Question

HOW NEW YORK GOVERNOR AND THE US GOVERNOR GOT IT WRONG ELDER DURING THE CORONA VIRUS OUTBREAK

Answer 1

The US is now the global epicenter of the pandemic, surpassing the number of reported cases in China, where the virus began, and Italy, the hardest-hit European nation. Although public health officials report that the peak of the outbreak in the US is still weeks, perhaps months, away, shortcomings in the US response - as well as some strengths have already become apparent.

At the state and local level, some leaders have been more proactive than others. San Francisco implemented a stay-at-home order on March 16. Despite being the country's second most densely-populated city, it has only recorded 10 deaths from the virus.

New York Governor Andrew Cuomo didn't issue a similar order until a week later. The virus was already running rampant in his state, but that was only beginning to become clear.

Medical supply shortages

Masks, gloves, gowns, and ventilators. Doctors and hospitals across the country, but particularly in areas hardest hit by the pandemic, are scrambling for items essential to help those stricken by the virus and protect medical professionals.

The lack of adequate supplies has forced healthcare workers to reuse existing sanitary garb or create their own makeshift gear. A shortage of ventilators has state officials worried they will soon be forced into performing medical triage, deciding on the fly who receives the life-sustaining support - and who doesn't.

On Tuesday, New York Governor Andrew Cuomo complained that states, along with the federal government, were competing for equipment, driving up prices for everyone.

"It's like being on eBay with 50 other states, bidding on a ventilator," he said.

It didn't have to be this way, says Jeffrey Levi, a professor of health policy and management at George Washington University. The US government failed to adequately maintain the stockpile of supplies necessary to deal with a pandemic like this - and then moved too slowly when the nature of the current crisis became apparent.

"We lost many weeks in terms of ramping up the production capacity around personal protection equipment and never fully utilizing government authority to make sure that production took place," he says.

Testing delays

According to Professor Levi, ramping up testing at an early date - as done in nations like South Korea and Singapore - is the key to controlling a viral outbreak like Covid-19. The inability of the US government to do so was the critical failure from which subsequent complications have cascaded.

"All of pandemic response is dependent on situational awareness - knowing what is going on and where it is happening," he says.

Without this information, public health officials are essentially flying blind, not knowing where the next viral hotspot will flare-up. Comprehensive testing means infected patients can be identified and isolated, limiting the need for the kind of sweeping state-wide shelter-in-place orders that have frozen the US economy and led to millions of unemployed workers.

Levi says the responsibility for this failure lies squarely with the Trump administration, which disregarded pandemic response plans dating back more than a decade to the George W Bush presidency and failed to fully staff its public health bureaucracy.

"The political leadership in this administration really doesn't believe in government," Levi says. "That has really hampered their willingness to harness the resources the federal government had to respond at a time like this."

Social-distancing failures

College students on spring break from classes packed Florida beaches. New York City residents filled subway cars. A church in Louisiana continues to welcome thousands despite pastor Tony Spell being criminally cited for violating an order limiting the size of gatherings.

"The virus, we believe, is politically motivated," Spell told a local television station. "We hold our religious rights dear, and we are going to assemble no matter what someone says."

Across the country, there have been numerous examples of Americans failing to heed the calls by public health professionals to avoid close social contact, sometimes abetted by local and state government officials who have been reluctant to order businesses to shutter and citizens to shelter in place.

Even steps taken with the best of intentions might have had adverse consequences. Curtailing public-transportation services, such as New York's subway, may have led to trains and busses that were more crowded. Universities that sent students home to their families may have contributed to the spread of the virus by returning infected individuals to cities, neighborhoods, and homes not yet in full lockdown.

The lack of clarity in the president's order to halt entry into the US from Europe - which at first seemed to apply US citizens as well as foreign nationals - led to a crushing crowds at airports where unscreened infected passengers could easily transit the disease to others.

Decisions like those may have had dire consequences, hampering efforts to contain the spread of the disease throughout the nation - the public health equivalent of throwing petrol on an already raging fire.

The governor has failed to take responsibility for the obvious failures, consistently blaming others and at one point even saying “governors don’t do pandemics”. (Actually, some governors just don’t read their state’s pandemic plans.) But much of the press has ignored this, focusing instead on Cuomo’s aesthetic presentation: his poise during press conferences, his dramatic statements about “taking responsibility” (even when he obviously hasn’t), and his invisible good looks,

The mask mural is yet another publicity stunt mistaken by the press as a sign of leadership. On 29 April, Cuomo unveiled a wall of handmade cloth masks that had been sent to his office by concerned citizens all over America. He called it “a self-portrait of America. Do you know what that spells? It spells love.” Since the arrangement of masks doesn’t form words, the mural doesn’t actually spell anything, but it is a perfect symbol of Cuomo’s leadership failures. Handmade cloth face coverings are not as effective as N95 masks, of course, but if unsuitable for healthcare workers they would still have been perfectly appropriate to distribute to New Yorkers (some of whom have been brutally arrested for not wearing masks). But Cuomo, rather than putting the needs of New Yorkers first, chose to tack hundreds of cloth masks on a wall as a monument to himself.

And some governors, like Andrew Cuomo of New York, a Democrat, have really risen to the challenge, he said. More than any other governor, Cuomo has channeled the nation's yearning for sober, decisive and competent leadership during this time of crisis," Hildebrand said. "And his blend of cajoling and flattery in dealing with President Trump is a model for the times. Watching his candid yet reassuring briefings, one is struck with feeling that Cuomo has finally found his moment to shine.

If the coronavirus is exposing some of the flaws in the US healthcare system - high costs, a lack of universal coverage, and supply chains that are unable to withstand a shock - it also could end up highlighting the strength of the nation's research and drug development infrastructure.

Pharmaceutical manufacturers and medical researchers are rushing to learn more about the virus in an attempt to devise new strategies to defeat the pandemic.

One company has developed a new fast-response test that can identify those carrying the virus almost immediately, ending the current testing backlog and allowing public health officials to quickly identify new outbreak hotspots and make quarantining decisions.