talkingpointsmemo--2020-03-25--‘It Got Real, Fast’: COVID-19 Has Devastated The Normal Practice Of Medicine

Even if they don ’ t practice in an area particularly hard hit by the coronavirus , the pandemic is already at every primary care doctor ’ s doorstep .
As hospitals buckle under the pressure that COVID-19 has placed on their facilities , primary care doctors across the country are facing their own challenges in adapting to an approach to care where patients , as well as their staff , are discouraged against leaving their homes .
Whether they ’ re in areas where the virus has spread significantly , or those regions that remain relatively isolated from the @ @ @ @ @ @ @ make drastic changes to how they operate their practices .
“ We are being exposed to a new way of practicing medicine , ” said Dr. Nikhil Hemady , the chief medical officer of Honor Community Health , which is near Detroit .
“ The way I look at it is that we are at war .
We are truly practicing medicine like we are at war.
” In interviews with TPM , primary care providers from across the country described an increasingly perilous situation , whether they practice in family-style clinics , @ @ @ @ @ @ @ They ’ ve recounted layoffs , furloughs and cutbacks to hours they ’ ve had to impose just a few weeks into the current pandemic .
Their patients have struggled with the new technology doctors have had to adopt to deliver care .
Their staff fear contracting the virus themselves , as they face the same shortfall in protective equipment that is currently plaguing larger health care systems .
These practitioners worry not just about facing the current crisis , but whether their clinics will still be standing when the United States makes @ @ @ @ @ @ @ pandemic .
“ Primary care is hard to keep afloat in the best of times , ” said Christi Siedlecki , the CEO of Grants Pass Clinic in southern Oregon .
“ This is really scary.
” Siedlecki did the best she could to prepare for how the outbreak would upend her clinic ’ s operations , but the changes to the medical landscape arrived before she could find her footing .
For the last month or so , she knew COVID-19 was coming in only a matter of time .
Her community @ @ @ @ @ @ @ thoroughfare between Washington and California , and positive cases have been confirmed in counties surrounding hers .
About three weeks ago , preparing for the outbreak became “ all consuming , ” she said .
By the time another week went by , her clinic had seen a “ significant ” drop of in-person patient traffic that is the source of most of its revenue .
“ No sooner than when we were putting forward our first efforts to get organized , it got real and it got real , fast , ” @ @ @ @ @ @ @ Stay In Their Cars Perhaps the biggest challenge primary care doctors are facing is the need to discourage all unnecessary in-person interactions to stem the spread of the virus .
This effort is particularly crucial at health care facilities , where the most regular patients can also be the most vulnerable to COVID-19 : older people and those with chronic conditions .
These primary care providers are also serving as a frontline defense against the virus , as they are where those exhibiting symptoms go for assessments and in the hope of getting @ @ @ @ @ @ @ very concerned about our patients with chronic conditions and things that we would usually be managing aggressively , ” said Dr. Jennifer Aloff , of the Michigan practice Midland Family Physicians .
“ They ’ re doing the right thing by staying at home , but I am concerned about how we will handle the deluge when things return back to normal , whenever that may be.
” Some practices have reworked their operations to adapt to this conundrum .
Aloff described scheduling visits for relatively healthy patients in the morning , and @ @ @ @ @ @ @ has also delivered infant immunization shots and splinted broken wrists while their patients remained in their cars .
“ We are trying to meet patients ’ needs however the patient is comfortable , ” she said .
More broadly , the situation has necessitated the expansion of what ’ s known as “ telehealth ” — i.e .
consultations conducted through electronic communication platforms — as well as less technologically-advanced methods of delivering care , such as in video chats and phone calls .
While prudent for protecting the public health , this @ @ @ @ @ @ @ practically overnight that doctors have had to grapple with Clinics have had to quickly scale up their technology platforms at a time that telehealth technology contractors are slammed with requests for assistance .
They ’ ve had to buy new equipment — such as laptops , so staff can work from home , or new phones , so they don ’ t have to give out their personal numbers to patients — just as their revenues are drying up .
Meanwhile , patients have had their own issues with adapting to the new @ @ @ @ @ @ @ known to struggle with the technology , and due to the self-isolation the outbreak requires , they can ’ t have their younger relatives come over to set the services up .
Others , especially lower-income patients who may rely on community health centers , don ’ t have consistent internet access at all .
Doctors have tried to make the technology more accessible — for instance , by switching from an app a user must download to a web-based link they can send to patients via texts .
But often , clinics @ @ @ @ @ @ @ to advise and treat patients , a form of care for which they ’ ll get extremely low reimbursements , if any at all .
The financial realities of this new environment have turned a challenging time for many clinics into a fullblown panic .
For primary care doctors , their financial model is built around the money they take in for in-person visits .
The Trump administration has loosened the rules around telehealth and virtual visits in a way that has made it easier for doctors to be paid for that type @ @ @ @ @ @ @ programs like Medicaid .
But they ’ re often still taking a haircut , even in the most generous categories of those reimbursements .
Some private plans have not followed the federal government ’ s lead in expanding clinics ’ ability to bring in revenue via telehealth , policy experts told TPM .
Doctors and policy experts said that many primary care practices were seeing a 50-60 percent drop in business in recent weeks .
Aloff said that the number of patients her clinic is seeing has dropped around 95 percent , and @ @ @ @ @ @ @ financial situation has led to clinics making tough choices to make ends meet .
Already , there have been layoffs , as well as efforts to reduce the hours of staff .
The need to quarantine several staffers who are feared to have come down with the virus has also reduced payroll costs for some practices .
Honor Community Health closed 14 of its 16 locations for in-person visits , according to Hemady .
( Eight of those locations were at schools that were closed for the outbreak . )
But even with @ @ @ @ @ @ @ care physicians are still struggling with a shortfall of personal protective equipment , such as gowns , masks and goggles that will protect staff from contracting the virus and spreading it to other patients .
The “ disjointed ” distribution network for that equipment — as well as for COVID-19 tests and other supplies — means that the “ smaller entity , the longer it takes to get things to them , ” according to Shawn Martin , the CEO designee of the American Academy of Family Physicians .
Aloff recalled a lucky @ @ @ @ @ @ @ the form of a patient who is also an electrical contractor .
“ He said , ‘ Hey , I ’ ve got coveralls and goggles .
Do you want them ?
’ ” she said .
“ So we ’ ve had some patients outreaching to see if they can be helpful .
”

Even if they don’t practice in an area particularly hard hit by the coronavirus, the pandemic is already at every primary care doctor’s doorstep.
As hospitals buckle under the pressure that COVID-19 has placed on their facilities, primary care doctors across the country are facing their own challenges in adapting to an approach to care where patients, as well as their staff, are discouraged against leaving their homes.
Whether they’re in areas where the virus has spread significantly, or those regions that remain relatively isolated from the outbreak, these physicians have had to make drastic changes to how they operate their practices.
“We are being exposed to a new way of practicing medicine,” said Dr. Nikhil Hemady, the chief medical officer of Honor Community Health, which is near Detroit. “The way I look at it is that we are at war. We are truly practicing medicine like we are at war.”
In interviews with TPM, primary care providers from across the country described an increasingly perilous situation, whether they practice in family-style clinics, community health centers or ambulatory facilities. They’ve recounted layoffs, furloughs and cutbacks to hours they’ve had to impose just a few weeks into the current pandemic. Their patients have struggled with the new technology doctors have had to adopt to deliver care. Their staff fear contracting the virus themselves, as they face the same shortfall in protective equipment that is currently plaguing larger health care systems.
These practitioners worry not just about facing the current crisis, but whether their clinics will still be standing when the United States makes it to the other side of the pandemic.
“Primary care is hard to keep afloat in the best of times,” said Christi Siedlecki, the CEO of Grants Pass Clinic in southern Oregon. “This is really scary.”
Siedlecki did the best she could to prepare for how the outbreak would upend her clinic’s operations, but the changes to the medical landscape arrived before she could find her footing.
For the last month or so, she knew COVID-19 was coming in only a matter of time. Her community is right on I-5, the main thoroughfare between Washington and California, and positive cases have been confirmed in counties surrounding hers.
About three weeks ago, preparing for the outbreak became “all consuming,” she said. By the time another week went by, her clinic had seen a “significant” drop of in-person patient traffic that is the source of most of its revenue.
“No sooner than when we were putting forward our first efforts to get organized, it got real and it got real, fast,” Siedlec said.
Splinting Wrists While Patients Stay In Their Cars
Perhaps the biggest challenge primary care doctors are facing is the need to discourage all unnecessary in-person interactions to stem the spread of the virus. This effort is particularly crucial at health care facilities, where the most regular patients can also be the most vulnerable to COVID-19: older people and those with chronic conditions.
These primary care providers are also serving as a frontline defense against the virus, as they are where those exhibiting symptoms go for assessments and in the hope of getting still-elusive tests.
“I’m very concerned about our patients with chronic conditions and things that we would usually be managing aggressively,” said Dr. Jennifer Aloff, of the Michigan practice Midland Family Physicians. “They’re doing the right thing by staying at home, but I am concerned about how we will handle the deluge when things return back to normal, whenever that may be.”
Some practices have reworked their operations to adapt to this conundrum. Aloff described scheduling visits for relatively healthy patients in the morning, and sick in the afternoon.
The staff has also delivered infant immunization shots and splinted broken wrists while their patients remained in their cars.
“We are trying to meet patients’ needs however the patient is comfortable,” she said.
More broadly, the situation has necessitated the expansion of what’s known as “telehealth” — i.e. consultations conducted through electronic communication platforms — as well as less technologically-advanced methods of delivering care, such as in video chats and phone calls.
While prudent for protecting the public health, this shift has presented a range of obstacles practically overnight that doctors have had to grapple with
Clinics have had to quickly scale up their technology platforms at a time that telehealth technology contractors are slammed with requests for assistance.
They’ve had to buy new equipment — such as laptops, so staff can work from home, or new phones, so they don’t have to give out their personal numbers to patients — just as their revenues are drying up.
Meanwhile, patients have had their own issues with adapting to the new systems. Older patients in particular are known to struggle with the technology, and due to the self-isolation the outbreak requires, they can’t have their younger relatives come over to set the services up. Others, especially lower-income patients who may rely on community health centers, don’t have consistent internet access at all.
Doctors have tried to make the technology more accessible — for instance, by switching from an app a user must download to a web-based link they can send to patients via texts.
But often, clinics are just relying on audio-only phone calls to advise and treat patients, a form of care for which they’ll get extremely low reimbursements, if any at all.
A Major Drop Off In Appointments
The financial realities of this new environment have turned a challenging time for many clinics into a fullblown panic.
For primary care doctors, their financial model is built around the money they take in for in-person visits. The Trump administration has loosened the rules around telehealth and virtual visits in a way that has made it easier for doctors to be paid for that type of care, through federal health care programs like Medicaid. But they’re often still taking a haircut, even in the most generous categories of those reimbursements. Some private plans have not followed the federal government’s lead in expanding clinics’ ability to bring in revenue via telehealth, policy experts told TPM.
Doctors and policy experts said that many primary care practices were seeing a 50-60 percent drop in business in recent weeks. Aloff said that the number of patients her clinic is seeing has dropped around 95 percent, and that included telehealth appointments.
This dire financial situation has led to clinics making tough choices to make ends meet. Already, there have been layoffs, as well as efforts to reduce the hours of staff. The need to quarantine several staffers who are feared to have come down with the virus has also reduced payroll costs for some practices.
Honor Community Health closed 14 of its 16 locations for in-person visits, according to Hemady. (Eight of those locations were at schools that were closed for the outbreak.)
But even with this drop of in-person traffic, primary care physicians are still struggling with a shortfall of personal protective equipment, such as gowns, masks and goggles that will protect staff from contracting the virus and spreading it to other patients.
The “disjointed” distribution network for that equipment — as well as for COVID-19 tests and other supplies — means that the “smaller entity, the longer it takes to get things to them,” according to Shawn Martin, the CEO designee of the American Academy of Family Physicians.
Aloff recalled a lucky break that befell her clinic, in the form of a patient who is also an electrical contractor.
“He said, ‘Hey, I’ve got coveralls and goggles. Do you want them?’” she said. “So we’ve had some patients outreaching to see if they can be helpful.”


talkingpointsmemo--2020-03-25--Trump Admin Urged To Free Migrants After Detainee Tests Positive For COVID-19

WASHINGTON ( AP ) — Pressure was mounting on the Trump administration Wednesday to release people from immigration detention facilities where at least one detainee has tested positive for COVID-19 and advocates fear tight quarters and overall conditions could cause rapid spread of the virus .
The U.S. holds around 37,000 people in immigration detention .
Detainees and advocates say many are vulnerable because of age and pre-existing medical conditions , and because they are often held in open rooms , beds 3-feet apart , and without adequate supplies of masks or other protections .
“ It ’ s impossible @ @ @ @ @ @ @ Battistotti , an Italian who is among 170 people detained by U.S. Immigration and Customs Enforcement at the Bristol County jail in Massachusetts .
“ People are panicking .
People are in fear.
” The 54-year-old Battistotti was among about 100 detainees at the county jail near Cape Cod who signed a letter released by a local immigration lawyer detailing conditions inside .
They asked to be released to await decisions on their immigration cases .
“ I don ’ t want to die in an ICE jail , ” he said in @ @ @ @ @ @ @ .
“ Why can ’ t I fight my case on the outside ?
” The agency , which reported the positive test of a 31-year-old man from Mexico held in Bergen County , New Jersey , on Tuesday , has announced steps to protect detained migrants and staff from the virus , but hasn ’ t said whether it plans to review cases for possible release because of the outbreak .
It did not immediately respond to a request to comment on the complaints about conditions from the detainees and their advocates @ @ @ @ @ @ @ its overall hard line on immigration , a signature policy of President Donald Trump , and its response to the outbreak , with ICE announcing previously that it would “ temporarily adjust ” operations to focus on apprehending people who pose a risk to public safety or are subject to mandatory detention because of a criminal record .
Immigrant advocates , including the American Civil Liberties Union , are filing lawsuits in California , Maryland , Pennsylvania and elsewhere , seeking court orders for the immediate release of people in immigration detention , @ @ @ @ @ @ @ age or medical conditions .
Advocates have also asked a court in Los Angeles to order the Office of Refugee Resettlement to release to eligible sponsors around 1,200 migrant children who were apprehended without parents or legal guardians and have been held in government-contracted shelters for more than 30 days .
They said two staff members at two such facilities in New York have tested positive for COVID-19 .
It ’ s unclear how many immigration detainees overall are at higher risk , but one California suit alone had 13 plaintiffs , all @ @ @ @ @ @ @ 9th Circuit Court of Appeals in San Francisco on Monday , citing the “ rapidly escalating public health crisis , ” ordered the immediate release of a 37-year-old woman who is fighting deportation to Mexico .
The woman ’ s lawyer , Max Carter-Oberstone , said the government told him it would not oppose the decision but she still had not been released as of early Wednesday .
The court took the action on its own initiative in a rare move on behalf of a woman who says she has been threatened with @ @ @ @ @ @ @ cartel .
“ It wasn ’ t something we asked for or were expecting , ” Carter-Oberstone said .
“ The court is clearly reacting to the greater public health crisis that we ’ re in right now and re-evaluating how it ’ s going to dispose of its immigration cases in light of that crisis that we ’ re all experiencing.
” The situation in immigration detention , which include facilities run by local jurisdictions and private contractors , is similar to that facing jails and prisons , with staff also at @ @ @ @ @ @ @ sickened at least 55,000 people and killed about 800 in the U.S. One difference is that more than half of ICE detainees have no criminal charges or conviction and are held only for immigration reasons .
Under previous administrations , many would likely have been released on bond as they pursued their cases .
ICE has reported one positive test of an employee at a detention facility in Elizabeth , New Jersey , and 18 confirmed cases among staff not involved in detaining migrants .
A contractor reported a positive case of a @ @ @ @ @ @ @ County , Texas .
The agency says it is screening new detainees and isolating detainees who show symptoms of the coronavirus disease .
Detainees say those measures won ’ t do much , with people staying in dorm-like bays with no social distancing possible or in smaller rooms that they sometimes have to clean themselves , with insufficient cleaning supplies .
Francisca Morales Diaz , a 45-year-old from Mexico who was released Friday from an ICE detention center in Louisiana , said she and others were issued soap and toilet paper for their @ @ @ @ @ @ @ would run out .
When they complained , she says they were told there were shortages on the outside as well .
“ There isn ’ t enough medicine .
It ’ s not well-maintained , ” Morales told AP .
Her fear is that “ at any moment , they ’ re going to come and take me back there.
” Ira Alkalay , a lawyer representing some of the detainees at the jail near Cape Cod , said the detainees are responsible for cleaning their unit , which includes a dining @ @ @ @ @ @ @ t even given bleach .
Some who signed the letter suffer from respiratory ailments such as tuberculosis , emphysema and asthma that put them at higher risk to the virus .
“ These are not sanitary conditions at all , ” Alkalay said .
“ If the virus is introduced , many people could get sick all at once .
Hospitals in the area can become quickly overwhelmed.
” The office of Bristol County Sheriff Thomas Hodgson , who has made headlines for offering to send the jail ’ s ICE detainees to @ @ @ @ @ @ @ wall , has stressed there are currently no confirmed or suspected cases of the virus at the facility .
“ We suspect these detainees are working with outside political activist groups to use the coronavirus crisis to advance their political agenda , ” the sheriff ’ s spokesman , Jonathan Darling , said this week .
Eunice Cho , an ACLU lawyer , said the confined spaces and limited medical treatment in many immigration jails made them especially vulnerable — and if the virus spreads through one facility , the number of sick @ @ @ @ @ @ @ overwhelm area hospitals .
Many ICE jails are in rural areas with smaller hospitals .
“ This is closely related to the public health of our entire community , ” Cho said .
Associated Press writer Amy Taxin in Orange County , California contributed to this report .

WASHINGTON (AP) — Pressure was mounting on the Trump administration Wednesday to release people from immigration detention facilities where at least one detainee has tested positive for COVID-19 and advocates fear tight quarters and overall conditions could cause rapid spread of the virus.
The U.S. holds around 37,000 people in immigration detention. Detainees and advocates say many are vulnerable because of age and pre-existing medical conditions, and because they are often held in open rooms, beds 3-feet apart, and without adequate supplies of masks or other protections.
“It’s impossible to stay calm,” said Marco Battistotti, an Italian who is among 170 people detained by U.S. Immigration and Customs Enforcement at the Bristol County jail in Massachusetts. “People are panicking. People are in fear.”
The 54-year-old Battistotti was among about 100 detainees at the county jail near Cape Cod who signed a letter released by a local immigration lawyer detailing conditions inside. They asked to be released to await decisions on their immigration cases.
“I don’t want to die in an ICE jail,” he said in a phone interview with The Associated Press. “Why can’t I fight my case on the outside?”
The agency, which reported the positive test of a 31-year-old man from Mexico held in Bergen County, New Jersey, on Tuesday, has announced steps to protect detained migrants and staff from the virus, but hasn’t said whether it plans to review cases for possible release because of the outbreak. It did not immediately respond to a request to comment on the complaints about conditions from the detainees and their advocates.
The administration has tried to balance its overall hard line on immigration, a signature policy of President Donald Trump, and its response to the outbreak, with ICE announcing previously that it would “temporarily adjust” operations to focus on apprehending people who pose a risk to public safety or are subject to mandatory detention because of a criminal record.
Immigrant advocates, including the American Civil Liberties Union, are filing lawsuits in California, Maryland, Pennsylvania and elsewhere, seeking court orders for the immediate release of people in immigration detention, especially those at risk because of their age or medical conditions.
Advocates have also asked a court in Los Angeles to order the Office of Refugee Resettlement to release to eligible sponsors around 1,200 migrant children who were apprehended without parents or legal guardians and have been held in government-contracted shelters for more than 30 days. They said two staff members at two such facilities in New York have tested positive for COVID-19.
It’s unclear how many immigration detainees overall are at higher risk, but one California suit alone had 13 plaintiffs, all over 55.
A panel of the 9th Circuit Court of Appeals in San Francisco on Monday, citing the “rapidly escalating public health crisis,” ordered the immediate release of a 37-year-old woman who is fighting deportation to Mexico.
The woman’s lawyer, Max Carter-Oberstone, said the government told him it would not oppose the decision but she still had not been released as of early Wednesday. The court took the action on its own initiative in a rare move on behalf of a woman who says she has been threatened with death by members of a Mexican drug cartel.
“It wasn’t something we asked for or were expecting,” Carter-Oberstone said. “The court is clearly reacting to the greater public health crisis that we’re in right now and re-evaluating how it’s going to dispose of its immigration cases in light of that crisis that we’re all experiencing.”
The situation in immigration detention, which include facilities run by local jurisdictions and private contractors, is similar to that facing jails and prisons, with staff also at risk from a virus that already has sickened at least 55,000 people and killed about 800 in the U.S.
One difference is that more than half of ICE detainees have no criminal charges or conviction and are held only for immigration reasons. Under previous administrations, many would likely have been released on bond as they pursued their cases.
ICE has reported one positive test of an employee at a detention facility in Elizabeth, New Jersey, and 18 confirmed cases among staff not involved in detaining migrants. A contractor reported a positive case of a staff member at a facility in Harris County, Texas. The agency says it is screening new detainees and isolating detainees who show symptoms of the coronavirus disease.
Detainees say those measures won’t do much, with people staying in dorm-like bays with no social distancing possible or in smaller rooms that they sometimes have to clean themselves, with insufficient cleaning supplies.
Francisca Morales Diaz, a 45-year-old from Mexico who was released Friday from an ICE detention center in Louisiana, said she and others were issued soap and toilet paper for their own use once a week and they would run out. When they complained, she says they were told there were shortages on the outside as well.
“There isn’t enough medicine. It’s not well-maintained,” Morales told AP. Her fear is that “at any moment, they’re going to come and take me back there.”
Ira Alkalay, a lawyer representing some of the detainees at the jail near Cape Cod, said the detainees are responsible for cleaning their unit, which includes a dining area and bathrooms, but aren’t even given bleach. Some who signed the letter suffer from respiratory ailments such as tuberculosis, emphysema and asthma that put them at higher risk to the virus.
“These are not sanitary conditions at all,” Alkalay said. “If the virus is introduced, many people could get sick all at once. Hospitals in the area can become quickly overwhelmed.”
The office of Bristol County Sheriff Thomas Hodgson, who has made headlines for offering to send the jail’s ICE detainees to help build Trump’s promised border wall, has stressed there are currently no confirmed or suspected cases of the virus at the facility.
“We suspect these detainees are working with outside political activist groups to use the coronavirus crisis to advance their political agenda,” the sheriff’s spokesman, Jonathan Darling, said this week.
Eunice Cho, an ACLU lawyer, said the confined spaces and limited medical treatment in many immigration jails made them especially vulnerable — and if the virus spreads through one facility, the number of sick people who would require advanced care could overwhelm area hospitals. Many ICE jails are in rural areas with smaller hospitals.
“This is closely related to the public health of our entire community,” Cho said.
________________________________
Marcelo reported from Boston. Merchant reported from Houston.
Associated Press writer Amy Taxin in Orange County, California contributed to this report.


talkingpointsmemo--2020-03-25--COVID-19 Fears Swell In Rural America As Pandemic Erupts In Far Away Cities

DUFUR , Ore. ( AP ) — The social distancing rules repeated like a mantra in America ’ s urban centers , where the coronavirus is spreading exponentially , might seem silly in wide-open places where neighbors live miles apart and “ working from home ” means another day spent branding calves or driving a tractor alone through a field .
But as the pandemic spreads through the U.S. , those living in rural areas , too , are increasingly threatened .
Tiny towns tucked into Oregon ’ s windswept plains and cattle ranches miles from anywhere in South Dakota @ @ @ @ @ @ @ of the new coronavirus , but their main streets are also empty and their medical clinics overwhelmed by the worried .
Residents from rural Alabama to the woods of Vermont to the frozen reaches of Alaska fear the spread of the disease from outsiders , the social isolation that comes when the town ’ s only diner closes , and economic collapse in places where jobs were already scarce .
“ Nobody knows what to do and they ’ re just running in circles , so stay away from me is what I @ @ @ @ @ @ @ Filbin , a 70-year-old cattle rancher in Wasco County , Oregon , one of the few parts of the state that has yet to see a case of COVID-19 .
“ Right now , we ’ re pretty clean over here , but we ’ re not immune to nothin ’ — and if they start bringing it over , it ’ ll explode here.
” To make matters worse , some of the most remote communities have limited or no internet access and spotty cellphone service .
That makes telecommuting and online @ @ @ @ @ @ @ school and work closures , and it eliminates the possibility of the FaceTime card games and virtual cocktail hours that urban Americans have turned to in droves to stay connected .
The routine ways that rural Americans connect — a bingo night , stopping in at a local diner or attending a potluck — are suddenly taboo .
“ Rural people are reliant on their neighbors and have more confidence and trust in their neighbors , ” said Ken Johnson , a senior demographer at the Carsey School of Public Policy and professor @ @ @ @ @ @ @ Hampshire .
“ Now you have people who are supposed to self-isolate themselves .
What does that mean when people you depend on , in order to help you , are going to put themselves and their families at risk ?
I don ’ t know what that will do in rural America.
” Neil Bradshaw , the mayor of Ketchum , Idaho , is starting to see the answer in his own community .
The rural resort town has struggled since the arrival of COVID-19 , and he fears if the virus @ @ @ @ @ @ @ it .
The town is nestled next door to the tony skiing destination Sun Valley Resort and is known as the second-home haven for dozens of celebrities .
It ’ s also become the epicenter of Idaho ’ s caseload , with at least 35 cases and known community spread of the virus .
At least 14 of the cases are among health care workers , forcing the town ’ s small medical workers to bring in replacement staffers from nearby cities .
“ Our town thrives on people coming to town , @ @ @ @ @ @ @ history we are discouraging visitors , ” said Bradshaw , of the town of 2,700 people .
“ Initially people had different levels of adoption , but there ’ s tremendous community pressure that we ’ re all in this together .
We ’ ve gone from being a vibrant town to a ghost town.
” The town ’ s coffers rely on a local option tax , and if that drops by half the city will have lost $ 700,000 in revenue , he said .
Some communities have pushed back on @ @ @ @ @ @ @ a standstill .
Leaders from seven Utah counties , for example , sent a letter earlier this week to Gov .
Gary Herbert urging a “ return to normalcy , ” and said the closure of schools and business was causing panic and hurting the economy .
“ As of ( Monday ) , the total deaths attributed to the virus in the United States stands at ninety , ” the letter states .
“ Not nine hundred , not nine thousand , not ninety thousand .
Ninety .
This number is sure @ @ @ @ @ @ @ we need to keep our wits about us.
” Others worry about outsiders bringing the disease to truly remote areas that aren ’ t equipped to deal with it .
Across the nation , there are over 51,000 general intensive care beds in urban counties , compared with just 5,600 in rural counties , according to data compiled by The Associated Press .
Those beds serve a smaller population than in urban areas , but it would still take fewer people in rural areas to overwhelm a typical hospital .
In fiscal year @ @ @ @ @ @ @ eight ICU beds , compared with 20 for a typical hospital in an urban area .
In Georgiana , a small town in southern Alabama , the only hospital closed last year , so residents flocked to the health clinic instead when a person in a town 5 miles ( 8 kilometers ) away was diagnosed with COVID-19 .
More than 30 % of Georgiana ’ s 1,600 residents are over age 60 , putting them at higher risk with limited medical facilities to serve them , said Mayor Jerome Antone .
For @ @ @ @ @ @ @ mild or moderate symptoms , such as fever and cough that clear up in two to three weeks .
For some , especially older adults and people with existing health problems , it can cause more severe illness , including pneumonia and death .
Georgiana ’ s older residents , Antone said , are “ aggressively upset , ” even though no one there has been diagnosed yet .
In Alaska ’ s Point Hope , an Inupiat whaling village at the edge of the Arctic Ocean nearly 700 miles ( 1,130 kilometers @ @ @ @ @ @ @ have been preparing and discussing potential issues such as air travel into town .
The state ’ s limited road system doesn ’ t reach the community of 900 people , which relies on planes for much of its connection to the outside world .
This week , one of the two airlines that serve Point Hope will begin restricting flights to cargo and passengers with medical or other essential needs .
Still , residents worry the recent deaths of two elders will bring out-of-town mourners for the funerals .
“ We have @ @ @ @ @ @ @ into our village , ” said acting Mayor Daisy Sage .
“ This coronavirus is serious.
” Thousands of miles away , in South Dakota , falling prices for beef are generating as much — or more — worry than the virus .
Sam Stoddard , a cattle rancher near the town of Kadoka , population 650 , said futures markets for beef have dropped up to 30 % because of the coronavirus .
He ’ s worried about longtime ranchers being able to hang on .
If the market remains terrible , @ @ @ @ @ @ @ selling their calves until later in the year — but no one knows how long the economy will be in upheaval , leaving everyone stressed .
At the same time , the state has not shuttered businesses , leaving residents wondering what to expect next .
South Dakota has 30 confirmed cases of the coronavirus .
“ Normally this time of year we ’ re more worried about a big blizzard coming in and killing 10 % of our calves .
You know it ’ s coming , and you can prepare for @ @ @ @ @ @ @ With this , you don ’ t know what ’ s coming or what you should be doing.
” Associated Press writers Michael Casey in Boston ; Stephen Groves in Sioux Falls , South Dakota ; Rebecca Boone in Boise , Idaho ; Jay Reeves in Birmingham , Alabama ; Rachel D ’ Oro in Anchorage , Alaska ; and Nicholas Forster in New York City contributed to this report .

DUFUR, Ore. (AP) — The social distancing rules repeated like a mantra in America’s urban centers, where the coronavirus is spreading exponentially, might seem silly in wide-open places where neighbors live miles apart and “working from home” means another day spent branding calves or driving a tractor alone through a field.
But as the pandemic spreads through the U.S., those living in rural areas, too, are increasingly threatened. Tiny towns tucked into Oregon’s windswept plains and cattle ranches miles from anywhere in South Dakota might not have had a single case of the new coronavirus, but their main streets are also empty and their medical clinics overwhelmed by the worried.
Residents from rural Alabama to the woods of Vermont to the frozen reaches of Alaska fear the spread of the disease from outsiders, the social isolation that comes when the town’s only diner closes, and economic collapse in places where jobs were already scarce.
“Nobody knows what to do and they’re just running in circles, so stay away from me is what I’m saying,” said Mike Filbin, a 70-year-old cattle rancher in Wasco County, Oregon, one of the few parts of the state that has yet to see a case of COVID-19.
“Right now, we’re pretty clean over here, but we’re not immune to nothin’ — and if they start bringing it over, it’ll explode here.”
To make matters worse, some of the most remote communities have limited or no internet access and spotty cellphone service. That makes telecommuting and online learning challenging in an era of blanket school and work closures, and it eliminates the possibility of the FaceTime card games and virtual cocktail hours that urban Americans have turned to in droves to stay connected.
The routine ways that rural Americans connect — a bingo night, stopping in at a local diner or attending a potluck — are suddenly taboo.
“Rural people are reliant on their neighbors and have more confidence and trust in their neighbors,” said Ken Johnson, a senior demographer at the Carsey School of Public Policy and professor of sociology at the University of New Hampshire. “Now you have people who are supposed to self-isolate themselves. What does that mean when people you depend on, in order to help you, are going to put themselves and their families at risk? I don’t know what that will do in rural America.”
Neil Bradshaw, the mayor of Ketchum, Idaho, is starting to see the answer in his own community.
The rural resort town has struggled since the arrival of COVID-19, and he fears if the virus lingers too long, it could devastate it. The town is nestled next door to the tony skiing destination Sun Valley Resort and is known as the second-home haven for dozens of celebrities.
It’s also become the epicenter of Idaho’s caseload, with at least 35 cases and known community spread of the virus. At least 14 of the cases are among health care workers, forcing the town’s small medical workers to bring in replacement staffers from nearby cities.
“Our town thrives on people coming to town, and for the first time in our history we are discouraging visitors,” said Bradshaw, of the town of 2,700 people. “Initially people had different levels of adoption, but there’s tremendous community pressure that we’re all in this together. We’ve gone from being a vibrant town to a ghost town.”
The town’s coffers rely on a local option tax, and if that drops by half the city will have lost $700,000 in revenue, he said.
Some communities have pushed back on shutdowns that have brought daily life to a standstill. Leaders from seven Utah counties, for example, sent a letter earlier this week to Gov. Gary Herbert urging a “return to normalcy,” and said the closure of schools and business was causing panic and hurting the economy.
“As of (Monday), the total deaths attributed to the virus in the United States stands at ninety,” the letter states. “Not nine hundred, not nine thousand, not ninety thousand. Ninety. This number is sure to rise in the near future but we need to keep our wits about us.”
Others worry about outsiders bringing the disease to truly remote areas that aren’t equipped to deal with it. Across the nation, there are over 51,000 general intensive care beds in urban counties, compared with just 5,600 in rural counties, according to data compiled by The Associated Press.
Those beds serve a smaller population than in urban areas, but it would still take fewer people in rural areas to overwhelm a typical hospital. In fiscal year 2018, the average rural hospital had eight ICU beds, compared with 20 for a typical hospital in an urban area.
In Georgiana, a small town in southern Alabama, the only hospital closed last year, so residents flocked to the health clinic instead when a person in a town 5 miles (8 kilometers) away was diagnosed with COVID-19. More than 30% of Georgiana’s 1,600 residents are over age 60, putting them at higher risk with limited medical facilities to serve them, said Mayor Jerome Antone.
For most people, the new coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia and death.
Georgiana’s older residents, Antone said, are “aggressively upset,” even though no one there has been diagnosed yet.
In Alaska’s Point Hope, an Inupiat whaling village at the edge of the Arctic Ocean nearly 700 miles (1,130 kilometers) north of Anchorage, tribal leaders have been preparing and discussing potential issues such as air travel into town. The state’s limited road system doesn’t reach the community of 900 people, which relies on planes for much of its connection to the outside world.
This week, one of the two airlines that serve Point Hope will begin restricting flights to cargo and passengers with medical or other essential needs.
Still, residents worry the recent deaths of two elders will bring out-of-town mourners for the funerals.
“We have all kinds of different people who come into our village,” said acting Mayor Daisy Sage. “This coronavirus is serious.”
Thousands of miles away, in South Dakota, falling prices for beef are generating as much — or more — worry than the virus.
Sam Stoddard, a cattle rancher near the town of Kadoka, population 650, said futures markets for beef have dropped up to 30% because of the coronavirus. He’s worried about longtime ranchers being able to hang on.
If the market remains terrible, he said, ranchers can put off selling their calves until later in the year — but no one knows how long the economy will be in upheaval, leaving everyone stressed.
At the same time, the state has not shuttered businesses, leaving residents wondering what to expect next. South Dakota has 30 confirmed cases of the coronavirus.
“Normally this time of year we’re more worried about a big blizzard coming in and killing 10% of our calves. You know it’s coming, and you can prepare for it,” Stoddard said.
“With this, you don’t know what’s coming or what you should be doing.”
___
Associated Press writers Michael Casey in Boston; Stephen Groves in Sioux Falls, South Dakota; Rebecca Boone in Boise, Idaho; Jay Reeves in Birmingham, Alabama; Rachel D’Oro in Anchorage, Alaska; and Nicholas Forster in New York City contributed to this report.


talkingpointsmemo--2020-03-25--Restaurateur, ‘Top Chef’ Winner Dies Of COVID-19

NEW YORK — A “ Top Chef Masters ” winner and beloved restaurateur , Floyd Cardoz , has died of @ @ @ @ @ He was 59 .
A statement released by his company says Cardoz died Wednesday .
@ @ @ @ @ ago to Mountainside Medical Center in Montclair , New Jersey , with a fever and @ @ @ @ @ virus .
The chef won season three of Bravo ’ s “ Top Chef Masters @ @ @ @ @ was a partner in three restaurants in his native Mumbai .
In addition , he @ @ @ @ @ operated the popular Manhattan eatery Tabla in the early 2000s .
It closed in 2010 @

NEW YORK — A “Top Chef Masters” winner and beloved restaurateur, Floyd Cardoz, has died of complications from the coronavirus. He was 59.
A statement released by his company says Cardoz died Wednesday. He was admitted a week ago to Mountainside Medical Center in Montclair, New Jersey, with a fever and subsequently tested positive for the virus.
The chef won season three of Bravo’s “Top Chef Masters” in 2011. He was a partner in three restaurants in his native Mumbai. In addition, he and famed restaurateur Danny Meyer operated the popular Manhattan eatery Tabla in the early 2000s. It closed in 2010.


talkingpointsmemo--2020-03-25--Putin Delays Vote That Would Extend His Rule, Citing COVID-19 Outbreak

MOSCOW ( AP ) — Citing the coronavirus , Russian President Vladimir Putin on Wednesday postponed a nationwide vote on proposed constitutional amendments that include a change potentially allowing him to stay in office until 2036 .
Putin didn ’ t set a new date for the plebiscite , which was originally scheduled for April 22 , saying that it would depend on how the pandemic develops in Russia .
The country reported its first two deaths from the virus on Wednesday .
He also announced during a televised address to the nation that the government doesn ’ t want @ @ @ @ @ @ @ , except for those in essential sectors .
Stores , pharmacies and banks will stay open , he said .
“ Health , life and safety of the people is an absolute priority for us , ” Putin said .
“ That is why I believe that the vote should be postponed .
We will assess how the situation in the regions and the country as a whole develops , and will set a new date for the vote based exclusively on professional opinion and advice from doctors and experts.
” Under the @ @ @ @ @ @ @ be able to run for president again in 2024 because of term limits .
A new measure would reset his term count , allowing him to run for two more six-year terms if he chooses .
The 67-year-old Putin has been in power since 2000 , longer than any other ruler in the country since Soviet dictator Josef Stalin .
Other constitutional changes further strengthen the presidency and emphasize the priority of Russian law over international norms — a provision reflecting the Kremlin ’ s irritation with the European Court of Human Rights @ @ @ @ @ @ @ issued verdicts against Russia .
There also are proposed amendments to outlaw same-sex marriage and to mention “ a belief in God ” as one of Russia ’ s traditional values .
Authorities in Moscow and other cities already have put up billboards promoting the constitutional changes as essential for Russia ’ s well-being and stability .
Officials reported 163 more virus cases in the country Wednesday from a day earlier , bringing the national total to 658 .
That marked a significantly bigger daily increase from previous days , when the number @ @ @ @ @ @ @ dozens .
Russia ’ s comparatively low number of cases given its size and shared border with China raised questions and doubts about the veracity of official statistics .
Moscow Mayor Sergei Sobyanin told Putin on Tuesday that the low number could reflect insufficient screening in Russia rather than the actual scale of the outbreak and said the situation was “ serious.
” Kremlin critics have accused the authorities of manipulating coronavirus statistics to ram the constitutional vote through at any cost — allegations that the government has rejected .
Last week , @ @ @ @ @ @ @ changes , he kept the door open for delaying it if the coronavirus situation worsened .
On Tuesday , he donned a yellow hazmat suit to visit a Moscow hospital treating COVID-19 patients , where the chief doctor warned him that Russia needed to “ prepare for the Italian scenario.
” Italy has been the hardest-hit nation in Europe with more than 69,000 infections and over 6,800 deaths .
While telling Russians they shouldn ’ t go to work next week , Putin also asked them to stay home , although it was @ @ @ @ @ @ @ or would mean a government lockdown order similar to those in other countries .
“ Don ’ t think ‘ I won ’ t be hurt.
’ Anyone could be hurt , and what ’ s going on now in many countries in Western Europe and across the ocean could be our near future , ” Putin said .
“ Believe me , the safest thing you can do now is to stay home .
It ’ s necessary to take care of yourselves and your relatives , show discipline and responsibility.
” @ @ @ @ @ @ @ businesses hurt by the outbreak and promised tax breaks for businesses and individuals , a deferment on mortgages and a half-year moratorium on bankruptcies .
He also offered tax incentives for small and medium businesses to help them retain their employees along with measures to support families with children .
At the same time , Putin ordered a new tax on dividends being funneled into tax havens abroad , saying that a 2 percent tax on such transfers is “ unfairly ” low in the current situation .
He also said a standard @ @ @ @ @ @ @ from bank accounts to help the nation survive the coronavirus shock .
The outbreak poses a severe challenge to Putin at a time when prices for oil , Russia ’ s main source of income , plummeted amid a price war with Saudi Arabia , causing the ruble to drop sharply .
That boosted the cost of imports and sped up inflation .
Russian authorities so far have refrained from sweeping lockdowns and closures of businesses , but they will likely change course as the outbreak spreads .
That could deal a crippling @ @ @ @ @ @ @ by sagging energy prices and Western sanctions .
Many in Russia have voiced concern that its underfunded health care system could be hard pressed to cope with a coronavirus crisis .
The Russian military on Wednesday launched massive drills to train for deployment across the vast country to help the infected and quarantined areas .
Putin didn ’ t say if the coronavirus outbreak could prompt the Kremlin to scale down or cancel the May 9 celebrations marking the 75th anniversary of the Allies ’ victory over Nazi Germany in World War II @ @ @ @ @ @ @ in Red Square to mark the nation ’ s most important holiday to be attended by foreign leaders , including Chinese President Xi Jinping and French President Emmanuel Macron .
Kremlin spokesman Dmitry Peskov said a decision on whether to go ahead with the parade will be made later , depending on how the coronavirus situation develops .

MOSCOW (AP) — Citing the coronavirus, Russian President Vladimir Putin on Wednesday postponed a nationwide vote on proposed constitutional amendments that include a change potentially allowing him to stay in office until 2036.
Putin didn’t set a new date for the plebiscite, which was originally scheduled for April 22, saying that it would depend on how the pandemic develops in Russia. The country reported its first two deaths from the virus on Wednesday.
He also announced during a televised address to the nation that the government doesn’t want Russians to go to work next week, except for those in essential sectors. Stores, pharmacies and banks will stay open, he said.
“Health, life and safety of the people is an absolute priority for us,” Putin said. “That is why I believe that the vote should be postponed. We will assess how the situation in the regions and the country as a whole develops, and will set a new date for the vote based exclusively on professional opinion and advice from doctors and experts.”
Under the current law, Putin wouldn’t be able to run for president again in 2024 because of term limits. A new measure would reset his term count, allowing him to run for two more six-year terms if he chooses.
The 67-year-old Putin has been in power since 2000, longer than any other ruler in the country since Soviet dictator Josef Stalin.
Other constitutional changes further strengthen the presidency and emphasize the priority of Russian law over international norms — a provision reflecting the Kremlin’s irritation with the European Court of Human Rights and other international bodies that have often issued verdicts against Russia.
There also are proposed amendments to outlaw same-sex marriage and to mention “a belief in God” as one of Russia’s traditional values.
Authorities in Moscow and other cities already have put up billboards promoting the constitutional changes as essential for Russia’s well-being and stability.
Officials reported 163 more virus cases in the country Wednesday from a day earlier, bringing the national total to 658. That marked a significantly bigger daily increase from previous days, when the number of new infections grew only by several dozens.
Russia’s comparatively low number of cases given its size and shared border with China raised questions and doubts about the veracity of official statistics. Moscow Mayor Sergei Sobyanin told Putin on Tuesday that the low number could reflect insufficient screening in Russia rather than the actual scale of the outbreak and said the situation was “serious.”
Kremlin critics have accused the authorities of manipulating coronavirus statistics to ram the constitutional vote through at any cost — allegations that the government has rejected.
Last week, when Putin ordered the vote on constitutional changes, he kept the door open for delaying it if the coronavirus situation worsened. On Tuesday, he donned a yellow hazmat suit to visit a Moscow hospital treating COVID-19 patients, where the chief doctor warned him that Russia needed to “prepare for the Italian scenario.” Italy has been the hardest-hit nation in Europe with more than 69,000 infections and over 6,800 deaths.
While telling Russians they shouldn’t go to work next week, Putin also asked them to stay home, although it was unclear if his call was just advisory or would mean a government lockdown order similar to those in other countries.
“Don’t think ‘I won’t be hurt.’ Anyone could be hurt, and what’s going on now in many countries in Western Europe and across the ocean could be our near future,” Putin said. “Believe me, the safest thing you can do now is to stay home. It’s necessary to take care of yourselves and your relatives, show discipline and responsibility.”
He pledged that the government will support businesses hurt by the outbreak and promised tax breaks for businesses and individuals, a deferment on mortgages and a half-year moratorium on bankruptcies. He also offered tax incentives for small and medium businesses to help them retain their employees along with measures to support families with children.
At the same time, Putin ordered a new tax on dividends being funneled into tax havens abroad, saying that a 2 percent tax on such transfers is “unfairly” low in the current situation. He also said a standard income rate will be applied on yields from bank accounts to help the nation survive the coronavirus shock.
The outbreak poses a severe challenge to Putin at a time when prices for oil, Russia’s main source of income, plummeted amid a price war with Saudi Arabia, causing the ruble to drop sharply. That boosted the cost of imports and sped up inflation.
Russian authorities so far have refrained from sweeping lockdowns and closures of businesses, but they will likely change course as the outbreak spreads. That could deal a crippling blow to a Russian economy already weakened by sagging energy prices and Western sanctions.
Many in Russia have voiced concern that its underfunded health care system could be hard pressed to cope with a coronavirus crisis. The Russian military on Wednesday launched massive drills to train for deployment across the vast country to help the infected and quarantined areas.
Putin didn’t say if the coronavirus outbreak could prompt the Kremlin to scale down or cancel the May 9 celebrations marking the 75th anniversary of the Allies’ victory over Nazi Germany in World War II. Russia has planned a massive parade in Red Square to mark the nation’s most important holiday to be attended by foreign leaders, including Chinese President Xi Jinping and French President Emmanuel Macron.
Kremlin spokesman Dmitry Peskov said a decision on whether to go ahead with the parade will be made later, depending on how the coronavirus situation develops.


talkingpointsmemo--2020-03-25--NYPD Now Patrolling New York City Streets To Enforce Social Distancing

Just days after New York leaders ordered people to stay home , authorities mobilized to head off a potential public health disaster Wednesday , the city ’ s emergence as the nation ’ s biggest coronavirus hot spot a warning flare for the rest of the country .
A makeshift morgue was set up outside Bellevue Hospital , and the city ’ s police , their numbers dwindling by the day as more fall sick , were told to patrol nearly empty streets to enforce social distancing .
Public health officials hunted down beds and medical equipment and put out @ @ @ @ @ @ @ for fear the number of sick will explode in a matter of weeks , overwhelming hospitals the way the virus did in Italy and Spain .
Worldwide , the death toll climbed past 20,000 , according to a running count kept by Johns Hopkins University .
The number of dead in the U.S. topped 800 , with more than 60,000 infections .
New York State alone accounted for more than 30,000 cases and close to 300 deaths , most of them in New York City .
Gov .
Andrew Cuomo , again pleading @ @ @ @ @ @ @ onslaught , attributed the cluster to the city ’ s role as a gateway to international travelers and the sheer density of its population , with 8.6 million people sharing subways , elevators , apartment buildings and offices .
“ Our closeness makes us vulnerable , ” he said .
“ But it ’ s true that your greatest weakness is also your greatest strength .
And our closeness is what makes us who we are .
That is what New York is.
” In other developments around the globe : — The @ @ @ @ @ @ @ on a mammoth economic relief package , a $ 2 trillion plan to help businesses survive the crisis and give households checks of $ 1,200 per adult and $ 500 per child .
Stocks rallied on Wall Street for the second day in a row .
— Prince Charles , the 71-year-old heir to the British throne , tested positive for the virus but was showing only mild symptoms and was isolating himself at a royal estate in Scotland , his office said .
— Spain ’ s death toll rose past 3,400 @ @ @ @ @ @ @ a one-day spike of 700 fatalities .
It is now second only to Italy , with over 7,500 deaths .
__ China ’ s Hubei province , where the outbreak first emerged late last year , started lifting its lockdown .
— Russian President Vladimir Putin postponed a nationwide vote on proposed constitutional amendments that could enable him to extend his hold on power .
The decision came as Russia reported its first deaths from the virus , two elderly patients who had underlying conditions .
— The French Riviera city of Cannes @ @ @ @ @ @ @ festival to the homeless .
More than 440,000 people worldwide have been infected overall , by Johns Hopkins ’ count .
More than 100,000 have recovered .
Other states braced for a version of New York ’ s nightmare , with fears over public events held in the weeks before the virus exploded .
A month after Mardi Gras in and around New Orleans , Louisiana is seeing a ballooning number of cases and now has the third-highest rate per capita in the U.S. , according to the governor .
Sixty-five Louisiana residents @ @ @ @ @ @ @ been confirmed in three-quarters of the state ’ s 64 parishes .
For most people , the coronavirus causes mild or moderate symptoms , such as fever and cough that clear up in two to three weeks .
For some , especially older adults and people with existing health problems , it can cause more severe illness , including pneumonia .
Long reported from Washington .
Associated Press reporters around the world contributed .

Just days after New York leaders ordered people to stay home, authorities mobilized to head off a potential public health disaster Wednesday, the city’s emergence as the nation’s biggest coronavirus hot spot a warning flare for the rest of the country.
A makeshift morgue was set up outside Bellevue Hospital, and the city’s police, their numbers dwindling by the day as more fall sick, were told to patrol nearly empty streets to enforce social distancing.
Public health officials hunted down beds and medical equipment and put out a call for more doctors and nurses for fear the number of sick will explode in a matter of weeks, overwhelming hospitals the way the virus did in Italy and Spain.
Worldwide, the death toll climbed past 20,000, according to a running count kept by Johns Hopkins University. The number of dead in the U.S. topped 800, with more than 60,000 infections.
New York State alone accounted for more than 30,000 cases and close to 300 deaths, most of them in New York City.
Gov. Andrew Cuomo, again pleading for help in dealing with the coming onslaught, attributed the cluster to the city’s role as a gateway to international travelers and the sheer density of its population, with 8.6 million people sharing subways, elevators, apartment buildings and offices.
“Our closeness makes us vulnerable,” he said. “But it’s true that your greatest weakness is also your greatest strength. And our closeness is what makes us who we are. That is what New York is.”
In other developments around the globe:
— The White House and legislative leaders reached agreement on a mammoth economic relief package, a $2 trillion plan to help businesses survive the crisis and give households checks of $1,200 per adult and $500 per child. Stocks rallied on Wall Street for the second day in a row.
— Prince Charles, the 71-year-old heir to the British throne, tested positive for the virus but was showing only mild symptoms and was isolating himself at a royal estate in Scotland, his office said.
— Spain’s death toll rose past 3,400, eclipsing China’s, after a one-day spike of 700 fatalities. It is now second only to Italy, with over 7,500 deaths.
__ China’s Hubei province, where the outbreak first emerged late last year, started lifting its lockdown.
— Russian President Vladimir Putin postponed a nationwide vote on proposed constitutional amendments that could enable him to extend his hold on power. The decision came as Russia reported its first deaths from the virus, two elderly patients who had underlying conditions.
— The French Riviera city of Cannes opened the site of its world-famous film festival to the homeless.
More than 440,000 people worldwide have been infected overall, by Johns Hopkins’ count. More than 100,000 have recovered.
Other states braced for a version of New York’s nightmare, with fears over public events held in the weeks before the virus exploded.
A month after Mardi Gras in and around New Orleans, Louisiana is seeing a ballooning number of cases and now has the third-highest rate per capita in the U.S., according to the governor. Sixty-five Louisiana residents have died, and the virus has been confirmed in three-quarters of the state’s 64 parishes.
For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia.
___
Long reported from Washington. Associated Press reporters around the world contributed.


talkingpointsmemo--2020-03-25--Experts, Not Easter, Should Dictate COVID-19 Protocol Biden Says

Former Vice President Joe Biden on Wednesday sided with COVID-19 experts in cautioning against relaxing social distancing measures too quickly .
The line from the Democratic presidential contender came as he ’ s struggled to make his presence felt on the COVID-19 crisis .
President Donald Trump and several Democrats , including New York Gov .
Andrew Cuomo and Biden ’ s opponent Sen. Bernie Sanders ( I-VT ) , have made themselves regularly available on live-streams and to the press .
But as Biden acknowledged Wednesday , it took his campaign four days to set up his rec room @ @ @ @ @ @ @ that he wanted the country to be “ opened up and rarin ’ to go by Easter.
” Right-wing politicians and pundits have added to the chorus of voices who say , essentially , that otherwise-preventable COVID-19 deaths are worth goosing the economy .
But public health experts have cautioned that social distancing measures , including shutting down restaurants and other public gathering places , may need to continue long after mid-April in order to sufficiently “ flatten the curve ” of the disease and avoid overwhelming hospitals .
In a press briefing @ @ @ @ @ @ @ opinions that easing up on social distancing too early could lead to a second spike in COVID-19 infections .
“ Now he ’ s suggesting he wants to get the country back open by Easter , ” Biden said , referring to Trump .
“ Look , we all want to get back to normal as quickly as possible , but we have a lot to do to make that possible .
We have to do it in a smart way , not to meet some arbitrary or symbolic timeline.
” “ It @ @ @ @ @ @ @ for our people and for our economy if we sent people back to work just as we were beginning to see the impact of social distancing take hold , only to unleash a second spike in infections , ” Biden added .
The former vice president said at one point during the press briefing that he was “ chomping at the bit ” and that he wished he was back in the Senate in order to have an impact on COVID-19 response .
He also pressed Trump to use the Defense Production Act @ @ @ @ @ @ @ ventilators and other supplies was available where the virus threatens to overwhelm local health care capacity .
Trump so far has resisted using the war-time law .
“ He said he ’ s a war-time President , ” Biden said of Trump .
“ Well , act like one.
” Separately , asked what he would tell former Goldman Sachs CEO Lloyd Blankfein and other Wall Street leaders who ’ ve called for quickly ending social distancing guidelines , Biden said he would “ urge them to the think about the science.
” @ @ @ @ @ @ @ , the science of medicine.
” “ The idea of arbitrarily setting a time — I ’ d like to be able to say , we ’ re going to be back to normal next Friday , ” Biden said .
“ That ’ d be wonderful , but it can ’ t be arbitrary .
We have to look at the recent history of what happened in other countries .
”

Former Vice President Joe Biden on Wednesday sided with COVID-19 experts in cautioning against relaxing social distancing measures too quickly.
The line from the Democratic presidential contender came as he’s struggled to make his presence felt on the COVID-19 crisis.
President Donald Trump and several Democrats, including New York Gov. Andrew Cuomo and Biden’s opponent Sen. Bernie Sanders (I-VT), have made themselves regularly available on live-streams and to the press. But as Biden acknowledged Wednesday, it took his campaign four days to set up his rec room for internet briefings.
Trump said Tuesday that he wanted the country to be “opened up and rarin’ to go by Easter.” Right-wing politicians and pundits have added to the chorus of voices who say, essentially, that otherwise-preventable COVID-19 deaths are worth goosing the economy.
But public health experts have cautioned that social distancing measures, including shutting down restaurants and other public gathering places, may need to continue long after mid-April in order to sufficiently “flatten the curve” of the disease and avoid overwhelming hospitals.
In a press briefing Wednesday, Biden emphasized those experts’ opinions that easing up on social distancing too early could lead to a second spike in COVID-19 infections.
“Now he’s suggesting he wants to get the country back open by Easter,” Biden said, referring to Trump. “Look, we all want to get back to normal as quickly as possible, but we have a lot to do to make that possible. We have to do it in a smart way, not to meet some arbitrary or symbolic timeline.”
“It would be a catastrophic thing to do for our people and for our economy if we sent people back to work just as we were beginning to see the impact of social distancing take hold, only to unleash a second spike in infections,” Biden added.
The former vice president said at one point during the press briefing that he was “chomping at the bit” and that he wished he was back in the Senate in order to have an impact on COVID-19 response.
He also pressed Trump to use the Defense Production Act to ensure that the national supply of ventilators and other supplies was available where the virus threatens to overwhelm local health care capacity. Trump so far has resisted using the war-time law.
“He said he’s a war-time President,” Biden said of Trump. “Well, act like one.”
Separately, asked what he would tell former Goldman Sachs CEO Lloyd Blankfein and other Wall Street leaders who’ve called for quickly ending social distancing guidelines, Biden said he would “urge them to the think about the science.”
“Not the science of Wall Street, the science of medicine.”
“The idea of arbitrarily setting a time — I’d like to be able to say, we’re going to be back to normal next Friday,” Biden said. “That’d be wonderful, but it can’t be arbitrary. We have to look at the recent history of what happened in other countries.”


talkingpointsmemo--2020-03-25--Washington Has An Innovative Way To Fund Its COVID Response – If It Can Get Trump’s OK

Washington state petitioned the Trump administration on Tuesday for a nearly unprecedented change to its Medicaid program , tailored to respond to the state ’ s climbing number of COVID-19 patients .
The ask would see the state create a COVID-19 Disaster Relief Fund , allowing private philanthropists and local governments to finance much-needed emergency services targeted at getting control of the pandemic .
The move comes as Washington continues to battle the epidemic , with nearly 2,500 cases in the state and 123 deaths , almost two months after the first case appeared in the state .
The request @ @ @ @ @ @ @ notes the urgency , saying that “ COVID-19 now threatens the lives of millions and places extraordinary strain on Washington state ’ s healthcare system , ” adding that “ ongoing response efforts and a clear-eyed projection of what is ahead have made it clear ” that the state needs the federal approval it seeks .
Jason McGill , Assistant Director for Medicaid at Washington state ’ s Department of Health , told TPM that the request would allow “ local dollars and philanthropy dollars to pay for non-traditional Medicaid services ” that @ @ @ @ @ @ @ .
That includes quarantine isolation tents , disease screening centers , and shelters for the COVID-positive homeless , among other things .
“ That ’ s our big ask , ” McGill added , saying that it remains to be seen whether the federal government would determine that “ the financing makes sense , and if they have the wherewithal to approve that.
” The request was issued to CMS by asking for what is known in Medicaid parlance as a 1115 waiver , in which the federal government can approve temporary changes @ @ @ @ @ @ @ a crisis .
Washington state already petitioned the federal government with a different 1115 waiver last week , and also asked for emergency Medicaid changes under a separate waiver that was issued pursuant to President Trump ’ s emergency declaration .
The Trump administration partially approved that request , and Washington has come back for more in response to what it describes in the Tuesday waiver request as an “ ever-escalating ” crisis .
McGill told TPM that the state made the request under a template that CMS issued over the weekend as @ @ @ @ @ @ @ process through which dozens of states are asking for emergency changes to their government-run health insurance programs .
CMS approved a similar waiver in 2006 , McGill said , for Louisiana following Hurricane Katrina .
That program allowed the state to forego budgetary requirements to expand its Medicaid coverage in the aftermath of the hurricane .
It ’ s not clear what private philanthropies would contribute to the disaster relief fund , should it be approved .
Money from the fund , the state says , would finance quarantine sites , the purchase @ @ @ @ @ @ @ and the establishment of a statewide tracking center to standardize and monitor COVID-19 cases .

Washington state petitioned the Trump administration on Tuesday for a nearly unprecedented change to its Medicaid program, tailored to respond to the state’s climbing number of COVID-19 patients.
The ask would see the state create a COVID-19 Disaster Relief Fund, allowing private philanthropists and local governments to finance much-needed emergency services targeted at getting control of the pandemic.
The move comes as Washington continues to battle the epidemic, with nearly 2,500 cases in the state and 123 deaths, almost two months after the first case appeared in the state.
The request to Centers for Medicaid & Medicare Services notes the urgency, saying that “COVID-19 now threatens the lives of millions and places extraordinary strain on Washington state’s healthcare system,” adding that “ongoing response efforts and a clear-eyed projection of what is ahead have made it clear” that the state needs the federal approval it seeks.
Jason McGill, Assistant Director for Medicaid at Washington state’s Department of Health, told TPM that the request would allow “local dollars and philanthropy dollars to pay for non-traditional Medicaid services” that the federal program currently does not cover.
That includes quarantine isolation tents, disease screening centers, and shelters for the COVID-positive homeless, among other things.
“That’s our big ask,” McGill added, saying that it remains to be seen whether the federal government would determine that “the financing makes sense, and if they have the wherewithal to approve that.”
The request was issued to CMS by asking for what is known in Medicaid parlance as a 1115 waiver, in which the federal government can approve temporary changes to its health-care programs in response to a crisis.
Washington state already petitioned the federal government with a different 1115 waiver last week, and also asked for emergency Medicaid changes under a separate waiver that was issued pursuant to President Trump’s emergency declaration.
The Trump administration partially approved that request, and Washington has come back for more in response to what it describes in the Tuesday waiver request as an “ever-escalating” crisis.
McGill told TPM that the state made the request under a template that CMS issued over the weekend as part of a bid to standardize the process through which dozens of states are asking for emergency changes to their government-run health insurance programs.
CMS approved a similar waiver in 2006, McGill said, for Louisiana following Hurricane Katrina. That program allowed the state to forego budgetary requirements to expand its Medicaid coverage in the aftermath of the hurricane.
It’s not clear what private philanthropies would contribute to the disaster relief fund, should it be approved. Money from the fund, the state says, would finance quarantine sites, the purchase of ventilators, personal protective equipment, and the establishment of a statewide tracking center to standardize and monitor COVID-19 cases.
Tierney Sneed contributed to this report.
Read the document here:


talkingpointsmemo--2020-03-25--Are Gun Shops Essential? PA Gov Reverses Amid Nationwide Push For Weapons Access

Pennsylvania Governor Tom Wolf ( D ) , like many governors nationwide , issued an executive order last week to shutter non-essential businesses across the state to slow the spread of coronavirus .
But by Tuesday , he had quietly amended that order to exempt firearms retailers from the blanket closure .
His reversal came after three state Supreme Court justices , writing for the minority , argued that his decision would completely shut down all gun sales , since law dictates that the transactions must be made in person .
That , they argued , would block Pennsylvanians from @ @ @ @ @ @ @ , if firearm dealers are not able to conduct any business in-person at their licensed premises , then no transfers of firearms can be completed , ” wrote Justice David Wecht for the group , pointing out that law requires in-person gun transactions .
“ This amounts to an absolute and indefinite prohibition upon the acquisition of firearms by the citizens of this Commonwealth — a result in clear tension with the Second Amendment to the United States Constitution and Article I , Section 21 of the Pennsylvania Constitution.
” Citing the allowance @ @ @ @ @ @ @ their dine-in operations are shut down , Wecht encouraged Wolf to create an allowance for the part of gun purchasing that must be conducted in person to avoid “ an impermissible intrusion upon a fundamental constitutional right.
” Though the state Supreme Court majority actually decided in Wolf ’ s favor against a firm representing a local gun shop and would-be gun owner , the words of the dissenting justices — notably , all of the Democrats on the bench — seem to have changed the mind of the similarly-ideologically aligned governor .
@ @ @ @ @ @ @ to give gun retailers the loophole the Democratic justices urged .
In an exception to his closure of all “ sporting goods , hobby , and musical instrument stores , ” he wrote that “ firearms dealers may operate physical businesses on a limited basis to complete only the portions of a sale/transfer that must be conducted under the law.
” He added that such transactions must be made by appointment during limited hours to cut down on unsafe congregating , and that the gun dealers must enforce social distancing and thoroughly sanitize @ @ @ @ @ @ @ odd-couple pairing , that stance taken by the Democratic justices and enacted by the Democratic governor is exactly what the National Shooting Sports Foundation , the gun industry ’ s trade association , has been pushing nationwide .
Since late last week , the group had been in full-fledged pressure mode , trying to convince the White House , Department of Homeland Security , governors , mayors , state legislators and county officials of the essential nature of gun manufacturing and retail , NSSF spokesman Mark Olivia told TPM .
“ Our national @ @ @ @ @ @ @ said , explaining that domestic manufacturers supply most of the “ small arms ” to the military , and that all but the largest police departments get their weapons cache from local retailers .
But , soldiers and police officers aren ’ t alone — people out of uniform seem to be clamoring for weapons accessibility amid the pandemic as well .
Per Olivia , the number of background checks conducted since the outbreak began — the FBI-provided data by which the group tracks gun purchases — has been “ eye-popping.
” “ @ @ @ @ @ @ @ FBI , ” he said .
“ The March 16 , 2020 volume for background checks is 300 percent the volume on March 16 , 2019 .
Since February 23 , background checks have been roughly double every day as the same days last year.
” Olivia added that the group hasn ’ t yet adjusted those numbers like members usually do at the beginning of each month , winnowing out background checks for things like permits to get a better idea of the numbers attached to gun sales .
Still , he @ @ @ @ @ @ @ it from our retailers , our distributors : they ’ re swamped trying to keep up with the demand.
” While getting all Rambo-d up in the face of an unshootable disease may strike some as odd , to Olivia , it makes perfect sense .
“ Police departments are having to scale back what they ’ re doing , city and state officials are turning criminals out of jails and prisons in fear of infection , ” he said .
“ In uncertain times , people are concerned for their safety .
@

Pennsylvania Governor Tom Wolf (D), like many governors nationwide, issued an executive order last week to shutter non-essential businesses across the state to slow the spread of coronavirus.
But by Tuesday, he had quietly amended that order to exempt firearms retailers from the blanket closure.
His reversal came after three state Supreme Court justices, writing for the minority, argued that his decision would completely shut down all gun sales, since law dictates that the transactions must be made in person. That, they argued, would block Pennsylvanians from their constitutional rights.
“Quite simply, if firearm dealers are not able to conduct any business in-person at their licensed premises, then no transfers of firearms can be completed,” wrote Justice David Wecht for the group, pointing out that law requires in-person gun transactions. “This amounts to an absolute and indefinite prohibition upon the acquisition of firearms by the citizens of this Commonwealth — a result in clear tension with the Second Amendment to the United States Constitution and Article I, Section 21 of the Pennsylvania Constitution.”
Citing the allowance for restaurants to continue takeout services while their dine-in operations are shut down, Wecht encouraged Wolf to create an allowance for the part of gun purchasing that must be conducted in person to avoid “an impermissible intrusion upon a fundamental constitutional right.”
Though the state Supreme Court majority actually decided in Wolf’s favor against a firm representing a local gun shop and would-be gun owner, the words of the dissenting justices — notably, all of the Democrats on the bench — seem to have changed the mind of the similarly-ideologically aligned governor.
On Tuesday, he amended his order to give gun retailers the loophole the Democratic justices urged.
In an exception to his closure of all “sporting goods, hobby, and musical instrument stores,” he wrote that “firearms dealers may operate physical businesses on a limited basis to complete only the portions of a sale/transfer that must be conducted under the law.” He added that such transactions must be made by appointment during limited hours to cut down on unsafe congregating, and that the gun dealers must enforce social distancing and thoroughly sanitize the stores between sales.
In an odd-couple pairing, that stance taken by the Democratic justices and enacted by the Democratic governor is exactly what the National Shooting Sports Foundation, the gun industry’s trade association, has been pushing nationwide.
Since late last week, the group had been in full-fledged pressure mode, trying to convince the White House, Department of Homeland Security, governors, mayors, state legislators and county officials of the essential nature of gun manufacturing and retail, NSSF spokesman Mark Olivia told TPM.
“Our national security mission still continues,” he said, explaining that domestic manufacturers supply most of the “small arms” to the military, and that all but the largest police departments get their weapons cache from local retailers.
But, soldiers and police officers aren’t alone — people out of uniform seem to be clamoring for weapons accessibility amid the pandemic as well.
Per Olivia, the number of background checks conducted since the outbreak began — the FBI-provided data by which the group tracks gun purchases — has been “eye-popping.”
“Last week, we spoke with the FBI,” he said. “The March 16, 2020 volume for background checks is 300 percent the volume on March 16, 2019. Since February 23, background checks have been roughly double every day as the same days last year.”
Olivia added that the group hasn’t yet adjusted those numbers like members usually do at the beginning of each month, winnowing out background checks for things like permits to get a better idea of the numbers attached to gun sales.
Still, he said, “we’ve seen it from our retailers, our distributors: they’re swamped trying to keep up with the demand.”
While getting all Rambo-d up in the face of an unshootable disease may strike some as odd, to Olivia, it makes perfect sense.
“Police departments are having to scale back what they’re doing, city and state officials are turning criminals out of jails and prisons in fear of infection,” he said. “In uncertain times, people are concerned for their safety.”


talkingpointsmemo--2020-04-16--‘They’re Adding’: Trump Sows Doubt About Untested COVID-19 Deaths That Threaten His Narrative

This piece is part of our weekly Prime series on corruption and the Trump Swamp , but it has been moved outside of the paywall while we cover COVID-19 .
The Maria-fication of the coronavirus pandemic ’ s death toll has begun .
After Hurricane Maria collided with Puerto Rico in 2017 , President Donald Trump simply could not acknowledge that thousands of people — not a couple dozen — had died as a result of the massive and powerful storm .
At the time , Trump said studies showing the massive death toll were pushed by Democrats to make @ @ @ @ @ @ @ as now , Trump insisted that he , in fact , had done a great job — “ an incredible unsung success.
” And yesterday , responding to the news that New York had begun releasing numbers on “ probable ” COVID-19 deaths , Trump planted the same seeds of doubt .
According to the new data , nearly 3,800 people died of a suspected coronavirus cases , but the deaths were never confirmed with a test for the disease .
“ New York added 3,000 deaths because they died and they ’ @ @ @ @ @ @ @ It was a heart attack , ’ they ’ re saying ‘ It was a heart attack caused by this , ' ” the President said at a press briefing .
“ So they ’ re adding.
” In reality , the city said upon announcing these “ probable ” COVID-19 deaths Tuesday that they described people who had not been tested as coronavirus carriers , but whose “ death certificate lists as a cause of death ‘ COVID-19 ’ or an equivalent.
” There aren ’ t remotely enough tests to confirm @ @ @ @ @ @ @ , and less still to test the entire United States .
Many , if not most , who die of the disease will do so without any confirmation that they participated in a global pandemic .
Nursing homes in New York City offer a dramatic example : A full 70 % of COVID-19 deaths in assisted living facilities and hospices , as recorded by the city , were “ probable ” rather than “ confirmed ” with a test .
And yet those homes house the populations most vulnerable to the virus : @ @ @ @ @ @ @ living in a communal setting .
Even the “ probable ” cases appear to be undercounting the death toll : Based on monthly morbidity averages in years past , there have likely been upwards of 13,000 COVID-19 deaths in New York City .
Gov .
Andrew Cuomo ( D ) , asked about Trump ’ s remark in a news conference Thursday , said they were “ more bizarre than usual , ” then accurately pointed out that death statistics as recorded in the middle of the pandemic were just a “ rough @ @ @ @ @ @ @ out that New York City had followed CDC guidelines in keeping records of probable COVID-19 deaths .
“ It ’ s the President ’ s own CDC that put out this guidance , ” DeRosa said .
Trump has expressed publicly that he views COVID-19 data , like the stock market , as a ticker of his own success .
In early March , for example , he expressed a wariness of allowing the virus-stricken Grand Princess cruise ship to dock in California because “ I like the numbers being where they are.
@ @ @ @ @ @ @ that 60,000 people could die as a result of the pandemic — a downward estimate from an earlier 100,000-200,000 range — Trump sounded triumphant that more people were expected to die than those currently engraved on the Vietnam Veterans Memorial in D.C. “ You can never be happy , ” he said of the figure , “ but that ’ s a lot fewer than we were originally told and thinking.
” Here ’ s what else we were watching this week : • None The White House Pushed FEMA To Give its @ @ @ @ @ @ @ Never Had to Bid • White House Rejects Bailout for U.S .
Postal Service Battered by Coronavirus • In Unprecedented Move , Treasury Orders Trump ’ s Name Printed on Stimulus Checks • None Why Are Rich Americans Getting $ 1.7 Million Stimulus Checks ?
• The E.P.A .
Is Weakening Controls on Mercury

This piece is part of our weekly Prime series on corruption and the Trump Swamp, but it has been moved outside of the paywall while we cover COVID-19.
The Maria-fication of the coronavirus pandemic’s death toll has begun.
After Hurricane Maria collided with Puerto Rico in 2017, President Donald Trump simply could not acknowledge that thousands of people — not a couple dozen — had died as a result of the massive and powerful storm.
At the time, Trump said studies showing the massive death toll were pushed by Democrats to make him look bad. And then, as now, Trump insisted that he, in fact, had done a great job — “an incredible unsung success.”
And yesterday, responding to the news that New York had begun releasing numbers on “probable” COVID-19 deaths, Trump planted the same seeds of doubt. According to the new data, nearly 3,800 people died of a suspected coronavirus cases, but the deaths were never confirmed with a test for the disease.
“New York added 3,000 deaths because they died and they’re now saying, rather than ‘It was a heart attack,’ they’re saying ‘It was a heart attack caused by this,'” the President said at a press briefing. “So they’re adding.”
In reality, the city said upon announcing these “probable” COVID-19 deaths Tuesday that they described people who had not been tested as coronavirus carriers, but whose “death certificate lists as a cause of death ‘COVID-19’ or an equivalent.”
There aren’t remotely enough tests to confirm each COVID-19 case in New York City, and less still to test the entire United States. Many, if not most, who die of the disease will do so without any confirmation that they participated in a global pandemic.
Nursing homes in New York City offer a dramatic example: A full 70% of COVID-19 deaths in assisted living facilities and hospices, as recorded by the city, were “probable” rather than “confirmed” with a test. And yet those homes house the populations most vulnerable to the virus: The elderly, infirm and immunocompromised, living in a communal setting.
Even the “probable” cases appear to be undercounting the death toll: Based on monthly morbidity averages in years past, there have likely been upwards of 13,000 COVID-19 deaths in New York City.
Gov. Andrew Cuomo (D), asked about Trump’s remark in a news conference Thursday, said they were “more bizarre than usual,” then accurately pointed out that death statistics as recorded in the middle of the pandemic were just a “rough estimate.” His secretary Melissa DeRosa pointed out that New York City had followed CDC guidelines in keeping records of probable COVID-19 deaths.
“It’s the President’s own CDC that put out this guidance,” DeRosa said.
Trump has expressed publicly that he views COVID-19 data, like the stock market, as a ticker of his own success.
In early March, for example, he expressed a wariness of allowing the virus-stricken Grand Princess cruise ship to dock in California because “I like the numbers being where they are.”
Similarly, when government calculations projected that 60,000 people could die as a result of the pandemic — a downward estimate from an earlier 100,000-200,000 range — Trump sounded triumphant that more people were expected to die than those currently engraved on the Vietnam Veterans Memorial in D.C.
“You can never be happy,” he said of the figure, “but that’s a lot fewer than we were originally told and thinking.”
Here’s what else we were watching this week:


talkingpointsmemo--2020-04-16--Disgraced Ex-Rep. Hunter Dipped Into Campaign Funds For Bar Tab After Resigning

The disgraced ( now-former ) Rep. Duncan Hunter ( R-CA ) apparently couldn ’ t help himself .
The “ @ @ @ @ @ ” committee filed a document to the Federal Election Commission on Wednesday that revealed Hunter @ @ @ @ @ pick up a $ 137.20 bill at Hawk ‘ n ’ Dove , a bar @ @ @ @ @ 9 .
That was a mere two days after he submitted his letter of resignation @ @ @ @ @ month after he had pleaded guilty to campaign fund misuse .
Hunter was handed an @ @ @ @ @ .
His abuse of donor money included flights for his pet rabbit , fine dining @ @ @ @ @ five women with whom he was having extramarital affairs .
Politico editor Steven Shepard was @ @ @ @ @ payment .

The disgraced (now-former) Rep. Duncan Hunter (R-CA) apparently couldn’t help himself.
The “Duncan D. Hunter for Congress” committee filed a document to the Federal Election Commission on Wednesday that revealed Hunter had used campaign money to pick up a $137.20 bill at Hawk ‘n’ Dove, a bar in D.C., on January 9.
That was a mere two days after he submitted his letter of resignation and a little over a month after he had pleaded guilty to campaign fund misuse.
Hunter was handed an 11-month prison sentence in March. His abuse of donor money included flights for his pet rabbit, fine dining, and luxury vacations with five women with whom he was having extramarital affairs.
Politico editor Steven Shepard was the first to flag the payment.


talkingpointsmemo--2020-04-16--Midwest Governors Team Up To Coordinate Reopening Guidelines

Like their colleagues to the east and west , seven governors from the Midwest region announced Thursday that they are partnering up to coordinate guidelines on reopening the economies in their states .
The move comes as President Trump is prepared to announce guidelines to begin reopening the economy at the end of the month .
Michigan Gov .
Gretchen Whitmer ( D ) , Illinois Gov .
J.B. Pritzker ( D ) , Ohio Gov .
Mike Dewine ( R ) , Wisconsin Gov .
Tony Evers ( D ) , Minnesota Gov .
Tim Walz ( D ) @ @ @ @ @ @ @ R ) and Kentucky Gov .
Andy Beshear ( D ) issued a statement Thursday announcing the joint effect to “ safely reopen ” their economies .
“ We recognize that our economies are all reliant on each other , and we must work together to safely reopen them so hardworking people can get back to work and businesses can get back on their feet , ” the governors said in a joint statement .
The move comes after governors from the East Coast states of New York , New Jersey , Connecticut @ @ @ @ @ @ @ and Massachusetts announced earlier this week a joint regional task force focused on reopening economies .
Shortly after East Coast states ’ announcement , states on the West Coast such as Washington , Oregon and California also announced they would coordinate plans to reopen economies .

Like their colleagues to the east and west, seven governors from the Midwest region announced Thursday that they are partnering up to coordinate guidelines on reopening the economies in their states. The move comes as President Trump is prepared to announce guidelines to begin reopening the economy at the end of the month.
Michigan Gov. Gretchen Whitmer (D), Illinois Gov. J.B. Pritzker (D), Ohio Gov. Mike Dewine (R), Wisconsin Gov. Tony Evers (D), Minnesota Gov. Tim Walz (D), Indiana Gov. Eric Holcomb (R) and Kentucky Gov. Andy Beshear (D) issued a statement Thursday announcing the joint effect to “safely reopen” their economies.
“We recognize that our economies are all reliant on each other, and we must work together to safely reopen them so hardworking people can get back to work and businesses can get back on their feet,” the governors said in a joint statement.
NEW: Midwest governors Gretchen Whitmer, Mike DeWine, Tony Evers, Tim Walz, JB Pritzker, Eric Holcomb and Andy Beshear just announced they will coordinate to reopen the economy in the Midwest region. pic.twitter.com/ySqj39bGbh — Kat Stafford (@kat__stafford) April 16, 2020
The move comes after governors from the East Coast states of New York, New Jersey, Connecticut, Pennsylvania, Rhode Island, Delaware and Massachusetts announced earlier this week a joint regional task force focused on reopening economies.
Shortly after East Coast states’ announcement, states on the West Coast such as Washington, Oregon and California also announced they would coordinate plans to reopen economies.