Bacon's Rebellion

Democracy Thrives in Sunlight

Shortage of Personal Protection Equipment Looming

—

by

James A. Bacon
in

by James C. Sherlock

Virginia physicians and health professionals in the front lines of the fight against the COVID-19 virus are suffering from a lack of protective clothing and equipment that could put them at risk and hinder the treatment of sick patients.

In Virginia, the Secretary of Health and Human Resources oversees the sharing of personal protective equipment and clothing among health systems, hospitals and independent physicians to ensure the protection of all. 

With the permission of Dr. Soheila Rostami, president of the Medical Society of Northern Virginia (MSNV), I post  her message to Secretary Daniel Carey.

Doctor Carey,

We find ourselves under unprecedented circumstances with the COVID-19 response. So far, in Northern Virginia, only Virginia Hospital Center is conducting public testing, but only for Arlington County residents. Community physicians are not equipped to handle specimen collections or testing; there is a shortage of personal protection equipment (PPE’s) and without proper protection, we risk the health of our staff, ourselves and that of our families. Furthermore, our offices are generally not set up for dealing with the aerosols associated with this highly communicable disease. Under a public health state of emergency, public governmental entities are supposed to coordinate efforts to set clear expectations for people to access testing, as well as where that testing will occur. We need to have a clear understanding of where to refer our patients for diagnostic testing.

MSNVA is in the process of leading an effort to collect unused PPEs for frontline physicians and nurses. We are directing the MSNVA staff to coordinate communication, pick up and distribution. We will be developing guidelines for our community physicians. We cannot risk a shortage of physicians, nurses and ancillary providers due to lack of protection. We must isolate our non-infected patients from the risk of being near those infected. Please consider adding the following actions into the current emergency response protocols:

  1. Create a distribution pipeline for PPEs for independent physicians in our community
  2. Provide guidance for physician offices to treat patients without unnecessarily exposing other patients and staff to COVID-19
  3. Coordinate independent testing facilities so physician offices and hospitals struggling to procure PPE do not need to test patients.
  4. Coordinate with state and local medical societies to disseminate information to community physicians in real-time.

We are available to assist with recommendations and welcome the opportunity to be involved with the response efforts.”

A Message to Dr. Rostami from a Northern Virginia physician the same day:

Most of the pediatric practices are in need. I run out of gowns next week, even with limiting usage to 2 per day. Would appreciate any and all personal protective equipment that can be gotten.

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68 responses to “Shortage of Personal Protection Equipment Looming”

  1. Acbar Avatar
    Acbar

    This is yesterday’s headline. The fact that it remains today’s headline in the current emergency is astounding, and a devastating critique of everyone responsible both federal and State. But there’s time enough to assign blame; we simply have to get over this diddling NOW. Let alone face masks and swabs, where are the tests? Testing, testing, testing, drive-through and in every clinic and lab, on the spot results, is the key to control. “For want of a nail, a shoe . . . a kingdom . . . was lost.”

  2. LarrytheG Avatar
    LarrytheG

    The problem is that there is a worldwide shortage.

    I don’t know how a state office could have planned for that
    or fix it now.

    I think at the top Federal level, had we reacted in January – we’d be
    in better shape now.

    The greatest country on earth looks pretty pathetic right now.

  3. Acbar Avatar
    Acbar

    The current White House disbanded all those capabilities. Putting aside the politics of inherited personnel from the prior admin., we have a President who fundamentally is not an institutionalist. His instinct is not to create and mobilize a capable bureaucracy for the public good, but to solve things himself based on his “gut instinct.” He is not alone; there are lots of folks including some on the left who have no faith in our institutions — government or private. There is a generational component to this too. We will have a long way to go to claw back to normalcy after this administration – unless the next one is like it.

    1. LarrytheG Avatar
      LarrytheG

      Well, he demands loyalty and alignment with his views if you are to be an adviser.

      You can see it when others speak – very carefully not to openly contradict him but to talk around it…

      If you fire people who tell you the truth – then you’re in trouble as are all the folks who demand on your leadership.

      Yes, we’re seeing how this works. In January – the truth was there.

    2. sherlockj Avatar
      sherlockj

      The issue that Dr. Rostami is referring to is not a regional shortage but rather what she considers a regional maldistribution of personal protective equipment (PPE) in Northern Virginia. She represents mostly independent physicians who make up about half of the practicing physician population in Northern Virginia.

      She is asking Dr. Carey to get involved and direct the movement of any excess PPE from the hospitals who have supplies and are ordering more (and whose orders are filled with the priority that comes to large customers) to the independent physicians like the pediatrician whose email I included who are struggling to purchase what they need. She thinks that the shelves are empty for them only.

      That is not a national issue, it is a state issue. Under our federal system the states are supposed to train and exercise for such contingencies and to have sorted things like this out ahead of an emergency. She is asking Dr. Carey, our Secretary of Health and Human Resources, to see if there are PPE on the shelves of large hospitals that can be deployed to independent primary care physicians.

      Seems like a reasonable request.

      1. LarrytheG Avatar
        LarrytheG

        Jim, have you seen news reports like this:

        Doctors Say Shortage of Protective Gear Is Dire
        The lack of proper masks, gowns and eye gear is imperiling the ability of medical workers to fight the coronavirus — and putting their own lives at risk.

        The Open Cities Community Health Center in St. Paul, Minn., is considering shutting down because it doesn’t have enough face masks.
        Doctors at Barnes Jewish Hospital in St. Louis are performing invasive procedures on coronavirus patients with loose fitting surgical masks rather than the tight respirator masks recommended by health agencies.

        At a Los Angeles emergency room, doctors were given a box of expired masks, and when they tried to put them on, the elastic bands snapped.

        With coronavirus cases soaring, doctors, nurses and other front-line medical workers across the United States are confronting a dire shortage of masks, surgical gowns and eye gear to protect them from the virus.”

        Seems like it’s hospitals in many states including New York.

        no?

  4. sherlockj Avatar
    sherlockj

    I can’t speak to those cases, only relaying the information on this specific case. Like in any crisis, we will find good stories and bad. The nation’s system for planning, training and exercising for scenario driven emergencies including viral pandemics has been in place since soon after 9/11. The federal government pays the costs. The exercises are supposed to test the system to identify weaknesses. Inspections of hospitals are required to certify readiness of personnel, equipment and logistics. To the degree that federal, state and local governments and the healthcare sector may not be ready with all that infrastructure to ensure we are ready tells us more about human beings than the systems they create. It is to some considerable degree about motivation. Many likely participated in exercises that were not real enough with scenarios which seemed too remote. Perhaps those who designed the scenarios did not do enough research or had insufficient imagination. The folks who led the participation may not have been sufficiently compelling. Perhaps no system of free men in a federal system of government can do everything a dictatorship can do to enforce compliance in peacetime but I would not swap. Compliance absent motivation will always produce poor readiness. Free people prove much more resourceful once engaged.

  5. LarrytheG Avatar
    LarrytheG

    In terms of disaster planning, typically, there are discussions about bringing in help and supplies from other places and what organizations would be in charge of doing that and handling logistics.

    In a world-wide pandemic that affects ALL locations, the concept of bringing in help from outside a location is counter to likely realities.

    So we are hearing all these stories of various locations and organizations unable to get material and equipment from sources they expected to be able to obtain them from so that has set off efforts to “find” other sources and in term competition and the realization that there is simply more demand that there is available supplies.

    There IS such a thing as a Strategic National Stockpile
    Strategic National Stockpile is the nation’s largest supply of potentially life-saving pharmaceuticals and medical supplies for use in a public health emergency severe enough to cause local supplies to run out.

    https://www.phe.gov/about/sns/Pages/default.aspx

    lots of interesting info here and if it worked in reality according to the words on the website – things might be better:

    About the Strategic National Stockpile
    With approximately 200 federal and contract employees, the Strategic National Stockpile is organized to support any public health threat. Stockpile staff represent a variety of specialties, and all work together to ensure the right resources are ready and can get to the right place at the right time.

    Operational Logistics Branch

    The Operational Logistics Branch is responsible for the stockpile’s inventory of antibiotics, medical supplies, equipment, antidotes, antitoxins, antivirals, vaccines, and other pharmaceuticals that are strategically located throughout the United States and its territories. This branch:

    Gets needed medicines and supplies into the stockpile
    Makes sure the right amounts and types of medicines and supplies are available to respond to an emergency

    * Ensures the stockpile can resupply state and local public health agencies in a catastrophic health event”

    Note the last bullet –

    bottom line without assigning blame – we simply do not have enough supplies and equipment – it’s NOT an issue that we have the stuff but
    we cannot get it to where it is needed. We simply do not have enough.

  6. djrippert Avatar
    djrippert

    Gotta love Bacon’s Rebellion and the Richmond apologist corps. From Capt. Sherlock:

    “That is not a national issue, it is a state issue. Under our federal system the states are supposed to train and exercise for such contingencies and to have sorted things like this out ahead of an emergency.”

    “The Governor and for him his Secretary of Health and Human Resources have sufficient emergency authority to do what Dr. Rostami requests. Her requests are both reasonable.”

    And how do the Richmond apologists answer?

    But, but, but … Trump.
    The frontline doctors are wrong. The protective gear should stay at the hospitals.

    Amazing.

    Wasn’t it just about a week ago that Northam declared “We are prepared. Trust me.” ? His attitude was simple – go away little people and stop asking me inconvenient questions. Where is all that preparedness now?

    Waiting for the crisis to be over before assessing blame sounds all fine and dandy but how many more corpses will we have to discuss if we let Northam continue his reign of incompetence? The time to hold him accountable is now not after the bodies pile up. Even his Lieutenant Governor, Justin Fairfax, has been publicly critical of Northam’s actions to date.

    Short term – we need to embarrass Northam into action. Long term – we have to resolve never to elect another member of the plantation elite to any office of significance in Virginia.

    What an absolute clown show.

    1. LarrytheG Avatar
      LarrytheG

      I guess to know what Northam is not doing compared to other states, perhaps Maryland since DJ knows that state.

      So what should Northam be doing instead that other states are doing and he is not?

      1. djrippert Avatar
        djrippert

        Northam needs to watch Gov Cuomo’s news conference from yesterday and repeat that for Virginia. That would be a start. Then he needs to admit that we’re not really prepared because nobody was prepared for this. In other words, he needs to do something he finds difficult – he needs to stop lying. He needs a list of actions that are being taken in response to our lack of preparedness – for example … distributing the protective gear to primary care doctors. Or, he can tell the primary care doctors to go pound sand because he wants to keep the protective gear at the hospitals. In that case people exhibiting symptoms should be told to go to hospitals instead of their primary care doctor. But when the president of the Medical Society or Northern Virginia publicly declares a problem Northam needs to respond and respond publicly.

        Basically he needs to display a level of leadership he has failed to display so far in this crisis.

  7. Dick Hall-Sizemore Avatar
    Dick Hall-Sizemore

    It seems that the NoVa doctor is asking the state to direct hospitals to disburse some of their PPEs on hand to private doctors. Because there is an expectation that there will be increased admissions due to the virus, does it make sense for hospitals to be decreasing their supply of PPEs?

    Her request for the state to relieve community physicians of the responsibility for testing seems reasonable. That is arguably a state responsibility, but it does seem that the effort is fragmented. Sentara is leading the testing activities in Hampton Roads, with several drive-thru sites. In the Richmond area, it seems that the district health department has taken on that responsibility, although there has been only one short-lived drive-thru site. A distinct epidemiologist spent a lot of time in a Henrico retirement community yesterday testing residents and found three positives. There are reports of other people testing positive, but it is not clear who is conducting the tests; I assume hospitals. I have seen any reports of how the testing is being done in NoVa, other than the letter from the doctor reporting about the hospital in Arlington. It would seem that INOVA is big enough to take on this responsibility in Fairfax County.

    1. sherlockj Avatar
      sherlockj

      The Governor and for him his Secretary of Health and Human Resources have sufficient emergency authority to do what Dr. Rostami requests. Her requests are both reasonable.
      As for testing, you have it right. If there is no state-appointed regional test authority one should be appointed.
      Relative to PPE, her request is that the Secretary of Health and Human Resources get involved and determine whether there is a maldistribution. The Department of Health, which works for him, has personnel who inspect hospitals as a full time job. They could be dispatched to inspect the supply situation and report. The Governor has sufficient emergency authority to move supplies and equipment from A to B if he and for him the Secretary determines that supply and front line demand are misaligned.
      I suspect that people who read this column are older than the general population. But read the email from the pediatrician again and think what your position would be if he or she was treating your child.
      All she is asking the Secretary to do is his job. She is not asking for a miracle of the loaves and fishes.

      1. LarrytheG Avatar
        LarrytheG

        For myself, if somebody was going to run out , I’d rather it NOT be the hospitals.

        Once the hospitals are out, we’re in big, big trouble.

        I cannot imagine any hospital, given the current environment where other hospitals and entire states cannot get enough – that any hospital would be responsible in giving up any of it’s supplies unless it had something like more than enough to handle a worse case scenario.

        This pandemic is unprecedented. Hospitals across the country are warning that they are down to a one month supply and cannot obtain more. It would be unconscionable to take from their supplies for any purpose now other than to give some to other hospitals and when you do that – know that the hospital you’re taking from, likely will have to stop treating patients at some point without a resupply.

        these are tough issues with no good solutions. We’re literally deciding who will NOT get supplies and may have to cease operation.

        In that kind of scenario – we let non-hospital practices do without at least in my view – which may not have all the facts that Jim might.

        1. sherlockj Avatar
          sherlockj

          The nation absolutely does not want people flooding the hospitals who don’t need to be there. We want them to contact their primary care physicians first. That is the government guidance. Not nearly everyone is going to be able to use telemedicine and have the tools at home to measure vitals. Those physicians need the PPE to see their patients, even those with a disassociated problem and reporting no virus like symptoms. Dr. Rostami’s letter does not presume the outcome of the Secretary’s decision on locating supplies, just for him to make one and announce it. Again, reasonable request.

  8. Dick Hall-Sizemore Avatar
    Dick Hall-Sizemore

    It seems that the NoVa doctor is asking the state to direct hospitals to disburse some of their PPEs on hand to private doctors. Because there is an expectation that there will be increased admissions due to the virus, does it make sense for hospitals to be decreasing their supply of PPEs?

    Her request for the state to relieve community physicians of the responsibility for testing seems reasonable. That is arguably a state responsibility, but it does seem that the effort is fragmented. Sentara is leading the testing activities in Hampton Roads, with several drive-thru sites. In the Richmond area, it seems that the district health department has taken on that responsibility, although there has been only one short-lived drive-thru site. A distinct epidemiologist spent a lot of time in a Henrico retirement community yesterday testing residents and found three positives. There are reports of other people testing positive, but it is not clear who is conducting the tests; I assume hospitals. I have seen any reports of how the testing is being done in NoVa, other than the letter from the doctor reporting about the hospital in Arlington. It would seem that INOVA is big enough to take on this responsibility in Fairfax County.

  9. LarrytheG Avatar
    LarrytheG

    In terms of disaster planning, typically, there are discussions about bringing in help and supplies from other places and what organizations would be in charge of doing that and handling logistics.

    In a world-wide pandemic that affects ALL locations, the concept of bringing in help from outside a location is counter to likely realities.

    So we are hearing all these stories of various locations and organizations unable to get material and equipment from sources they expected to be able to obtain them from so that has set off efforts to “find” other sources and in term competition and the realization that there is simply more demand that there is available supplies.

    There IS such a thing as a Strategic National Stockpile
    Strategic National Stockpile is the nation’s largest supply of potentially life-saving pharmaceuticals and medical supplies for use in a public health emergency severe enough to cause local supplies to run out.

    https://www.phe.gov/about/sns/Pages/default.aspx

    lots of interesting info here and if it worked in reality according to the words on the website – things might be better:

    About the Strategic National Stockpile
    With approximately 200 federal and contract employees, the Strategic National Stockpile is organized to support any public health threat. Stockpile staff represent a variety of specialties, and all work together to ensure the right resources are ready and can get to the right place at the right time.

    Operational Logistics Branch

    The Operational Logistics Branch is responsible for the stockpile’s inventory of antibiotics, medical supplies, equipment, antidotes, antitoxins, antivirals, vaccines, and other pharmaceuticals that are strategically located throughout the United States and its territories. This branch:

    Gets needed medicines and supplies into the stockpile
    Makes sure the right amounts and types of medicines and supplies are available to respond to an emergency

    * Ensures the stockpile can resupply state and local public health agencies in a catastrophic health event”

    Note the last bullet –

    bottom line without assigning blame – we simply do not have enough supplies and equipment – it’s NOT an issue that we have the stuff but
    we cannot get it to where it is needed. We simply do not have enough.

  10. djrippert Avatar
    djrippert

    Gotta love Bacon’s Rebellion and the Richmond apologist corps. From Capt. Sherlock:

    “That is not a national issue, it is a state issue. Under our federal system the states are supposed to train and exercise for such contingencies and to have sorted things like this out ahead of an emergency.”

    “The Governor and for him his Secretary of Health and Human Resources have sufficient emergency authority to do what Dr. Rostami requests. Her requests are both reasonable.”

    And how do the Richmond apologists answer?

    But, but, but … Trump.
    The frontline doctors are wrong. The protective gear should stay at the hospitals.

    Amazing.

    Wasn’t it just about a week ago that Northam declared “We are prepared. Trust me.” ? His attitude was simple – go away little people and stop asking me inconvenient questions. Where is all that preparedness now?

    Waiting for the crisis to be over before assessing blame sounds all fine and dandy but how many more corpses will we have to discuss if we let Northam continue his reign of incompetence? The time to hold him accountable is now not after the bodies pile up. Even his Lieutenant Governor, Justin Fairfax, has been publicly critical of Northam’s actions to date.

    Short term – we need to embarrass Northam into action. Long term – we have to resolve never to elect another member of the plantation elite to any office of significance in Virginia.

    What an absolute clown show.

    1. LarrytheG Avatar
      LarrytheG

      I guess to know what Northam is not doing compared to other states, perhaps Maryland since DJ knows that state.

      So what should Northam be doing instead that other states are doing and he is not?

      1. djrippert Avatar
        djrippert

        Northam needs to watch Gov Cuomo’s news conference from yesterday and repeat that for Virginia. That would be a start. Then he needs to admit that we’re not really prepared because nobody was prepared for this. In other words, he needs to do something he finds difficult – he needs to stop lying. He needs a list of actions that are being taken in response to our lack of preparedness – for example … distributing the protective gear to primary care doctors. Or, he can tell the primary care doctors to go pound sand because he wants to keep the protective gear at the hospitals. In that case people exhibiting symptoms should be told to go to hospitals instead of their primary care doctor. But when the president of the Medical Society or Northern Virginia publicly declares a problem Northam needs to respond and respond publicly.

        Basically he needs to display a level of leadership he has failed to display so far in this crisis.

        1. Reed Fawell 3rd Avatar
          Reed Fawell 3rd

          I get the distinct impression that Virginia’s health care system VERY LIKELY has LOST this Corona-virus war BEFORE it’s started in earnest.

          1. idiocracy Avatar
            idiocracy

            Well, it certainly wouldn’t be the first time Virginia lost a war because of stupidity and incompetence, would it? Sometimes I wonder if Pocahontas was a carrier for X-linked mental retardation. That might explain a few things.

  11. Steve Haner Avatar
    Steve Haner

    This is a problem our business guys can solve and by this time next week my prediction is they will have. I’m sure the supply chain starting gearing up two weeks ago. I do have this vision of an entrepreneur sitting on a phone waiting for some government permit needed to reopen a production line….We are in a “seek forgiveness, not permission” time now.

    Fairfax is just grandstanding. As are more than a few on this blog…..

    Much calmer time at the Kroger this morning. More checkout lines. But still spot shortages clearly tied to hoarding – paper products, cleaning products, beef, chicken and pasta. But produce back in stock, plenty of dairy. People are rediscovering how to cook at home! And houses must be spic and span by now (I do think some of the cleaning supplies went for business use.) On the way home saw gas at $1.76. Wow.

    1. LarrytheG Avatar
      LarrytheG

      re: ” vision of an entrepreneur sitting on a phone waiting for some government permit needed to reopen a production line”or permission to import from Asia?

      I suspect South Korea has supplies… eh?

      😉

    2. djrippert Avatar
      djrippert

      The biggest question (which Northam has not addressed) is why we only have 114 confirmed cases. While it sounds strange to ask … Are we really just that lucky? Or is the deluge coming like it did in New York City and state? Have we done enough testing to even know where we stand? If Northam wants people to practice social distancing, avoid crowds, self-isolate, etc he needs to make his case. 114 cases and two deaths is terrible for the people infected and the families of the dead but it is much ado about nothing from an epidemic perspective.

      As you might imagine I’m no fan of NY Gov Coumo most of the time. However, he really stepped up during this crisis. His detailed and transparent press conference did as much as possible to calm the nerves of New Yorkers who are rightly concerned about the government’s ability to manage this epidemic. He admitted there were problems and described how those problems were being addressed. After that press conference I wonder why he’s not the Democratic candidate for president.

      My fear in Virginia is that we’ll finally start testing, the you know what will hit the fan and all of the problems like the one described in this article will fall on us like a hailstorm. The time to convince people that the government is in control is now. The time to solve maldistribution of protective gear is now. The time to establish confidence in our state government is now. But that all starts with an honest appraisal of where we really stand. Not with statements like “We’re prepared, trust me”.

  12. Steve Haner Avatar
    Steve Haner

    This is a problem our business guys can solve and by this time next week my prediction is they will have. I’m sure the supply chain starting gearing up two weeks ago. I do have this vision of an entrepreneur sitting on a phone waiting for some government permit needed to reopen a production line….We are in a “seek forgiveness, not permission” time now.

    Fairfax is just grandstanding. As are more than a few on this blog…..

    Much calmer time at the Kroger this morning. More checkout lines. But still spot shortages clearly tied to hoarding – paper products, cleaning products, beef, chicken and pasta. But produce back in stock, plenty of dairy. People are rediscovering how to cook at home! And houses must be spic and span by now (I do think some of the cleaning supplies went for business use.) On the way home saw gas at $1.76. Wow.

    1. djrippert Avatar
      djrippert

      The biggest question (which Northam has not addressed) is why we only have 114 confirmed cases. While it sounds strange to ask … Are we really just that lucky? Or is the deluge coming like it did in New York City and state? Have we done enough testing to even know where we stand? If Northam wants people to practice social distancing, avoid crowds, self-isolate, etc he needs to make his case. 114 cases and two deaths is terrible for the people infected and the families of the dead but it is much ado about nothing from an epidemic perspective.

      As you might imagine I’m no fan of NY Gov Coumo most of the time. However, he really stepped up during this crisis. His detailed and transparent press conference did as much as possible to calm the nerves of New Yorkers who are rightly concerned about the government’s ability to manage this epidemic. He admitted there were problems and described how those problems were being addressed. After that press conference I wonder why he’s not the Democratic candidate for president.

      My fear in Virginia is that we’ll finally start testing, the you know what will hit the fan and all of the problems like the one described in this article will fall on us like a hailstorm. The time to convince people that the government is in control is now. The time to solve maldistribution of protective gear is now. The time to establish confidence in our state government is now. But that all starts with an honest appraisal of where we really stand. Not with statements like “We’re prepared, trust me”.

    2. LarrytheG Avatar
      LarrytheG

      re: ” vision of an entrepreneur sitting on a phone waiting for some government permit needed to reopen a production line”or permission to import from Asia?

      I suspect South Korea has supplies… eh?

      😉

  13. TooManyTaxes Avatar
    TooManyTaxes

    Traditionally, states have put the first boots on the ground during emergencies. Localities respond, but more often than not, they need help from the state. The feds have traditionally provided money cuz they are the ones who can print it.

    I’ve been slow to criticize Northam, a person I abhor, because it’s a tough job to be in charge of a state in the midst of a pandemic. But bottom line: Northam is the guy in charge. He needs money from the feds but he’s the guy that can mobilize the National Guard. He can call the GA back into session and ask them to reallocate funds from virtue signaling to addressing the pandemic and the economic fall-out from the catastrophe. It’s beyond debate that, if he wrote a second edition of Profiles in Courage, Northam would not be included in the book.

    As far as the media are concerned, it’s a shame most of them weren’t in Italy for a self-admiration convention.

    1. LarrytheG Avatar
      LarrytheG

      re: the National Guard.

      has ANY state done that?

      I though Cuomo has been on the air begging Trump to let him call out the NG.

      Do State Govs have to have agreement from the Feds to call out the NG?

      1. Steve Haner Avatar
        Steve Haner

        Yes, several states are using National Guard personnel for some tasks. No, governors do not need federal authority.

        https://heavy.com/news/2020/03/the-national-guard-is-responding-to-covid-19-coronavirus-national-emergency/

        1. LarrytheG Avatar
          LarrytheG

          Okay, so that is one of the complaints with Northam then…. people
          want him to call up the NG?

      2. TooManyTaxes Avatar
        TooManyTaxes

        Many states, including New York and Virginia, have state volunteer forces (generic term) that can be called up by the Governor to assist the National Guard and other state and local entities. http://vdf.virginia.gov/joinvdf/ People who are U.S citizens and legal residents with or without prior military service, ages 16 to 65 can join the Virginia Defense Force. Members must have a valid social security number and no felony convictions.

        I bet that, if a call to aid was made by Northam, a number of Virginians would volunteer to join the VDF for the time of need.

  14. TooManyTaxes Avatar
    TooManyTaxes

    Traditionally, states have put the first boots on the ground during emergencies. Localities respond, but more often than not, they need help from the state. The feds have traditionally provided money cuz they are the ones who can print it.

    I’ve been slow to criticize Northam, a person I abhor, because it’s a tough job to be in charge of a state in the midst of a pandemic. But bottom line: Northam is the guy in charge. He needs money from the feds but he’s the guy that can mobilize the National Guard. He can call the GA back into session and ask them to reallocate funds from virtue signaling to addressing the pandemic and the economic fall-out from the catastrophe. It’s beyond debate that, if he wrote a second edition of Profiles in Courage, Northam would not be included in the book.

    As far as the media are concerned, it’s a shame most of them weren’t in Italy for a self-admiration convention.

    1. LarrytheG Avatar
      LarrytheG

      re: the National Guard.

      has ANY state done that?

      I though Cuomo has been on the air begging Trump to let him call out the NG.

      Do State Govs have to have agreement from the Feds to call out the NG?

      1. TooManyTaxes Avatar
        TooManyTaxes

        Many states, including New York and Virginia, have state volunteer forces (generic term) that can be called up by the Governor to assist the National Guard and other state and local entities. http://vdf.virginia.gov/joinvdf/ People who are U.S citizens and legal residents with or without prior military service, ages 16 to 65 can join the Virginia Defense Force. Members must have a valid social security number and no felony convictions.

        I bet that, if a call to aid was made by Northam, a number of Virginians would volunteer to join the VDF for the time of need.

  15. Reed Fawell 3rd Avatar
    Reed Fawell 3rd

    My sense now is that history will record this corona-virus as relatively mild and benign by major league pandemic plague standards worldwide down through history.

    Consider, for example, that the Roman Plague of decimated up to 100 million lives 590 AD. The Black Death Plague claimed up to 200 million lives between 1331–1353. Smallpox slaughtered 5-8 million people from 1331 to 1353 in Mexico alone. The Bubonic plague terminated 22 million between 1855–1860 in India alone.

    In the 2oth century the 1918-20 Spanish Flu sent to their graves up to 100 million lives. The Asian Flu killed two million people worldwide between 1958-1959; the Hong Kong flu cut down another one million between 1968 and 1969.

    In the 21st century, only two decades old, the Swine Flu claimed between 151,700 – 575,400 lives in 2009.

    Here today with the Corona-Virus, I fear the death toll, and the lasting economic harm, done in the United States may be unduly high by reason of America’s gross unpreparedness, and its own incompetence, and dysfunction on many levels, all of these failures having derived largely our own doings, and our own faults, that we have built and baked into American society, culture and institutions over many decades.

    There is and will be much to learn about these historical events, monumental failings, and failures, that are ongoing this very day in America.

    Some of them have been raised and pointed out on this blog, including in comments just above. Here is another example from another highly informative blog that has come to my attention.

    “Emergent Ventures prize winners for coronavirus work by Tyler Cowen

    I am happy to announce the first cohort of Emergent Ventures prize winners for their work fighting the coronavirus. Here is a repeat of the original prize announcement, and one week or so later I am delighted there are four strong winners, with some like others on the way. Again, this part of Emergent Ventures comes to you courtesy of the Mercatus Center and George Mason University. Here is the list of winners:

    Social leadership prize: Helen Chu and her team at the University of Washington. Here is a NYT article about Helen Chu’s work, excerpt:

    Dr. Helen Y. Chu, an infectious disease expert in Seattle, knew that the United States did not have much time…

    As luck would have it, Dr. Chu had a way to monitor the region. For months, as part of a research project into the flu, she and a team of researchers had been collecting nasal swabs from residents experiencing symptoms throughout the Puget Sound region.

    To repurpose the tests for monitoring the coronavirus, they would need the support of state and federal officials. But nearly everywhere Dr. Chu turned, officials repeatedly rejected the idea, interviews and emails show, even as weeks crawled by and outbreaks emerged in countries outside of China, where the infection began.

    By Feb. 25, Dr. Chu and her colleagues could not bear to wait any longer. They began performing coronavirus tests, without government approval.

    What came back confirmed their worst fear. They quickly had a positive test from a local teenager with no recent travel history. The coronavirus had already established itself on American soil without anybody realizing it.

    And to think Helen is only an assistant professor.

    Data gathering and presentation prize: Avi Schiffmann

    Here is a good write-up on Avi Schiffmann, excerpt:

    A self-taught computer maven from Seattle, Avi Schiffmann uses web scraping technology to accurately report on developing pandemic, while fighting misinformation and panic.

    Avi started doing this work in December, remarkable prescience, and he is only 17 years old. Here is a good interview with him:

    I’d like to be the next Avi Schiffmann and make the next really big thing that will change everything.

    Prize for good policy thinking: The Imperial College researchers, led by Neil Ferguson, epidemiologist …”

    For more information found on this blog go to, and subscribe to: https://marginalrevolution.com/

    Meanwhile, please note how single individuals step up to problems, often having to overcome large institutions, and corrupted systems, to find solutions.

  16. Reed Fawell 3rd Avatar
    Reed Fawell 3rd

    My sense now is that history will record this corona-virus as relatively mild and benign by major league pandemic plague standards worldwide down through history.

    Consider, for example, that the Roman Plague of decimated up to 100 million lives 590 AD. The Black Death Plague claimed up to 200 million lives between 1331–1353. Smallpox slaughtered 5-8 million people from 1331 to 1353 in Mexico alone. The Bubonic plague terminated 22 million between 1855–1860 in India alone.

    In the 2oth century the 1918-20 Spanish Flu sent to their graves up to 100 million lives. The Asian Flu killed two million people worldwide between 1958-1959; the Hong Kong flu cut down another one million between 1968 and 1969.

    In the 21st century, only two decades old, the Swine Flu claimed between 151,700 – 575,400 lives in 2009.

    Here today with the Corona-Virus, I fear the death toll, and the lasting economic harm, done in the United States may be unduly high by reason of America’s gross unpreparedness, and its own incompetence, and dysfunction on many levels, all of these failures having derived largely our own doings, and our own faults, that we have built and baked into American society, culture and institutions over many decades.

    There is and will be much to learn about these historical events, monumental failings, and failures, that are ongoing this very day in America.

    Some of them have been raised and pointed out on this blog, including in comments just above. Here is another example from another highly informative blog that has come to my attention.

    “Emergent Ventures prize winners for coronavirus work by Tyler Cowen

    I am happy to announce the first cohort of Emergent Ventures prize winners for their work fighting the coronavirus. Here is a repeat of the original prize announcement, and one week or so later I am delighted there are four strong winners, with some like others on the way. Again, this part of Emergent Ventures comes to you courtesy of the Mercatus Center and George Mason University. Here is the list of winners:

    Social leadership prize: Helen Chu and her team at the University of Washington. Here is a NYT article about Helen Chu’s work, excerpt:

    Dr. Helen Y. Chu, an infectious disease expert in Seattle, knew that the United States did not have much time…

    As luck would have it, Dr. Chu had a way to monitor the region. For months, as part of a research project into the flu, she and a team of researchers had been collecting nasal swabs from residents experiencing symptoms throughout the Puget Sound region.

    To repurpose the tests for monitoring the coronavirus, they would need the support of state and federal officials. But nearly everywhere Dr. Chu turned, officials repeatedly rejected the idea, interviews and emails show, even as weeks crawled by and outbreaks emerged in countries outside of China, where the infection began.

    By Feb. 25, Dr. Chu and her colleagues could not bear to wait any longer. They began performing coronavirus tests, without government approval.

    What came back confirmed their worst fear. They quickly had a positive test from a local teenager with no recent travel history. The coronavirus had already established itself on American soil without anybody realizing it.

    And to think Helen is only an assistant professor.

    Data gathering and presentation prize: Avi Schiffmann

    Here is a good write-up on Avi Schiffmann, excerpt:

    A self-taught computer maven from Seattle, Avi Schiffmann uses web scraping technology to accurately report on developing pandemic, while fighting misinformation and panic.

    Avi started doing this work in December, remarkable prescience, and he is only 17 years old. Here is a good interview with him:

    I’d like to be the next Avi Schiffmann and make the next really big thing that will change everything.

    Prize for good policy thinking: The Imperial College researchers, led by Neil Ferguson, epidemiologist …”

    For more information found on this blog go to, and subscribe to: https://marginalrevolution.com/

    Meanwhile, please note how single individuals step up to problems, often having to overcome large institutions, and corrupted systems, to find solutions.

  17. sherlockj Avatar
    sherlockj

    The Governor can call out the National Guard as he wishes.
    If Guard forces are federalized by the President, they
    1. Do not work for the Governor.
    2. Cannot enforce state laws.
    3. Are now federal military resources and cannot operate within the states except under Presidential deployment order. That order will state the mission and the limits of the mission. Even then, federalized National Guardsmen may not enforce federal statutes outside of the specifics of the deployment order unless deputized as U.S. Marshals.

    1. djrippert Avatar
      djrippert

      COVID-19 should be a state-by-state matter. The Feds should provide funding but the response in Wyoming can and should be different than the response in New York. It seems to me that the only reason to federalize the national guard in this situation is because the responses from the states’ governors (or at least some of them) are insufficient. While the initial response from the Feds on matter of health was ridiculous (a hoax?) the Feds now seem far more on top of things than the Virginia state government. As a side note the Feds did actively and effectively address the economic implications of COVID-19, at least to the extent those issues can be addressed. However, health should be the top priority and I have little faith in Richmond on that one. If they have a plan they are keeping it to themselves – which is probably the biggest error in crisis management you can make.

      What’s the plan Ralph? You have no political future to squander. You can’t run for governor again in 2021 and your blackface photo killed any national political ambitions you might have once harbored. Your reaction to COVID-19 is all anybody will remember of your time as governor. What’s the plan Ralph?

      1. LarrytheG Avatar
        LarrytheG

        So you’re a fan of Cuomo?

        he’s been on TV more than the POTUS!

        and his big mantra is to tell the public everything – as much as he can and he says that’s how you get citizens to pay attention and do what is expected.

        like this:

        Governor Cuomo Signs the ‘New York State on PAUSE’ Executive Order

        https://www.governor.ny.gov/news/governor-cuomo-signs-new-york-state-pause-executive-order

        He is saying NY does not have enough PPE either by the way.

        1. sherlockj Avatar
          sherlockj

          Too much of gubernatorial and mayoral politics is about public policy, not execution management skills. I personally am a fan of any Governor, mayor or city/county executive who calmly takes charge in an emergency, already knows his or her authorities and responsibilities and has trained with his or her people in emergency response. Leadership will out.

        2. djrippert Avatar
          djrippert

          I’m a fan of Cuomo’s handling of COVID-19. I was a fan of Giuliani’s handling of 9/11.

          I’m sure there is not enough PPE. However, Cuomo is admitting that and (partially) using that fact to encourage New Yorkers to take the isolation orders seriously. He’s also asking PPE product providers to sell non-essential inventory to the state and ramp up production. You know – doing what a governor can do in a crisis.

          I’d think that the key with PPE in Virginia would be to inventory the material at hand (what, how much, where) and establish a plan to get some of the material to whatever hotspots develop. Flatten the curve and all that. There also needs to be a policy as to whether primary care physicians are the front line or if emergency rooms are the front line. If it’s primary care physicians then they need PPE.

          1. LarrytheG Avatar
            LarrytheG

            I like Cuomo’s handling also – he’s forceful and pragmatic.

            But he has no doubt who the top “front line” is – it’s the hospitals which have to treat everyone for all conditions and if they run out of protective gear – they’re in trouble.

            The front-line doctors are obviously important – critical even – but when push comes to shove in an emergency, triage has to take place and I cannot imagine a situation where the hospitals have to turn away really sick people – literally picking who lives and who dies.

            That happens in places like Iraq and Syria and indeed developing and 3rd world countries , and obviously it has potential here but at the end of the day, the hospitals have to be the last thing to go down.

            my opinion of course and I realize others may not agree.

            There is so much room here for missteps from a wide variety of officials and leaders and indeed, we should be thankful for the good and great ones – but an environment where various groups of differing views are all criticizing – from all sides such that the person in their focus is literally damned if you do and damned if you don’t. That’s not a productive process.

            There will be time enough for lessons learned after but in general our politics has become so toxic that no matter what Northam did – he’d have critics – and so do most of his counter-parts in other states. We just have a corrosive body politic these days.

      2. TooManyTaxes Avatar
        TooManyTaxes

        If the President calls up the National Guard, it is nationalized and beyond the control of state governors. That doesn’t seem like a good idea to me.

  18. sherlockj Avatar
    sherlockj

    The Governor can call out the National Guard as he wishes.
    If Guard forces are federalized by the President, they
    1. Do not work for the Governor.
    2. Cannot enforce state laws.
    3. Are now federal military resources and cannot operate within the states except under Presidential deployment order. That order will state the mission and the limits of the mission. Even then, federalized National Guardsmen may not enforce federal statutes outside of the specifics of the deployment order unless deputized as U.S. Marshals.

    1. djrippert Avatar
      djrippert

      COVID-19 should be a state-by-state matter. The Feds should provide funding but the response in Wyoming can and should be different than the response in New York. It seems to me that the only reason to federalize the national guard in this situation is because the responses from the states’ governors (or at least some of them) are insufficient. While the initial response from the Feds on matter of health was ridiculous (a hoax?) the Feds now seem far more on top of things than the Virginia state government. As a side note the Feds did actively and effectively address the economic implications of COVID-19, at least to the extent those issues can be addressed. However, health should be the top priority and I have little faith in Richmond on that one. If they have a plan they are keeping it to themselves – which is probably the biggest error in crisis management you can make.

      What’s the plan Ralph? You have no political future to squander. You can’t run for governor again in 2021 and your blackface photo killed any national political ambitions you might have once harbored. Your reaction to COVID-19 is all anybody will remember of your time as governor. What’s the plan Ralph?

      1. LarrytheG Avatar
        LarrytheG

        So you’re a fan of Cuomo?

        he’s been on TV more than the POTUS!

        and his big mantra is to tell the public everything – as much as he can and he says that’s how you get citizens to pay attention and do what is expected.

        like this:

        Governor Cuomo Signs the ‘New York State on PAUSE’ Executive Order

        https://www.governor.ny.gov/news/governor-cuomo-signs-new-york-state-pause-executive-order

        He is saying NY does not have enough PPE either by the way.

        1. sherlockj Avatar
          sherlockj

          Too much of gubernatorial and mayoral politics is about public policy, not execution management skills. I personally am a fan of any Governor, mayor or city/county executive who calmly takes charge in an emergency, already knows his or her authorities and responsibilities and has trained with his or her people in emergency response. Leadership will out.

        2. djrippert Avatar
          djrippert

          I’m a fan of Cuomo’s handling of COVID-19. I was a fan of Giuliani’s handling of 9/11.

          I’m sure there is not enough PPE. However, Cuomo is admitting that and (partially) using that fact to encourage New Yorkers to take the isolation orders seriously. He’s also asking PPE product providers to sell non-essential inventory to the state and ramp up production. You know – doing what a governor can do in a crisis.

          I’d think that the key with PPE in Virginia would be to inventory the material at hand (what, how much, where) and establish a plan to get some of the material to whatever hotspots develop. Flatten the curve and all that. There also needs to be a policy as to whether primary care physicians are the front line or if emergency rooms are the front line. If it’s primary care physicians then they need PPE.

  19. James A. Bacon Avatar
    James A. Bacon

    I was conversing last night with the director of a Virginia health care clinic. Her staff has no protective gear, and everyone is very worried. She made the call, a tough one, to suspend outreach medical services to a particularly high-risk group. The lack of protective equipment is not abstract. It is having real-world consequences right now.

    1. djrippert Avatar
      djrippert

      Absent a properly communicated plan panic ensues. What’s the plan Ralph? You told us how prepared we were. Now we’re hearing about a lack of protective gear and cutbacks to medical services to high risk groups based on that lack of gear. What’s the plan Ralph?

    2. Reed Fawell 3rd Avatar
      Reed Fawell 3rd

      Jim’s comment above sums up in one telling detail why I have such a lack of confidence in where Virginia stands right now. Hope I am wrong.

    3. LarrytheG Avatar
      LarrytheG

      and yet – the response is to assign blame… as if the equipment is available but we screwed up getting it to them…

      We just got back from WalMart. It was MUCH WORSE than the other day. Most all the meat is gone including lunch meat, hot dogs, etc. picked clean. TP is gone. I think people are convinced that supplies will not be available later so they’re getting everything they can right now.

      I pretty much imagine how the preppers are doing. They’re telling us “we told you so”.

    4. Reed Fawell 3rd Avatar
      Reed Fawell 3rd

      Of course, we should assign blame. To do otherwise is totally irresponsible. There can be no excuse our health system was not prepared for this, not even in the most fundamental ways, protective masks and gowns, for example. My God, plagues are older than Moses. Mass death is a common weapon of war, one our enemies have refined to a sophisticated art. Yet, again, we have proven ourselves incompetent fools. Now, as usual, a few heroes will save the day for us over our strenuous objections and utter stupidity in understanding and preparing for the simplest and most obvious of risks and antidotes. Health care is a joke in America, the vast difference in its claims, its costs, and its performance against simple threats to Americans’ health.

      1. LarrytheG Avatar
        LarrytheG

        I see this through a 9-11 prism. If were are wrong – and it does look like it, then there are a whole bunch who screwed up , not one or two and I’d sure like to know who did it right if any.

        We’re still figuring out how to fix 9-11..

        South Korea did it right – they are bigger than California .. smaller than China and bigger than Italy.

  20. James A. Bacon Avatar
    James A. Bacon

    I was conversing last night with the director of a Virginia health care clinic. Her staff has no protective gear, and everyone is very worried. She made the call, a tough one, to suspend outreach medical services to a particularly high-risk group. The lack of protective equipment is not abstract. It is having real-world consequences right now.

    1. djrippert Avatar
      djrippert

      Absent a properly communicated plan panic ensues. What’s the plan Ralph? You told us how prepared we were. Now we’re hearing about a lack of protective gear and cutbacks to medical services to high risk groups based on that lack of gear. What’s the plan Ralph?

    2. Reed Fawell 3rd Avatar
      Reed Fawell 3rd

      Jim’s comment above sums up in one telling detail why I have such a lack of confidence in where Virginia stands right now. Hope I am wrong.

    3. LarrytheG Avatar
      LarrytheG

      and yet – the response is to assign blame… as if the equipment is available but we screwed up getting it to them…

      We just got back from WalMart. It was MUCH WORSE than the other day. Most all the meat is gone including lunch meat, hot dogs, etc. picked clean. TP is gone. I think people are convinced that supplies will not be available later so they’re getting everything they can right now.

      I pretty much imagine how the preppers are doing. They’re telling us “we told you so”.

    4. Reed Fawell 3rd Avatar
      Reed Fawell 3rd

      Of course, we should assign blame. To do otherwise is totally irresponsible. There can be no excuse our health system was not prepared for this, not even in the most fundamental ways, protective masks and gowns, for example. My God, plagues are older than Moses. Mass death is a common weapon of war, one our enemies have refined to a sophisticated art. Yet, again, we have proven ourselves incompetent fools. Now, as usual, a few heroes will save the day for us over our strenuous objections and utter stupidity in understanding and preparing for the simplest and most obvious of risks and antidotes. Health care is a joke in America, the vast difference in its claims, its costs, and its performance against simple threats to Americans’ health.

      1. LarrytheG Avatar
        LarrytheG

        I see this through a 9-11 prism. If were are wrong – and it does look like it, then there are a whole bunch who screwed up , not one or two and I’d sure like to know who did it right if any.

        We’re still figuring out how to fix 9-11..

        South Korea did it right – they are bigger than California .. smaller than China and bigger than Italy.

  21. sherlockj Avatar
    sherlockj

    Too much of gubernatorial and mayoral politics is about public policy and of course money, not execution management skills. I personally am a fan of any Governor, mayor or city/county executive who calmly takes charge in an emergency, already knows his or her authorities and responsibilities and has trained with his or her people in emergency response. At that point it is leadership that matters. An old saying applies, “lead, follow or get out of the way.”

  22. sherlockj Avatar
    sherlockj

    Too much of gubernatorial and mayoral politics is about public policy and of course money, not execution management skills. I personally am a fan of any Governor, mayor or city/county executive who calmly takes charge in an emergency, already knows his or her authorities and responsibilities and has trained with his or her people in emergency response. At that point it is leadership that matters. An old saying applies, “lead, follow or get out of the way.”

  23. LarrytheG Avatar
    LarrytheG

    interesting chart but no longer up to date. I wonder what one that shows US States would look like:

    https://www.macleans.ca/wp-content/uploads/2020/03/GILMORE1-1-981×562.png

    1. djrippert Avatar
      djrippert

      Smart to use log scale. I do wonder whether these graphs should be per capita vs total cases. It seems to me that a populous country like the US is going to have more cases. Regardless, those curves look frightening. But once again … are we just lucky in Virginia? Or is the dam about to break?

  24. Reed Fawell 3rd Avatar
    Reed Fawell 3rd

    Above I said:

    “Of course, we should assign blame. To do otherwise is totally irresponsible. There can be no excuse our health system was not prepared for this, not even in the most fundamental ways, protective masks and gowns, for example. My God, plagues are older than Moses. Mass death is a common weapon of war, one our enemies have refined to a sophisticated art. Yet, again, we have proven ourselves incompetent fools. Now, as usual, a few heroes will save the day for us over our strenuous objections and utter stupidity in understanding and preparing for the simplest and most obvious of risks and antidotes. Health care is a joke in America, the vast difference in its claims, its costs, and its performance against simple threats to Americans’ health.”

    There are many reasons for these gross failures. Bertrand Russell’s observation likely is chief among them: “Most people would sooner die than think, and most of them do.”

    But how about too the obvious and chronic failures of group dynamics that so often shift a group from its laudable initial mission of say “helping and or serving others” to that of preserving the self interests and survival to the group, most particularly its leaders, first and foremost. And thus to do so at the expense of its original mission that instead is eaten alive by private interests of group and its leaders.

    This dynamic explains why the health systems of Europe, even its most modern, appear in growing numbers to be close to being overwhelmed at least in part, if not in whole, by this virus.

    Thus too we can fairly say that most American health systems likely are run for the benefit of doctors, administrators and insurers first, before the needs of their patients, particularly so the basic patient needs, if only because those needs to not pay well, do not finance status building cutting edge infrastructure, and do not confer the greatest status on doctors, along with putting the most money in their pockets and the system’s pocket.

    So America’s health system now resembles US higher education in numerous ways.

    This is perhaps the primary reason why American hospitals and public health today are so grossly unprepared to fight and win the war against the Caronavirus, or any other event inflicting mass casualties on the American people. Simply put, there is not enough money and status to be gained to make such preparation and constant readiness worthwhile to the health care industry.

    One final note – based on recent reporting in Washington Post, the odds appear to be rising that this war against the virus will be refocused sharply by the press and its political allies into a war against Donald Trump. Of so this will be a great tragedy for the nation if only because it will severely and perhaps irreparably impair America’s ability to limit the ongoing damage the crisis is inflicting on the nation.

  25. Reed Fawell 3rd Avatar
    Reed Fawell 3rd

    Above I said:

    “Of course, we should assign blame. To do otherwise is totally irresponsible. There can be no excuse our health system was not prepared for this, not even in the most fundamental ways, protective masks and gowns, for example. My God, plagues are older than Moses. Mass death is a common weapon of war, one our enemies have refined to a sophisticated art. Yet, again, we have proven ourselves incompetent fools. Now, as usual, a few heroes will save the day for us over our strenuous objections and utter stupidity in understanding and preparing for the simplest and most obvious of risks and antidotes. Health care is a joke in America, the vast difference in its claims, its costs, and its performance against simple threats to Americans’ health.”

    There are many reasons for these gross failures. Bertrand Russell’s observation likely is chief among them: “Most people would sooner die than think, and most of them do.”

    But how about too the obvious and chronic failures of group dynamics that so often shift a group from its laudable initial mission of say “helping and or serving others” to that of preserving the self interests and survival to the group, most particularly its leaders, first and foremost. And thus to do so at the expense of its original mission that instead is eaten alive by private interests of group and its leaders.

    This dynamic explains why the health systems of Europe, even its most modern, appear in growing numbers to be close to being overwhelmed at least in part, if not in whole, by this virus.

    Thus too we can fairly say that most American health systems likely are run for the benefit of doctors, administrators and insurers first, before the needs of their patients, particularly so the basic patient needs, if only because those needs to not pay well, do not finance status building cutting edge infrastructure, and do not confer the greatest status on doctors, along with putting the most money in their pockets and the system’s pocket.

    So America’s health system now resembles US higher education in numerous ways.

    This is perhaps the primary reason why American hospitals and public health today are so grossly unprepared to fight and win the war against the Caronavirus, or any other event inflicting mass casualties on the American people. Simply put, there is not enough money and status to be gained to make such preparation and constant readiness worthwhile to the health care industry.

    One final note – based on recent reporting in Washington Post, the odds appear to be rising that this war against the virus will be refocused sharply by the press and its political allies into a war against Donald Trump. Of so this will be a great tragedy for the nation if only because it will severely and perhaps irreparably impair America’s ability to limit the ongoing damage the crisis is inflicting on the nation.

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