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Governors warn of dire ventilator shortages as virus pandemic rages. Trump says some are playing 'politics' – USA TODAY



WASHINGTON – Governors’ warnings of life-threatening shortages of ventilators have emerged as a flashpoint between President Donald Trump and the states as the coronavirus crisis deepens.

“Some states have more ventilators than they need,” Trump told a news briefing Saturday. “They don’t even like to admit it. They’ll admit it when everything’s over but that doesn’t help us very much.“

Governors in hard-hit states like New York, Michigan and Louisiana say doctors could be forced to make life or death decisions about who will get ventilators and who won’t if hospitals starting running out of the machines when the peak of the crisis hits.

Louisiana Gov. John Bel Edwards has said his state is expected to exhaust its supply of ventilators by April 6. Though Louisiana has received some ventilators from the national stockpile, Edwards said his state still needs thousands more.

New York Gov. Andrew Cuomo has estimated his state will need as many as 30,000 ventilators and could start facing shortages by the middle of next week.

Cuomo dismissed the suggestion that he was overstating the needs. He said New York was prepared to pay for 17,000 ventilators it had ordered on its own but didn’t get them because of competing demands.

“We were not looking to spend a penny that we didn’t have to spend,” Cuomo said.

Wartime powers: Trump hasn’t ordered any ventilators from GM, despite saying he was using his authority to force production

US coronavirus map: Tracking the outbreak 

The tensions between the governors and the Trump administration grew this week when Jared Kushner, a senior White House adviser and the president’s son-in-law, referred to the federal stockpile of medical supplies as “our stockpile.”

“It’s not supposed to be states’ stockpiles that they then use,” he said.

Trump has said the federal government is ready to help the states but needs the “flexibility of moving the ventilators” to virus hot spots. He and his aides say the administration will mobilize the equipment to areas where it’s most needed days in advance but they’re also urging states to tap their own stockpiles and do what they can to obtain their own supplies.

Several governors want the federal government to use its clout to buy more ventilators. The Federal Emergency Management Agency could then distribute to states in the greatest need, the governors argue.

“Why would you create a situation where the 50 states are competing with each other and then the federal government, FEMA, comes in and competes with the rest of it?” Cuomo asked.

Illinois Gov. J.B. Pritzker and Michigan Governor Gretchen Whitmer have also expressed frustration over competing against one another – and the federal government – in bidding for supplies in the private market, which has led to price-gouging.

So how many ventilators are likely to be needed, how many are there now and why are they in such short supply? Here’s an overview of what led to the problems and the debate over how to solve them. 

How many ventilators are available?

Trump has declared the U.S would produce 100,000 ventilators in 100 days and told reporters Thursday that 11 companies were behind the effort to expedite production. While General Motors and Ford have said they would manufacture ventilators, it wasn’t immediately clear what other companies were producing the machines. 

Most of the 100,000 ventilators Trump promised to have by June will not be available until the end of the month at the earliest, FEMA officials told the House Oversight Committee this week. 

FEMA said there were just 9,500 ventilators in the national stockpile, with about 3,200 expected to be added by the week of April 13, according to documents from the agency released by the committee’s Democrats. 

The U.S. coronavirus crisis is projected to peak by the middle of April, when nearly 32,000 ventilators will be needed to address the outbreak, according to data from the Washington Institute for Health Metrics and Evaluation.

FEMA acknowledges “that the Strategic National Stockpile (SNS) alone could not fulfill all requirements at the State and tribal level” in response to the coronavirus pandemic,” according to an agency spokesperson.

FEMA officials have told the House Oversight Committee the demand for ventilators “outstrips the capacity” of the national stockpile as well as the 1,065 machines donated by the Department of Defense.

As of April 2, FEMA officials have shipped 8,100 ventilators from the national stockpile, a FEMA spokesperson said, adding that the agency is expediting critical medical supplies from the global market to medical distributors across the country. 

Six flights carrying medical supplies from Asia have arrived in the U.S. since March 29, including two flights that arrived Chicago and Columbus, Ohio, early on Friday, according to the FEMA spokesperson. The agency has scheduled 27 additional flights through April 18. 

The medical supplies will be given first to medical distributors in areas of greatest need and the remainder “will be infused into the broader U.S. supply chain,” the FEMA spokesperson said. 

FEMA also points to the $16 billion allocated to build up the stockpile in the $2 trillion-dollar stimulus package passed by Congress last week that will help address the shortage. 

Why is there a shortage?

The Strategic National Stockpile, which is managed by the Department of Health and Human Services, consists of several secretly located warehouses across the U.S. that contain emergency medical supplies. 

Former Wisconsin Gov. Tommy Thompson, who served as health secretary under former President George W. Bush and oversaw the outbreaks of anthrax, SARS, and Monkeypox, said the number of warehouses was expanded to 12 from eight after the 9/11 attacks. 

Thompson, who said he offered a federal plan for preparation for a pandemic before he left office, said Congress failed to appropriate funding to replenish the depleted stockpiles over the years. 

“They were maintained, but they were not expanded,” he told USA TODAY. “I think it was lack of attention. I don’t think you blame the governors, I don’t think you blame the president, I think that everybody neglected filling these sites with what was needed.”

Greg Burel, who served as head of the SNS for more than 12 years before he retired in January, said the stockpile was not initially designed for pandemic influenza but Congress began investing funds in preparation for such an event in the early 2000s. 

“We always knew that even then, it wasn’t as much as some of the models suggested we would need if it was a 1918 sort of an event,” he said, referring to the flu pandemic of 1918. “Even with the pandemic influenza money, it was going to be almost impossible fiscally, to stockpile our way out of that kind of a problem.”

Burel added that Congress never saw fit to fund the replacement of materials exhausted during the the 2009 flu epidemic, which played a hand in today’s unfolding coronavirus crisis. He added that local and state health departments lack the funding needed and the private health care supply chain operates in “just-in-time” basis that hinders any sort of wide-scale response to a pandemic.

‘We’re not an ordering clerk’

Trump has said federal government’s stockpile can help the country through the crisis but has also criticized states for having ‘insatiable appetites’ for equipment and not doing enough to build their own supplies.

“States should have been building their stockpiles,” he added. “We’re a back-up, we’re not an ordering clerk,” he said.

But the existence of the stockpile is aimed directly at helping states, according to Josh Gotbaum, a former assistant secretary of defense for economic security and executive associate director for Office of Management and Budget under former President Bill Clinton. 

“The whole purpose of emergency stockpiles is to protect the nation in an emergency. Even if the stockpiles are inadequate, they still must be used for the entire nation,” he said. “It’s not to make sure there’s enough ventilators for the Army, Navy, Air Force and Marines. The Defense Department already takes care of that.”

Coronavirus: Will I get a check? Where do I find peanut butter? What crisis-hit Americans are asking lawmakers amid coronavirus

Cuomo said Friday the government should send more ventilators and medical supplies that New York could then redeploy to other hard-hit localities where demand is surging. 

“What is the alternative to the crisis that we see looming nationwide?” he said. “New York is in crisis. Help New York and then pick up the camp and go to the next place as this rolls across the country.”

Thompson said while Cuomo and other governors are rightly focused on their states, Trump has to assess where the life-saving machines are needed most across the country. 

“The stockpiles are federal…the president is responsible for all the states,” Thompson said. “So he’s got to make that tough decision.”

Can Trump use wartime powers to get more ventilators?

Trump has shown ambivalence about use the full authority of the Korean War-era Defense Production Act to compel private companies to make ventilators, masks and other equipment. He has at times likened the wartime authority to nationalization of private industry and invoked Venezuela’s economy as an example of the dangers of the approach.

While Trump announced a week ago that he was activating the DPA to force General Motors to manufacture ventilators for coronavirus, the administration had not formally ordered any machines as of Thursday, USA TODAY has learned.

Trump this week announced a fresh request to Secretary of Health and Human Services Alex Azar to use the act for several other companies, including General Electric, Hill-Rom Holdings, Medtronic, ResMed, Royal Philips, and Vyaire Medical.

But the latest order provided no more detail on how the government would compel those companies to make ventilators than the order targeted at General Motors. The order also did not clarify how many ventilators the administration is requesting.

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Hydroxy hysteria: When saving lives collides with politics and bureaucracy | TheHill – The Hill



Field reports from physicians around the world suggest that hydroxychloroquine, a relatively inexpensive drug used to treat malaria for more than 60 years, may be useful in fighting COVID-19. Based on this emerging data, President TrumpDonald John TrumpSanders says he wouldn’t ‘drop dead’ if Trump decided on universal healthcare Overnight Health Care: Trump officials lay groundwork for May reopening | Democrats ramp up talks with Mnuchin on next relief deal | Fauci says death toll could be around 60,000 Hillicon Valley: State officials push for more election funds | Coronavirus surveillance concerns ramp up pressure for privacy bill | Senators warned not to use Zoom | Agencies ask FCC to revoke China Telecom’s license MORE has suggested that doctors consider the “off-label” use of hydroxychloroquine in this global emergency.

So why is President Trump being ridiculed or condemned for at least spreading a ray of hope against a disease so new it would be impossible for the Food and Drug Administration (FDA) to have its own officially approved treatment yet? Is the president promoting quackery, or worse?

Nothing of the sort.


To start, hydroxychloroquine is not being used without any safeguards. The standard clinical trials proving its value against this disease have not been conducted — but hydroxychloroquine was tested and approved six decades ago, and it has an established record of efficacy and side effects that physicians can review. More importantly, no doctor is (or should be) prescribing it without following standard protocols observed for any drug or any patient.

While hydroxychloroquine may not be the best or ultimate cure against COVID-19, and while its use may be more experimental than proven at this stage, the fact is that this is not a normal situation. We face a new, dangerously infectious virus, and abnormal times can require abnormal measures. Hydroxychloroquine has shown promise in treating symptomatic cases of COVID-19, which is why many doctors are using it. And a recent survey of some 1,200 U.S. doctors found that 65 percent said they would prescribe it to treat or prevent COVID-19 in a family member.

Indeed, medical authorities have explained for years that off-label drug use — prescribing a medication for a health condition other than its normal, approved purpose — can be an innovative way to broaden therapeutic tools in challenging medical situations. Here is what the FDA itself tells us:

Once the FDA approves a drug, health care providers generally may prescribe the drug for an unapproved use when they judge that it is medically appropriate for their patient. You may be asking yourself why your health care provider would want to prescribe a drug to treat a disease or medical condition that the drug is not approved for. One reason is that there might not be an approved drug to treat your disease or medical condition. Another is that you may have tried all approved treatments without seeing any benefits. In situations like these, you and your health care provider may talk about using an approved drug for an unapproved use to treat your disease or medical condition.

And here is what the National Library of Medicine said — well before COVID-19 appeared on the scene — about using hydroxychloraquine against diseases for which the drug had never been officially approved: “It is also used to treat discoid or systemic lupus erythematosus and rheumatoid arthritis in patients whose symptoms have not improved with other treatments. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.”


What, then, is really going on with this debate? Sad to say, it appears that at least some of the president’s critics are being influenced by what might otherwise be rational disagreements with him on other issues, a legitimate rivalry between political parties, or even a purely personal dislike for Trump. This, despite the potential for needless deaths of thousands of Americans who contract COVID-19, long before the FDA can finish the typical multi-year process of approving a drug for any one disease.

If any example shows us that partisan politics generally has gotten out of hand, it would be this. But it is more than this, too. In truth, President Trump has a different view of “expertise” than most liberals, progressives, academics or Washington insiders. He has shown a willingness to listen to the results of scientific research, but he does not automatically “defer to the experts” on the policy implications of that research. As his record of regulatory reform has demonstrated, he is willing to cut bureaucratic red tape in order to get results.

There is not an FDA-approved treatment for COVID-19 yet — it is simply too early. But that does not mean it is an “insult against science” to conclude that governmental action should be taken in the midst of an emergency based on the best facts available. Indeed, even outside of an emergency, it is no disrespect to science to say some medical treatments that some physicians deem prudent for their patients should be allowed — and, yes, promoted — even if those have not been the subject of someone’s peer-reviewed Ph.D. thesis or years of regulatory process. Even when the experts have the time to spend years studying a problem, they often can be wrong. Doctors in the field who are treating patients have valuable information to contribute in this crisis, too.

Even when the experts are correct, there often are many assumptions and policy biases hidden in the way they articulate their conclusions and recommendations. And organizations like the FDA have their own inherent institutional biases. The more involved and sophisticated the FDA can make the process of investigating drug “efficacy,” the more the process tends to help the biggest drug companies and deter smaller competitors. If you are part of that process — a lobbyist, a drug company executive, or even an FDA scientist committed to applying the most rigorous possible standards — you may see an emergency order moving an experimental drug or process to the top of the list as a challenge to the established way of doing business.

In this crisis, the president rightly has become deeply involved in the details of public policy and is working closely with members of his White House coronavirus task force. You may disagree with his views or his style, but the establishment needs to be shaken up: The normal order of business will not be enough to defeat COVID-19. And even if you think we were unprepared for COVID-19, it was not simply the fault of one man. It is part of the problem with our national approach to solving challenges: too much regulation, too much cronyism, too much corruption.

This crisis is a wake-up call. We need to set aside the old ways of doing things in Washington, innovate together, put on our masks, and get our country back to work. 

Ramin Oskoui, MD, is CEO of Foxhall Cardiology in Washington and has met with President Trump and White House advisers on the coronavirus pandemic.

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Politics This Morning: Parliament to sit over Easter weekend to pass feds' wage subsidy bill – The Hill Times



Good Friday morning,

Parliament is set to sit over the long weekend to pass the feds’ $73-billion wage subsidy, with the House is slated to convene Saturday at around noon. In a tweet yesterday afternoon, Government House Leader Pablo Rodriguez said he put in a request to the Speaker so that the government can “bring in new emergency economic measures” to support businesses and workers amid the coronavirus pandemic.

Finance Minister Bill Morneau expressed frustration the other day over the pace of negotiations, suggesting that other parties had been delaying the recall of Parliament. But outgoing Conservative Leader Andrew Scheer pushed back, tweeting a letter addressed to the prime minister that “while we can all agree that there is a need to move quickly in this current crisis, when there is no debate, no discussion, no opportunity for regular questions from Opposition, it makes it that much harder to perfect legislation.”

Parliamentary Budget Officer Yves Giroux released a series of reports, including one that projected the federal deficit could soar to $184.2-billion for the 2020-21 fiscal year. The last time Canada was that deep in the red was in 1984-85. That analysis does not yet account for the multibillion-dollar wage subsidy program.

In jobless numbers for March, StatsCan reported that more than a million people have been laid off, leading to a jump in the unemployment rate from 5.6 per cent to  7.8 per cent. That does account for those who have seen their hours cut or income slowly dry up due to the pandemic. Women, particularly those between 25 and 54, were disproportionately affected, losing their jobs twice as men in that cohort.

After facing daily pressure to release national projections forecasting the extent of the pandemic’s toll, Prime Minister Justin Trudeau and public health officials offered a preview of what Canadians could expect. With the current measures in place, Canada could see up to 44,000 deaths related to COVID-19 in the coming months. In the short term, the public health agency said there could be between 500 and 700 deaths by next week. While federal officials said the social-distancing measures could last between 12 and 18 months, given that a vaccine is still a long way off, the Quebec government is eyeing a gradual return to some sense of normalcy, as the number of cases have started to stabilize, according to The Canadian Press. It was still unclear which parts of the economy would be reawakened.

Chief public health officer Dr. Theresa Tam said Canadians can expect a “very cautious approach” to relaxing physical-distancing measures, with different parts of the country’s experiences expected to vary, depending on the severity of the outbreak.

In other non-COVID news, Canada is planning to go ahead with its sale of armoured vehicles to Saudi Arabia, after it reached a new deal, worth $14-billion, which would give the feds the ability to be more open about the terms, according to CBC.

The Hill Times

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The Atlantic Politics Daily: Two Key Swing States During a Pandemic – The Atlantic



It’s Thursday, April 9. In today’s newsletter: There’s something about Michigan and Florida. Plus: How the legacy of Bernie Sanders might live on.




Two COVID-19 Swing-State Case Studies

President Trump’s complicated relationships with the governors of two swing states could ultimately cost him reelection, my colleague Ron Brownstein writes.

First, Michigan: The president said at a White House press briefing in March he told Vice President Mike Pence not to “call the woman in Michigan”—Governor Gretchen Whitmer—if she didn’t “treat [him] right.” While he won Michigan in 2016 by a slim 0.23 percent margin, that sort of hostility could hurt his chances of doing so again.

The president can hardly afford any erosion in the populous Detroit metropolitan area …. “It is politically stupid of the president to pick a fight with a governor who is trying to manage a crisis in a state that he has to win,” one political strategist told Ron.

Governor Gretchen Whitmer is hardly the only Democrat to face the president’s ire. The president has expressed displeasure toward Democratic leadership across the country for what he regards as insufficient gratitude to the administration’s response efforts, my colleague Peter Nicholas has reported. But what happens when the COVID-19 outbreak peaks in red states?

On the opposite end of the spectrum: The Trump administration’s fingerprints are all over Florida Governor Ron DeSantis’s playbook. DeSantis initially dragged his feet over shutting down Florida (all the while, Trump described him as a “great governor” who “knows exactly what he’s doing”).

In Florida, conditions have not yet reached such a crisis point, though its caseload is growing steadily. But because DeSantis waited so long to act, he and Trump could be punished if the outbreak ultimately imposes a heavy cost on the state.

Read Ron’s full analysis.

—Kaila Philo




The departure of Bernie Sanders from the 2020 presidential primary leaves Joe Biden the presumptive nominee. The greatest accomplishment of the Sanders campaign has less to do with moving good ideas out of the “radical” category and into the mainstream, the writer John Nichols argues—and more to do with inspiring the people who will carry those ideas forward. In a way, Bernie Sanders has won.

+ The left’s theory of politics fell apart in this cycle’s Democratic primary, but its policy critique of the Barack Obama era has real merit, Adam Serwer argued in March, and the centrist wing of the party should not dismiss it.




+ Launching a column on happiness during a pandemic seems awkward, but that’s what we’re doing today: Here’s the first installment of our new weekly column on how to live a life that feels whole and meaningful, from Arthur C. Brooks.

+ America’s obsession with keeping aid from the undeserving is making a bad economic crisis worse, Mehrsa Baradaran argues. It should just send checks—yet won’t.

+ If there is a way to stop COVID-19, it will be by blocking its proteins from hijacking, suppressing, and evading humans’ cellular machinery. These are the best hopes for a coronavirus drug, our science writer Sarah Zhang reports.

You can keep up with The Atlantic’s most crucial coronavirus coverage here.


Today’s newsletter was written by Kaila Philo, a Politics fellow. It was edited by Shan Wang, who oversees newsletters.

You can reply directly to this newsletter with questions or comments, or send a note to

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Kaila Philo is an editorial fellow at The Atlantic.

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