received England Golf’s Gerald Micklem Award for his outstanding contribution to the game. He was presented with the award by England Golf’s outgoing President, Nigel Evans, at the organisation’s annual meeting today. “I feel honoured and delighted to receive this award and to join such a distinguished list of former recipients,” said Bill. “Golf has been a huge part of my life and it has given me so much. A great deal of that is due to my involvement with the English Golf Union and England Golf, for which I am very grateful.” Bill is a Scot who has been one of the most prominent figures in England golfing life, having been President of the former English Golf Union and, most recently, chairing the England Golf Partnership for ten years until his retirement last year. But his contribution to the game extends far beyond England, for he has been a member of the R&A since 1974, chairing three of its committees, and has also represented England on the European Golf Association council and been a member of its championship committee.  As a referee he has officiated at 10 Open Championships, three US Masters, one Ryder Cup and two Walker Cups as well as the St Andrews and Jacques Leglise Trophies. He has also visited the United States and Japan on many occasions representing the R&A. Bill began playing golf in Glasgow, where he was born. He was reserve for the Scottish Boys’ team v England Boys in 1951 and later captained the Glasgow University team, receiving a “Blue” and going on to play for Scottish Universities. Bill qualified as a Scottish solicitor in 1957 and after two years in practice in Glasgow joined the Distillers Company in London as a legal adviser. When Distillers was taken over by Guinness in 1986 Bill continued with that company until his retirement in 1994. Bill joined Royal Mid-Surrey Golf Club in 1960 and was club champion in 1963 and 1974, the year in which he became the youngest-ever Captain, apart from H R H The Prince of Wales who was Captain in 1926. He still holds that distinction. He was President of the club from 2003 to 2013 and on his retirement was elected a Life Member Bill played for Surrey during the 1970s and was county captain for three years, going on to be County President from 1986 to 1988. He represented Surrey on the EGU Council and was Chairman of the Championship and National Coaching committees. Bill was elected a Vice-President of the Artisan Golfers’ Association in December 1992. He was elected President in November 2003 following the death of the previous incumbent Sir Anthony Hollis, a month or two earlier. He is still President of the AGA. Bill no longer plays competitive golf but still enjoys a few holes with friends at Royal Mid-Surrey and Walton Heath, of which he is an Honorary Member. He tries to get to the other clubs of which he is a member at least once a year: Prestwick in Scotland, The R&A in St Andrews and Merion in the United States. Bill Bryce (right) receives the Micklem Award from Nigel Evans (image © Leaderboard Photography) 14 Apr 2016 Bill Bryce receives Micklem Award last_img read more