On virus, Trump and health advisers go their separate ways

WASHINGTON (AP) — A multi-state coronavirus surge in the countdown to Election Day has exposed a clear split between President Donald Trump’s bullish embrace of a return to normalcy and urgent public warnings from the government’s top health officials.

It’s the opposite of what usually happens in a public health crisis, because political leaders tend to repeat and amplify the recommendations of their health experts, not short-circuit them. “It’s extremely unusual for there to be simultaneous contrary messaging,” said John Auerbach, who heads the nonpartisan Trust for America’s Health.

The president and the health officials appear to be moving farther apart since White House chief of staff Mark Meadows declared last Sunday “we’re not going to control the pandemic.”

Since then, Health and Human Services Assistant Secretary Adm. Brett Giroir has done a round of interviews warning that the country’s situation is “tenuous” but that Americans can indeed control the virus by practicing what he calls the “3W’s” — watching your distance from others, wearing a mask, and frequently washing your hands.

White House coronavirus adviser Dr. Deborah Birx, touring the states to raise prevention awareness, lamented in Bismarck, North Dakota, that she hadn’t seen such disdain for mask wearing elsewhere. “We find that deeply unfortunate because you don’t know who’s infected and you don’t know if you’re infected yourself,” she told reporters. The state’s positive test rate is 11%, above the level indicating widespread transmission.

HHS Secretary Alex Azar, for his part, has a profile photo of himself masked up on his Twitter account.


But Trump continues to ridicule masks and mask-wearing as he insists the U.S. has turned the corner on the virus. At a reelection rally Wednesday in Bullhead City, Arizona, the president painted a sardonic word picture of left-coast Californians trying to eat through their masks.

“How about California … where you are supposed to eat with the mask (and) can’t take it off?” Trump said. “You see people and, boy, you know when you have spaghetti and meat sauce … you walk out it looks like you got into a fight.”

That’s not actually what the California governor’s office recently recommended to restaurant goers. The advice was to keep the mask on when not eating, or “between bites.” An illustration showed a diner masked while reading the menu and, later, while wiping her hands with a napkin after eating.

It might all be considered political theater if the nation’s situation weren’t so serious.

“We are in a third wave,” said Marta Wosinska of the Duke-Margolis Center for Health Policy. “We are seeing pretty dramatic increases in the number of people hospitalized and an uptick in deaths.”

The White House insists there’s no conflict between Trump and the health advisers who back in the spring shared the briefing room podium with the president on many an occasion.

“As the president has said, the cure cannot be worse than the disease and this country should be open armed with best practices, such as social distancing, good hygiene,

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White House advisers warn COVID-19 spread in Midwest and West is ‘unrelenting’

The White House Coronavirus Task Force has reportedly warned of a “persistent and broad spread” of COVID-19 infections across the U.S. West, advocating stricter prevention efforts to help slow the spread of transmission, per Reuters.

“We are on a very difficult trajectory. We’re going in the wrong direction,” Anthony Fauci, the most prominent task force member, said.


PROPOSAL TO LET CORONAVIRUS SPREAD NATURALLY THROUGH US POPULATION INTERESTS WHITE HOUSE, ALARMS MEDICAL ESTABLISHMENT

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THE FIRST DEATH FROM A CORONAVIRUS REINFECTION HAS BEEN REPORTED

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Data reveal that cases are high and remaining high in states like Wisconsin, Montana, Wyoming, North and South Dakota, Utah, Iowa, Tennessee, Arkansas and Minnesota, among dozens of others. Many of these states are key battleground states that have potential to determine the outcome of the competitive election between incumbent President Trump and Democratic candidate Joe Biden.

Fauci confirmed that new cases are increasing in 47 states, along with hospitalizations.

Wisconsin, in particular, is on track to run out of intensive care unit beds.

“Every single positive increases the probability or likelihood of having another patient who is hospitalized,” Bill Melms, chief medical officer for Marshfield Clinic Health System, told the Milwaukee Journal-Sentinel.

On a national level, the two-week change in new cases is up by 41 percent, with fatalities increasing by nine percent on average. 

Roughly 1,016 new COVID-19 deaths and 81,457 new cases were reported on Oct. 28, per The New York Times.

“We continue to see unrelenting, broad community spread in the Midwest, Upper Midwest and West. This will require aggressive mitigation to control both the silent, asymptomatic spread and symptomatic spread,” one state report said.

A nationwide lockdown has still not been issued, and some states do not have a mandatory mask order, such as Alaska, Florida, Georgia, Iowa, Missouri, Nebraska, North and South Dakota, Utah, and Wyoming. Most of these states are experiencing surges in new cases.


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Top medical advisers arguing hard for tighter coronavirus restrictions

Sir Patrick Vallance and Chris Whitty, the government’s top scientific and medical advisers, are understood to be arguing hard with ministers for tighter restrictions across England ahead of Christmas.



a man wearing glasses and a suit and tie: Photograph: WPA/Getty Images


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Photograph: WPA/Getty Images

The pair are calling for tougher measures armed with what has been described as new modelling from experts on Sage, the government’s epidemics advisory group, showing that deaths this winter could exceed those in the spring.

Just last month, on 21 September, the pair were accused of doom-mongering when they appeared on national television as a double act, warning of the possibility of 50,000 cases and 200 Covid deaths a day by mid-October.

The measures Boris Johnson announced later that day – closing pubs at 10pm, encouraging working from home and penalties for people who break the rule of six – were supposed to prevent those numbers being reached. But they have not. Deaths have exceeded 200 and even 300 in recent days.

There is now clear evidence that the trajectory of infections, hospital admissions and deaths is rising steadily , in spite of the tier system of controls on people’s social activities.

According to some newspapers, the death toll is likely to be higher than it was in the spring. New modelling was said to predict that deaths would plateau, but at a relatively high level even though lower than earlier in the year. That plateau would continue for months. Vallance was said to be pushing for tier 3 restrictions across the whole of England before Christmas.

The existence of new modelling surprised some members of Sage – although not the conclusions that Vallance and Whitty had reached. The evidence was there in a report that Vallance himself commissioned from the Academy of Medical Sciences in July.

That report, “Preparing for a Challenging Winter 2020/21” modelled a “reasonable worst-case scenario”, in which the R – the number of people infected by each person with the virus – rose to 1.7. It estimated that almost 120,000 Covid hospital deaths between September this year and June next year, “over double the number that occurred during the first wave in spring 2020”.

In addition, it warned of further disruption of the NHS and social care, a backlog of non-Covid cases and a possible influenza epidemic. “There is a need for urgent preparation to mitigate the risks of a particularly challenging winter 2020/21,” said the report.

That preparation should have happened over the summer, said Prof Dame Anne Johnson, president elect of the Academy of Medical Sciences, who was one of the authors.

“What we suggested in the report was that the time to be really working on suppressing the virus is exactly when it is really low. Keep it down there. And of course we didn’t do that and there were a lot of reasons,” she said.

“When we came out of lockdown we went very nervously to restaurants. We continued to queue outside shops. Somehow all that effort which wasn’t necessarily about not meeting

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Guidelines for approving a coronavirus vaccine will be the focus of FDA advisers meeting Thursday

The vaccine advisory committee, meeting remotely in an all-day session, will not review a specific vaccine because no company has applied for the FDA’s imprimatur. Rather, the group will provide views on the FDA’s standards governing whether a vaccine is sufficiently safe and effective to warrant an emergency use authorization. It will also weigh in on the conduct of clinical trials once a vaccine is cleared and monitoring safety on an ongoing basis.

Even a general discussion is an important milestone, especially after protracted political melodrama involving the vaccine review process, experts said.

“The visual of scientists sitting around the table carefully discussing what a safe and effective vaccine might look like is an important moment for the FDA,” said Jason L. Schwartz, assistant professor of health policy and management at the Yale School of Public Health. “For months, all the FDA could do was offer promises about how science would guide its decisions on the vaccine. This shows how that will happen as data begins to come in.”

The panel will offer the agency advice for navigating the “extraordinary and unprecedented steps” of clearing a vaccine on an emergency basis, said M. Miles Braun, former director of the FDA’s division of epidemiology and an adjunct professor at the Georgetown University School of Medicine, during a media briefing Wednesday. FDA officials will want to know they are “on firm ground, and not missing any issues,” Braun said.

The FDA has said it will hold additional advisory committee meetings to consider applications from vaccine makers, which could begin arriving as soon as mid-November.

The panel, called the Vaccines and Related Biological Products Advisory Committee, is made up mostly of academic experts in infectious diseases, immunology and biostatistics. Some members recused themselves because they work at hospitals where coronavirus vaccine trials are being conducted or are involved in the trials. They were replaced by temporary members, including Arnold Monto, a University of Michigan epidemiologist who will serve as committee chairman, according to documents on the FDA website.

The FDA on Wednesday posted the topics it wants to discuss with the committee, including the effects of vaccines in specific populations. One of the most complicated questions centers on how to continue clinical trials after a vaccine is authorized. Should participants who received the placebo be notified and allowed to get the vaccine? If so, will that hurt the trial’s ability to collect useful data on an ongoing basis, and how can that be mitigated?

The FDA has used advisory committees for decades to bulk up its expertise and win buy-in from the public and outside scientists on its decisions. The FDA is not required to take advice from the panels but often does. The vaccine committee is expected to play an especially important role given the political pressure exerted by the White House on the FDA in recent weeks and months.

The White House held up the guidance, but the FDA circumvented the blockade by publishing it as part of briefing materials provided

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CDC criticizes White House medical adviser’s discredited mask claim

WASHINGTON — The Centers for Disease Control and Prevention is criticizing a top White House coronavirus adviser for spreading misinformation about facial coverings, in a potential escalation of the feud between the administration and public health officials within the federal government. 

That adviser, Stanford neuroradiologist Dr. Scott Atlas, appears to have taken a statistic from a CDC study wildly out of context to pose an anti-mask argument that has been central to his and President Trump’s approach.

Atlas, a source of nearly endless controversy, sent a tweet on Saturday calling into question the efficacy of facial coverings in preventing the coronavirus. “Masks work? No,” said his tweet. In recent months, Atlas has become Trump’s pandemic point man, angering other members of the White House coronavirus task force, including Drs. Deborah Birx and Anthony Fauci. 

One former staffer on the coronavirus task force called him a “disaster.”

The missive was widely condemned by public health officials and ultimately removed by Twitter. It has also earned disapproval from the CDC, whose director has complained about Atlas’s credibility. 

In a statement emailed to Yahoo News, the CDC disputed Atlas’s conclusions without naming him directly. “CDC guidance on masks has clearly stated that wearing a mask is intended to protect other people in case the mask wearer is infected. At no time has CDC guidance suggested that masks were intended to protect the wearers.

“Growing evidence increasingly shows that wearing masks in community settings reduces transmission among individuals in that community,” the statement continued. “There are laboratory studies, animal studies, community and epidemiological studies, as well as policy studies that show masking reduces transmission in communities by blocking exhaled respiratory droplets.”

White House coronavirus adviser Dr. Scott Atlas speaks at the White House, Monday, Oct. 12, 2020, in Washington. (Alex Brandon/AP)
Trump coronavirus adviser Dr. Scott Atlas at the White House on Oct. 12. (Alex Brandon/AP)

The CDC further speculated that while mask wearing has led to “sufficient protection” within subjects’ social networks, those subjects likely contracted the coronavirus in a bar or restaurant, where people take off masks to eat and drink. 

Atlas’s Saturday tweet cited Los Angeles, Miami, Israel and Spain as places where, he said, masks did not work. He said there were “many harms” to wearing masks, though it is not clear what those were. 

That conclusion appeared to be based on an errant reading of a CDC study published in the Sept. 11 issue of its Morbidity and Mortality Weekly Report, a compendium of the latest research. The study in question reviewed data from 154 people who had tested positive for the coronavirus and had been treated at 11 medical centers around the country.

Atlas’s tweet was subsequently removed for violating Twitter’s rules on spreading misinformation. The social media site has taken a more aggressive stance in regard to conspiracy theories and fake news, including when such items are disseminated by the president himself.

Uncowed, Atlas followed up on Saturday with another tweet, in which he attempted to explain his original message. “That means the right policy is @realDonaldTrump guideline: use masks for their intended purpose

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