talkingpointsmemo--2020-04-26--The Amazon Lockdown: How an Unforgiving Algorithm Drives Suppliers to Favor the E-Commerce Giant Ove

The Amazon Lockdown: How an Unforgiving Algorithm Drives Suppliers to Favor the E-Commerce Giant Over Other Retailers

This story first appeared at ProPublica .
ProPublica is a Pulitzer Prize-winning investigative newsroom .
Sign up for The Big Story newsletter to receive stories like this one in your inbox .
During the second week of March , as the stock market and many U.S. businesses slumped , Peter Spenuzza ’ s company , Rise Bar , enjoyed an unexpected boost .
Amazon , where the protein bars are sold , suggested Spenuzza keep 18,000 packages in its warehouses , up from the usual 4,000 , based on soaring demand for almond honey and other flavors .
Demand on @ @ @ @ @ @ @ that peak , poses a dilemma for Spenuzza .
Rise Bars are also sold in grocery chains nationally .
Although his Irvine , California , plant has been running at full production capacity , he didn ’ t have enough bars to send both to Amazon and to all the brick-and-mortar retailers who also have increased their orders .
One week in March , when he ran out of stock on Amazon , its algorithm demoted his product listings in Amazon ’ s search results and removed his sponsored ads .
Rise Bar @ @ @ @ @ @ @ ’ s “ best seller ” ranking in the grocery category , allowing competitors to leapfrog him .
The brand ’ s weekly Amazon sales dipped by 25 % .
Dismayed , Spenuzza decided to regularly send the e-commerce giant the “ lion ’ s share ” of his inventory and ship whatever is left to everyone else , he said .
“ I ’ ve done as much as possible to filter all of our in-demand items to Amazon , ” he said .
He ’ s not alone .
At a @ @ @ @ @ @ @ is collapsing , Amazon is strengthening its competitive position in ways that could outlast the pandemic — and that could raise antitrust concerns .
Increasingly , manufacturers of in-demand products are catering to Amazon , while competing retailers take the leftovers , consultants and brand executives told ProPublica .
“ Amazon has the power to bury sellers and suppliers if they don ’ t comply , ” said Sally Hubbard , director of enforcement strategy at Open Markets Institute , a think tank that has been critical of Amazon and other big tech @ @ @ @ @ @ @ through an algorithm , but it ’ s still the wrath of the monopolist that they are afraid of .
… Amazon is able to cut off its competitors ’ access to inventory by leveraging its monopoly power.
” As locked-down shoppers have flocked to buy food , medicine , cleaning supplies and personal care products on Amazon , the retailer has in turn upped its suggested inventory levels for many manufacturers that sell their products on its platform .
It has also expanded purchases of certain essential products that it sells directly @ @ @ @ @ @ @ three times as much as it did before the pandemic , executives said .
The heightened demand has forced both third-party sellers on Amazon ’ s platform and its direct suppliers into difficult decisions over where to send inventory , consultants said .
Often , like Rise Bar , they ’ re favoring Amazon ahead of other retailers .
Third-party sellers like Spenuzza don ’ t have to keep as much merchandise in stock as Amazon recommends .
But if they run out on Amazon , where “ best seller ” status and @ @ @ @ @ @ @ results are linked to availability , the impact on sales could be devastating .
This pattern makes it harder for Amazon competitors , such as grocery and discount chains that have remained open during the pandemic , to keep coveted items in stock .
“ Everybody in retail realizes there ’ s limited access to certain stuff , so you better get there first , ” said James Thomson , the former business head of an Amazon team that recruits third-party sellers and now a consultant to brands working with the company .
@ @ @ @ @ @ @ afford to pony up the cash all at once and say , ‘ Back up the trucks , we ’ ll take it all.
’ ” Thomson called going out of stock on Amazon a “ cardinal sin.
” An Amazon spokesperson said that the company is a relatively small player in the retail market , competing with “ all the other online and brick and mortar stores , ” and that Amazon is not responsible for suppliers prioritizing it over other customers .
The algorithm is designed “ to feature items we @ @ @ @ @ @ @ and that includes items that are in-stock , ” the spokesperson said .
“ We are working to help our selling partners during this challenging time and evaluating several ideas to mitigate the impact of different demand patterns we are seeing in light of COVID-19.
” “ Retail is a competitive industry with many choices for both customers and suppliers , ” the spokesperson added .
“ Suppliers make their own business decisions , not Amazon.
” In an April 16 letter to shareholders , CEO Jeff Bezos said the “ demand we @ @ @ @ @ @ @ and remains high ” and acknowledged it has created “ major challenges for our suppliers and delivery network.
” The company has waived fees typically imposed on suppliers who can ’ t fulfill purchase orders .
Amazon is facing at least one European antitrust investigation and two in the U.S .
The House Judiciary Committee last June announced an investigation into possible anti-competitive conduct by large tech companies including Amazon .
In addition , the Federal Trade Commission has been looking into possible anti-competitive practices at Amazon for at least nine months , @ @ @ @ @ @ @ company exerts over its suppliers , according to media reports .
The House investigation is ongoing , according to a spokesman for the chairman of the Judiciary committee ’ s antitrust subcommittee , while the FTC declined to comment .
The Amazon spokesperson declined to comment specifically on the investigations .
“ We face intense competition in every segment in which we operate , and we love that competition because it makes us serve customers better , ” the spokesperson said .
To build an antitrust case against Amazon , the government would @ @ @ @ @ @ @ substantial market power that was gained or maintained through improper conduct , said William Kovacic , director of the Competition Law Center at George Washington University Law School and a former chairman of the Federal Trade Commission .
Sellers favoring Amazon over other retailers could be a sign of market power , he said .
“ That everybody does just what you want and puts you first out of fear that if they fall out of favor with you , they ’ re in real trouble — that could be taken as proof @ @ @ @ @ @ @ said .
“ How people regard you , how they react to you , how they respond to your wishes is an indication of whether you have market power , and that is a key issue in these cases .
If people say , ‘ We don ’ t dare alienate them , ’ that is a part of that proof .
You have market power with respect to retailing and distribution because everyone knows if they disappoint you there will be a heavy price to pay .
… The crisis reinforces the @ @ @ @ @ @ @ ” One advantage that Amazon has long enjoyed over some competitors is that it can afford to make little profit on retail in the short term to boost market share and traffic , Hubbard said .
Unlike most traditional retailers , Amazon can rely on revenue from other parts of its business empire , such as cloud computing .
It has a history of pricing below cost to exclude competitors , a practice known as predatory pricing , said Hubbard , a former New York state assistant attorney general for antitrust issues .
@ @ @ @ @ @ @ ’ t always have enough toilet paper and disinfecting wipes .
And traditional retailers also have ways of penalizing suppliers who don ’ t fulfill purchase orders .
For example , they can reassign the shelf space reserved for one supplier ’ s merchandise to a competitor .
Retailers including Walmart , Target and Costco also sell merchandise online , but those retailers ’ e-commerce sites account for a small proportion of their overall sales , so suppliers may be less concerned about running out of stock on those sites .
Aside from @ @ @ @ @ @ @ offers several carrots to brands , including a massive customer audience and high levels of customer trust , said Steve Yates , chief executive of a firm that advises sellers on the platform .
“ There ’ s good reason to say , ‘ If I have limited amount of inventory and where am I going to put it that is going to be most effective , ’ that Amazon is that place , ” Yates said .
Amazon represents less than 4 % of the U.S. retail market , and the same @ @ @ @ @ @ @ to the company spokesperson .
Its 2018 retail sales were less than one-third of Walmart ’ s , according to data published by the National Retail Federation .
However , Amazon accounts for nearly 40 % of U.S. online sales , as against less than 5 % for Walmart , according to eMarketer .
Both e-commerce ’ s proportion of overall retail sales , and Amazon ’ s slice of e-commerce , are expected to increase because of consumer shifts online during the pandemic , according to the market research firm .
While @ @ @ @ @ @ @ in March , the worst monthly decline on record , sales at Amazon have been booming .
In response to customer demand , the company has hired 100,000 workers , with plans to hire 75,000 more .
For the week ending April 12 , customer spending on Amazon grew about 44 % compared to the same period last year , according to Facteus , a company that analyzes consumer transaction data .
Spending at Walmart was flat over the same period , although it did experience a spike in mid-March , according to @ @ @ @ @ @ @ Amazon category manager who now runs a consulting firm advising consumer brands working with the company , said large requests for high-priority goods have pushed some of his clients to choose between Amazon and other retailers .
One supplements brand deliberated last month about whether to send its in-demand inventory to Costco or to Amazon , both of which it considered important to its business .
In the end , the brand drastically reduced supplies to Costco , Naim said .
Naim declined to identify the company because it did not want to @ @ @ @ @ @ @ sell deodorant , feminine care items and beauty and sexual wellness products have asked Naim whether they should sideline big-box retailers — even ones where sales have been strong — in order to maintain high levels of inventory at Amazon , he said .
He typically advises to favor Amazon .
Going out of stock on Amazon harms a brand ’ s rankings , such as “ best seller , ” which directly correlate to sales and are “ difficult to recover , ” he said .
Brands may give Amazon 80 % @ @ @ @ @ @ @ least have something left over ” for big-box retailers such as Walmart , Target and Costco , he said .
Spokesmen for Costco and Target declined to comment .
Walmart did not respond to a request for comment .
“ It ’ s a tough decision , ” Naim said .
“ But you ’ re almost pinned against the wall in that you have to allocate at least a sufficient amount to Amazon to avoid going out of stock because the consequences of going out of stock on Amazon are often greater @ @ @ @ @ @ @ stock elsewhere .
Amazon is so powerful right now , and there are so many customers on it .
The impact of not being on Amazon is probably greater than not being in some of those stores.
” Another Naim client , Ramon van Meer , CEO of Las Vegas-based Alpha Paw , hasn ’ t been able to obtain new supply of his company ’ s popular dog training pads even as demand on Amazon for them has risen .
China has diverted some of the raw material used to manufacture the @ @ @ @ @ @ @ van Meer said .
Down to a 6- to 8-week supply of pads , van Meer has put on hold plans to expand to brick-and-mortar stores , and he will reassign inventory designated for sales on his own website to Amazon .
He ’ s also suspended advertising on Facebook and Instagram to dampen demand until he can find a manufacturer in a different country .
“ The worst thing that can happen for an Amazon seller is to go out of stock , ” van Meer said .
“ I ’ m @ @ @ @ @ @ @ for Amazon .
I ’ d rather be out of stock on my own store than be out of stock on Amazon.
” Some suppliers have enough inventory to accommodate Amazon and their other customers .
Beginning the first week of March , Amazon began sending purchase orders to Italy-based Corman of up to three times the normal amount for its Organyc brand feminine care products , said James Ebel , the company ’ s global vice president of marketing .
In addition to Amazon , which sells Organyc ’ s products directly @ @ @ @ @ @ @ such as CVS and Walgreens .
Corman , which had already planned for U.S. growth , was able to increase production to keep up with demand from both Amazon and traditional retailers .
“ On Amazon , there has been a remarkable change in terms of our volume , ” Ebel said .
“ The migration of consumers to the platform is going to have a long-term impact.
” Amazon typically recommends that Fairy Tales Hair Care , based in New Jersey , keep a 30-day supply of its bestselling children ’ s @ @ @ @ @ @ @ to 90 days , CEO Risa Barash said .
Even so , the brand has enough inventory for Amazon and traditional retailers like the Wegmans , Meijer and H-E-B grocery chains , Barash said .
Eric Heller , a former Amazon senior manager , said some household-name brands he advises are shifting inventory from brick-and-mortar retailers to Amazon .
Beyond a desire to prevent going out of stock , they view supplying Amazon as “ altruistic ” since consumers are wary of leaving their homes , Heller said .
Hubbard , of Open @ @ @ @ @ @ @ online shopping during the pandemic .
“ It doesn ’ t have to be evil for it to be anti-competitive , ” she said .
“ You can create something of value but still be engaging in conduct that is distorting the competitive marketplace.
” Even as Amazon has increased its stock of high-priority merchandise , it has reduced purchases of some items it deems nonessential .
“ Exploding Kittens , ” a popular card game made by one of Naim ’ s clients , went out of stock when Amazon temporarily stopped @ @ @ @ @ @ @ also extended delivery times for some of his other clients ’ products .
Slower delivery correlates to lower sales because customers generally don ’ t want to wait weeks to receive an order .
Amazon has also differentiated delivery times for nonessential items in a way that some of its critics regard as potentially anti-competitive .
It placed shipping delays of several weeks on nonessential items sold by some third-party merchants on its platform .
But it promised delivery within days of nearly identical products that it sells under its AmazonBasics private label @ @ @ @ @ @ @ products are only about 1 % of total sales , consultants said that AmazonBasics has taken market share from competitors in products such as batteries .
In late March , ProPublica found that products including an in-stock backpack , a wireless mouse , a digital alarm clock and a set of wine glasses offered by third-party sellers all showed a delayed delivery of three weeks .
( Items may arrive faster than the stated delivery date . )
Amazon ’ s own , similarly priced versions of those products were available in several @ @ @ @ @ @ @ such as a coffee maker , were also delayed .
A review this past week indicated that this gap had been eliminated and delivery times were similar .
“ The changes to our logistics network to meet increased demand resulting from COVID-19 were not designed to advantage Amazon brands , retail vendors or sellers , ” the Amazon spokesperson said .
“ They have been based on how to best serve customers during the outbreak while helping ensure the health and safety of our employees.
” Kovacic , the former FTC chairman , @ @ @ @ @ @ @ general counsel , “ I ’ d be begging ” for the company to avoid the appearance of self-preference — a key area of government inquiry , he said — even if unintentional .
“ They should not want to be doing anything at the moment that reinforces those concerns.
” Other Amazon decisions during the pandemic have highlighted the risk to sellers of relying on the company .
Under its Fulfillment by Amazon program , the retail giant for a fee packs and ships third-party sellers ’ goods from its warehouses to @ @ @ @ @ @ @ customer service .
But on March 17 , it told these merchants that its warehouses would temporarily stop accepting shipments of products it deemed nonessential .
Combined with Amazon ’ s nearly monthlong shipping delays on nonessential items already in warehouses , many sellers were left scrambling to fill customer orders themselves , said Tim Hughes , chief operating officer of a consulting firm that helps brands manage their Amazon accounts .
In addition , sellers whose nonessential products were already stored in Amazon ’ s warehouses have been temporarily unable to retrieve @ @ @ @ @ @ @ fulfilling customer orders .
“ A lot of these people send all their inventory to Amazon , so there ’ s nothing they can do , ” Hughes said .
The merchandise is , in effect , “ held hostage ” until Amazon employees fetch it from the warehouse and return it to sellers , said Hughes , who worked in product management at Amazon .
To prioritize products such as household staples and medical supplies , Amazon has “ temporarily paused removal operations ” in some of its warehouses , the spokesperson @ @ @ @ @ @ @ a change for our selling partners .
… We are working to increase capacity.
” Spenuzza , the Rise Bar CEO , has sold his product on Amazon for nine years .
Last month , he and consultant Rachel Johnson Greer , who advises him on his Amazon business , discussed whether to fulfill a large order from Costco , she said .
Greer , a former Amazon senior program manager , warned him that being out of stock on Amazon would cause the algorithm to send Rise Bar listings further down on @ @ @ @ @ @ @ fewer potential customers seeing — and buying — his products there .
“ If you go out of stock on Amazon , you can have major problems , ” Greer said .
“ If I fulfill this order for Costco , I might drop in my rank from Amazon and I might not be able to get it back .
… Amazon is a single point of failure for a lot of these folks.
” Spenuzza filled Costco ’ s order for one week , and also sent stock to Amazon , he @ @ @ @ @ @ @ a week for Amazon to move the packages into its warehouse , and by the time the inventory was entered into the system , most of the Rise Bar flavors were out of stock .
“ Amazon was so overwhelmed that they needed to prioritize the highest selling essential items , ” he said .
During a late-March trip to a grocery store in Long Beach , Spenuzza noticed that shelves usually stocked with dozens of types of bars now looked “ half-empty , ” he said .
He knew that stores would @ @ @ @ @ @ @ to them , he said .
But he couldn ’ t spare the product .
That week , he sent about three-fourths of his protein bars to Amazon , up from 45 % in January .

This story first appeared at ProPublica. ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox.
During the second week of March, as the stock market and many U.S. businesses slumped, Peter Spenuzza’s company, Rise Bar, enjoyed an unexpected boost. Amazon, where the protein bars are sold, suggested Spenuzza keep 18,000 packages in its warehouses, up from the usual 4,000, based on soaring demand for almond honey and other flavors.
Demand on Amazon, which is still close to that peak, poses a dilemma for Spenuzza. Rise Bars are also sold in grocery chains nationally. Although his Irvine, California, plant has been running at full production capacity, he didn’t have enough bars to send both to Amazon and to all the brick-and-mortar retailers who also have increased their orders. One week in March, when he ran out of stock on Amazon, its algorithm demoted his product listings in Amazon’s search results and removed his sponsored ads. Rise Bar plummeted from 2,000 to 8,000 in Amazon’s “best seller” ranking in the grocery category, allowing competitors to leapfrog him.
The brand’s weekly Amazon sales dipped by 25%. Dismayed, Spenuzza decided to regularly send the e-commerce giant the “lion’s share” of his inventory and ship whatever is left to everyone else, he said.
“I’ve done as much as possible to filter all of our in-demand items to Amazon,” he said.
He’s not alone. At a time when much of the retail sector is collapsing, Amazon is strengthening its competitive position in ways that could outlast the pandemic — and that could raise antitrust concerns. Increasingly, manufacturers of in-demand products are catering to Amazon, while competing retailers take the leftovers, consultants and brand executives told ProPublica.
“Amazon has the power to bury sellers and suppliers if they don’t comply,” said Sally Hubbard, director of enforcement strategy at Open Markets Institute, a think tank that has been critical of Amazon and other big tech companies. “It might be automated through an algorithm, but it’s still the wrath of the monopolist that they are afraid of. … Amazon is able to cut off its competitors’ access to inventory by leveraging its monopoly power.”
As locked-down shoppers have flocked to buy food, medicine, cleaning supplies and personal care products on Amazon, the retailer has in turn upped its suggested inventory levels for many manufacturers that sell their products on its platform. It has also expanded purchases of certain essential products that it sells directly to shoppers, often buying two or three times as much as it did before the pandemic, executives said.
The heightened demand has forced both third-party sellers on Amazon’s platform and its direct suppliers into difficult decisions over where to send inventory, consultants said. Often, like Rise Bar, they’re favoring Amazon ahead of other retailers. Third-party sellers like Spenuzza don’t have to keep as much merchandise in stock as Amazon recommends. But if they run out on Amazon, where “best seller” status and a listing’s position in search results are linked to availability, the impact on sales could be devastating.
This pattern makes it harder for Amazon competitors, such as grocery and discount chains that have remained open during the pandemic, to keep coveted items in stock. “Everybody in retail realizes there’s limited access to certain stuff, so you better get there first,” said James Thomson, the former business head of an Amazon team that recruits third-party sellers and now a consultant to brands working with the company. “The difference is that Amazon can afford to pony up the cash all at once and say, ‘Back up the trucks, we’ll take it all.’” Thomson called going out of stock on Amazon a “cardinal sin.”
An Amazon spokesperson said that the company is a relatively small player in the retail market, competing with “all the other online and brick and mortar stores,” and that Amazon is not responsible for suppliers prioritizing it over other customers. The algorithm is designed “to feature items we believe customers will want to purchase, and that includes items that are in-stock,” the spokesperson said. “We are working to help our selling partners during this challenging time and evaluating several ideas to mitigate the impact of different demand patterns we are seeing in light of COVID-19.”
“Retail is a competitive industry with many choices for both customers and suppliers,” the spokesperson added. “Suppliers make their own business decisions, not Amazon.”
In an April 16 letter to shareholders, CEO Jeff Bezos said the “demand we are seeing for essential products has been and remains high” and acknowledged it has created “major challenges for our suppliers and delivery network.” The company has waived fees typically imposed on suppliers who can’t fulfill purchase orders.
Amazon is facing at least one European antitrust investigation and two in the U.S. The House Judiciary Committee last June announced an investigation into possible anti-competitive conduct by large tech companies including Amazon. In addition, the Federal Trade Commission has been looking into possible anti-competitive practices at Amazon for at least nine months, examining among other things the power the company exerts over its suppliers, according to media reports. The House investigation is ongoing, according to a spokesman for the chairman of the Judiciary committee’s antitrust subcommittee, while the FTC declined to comment.
The Amazon spokesperson declined to comment specifically on the investigations. “We face intense competition in every segment in which we operate, and we love that competition because it makes us serve customers better,” the spokesperson said.
To build an antitrust case against Amazon, the government would need to prove that the company has substantial market power that was gained or maintained through improper conduct, said William Kovacic, director of the Competition Law Center at George Washington University Law School and a former chairman of the Federal Trade Commission. Sellers favoring Amazon over other retailers could be a sign of market power, he said.
“That everybody does just what you want and puts you first out of fear that if they fall out of favor with you, they’re in real trouble — that could be taken as proof of your market power,” Kovacic said. “How people regard you, how they react to you, how they respond to your wishes is an indication of whether you have market power, and that is a key issue in these cases. If people say, ‘We don’t dare alienate them,’ that is a part of that proof. You have market power with respect to retailing and distribution because everyone knows if they disappoint you there will be a heavy price to pay. … The crisis reinforces the position of significance that they had before.”
One advantage that Amazon has long enjoyed over some competitors is that it can afford to make little profit on retail in the short term to boost market share and traffic, Hubbard said. Unlike most traditional retailers, Amazon can rely on revenue from other parts of its business empire, such as cloud computing. It has a history of pricing below cost to exclude competitors, a practice known as predatory pricing, said Hubbard, a former New York state assistant attorney general for antitrust issues.
To be sure, even Amazon doesn’t always have enough toilet paper and disinfecting wipes. And traditional retailers also have ways of penalizing suppliers who don’t fulfill purchase orders. For example, they can reassign the shelf space reserved for one supplier’s merchandise to a competitor. Retailers including Walmart, Target and Costco also sell merchandise online, but those retailers’ e-commerce sites account for a small proportion of their overall sales, so suppliers may be less concerned about running out of stock on those sites.
Aside from the stick of the algorithm, Amazon offers several carrots to brands, including a massive customer audience and high levels of customer trust, said Steve Yates, chief executive of a firm that advises sellers on the platform. “There’s good reason to say, ‘If I have limited amount of inventory and where am I going to put it that is going to be most effective,’ that Amazon is that place,” Yates said.
Amazon represents less than 4% of the U.S. retail market, and the same percentage of the grocery segment, according to the company spokesperson. Its 2018 retail sales were less than one-third of Walmart’s, according to data published by the National Retail Federation. However, Amazon accounts for nearly 40% of U.S. online sales, as against less than 5% for Walmart, according to eMarketer. Both e-commerce’s proportion of overall retail sales, and Amazon’s slice of e-commerce, are expected to increase because of consumer shifts online during the pandemic, according to the market research firm.
While U.S. retail sales decreased by 8.7% in March, the worst monthly decline on record, sales at Amazon have been booming. In response to customer demand, the company has hired 100,000 workers, with plans to hire 75,000 more. For the week ending April 12, customer spending on Amazon grew about 44% compared to the same period last year, according to Facteus, a company that analyzes consumer transaction data. Spending at Walmart was flat over the same period, although it did experience a spike in mid-March, according to Facteus.
Fahim Naim, a former Amazon category manager who now runs a consulting firm advising consumer brands working with the company, said large requests for high-priority goods have pushed some of his clients to choose between Amazon and other retailers. One supplements brand deliberated last month about whether to send its in-demand inventory to Costco or to Amazon, both of which it considered important to its business. In the end, the brand drastically reduced supplies to Costco, Naim said. Naim declined to identify the company because it did not want to upset Costco.
Similarly, clients that sell deodorant, feminine care items and beauty and sexual wellness products have asked Naim whether they should sideline big-box retailers — even ones where sales have been strong — in order to maintain high levels of inventory at Amazon, he said. He typically advises to favor Amazon.
Going out of stock on Amazon harms a brand’s rankings, such as “best seller,” which directly correlate to sales and are “difficult to recover,” he said. Brands may give Amazon 80% of inventory “so they can at least have something left over” for big-box retailers such as Walmart, Target and Costco, he said. Spokesmen for Costco and Target declined to comment. Walmart did not respond to a request for comment.
“It’s a tough decision,” Naim said. “But you’re almost pinned against the wall in that you have to allocate at least a sufficient amount to Amazon to avoid going out of stock because the consequences of going out of stock on Amazon are often greater than the consequences of going out of stock elsewhere. Amazon is so powerful right now, and there are so many customers on it. The impact of not being on Amazon is probably greater than not being in some of those stores.”
Another Naim client, Ramon van Meer, CEO of Las Vegas-based Alpha Paw, hasn’t been able to obtain new supply of his company’s popular dog training pads even as demand on Amazon for them has risen. China has diverted some of the raw material used to manufacture the pads to making protective face masks, van Meer said. Down to a 6- to 8-week supply of pads, van Meer has put on hold plans to expand to brick-and-mortar stores, and he will reassign inventory designated for sales on his own website to Amazon. He’s also suspended advertising on Facebook and Instagram to dampen demand until he can find a manufacturer in a different country.
“The worst thing that can happen for an Amazon seller is to go out of stock,” van Meer said. “I’m really holding as much inventory as possible for Amazon. I’d rather be out of stock on my own store than be out of stock on Amazon.”
Some suppliers have enough inventory to accommodate Amazon and their other customers. Beginning the first week of March, Amazon began sending purchase orders to Italy-based Corman of up to three times the normal amount for its Organyc brand feminine care products, said James Ebel, the company’s global vice president of marketing. In addition to Amazon, which sells Organyc’s products directly to customers, Corman also supplies pharmacies such as CVS and Walgreens. Corman, which had already planned for U.S. growth, was able to increase production to keep up with demand from both Amazon and traditional retailers.
“On Amazon, there has been a remarkable change in terms of our volume,” Ebel said. “The migration of consumers to the platform is going to have a long-term impact.”
Amazon typically recommends that Fairy Tales Hair Care, based in New Jersey, keep a 30-day supply of its bestselling children’s shampoo. That recommendation is now up to 90 days, CEO Risa Barash said. Even so, the brand has enough inventory for Amazon and traditional retailers like the Wegmans, Meijer and H-E-B grocery chains, Barash said.
Eric Heller, a former Amazon senior manager, said some household-name brands he advises are shifting inventory from brick-and-mortar retailers to Amazon. Beyond a desire to prevent going out of stock, they view supplying Amazon as “altruistic” since consumers are wary of leaving their homes, Heller said.
Hubbard, of Open Markets Institute, acknowledged the value of online shopping during the pandemic. “It doesn’t have to be evil for it to be anti-competitive,” she said. “You can create something of value but still be engaging in conduct that is distorting the competitive marketplace.”
Even as Amazon has increased its stock of high-priority merchandise, it has reduced purchases of some items it deems nonessential. “Exploding Kittens,” a popular card game made by one of Naim’s clients, went out of stock when Amazon temporarily stopped ordering it, Naim said. Amazon also extended delivery times for some of his other clients’ products. Slower delivery correlates to lower sales because customers generally don’t want to wait weeks to receive an order.
Amazon has also differentiated delivery times for nonessential items in a way that some of its critics regard as potentially anti-competitive. It placed shipping delays of several weeks on nonessential items sold by some third-party merchants on its platform. But it promised delivery within days of nearly identical products that it sells under its AmazonBasics private label. While Amazon said its private label products are only about 1% of total sales, consultants said that AmazonBasics has taken market share from competitors in products such as batteries.
In late March, ProPublica found that products including an in-stock backpack, a wireless mouse, a digital alarm clock and a set of wine glasses offered by third-party sellers all showed a delayed delivery of three weeks. (Items may arrive faster than the stated delivery date.) Amazon’s own, similarly priced versions of those products were available in several days, though some AmazonBasics products, such as a coffee maker, were also delayed. A review this past week indicated that this gap had been eliminated and delivery times were similar.
“The changes to our logistics network to meet increased demand resulting from COVID-19 were not designed to advantage Amazon brands, retail vendors or sellers,” the Amazon spokesperson said. “They have been based on how to best serve customers during the outbreak while helping ensure the health and safety of our employees.”
Kovacic, the former FTC chairman, said if he were Amazon’s general counsel, “I’d be begging” for the company to avoid the appearance of self-preference — a key area of government inquiry, he said — even if unintentional. “They should not want to be doing anything at the moment that reinforces those concerns.”
Other Amazon decisions during the pandemic have highlighted the risk to sellers of relying on the company. Under its Fulfillment by Amazon program, the retail giant for a fee packs and ships third-party sellers’ goods from its warehouses to their customers, as well as providing customer service. But on March 17, it told these merchants that its warehouses would temporarily stop accepting shipments of products it deemed nonessential. Combined with Amazon’s nearly monthlong shipping delays on nonessential items already in warehouses, many sellers were left scrambling to fill customer orders themselves, said Tim Hughes, chief operating officer of a consulting firm that helps brands manage their Amazon accounts. In addition, sellers whose nonessential products were already stored in Amazon’s warehouses have been temporarily unable to retrieve their merchandise as the company has prioritized fulfilling customer orders.
“A lot of these people send all their inventory to Amazon, so there’s nothing they can do,” Hughes said. The merchandise is, in effect, “held hostage” until Amazon employees fetch it from the warehouse and return it to sellers, said Hughes, who worked in product management at Amazon.
To prioritize products such as household staples and medical supplies, Amazon has “temporarily paused removal operations” in some of its warehouses, the spokesperson acknowledged. “We know this is a change for our selling partners. … We are working to increase capacity.”
Spenuzza, the Rise Bar CEO, has sold his product on Amazon for nine years. Last month, he and consultant Rachel Johnson Greer, who advises him on his Amazon business, discussed whether to fulfill a large order from Costco, she said. Greer, a former Amazon senior program manager, warned him that being out of stock on Amazon would cause the algorithm to send Rise Bar listings further down on the search results pages, resulting in fewer potential customers seeing — and buying — his products there.
“If you go out of stock on Amazon, you can have major problems,” Greer said. “If I fulfill this order for Costco, I might drop in my rank from Amazon and I might not be able to get it back. … Amazon is a single point of failure for a lot of these folks.”
Spenuzza filled Costco’s order for one week, and also sent stock to Amazon, he said. But it took more than a week for Amazon to move the packages into its warehouse, and by the time the inventory was entered into the system, most of the Rise Bar flavors were out of stock. “Amazon was so overwhelmed that they needed to prioritize the highest selling essential items,” he said.
During a late-March trip to a grocery store in Long Beach, Spenuzza noticed that shelves usually stocked with dozens of types of bars now looked “half-empty,” he said. He knew that stores would be grateful for any bars he shipped to them, he said. But he couldn’t spare the product. That week, he sent about three-fourths of his protein bars to Amazon, up from 45% in January.
Ava Kofman contributed reporting.


talkingpointsmemo--2020-04-26--Nursing Homes Violated Basic Health Standards, Allowing the Coronavirus to Explode

This story first appeared at ProPublica .
ProPublica is a Pulitzer Prize-winning investigative newsroom .
Sign up for The Big Story newsletter to receive stories like this one in your inbox .
One by one , toward the end of March , residents of Enumclaw Health and Rehabilitation Center outside of Seattle started coming down with symptoms of COVID-19 .
On March 22 , residents in Rooms 503 and 522 were moved to a wing for COVID-19 patients .
Another resident began showing symptoms , too , and was also moved .
In all three cases , their roommates were @ @ @ @ @ @ @ given no instructions about using any added precautions to care for them .
At least two of the three residents ’ roommates subsequently came down with the disease caused by the novel coronavirus .
During an interview with a health inspector days later , a staffer said that “ they were told by corporate not to start the roommate on isolation , and continue with surveillance to conserve PPE [ Personal Protective Equipment ] , ” according to an inspection report obtained from the Centers for Medicare and Medicaid Services , or CMS @ @ @ @ @ @ @ account .
Enumclaw , the inspectors concluded , “ failed to take appropriate actions related to a COVID-19 outbreak .
These failed practices may have contributed to multiple residents and staff contracting COVID-19.
” Enumclaw is one of nine nursing homes around the country that federal inspectors have determined have put residents ’ health and safety in “ immediate jeopardy ” for their actions and inaction in stopping the spread of COVID-19 .
ProPublica requested all records involving such citations since March 1 from CMS .
The facilities cited include Life Care Center @ @ @ @ @ @ @ where more than 40 residents died and which became an early epicenter of the virus ’ s American spread .
Others include Aperion Care Chicago Heights , a facility in a suburb south of Chicago , and Advantage Living Center – Roseville , north of Detroit .
Even though inspectors have stopped routine visits to nursing homes during the pandemic , they continue to investigate the most serious allegations involving failures to control infections .
Among the problems cited in the reports reviewed by ProPublica : a lack of personal protective equipment , @ @ @ @ @ @ @ , inadequate staff and not acting quickly enough when residents exhibited symptoms of the disease .
Nursing home residents have been among the hardest hit by COVID-19 .
To date , more than 10,000 nursing home residents have died , according to The Wall Street Journal and the Kaiser Family Foundation , a health care philanthropy .
In some states , nursing home residents account for more than half of COVID-19 deaths .
The inspection records are a glimpse into the kind of mistakes that could be at the root of the widespread @ @ @ @ @ @ @ told , there are about 15,000 nursing homes in the United States , which house about 1.3 million people .
The homes offer a high level of care for those who need help with activities of daily living , such as eating , bathing and getting dressed .
They also offer skilled rehabilitation for patients after medical procedures or illnesses .
Because Medicaid pays for a substantial share of care at the homes , and Medicare pays for some , CMS sets the standards under which they operate .
Many of the homes @ @ @ @ @ @ @ weeks related to COVID-19 have been cited in the past for violations of those rules .
At Enumclaw alone , 38 residents and 10 staffers tested positive for COVID-19 as of April 2 , federal regulators noted .
Five residents had died .
Abraham Ritter ’ s 68-year-old mother , Patricia , has been a resident of Enumclaw since 2004 .
“ My concern is that my mother has a death sentence being in that nursing home , ” Ritter said .
“ I don ’ t have anywhere else I can put @ @ @ @ @ @ @ going to take reasonable precautions to ensure health and safety , it ’ s not a matter of if she ’ s going to catch this , it ’ s when.
” In a statement to ProPublica , Enumclaw said its top priority is the “ safety and wellbeing of our residents.
” “ Since the beginning of the pandemic , we ’ ve continued to work with county and state health departments as necessary , ” the home said .
“ As we identify areas of opportunity , immediate changes are implemented @ @ @ @ @ @ @ across the company is provided.
” The home said it is following the most up-to-date recommendations on policies and procedures from the Centers for Disease Control and Prevention and CMS .
Separately , in its plan to correct the violations , Enumclaw said , “ residents at the facility who have been in contact with another resident or staff member with symptoms or became symptomatic are in isolation.
” Nursing home experts said oversight of facilities is critical during the COVID-19 outbreak , when most visitors are prohibited from visiting their loved ones @ @ @ @ @ @ @ .
“ I believe this crisis has overwhelmed nursing homes , ” said David Grabowski , a professor in the Department of Health Care Policy at Harvard Medical School .
“ Nursing homes have struggled with infection control and care quality for a long time .
However , this crisis has completely devastated the industry .
“ Have certain nursing homes not met CMS guidance ?
Of course .
Is that the major takeaway here ?
No , ” he added .
“ I think the primary story is that the federal government @ @ @ @ @ @ @ and their staff .
The government ’ s inaction has led to far more care issues than the COVID-related violations CMS has identified to date.
” At Beaconshire Nursing Centre , a facility in Detroit , an inspector watched a nursing assistant eat her lunch while feeding a resident who had COVID-19 symptoms .
The nursing assistant didn ’ t have on protective gloves or a gown , as required in such situations , and her mask was below her chin so she could eat her food .
The staffer was immediately counseled @ @ @ @ @ @ @ nursing and sent home .
A lawyer for Beaconshire told ProPublica that the citations found in the inspection report were based on the actions of just one employee and that the staffer was later terminated .
At The Hearthstone nursing home in Seattle , an inspector watched a nursing assistant without eye protection such as goggles walk into the room of a resident in isolation for suspected COVID-19 .
The same nursing assistant helped change the resident ’ s soiled briefs , according to the report .
The nursing assistant then removed her @ @ @ @ @ @ @ gloves .
The nursing assistant then fed the resident without washing her hands .
The Hearthstone said in a statement that all of its staff were later trained on proper hygiene and use of personal protective equipment .
The nursing assistant was “ excluded from work ” for 14 days based on the possible exposure and tested negative for COVID-19 , the home said .
And at Advantage Living Center – Roseville , an inspector wrote a 69-page report concluding that the facility waited too long to send one resident to the hospital @ @ @ @ @ @ @ in health.
” According to the report , the resident eventually died in a hospital from probable COVID-19 .
The resident ’ s test results were pending , the report stated .
The inspector also wrote about significant understaffing because of employees not showing up to work .
One nursing assistant , for instance , was responsible for 41 residents during a shift and another nursing assistant was responsible for 31 .
The report said the nursing assistants weren ’ t able to provide care for all the residents during the shifts .
@ @ @ @ @ @ @ of the nursing assistants told an inspector .
A facility executive pushed back against the report , saying the home was contesting it based on multiple errors and inaccuracies .
Kelsey Hastings , a partner and chief executive of Advantage Living Centers , said in an email that the nursing home has provided a detailed response to federal officials including evidence that contradicts the inspector .
Specifically , Hastings told ProPublica , the inspector “ did not confirm the number of staff members on the shift and the nurse who she spoke to @ @ @ @ @ @ @ on the unit of which we have documentation as well.
” “ Our staff has been providing a high level of care under difficult and extenuating circumstances , ” Hastings wrote in an email .
Hastings would not provide ProPublica a copy of the response , citing privacy laws and an inability to redact personal information by deadline .
“ We have followed CDC guidelines and have altered guidelines almost daily as a result of constant changes in recommendations .
Our other facilities have been following the same guidelines and surveyors have given @ @ @ @ @ @ @ the processes in place.
” Records show that Advantage Living has been cited for inadequate infection control in the past at the facility .
Hastings did not respond to a question about the facility ’ s prior violations .
Aperion Care Chicago Heights did not respond to requests for comment .
Life Care Center said in a statement this month it would “ continue to work with CMS to find solutions ” to the citations in the report , which led to a $ 611,000 fine .
“ We are working hard to @ @ @ @ @ @ @ and respectful manner so as to provide our residents the best care , “ the statement said .
Organizations that represent nursing homes said they are doing the best they can .
The American Health Care Association , the industry trade group , said long-term care facilities have not received the support they need from federal , state and local agencies during the COVID-19 pandemic .
“ The reality is that many of these citations have occurred because long term care providers are facing an unprecedented situation that has left them begging for @ @ @ @ @ @ @ ) and staffing resources , ” Mark Parkinson , the group ’ s president and CEO , said in a statement .
“ Just like hospitals , we have called for help .
In our case , nobody has listened.
” LeadingAge , an association of nonprofit senior service organizations , said that in the midst of a pandemic , regulators should take a collaborative approach in working with facilities .
“ By that we mean working constructively with providers to not only identify infection control issues , but problem-solve and meaningfully address @ @ @ @ @ @ @ Finck-Boyle , the group ’ s vice president for regulatory affairs , wrote in response to questions from ProPublica .
“ We do expect our members to comply with all CMS requirements , including guidance issued during this time of crisis , ” she added .
“ That said , CMS guidance has been limited and vague in response to the response to the detailed questions we receive from members on a daily basis .
Often times , CMS has referred to CDC guidance , which offers recommendations — not requirements.
” LeadingAge @ @ @ @ @ @ @ week to complain about a new requirement that nursing homes report data on COVID-19-positive residents to the CDC or face fines , saying it “ will lead to inconsistent and contradictory data , and exacerbate public confusion.
” CMS first told nursing homes to prepare for the coronavirus on Feb. 6 , saying , “ Every Medicare participating facility in the nation ’ s health care system must adhere to standards for infection prevention and control in order to provide safe , high quality care.
” It has followed up with additional guidance @ @ @ @ @ @ @ the use of PPE .
CMS also suspended routine nursing home inspections and said it would only focus on situations in which residents are in immediate jeopardy for serious injury or death .
It said if inspectors lacked adequate PPE , they couldn ’ t enter homes .
CMS did not respond to questions about concerns raised by nursing homes and their trade groups .
The challenges facing nursing homes are expected to grow , not only as outbreaks continue to sweep through homes but also as COVID-19 patients are released from hospitals @ @ @ @ @ @ @ of their recovery .
Advocates have cautioned about the risk they pose to already frail patients who don ’ t have the disease .
Richard Mollot , executive director of The Long Term Care Community Coalition , an advocacy group for nursing home residents , said he believes that nursing homes have responded to the crisis poorly overall , “ but we do hear of some nursing homes that are truly working to honor their legal and moral commitments to residents and families.
” “ For the most part , we see facilities @ @ @ @ @ @ @ of the pandemic ( especially after it hit the Kirkland , Washington facility ) , nursing homes that are taking in new residents even when they have woefully inadequate staffing for their current residents and , even , numerous reports of facilities discharging current residents so that they can take in COVID-19 patients ( for whom there is considerable reimbursement ) , ” Mollot said in an email .
Back at Enumclaw Health and Rehabilitation Center , the nursing home outside Seattle , the citations went beyond failing to properly take precautions after @ @ @ @ @ @ @ The facility “ failed to operationalize their infection prevention and control program to provide a safe , sanitary environment , and to help prevent the development and transmission of communicable diseases and infections , in particular COVID-19 , ” inspectors wrote .
And it failed to immediately notify the state Health Department about the illnesses there .
The problems were on full display when the inspector arrived on March 26 .
The administrator escorted the surveyor down the hallways , past 10 resident rooms and through resident care areas , to a nursing @ @ @ @ @ @ @ epicenter of the facility ’ s COVID-19 outbreak , to be screened for a fever .
The only thermometer available at the nurse ’ s station was an oral thermometer , so the surveyor had to remove their face mask .
When asked about the use of an oral thermometer , the administrator said , “ That ’ s all we have.
” In its plan of correction , the home said it is now in close touch with the state Health Department about infections and has moved a thermometer to the facility @ @ @ @ @ @ @ , whose mom is in the home , said the COVID-19 crisis has simply exacerbated long-known problems with the nursing home care industry , specifically around staffing .
“ Low-paid employees are stretched , even before this crisis , far too thin , ” he said .
“ They didn ’ t have enough employees doing enough work.
” Do you work in a nursing home or have a family member in one ?
Share your experience .

This story first appeared at ProPublica. ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox.
One by one, toward the end of March, residents of Enumclaw Health and Rehabilitation Center outside of Seattle started coming down with symptoms of COVID-19.
On March 22, residents in Rooms 503 and 522 were moved to a wing for COVID-19 patients. Another resident began showing symptoms, too, and was also moved.
In all three cases, their roommates were left in their rooms and staff were given no instructions about using any added precautions to care for them. At least two of the three residents’ roommates subsequently came down with the disease caused by the novel coronavirus.
During an interview with a health inspector days later, a staffer said that “they were told by corporate not to start the roommate on isolation, and continue with surveillance to conserve PPE [Personal Protective Equipment],” according to an inspection report obtained from the Centers for Medicare and Medicaid Services, or CMS. A second nurse gave a similar account.
Enumclaw, the inspectors concluded, “failed to take appropriate actions related to a COVID-19 outbreak. These failed practices may have contributed to multiple residents and staff contracting COVID-19.”
Enumclaw is one of nine nursing homes around the country that federal inspectors have determined have put residents’ health and safety in “immediate jeopardy” for their actions and inaction in stopping the spread of COVID-19. ProPublica requested all records involving such citations since March 1 from CMS. The facilities cited include Life Care Center of Kirkland, another facility outside Seattle where more than 40 residents died and which became an early epicenter of the virus’s American spread. Others include Aperion Care Chicago Heights, a facility in a suburb south of Chicago, and Advantage Living Center – Roseville, north of Detroit.
Even though inspectors have stopped routine visits to nursing homes during the pandemic, they continue to investigate the most serious allegations involving failures to control infections.
Among the problems cited in the reports reviewed by ProPublica: a lack of personal protective equipment, failure to maintain social distancing among residents, inadequate staff and not acting quickly enough when residents exhibited symptoms of the disease.
Nursing home residents have been among the hardest hit by COVID-19. To date, more than 10,000 nursing home residents have died, according to The Wall Street Journal and the Kaiser Family Foundation, a health care philanthropy. In some states, nursing home residents account for more than half of COVID-19 deaths. The inspection records are a glimpse into the kind of mistakes that could be at the root of the widespread outbreaks occurring in these facilities.
All told, there are about 15,000 nursing homes in the United States, which house about 1.3 million people. The homes offer a high level of care for those who need help with activities of daily living, such as eating, bathing and getting dressed. They also offer skilled rehabilitation for patients after medical procedures or illnesses. Because Medicaid pays for a substantial share of care at the homes, and Medicare pays for some, CMS sets the standards under which they operate. Many of the homes that received immediate jeopardy citations in recent weeks related to COVID-19 have been cited in the past for violations of those rules.
At Enumclaw alone, 38 residents and 10 staffers tested positive for COVID-19 as of April 2, federal regulators noted. Five residents had died.
Abraham Ritter’s 68-year-old mother, Patricia, has been a resident of Enumclaw since 2004.
“My concern is that my mother has a death sentence being in that nursing home,” Ritter said. “I don’t have anywhere else I can put her. If they’re not going to take reasonable precautions to ensure health and safety, it’s not a matter of if she’s going to catch this, it’s when.”
In a statement to ProPublica, Enumclaw said its top priority is the “safety and wellbeing of our residents.”
“Since the beginning of the pandemic, we’ve continued to work with county and state health departments as necessary,” the home said. “As we identify areas of opportunity, immediate changes are implemented, policies are updated, and education across the company is provided.”
The home said it is following the most up-to-date recommendations on policies and procedures from the Centers for Disease Control and Prevention and CMS. Separately, in its plan to correct the violations, Enumclaw said, “residents at the facility who have been in contact with another resident or staff member with symptoms or became symptomatic are in isolation.”
Nursing home experts said oversight of facilities is critical during the COVID-19 outbreak, when most visitors are prohibited from visiting their loved ones and inspectors are likewise mostly staying away.
“I believe this crisis has overwhelmed nursing homes,” said David Grabowski, a professor in the Department of Health Care Policy at Harvard Medical School. “Nursing homes have struggled with infection control and care quality for a long time. However, this crisis has completely devastated the industry.
“Have certain nursing homes not met CMS guidance? Of course. Is that the major takeaway here? No,” he added. “I think the primary story is that the federal government has largely failed our nursing home residents and their staff. The government’s inaction has led to far more care issues than the COVID-related violations CMS has identified to date.”
At Beaconshire Nursing Centre, a facility in Detroit, an inspector watched a nursing assistant eat her lunch while feeding a resident who had COVID-19 symptoms. The nursing assistant didn’t have on protective gloves or a gown, as required in such situations, and her mask was below her chin so she could eat her food. The staffer was immediately counseled by the home’s director of nursing and sent home. A lawyer for Beaconshire told ProPublica that the citations found in the inspection report were based on the actions of just one employee and that the staffer was later terminated.
At The Hearthstone nursing home in Seattle, an inspector watched a nursing assistant without eye protection such as goggles walk into the room of a resident in isolation for suspected COVID-19. The same nursing assistant helped change the resident’s soiled briefs, according to the report. The nursing assistant then removed her gloves, revealing a second layer of gloves. The nursing assistant then fed the resident without washing her hands. The Hearthstone said in a statement that all of its staff were later trained on proper hygiene and use of personal protective equipment. The nursing assistant was “excluded from work” for 14 days based on the possible exposure and tested negative for COVID-19, the home said.
And at Advantage Living Center – Roseville, an inspector wrote a 69-page report concluding that the facility waited too long to send one resident to the hospital despite evidence of a “severe decline in health.” According to the report, the resident eventually died in a hospital from probable COVID-19. The resident’s test results were pending, the report stated. The inspector also wrote about significant understaffing because of employees not showing up to work. One nursing assistant, for instance, was responsible for 41 residents during a shift and another nursing assistant was responsible for 31. The report said the nursing assistants weren’t able to provide care for all the residents during the shifts.
“It feels horrible,” one of the nursing assistants told an inspector.
A facility executive pushed back against the report, saying the home was contesting it based on multiple errors and inaccuracies. Kelsey Hastings, a partner and chief executive of Advantage Living Centers, said in an email that the nursing home has provided a detailed response to federal officials including evidence that contradicts the inspector.
Specifically, Hastings told ProPublica, the inspector “did not confirm the number of staff members on the shift and the nurse who she spoke to was not aware of all staff members on the unit of which we have documentation as well.”
“Our staff has been providing a high level of care under difficult and extenuating circumstances,” Hastings wrote in an email. Hastings would not provide ProPublica a copy of the response, citing privacy laws and an inability to redact personal information by deadline.
“We have followed CDC guidelines and have altered guidelines almost daily as a result of constant changes in recommendations. Our other facilities have been following the same guidelines and surveyors have given no citations and have complimented teams on the processes in place.”
Records show that Advantage Living has been cited for inadequate infection control in the past at the facility. Hastings did not respond to a question about the facility’s prior violations.
Aperion Care Chicago Heights did not respond to requests for comment. Life Care Center said in a statement this month it would “continue to work with CMS to find solutions” to the citations in the report, which led to a $611,000 fine. “We are working hard to address their current concerns in a timely and respectful manner so as to provide our residents the best care,“ the statement said.
Organizations that represent nursing homes said they are doing the best they can.
The American Health Care Association, the industry trade group, said long-term care facilities have not received the support they need from federal, state and local agencies during the COVID-19 pandemic.
“The reality is that many of these citations have occurred because long term care providers are facing an unprecedented situation that has left them begging for testing, personal protective equipment (PPE) and staffing resources,” Mark Parkinson, the group’s president and CEO, said in a statement. “Just like hospitals, we have called for help. In our case, nobody has listened.”
LeadingAge, an association of nonprofit senior service organizations, said that in the midst of a pandemic, regulators should take a collaborative approach in working with facilities. “By that we mean working constructively with providers to not only identify infection control issues, but problem-solve and meaningfully address issues on the spot,” Janine Finck-Boyle, the group’s vice president for regulatory affairs, wrote in response to questions from ProPublica.
“We do expect our members to comply with all CMS requirements, including guidance issued during this time of crisis,” she added. “That said, CMS guidance has been limited and vague in response to the response to the detailed questions we receive from members on a daily basis. Often times, CMS has referred to CDC guidance, which offers recommendations — not requirements.”
LeadingAge wrote to Trump administration health officials this week to complain about a new requirement that nursing homes report data on COVID-19-positive residents to the CDC or face fines, saying it “will lead to inconsistent and contradictory data, and exacerbate public confusion.”
CMS first told nursing homes to prepare for the coronavirus on Feb. 6, saying, “Every Medicare participating facility in the nation’s health care system must adhere to standards for infection prevention and control in order to provide safe, high quality care.” It has followed up with additional guidance to restrict nonessential visitors and related to the use of PPE.
CMS also suspended routine nursing home inspections and said it would only focus on situations in which residents are in immediate jeopardy for serious injury or death. It said if inspectors lacked adequate PPE, they couldn’t enter homes.
CMS did not respond to questions about concerns raised by nursing homes and their trade groups.
The challenges facing nursing homes are expected to grow, not only as outbreaks continue to sweep through homes but also as COVID-19 patients are released from hospitals and require skilled nursing care as part of their recovery. Advocates have cautioned about the risk they pose to already frail patients who don’t have the disease.
Richard Mollot, executive director of The Long Term Care Community Coalition, an advocacy group for nursing home residents, said he believes that nursing homes have responded to the crisis poorly overall, “but we do hear of some nursing homes that are truly working to honor their legal and moral commitments to residents and families.”
“For the most part, we see facilities that failed to take steps in anticipation of the pandemic (especially after it hit the Kirkland, Washington facility), nursing homes that are taking in new residents even when they have woefully inadequate staffing for their current residents and, even, numerous reports of facilities discharging current residents so that they can take in COVID-19 patients (for whom there is considerable reimbursement),” Mollot said in an email.
Back at Enumclaw Health and Rehabilitation Center, the nursing home outside Seattle, the citations went beyond failing to properly take precautions after some residents began displaying COVID-19 symptoms.
The facility “failed to operationalize their infection prevention and control program to
provide a safe, sanitary environment, and to help prevent the development and transmission of communicable diseases and infections, in particular COVID-19,” inspectors wrote. And it failed to immediately notify the state Health Department about the illnesses there.
The problems were on full display when the inspector arrived on March 26. The administrator escorted the surveyor down the hallways, past 10 resident rooms and through resident care areas, to a nursing station in the 500 unit, the epicenter of the facility’s COVID-19 outbreak, to be screened for a fever. The only thermometer available at the nurse’s station was an oral thermometer, so the surveyor had to remove their face mask.
When asked about the use of an oral thermometer, the administrator said, “That’s all we have.”
In its plan of correction, the home said it is now in close touch with the state Health Department about infections and has moved a thermometer to the facility entrance to check visitors there.
Ritter, whose mom is in the home, said the COVID-19 crisis has simply exacerbated long-known problems with the nursing home care industry, specifically around staffing.
“Low-paid employees are stretched, even before this crisis, far too thin,” he said. “They didn’t have enough employees doing enough work.”
Do you work in a nursing home or have a family member in one? Share your experience.


talkingpointsmemo--2020-04-26--The Many Potential Consequences Of A Delayed Census During Coronavirus

JEFFERSON CITY , Mo .
( AP ) — The U.S. Census Bureau needs more time to wrap up the once-a-decade count because of the coronavirus , opening the possibility of delays in drawing new legislative districts that could help determine what political party is in power , what laws pass or fail and whether communities of color get a voice in their states .
The number of people counted and their demographics guide how voting districts for the U.S. House and state legislatures are redrawn every 10 years .
The monthslong delay in census data could make a divisive @ @ @ @ @ @ @ into costly special sessions to complete the work or postponing some primary elections .
“ It will pinch the timing for sure on everybody , ” said Justin Levitt , a professor at Loyola Law School in Los Angeles who tracks redistricting nationwide .
“ For a few states , that ’ s incredibly meaningful.
” Despite the complications , advocates , lawmakers and others largely embraced the census delay as necessary to get a complete count .
With the U.S. so politically polarized , redistricting plays a major role in whether Republicans @ @ @ @ @ @ @ state and how those lawmakers ’ decisions can affect people ’ s lives .
Parties that win large legislative majorities can tilt policy to the left or right on abortion , guns , taxes and other contentious issues .
Redistricting typically is done by state lawmakers and governors , but an increasing number of states have shifted to special commissions .
The new districts frequently are challenged in court for not properly representing minority communities or for favoring one party over another in what is called gerrymandering .
After Republicans scored big statehouse @ @ @ @ @ @ @ , they used their enhanced power in 2011 to draw districts to their advantage in some states , spawning Democratic-backed lawsuits that spanned much of the next decade .
Democrats have historically done the same when they were in control .
The census delay could trigger more lawsuits .
Because of stay-at-home orders designed to combat the coronavirus , the Census Bureau put off hiring and training temporary census takers in mid-March .
They won ’ t start knocking on doors of people who haven ’ t answered the questionnaire until August .
@ @ @ @ @ @ @ wrap up the count from the end of July to the end of October .
Congress must approve the Census Bureau ’ s request to delay turning over redistricting data to the states from the end of March 2021 to the end of July 2021 .
A delay could have big implications for states with legislative elections next year — New Jersey and Virginia .
“ There will not be enough time for redistricting , candidate filing , preparing for an election and running a general election .
There simply won ’ t @ @ @ @ @ @ @ Michael McDonald , a political science professor at the University of Florida .
California , Illinois , North Carolina and Texas all have early 2022 primaries , which could create a compressed schedule for new maps .
Some states could require special legislative sessions to complete the work before candidates file to run for office in 2022 .
Others may have to postpone candidate filing , said Michael Li , a redistricting attorney at New York University School of Law ’ s Brennan Center for Justice .
The New Jersey Constitution requires a @ @ @ @ @ @ @ days of receiving census data and candidates to run in those new districts that same year .
The state ’ s primary elections are scheduled for June 8 , 2021 , seven weeks before the Census Bureau ’ s new deadline for turning over the population figures .
“ A delay in the release of the census information has the potential to throw everything out of whack , ” said Al Barlas , Republican chairman of New Jersey ’ s redistricting commission .
“ There ’ s constitutional ramifications to this .
There @ @ @ @ @ @ @ ” Barlas added .
“ Do you move the primary from June back ?
… Do you do a gubernatorial primary and everybody-else-primary in June , but do you do a legislative primary later , perhaps in August or right after Labor Day ?
Honestly , I don ’ t know.
” In 2011 , Virginia moved its primary from June 14 to Aug. 23 to allow time for redistricting after receiving census data .
A similar delay could be needed for its 2021 election , which is scheduled for the second Tuesday @ @ @ @ @ @ @ this November on a constitutional amendment creating a bipartisan commission to draw the districts .
If approved , the commission would have 45 days after receiving the census numbers to submit new maps to lawmakers for a vote .
State Sen. George Barker , a Democrat who sponsored the amendment , said it ’ s unclear whether the 2021 primary could be delayed long enough to allow time for the work .
If not , candidates may have to run under current districts in 2021 , he said .
“ If the data @ @ @ @ @ @ @ early to mid-July , it would be very , very difficult to get it done in time to even come close to meeting requirements for both the primary and a general election , ” Barker said .
Schneider reported from Orlando , Florida .
Follow Lieb on Twitter at : http : //twitter.com/DavidALieb .
Follow Schneider at : http : //twitter.com/MikeSchneiderAP

JEFFERSON CITY, Mo. (AP) — The U.S. Census Bureau needs more time to wrap up the once-a-decade count because of the coronavirus, opening the possibility of delays in drawing new legislative districts that could help determine what political party is in power, what laws pass or fail and whether communities of color get a voice in their states.
The number of people counted and their demographics guide how voting districts for the U.S. House and state legislatures are redrawn every 10 years. The monthslong delay in census data could make a divisive process more complicated, potentially forcing lawmakers into costly special sessions to complete the work or postponing some primary elections.
“It will pinch the timing for sure on everybody,” said Justin Levitt, a professor at Loyola Law School in Los Angeles who tracks redistricting nationwide. “For a few states, that’s incredibly meaningful.”
Despite the complications, advocates, lawmakers and others largely embraced the census delay as necessary to get a complete count.
With the U.S. so politically polarized, redistricting plays a major role in whether Republicans or Democrats drive the agenda in each state and how those lawmakers’ decisions can affect people’s lives. Parties that win large legislative majorities can tilt policy to the left or right on abortion, guns, taxes and other contentious issues.
Redistricting typically is done by state lawmakers and governors, but an increasing number of states have shifted to special commissions.
The new districts frequently are challenged in court for not properly representing minority communities or for favoring one party over another in what is called gerrymandering.
After Republicans scored big statehouse victories in the 2010, for example, they used their enhanced power in 2011 to draw districts to their advantage in some states, spawning Democratic-backed lawsuits that spanned much of the next decade. Democrats have historically done the same when they were in control.
The census delay could trigger more lawsuits.
Because of stay-at-home orders designed to combat the coronavirus, the Census Bureau put off hiring and training temporary census takers in mid-March. They won’t start knocking on doors of people who haven’t answered the questionnaire until August. The bureau pushed back the deadline to wrap up the count from the end of July to the end of October.
Congress must approve the Census Bureau’s request to delay turning over redistricting data to the states from the end of March 2021 to the end of July 2021.
A delay could have big implications for states with legislative elections next year — New Jersey and Virginia.
“There will not be enough time for redistricting, candidate filing, preparing for an election and running a general election. There simply won’t be time for it,” said Michael McDonald, a political science professor at the University of Florida.
California, Illinois, North Carolina and Texas all have early 2022 primaries, which could create a compressed schedule for new maps. Some states could require special legislative sessions to complete the work before candidates file to run for office in 2022. Others may have to postpone candidate filing, said Michael Li, a redistricting attorney at New York University School of Law’s Brennan Center for Justice.
The New Jersey Constitution requires a commission to adopt new maps within 30 days of receiving census data and candidates to run in those new districts that same year. The state’s primary elections are scheduled for June 8, 2021, seven weeks before the Census Bureau’s new deadline for turning over the population figures.
“A delay in the release of the census information has the potential to throw everything out of whack,” said Al Barlas, Republican chairman of New Jersey’s redistricting commission.
“There’s constitutional ramifications to this. There’s obviously timelines and deadlines,” Barlas added. “Do you move the primary from June back? … Do you do a gubernatorial primary and everybody-else-primary in June, but do you do a legislative primary later, perhaps in August or right after Labor Day? Honestly, I don’t know.”
In 2011, Virginia moved its primary from June 14 to Aug. 23 to allow time for redistricting after receiving census data. A similar delay could be needed for its 2021 election, which is scheduled for the second Tuesday in June.
Virginia voters are deciding this November on a constitutional amendment creating a bipartisan commission to draw the districts. If approved, the commission would have 45 days after receiving the census numbers to submit new maps to lawmakers for a vote.
State Sen. George Barker, a Democrat who sponsored the amendment, said it’s unclear whether the 2021 primary could be delayed long enough to allow time for the work. If not, candidates may have to run under current districts in 2021, he said.
“If the data isn’t in until sometime in early to mid-July, it would be very, very difficult to get it done in time to even come close to meeting requirements for both the primary and a general election,” Barker said.
___
Schneider reported from Orlando, Florida. Follow Lieb on Twitter at: http://twitter.com/DavidALieb. Follow Schneider at: http://twitter.com/MikeSchneiderAP


talkingpointsmemo--2020-04-26--UK Prime Minister Boris Johnson Returning To Work After COVID-19 Recovery

LONDON ( AP ) — British Prime Minister Boris Johnson is returning to work after recovering from a coronavirus infection that put him in intensive care , with his government facing growing criticism over the deaths and disruption the virus has caused .
Johnson ’ s office said he would be back at his desk in 10 Downing St. on Monday , two weeks after he was released from a London hospital .
Foreign Secretary Dominic Raab , who has been standing in for the prime minister , said Sunday that Johnson was “ raring to go.
” Britain has @ @ @ @ @ @ @ hospitalized with COVID-19 , the fifth country in the world to reach that total .
Thousands more are thought to have died in nursing homes .
Johnson , 55 , spent a week at St. Thomas ’ Hospital , including three nights in intensive care , where he was given oxygen and watched around the clock by medical workers .
After he was released on April 12 , he recorded a video message thanking staff at the hospital for saving his life .
Johnson has not been seen in public since , as @ @ @ @ @ @ @ minister ’ s country retreat outside London .
Opposition politicians say Britain ’ s coronavirus death toll could have been lower if Johnson ’ s Conservative government had imposed a nationwide lockdown sooner .
They are also demanding to know when and how the government will ease the restrictions that were imposed March 23 and run to at least May 7 .
“ Decisions need to be taken quicker and communication with the public needs to be clearer , ” opposition Labour Party leader Keir Starmer said in a letter to Johnson .
@ @ @ @ @ @ @ sacrifices to make the lockdown work , ” he wrote .
“ They deserve to be part of an adult conversation about what comes next.
” Despite the toll , which saw another 813 virus-related deaths announced Saturday , some in Britain are growing impatient with the restrictions , which have brought much of the economy and daily life to a halt .
Road traffic has begun to creep up after plummeting when the lockdown first was imposed , and some businesses have begun to reopen after implementing social-distancing measures .
Scientists say @ @ @ @ @ @ @ the pandemic but is not yet out of danger .
The number of people hospitalized with COVID-19 is declining and the number of daily deaths peaked on April 8 .
But with hundreds of new deaths announced each day , some health experts say Britain could eventually have the highest virus death toll in Europe .
As fears recede that the health system will be overwhelmed , opponents are criticizing Johnson ’ s government over shortages of protective equipment for medical workers and a lack of testing for the virus .
More than @ @ @ @ @ @ @ far .
The government has promised to conduct 100,000 coronavirus tests a day by the end of the month , but has yet to reach even 30,000 a day .
Increasing testing , so that all people with the virus can be identified and their contacts traced and isolated , is key to loosening the lockdown .
The British government says all health care staff and other essential workers can be tested if they show symptoms .
It is rolling out almost 100 mobile testing sites , staffed by soldiers , to conduct @ @ @ @ @ @ @ , prisons and other sites .
In the first two days of expanded testing , however , the online system handling daily demand for the tests had exceeded the supply by early morning .
Follow AP news coverage of the coronavirus pandemic at https : //apnews.com/VirusOutbreak and https : //apnews.com/UnderstandingtheOutbreak

LONDON (AP) — British Prime Minister Boris Johnson is returning to work after recovering from a coronavirus infection that put him in intensive care, with his government facing growing criticism over the deaths and disruption the virus has caused.
Johnson’s office said he would be back at his desk in 10 Downing St. on Monday, two weeks after he was released from a London hospital. Foreign Secretary Dominic Raab, who has been standing in for the prime minister, said Sunday that Johnson was “raring to go.”
Britain has recorded more than 20,000 deaths among people hospitalized with COVID-19, the fifth country in the world to reach that total. Thousands more are thought to have died in nursing homes.
Johnson, 55, spent a week at St. Thomas’ Hospital, including three nights in intensive care, where he was given oxygen and watched around the clock by medical workers. After he was released on April 12, he recorded a video message thanking staff at the hospital for saving his life.
Johnson has not been seen in public since, as he recovered at Chequers, the prime minister’s country retreat outside London.
Opposition politicians say Britain’s coronavirus death toll could have been lower if Johnson’s Conservative government had imposed a nationwide lockdown sooner. They are also demanding to know when and how the government will ease the restrictions that were imposed March 23 and run to at least May 7.
“Decisions need to be taken quicker and communication with the public needs to be clearer,” opposition Labour Party leader Keir Starmer said in a letter to Johnson.
“The British public have made great sacrifices to make the lockdown work,” he wrote. “They deserve to be part of an adult conversation about what comes next.”
Despite the toll, which saw another 813 virus-related deaths announced Saturday, some in Britain are growing impatient with the restrictions, which have brought much of the economy and daily life to a halt. Road traffic has begun to creep up after plummeting when the lockdown first was imposed, and some businesses have begun to reopen after implementing social-distancing measures.
Scientists say the U.K. has reached the peak of the pandemic but is not yet out of danger. The number of people hospitalized with COVID-19 is declining and the number of daily deaths peaked on April 8.
But with hundreds of new deaths announced each day, some health experts say Britain could eventually have the highest virus death toll in Europe.
As fears recede that the health system will be overwhelmed, opponents are criticizing Johnson’s government over shortages of protective equipment for medical workers and a lack of testing for the virus. More than 100 infected medical workers have died so far.
The government has promised to conduct 100,000 coronavirus tests a day by the end of the month, but has yet to reach even 30,000 a day. Increasing testing, so that all people with the virus can be identified and their contacts traced and isolated, is key to loosening the lockdown.
The British government says all health care staff and other essential workers can be tested if they show symptoms. It is rolling out almost 100 mobile testing sites, staffed by soldiers, to conduct tests at nursing homes, police stations, prisons and other sites.
In the first two days of expanded testing, however, the online system handling daily demand for the tests had exceeded the supply by early morning.
___
Follow AP news coverage of the coronavirus pandemic at https://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak


talkingpointsmemo--2020-04-26--Pentagon Focuses On Testing Most Vital Personnel For COVID-19

WASHINGTON ( AP ) — With limited supplies of coronavirus tests available , the Pentagon is focusing first on testing those performing duties deemed most vital to national security .
Atop the list are the men and women who operate the nation ’ s nuclear forces , some counterterrorism forces , and the crew of a soon-to-deploy aircraft carrier .
Defense leaders hope to increase testing from the current rate of about 7,000 a day to 60,000 by June .
This will enable them to test those showing symptoms as well as those who do not .
The current tight @ @ @ @ @ @ @ phased approach , which includes testing sailors aboard the USS Nimitz , the Bremerton , Washington-based Navy carrier next in line to head to the Pacific .
Officials hope to avoid a repeat of problems that plagued the virus-stricken USS Theodore Roosevelt .
On Friday the Navy disclosed a virus outbreak aboard another ship at sea , the USS Kidd .
Despite President Donald Trump ’ s assertion that testing capacity is not an issue in the United States , Pentagon officials don ’ t expect to have enough tests for all service @ @ @ @ @ @ @ Secretary Mark Esper recently approved the tiered approach .
It expands the Pentagon ’ s practice of testing mainly those who show symptoms of the virus to eventually testing everyone .
Many virus carriers show no symptoms but can be contagious , as was discovered aboard the Roosevelt .
The aim is to allocate testing materials to protect what the military considers its most important missions , while not depleting supplies for high-risk groups in the civilian population , including the elderly at nursing homes and health care professionals on the front lines @ @ @ @ @ @ @ tier of U.S. troops are being tested this month , followed in May and June by the second-highest priority group : forces in combat zones such as Syria , Iraq and Afghanistan .
Next will be those abroad outside of war zones , like troops in Europe and aboard ships at sea , as well as those returning to the United States from overseas deployments .
Last in line : the remainder of the force .
Gen. John Hyten , vice chairman of the Joint Chiefs of Staff , said the first three @ @ @ @ @ @ @ .
By then the Pentagon hopes to reach its goal of being able to conduct 60,000 tests per day .
To complete testing of the entire force will take “ into the summer , ” he said without being specific .
Hyten said that testing under this tiered approach started to step up in mid-April , and that it included a plan to fully test the crew of the Nimitz .
The complications that come with trying to test for coronavirus aboard a ship while it ’ s already underway were made clear @ @ @ @ @ @ @ port at Guam in late March after discovering its first infections .
It wasn ’ t able to test 100 % of the crew until a few days ago .
Beyond its desire to limit the spread of the virus , the Pentagon views testing and associated measures such as isolating and quarantining troops as tools to keep the force viable and to ensure it can perform its central function : to defend the nation .
At least 3,900 members of the military had tested positive , including more than 850 from the @ @ @ @ @ @ @ and younger than the general U.S. population , are thought to be less vulnerable to COVID-19 , the disease caused by the virus .
So far only two military members have died from it .
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 .
The military ’ s staggered @ @ @ @ @ @ @ said , because of limited supplies and incomplete knowledge about the virus .
“ It is a supply issue right now , which is causing us not to be able to go down the full spectrum of all of the forces , ” Hyten said .
“ So we ’ ll have to — that ’ s why we came up with the tiered approach.
” Keeping coronavirus out of the nuclear force has been a high priority from the earliest days of this crisis .
There are several reasons for that , @ @ @ @ @ @ @ operating those forces 24/7 is central to deterring an attack on the United States .
Also , there are limited numbers of military personnel certified to perform those missions , which include controlling Minuteman 3 intercontinental ballistic missiles from cramped underground modules and operating nuclear-armed Ohio-class submarines .
Since early in the outbreak crisis , Minuteman 3 launch officers have been operating in the missile fields for 14 days at a time , an extraordinary arrangement for personnel who for years had done 24-hour shifts and then returned to base .
Gen. David @ @ @ @ @ @ @ staff , said Wednesday there are no COVID-positive cases in the nuclear force .
That ’ s a “ no fail ” mission , he said , that will have to work around the virus indefinitely .
Other first-tier forces , Goldfein said , are elements of the new Space Force , including those who operate Global Positioning System navigation satellites as well as the satellites that would provide early warning of a missile attack on the United States or its allies .
The Air Force and the other services are prioritizing testing @ @ @ @ @ @ @ , “ to make sure that as test kits become available , we ’ re able to put them where they are most needed.
” Goldfein said the military understands that the limited national supply of test kits means it can not have all that it would like .
“ One of the top priorities right now across the nation is nursing homes , ” he said .
“ I would not want to take tests away from that top national priority for my younger and healthier force .
As tests become available @ @ @ @ @ @ @ and we know where we need to put them .
”

WASHINGTON (AP) — With limited supplies of coronavirus tests available, the Pentagon is focusing first on testing those performing duties deemed most vital to national security. Atop the list are the men and women who operate the nation’s nuclear forces, some counterterrorism forces, and the crew of a soon-to-deploy aircraft carrier.
Defense leaders hope to increase testing from the current rate of about 7,000 a day to 60,000 by June. This will enable them to test those showing symptoms as well as those who do not.
The current tight supply forced the Pentagon to take a phased approach, which includes testing sailors aboard the USS Nimitz, the Bremerton, Washington-based Navy carrier next in line to head to the Pacific. Officials hope to avoid a repeat of problems that plagued the virus-stricken USS Theodore Roosevelt. On Friday the Navy disclosed a virus outbreak aboard another ship at sea, the USS Kidd.
Despite President Donald Trump’s assertion that testing capacity is not an issue in the United States, Pentagon officials don’t expect to have enough tests for all service members until sometime this summer.
Defense Secretary Mark Esper recently approved the tiered approach. It expands the Pentagon’s practice of testing mainly those who show symptoms of the virus to eventually testing everyone. Many virus carriers show no symptoms but can be contagious, as was discovered aboard the Roosevelt.
The aim is to allocate testing materials to protect what the military considers its most important missions, while not depleting supplies for high-risk groups in the civilian population, including the elderly at nursing homes and health care professionals on the front lines of battling the virus.
The first tier of U.S. troops are being tested this month, followed in May and June by the second-highest priority group: forces in combat zones such as Syria, Iraq and Afghanistan. Next will be those abroad outside of war zones, like troops in Europe and aboard ships at sea, as well as those returning to the United States from overseas deployments.
Last in line: the remainder of the force.
Gen. John Hyten, vice chairman of the Joint Chiefs of Staff, said the first three groups could be fully tested by June. By then the Pentagon hopes to reach its goal of being able to conduct 60,000 tests per day. To complete testing of the entire force will take “into the summer,” he said without being specific.
Hyten said that testing under this tiered approach started to step up in mid-April, and that it included a plan to fully test the crew of the Nimitz. The complications that come with trying to test for coronavirus aboard a ship while it’s already underway were made clear with the Roosevelt, which pulled into port at Guam in late March after discovering its first infections. It wasn’t able to test 100% of the crew until a few days ago.
Beyond its desire to limit the spread of the virus, the Pentagon views testing and associated measures such as isolating and quarantining troops as tools to keep the force viable and to ensure it can perform its central function: to defend the nation. At least 3,900 members of the military had tested positive, including more than 850 from the Roosevelt.
Military members, being fitter and younger than the general U.S. population, are thought to be less vulnerable to COVID-19, the disease caused by the virus. So far only two military members have died from it.
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.
The military’s staggered approach to testing is necessary, officials said, because of limited supplies and incomplete knowledge about the virus.
“It is a supply issue right now, which is causing us not to be able to go down the full spectrum of all of the forces,” Hyten said. “So we’ll have to — that’s why we came up with the tiered approach.”
Keeping coronavirus out of the nuclear force has been a high priority from the earliest days of this crisis. There are several reasons for that, including the Pentagon’s view that operating those forces 24/7 is central to deterring an attack on the United States. Also, there are limited numbers of military personnel certified to perform those missions, which include controlling Minuteman 3 intercontinental ballistic missiles from cramped underground modules and operating nuclear-armed Ohio-class submarines.
Since early in the outbreak crisis, Minuteman 3 launch officers have been operating in the missile fields for 14 days at a time, an extraordinary arrangement for personnel who for years had done 24-hour shifts and then returned to base.
Gen. David Goldfein, the Air Force chief of staff, said Wednesday there are no COVID-positive cases in the nuclear force. That’s a “no fail” mission, he said, that will have to work around the virus indefinitely.
Other first-tier forces, Goldfein said, are elements of the new Space Force, including those who operate Global Positioning System navigation satellites as well as the satellites that would provide early warning of a missile attack on the United States or its allies.
The Air Force and the other services are prioritizing testing in their own ranks, he said, “to make sure that as test kits become available, we’re able to put them where they are most needed.”
Goldfein said the military understands that the limited national supply of test kits means it cannot have all that it would like.
“One of the top priorities right now across the nation is nursing homes,” he said. “I would not want to take tests away from that top national priority for my younger and healthier force. As tests become available, we’ve tiered them out and we know where we need to put them.”


talkingpointsmemo--2020-04-27--Watch Live: Trump Holds Press Briefing

Watch Live: Trump Holds Press Briefing

WASHINGTON , DC - MARCH 19 : President Donald J. Trump speaks with his coronavirus task force in response to @ @ @ @ @ a briefing in the James S. Brady Press Briefing Room at the White H ... @ @ @ @ @ 19 : President Donald J. Trump speaks with his coronavirus task force in response to @ @ @ @ @ a briefing in the James S. Brady Press Briefing Room at the White House on @ @ @ @ @ 2020 in Washington , DC .
( Photo by Jabin Botsford/The Washington Post via Getty @ @

WASHINGTON, DC - MARCH 19 : President Donald J. Trump speaks with his coronavirus task force in response to the COVID-19 coronavirus pandemic during a briefing in the James S. Brady Press Briefing Room at the White H...
WASHINGTON, DC - MARCH 19 : President Donald J. Trump speaks with his coronavirus task force in response to the COVID-19 coronavirus pandemic during a briefing in the James S. Brady Press Briefing Room at the White House on Thursday, March 19, 2020 in Washington, DC. (Photo by Jabin Botsford/The Washington Post via Getty Images)
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