COVID-19 Update

World

• New Cases:   474,163 (⬆︎ 1.01%)
• New Deaths:      5,712 (⬆︎   .47%)

USA

• New Cases:   88,905 (⬆︎ .94%)
• New Deaths:       522 (⬆︎ .22%)

WaPo:

Top Trump adviser bluntly contradicts president on covid-19 threat, urging all-out response

“This is not about lockdowns … It’s about an aggressive balanced approach that is not being implemented," says internal White House report that challenges many of Trump’s pronouncements.

A top White House coronavirus adviser sounded alarms Monday about a new and deadly phase in the health crisis, pleading with top administration officials for “much more aggressive action,” even as President Trump continues to assure rallygoers the nation is “rounding the turn” on the pandemic.

“We are entering the most concerning and most deadly phase of this pandemic … leading to increasing mortality,” said the Nov. 2 report from Deborah Birx, coordinator of the White House coronavirus task force. “This is not about lockdowns — It hasn’t been about lockdowns since March or April. It’s about an aggressive balanced approach that is not being implemented.”

Birx’s internal report, shared with top White House and agency officials, contradicts Trump on numerous points: While the president holds large campaign events with hundreds of attendees, most without masks, she explicitly warns against them. While the president blames rising cases on more testing, she says testing is “flat or declining” in many areas where cases are rising. And while Trump says the country is “rounding the turn,” Birx notes the country is entering its most dangerous period yet and will see more than 100,000 new cases a day this week.

Through a spokesperson, Birx did not respond to a request for comment.

Other health experts, including Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, have warned of record surges in cases and hospitalizations as the United States records more than 9 million cases and 230,000 deaths. “We’re in for a whole lot of hurt,” Fauci told The Washington Post late Friday, predicting a long and potentially deadly winter unless there’s an “abrupt change” — prompting Trump to suggest he planned to fire the scientist after the election.

But Birx’s daily missives go further, revealing how much the administration’s internal reports are in direct conflict with Trump’s public pronouncements that downplay the seriousness of the threat and erroneously suggest few people are dying. They also speak to the increasing desperation of health officials to spotlight the risks of a pandemic that is forecast to take thousands more lives as the weather worsens unless people change their behaviors. Some officials are also concerned about recouping their reputations in a post-Trump era.

The increasingly dire tone of Birx’s reports has gotten little traction, according to an administration official who works with her and spoke on the condition of anonymity to share sensitive information. “She feels like she’s being ignored,” the official said.

Birx’s message “has been urgent for weeks,” said another administration official, “as has the plea for the administration to ask the American people to use masks, avoid gatherings and socially distance, basically since it became apparent that we were heading into a third surge.”

The report hits hard on the worsening situation: “Cases are rapidly rising in nearly 30 percent of all USA counties, the highest number of county hotspots we have seen with this pandemic,” it said. “Half of the United States is in the red or orange zone for cases despite flat or declining testing.”

Sounding a similar theme to past reports, it calls for “much more aggressive action from messaging, to testing, to surging personnel around the country before the crisis point.”

What is “essential at this time point,” the report said, is “consistent messaging about uniform use of masks, physical distancing and hand washing with profound limitation on indoor gatherings especially with family and friends.”

It adds: “This is about empowerment [sic] Americans with the knowledge and data for decision-making to prevent community spread and save lives.”

The president appears unpersuaded by such messages, convinced by new medical adviser Scott Atlas, a neuroradiologist with no infectious-disease experience, that allowing healthy people to return to daily activities without restrictions will hasten herd immunity and bolster the economy, say some advisers who spoke on the condition of anonymity because they were not authorized to speak publicly.

Trump plans to hold a large indoor gathering for 300 to 400 guests at the White House on Tuesday to watch the election returns, only a few weeks after a White House event to announce his Supreme Court nominee Amy Coney Barrett became a superspreader event.

White House communications director Alyssa Farah disputed the report’s suggestion that the administration’s response has been inadequate to the crisis. She said the White House has “significantly increased” the U.S. national stockpile to ensure the country has sufficient personal protective equipment; bought 150 million coronavirus tests and distributed them to the most vulnerable populations, including nursing homes, assisted-living facilities and Native American tribal areas; and sent special teams to states and nursing homes with the most cases.

In addition, she said, the administration continues to work to “safely rush therapeutics” to the sick and develop vaccines. “We are working around-the-clock to safely treat the virus and ultimately defeat it,” Farah said.

Birx’s report goes to pains to dispute Trump’s false claims that coronavirus cases are increasing only because of increases in testing. Monday’s report notes that although testing is flat, a rising number of tests are positive, suggesting “community spread is much worse than is evident by current [measurements].”

An earlier, Oct. 17 report sounded the same theme: It cited increasing daily hospital admissions, rising fatalities and emergency room visits, and bluntly stated, “this is not due to increased testing but broad and ever increasing community spread.”

That report added these words highlighted in bold: “There is an absolute necessity of the Administration to use this moment to ask the American people to wear masks, physical distance and avoid gatherings in both public and private spaces.” On that day, Trump held two large rallies, according to his public schedule, one in Michigan and one in Wisconsin.

Officials describe Birx as frustrated with Atlas’ growing influence. She has challenged his views in task force meetings, suggesting that reopening society without any restrictions would lead to thousands of deaths.

In recent weeks, Birx has crisscrossed the country, traveling to dozens of virus hot spots, where she has urged state and local officials to mandate masks, close bars and restaurants and encourage distancing.

Birx is said to be close to Vice President Pence, but he’s been on the road campaigning in recent weeks, taking his attention away from the coronavirus, according to a senior administration official who spoke on the condition of anonymity to share internal discussions.

Unlike Fauci, a highly regarded civil servant who Trump has criticized as a “Democrat,” Birx was chosen by the administration to helm the response and has been lavishly praised in the past by Trump.

Fauci said in his interview Friday that he and Birx lost the president’s ear as Trump worried increasingly about a sputtering economy and his reelection prospects.

“They needed to have a medical message that was essentially consistent with what they were saying, and one of the ways to say, ‘The outbreak is over. [Mitigation strategies are] really irrelevant because it doesn’t make any difference. All you need to do is prevent people from dying and protect people in places like the nursing homes,’ ” Fauci said.

On Getting Rat-Fucked

I don't know what it's like "out there". Like most Americans, I don't spend much time or energy looking at my country from the perspective of any other country.

I've tried to do that, and I know I should try to get back to doing that again, but also like most Americans now, it seems the problems here in USAmerica Inc are such that make it impossible to fight the fire from anywhere but inside the house. And we'll just have to trust that others can see our efforts, and provide the perspective we need to stay oriented and focused.

Of course, that assumes there are more good people who want to help - and who want to see us succeed - than there are who feel the need to tear us down.

Ever cautious though.

A little paranoia is, as always, in order. Because there's always some asshole who just wants to see it all crash and burn.

WaPo:

Suspicious robocall campaign warning people to ‘stay home’ spooks voters nationwide

An unidentified robocaller has placed an estimated 10 million calls in the past several weeks warning people to “stay safe and stay home,” spooking some Americans who said they saw it as an attempt to scare them away from the polls on Election Day.

The barrage of calls all feature the same short, recorded message: A computerized female voice says the message is a “test call” before twice encouraging people to remain inside. The robocalls, which have come from a slew of fake or unknown numbers, began over the summer and intensified in October, and now appear to have affected nearly every Zip code in the United States.

The reach and timing of the calls recently caught the attention of YouMail, a tech company that offers a robocall-blocking app for smartphones, as well as some of the country’s top telecom carriers, which determined from an investigation that the calls may be foreign in origin and sophisticated in their tactics. Data from YouMail shows that the calls have reached 280 of the country’s 317 area codes since the campaign began in the summer.

While the robocall does not explicitly mention the 2020 presidential election or issues that might affect voters’ well-being, including the coronavirus pandemic, it still threatens to create confusion, said Alex Quilici, YouMail’s chief executive. And it illustrates worrisome vulnerabilities in the country’s phone system, he said, that sophisticated actors could exploit.

“If you wanted to cause havoc in America for the elections, one way to do it is clearly robocalling,” Quilici said. “This whole thing is exposing [that] it can be very difficult to react quickly to a large calling volume campaign.”

When Zach McMullen received a call Monday telling him it was “time to stay home,” he assumed the warning was related to the coronavirus. His co-workers at an Atlanta bakery had received the same message, and they initially figured it was the city government enforcing its public health guidelines.

But the “robotic voice” gave McMullen pause, as did the second call — and then the third, and the fourth — delivering the same monotone message on the same day.

“I think they mean stay home and don't vote,” the 37-year-old concluded.

The torrent of calls illustrated the wide array of technologies that voters say are being used to convince and confuse them in the closing days of a dizzying presidential campaign. Four years after Russian agents exploited social media to spread divisive messages, Americans have come to expect similar efforts everywhere — including on their phones.

Robocalls long have represented a national scourge: Scammers contributed greatly to the 4 billion automated calls placed to Americans just last month, outwitting years of efforts by Washington regulators to crack down on the spam. But these tactics — dialing Americans en masse, sometimes illegally and without their consent — have taken on greater significance given the contentiousness of the 2020 presidential race. The same tools that have helped candidates and their allies reach their supporters properly also represent new avenues for falsehoods to spread widely — and without much visibility.

The “stay home” robocall appears to have bombarded Americans since the summer, sometimes yielding a roughly estimated half-million calls each day, according to data collected by YouMail.

USTelecom, a trade association for AT&T, Verizon and other telecom giants, has sought to trace and combat the campaign in recent days, according to Brian Weiss, the group’s spokesman. He said early evidence suggests that the calls are “possibly coming from Europe,” though they are sometimes routed through other foreign telecom providers.

The unidentified actor behind the robocall campaign also appears to have relied on other sophisticated tactics to ensure that the companies behind the country’s phone systems could not easily stop it, according to USTelecom and other robocall experts. That includes cycling through phone numbers, often using a number similar to the one owned by the person they are trying to dial, a practice known as spoofing.

Unlike most robocall scams, which seek to swindle Americans into returning the calls and surrendering sensitive information, the “stay home” campaign also has raised suspicions because the calls include no such effort.

“They’re usually threatening you to provide your Social Security number or something will happen to you,” said Giulia Porter, the vice president of marketing at TelTech, which owns the smartphone blocking app RoboKiller. “From this robocall, we can’t see anything that is indicating they’re actually trying to get something from you.”

The nature of the message gave many recipients across the country the impression that the cryptic alert sought to keep them from the polls. The concerns they expressed — that it might succeed in turning people off from voting — reflect long-standing fears that the pandemic could undermine participation in the 2020 election. Numerous states have expanded opportunities to vote by mail in response to safety concerns, and election administrators have taken pains to retrofit in-person voting for the coronavirus, supplying hand sanitizer and other safeguards.

“My reaction was this is likely an attempt to get people not to vote,” said Kevin Porman, a 40-year-old living outside Indianapolis.

For some recipients, there was no risk of that.

Laurie Chiambalero, a nurse in Philadelphia who has a Boston area code, said she answered the call out of a belief that it might be a friendly public health reminder.

“But when I got it a second time,” she said, “it really felt like it was telling me to stay indoors the next few days because of the election."

Chiambalero, however, said she’d already cast her ballot. “They’re not intimidating me,” she announced.

COVID-19 Update

World

• New Cases:   437,261 (⬆︎ .94%)
• New Deaths:      5,305 (⬆︎ .44%)

USA

• New Cases:   71,321 (⬆︎ .76%)
• New Deaths:       399 (⬆︎ .17%)

We have about 60 days til Year End, and about 150 days before we can expect a safe and effective vaccine to be on its way out to the general population.

This is rather optimistic - and maybe pretty random on my part - but it's a convenient point of reference so that's what I'm goin' with.

Straight Line Projections - averaging the Daily Growth Rate over the last 7 days in October

• Dead Americans by Year's End:    295,000
• Dead Americans by April 1, 2021: 368,400

Hopefully, of course, over the next several days-to-weeks, we'll have a president who listens to the people who actually know something about public health policy, and follows their recommendations.

WaPo:

Covid had spared Alaska’s most remote villages. Not anymore.

The Siberian Yupik town of Gambell, Alaska, sits on the western edge of St. Lawrence Island in the Bering Sea, closer to Russia than the Alaska mainland and two plane rides from Anchorage. Whale and walrus are among the primary stocks harvested for food; the nearest hospital is more than 100 miles away in Nome. But Gambell’s remoteness has not protected it from the coronavirus.

Now everyone in this 700-person Indigenous community knows someone who had the coronavirus. Thirty-three residents tested positive this month, part of a wave of coronavirus cases that have shut down small towns in Alaska. Currently, more than 20 communities in western Alaska are either on strict lockdown or advised to be on one.

For months, Alaska’s remote, mostly Indigenous rural communities protected themselves from the coronavirus through restrictions on travel and local health measures. Once the virus arrived, though, conditions enabled it to spread like wildfire. Cases have exploded in recent weeks in some of the country’s most geographically isolated regions, leaving residents and health officials fearful that acute cases could quickly overwhelm the state’s meager hospital system.

In Chevak, a town of 1,075 near the mouth of the Yukon River in far western Alaska, almost a fifth of its residents have tested positive for the coronavirus as of this week.

After a handful of positive tests, Mayor Richard Tuluk said, leaders and health officials in the region quickly arranged for widespread testing at Chevak’s small local clinic. More than 700 people submitted samples. Tuluk says around 170 came back positive.

Chevak and other towns in the region have suspended in-person instruction across dozens of tiny community schools, relying on distance learning in a region with inconsistent and expensive Internet. The community’s lone store closed for days, prompting complaints from residents unable to get necessities like milk or diapers. The post office is severely backlogged. Masking is more strictly observed, and gatherings beyond immediate family have all but ceased.

Alaska managed to contain the spread of the coronavirus in the first months of the pandemic by locking down early. But numbers crept up over the summer and are now rising exponentially, with hundreds of daily cases reported. At 48.3 new cases per 100,000 residents over the past week, the positivity rate is the eighth highest in the country, though Alaska has so far maintained among the lowest mortality rates for covid-19, the disease caused by the coronavirus.

Chevak hasn’t yet seen high numbers of people falling seriously ill after testing positive.

“Knock on wood,” Tuluk said. “So far we haven’t heard of any of our elders getting sick or things like that.”

Lockdowns, quarantines and self-isolation are difficult in rural Alaska, particularly in the state’s western and northern quadrants. Housing is cramped. The inadequate broadband system makes Internet distractions like video-streaming or gaming difficult.

“Every household is sticking to themselves as much as possible,” said Charlotte Apatiki, who is Siberian Yupik and city clerk in Gambell.

At the height of its lockdown in late September and early October, the community’s store would only take food orders called in ahead of time as supply shipments sputtered. The mayor and some village police officers delivered food and water to residents in isolation.

“There was no fresh produce for quite a while, no fresh meat, nothing but canned goods,” Apatiki said.

In spite of the fear and difficulty, the measures worked. Gambell hasn’t had a new case in three weeks, according to Mayor Joel James.

Hundreds of miles over water from St. Lawrence Island, around 23,000 mostly Yupik residents occupy 58 communities in the Yukon-Kuskokwim Region, all of which are disconnected from the state’s road system and accessible only by boat, plane or snowmobile. With more than a hundred cases per 100,000 people in the region, if it were a state, it would have the fourth highest rate of positive tests in the country, health officials told public radio station KYUK.

“I literally cannot sleep at night because of how worried I am,” said Ellen Hodges, chief of staff at the Yukon-Kuskokwim Health Corporation in Bethel. She fears the region will follow national trends, with early spread among the young giving way to infections among older adults that end up acutely sick in clinics or hospitals.

“Given our fragile health-care system and the remote nature of where we live, I’m concerned we will overwhelm our health-care system in a matter of weeks,” Hodges said.

Conditions are ripe for viral transmission. The region has some of the most dense housing in the country. It’s not uncommon for 10 people to live in a two-bedroom house with one bathroom, Hodges said. Forty percent of homes do not have water or sewer systems.

“Imagine if you had to pack every ounce of water to your house,” Hodges said. “You might not spend a lot of extra time washing your hands if you don’t have access to clean, fresh, running water.”

Contact tracing links many of the cases to spread within family groups but also to funerals, birthdays, religious services and even a gender reveal party, according to Hodges.

The alarm is not just that small rural clinics or regional hospitals will be overwhelmed, but that with cases also rising in Alaska’s population hubs along the road-system, there will be nowhere to send the acutely sick.

“You really start to see cracks manifest in the system,” said Jared Kosin, CEO of the Alaska State Hospital and Nursing Home Association in Anchorage, which is home to the bulk of the state’s medical capacity. “Covid hospitalizations and covid ICU stays are definitely on the rise.”

At 7.27 percent, the state’s hospital bed capacity is just below the national average of 8 percent. But the case acceleration has only started in the last few weeks.

Though Alaska has not yet had to take the kinds of emergency measures seen in some Western and Midwestern states in recent weeks, Kosin sees troubling indicators. Fall is a busy season for hospitals. The flu hits. And people who have met their annual deductibles access medical services more frequently. Although Kosin’s organization doesn’t track specific figures, he is hearing about more illness among staffers, as well as burnout. It’s a situation exacerbated by Alaska’s reliance on itinerant medical professionals from out of state, who travel in to work well-paid stints at facilities where it can be hard to retain permanent staff.

“It’s incredibly difficult right now to find any travelers, because they’re in such high demand from everywhere else in the Lower 48. And on top of that, it’s winter here, which might turn some of them off to begin with,” Koskin said. “We’re really kind of left on our own.”

Though emergency rooms and intensive care units are not yet overwhelmed in Anchorage, Kosin believes it’s only a matter of time until the surging case counts translate into hospitalizations.

“The math doesn’t work out,” he said.

Even with alarm bells going off, Alaska has fared better than many other states, thanks in part to widespread testing.

“We have had broad, sweeping testing from the beginning, so that has meant that our case fatality rate is lower,” said Anne Zink, Alaska’s chief medical officer.

In Chevak, initial early cases led health officials to launch the rapid testing process that turned up evidence of rampant community spread.

“That would be impossible to pull off in the same sort of way in Anchorage,” Zink said. “So I think it does identify a lot more asymptomatic and mildly symptomatic cases you wouldn’t identify.”

The state is focusing its latest public health push on testing capacity. It coordinated with private companies to send out hundreds more testing machines, shipped out 4,000 rapid antigen testing kits to the hub community of Bethel, with another 25,000 scheduled to be distributed in rural areas in the weeks ahead.

In a Wednesday press briefing, Gov. Mike Dunleavy (R) encouraged masking and social distancing but resisted broader measures like a mask mandate or mandatory business closures.

“If we keep working on this as individuals, and looking out for ourselves and each other, we should be able to get the cases flattening out,” Dunleavy said.

Dunleavy, who lived and worked for years in rural western Alaska, made little mention of specific provisions for the region beyond additional testing resources and protective equipment earmarked for communities.

Alaska has fared better than many states during the pandemic. It locked down early and strictly, and it has the lowest number of nursing homes per capita in the country, sites of some of the country’s most devastatingly fatal outbreaks.

Still, Zink, who continues working shifts as an ER physician taking care of sick patients, is concerned that the rising case counts are going to lead to more acute illness, suffering and death.

“I don’t wish this on anyone,” she said.

Today's Tweet

Daddy State Awareness - rule 1: Every accusation is a confession.

Vote out the Trump Crime Family! #TrumpTerroism pic.twitter.com/7M2l7NTYPO

— MeidasTouch.com (@MeidasTouch) November 1, 2020

COVID-19 Update

World

• New Cases:   475,384 (⬆︎ 1.03%)
• New Deaths:      6,504 (⬆︎   .54%)

USA

• New Cases:   86,293 (⬆︎ .93%)
• New Deaths        914 (⬆︎ .39%)

If the previous several months had been a guide, the weekend numbers would've been down significantly. The fact that yesterday's cases would've been a new record 4 days ago does not bode well.

WaPo:

‘A whole lot of hurt’: Fauci warns of covid-19 surge, offers blunt assessment of Trump’s response

President Trump’s repeated assertions the United States is “rounding the turn” on the novel coronavirus have increasingly alarmed the government's top health experts, who say the country is heading into a long and potentially deadly winter with an unprepared government unwilling to make tough choices.

“We’re in for a whole lot of hurt. It’s not a good situation,” Anthony S. Fauci, the country’s leading infectious-disease expert, said in a wide-ranging interview late Friday. “All the stars are aligned in the wrong place as you go into the fall and winter season, with people congregating at home indoors. You could not possibly be positioned more poorly.”

Fauci, a leading member of the government’s coronavirus response, said the United States needed to make an “abrupt change” in public health practices and behaviors. He said the country could surpass 100,000 new coronavirus cases a day and predicted rising deaths in the coming weeks. He spoke as the nation set a new daily record Friday with more than 98,000 cases. As hospitalizations increase, deaths are also ticking up, with more than 1,000 reported Wednesday and Thursday, bringing the total to more than 230,000 since the start of the pandemic, according to health data analyzed by The Washington Post.

Fauci’s blunt warnings come as Trump has rallied in states and cities experiencing record surges in infections and hospitalizations in a last-ditch effort to convince voters he has successfully managed the pandemic. He has held maskless rallies with thousands of supporters, often in violation of local health mandates.

Even as new infections climb in 42 states, Trump has downplayed the virus or mocked those who take it seriously. “Covid-19, covid, covid, covid,” he said during one event, lamenting that the news media gives it too much attention. In another rally, he baselessly said that U.S. doctors record more deaths from covid-19, the disease the coronavirus causes, than other nations because they get more money.

“I mean our doctors are very smart people. So what they do is they say, ‘I’m sorry but everybody dies of covid,’ ” Trump said Friday at a rally in Waterford Township, Mich., without offering any evidence.

By contrast, former vice president Joe Biden and Sen. Kamala D. Harris have consistently worn masks in public, and have held socially distanced events. When two people around Harris tested positive for the coronavirus in October, she canceled travel for several days. Asked about the difference between their approaches, Fauci said Biden’s campaign “is taking it seriously from a public health perspective.” Trump, Fauci said, is “looking at it from a different perspective.” He said that perspective was “the economy and reopening the country.”

Fauci, who once took a starring role in the response and briefed the president almost every day as director of the National Institute of Allergy and Infectious Diseases, described a disjointed response as cases surge. Several current and former senior administration officials said the White House is almost entirely focused on a vaccine, even though experts warn it is unlikely to be a silver bullet that ends the pandemic immediately since it will take months under the best of circumstances to inoculate tens of millions of people to achieve herd immunity.

Officials told governors on a call Friday that they hoped to begin distributing a vaccine by the end of the year, giving some specific guidance on how states would receive their first doses. Fauci focused on the rise in cases, according to people familiar with the call.

Fauci said the White House coronavirus task force meets less frequently and has far less influence as the president and his top advisers have focused on reopening the country. “Right now, the public health aspect of the task force has diminished greatly,” he said.

Fauci said he and Deborah Birx, coronavirus task force coordinator, no longer have regular access to the president and he has not spoken to Trump since early October. “The last time I spoke to the president was not about any policy; it was when he was recovering in Walter Reed, he called me up,” he said. Fauci said he phones into meetings of other staffers but largely avoids the West Wing because “of all the infections there.”

He also lamented that Scott Atlas, a neuroradiologist and Trump’s favored pandemic adviser, who advocates letting the virus spread among young healthy people and reopening the country without restrictions, is the only medical adviser the president regularly meets with.

“I have real problems with that guy,” Fauci said of Atlas. “He’s a smart guy who’s talking about things that I believe he doesn’t have any real insight or knowledge or experience in. He keeps talking about things that when you dissect it out and parse it out, it doesn’t make any sense.”

Fauci said he actually appreciated chief of staff Mark Meadows saying last weekend on CNN that the administration was not going to control the pandemic. “I tip my hat to him for admitting the strategy,” he said. “He is straightforward in telling you what’s on his mind. I commend him for that.”

At one point during the interview, Fauci said he needed to be careful with his words because he would be blocked from doing appearances in the future.

Judd Deere, a White House spokesman, offered blistering criticism of Fauci for his comments in a statement to The Washington Post on Saturday. Deere said Fauci “knows the risks [from the coronavirus] today are dramatically lower than they were only a few months ago.”

“It’s unacceptable and breaking with all norms for Dr. Fauci, a senior member of the President’s Coronavirus Task Force and someone who has praised President Trump’s actions throughout this pandemic, to choose three days before an election to play politics,” Deere said. “As a member of the Task Force, Dr. Fauci has a duty to express concerns or push for a change in strategy, but he’s not done that, instead choosing to criticize the President in the media and make his political leanings known by praising the President’s opponent — exactly what the American people have come to expect from The Swamp.”

Deere added that the president “always put the well-being of the American people first,” citing his decision to cut off travel from China, his early shutdown of the country and his mobilization of the private sector to deliver critical supplies and develop treatments and vaccines.

Fauci’s candid warnings about the threat of the virus have angered the president, who has mocked the scientist for his prognostications early in the outbreak — for instance, saying that masks were not necessary — and even for his baseball pitch. “People are tired of hearing Fauci and these idiots, all these idiots who got it wrong,” Trump said during one rally in October.

Some White House advisers have been leery of a public fight with Fauci — knowing his popularity is higher than that of the president. But they’ve also grown frustrated by his media appearances and complain he is too focused on his personal reputation and is “not on the team,” said one senior administration official who spoke on the condition of anonymity because he was not authorized to comment. The doctor has become loathed among many Trump supporters, and Fauci has told others that he has experienced a surge in harassment and threats.

White House spokespeople did not offer comments from either Atlas or Birx despite being asked several times.

Several senior administration officials and outside advisers described a White House overwhelmed by the pandemic, with a feeling of helplessness over the inability to curb its spread without also throttling the economy or damaging the president’s reelection chances.

“People need to take a step back and be humble about this,” said Joe Grogan, the former head of the domestic policy council under Trump. “Nobody, regardless of political party or ideology, should be getting arrogant about how they have this figured out.”

However, the campaign trail message that life is returning to normal underscores how little the president and White House have focused on the pandemic beyond pushing for development and approvals of vaccines and treatments. With the clearance of a vaccine unlikely until year’s end, that raises questions about what happens after Election Day, during what is projected to be the worst stretch yet of the pandemic. The Trump administration will be in charge of managing the pandemic until at least Jan. 20, no matter who wins.

“We need to plan now for how we turn the corner in 2021, and one thing we should be doing is laying the foundation to get public schools reopened in the late winter or early spring,” said Trump’s former Food and Drug Administration commissioner, Scott Gottlieb. “If we don’t plan now, we’ll lose the opportunity to prioritize opening what should be most important to us, just as we lost that chance in the fall because we didn’t plan appropriately this summer.”

Without the ear of the president or other top White House officials, Fauci and other health experts believe the most effective thing they can do is get the public health message out through local and national television media interviews. Birx, the coronavirus coordinator, has traveled across the country in recent weeks delivering blunt advice to state and local leaders grappling with surges of infections, hospitalizations and deaths.

“The thing we can do is to try to get the message out,” Fauci said.

Earlier in the pandemic, Fauci said he and Birx would agree on a message that Birx, who works out of the White House and once met with the president almost every day, would deliver to Trump.

“All of a sudden, they didn’t like what the message was because it wasn’t what they wanted to do anymore,” he said. “They needed to have a medical message that was essentially consistent with what they were saying.

“And one of the ways to say the outbreak is over is [to say] it’s really irrelevant because it doesn’t make any difference. All you need to do is prevent people from dying and protect people in places like the nursing homes,” Fauci said. “And because of that, Debbie almost never ever sees the president anymore. The only medical person who sees the president on a regular basis is Scott Atlas. It’s certainly not Debbie Birx.”

Although Trump, Atlas and other top officials say their strategy is to “protect the vulnerable,” health experts say the administration has not done enough to protect those in nursing homes. The administration has sent tests to nursing homes and other hard-hit communities, but not nearly the number that experts say are needed. Many nursing homes are also experiencing shortages of personal protective equipment, personnel and other critical supplies that the administration has not sufficiently addressed.

While Atlas has publicly rebutted assertions that he promotes a herd immunity strategy, he recently endorsed the Great Barrington Declaration — a document named after the town in Massachusetts where it was unveiled on Oct. 4 at a libertarian think tank — that calls for allowing the coronavirus to spread freely at “natural” rates among healthy young people, while keeping most aspects of the economy up and running.

“He insists he’s not somebody who’s pushing for herd immunity,” Fauci said of Atlas. “He says, ‘That’s not what I mean.’ [But] everything he says — when you put them together and stitch them together — everything is geared toward the concept of ‘it doesn’t make any difference if people get infected. It’s a waste of time. Masks don’t work. Who cares,’ and the only thing you need to do is protect the vulnerable, like people in the nursing homes,” Fauci said.

Fauci said that many people who catch the virus recover “virologically” but will have chronic health problems.

“The idea of this false narrative that if you don’t die, everything is hunky dory is just not the case,” he said. “But to say, ‘Let people get infected, it doesn’t matter, just make sure people don’t die’ — to me as a person who’s been practicing medicine for 50 years, it doesn’t make any sense at all.”

A similar assessment was offered by Tom Bossert, the former homeland security adviser in the Trump administration. “It sounds alluring,” Bossert said. “It sounds so seductive. It’s not possible. Math makes it irresponsible to even try and say it.”

Fauci and other top health experts applauded the substantial growth in expertise about how to treat covid-19 since last spring that has led to a dramatic reduction in death rates.

“Even though we’re getting challenged with more cases,” he said, “the medical system is much better prepared to take care of seriously ill people, so that’s the reason why I think the surge of cases is going to be counterbalanced by better experience.”

Nonetheless, he and others said they are worried about regions of the country that may be ill-prepared to deal with a winter surge of infections, including Midwestern and Western states because they have limited intensive care beds, as well as nurses who can treat growing numbers of covid-19 patients.

“It’s much more about some of the states like Utah, Nevada, South Dakota, North Dakota, where … they never had a pretty good reserve of intensive care beds and things like that. I hope they’ll be okay, but it’s still a risk that, as you get more surging, they’re going to run out of capacity,” Fauci said.

Today's Tweet

And Obama smiles

Madame Tussauds in Berlin loaded its effigy of President Trump into a dumpster, a move apparently intended to reflect its expectations of #Election2020 https://t.co/YgPEZnLfnj pic.twitter.com/C7L6kVczNy

— Reuters (@Reuters) October 30, 2020

COVID-19 Update

World

• New Cases:   573,616 (⬆︎ 1.26%)
• New Deaths:      7,510 (⬆︎   .63%)

USA

• New Cases:   101,461 (⬆︎ 1.10%) 🥳 NEW RECORD! 🎉
• New Deaths:         988 (⬆︎   .42%)

And President Stoopid is scheduled to do another dozen or so rallies before Election Day.

So I guess it's just not enough that he won't model the behavior that slows this fucking thing down - he has to amp it up by getting people together in large, close-in bunches so they can get real contagious-y with each other.

Here comes a shit load more infections and dead Americans.

WaPo:

First, coronavirus infections increased. 

Then, hospitalizations. 

Now, deaths are on the rise.

Coronavirus infections soared this week to record levels, hospitalizations are up in almost every state, and now — predictably, but slowly — deaths are rising, too.

The nation passed another milestone Friday with 9 million confirmed cases since the start of the pandemic, including more than 98,000 new cases, a daily record. More than 1,000 deaths in the United States from the novel coronavirus were reported each day Wednesday and Thursday, according to health data analyzed by The Washington Post, continuing an upward trend that began two weeks ago.

All signs indicate that this isn’t a blip but rather a reflection of a massive surge in infections that, without a dramatic effort to reverse the trend, will drive up the death toll for weeks to come. At least 229,000 people in the United States have died of covid-19, the disease caused by the virus.

But the mortality numbers have become political fodder on the campaign trail. Depending on whom you listen to, the coronavirus just isn’t that deadly anymore. Or it’s killing people in droves.

The truth is that mortality rates have improved, but the accelerating spread of the virus is driving up the absolute numbers of deaths.

Doctors have reported better outcomes thanks to improved techniques for treating patients and the use of the steroid dexamethasone and the antiviral remdesivir. In a widely reported study, researchers at NYU Langone Health found that the death rate among more than 5,000 patients in the system’s three hospitals dropped from 25.6 percent in March to 7.6 percent in August.

Still, this remains a potentially deadly disease, and a large proportion of the population is still vulnerable to infection. With the number of infections hitting daily records, there is reason to expect that deaths will keeping rising until the spread of the virus is contained.

Deaths lag infections by many weeks. In hard-hit North Dakota, daily infections have doubled since the end of September, while the average number of deaths from covid-19 is up 50 percent. In Indiana, cases are up 150 percent in that time, and deaths are up 93 percent.

In Wisconsin, cases began spiking in early September, and deaths began to rise sharply at the end of the month. Of the 2,029 deaths there from the pandemic, more than half have occurred since Sept. 25.

President Trump and his son Donald Trump Jr. have in recent days said there has been an excessive focus on infections rather than deaths, which have not risen as quickly and remain lower than in the early days of the pandemic.

“Do you ever notice, they don’t use the word ‘death’? They use the word ‘cases,’ ” the president said Tuesday in Omaha. He brought up his 14-year-old son. “Like, Barron Trump is a case. He has sniffles, he was sniffling. One Kleenex, that’s all he needed, and he was better. But he’s a case.”

The younger Trump posted a graph on his Instagram account, based on incomplete Centers for Disease Control and Prevention data, that he claimed showed deaths dropping.

“Why isn’t the ACTUAL data from the CDC being discussed? . . . [W]hile there have been increases in new cases per week, there has actually been a steady decrease in deaths per week,” Trump Jr. wrote. He echoed that argument in a television interview Thursday on Fox News, saying he asked himself why people weren’t talking about deaths, and deciding, “Oh, because the number is almost nothing. Because we’ve gotten control of this thing, we understand how it works.”

His description of the CDC death data is misleading. CDC official Robert Anderson, head of the agency’s mortality data branch, did not comment for this article but pointed to the CDC document — which Trump Jr. himself linked to from his Instagram account — that explains that the most recent death data is incomplete: “It is important to note that it can take several weeks for death records to be submitted to National Center for Health Statistics (NCHS), processed, coded, and tabulated. Therefore, the data shown on this page may be incomplete, and will likely not include all deaths that occurred during a given time period, especially for the more recent time periods.”

Former vice president Joe Biden, by contrast, emphasizes the death toll in his speeches. In a short address Wednesday in Wilmington, Del., he said Trump’s minimizing of the death rate is “an insult” to everyone who has lost a loved one to covid-19.

He spoke of “the refusal of the Trump administration to recognize the reality we’re living through at a time when almost 1,000 Americans a day are dying,” and said that refusal “is an insult to every single person suffering from covid-19 and every family who’s lost a loved one.”

That cohort includes Kathryn Hering Rikess, whose son Cole Hering died in Knoxville, Tenn., at the age of 36 after a lengthy battle with covid-19. She said she is frustrated by the politicization of the virus and the refusal of some people to follow simple health guidelines such as mask-wearing. She keeps thinking her son is going to call on Sundays to talk football, to sign off with an “I love you, Mom.”

“No one should feel the pain that I’m feeling,” she said. “No one. Just follow the rules. Let’s get over this so I can have a funeral for my child and get on with it.”

White House spokesman Judd Deere said any suggestion that Trump hasn’t taken the threat of the virus seriously “is completely false,” and cited a number of actions by the president, including the travel ban affecting China and the spring shutdown of parts of the economy, “which saved millions of lives,” as well as support for therapeutics and a vaccine. “Thanks to the bold actions of President Trump, the risks today are dramatically lower than they were only a few months ago with mortality rates falling over 80%.”

Nationally, the daily death toll from the virus remains well below the numbers seen during the initial spring wave of the pandemic, when more than 2,200 people were dying each day on average. That declined until early July. But then a surge of infections in May and June, particularly in the Sun Belt and reflecting the end of many shutdowns and restrictions, began once again driving up the death toll.

The number dipped again in September but has risen steadily this month along with the arrival of colder weather and the accelerating spread of the virus. Since Oct. 22, 13 states have reached their all-time high for average daily deaths: Alaska, Idaho, Iowa, Kansas, Kentucky, Montana, Nebraska, North Carolina, Oklahoma, South Dakota, Tennessee, Wisconsin and Wyoming.

An influential model from the University of Washington’s Institute for Health Metrics and Evaluation forecasts that, under current policies, more than 2,000 people will be dying each day by the end of December, close to the horrific death toll in April when the Northeast was first pounded by the pandemic.

But that is not set in stone: Public health measures can reverse the trends if people adhere to guidelines, including wearing facial coverings and maintaining physical distancing, and if communities are aggressive about contact tracing and isolation of people who are infected, experts say.

This week, Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, said he is generally skeptical of models because their forecasts depend on many assumptions fed into them. He expressed alarm at the high rate of infections daily — the “baseline” — as the country heads deeper into fall and winter.

But he also noted that improved treatments have lowered mortality among the severely ill. There is no way to predict accurately what the death toll will be, he said.

“I would expect that as more people get infected, and more people get into the hospital, we will have an increase in deaths. It is impossible to predict what the level of deaths will be related to the number of hospitalizations,” Fauci said.

He and others have warned that widespread transmission of the virus among young people will lead to dangerous cases among the more vulnerable members of society — the elderly and people with chronic health conditions. The virus incubates for up to 14 days and the spread can be subtle and slow.

“One 20-year-old infects another 20-year-old who infects another 20-year-old who infects Grandma. So you have eight to 10 weeks,” Fauci said.

The scientific reality hasn’t changed since the start of the pandemic: This is a potentially lethal but quirky virus that can infect some people without generating any symptoms at all, while making others severely ill, damaging their lungs, heart, kidneys and other organs, with symptoms sometimes lingering for weeks or months — a syndrome known informally as “long covid.”

The CDC has stated that its best estimate for the infection fatality rate is 0.65 percent, meaning that for every 10,000 people who get the virus, 65 will die. There is a sharp age gradient: Mortality rises steadily with age, and the disease is far more likely to be fatal in the elderly. Other factors increasing risk involve underlying chronic conditions, including obesity, heart disease and diabetes.

The fatality rate, though, is not an intrinsic feature of the virus but rather one that depends on many factors, including improving treatments, level of exposure to the virus and access to health care.

Some demographic groups have borne a disproportionate burden of the disease. In the United States, African Americans account for 1 in 5 deaths, far exceeding their proportion of the population, and there are other disparities in infections, hospitalizations and deaths affecting people of color. Hispanics, for example, have much higher infection rates than Whites.

When infections rise, hospitalizations tend to increase a few weeks later. Some hospitalized patients end up in intensive care units, and some are placed on ventilators. This can take weeks to unfold. At the end of it, the death toll rises in an inescapable echo of the infections weeks earlier.

“Everything follows the thing before it. So the new positive cases drive the hospitalizations. The number of hospitalizations drive the pressure on the intensive care units. And those numbers drive the number of deaths,” said Bill Melms, chief medical officer at Wisconsin’s Marshfield Clinic Health System, which has locations in rural parts of the state.

Coronavirus hospitalizations across the Marshfield Clinic Health System were up 60 percent this week compared with last week. The system had 90 patients spread across nine hospitals Thursday — a number that is concerning because of the small, rural nature of their facilities. Melms expects the number could double in the next four weeks.

“We’re not going to see a light at the end of the tunnel — whether we’re talking about deaths, intensive care unit admissions or total hospital admissions — until we see the average number of positive cases in the state start to drop, and start to drop in a sustained way,” Melms said.

Experts said they believe the virus is spreading primarily in small, indoor gatherings, including inside bars and restaurants. Colder weather and the return of students to college campuses are also likely factors. Wisconsin, like many places in the United States far from the coasts, went largely unscathed in earlier waves of the pandemic. Those interior states are now flooded with cases.

Even so, some of the hardest-hit states have the lowest rates of mask-wearing.

“The current mind-set appears to be, at least, that people have said, ‘Well, it is what it is,’ ” said Nasia Safdar, medical director of infection control at University of Wisconsin Hospital and Clinics. “But it can’t really continue like this because health systems will soon have to come to a point where they may have to make very difficult decisions about covid care versus care for patients who don’t have covid but still need it.”

Trump has been blasting the news media for focusing on infections going up, falsely claiming this is simply because of more testing. His own testing czar, Adm. Brett Giroir, said this week that testing cannot explain the spike in cases because hospitalizations are rising.

Trump also used his own bout of covid-19 as a case study.

“I had it. Here I am, right?” he said in Omaha.

“That just shows you he doesn’t take this seriously even after he himself was hospitalized and had the whole world watching and hoping for his recovery,” said Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security and a spokesman for the Infectious Diseases Society of America. “There’s no way to minimize what this virus has done in any kind of honest way. This is another example of living in an alternative reality.”

Trump had access to experimental drugs not yet available to the general public. But his case is not statistically unusual: Most 74-year-old men with covid-19 survive, with or without special treatment.

This is not what rounding the corner looks like

Today's Today

click

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